共查询到20条相似文献,搜索用时 15 毫秒
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STUDY OBJECTIVE: To determine if the use of statins affects pneumonia-related outpatient visits, hospitalizations with survival, and deaths. DESIGN: Population-based, retrospective, nested case-control analysis. DATA SOURCE: United Kingdom-based General Practice Research Database. PARTICIPANTS: The study population (134,262 patients aged > or = 30 yrs) consisted of 55,118 patients who took statins and/or fibrates, 29,144 patients with hyperlipidemia not taking lipid-lowering agents, and 50,000 randomly selected patients without hyperlipidemia and without lipid-lowering treatment. MEASUREMENTS AND MAIN RESULTS: We identified 1253 patients with pneumonia and matched them with 4838 control subjects based on age, sex, general practice, and index date. After adjusting for comorbidity and frequency of visits to general practitioners, we calculated the risks (odds ratios with 95% confidence intervals) of uncomplicated pneumonia, hospitalization for pneumonia with survival, and fatal pneumonia in participants who used statins compared with those who did not. Current statin users had a significantly reduced risk of fatal pneumonia (adjusted odds ratio 0.47, 95% confidence interval 0.25-0.88) and slightly but not significantly reduced risks of uncomplicated pneumonia and pneumonia hospitalization with survival. Recent or past statin use and fibrate use at any time were not associated with a reduced risk of pneumonia. CONCLUSION: Current use of statins was associated with a reduced risk of pneumonia. The risk reduction was particularly strong in the subgroup of patients with fatal pneumonias. 相似文献
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Ruokoniemi P Korhonen MJ Helin-Salmivaara A Lavikainen P Jula A Junnila SY Kettunen R Huupponen R 《British journal of clinical pharmacology》2011,71(5):766-776
AIMS
To evaluate whether good statin adherence is associated with a reduced incidence of major coronary events (MCEs) among diabetic patients with and without coronary heart disease (CHD).METHODS
Using data derived by linkage of nationwide health databases in Finland, we conducted a nested case–control analysis of 3513 cases with an MCE, a composite of acute myocardial infarction and/or coronary revascularization, and 20 090 matched controls identified from a cohort of 60 677 statin initiators with diabetes. Cases and controls were matched according to gender, time of cohort entry and duration of follow-up and further classified to two risk groups according to the presence of CHD at statin initiation. The incidence of MCEs was compared between patients with good statin adherence (the proportion of days covered ≥80%) and patients with poor statin adherence (<80%). Odds ratios (OR) for MCEs were estimated by conditional logistic regression adjusting for several covariables.RESULTS
Good statin adherence was associated with a reduced incidence of MCEs in those with prior CHD [OR 0.84 (95% CI 0.74–0.95)] and in those without it [OR 0.86 (95% CI 0.78–0.95)]. The association persisted among those followed up for 5 years or longer [OR 0.77 (95% CI 0.58–1.02) and OR 0.79 (95% CI 0.66–0.94) respectively]. In sensitivity analyses, a reduced MCE incidence was observed also in those without any documented cardiovascular disease (CVD) at statin initiation [OR 0.87 (95% CI 0.78–0.96) overall and OR 0.80 (95% CI 0.66–0.97) for those followed up 5 years or longer].CONCLUSIONS
In patients with diabetes, good adherence to statins predicts reduced incidence of MCEs irrespective of the presence of CHD at statin initiation. 相似文献5.
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《中国医药科学》2016,(15):13-16
目的研究瘦素水平与首发抑郁症临床症状之间的相关性。方法选取40名首发抑郁症患者(2015年3~10月在湖州市第三人民医院心身科住院)作为病例组,通过汉密尔顿量抑郁量表(HAMD)测评临床症状,以40名健康人群作为对照组,两者均为男女各20例,测两组患者的血浆瘦素水平。结果 (1)不同性别的血浆瘦素水平具有统计学差异,女性血浆瘦素水平要高于男性血浆瘦素水平(P0.05)。病例组的血浆瘦素水平高于对照组,两者有统计学差异(P0.05)。(2)病例组的血浆瘦素水平与HAMD总分呈正相关(r=0.746,P0.05)。(3)病例组的血浆瘦素水平和HAMD的下列因子呈正相关:焦虑/躯体化因子(r=0.415,P0.05),睡眠障碍因子(r=0.409,P0.05)。结论 (1)女性的血浆瘦素水平要高于男性的血浆瘦素水平。(2)首发抑郁症患者的血浆瘦素水平要高于健康人群,瘦素水平越高,抑郁程度越重。 相似文献
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Janusz K. Rybakowski Kristof Vansteelandt Tomasz Szafranski Eric Thys Marek Jarema W. Wolfgang Fleischhacker René S. Kahn Joseph Peuskens 《European neuropsychopharmacology》2012,22(12):875-882
