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blood journal england

C Piernas, P Aveyard, S A Jebb
BackgroundPublic policies and clinical guidelines encourage people to achieve and maintain a healthy weight, and societal culture, especially among women, tends to idealise thinness.ObjectivesTo examine trends over time in the prevalence of weight loss attempts in England (1997-2013) and to investigate if the characteristics associated with attempts to lose weight have changed.MethodsObservational study using nationally representative data on adults ≥18y who participated in the Health Survey for England (HSE) in 1997 (n=8,066), 1998 (n=14,733), 2002 (n=8,803), 2012 (n=7,132) and 2013 (n=7,591), with self-reported attempts to lose weight, cardiovascular disease (CVD) events or medications and measured height, weight and blood pressure...
August 16, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
INTRODUCTION: Acute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes...
August 4, 2016: BMJ Open
Gaia Kiru, Colin Bicknell, Emanuela Falaschetti, Janet Powell, Neil Poulter
BACKGROUND: Although data are inconsistent, angiotensin-converting enzyme inhibitors (ACE-Is) have been associated with a reduced incidence of abdominal aortic aneurysm (AAA) rupture in analysis of administrative databases. OBJECTIVES: (1) To investigate whether or not the ACE-I perindopril (Coversyl arginine, Servier) reduces small AAA growth rate and (2) to evaluate blood pressure (BP)-independent effects of perindopril on small AAA growth and to compare the repeatability of measurement of internal and external aneurysm diameters...
July 2016: Health Technology Assessment: HTA
Paul R Mouncey, Tiffany M Osborn, G Sarah Power, David A Harrison, M Zia Sadique, Richard D Grieve, Rahi Jahan, Jermaine C K Tan, Sheila E Harvey, Derek Bell, Julian F Bion, Timothy J Coats, Mervyn Singer, J Duncan Young, Kathryn M Rowan
BACKGROUND: Early goal-directed therapy (EGDT) is recommended in international guidance for the resuscitation of patients presenting with early septic shock. However, adoption has been limited and uncertainty remains over its clinical effectiveness and cost-effectiveness. OBJECTIVES: The primary objective was to estimate the effect of EGDT compared with usual resuscitation on mortality at 90 days following randomisation and on incremental cost-effectiveness at 1 year...
November 2015: Health Technology Assessment: HTA
Tetsuichi Yoshizato, Bogdan Dumitriu, Kohei Hosokawa, Hideki Makishima, Kenichi Yoshida, Danielle Townsley, Aiko Sato-Otsubo, Yusuke Sato, Delong Liu, Hiromichi Suzuki, Colin O Wu, Yuichi Shiraishi, Michael J Clemente, Keisuke Kataoka, Yusuke Shiozawa, Yusuke Okuno, Kenichi Chiba, Hiroko Tanaka, Yasunobu Nagata, Takamasa Katagiri, Ayana Kon, Masashi Sanada, Phillip Scheinberg, Satoru Miyano, Jaroslaw P Maciejewski, Shinji Nakao, Neal S Young, Seishi Ogawa
BACKGROUND: In patients with acquired aplastic anemia, destruction of hematopoietic cells by the immune system leads to pancytopenia. Patients have a response to immunosuppressive therapy, but myelodysplastic syndromes and acute myeloid leukemia develop in about 15% of the patients, usually many months to years after the diagnosis of aplastic anemia. METHODS: We performed next-generation sequencing and array-based karyotyping using 668 blood samples obtained from 439 patients with aplastic anemia...
July 2, 2015: New England Journal of Medicine
Xavier Pi-Sunyer, Arne Astrup, Ken Fujioka, Frank Greenway, Alfredo Halpern, Michel Krempf, David C W Lau, Carel W le Roux, Rafael Violante Ortiz, Christine Bjørn Jensen, John P H Wilding
BACKGROUND: Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagon-like peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously. METHODS: We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension...
July 2, 2015: New England Journal of Medicine
Kerry Dobbs, Cecilia Domínguez Conde, Shen-Ying Zhang, Silvia Parolini, Magali Audry, Janet Chou, Emma Haapaniemi, Sevgi Keles, Ivan Bilic, Satoshi Okada, Michel J Massaad, Samuli Rounioja, Adel M Alwahadneh, Nina K Serwas, Kelly Capuder, Ergin Çiftçi, Kerstin Felgentreff, Toshiro K Ohsumi, Vincent Pedergnana, Bertrand Boisson, Şule Haskoloğlu, Arzu Ensari, Michael Schuster, Alessandro Moretta, Yuval Itan, Ornella Patrizi, Flore Rozenberg, Pierre Lebon, Janna Saarela, Mikael Knip, Slavé Petrovski, David B Goldstein, Roberta E Parrott, Berna Savas, Axel Schambach, Giovanna Tabellini, Christoph Bock, Talal A Chatila, Anne Marie Comeau, Raif S Geha, Laurent Abel, Rebecca H Buckley, Aydan İkincioğulları, Waleed Al-Herz, Merja Helminen, Figen Doğu, Jean-Laurent Casanova, Kaan Boztuğ, Luigi D Notarangelo
Background Combined immunodeficiencies are marked by inborn errors of T-cell immunity in which the T cells that are present are quantitatively or functionally deficient. Impaired humoral immunity is also common. Patients have severe infections, autoimmunity, or both. The specific molecular, cellular, and clinical features of many types of combined immunodeficiencies remain unknown. Methods We performed genetic and cellular immunologic studies involving five unrelated children with early-onset invasive bacterial and viral infections, lymphopenia, and defective T-cell, B-cell, and natural killer (NK)-cell responses...
