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The primary hypothesis of this study was that contraceptive methods that prevent exposure to sperm and seminal fluid (condoms, diaphragms, spermicides, withdrawal) are associated with an increased risk of developing preeclampsia during the subsequent pregnancy. A case-control study was conducted comparing the contraceptive and reproductive histories of 110 primiparous women with preeclampsia with 115 pregnant women without preeclampsia, aged 15 to 35 years, who gave birth at North Carolina Memorial Hospital, Chapel Hill, between 1984 and 1987. Controls were frequency matched to cases by age, race, and distance from the hospital. Unconditional logistic regression analysis indicated a 2.37-fold (95% confidence interval, 1.01 to 5.58) increased risk of preeclampsia for users of contraceptives that prevent exposure to sperm. A dose-response gradient was observed, with increasing risk of preeclampsia for those with fewer episodes of sperm exposure. These results were supportive of the hypothesis that birth control methods that prevent sperm exposure may play a role in the etiology of preeclampsia. [ABSTRACT FROM AUTHOR]

To examine the relationship between degree of treatment-induced blood pressure (BP) reduction and myocardial infarction, the experience of 1765 previously untreated, mild to moderate hypertensives (initial BP greater than or equal to 160 and/or greater than or equal to 95 mm Hg) in a systematic treatment program was reviewed. Over an average of 4.2 years, there were 39 morbid or fatal myocardial infarctions. Three types of fall in diastolic BP (final minus pretreatment) were defined: small (less than or equal to 6 mm Hg), moderate (7 to 17 mm Hg), and large (greater than or equal to 18 mm Hg). By Cox regression, an association was observed between myocardial infarctions and both a large and a small fall, relative to a moderate decline. Age and sex were independent risk factors. Body mass index, cholesterol level, electrocardiogram, race, prior cardiovascular disease, smoking status, initial and final revisit BP, total intreatment BP, and systolic BP were not. Since both a large and small reduction in diastolic BP were associated with a higher incidence of myocardial infarction (relative to a moderate fall), perhaps a moderate reduction in diastolic BP should be the goal of treatment for mild and moderate hypertensives. [ABSTRACT FROM AUTHOR]

Discusses the development of geriatric medicine in the United States. Inclusion of an offer of a certifying examination signifying special competence under the joint sponsorship of the American Board of Internal Medicine and the American Academy of Family Physicians; Finding that osteoporosis is a major cause of morbidity and mortality in elderly patients.