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31.
G G Birnie E M Quigley G Allan B M Goudie F Kennedy K E McColl C MacKay G D Murray W Murray R Pickard 《Scandinavian journal of gastroenterology》1984,19(7):885-888
Two hundred and thirteen patients were studied in a double-blind trial of cimetidine versus placebo in the treatment of acute upper gastrointestinal haemorrhage. One hundred and six patients were randomly allocated to receive cimetidine and 107 to receive placebo. There was no significant reduction in transfusion requirements, incidence of further haemorrhage, length of stay in hospital, or mortality in the treated group. There was no subgroup of patients with acute upper gastrointestinal bleeding which appeared to benefit from treatment with cimetidine. 相似文献
32.
Eyre S Barton A Shephard N Hinks A Brintnell W MacKay K Silman A Ollier W Wordsworth P John S Worthington J 《Arthritis and rheumatism》2004,50(3):729-735
OBJECTIVE: A previous whole-genome scan (WGS) of 182 UK rheumatoid arthritis (RA) affected sibling pair (ASP) families suggested linkage to HLA and 11 other chromosome regions. Replication of such findings in an independent cohort can help to distinguish true linkages from false-positive linkages. Since RA is a heterogeneous disease, some loci may be linked only in subsets of patients. Thus, the aim of this study was to investigate in an additional set of RA ASP families linkage to regions showing deviation in expected allele-sharing ratios in the UK WGS and to perform subset analysis on the combined cohort. METHODS: Twenty loci were investigated for linkage in 217 Caucasian UK RA ASPs. Stratification analysis was performed on the combined cohort of 377 RA ASP families to account for sex, RA severity, and the shared epitope (SE). RESULTS: None of the regions of linkage identified in the initial WGS achieved statistical significance in the second cohort. In contrast, after stratification analysis, 14 regions showed nominal evidence of linkage (logarithm of odds score >0.8) in one or more subgroups. In particular, the strength of evidence for linkage to chromosome 16p was increased in subsets of ASPs with younger age at disease onset (LOD score 2.38) and for linkage to chromosome 6q in female-female ASPs (LOD score 2.31) and in ASPs in which both siblings had 2 copies of the SE (LOD score 3.03). CONCLUSION: These results support the evidence for heterogeneity of RA. This information will inform the future design of association-based investigations as the search for disease genes in the linked regions begins. 相似文献
33.
A Randomized Controlled Trial of Team-Based Care: Impact of Physician-Pharmacist Collaboration on Uncontrolled Hypertension 总被引:1,自引:0,他引:1 下载免费PDF全文
Hunt JS Siemienczuk J Pape G Rozenfeld Y MacKay J LeBlanc BH Touchette D 《Journal of general internal medicine》2008,23(12):1966-1972
OBJECTIVE Evaluate the effectiveness of collaborative management of hypertension by primary care-pharmacist teams in community-based
clinics.
STUDY DESIGN A 12-month prospective, single-blind, randomized, controlled trial in the Providence Primary Care Research Network of patients
with hypertension and uncontrolled blood pressure.
METHODS As compared to usual primary care, intervention consisted of pharmacy practitioners participating in the active management
of hypertension in the primary care office according to established collaborative treatment protocols. At baseline, there
was no significant difference in blood pressure between groups. Primary outcome measures were the differences in mean systolic
and diastolic blood pressures between arms at study end. Secondary measures included blood pressure goal attainment (<140/90 mmHg),
hypertension-related knowledge, medication adherence, home blood pressure monitoring, resource utilization, quality of life,
and satisfaction.
RESULTS A total of 463 subjects were enrolled (n = 233 control, n = 230 intervention). Subjects receiving the intervention achieved
significantly lower systolic (p = 0.007) and diastolic (p = 0.002) blood pressures compared to control (137/75 mmHg vs. 143/78 mmHg).
In addition, 62% of intervention subjects achieved target blood pressure compared to 44% of control subjects (p = 0.003).
The intervention group received more total office visits (7.2 vs. 4.9, p < 0.0001), however had fewer physician visits (3.2
vs. 4.7, p < 0.0001) compared to control. Intervention subjects were prescribed more antihypertensive medications (2.7 vs.
