Comparison of oral anticoagulants for stroke prevention in atrial fibrillation using the UK clinical practice research Datalink Aurum: A reference trial (ARISTOTLE) emulation study.

Background: Stroke prevention guidance for patients with atrial fibrillation (AF) uses evidence generated from randomised controlled trials (RCTs). However, applicability to patient groups excluded from trials remains unknown. Real-world patient data provide an opportunity to evaluate outcomes in a trial analogous population of direct oral anticoagulants (DOACs) users and in patients otherwise excluded from RCTs; however, there remains uncertainty on the validity of methods and suitability of the data.

Cardiorenal effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers among people underrepresented in trials: analysis of routinely collected data with emulation of a reference trial (ONTARGET).

Cardiovascular disease is a leading cause of death globally. Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB), compared in the ONTARGET trial (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial), each prevent cardiovascular disease. However, trial results may not be generalizable, and their effectiveness in underrepresented groups is unclear.

All-cause and cause-specific mortality in US adults with periodontal diseases: A prospective cohort study.

Aim: This prospective cohort study investigated the association between periodontal diseases (PDs) and all-cause and cause-specific mortality.

Materials And Methods: We utilized adult participants recruited from six National Health and Nutrition Examination Survey cycles (1999-2014) and linked mortality data from the National Death Index up to December 2019. Baseline clinical periodontal examinations were performed by trained and calibrated examiners.

Effects of ACE inhibitors and angiotensin receptor blockers: protocol for a UK cohort study using routinely collected electronic health records with validation against the ONTARGET trial.

Introduction: Cardiovascular disease is a leading cause of death globally, responsible for nearly 18 million deaths worldwide in 2017. Medications to reduce the risk of cardiovascular events are prescribed based on evidence from clinical trials which explore treatment effects in an indicated sample of the general population. However, these results may not be fully generalisable because of trial eligibility criteria that generally restrict to younger patients with fewer comorbidities.

Haemobilia in a previously stented hilar cholangiocarcinoma: successful haemostasis after the insertion of fcSEMS.

Haemobilia describes blood loss from the biliary tract and classically presents as Quincke's triad: upper gastrointestinal bleeding (UGIB), jaundice and right upper quadrant abdominal pain. We discuss the case of a 70-year-old male with a previously stented Bismuth 1 hilar cholangiocarcinoma who presented with haematemesis. He had a similar presentation a month ago where a forward viewing gastroscope identified fresh and altered blood in the distal stomach but no clear source of bleeding.

Successful combined management for ruptured superior rectal artery aneurysm in neurofibromatosis type 1.

Neurofibromatosis type 1 (NF1) is an autosomally dominant inherited disorder characterized by neurocutaneous and bony lesions with multisystem vasculopathy in the form of stenotic and aneurysmal disease. The multisystemic nature of NF1 aneurysmal disease can have potentially serious clinical sequelae and complicated management. A 55-year-old woman with NF1 presented acutely with severe abdominal and back pain, diarrhea, and hypotension with a delayed fall in her hemoglobin.

Multiple pathways for regulation of sigmaS (RpoS) stability in Escherichia coli via the action of multiple anti-adaptors.

SigmaS, the stationary phase sigma factor of Escherichia coli and Salmonella, is regulated at multiple levels. The sigmaS protein is unstable during exponential growth and is stabilized during stationary phase and after various stress treatments. Degradation requires both the ClpXP protease and the adaptor RssB.

Human monocytes produce IL-1 and an inhibitor of IL-1 in response to two different signals.

Recently, IL-1 inhibitors from urine, monocytes, or monocyte lines have been described. The relationship of these inhibitors to the production, release, and immunological effects of IL-1 is unclear. The present studies were initiated to describe and quantitate the production of IL-1 and a 23 to 45-kDa IL-1 inhibitor from human monocytes in response to certain stimuli using a mouse thymocyte system responsive to IL-1.

The effect of antirheumatic drugs on interleukin 1 (IL-1) activity and IL-1 and IL-1 inhibitor production by human monocytes.

Interleukin 1 (IL-1) is an important mediator of immune regulation, inflammation and joint destruction in arthritis. The objective of our study was to investigate the effect of a number of representative antirheumatic agents on the activity of IL-1 and the production of both IL-1 and IL-1 inhibitor by human monocytes. IL-1 activity and production were measured by its effect on the proliferation of murine thymocytes; IL-1 inhibitor production was assayed by inhibition of IL-1 mediated thymocyte proliferation.

[Functional studies of the esophagus in gastroesophageal reflux: application to anti-reflux surgery].

A functional exploration of the esophagus, an acid reflux test, a manometry and an endoscopic examination were performed on 56 patients in succession, who had undergone a complete fundoplication for gastro-esophageal reflux. These tests were done pre-operatively as well as post-operatively at short term (1 year) and long term (4 years). The functional and endoscopic pre-operative work-up did not enable to isolate a group of patients likely to present a therapeutic failure.

[Gastroesophageal 99mTc scintigraphy in gastroesophageal reflux].

The aim of this study was to compare gastroesophageal 99mTc scintiscanning (GES), the pH reflux test (TRA) and esophageal manometry in the assessment of gastroesophageal reflux (GER). GES was performed after oral intake of sulfur colloid labeled with 99m technetium and 300 ml of water. Calculation of an index of reflux gave a semi-quantitative assessment of the GER.

[Completed calibrated fundoplication].

Complete fundoplication at present is the most effective surgical treatment of gastro-oesophageal reflux. However, it has a number of side-effects, including post-operative dysphagia, inability to eructate and painful gastric distension. Fifty-five patients were operated upon using a technique which comprises wide gastric release and fabrication of a tension-free valve around a 50F probe introduced through the mouth.

Transient pulmonary impairment during attacks of Crohn's disease.

Lung function was studied in 10 patients with Crohn's disease during and after an attack of the disease. Pulmonary volumes and lung transfer factor were not impaired but functional residual capacity was greater during the attack than during remission; it was also greater than in normal subjects. FRC values and disease activity decreased concomitantly during remission as well as finger clubbing.