Abstract:
OBJECTIVE:To assess the risk of cerebral thromboembolism in women using low dose oral contraceptives. DESIGN:A retrospective case-control study. SETTING:All Danish medical, neurological, neurosurgical, and gynaecological departments. SUBJECTS:All 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack during 1985-9 and 1588 age matched randomly selected controls. RESULTS:Of 692/1584 case/control questionnaires sent out, 590/1396 (85.3%/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had had thromboembolic disease previously, 13 were pregnant, and 152 had a disease predisposing to a cerebral thromboembolic attack. Of the 323 cases without a known predisposition, 320 reported use or non-use of oral contraception. Among the 1396 controls, eight refused to participate, were mentally retarded, or lived abroad; 18 returned an uncompleted questionnaire; 17 had had thromboembolic disease previously; 31 were pregnant; and 130 had a disease predisposing to a cerebral thromboembolic attack. Thus 1198 non-predisposed controls were available, among whom 1197 reported use or non-use of oral contraception. Among the 320 cases, 116 (36.3%) were oral contraceptive users at the time of the cerebral thromboembolic attack. By comparison there were 191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0. After multivariate analysis, including confounder control for age, smoking, years of schooling, and trend in use of different types of oral contraceptives during 1985-90, pills containing 50 micrograms oestrogen were associated with an odds ratio for cerebral thromboembolic attack of 2.9 (95% confidence interval 1.6 to 5.4), those containing 30-40 micrograms oestrogen an odds ratio of 1.8 (1.1 to 2.9), those containing progestogen only an odds ratio of 0.9 (0.4 to 2.4). The odds ratio did not change with increasing age or with duration of oral contraceptive use. A 50% increased risk of a cerebral thromboembolic attacks among cigarette smokers (after confounder control) was independent of oral contraception status and age. CONCLUSION:Low dose oral contraceptives are associated with an increased risk of cerebral thromboembolic attack. Combined or sequential pills containing 30-40 micrograms oestrogen are associated with a one third reduced risk compared with preparations containing 50 micrograms oestrogen. Progestogen only pills did not increase the risk of a cerebral thromboembolic attack. :The objective a retrospective case-control study was to assess the risk of cerebral thromboembolic attack during 1985-89 and 1588 age matched randomly selected controls were investigated. 590 case (85.3%) and 1396 control (88.1%) questionnaires were returned. Exclusions occurred for refusal to participate, unreliable diagnosis, previous thromboembolic disease, pregnancy, and a disease predisposing to a cerebral thromboembolic attack. Of the 323 cases without a known predisposition, 320 reported use or nonuse of OCs. From among the 1396 controls, 1198 nonpredisposed controls were available, among whom 1197 reported use of nonuse of OCs. Among the 320 cases, 116 (36.3%) were OC users at the time of the cerebral thromboembolic attack. By comparison, there were 191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0. Multivariate analysis controlled confounding factors for age, smoking, years of schooling, and use of different types of OCs during 1985-90. OCs containing 50 mcg estrogen were associated with an odds ratio for cerebral thromboembolic attack of 2.9, those containing 30-40 mcg estrogen with an odds ratio of 1.8, those containing progestogen only with an odds ratio of 0.9. A 50% increased risk of a cerebral thromboembolic attack among cigarette smokers was independent of OC status and age. Low dose OCs were associated with an increased risk of cerebral thromboembolic attack. Combined or sequential pills, containing 30-40 mcg estrogen, are associated with a one third reduced risk compared with preparations containing 50 mcg estrogen. Progestogen-only pills did not increase the risk of a cerebral thromboembolic attack.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Lidegaard Odoi
10.1136/bmj.306.6883.956subject
Has Abstractpub_date
1993-04-10 00:00:00pages
956-63issue
6883eissn
0959-8138issn
1756-1833journal_volume
306pub_type
杂志文章abstract:OBJECTIVES:To identify factors that differentiate between effective and ineffective computerised clinical decision support systems in terms of improvements in the process of care or in patient outcomes. DESIGN:Meta-regression analysis of randomised controlled trials. DATA SOURCES:A database of features and effects of...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.f657
更新日期:2013-02-14 00:00:00
abstract:OBJECTIVE:To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. DESIGN:Population based prospective cohort study. SETTING:Beaver Dam eye study. PARTICIPANTS:2451 normotensive people aged 43 to 84 years. MAIN OUTCOME MEASURES:Diameters of retinal arterioles and ve...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38124.682523.55
