MinervaBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7068.1342 (Published 23 November 1996) Cite this as: BMJ 1996;313:1342
Nowadays the main cause of mitral regurgitation in Western countries is degenerative disease rather than rheumatic damage, and repair of the valve seems to give better results than valve replacement. A study at the Mayo Clinic (New England Journal of Medicine 1996;335:1417-23) of 229 patients with isolated mitral regurgitation due to a flail leaflet found that surgery was almost unavoidable within 10 years of the diagnosis, and early intervention gave the best results.
Bacterial sexually transmitted diseases have become less common in Britain in recent years, but this does not apply to infections with human papillomavirus. One possible explanation is that use of oral contraceptives might be associated with an increased risk of genital warts. A paper in “Genitourinary Medicine” (1996;72:330-3) reports a study of 429 women with warts and 418 controls attending the department of genitourinary medicine in Edinburgh: the odds ratio for users of oral contraceptives was 1.7 (95% confidence interval 1.3 to 2.2). Confounding factors make for difficulties, but there is a plausible biological mechanism.
Young women going on treks and expeditions are often advised to take the combined oral contraceptive to prevent or control menstruation. A questionnaire study of 128 women members of the British Schools Exploring Society visiting high latitudes (British Journal of Family Planning 1996;22:123-6) found that those who had taken the pill for this purpose …