2.4, p = 0.02), but did not take more antihypertensive pills per day (2.4 vs. 2.5, p = 0.87). There were minimal differences
between groups in hypertension-related knowledge, medication adherence, quality of life, or satisfaction.
CONCLUSIONS Patients randomized to collaborative primary care-pharmacist hypertension management achieved significantly better blood pressure
control compared to usual care with no difference in quality of life or satisfaction.
The primary author had full access to all of the data in the study and takes responsibility for the integrity of the data
and the accuracy of the data analysis. 相似文献
34.
Because of a fancied light microscopic resemblance to transitional epithelium (urothelium), Brenner tumor (BT) of the ovary is commonly described as a transitional cell neoplasm. An inability to detect a great deal of similarity between the two at the ultrastructural level prompted this electron microscopic study comparing 3 benign Brenner tumors with normal urothelium and 6 transitional cell carcinomas (TCC) of varying histologic grade from the urinary bladder. To complement the ultrastructural observations, the immunophenotype of 8 benign BTs was evaluated together with that of 12 TCCs of the bladder using antibodies to thrombomodulin (TM), cytokeratin 20, cytokeratin 7, and carcinoembryonic antigen (CEA), all of which havebeen shown to react with TCCs of urothelial origin. At the ultrastructural level, there was only limited evidence of a morphologic likeness between the epithelial cells of BTs and those of the benign or neoplastic urothelium. The immunophenotype of the two tumors also differed significantly in that there was no reactivity for TM or cytokeratin 20 in the BTs, while these markers were expressed in the TCCs. Both BTs and TCCs were positive for cytokeratin 7 and may express CEA. 相似文献
35.
Ndip RN Malange AE Akoachere JF MacKay WG Titanji VP Weaver LT 《Tropical medicine & international health : TM & IH》2004,9(9):1036-1040
OBJECTIVE: To determine the prevalence and identify intra-familial risk factors associated with Helicobacter pylori infection in a paediatric population. METHODS: Cross-sectional study in the Buea and Limbe health districts, South West Cameroon. Stool samples were collected from 176 randomly selected apparently healthy children from two communities with different socioeconomic status. They comprised 86 males and 90 females aged 0-10 years with a mean age of 4.29. Helicobacter pylori status was determined using an enzyme-linked immunosorbent assay, the H. pylori stool antigen (HpSA) test. The test uses polyclonal anti-H. pylori capture antibody to detect H. pylori antigens in human stool. Epidemiological data were analysed using the Fisher test and odds ratio (OR) at 95% confidence intervals (CI). RESULTS: The overall prevalence of H. pylori was 52.27% (92 of 176). Univariate analysis showed that H. pylori prevalence was significantly higher in children of the low socioeconomic class, 62.50% (55 of 88) than in those of the high socioeconomic class, 42.05% (37 of 88) (P < 0.05; OR = 2.41, 95% CI: 1.26-4.64). Helicobacter pylori prevalence increased with age from 37.50% (12 of 32) for children aged <3 years, 50.00% (53 of 106) aged 3-6 years and 71.05% (27 of 38) aged 7-10 years (P > 0.05; OR = 0.81, 95% CI: 0.34-1.91). The frequency of infection was significantly higher in males, 64.00% (55 of 86) than in females, 41.11% (37 of 90), (P < 0.05; OR = 2.67, 95% CI: 1.39-5.17). CONCLUSIONS: This study highlights the continuing importance of age, sex and socioeconomic status in the acquisition of H. pylori infection. 相似文献
36.
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38.
