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December 20, 2001 Vol. 345 No. 25
Some studies have indicated that women who take oral contraceptives have an increased risk of myocardial infarction. This study focused specifically on second- and third-generation oral contraceptives. The risk of myocardial infarction was significantly increased by the use of second-generation pills; the findings regarding the use of third-generation pills were inconclusive but suggested that the risk was lower than that with second-generation pills.
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Serotyping is typically used to define HLA class I antigens during the selection of donors for bone marrow transplantation. Some HLA variants, however, are identifiable only by DNA sequencing of the allele (allele typing). Among more than 450 patients who received marrow transplants from unrelated donors, antigen mismatches were more predictive of graft rejection than allele mismatches.
Epidemiologic studies have linked the use of nonnarcotic analgesics with the development of chronic renal failure, yet whether this relation is causal has been unclear. This nationwide, population-based, case–control study of early-stage chronic renal insufficiency in Sweden found that the regular use of either aspirin or acetaminophen increases the risk of chronic renal failure by a factor of 2.5.
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The antiplatelet effects of aspirin are caused by the irreversible inhibition of the activity of the enzyme cyclooxygenase. In contrast, nonsteroidal antiinflammatory drugs (NSAIDs) are reversible inhibitors of this activity and have only transient effects on platelet function. This study found that pretreatment with ibuprofen before the administration of aspirin blocked the antiplatelet effects of aspirin. Neither the cyclooxygenase-2 inhibitor rofecoxib nor acetaminophen had this blocking effect.
A healthy 54-year-old woman comes for a routine examination and asks whether she should be taking any vitamin supplements. What do you advise? This article reviews the evidence that supports or fails to support the use of any of several common vitamin supplements for the prevention of disease.
In the wake of traumatic events, subjective reports of sleep disturbance are common. This review article examines both subjectively identified and objectively confirmed sleep disorders after traumatic events. Recommendations with respect to diagnostic procedures and therapeutic options are also reviewed.
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