70 research outputs found
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke
Background
Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared
the efficacy and safety of two antiplatelet regimens â aspirin plus extendedrelease
dipyridamole (ASAâERDP) versus clopidogrel.
Methods
In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive
25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive
75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke.
The secondary outcome was a composite of stroke, myocardial infarction, or death
from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075),
followed by superiority testing, was planned.
Results
A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke
occurred in 916 patients (9.0%) receiving ASAâERDP and in 898 patients (8.8%) receiving
clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The
secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for
ASAâERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events
among ASAâERDP recipients (419 [4.1%]) than among clopidogrel recipients (365
[3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage
(hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major
hemorrhagic event was similar in the two groups (1194 ASAâERDP recipients [11.7%],
vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11).
Conclusions
The trial did not meet the predefined criteria for noninferiority but showed similar rates
of recurrent stroke with ASAâERDP and with clopidogrel. There is no evidence that either
of the two treatments was superior to the other in the prevention of recurrent
stroke. (ClinicalTrials.gov number, NCT00153062.
Correlations of Gene Expression with Blood Lead Levels in Children with Autism Compared to Typically Developing Controls
The objective of this study was to examine the correlation between gene expression and lead (Pb) levels in blood in children with autism (AU, n = 37) compared to typically developing controls (TD, n = 15). We postulated that, though lead levels did not differ between the groups, AU children might metabolize lead differently compared to TD children. RNA was isolated from blood and processed on Affymetrix microarrays. Separate analyses of covariance (ANCOVA) corrected for age and gender were performed for TD, AU, and all subjects (AU + TD). To reduce false positives, only genes that overlapped these three ANCOVAs were considered. Thus, 48 probe sets correlated with lead levels in both AU and TD subjects and were significantly different between the groups (p(Diagnosis Ă log2 Pb) < 0.05). These genes were related mainly to immune and inflammatory processes, including MHC Class II family members and CD74. A large number (n = 791) of probe sets correlated (P â€Â 0.05) with lead levels in TD but not in AU subjects; and many probe sets (n = 162) correlated (P â€Â 0.05) with lead levels in AU but not in TD subjects. Only 30 probe sets correlated (P â€Â 0.05) with lead levels in a similar manner in the AU and TD groups. These data show that AU and TD children display different associations between transcript levels and low levels of lead. We postulate that this may relate to the underlying genetic differences between the two groups, though other explanations cannot be excluded
Social Networks among Elderly Women: Implications for Health Education Practice
The general aim of the present study was to examine and help clarify the properties of the distinctions between social networks and social support, their relationship to health status, and their impli cations for health education practice. More specifically, a secondary data analysis was conducted with 130 white women, community resi dents, between the ages of 60 and 68, which examined the relationship between psychological well-being and social network characteristics. These characteristics are categorized along three broad dimensions: structureâlinks in the overall network (size and density); interactionâ nature of the linkages themselves (frequency, homogeneity, content, reciprocity, intensity, and dispersion); and functions which networks provide (affective support and instrumental support). A combination was made and relative strength investigated of several network char acteristics representative of the quality of interactions (i. e., reciprocal affective support, intensity, and affective support) and those repre senting the quantity of interactions (i.e., size, density, and frequency).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67277/2/10.1177_109019818301000304.pd
Social Media, Gender and the Mediatisation of War: Exploring the German Armed Forcesâ Visual Representation of the Afghanistan Operation on Facebook
Studies on the mediatisation of war point to attempts of governments to regulate the visual perspective of their involvements in armed conflict â the most notable example being the practice of âembedded reportingâ in Iraq and Afghanistan. This paper focuses on a different strategy of visual meaning-making, namely, the publication of images on social media by armed forces themselves. Specifically, we argue that the mediatisation of war literature could profit from an increased engagement with feminist research, both within Critical Security/Critical Military Studies and within Science and Technology Studies that highlight the close connection between masculinity, technology and control. The article examines the German military mission in Afghanistan as represented on the German armed forcesâ official Facebook page. Germany constitutes an interesting, and largely neglected, case for the growing literature on the mediatisation of war: its strong antimilitarist political culture makes the representation of war particularly delicate. The paper examines specific representational patterns of Germanyâs involvement in Afghanistan and discusses the implications which arise from what is placed inside the frame of visibility and what remains out of its view
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke
Background
Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared
the efficacy and safety of two antiplatelet regimens â aspirin plus extendedrelease
dipyridamole (ASAâERDP) versus clopidogrel.
Methods
In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive
25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive
75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke.
The secondary outcome was a composite of stroke, myocardial infarction, or death
from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075),
followed by superiority testing, was planned.
Results
A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke
occurred in 916 patients (9.0%) receiving ASAâERDP and in 898 patients (8.8%) receiving
clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The
secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for
ASAâERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events
among ASAâERDP recipients (419 [4.1%]) than among clopidogrel recipients (365
[3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage
(hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major
hemorrhagic event was similar in the two groups (1194 ASAâERDP recipients [11.7%],
vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11).
Conclusions
The trial did not meet the predefined criteria for noninferiority but showed similar rates
of recurrent stroke with ASAâERDP and with clopidogrel. There is no evidence that either
of the two treatments was superior to the other in the prevention of recurrent
stroke. (ClinicalTrials.gov number, NCT00153062.
Telmisartan to prevent recurrent stroke and cardiovascular events
Background
Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent
stroke. In addition, inhibition of the reninâangiotensin system in high-risk patients
reduces the rate of subsequent cardiovascular events, including stroke. However, the
effect of lowering of blood pressure with a reninâangiotensin system inhibitor soon
after a stroke has not been clearly established. We evaluated the effects of therapy
with an angiotensin-receptor blocker, telmisartan, initiated early after a stroke.
Methods
In a multicenter trial involving 20,332 patients who recently had an ischemic stroke,
we randomly assigned 10,146 to receive telmisartan (80 mg daily) and 10,186 to receive
placebo. The primary outcome was recurrent stroke. Secondary outcomes were
major cardiovascular events (death from cardiovascular causes, recurrent stroke,
myocardial infarction, or new or worsening heart failure) and new-onset diabetes.
Results
The median interval from stroke to randomization was 15 days. During a mean followup
of 2.5 years, the mean blood pressure was 3.8/2.0 mm Hg lower in the telmisartan
group than in the placebo group. A total of 880 patients (8.7%) in the telmisartan group
and 934 patients (9.2%) in the placebo group had a subsequent stroke (hazard ratio in
the telmisartan group, 0.95; 95% confidence interval [CI], 0.86 to 1.04; P = 0.23). Major
cardiovascular events occurred in 1367 patients (13.5%) in the telmisartan group and
1463 patients (14.4%) in the placebo group (hazard ratio, 0.94; 95% CI, 0.87 to 1.01;
P = 0.11). New-onset diabetes occurred in 1.7% of the telmisartan group and 2.1% of the
placebo group (hazard ratio, 0.82; 95% CI, 0.65 to 1.04; P = 0.10).
Conclusions
Therapy with telmisartan initiated soon after an ischemic stroke and continued for
2.5 years did not significantly lower the rate of recurrent stroke, major cardiovascular
events, or diabetes. (ClinicalTrials.gov number, NCT00153062.
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