Depressive symptomatology is an important target of treatment in first episode schizophrenia. This reanalysis of the European First Episode Schizophrenia Trial (EUFEST) describes the depressive symptomatology and the effect of antipsychotic treatment in patients suffering from first episode schizophrenia and schizophreniform disorder randomized to treatment with low dose haloperidol (n=103), amisulpride (n=104), olanzapine (n=105), quetiapine (n=104) or ziprasidone (n=82) for one year. At baseline, the mean score on the Calgary Depression Scale for Schizophrenia (CDSS) was 5.1 (±4.9) with 38.3% of patients having a CDSS score≥6, i.e. clinically relevant depressive symptom severity. During treatment depression scores decreased, the mean CDSS score being 1.1 (±2.1) and 3.0% of patients having a CDSS≥6 at 52 weeks. The proportion of patients using antidepressants during the complete trial was 18.5% in the haloperidol group, 28.6% in the olanzapine group compared to 5.8% in the quetiapine group, 12.5% in the amisulpride group, and 9.8% in the ziprasidone group. There were no differences over time in the probability of being depressed (CDSS≥6) between the 5 treatment groups after adjustment for antidepressant use, nor in a sub analysis of patients who did not take any antidepressant. Depression scores at baseline or during the trial had no effect on treatment discontinuation or on the reduction of positive symptoms. In summary, the results of EUFEST did not demonstrate a differential effect of the antipsychotics studied on depressive symptomatology in patients with first episode schizophrenia. 相似文献
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OBJECTIVE: Case series and spontaneous reports of endometrial cancer have raised the question as to whether the use of tibolone (introduced into the UK in 1991) is associated with an increased risk of endometrial cancer. This study set out to evaluate whether tibolone use is associated with an increased risk of endometrial cancer. METHODS: Age-adjusted incidence rate ratios (IRRs) of endometrial cancer were calculated for tibolone use compared with the use of other hormone replacement therapy (HRT). Separate sets of controls, matched for age and general practice, were compared with cases, all nested within a cohort of HRT users identified from the UK General Practice Research Database (GPRD). Conditional logistic regression analysis, adjusted for potential confounders, was used to study the association between tibolone use and the risk of endometrial cancer. RESULTS: 4995 women used tibolone as their first HRT product; 10 783 (4.3%) of the users of combined HRT had changed to tibolone at some time during the study period. Amongst women whose HRT began with tibolone, the age-adjusted IRR relative to those who started with combined sequential HRT was 1.83 (95% CI 1.19, 2.82). The nested case-control study comprised 162 cases, each matched to two sets of 972 controls. There were 43 tibolone-exposed subjects, 28 of whom had used other HRT before or after tibolone. The adjusted odds ratio of the risk of endometrial cancer in women who had ever used tibolone, compared with users of combined sequential HRT, was 1.54 (95% CI 1.03, 2.32) in the age-matched set and 1.58 (95% CI 1.01, 2.47) in the practice-matched set. Sensitivity analyses did not decrease the risk estimates found. DISCUSSION: Tibolone may be associated with an increased risk of endometrial cancer compared with conventional forms of HRT, but our data are fragile. Residual bias and uncontrolled confounding cannot be excluded, and follow-up time is insufficient to draw any firm conclusions with respect to the endometrial safety of tibolone. 相似文献
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《中国医药科学》2016,(21):96-99
目的分别采用盐酸舍曲林和盐酸文拉法辛对首发抑郁症患者进行治疗,并对两种药物的疗效及不良反应发生情况进行比较。方法在我院2015年1~12月期间收治的首发抑郁症患者中选择62例作为此次研究的观察对象。根据治疗药物的不同将其分为两组,将采用盐酸舍曲林治疗的患者视为对照组(31例),将采用盐酸文拉法辛治疗的患者视为观察组(31例)。对两组患者治疗期间所发生的不良反应及治疗后的效果进行对比、分析。结果经过治疗,观察组的总有效率为93.55%,治疗1周后的HAMD评分为(19.66±1.44)分,不良反应发生率为19.35%;对照组的总有效率为83.87%,治疗1周后的HAMD评分为(25.91±1.05)分,不良反应发生率为22.58%。两组数据相比,发现两组患者的总有效率和不良反应发生率无明显差异(P0.05),但观察组治疗后的HAMD评分低于对照组,且差异显著(P0.05)。结论盐酸舍曲林和盐酸文拉法辛在治疗抑郁症中效果相当,不良反应均较少,安全性良好,但是盐酸文拉法辛更能有效缓解患者的抑郁情绪,可作为治疗抑郁症的首选药物。 相似文献
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Hypoglycemia in inpatients after gatifloxacin or levofloxacin therapy: nested case-control study 总被引:3,自引:0,他引:3
Graumlich JF Habis S Avelino RR Salverson SM Gaddamanugu M Jamma K Aldag JC 《Pharmacotherapy》2005,25(10):1296-1302
STUDY OBJECTIVES: To compare the incidence of hypoglycemic events in patients exposed to gatifloxacin or levofloxacin, and to measure the odds of experiencing a hypoglycemic event after receiving gatifloxacin versus levofloxacin while adjusting for confounders. DESIGN: Nested case-control study within a historical cohort. SETTING: A tertiary care, 730-bed, teaching hospital in central Illinois. PATIENTS: Seven thousand two hundred eighty-seven hospitalized patients who received gatifloxacin or levofloxacin therapy. MEASUREMENTS AND MAIN RESULTS: A total of 113 patients (case patients) had blood glucose levels below 51 mg/dl; 113 control patients, matched for age and sex, had no hypoglycemia. Matched conditional logistic regression models adjusted the odds of having hypoglycemia for significant covariates. The 12-month incidence of hypoglycemia was 11/1000 patients after levofloxacin administration and 21/1000 patients after gatifloxacin (absolute risk increase 10/1000 patients, 95% confidence interval [CI] 4-16/1000). Renal failure, sepsis syndrome, and concomitant hypoglycemic drug therapy significantly predicted hypoglycemia. After adjustment for significant predictors, the odds of having hypoglycemia were 2.81 (95% CI 1.02-7.70) times higher after gatifloxacin than levofloxacin therapy. CONCLUSION: Among inpatients, the incidence of hypoglycemic events is greater after treatment with gatifloxacin than levofloxacin. The odds of experiencing hypoglycemic events are greater with gatifloxacin even after adjusting for other hypoglycemia risk factors, such as concomitant hypoglycemic drugs, renal failure, and sepsis syndrome. 相似文献
