Thomas M MacDonald

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..This interaction is more likely in those who take ibuprofen chronically and is more important in those at high cardiovascular risk. Thus, a reasonable strategy might be to advise aspirin takers to avoid chronic ibuprofen...

..This paper discusses the safety of cyclooxygenase-2 inhibitors and describes the sort of studies that could be carried out to gather better safety information on their use versus standard nonsteroidal anti-inflammatory drugs...

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..73, 1.05-2.84, p=0.0305). Our finding lends support to the hypothesis that ibuprofen may interact with the cardioprotective effects of aspirin, at least in patients with established cardiovascular disease...

..Major changes in the reimbursement of primary care for the management of both hypertension and hypercholesterolaemia have occurred in the UK...

..To examine whether the blood pressure (BP) profiles of lumiracoxib and high-dose ibuprofen differed in patients treated with different classes of antihypertensive medications...

..05) enhanced only with valsartan. Valsartan reserved peripheral endothelial dysfunction through both NO-dependent and -independent pathways, while for the same degree of BP control, amlodipine had only a partial effect on NO bioactivity...

..To compare the relative risks of upper GI haemorrhage (UGIH) in users of Newer versus Older, non-specific NSAIDs when adjusted for channelling bias by regression on individual covariates, a propensity score and both...

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..NSAIDs may also increase cardiovascular risk due to mechanisms other than by raising blood pressure...

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..To determine the safety of spironolactone prescribing in the setting of the UK National Health Service...

..We aimed to generate a region-wide longitudinal register of stroke patients using record-linkage of existing clinical and research datasets...

..We have compared the treat-to-target and fire-and-forget statin prescribing strategies with respect to adherence and cardiovascular outcomes...

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..Many ICH patients have or will have indications for antiplatelet therapy. This observational study describes the level of antiplatelet prescribing and rate of subsequent events after ICH in Tayside, Scotland...

..To characterize patients with urate measurements by urate-lowering therapy (ULT) use and to study the impact of allopurinol treatment on cardiovascular and mortality outcomes...

..02). Salt loading impaired vascular endothelial function, left ventricular mechanical relaxation, and electric repolarization in young healthy normotensives...

..82, 0.71 to 0.95). CONCLUSIONS: The community effectiveness of statins in those groups that were not well represented in clinical trials was similar to the efficacy of statins in these trials...

..To compare the user profiles of the two classes of drug, using the Tayside Medicines Monitoring Unit (MEMO) record-linkage database...

..To investigate the death rate due to paracetamol poisoning in Scotland and what effect the reduction in over-the-counter paracetamol pack sizes in 1998 had on the death rate...

..63 (0.50, 5.29). The study shows that hypersensitivity reactions associated with NSAID use are rare, and provides no evidence that the risks of hypersensitivity reactions differ between naproxen and ibuprofen...

..These findings have implications for the management of patients who require treatment with NSAIDs...

..WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Statins reduce cholesterol concentrations and cardiovascular events in randomized clinical trials. * Much less is known about their impact in the setting of normal care...

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..Further studies of the effects of CINODs in humans are required, but these agents represent a potential exciting advance in the management of osteoarthritis...

..To investigate the effect of distance between home and acute hospital on mortality outcome of patients experiencing an incident myocardial infarction (MI)...

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..We hypothesised that such individuals could potentially be identified by an exaggerated systolic blood pressure (BP) response to a submaximal exercise...

..Serious adverse events were uncommon but despite this aspirin cost the NHS between 6 and 25 times the cost of aspirin tablets due to dispensing costs and the cost of managing adverse effects...

..To evaluate whether diabetes mellitus is a risk factor for the development of primary open angle glaucoma or ocular hypertension (OHT)...

..This raises the possibility that salt may have BP-independent adverse cardiac effects in susceptible hypertensive subjects...

..Continued exposure to antiplatelet regimens predicts good outcomes in patients with cerebral infarction...

..Good adherence to beta-blocker treatment after MI was associated with a lower risk of mortality...

..The approximate Bayesian bootstrap method was demonstrated to be a robust and easily implemented alternative to the full Bayesian approach to risk analysis whenever data are sparse...

..In 1998, OTC pack sizes of paracetamol were reduced. We have studied the effect of this pack size restriction on OTC supply of paracetamol, aspirin and ibuprofen...

..To look for evidence of a relation between antibiotic resistance and prescribing by general practitioners by analysis of prescribing at both practice and individual patient level...

..Training practice status was the dominant factor associated with significant differences in rates of antibiotic prescribing, in class of antibiotic prescribed and in performance indicators of antibiotic prescribing...

..These findings demonstrate the under-recognition/undertreatment of cardiovascular risk factors in UK primary care among patients at risk of CVD...

..The use, abuse and ways of reducing paracetamol toxicity are reviewed, but in view of the potential for harm, serious consideration should be given to changing the legal status of paracetamol, possibly to a prescription-only medicine...

..Reduction in trimethoprim prescribing alone may not reduce the prevalence of trimethoprim resistance...

..This involves anonymization of data, seeking specific ethical approval for research studies and obtaining relevant permissions from 'Caldicott Guardians', as described in this article...

..The client can make better decisions with the relevant information, thus breaking down the agency relationship that once existed...

..To investigate patterns of self monitoring of blood glucose concentration in diabetic patients who use insulin and to determine whether frequency of self monitoring is related to glycaemic control...

..To describe the epidemiology and estimate the health resource use of patients with viral hepatitis in Tayside, Scotland, using record linkage techniques...

