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21.
Nonsteroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons 总被引:25,自引:0,他引:25
M R Griffin J M Piper J R Daugherty M Snowden W A Ray 《Annals of internal medicine》1991,114(4):257-263
OBJECTIVE: To evaluate the relative risk for peptic ulcer disease that is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs. DESIGN: Nested case-control study. SETTING: Tennessee Medicaid program. PARTICIPANTS: Medicaid enrollees 65 years of age or older were included in the study. The 1415 case patients had been hospitalized for confirmed peptic ulcer disease at some point from 1984 through 1986. The 7063 control persons represented a stratified random sample of other Medicaid enrollees. MEASUREMENTS AND MAIN RESULTS: The estimated relative risk for the development of peptic ulcer disease among current users of nonaspirin nonsteroidal anti-inflammatory drugs, compared with that among nonusers, was 4.1 (95% CI, 3.5 to 4.7). For current users, the risk increased with increasing dose, from a relative risk of 2.8 (CI, 1.8 to 4.3) for the lowest to a relative risk of 8.0 (CI, 4.4 to 14.8) for the highest dose category. The risk was greatest in the first month of use (relative risk, 7.2; CI, 4.9 to 10.5). If the association is fully causal, 29% of peptic ulcers in the study sample resulted from the use of these drugs, and the excess risk associated with such use was 17.4 hospitalizations for ulcer disease per 1000 person-years of exposure. CONCLUSIONS: These data support other findings indicating that a clinically significant risk for serious ulcer disease is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs. The data show that this risk increases with dose and recency of use and that use of these drugs may be responsible for a large proportion of peptic ulcer disease among elderly persons. 相似文献
22.
23.
Chris Chase Robert F Dougherty Nicola Ray Susan Fowler John Stein 《Optometry and vision science》2007,84(3):229-236
PURPOSE: Many behavioral studies have found impaired perception of dynamic visual stimuli in dyslexia and several neuroimaging studies have found reduced activation of the human motion area MT+ in dyslexia. These results are often interpreted as a magnocellular (MC) deficit in dyslexia. It has also been claimed that colored filters can help dyslexics to read. One defining feature of the MC-pathway is a greater weight for L-cone input than M-cone input, and at most very weak S-cone input. We measured the subjective speed matches between L-, M-, and S-cone isolating stimuli in good and poor readers. METHODS: Subjects performed a speed-matching task with drifting cone-isolating stimuli to find the point of subjective equality between two drifting patterns. Such a task is known to activate cortical area MT+, presumably via the MC-pathway. RESULTS: L- to M-cone speed-match ratios were negatively correlated with single-word (r=-0.46) and irregular-word reading (r=-0.56) but not with non-word reading. CONCLUSIONS: Results suggest that relative L-cone sensitivity within the MC-pathway may limit orthographic reading performance. 相似文献
24.
Exposure of murine erythroleukemia cells (MELCs) to nicotinamide (NA) or its synthetic analog N′-methylnicotinamide (N′-MN) reduces cell growth and induces terminal differentiation, marked by increased heme and globin accumulation. On the contrary, 1-methylnicotinamide (1-MN), the primary metabolite of excess NA, was found to stimulate cell growth and reduce spontaneous differentiation of cultured MELCs. Log phase MELCs exhibited up to 50% higher cell density above untreated cells when cultured for up to 96 h with 2.5 mM 1-MN. When combined with NA or several chemically-unrelated inducers of hemoglobin synthesis in cultured MELCs, 1-MN reduced the globin mRNA levels and heme accumulation by 40–80%. 1-MN was able to inhibit heme production if present during only the first 24–48 h after NA exposure. Pre-treatment with 1-MN could not confer resistance of cells to effects of NA, suggesting the inhibition is reversible. Commitment to differentiate in semisolid medium by the most potent inducer, 5 mM N′-MN, was inhibited up to 95% by 2.5 mM concentrations of 1-MN. It appears that 1-MN has opposing effects on growth and induction of differentiation than those seen in MELC cultures exposed to NA or N′-MN. 相似文献
25.
