A case-control study was conducted in Los Angeles County, California, of 163 very young breast-cancer cases (all aged 32 or less at diagnosis) to investigate the role, if any, of oral contraceptives (OC) in the development of the disease. OC use before first full-term pregnancy (FFTP) was associated with an elevated risk, which increased with duration of OC use (relative risk approximately 2.2 at 6 years of use, P < 0.01). This increased risk could not be explained by other risk factors. OC use after FFTP was not associated with any change in risk. A first-trimester abortion before FFTP, whether spontaneous or induced, was associated with a 2.4-fold increase in breast-cancer risk (P < 0.005).

Although evidence of the efficacy of herbal preparations in treating psychiatric conditions is growing, translating the results of efficacy studies into effective treatments for patients is hampered by the chemical complexity of the products, the lack of standardization of commonly available preparations, and the paucity of well-controlled studies.

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Evidence-based medicine (EBM) has been defined as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." EBM requires the ability to apply a knowledge of medical informatics (e.g., efficiently searching the medical literature) and clinical epidemiology (e.g., being able to critically appraise the literature) to the treatment of individual patients. This article provides an introduction to the history, philosophy, and methods of EBM as applied to psychiatric practice. The article summarizes the five-step EBM model: (1) formulate the question; (2) search for answers; (3) appraise the evidence; (4) apply the results; and (5) assess the outcome. Resources (including Web sites) for further learning are provided.

Dietary histories and information concerning the use of nutritional supplements were obtained from 51 randomly selected residents of an Orange County, CA, retirement community. The nutrients for which dietary intakes were most apt to fall below 100% of the 1980 Recommended Dietary Allowance were: calcium, in both sexes; energy, in males; and iron, thiamin, riboflavin, and niacin in females. With the exception of calcium, few subjects had intakes below two-thirds of the Recommended Dietary Allowances. These findings are similar to those reported in previous dietary surveys of the elderly. Vitamin and mineral supplements were consumed by 72% of the subjects; such consumption was unrelated to dietary intake. Supplemental vitamin C was consumed by 67% of the subjects in amounts ranging from 30 to 5200 mg daily; supplemental vitamin E was taken by 51%, with amounts ranging from 8 to 1000 IU daily. Supplement use by this population is one of the highest reported among the elderly, an effect that may result from the affluence of the community, its geographic location, and from a high level of nutritional consciousness among its residents.