更新日期:2004-07-10 00:00:00
abstract::For many years Tayside has benefited from a successful opportunistic cytology screening programme. In recent years, however, the decrease in mortality due to cervical cancer has levelled off, with most cases of severe disease arising in women who have not been screened. In view of this the health board developed a new...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6692.163
更新日期:1989-07-15 00:00:00
abstract:OBJECTIVE:To investigate the risks of adverse pregnancy and birth outcomes for treated and untreated bipolar disorder during pregnancy. DESIGN:Population based cohort study using data from national health registers. SETTING:Sweden. PARTICIPANTS:332,137 women with a last menstrual period anytime after 1 July 2005 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e7085
更新日期:2012-11-08 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.d2202
更新日期:2011-04-26 00:00:00
abstract:OBJECTIVE:To examine differences in morbidity and mortality due to non-insulin dependent diabetes in African Caribbeans and Europeans. DESIGN:Cohort study of patients with non-insulin dependent diabetes drawn from diabetes clinics in London. Baseline investigations were performed in 1975-7; follow up continued until 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7061.848
更新日期:1996-10-05 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of a teacher led intervention to improve teenagers' knowledge about emergency contraception. DESIGN:Cluster randomised controlled trial. SETTING:24 mixed sex, state secondary schools in Avon, south west England. PARTICIPANTS:1974 boys and 1820 girls in year 10 (14-15 year olds)....
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7347.1179
更新日期:2002-05-18 00:00:00
abstract:OBJECTIVE:To identify modifiable factors that influence relatives' decision to allow organ donation. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, and CINAHL, without language restriction, searched to April 2008. Review methods Three authors independently assessed the eligibility of the identified studies. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.b991
更新日期:2009-04-21 00:00:00
abstract:OBJECTIVES:To compare the frequency of discrepancies in retracted reports of clinical trials with those in adjacent unretracted reports in the same journal. DESIGN:Blinded case-control study. SETTING:Journals in PubMed. POPULATION:50 manuscripts, classified on PubMed as retracted clinical trials, paired with 50 adja...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h4708
更新日期:2015-09-20 00:00:00
abstract:OBJECTIVES:To investigate use of commodes and attitudes of users and carers to them. DESIGN:Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS:140 users of a commode and 105 of their carers. RESULTS:Main reasons for being supplied with a co...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6914.1258
更新日期:1993-11-13 00:00:00
abstract:OBJECTIVE:To assess the effect of high dose inhaled corticosteroids on skin. DESIGN:Cross sectional study of patients receiving treatment for chest diseases. SETTING:Outpatient chest clinic in a teaching hospital. PATIENTS:68 Patients divided into four groups of similar age--namely, 15 receiving long term oral predn...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6739.1548
更新日期:1990-06-16 00:00:00
abstract:OBJECTIVES:To investigate current practice of screening children from abroad for infections after coming to the United Kingdom, and to make recommendations for future practice. DESIGN:A review of literature and a questionnaire sent to all health authorities and boards in the United Kingdom. SETTING:All health authori...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6755.800
更新日期:1990-10-06 00:00:00
abstract:OBJECTIVE:To study delays between sending referral letters and the outpatient appointment and to assess the content of referral and reply letters, their educational value, and the extent to which questions asked are answered by reply letters. DESIGN:Retrospective review of referrals to 16 consultant orthopaedic surgeo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6750.470
更新日期:1990-09-08 00:00:00
abstract::Monocycline is the most widely prescribed systemic antibiotic for acne largely because it needs to be given only once or twice a day and seems not to induce resistance. Up to April 1994 11 cases of minocycline induced systemic lupus erythematosus and 16 cases of hepatitis had been reported to the Committee on Safety o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7024.169
更新日期:1996-01-20 00:00:00
abstract::Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing.Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system.Setting Primary care...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j603
更新日期:2017-02-21 00:00:00