Mary Ellen Turner Kanwal Kher Tamara Rakusan Lawrence D’Angelo Sudesh Kapur Dena Selby Patricio E. Ray 《Pediatric nephrology (Berlin, Germany)》1997,11(2):161-163
We describe the clinical and pathological findings of the hemolytic uremic syndrome (HUS) in two children with human immunodeficiency
virus (HIV) infection. Both patients presented with microangiopathic hemolytic anemia, thrombocytopenia, and subsequently
developed renal failure. The diagnosis of HUS was confirmed by renal histopathology in both patients. None of these children
presented with bloody diarrhea, evidence of circulating antibody response to Escherichia coli O157 lipopolysaccharide, or other known risk factors for HUS, except for the presence of HIV infection. Each patient was
treated with intravenous plasma infusion and renal replacement therapy. Their clinical course was characterized by non-oliguria
and lack of significant hypertension throughout the acute phase of the disease. Despite these favorable clinical parameters,
both patients developed end-stage renal failure. The etiology of this atypical HUS characterized by poor renal survival remains
unknown and the role of HIV infection in its pathogenesis, although possible, is unclear.
Received March 5, 1996; received in revised form and accepted October 15, 1996 相似文献
26.
Significant increase (p less than 0.05) in circulating platelet counts was observed in a wide spectrum of experimental tumors in mice. The mechanism of this abnormality was investigated in strain A mice bearing a transplantable ascites tumor, Sarcoma 180 (S 180). Thrombocytosis observed in the tumor hosts was not due to prolonged platelet surviva], as 51Cr platelet half-life was normal. On the other hand, stimulation of thrombopoiesis, expressed in terms of platelet 75Selenomethionine (75SeM) incorporation, appeared to be the primary reason for elevated platelet counts in the tumor-bearers. Evaluation of thrombopoietic activity in the femoral marrow and spleen by measuring organ uptake of 75SeM and megakaryocyte counts indicated that tumor-induced stimulation in thrombopoiesis may be attributed to enhancement in splenic activity. Pretreatment of normal mice with tumor ascites or tumor cell-conditioned medium resulted in enhancement in thrombopoiesis. The findings suggest the production of some factor(s) by the tumor cells which probably mediate the stimulation of platelet production in tumor hosts. 相似文献
27.
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29.
M. J. Ray P. A. Carroll S. J. E. Just G. A. T. Hawson J. H. N. Belt 《Journal of clinical monitoring and computing》1994,10(2):97-100
Objective. The Ciba Corning 512 coagulation monitor (CC512) can be used to monitor heparin therapy by performing an activated
partial thromboplastin time (APTT) at the patient’s bedside. This study was designed to compare the CC512 results to results
using the laboratory system. The relative sensitivities of both systems to the effect of oral anticoagulant therapy also was
investigated.Methods. Activated partial thromboplastin times were performed with both the CC512 and laboratory system on 74 specimens from patients
receiving IV heparin therapy, and on 14 specimens from patients on warfarin only. Heparin assays were performed on 43 of the
specimens from the heparinized patients.Results. When a patient was receiving heparin only, the APTT results of the CC512 proved to be similar to existing laboratory methods.
The CC512 APTT results of patients on warfarin only were markedly prolonged, whereas the laboratory APTTs were only slightly
affected.Conclusion. The CC512 results were comparable to the laboratory system. However, the CC512 APTT was more sensitive to the effect of
warfarin than the laboratory APTT system used in this study. CC512 APTT results on a patient receiving both oral and intravenous
anticoagulation could be misleading.
The authors wish to thank D.M. O’Brien and the nursing staff of the Coronary Care Unit for providing CC512 data and laboratory
specimens, and I. Smith for the preparation of graphics. We also wish to thank Australian Diagnostics Corporation, which provided
consumables. 相似文献
30.
A procedure for the detection of brodifacoum (BDF) in serum was developed. Extraction of BDF was achieved by acidification of 2 ml of serum with 1 ml of 1.5% acetic acid followed by dual extractions with 10 ml diethyl ether and ether: acetonitrile [1:1]. In spiking experiments, 68 +/- 3, 61 +/- 4 and 65 +/- 5% of added BDF was recovered from serum containing 1000, 100 and 25 ng BDF/ml, respectively. Two high performance liquid chromatography solvent systems were used for chromatographic separation (A: 1.5% acetic acid, pH 4.5: acetonitrile [1:2] with 1% dibutylamine; and B:O.2 M tris(hydroxymethyl)aminomethane, pH 7.5:acetonitrile [1:3]). Detection limits were 75 and 3 ng BDF/ml of serum using ultraviolet absorption (254 nm) and fluorescence measurement (313 nm excitation, 375 nm emission), respectively. This method has been used successfully to monitor serum concentrations of BDF in experimental and field cases of exposure. 相似文献