June 18, 2015: New England Journal of Medicine
Rodney A Hayward, Peter D Reaven, Wyndy L Wiitala, Gideon D Bahn, Domenic J Reda, Ling Ge, Madeline McCarren, William C Duckworth, Nicholas V Emanuele
BACKGROUND: The Veterans Affairs Diabetes Trial previously showed that intensive glucose lowering, as compared with standard therapy, did not significantly reduce the rate of major cardiovascular events among 1791 military veterans (median follow-up, 5.6 years). We report the extended follow-up of the study participants. METHODS: After the conclusion of the clinical trial, we followed participants, using central databases to identify procedures, hospitalizations, and deaths (complete cohort, with follow-up data for 92...
June 4, 2015: New England Journal of Medicine
Douglas S Robinson, Harsha H Kariyawasam
INTRODUCTION: In September 2014 two large clinical studies of the anti-IL-5 monoclonal antibody mepolizumab in severe asthma were published in the New England Journal of Medicine (MENSA and SIRIUS). AREAS COVERED: Eosinophilic inflammation has long been recognised as a feature of asthma. Identification of IL-5 as a key cytokine specific for eosinophil development and survival lead to development of monoclonal antibody therapy targeting this pathway. These two important new studies suggested that this treatment could reduce exacerbation rates by 50% in asthmatic patients with persistent peripheral blood eosinophilia and persistent symptoms despite high-dose-inhaled corticosteroids and additional controller therapy, and frequent exacerbations...
June 2015: Expert Opinion on Biological Therapy
Paul R Mouncey, Tiffany M Osborn, G Sarah Power, David A Harrison, M Zia Sadique, Richard D Grieve, Rahi Jahan, Sheila E Harvey, Derek Bell, Julian F Bion, Timothy J Coats, Mervyn Singer, J Duncan Young, Kathryn M Rowan
BACKGROUND: Early, goal-directed therapy (EGDT) is recommended in international guidelines for the resuscitation of patients presenting with early septic shock. However, adoption has been limited, and uncertainty about its effectiveness remains. METHODS: We conducted a pragmatic randomized trial with an integrated cost-effectiveness analysis in 56 hospitals in England. Patients were randomly assigned to receive either EGDT (a 6-hour resuscitation protocol) or usual care...
April 2, 2015: New England Journal of Medicine
John Spertus
New England Journal of Medicine, Volume 372, Issue 11, Page 1069-1070, March 2015.
March 12, 2015: New England Journal of Medicine
Seema Jain, Derek J Williams, Sandra R Arnold, Krow Ampofo, Anna M Bramley, Carrie Reed, Chris Stockmann, Evan J Anderson, Carlos G Grijalva, Wesley H Self, Yuwei Zhu, Anami Patel, Weston Hymas, James D Chappell, Robert A Kaufman, J Herman Kan, David Dansie, Noel Lenny, David R Hillyard, Lia M Haynes, Min Levine, Stephen Lindstrom, Jonas M Winchell, Jacqueline M Katz, Dean Erdman, Eileen Schneider, Lauri A Hicks, Richard G Wunderink, Kathryn M Edwards, Andrew T Pavia, Jonathan A McCullers, Lyn Finelli
BACKGROUND: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. METHODS: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City...
February 26, 2015: New England Journal of Medicine
Elmi Muller, Zunaid Barday, Marc Mendelson, Delawir Kahn
BACKGROUND: The outcome of kidney transplantation in human immunodeficiency virus (HIV)-positive patients who receive organs from HIV-negative donors has been reported to be similar to the outcome in HIV-negative recipients. We report the outcomes at 3 to 5 years in HIV-positive patients who received kidneys from HIV-positive deceased donors. METHODS: We conducted a prospective, nonrandomized study of kidney transplantation in HIV-infected patients who had a CD4 T-cell count of 200 per cubic millimeter or higher and an undetectable plasma HIV RNA level...
February 12, 2015: New England Journal of Medicine
Stefan Verheye, E Marc Jolicœur, Miles W Behan, Thomas Pettersson, Paul Sainsbury, Jonathan Hill, Mathias Vrolix, Pierfrancesco Agostoni, Thomas Engstrom, Marino Labinaz, Ranil de Silva, Marc Schwartz, Nathalie Meyten, Neal G Uren, Serge Doucet, Jean-François Tanguay, Steven Lindsay, Timothy D Henry, Christopher J White, Elazer R Edelman, Shmuel Banai
BACKGROUND: Many patients with coronary artery disease who are not candidates for revascularization have refractory angina despite standard medical therapy. The balloon-expandable, stainless steel, hourglass-shaped, coronary-sinus reducing device creates a focal narrowing and increases pressure in the coronary sinus, thus redistributing blood into ischemic myocardium. METHODS: We randomly assigned 104 patients with Canadian Cardiovascular Society (CCS) class III or IV angina (on a scale from I to IV, with higher classes indicating greater limitations on physical activity owing to angina) and myocardial ischemia, who were not candidates for revascularization, to implantation of the device (treatment group) or to a sham procedure (control group)...