abstract:OBJECTIVE:To determine the value of short course, high dose albendazole chemotherapy in the treatment of persistent diarrhoea related to HIV in unselected patients in urban Zambia. DESIGN:A randomised double blind placebo controlled trial of albendazole 800 mg twice daily for two weeks. Patients were monitored intensi...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.312.7040.1187
更新日期:1996-05-11 00:00:00
abstract:OBJECTIVE:To determine, using research on duloxetine for major depressive disorder as an example, if there are inconsistencies between protocols, clinical study reports, and main publicly available sources (journal articles and trial registries), and within clinical study reports themselves, with respect to benefits an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g3510
更新日期:2014-06-04 00:00:00
abstract:OBJECTIVE:To investigate any long term effects of traumatic birth and obstetric procedures in relation to suicide by violent means in offspring as adults. DESIGN:Prospective case-control study. SETTING:Stockholm, Sweden. SUBJECTS:242 adults who committed suicide by violent means from 1978 to 1995, and who were born ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7169.1346
更新日期:1998-11-14 00:00:00
abstract:OBJECTIVE:To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN:Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING:Gothenburg, Sweden. SUBJEC...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6916.1385
更新日期:1993-11-27 00:00:00
abstract::Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestatio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3677
更新日期:2017-08-17 00:00:00
abstract:OBJECTIVE:To determine the relation between mothers' self reported drinking habits before, during, and after pregnancy and infants' mental and motor development at 18 months of age. DESIGN:Follow up study of all singleton live births born to primigravidas living in Dundee and booked into antenatal clinics from 1 May 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6793.22
更新日期:1991-07-06 00:00:00
abstract::The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.308.6938.1227
更新日期:1994-05-07 00:00:00
abstract:OBJECTIVE:To describe temporal trends in the time interval between first and second attempts at defibrillation and the association between this time interval and outcomes in patients with persistent ventricular tachycardia or ventricular fibrillation (VT/VF) arrest in hospital. DESIGN:Retrospective cohort study SETTI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i1653
更新日期:2016-04-06 00:00:00
abstract:OBJECTIVE:To evaluate the cost effectiveness of acupuncture in the management of chronic headache. DESIGN:Cost effectiveness analysis of a randomised controlled trial. SETTING:General practices in England and Wales. PARTICIPANTS:401 patients with chronic headache, predominantly migraine. Interventions Patients were ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38033.896505.EB
更新日期:2004-03-27 00:00:00
abstract::Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples'...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6962.1137
更新日期:1994-10-29 00:00:00
abstract:OBJECTIVE:To assess the effects of preventive home visits to elderly people living in the community. DESIGN:Systematic review. SETTING:15 trials retrieved from Medline, Embase, and the Cochrane controlled trial register. MAIN OUTCOME MEASURES:Physical function, psychosocial function, falls, admissions to institution...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.320.7237.754
更新日期:2000-03-18 00:00:00
abstract:OBJECTIVE:To describe the association between epithelial cell IgM, which has previously been associated with an increased incidence of loss of renal graft in children, with a novel cutaneous eruption and unexplained native renal disease. DESIGN:Observational study on children with epithelial cell antibody presenting w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6795.161
更新日期:1991-07-20 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of parenteral corticosteroids for the relief of acute severe migraine headache and prevention of recurrent headaches. DESIGN:Meta-analysis. DATA SOURCES:Electronic databases (Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS, and CINAHL), conference proceed...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39566.806725.BE
更新日期:2008-06-14 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of two mechanical methods of blood conservation in reducing the need for allogeneic red blood cells or coagulation products during cardiac surgery. DESIGN:Randomised controlled trial. SETTING:Regional cardiac centre in a teaching hospital in Southampton. PARTICIPANTS:263 adults ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7349.1299
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVES:To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among ol...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f4240
更新日期:2013-07-23 00:00:00