MacKay KA Tucker AJ Duncan AM Graham TE Robinson LE 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2012,22(9):704-711
Background and aimsEpidemiological studies suggest whole grain consumption is associated with a reduced risk of cardiovascular disease (CVD), possibly through alterations in glucose metabolism and subsequent effects on plasminogen activator inhibitor (PAI)-1, a novel biomarker for CVD. Our aim was to investigate the effect of 6 wk of whole grain wheat sourdough bread consumption versus refined white bread on PAI-1.Methods and ResultsNormoglycemic/normoinsulinemic (NGI; n = 14; age 53 ± 6 y; BMI 26.5 ± 2.9 kg/m2) and hyperglycemic/hyperinsulinemic (HGI; n = 14; age 57 ± 7 y; BMI 35.7 ± 5.7 kg/m2) adults incorporated whole grain wheat sourdough (162.5 g) or white (168.8 g) bread into their diet, for 6 wk in a randomized crossover study. Pre- and post-intervention, fasting blood samples were analyzed for PAI-1 (primary outcome), as well as glucose, insulin and glucagon (secondary outcomes) at fasting and postprandially after an oral glucose tolerance test (OGTT). Anthropometric measures, fasting glucose, insulin, glucagon and PAI-1 antigen and activity were not different between treatments in either NGI or HGI adults. Glucose incremental area under the curve (iAUC) was lower (19%, P = 0.02) after 6 wk consumption of whole grain wheat sourdough bread compared to white bread in the HGI group, with no differences in insulin or glucagon iAUC in either group.ConclusionOur data showed decreased glucose iAUC after an OGTT following 6 wk whole grain wheat bread consumption in adults with differing glycemic/insulinemic status, but no improvements in PAI-1 or fasting glycemic parameters. 相似文献
39.
目的评价鼻中隔偏曲矫正术对持续性变应性鼻炎(allergicrhinitis,AR)伴鼻中隔偏曲患者症状和生活质量的影响。方法应用症状视觉模拟评分量表(Visual Analogue Scale,VAs)和鼻结膜炎生存质量量表(Rhinocon junctivitis Quality of Life Questionnaire,RQI。Q)对62例持续性变应性鼻炎伴鼻中隔偏曲患者行鼻中隔偏曲术前、术后1个月、术后6个月临床症状和生活质量进行研究。结果鼻中隔偏曲矫正术后1个月、6个月患者症状、生活质量较术前均得到改善。术后1个月、6个月RQI.Q量表中各个维度的得分较术前明显降低,差异有统计学意义(P〈0.05);术后6个月除总评分外,其余各维度与术后1个月比较,差异无统计学意义(P〉0.05)。VAS量表显示:术后患者症状较术前均有不同程度的改善,但改善最明显的为鼻塞,其次为打喷嚏。结论变应性鼻炎伴鼻中隔偏曲患者的生活质量降低,鼻中隔偏曲矫正术能明显的改善患者症状同时能提高患者的生活质量。 相似文献
40.
Dieter J. Meyerhoff Shane MacKay Dominique Sappey-Marinier Raymond Deicken Giovanna Calabrese William P. Dillon Michael W. Weiner George Fein 《Alcoholism, clinical and experimental research》1995,19(3):685-692
We examined the effects of human immunodeficiency virus (HIV) infection and chronic alcohol consumption on cerebral phosphorus metabolites to determine if chronic alcohol abuse is a risk factor for the progression of neurological effects of HIV infection. We studied 15 HIV- alcoholics, 8 HIV- light/nondrinkers, 32 HIV+ alcoholics, and 41 HIV+ light/nondrinking men, with both HIV+ groups having similar CD4 lymphocyte counts. We used localized 31-phosphorus magnetic resonance spectroscopy after magnetic resonance imaging to examine two brain volumes in superior white matter and subcortical gray matter. Chronic alcohol consumption was associated with reduced white matter concentrations of phosphodiester (PDE) and phosphocreatine (PCr). Also in the white matter, acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) were associated with reduced concentrations of PDE and PCr, compared with both HIV- and clinically asymptomatic HIV+ subjects. Because no alcohol-by-HIV interactions were detected, the effects of HIV infection and alcohol abuse were cumulative. This is reflected in a successive decrease of white matter PDE and PCr concentrations in the order HIV- light/nondrinkers/HIV- alcoholics/HIV+ light/nondrinkers/HIV+ alcoholics. Subcortical gray matter PDE concentrations were lower in ARC/AIDS alcoholics than in HIV-light/nondrinking individuals. These findings suggest altered brain phospholipid metabolites and energy metabolites with alcohol abuse and HIV infection. They demonstrate that the adverse metabolic effects of HIV on the brain are augmented by chronic alcohol abuse. 相似文献