February 5, 2015: New England Journal of Medicine
Alexander Ströhle
High dietary salt intake increases blood pressure and impairs cardiovascular health in the long-run. Therefore, the World Health Organization (WHO) and the American Heart Association (AHA) have argued for a target of 1500-2000mg of sodium per day (4-5 g sodium chloride daily). However, this recommendation is accompanied by a growing criticism. Recently, two papers published in the New England Journal of Medicine and a meta-analysis published in the September issue of the American Journal of Hypertension have flared up the "salt controversy"...
December 2014: Medizinische Monatsschrift Für Pharmazeuten
Hala Ahmadieh
The paper entitled "Changes in diabetes-related complications in the United States, 1990-2010" published recently in the New England Journal of Medicine examined the spectrum of diabetes complications over the past 20 years based on a unique, nationally representative database in the Unites States. It was noted that although adults with diagnosis of diabetes have more than tripled between the years 1990 and 2010, the rates of all five major complications of diabetes have declined significantly with the greatest absolute declines being noted for acute myocardial infarction followed by stroke, lower-extremity amputation, end-stage renal disease and finally the death from hyperglycemic crisis...
December 2014: Annals of Translational Medicine
C Cristina Quarta, Joel N Buxbaum, Amil M Shah, Rodney H Falk, Brian Claggett, Dalane W Kitzman, Thomas H Mosley, Kenneth R Butler, Eric Boerwinkle, Scott D Solomon
BACKGROUND: Approximately 4% of black Americans carry a valine-to-isoleucine substitution (V122I) in the transthyretin protein, which has been associated with late-onset restrictive amyloid cardiomyopathy and increased risks of death and heart failure. METHODS: We determined genotype status for the transthyretin gene (TTR) in 3856 black participants in the Atherosclerosis Risk in Communities study and assessed clinical profiles, mortality, and the risk of incident heart failure in V122I TTR variant carriers (124 participants [3%]) versus noncarriers (3732 participants)...
January 1, 2015: New England Journal of Medicine
Giulio Genovese, Anna K Kähler, Robert E Handsaker, Johan Lindberg, Samuel A Rose, Samuel F Bakhoum, Kimberly Chambert, Eran Mick, Benjamin M Neale, Menachem Fromer, Shaun M Purcell, Oscar Svantesson, Mikael Landén, Martin Höglund, Sören Lehmann, Stacey B Gabriel, Jennifer L Moran, Eric S Lander, Patrick F Sullivan, Pamela Sklar, Henrik Grönberg, Christina M Hultman, Steven A McCarroll
BACKGROUND: Cancers arise from multiple acquired mutations, which presumably occur over many years. Early stages in cancer development might be present years before cancers become clinically apparent. METHODS: We analyzed data from whole-exome sequencing of DNA in peripheral-blood cells from 12,380 persons, unselected for cancer or hematologic phenotypes. We identified somatic mutations on the basis of unusual allelic fractions. We used data from Swedish national patient registers to follow health outcomes for 2 to 7 years after DNA sampling...
December 25, 2014: New England Journal of Medicine
Siddhartha Jaiswal, Pierre Fontanillas, Jason Flannick, Alisa Manning, Peter V Grauman, Brenton G Mar, R Coleman Lindsley, Craig H Mermel, Noel Burtt, Alejandro Chavez, John M Higgins, Vladislav Moltchanov, Frank C Kuo, Michael J Kluk, Brian Henderson, Leena Kinnunen, Heikki A Koistinen, Claes Ladenvall, Gad Getz, Adolfo Correa, Benjamin F Banahan, Stacey Gabriel, Sekar Kathiresan, Heather M Stringham, Mark I McCarthy, Michael Boehnke, Jaakko Tuomilehto, Christopher Haiman, Leif Groop, Gil Atzmon, James G Wilson, Donna Neuberg, David Altshuler, Benjamin L Ebert
BACKGROUND: The incidence of hematologic cancers increases with age. These cancers are associated with recurrent somatic mutations in specific genes. We hypothesized that such mutations would be detectable in the blood of some persons who are not known to have hematologic disorders. METHODS: We analyzed whole-exome sequencing data from DNA in the peripheral-blood cells of 17,182 persons who were unselected for hematologic phenotypes. We looked for somatic mutations by identifying previously characterized single-nucleotide variants and small insertions or deletions in 160 genes that are recurrently mutated in hematologic cancers...
December 25, 2014: New England Journal of Medicine
Janis L Abkowitz
New England Journal of Medicine, Volume 0, Issue 0, Ahead of Print.
December 25, 2014: New England Journal of Medicine
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