Displaying publications 1 - 20 of 26 in total

  1. Bernhardt J, Lindley RI, Lalor E, Ellery F, Chamberlain J, Van Holsteyn J, et al.
    BMJ, 2015;351:h6432.
    PMID: 26658193 DOI: 10.1136/bmj.h6432
    To report the number of participants needed to recruit per baby born to trial staff during AVERT, a large international trial on acute stroke, and to describe trial management consequences.
  2. Sheth T, Chan M, Butler C, Chow B, Tandon V, Nagele P, et al.
    BMJ, 2015;350:h1907.
    PMID: 25902738 DOI: 10.1136/bmj.h1907
    To determine if coronary computed tomographic angiography enhances prediction of perioperative risk in patients before non-cardiac surgery and to assess the preoperative coronary anatomy in patients who experience a myocardial infarction after non-cardiac surgery.
  3. Mons U, Müezzinler A, Gellert C, Schöttker B, Abnet CC, Bobak M, et al.
    BMJ, 2015 Apr 20;350:h1551.
    PMID: 25896935 DOI: 10.1136/bmj.h1551
    OBJECTIVE: To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures.

    DESIGN: Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis.

    RESULTS: Overall, 503,905 participants aged 60 and older were included in this study, of whom 37,952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar.

    CONCLUSIONS: Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.

  4. Solomon T, Ooi MH, Beasley DW, Mallewa M
    BMJ, 2003 Apr 19;326(7394):865-9.
    PMID: 12702624
  5. Ladjali M, Rattray TW, Walder RJ
    BMJ, 1993 Aug 21;307(6902):460.
    PMID: 8400925
  6. Black JA, Debelle GD
    BMJ, 1995 Jun 17;310(6994):1590-2.
    PMID: 7787654
  7. Cutting WA
    BMJ, 1992 Oct 03;305(6857):788-9.
    PMID: 1422355
  8. Jacobs MG, Brook MG, Weir WR, Bannister BA
    BMJ, 1991 Apr 06;302(6780):828-9.
    PMID: 2025706
  9. Connett GJ, Lee BW
    BMJ, 1994 May 14;308(6939):1282-4.
    PMID: 8205023
    Though Western medicines and ideas about asthma have become popular in many Asian nations, local beliefs about treatment prevail. The multiracial society of Singapore shows a variety of beliefs about causes of asthma attacks (for example, the balance of yin and yang) and types of treatment--herbal remedies, inhaled versus eaten medicines, the influence of Ramadan. Many of the cultural practices mentioned are probably preserved among south east Asian minorities residing in the United Kingdom. Eastern treatments typically take a holistic approach to asthma and do not ignore the psychosomatic component of the disorder.
  10. Pocock NS, Mahmood SS, Zimmerman C, Orcutt M
    BMJ, 2017 11 15;359:j5210.
    PMID: 29141900 DOI: 10.1136/bmj.j5210
  11. O'Donnell M, Mente A, Rangarajan S, McQueen MJ, O'Leary N, Yin L, et al.
    BMJ, 2019 03 13;364:l772.
    PMID: 30867146 DOI: 10.1136/bmj.l772
    OBJECTIVE: To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.

    DESIGN: International prospective cohort study.

    SETTING: 18 high, middle, and low income countries, sampled from urban and rural communities.

    PARTICIPANTS: 103 570 people who provided morning fasting urine samples.

    MAIN OUTCOME MEASURES: Association of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category variable for joint sodium and potassium was generated: sodium excretion (low (<3 g/day), moderate (3-5 g/day), and high (>5 g/day) sodium intakes) by potassium excretion (greater/equal or less than median 2.1 g/day).

    RESULTS: Mean estimated sodium and potassium urinary excretion were 4.93 g/day and 2.12 g/day, respectively. After a median follow-up of 8.2 years, 7884 (6.1%) participants had died or experienced a major cardiovascular event. Increasing urinary sodium excretion was positively associated with increasing potassium excretion (unadjusted r=0.34), and only 0.002% had a concomitant urinary excretion of <2.0 g/day of sodium and >3.5 g/day of potassium. A J-shaped association was observed of sodium excretion and inverse association of potassium excretion with death and cardiovascular events. For joint sodium and potassium excretion categories, the lowest risk of death and cardiovascular events occurred in the group with moderate sodium excretion (3-5 g/day) and higher potassium excretion (21.9% of cohort). Compared with this reference group, the combinations of low potassium with low sodium excretion (hazard ratio 1.23, 1.11 to 1.37; 7.4% of cohort) and low potassium with high sodium excretion (1.21, 1.11 to 1.32; 13.8% of cohort) were associated with the highest risk, followed by low sodium excretion (1.19, 1.02 to 1.38; 3.3% of cohort) and high sodium excretion (1.10, 1.02 to 1.18; 29.6% of cohort) among those with potassium excretion greater than the median. Higher potassium excretion attenuated the increased cardiovascular risk associated with high sodium excretion (P for interaction=0.007).

    CONCLUSIONS: These findings suggest that the simultaneous target of low sodium intake (<2 g/day) with high potassium intake (>3.5 g/day) is extremely uncommon. Combined moderate sodium intake (3-5 g/day) with high potassium intake is associated with the lowest risk of mortality and cardiovascular events.

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