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《Current medical research and opinion》2013,29(11):2849-2855
ABSTRACTBackground: Previous investigations suggested thiazolidinediones (TZDs) have the ability to suppress inflammation. Since the pathophysiology of atrial fibrillation (AF) after cardiothoracic surgery (CTS) likely involves an inflammatory mechanism, we sought to determine whether preoperative use of TZDs could further reduce the incidence of post-CTS AF in a population treated with beta-blockers and prophylactic amiodarone.Methods: All diabetic patients over the age of 50 years, not in atrial arrhythmia prior to surgery, who underwent CTS from the Atrial Fibrillation Suppression Trials I, II and III (AFIST I, II and III) were evaluated in this nested case-control study. Patient demographics, surgical characteristics, medication utilization and the incidence of post-CTS AF (AF > 5 minutes duration) were collected as part of AFIST I, II and III. Multivariate logistic regression was used to calculate adjusted odds ratios with 95% confidence intervals (CIs).Results: One hundred and eighty-four diabetic patients were enrolled in the three trials. Overall, the study population averaged 66.9 ± 7.3 years of age, 71.7% were male, 7.1% underwent valve surgery, 4.9% had prior AF, 17.9% had heart failure and 84.2% and 41.8% received postoperative beta-blockade and prophylactic amiodarone, respectively. Forty patients (21.7%) received a preoperative TZD and 144 (78.3%) did not. In total, 66 patients (35.9%) developed post-CTS AF. Upon multivariate logistic regression, the preoperative use of TZDs was found to be associated with a 20% non-statistically significant reduction in post-CTS AF (adjusted odds ratio; 0.80, 95% CI 0.32–1.99; p = 0.63).Limitations: Patients were not randomized to receive TZDs or not. We may not have had adequate power to evaluate our post-CTS AF endpoint.Conclusions: In a diabetic population treated perioperatively with beta-blocker and amiodarone, adjunctive TZD use was associated with a non-statistically significant reduction in a patient's odds of developing post-CTS AF. Further research is needed to determine whether TZDs, in fact, do not have anti-fibrillatory effects or whether our study was underpowered to detect a statistically significant benefit with TZDs. 相似文献
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BACKGROUND: The risk of gastric cancer could be influenced by acid-related diseases or by the use of acid-suppressive drugs, such as histamine H(2) receptor antagonists and proton pump inhibitors (PPIs). OBJECTIVE: To assess the association between exposure to acid-suppressive drugs and the risk of gastric cancer. METHODS: A nested case-control study was conducted among people registered in the Quebec health insurance plan (Canada). Cases represented a random sample of subjects diagnosed with gastric cancer between 1995 and 2003 who were matched on age and sex to at least four controls (using incidence density sampling). The index date was the date of cancer diagnosis for the cases, which was the index date for the matched controls. The exposure definition in the 5 years preceding the index date was based on the defined daily doses of acid-suppressive drugs and categorized into quartiles. RESULTS: The study included 1598 gastric cancer cases and 12 991 controls. The adjusted odds ratios for the association between exposure to acid-suppressive drugs and risk of gastric cancer were 1.47 (95% CI 1.23, 1.76), 1.32 (95% CI 1.10, 1.58), 1.48 (95% CI 1.24, 1.77) and 1.18 (95% CI 0.97, 1.44) for the first, second, third and fourth exposure quartiles, respectively. Similar results were obtained when use of H(2) receptor antagonists and PPIs were assessed separately (odds ratios for the association between PPIs and the risk of gastric cancer were slightly higher compared with H(2) receptor antagonists and risk of gastric cancer). CONCLUSIONS: A minor increase in the risk of gastric cancer was observed if exposure to either H(2) receptor antagonists or PPIs occurred within the past 5 years. However, this association is probably not causal since it is most likely due to confounding by indication. 相似文献