Use of depot medroxyprogesterone acetate and fracture risk

Depot medroxyprogesterone acetate (DMPA), which has a high rate of use among teenagers in Europe and the United States, has been associated with impaired bone mineral acquisition during adolescence and accelerated bone loss in later life. Studies on the association between DMPA use and fracture risk are limited.; We aimed at evaluating the relationship between use of hormonal contraceptives, specifically DMPA, and fracture risk.; We conducted a case-control analysis using the United Kingdom-based General Practice Research Database.; Participants were females aged 20-44 yr with an incident fracture diagnosis between 1995 and 2008.; Odds ratios (OR) with 95% confidence intervals (CI) of incident fracture in relation to exposure to DMPA or combined oral contraceptives were assessed. Adjustments were made for smoking, body mass index, and additional potential confounders.; We identified 17,527 incident fracture cases and 70,130 control patients (DMPA exposure: 11 and 8%, respectively). Compared with nonuse, current use of one to two, three to nine, or 10 or more DMPA prescriptions yielded adjusted OR for fractures of 1.18 (95% CI = 0.93-1.49), 1.36 (95% CI = 1.15-1.60), and 1.54 (95% CI = 1.33-1.78), respectively. Fracture risk was highest after longer treatment duration (<2-3 yr), and there was no difference in patients below and above the age of 30 yr. For users of combined estrogen-containing oral contraceptives, the OR were around 1.; This population-based study suggests that use of DMPA is associated with a slightly increased risk of fractures

Pairing gaps near ferromagnetic quantum critical points

We address the quantum-critical behavior of a two-dimensional itinerant ferromagnetic systems described by a spin-fermion model in which fermions interact with close to critical bosonic modes. We consider Heisenberg ferromagnets, Ising ferromagnets, and the Ising nematic transition. Mean-field theory close to the quantum critical point predicts a superconducting gap with spin-triplet symmetry for the ferromagnetic systems and a singlet gap for the nematic scenario. Studying fluctuations in this ordered phase using a nonlinear sigma model, we find that these fluctuations are not suppressed by any small parameter. As a result, we find that a superconducting quasi-long-range order is still possible in the Ising-like models but long-range order is destroyed in Heisenberg ferromagnets.Comment: 13 pages, 7 figure

Dynamics of dipoles and vortices in nonlinearly-coupled three-dimensional harmonic oscillators

The dynamics of a pair of three-dimensional matter-wave harmonic oscillators (HOs) coupled by a repulsive cubic nonlinearity is investigated through direct simulations of the respective GrossPitaevskii equations (GPEs) and with the help of the finite-mode Galerkin approximation (GA),which represents the two interacting wave functions by a superposition of 3 + 3 HO p -wave eigenfunctions with orbital and magnetic quantum numbers l = 1 and m = 1; 0; 1. First, the GA very accurately predicts a broadly degenerate set of the system's ground states in the p -wave manifold, in the form of complexes built of a dipole coaxial with another dipole or vortex, as well as complexes built of mutually orthogonal dipoles. Next, pairs of non-coaxial vortices and/or dipoles, including pairs of mutually perpendicular vortices, develop remarkably stable dynamical regimes, which feature periodic exchange of the angular momentum and periodic switching between dipoles and vortices. For a moderately strong nonlinearity, simulations of the coupled GPEs agree very well with results produced by the GA, demonstrating that the dynamics is accurately spanned by the set of six modes limited to l = 1.Comment: Physical Review E. In Pres

Consumers and Food

The majority of consumers in Italy, Spain, France and Switzerland buy food in supermarkets. They like the concept of farmers’ varieties and are willing to pay a price premium for foods from farmers’ varieties

Coronary interventions in Europe 1992

The general practice of coronary interventions is influenced by various aspects, traditional, cultural, socioeconomic and personal. The aim of this survey was to collect the data on coronary interventions in all member countries of the European Society of Cardiology. The data from 12 of the 35 national members were missing or grossly incomplete and were therefore excluded from the analysis. Coronary angiography The total number of coronary angiograms was reported as 683 888, an incidence of 1009 ± 1021 per million inhabitants (range 9 (Romania) to 3076 (Germany)). Germany (246115 cases), France (144 754), the United Kingdom (76 296), Italy (45 517) and Spain (43 495) registered 81% of all the coronary angiograms performed. Percutaneous transluminal coronary angioplasty (PTCA) The total number of reported PTCAs was 147 729, which on average accounted for 19 ± 11% (range 2 (Lithuania) to 53% (Netherlands)) of the coronary angiograms. Most of the PTCAs (82%) were confined to a single vessel. The highest incidence of multivessel PTCA was reported from Slovakia (28%). PTCA took place immediately after the diagnostic study in only 18% of cases. Adjusted per capita, Germany ranked first with 703 PTCAs per million inhabitants, followed by Iceland (619), France (614), Belgium (568) and Austria (485). A major in-hospital complication was reported in 2.5% of the patients undergoing PTCA: 0.4% hospital deaths, 1.0% emergency CABGs and 1.1% myocardial infarctions. New devices Stents were implanted in 3211 patients (2.7% of all PTCA patients), equally distributed between emergency situations (53%) and elective procedures. Other interventional devices were applied in 4133 cases (2.8% of all PTCA cases): directional atherectomy, rotablator, transluminal extraction catheter, laser and Rotacs accounted for 1452, 1232, 55, 558 and 222, respectively. Coronary ultrasound (1350 cases) and coronary angioscopy (373 cases) were rarely performed. Coronary artery bypass grafting (CABG) A total of 63 477 patients underwent CABG in the reporting centres resulting in a PTCA/CABG ratio of 2.3. A significant under-reporting of surgery in the participating centres must be assumed. Conclusions Although partial reporting might bias conclusions, several findings of this survey are noteworthy: (1) PTCA was a well accepted treatment for coronary artery disease, (2) PTCA was applied more frequently than CABG, (3) there was an extremely wide range of coronary angiography and PTCA performed per million inhabitants, (4) the most common additional procedure was stent implantation, but other new devices were only rarely applie

Prevention of restenosis after coronary angioplasty: A pharmacological approach

Evaluations of drugs for the prevention of resrenosis after human coronary angioplasty have been disappointing. Heparin failed to reduce resrenosis in a randomized study in Atlanta, Georgia, in patients maintained on heparin for 24 h. A randomized study in the same centre compared acetylsalicylic acid to anricoagulation with coumadin. Restenosis was slightly but nor significantly less frequent in patients on acelylsalicylic acid. An American multicentre randomized study comparing a combination of acetylsalicylic acid and dipyridamole to ticlopidine and to placebo revealed no difference in tertns of incidence of restenosis. Dipyridamole alone shows no effect against acute or late coronary artery resrenosis. Two calcium antagonists (diltiazem and nifedipine) did not significantly diminish restenosis in randomized trials. Neither did a thromboxane A inhibitor. Only eicosapentaenoic acid (EPA), an n-3fatty acid, significantly reduced reslenosis in a randomized study using a high dose. But the same compound proved ineffective in a similar study using a somewhat lower dose. Despite scientific evidence for the inefficacy of virtually all tested compounds, I do not know of a single institution that does not continue to discharge its patients after coronary angioplasty on one or several of the