..To investigate whether the extent of systolic dysfunction is a useful predictor of the costs of healthcare and social support for patients with heart failure...

..CONCLUSIONS: Despite the infrequent use of statin during the study period, good adherence to statin treatment was associated with lower risk of recurrent MI...

..The influence of socio-economic status on the prevalence of Type 1 and Type 2 diabetes mellitus, and on obesity, was explored using routinely collected healthcare data for the population of Tayside, Scotland...

..This hypothesis is based on previous data that a high urate concentration is independently associated with mortality with a risk ratio of 4.23 in CHF...

..To estimate mortality by drug use in a cohort of patients with PD relative to age- and sex-matched comparators...

..To evaluate the association between the use of ACE inhibitors and hospital admission for severe hypoglycemia and to explore the effects of potential confounding variables on this relationship...

..Correlation is strongest between BP and average activity integrated over the previous 15 min. Much of the variance in blood pressure remains unexplained...

..To define the prevalence of hypothyroid disease in children and young people, and describe its aetiology...

..Utilization and costs of prescription drugs were investigated in diabetic and nondiabetic patients...

..We found that the unadjusted risk ratios were biased downwards due to confounders and that this bias was reduced by using stratification based on the multiple propensity score...

..We hypothesized that nebivolol, a vasodilating beta-blocker, could improve endothelial dysfunction. We tested this hypothesis by comparing the effects of nebivolol and atenolol on endothelial function...

..We report an unusual association between phaeochromocyotoma and post-exertional malignant arrhythmia in a normotensive subject...

..There are few U.K. data on the incidence rates of amputation in diabetic subjects compared with the nondiabetic population...

..In conclusion, irbesartan improved QT dispersion, and this effect may be important in preventing sudden cardiac death in at-risk hypertensive subjects...

..The aim of this study was to define the relationship between physical activity and the magnitude of the percentage fall in blood pressure at night (nocturnal dip)...

..Although widely used, few data are available on the appropriateness of prescribing of acid-suppressing drugs (ASDs), despite guidelines on the investigation and treatment of dyspeptic patients...

..There were no associations found for diabetes or prior corticosteroid exposure. Community controls were found to be inappropriate controls for the study of trimethoprim-resistant bacteria in urine samples...

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..To assess the blood pressure response to oral spironolactone in hypertensive patients with primary aldosteronism identified with raised aldosterone to renin ratio...

..In particular, to test the hypothesis that one tablet per day is associated with better adherence than more than one...

..The re-emergence of mineralocorticoid receptor antagonists has provided clinicians with an important tool towards complete blockade of the renin-angiotensin-aldosterone axis...

..This cohort study evaluated medication discontinuation and target achievement in a United Kingdom primary care setting...

..To test the non-inferiority of a single dose of tadalafil 20 mg compared with placebo with respect to 26-h mean ambulatory systolic and diastolic blood pressure in treated and untreated hypertensive subjects...

..The number of birth records available and linkage to current databases make this a unique birth cohort with huge potential for the investigation of the fetal origins of adult disease...

..8, 3.1%; P= 0.92]. CONCLUSIONS It is possible to raise public awareness of clinical research using the media, but further efforts may be required to influence individuals' decisions to take part in clinical research...

..We discuss holistic measures, involving both information technology and people, taken to improve the security and privacy of data storage...

..2 with at least 90% power for an event rate of 5%. An example of a possible pharmacy-based randomized study design to demonstrate safety equivalence of OTC analgesics is given...

..We examined the effectiveness of statins on total cholesterol (TC), cardiovascular (CV) morbidity, and mortality in patients with OA or RA...

..For patients on T(4) replacement, the dose is guided by serum TSH concentrations, but some patients request higher doses due to adverse symptoms...

..The epidemiology of liver disease in Tayside (ELDIT) is a specially built register of liver disease for a well-defined geographical area of Scotland...

..The aim of the study was to explore the long-term effect of allopurinol on mortality and cardiovascular hospitalisations in heart failure (HF) patients...

..We draw upon the work of the Medicines Monitoring Unit (MEMO), University of Dundee, to illustrate its contribution to prescribing research...

..The midyear point prevalence of all-cause hypothyroidism rose from 2.2% in 1993 to 3.0% in 1996.The level of thyroid dysfunction in Tayside, Scotland is higher than previously reported, and it increased from 1993 to 1996...

..The exercise BP should perhaps be normalised in hypertension management to optimise regression of LV hypertrophy...

..The patients in this group have adverse cardiovascular risk profiles. Obesity was a common co-morbidity which may impair detailed 2-D echocardiographic assessment...

..The use of information technologies improves patient involvement in research as well as dramatically limiting the cost of the study. •?The online methodology facilitates rapid surveillance in response to urgent safety issues...

..We aimed to increase the number of stroke-type-specific diagnoses by augmenting SMR01 with data derived from CRIS reports and to assess the accuracy of this methodology...

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..This study supports the notion that there is a genetic component that regulates aldosterone production and that hyperaldosteronism might develop over time in susceptible individuals...

..56 (CI, 2.18 to 2.99). LIMITATIONS: Because the data were observational, residual confounding cannot be excluded. CONCLUSION: Treatment with high-dose glucocorticoids seemed to be associated with increased risk for cardiovascular disease...

..This highlights the need to resolve co-existing vascular risk factors in patients with hypertension...

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..Serum vitamin D and vitamin E concentrations were also measured but did not show any significant correlations with lung function...

..It also highlights the variability in risk and the impact of newer drugs. Risk stratification and the subsequent guided use of NSAIDs is likely to limit the pharmacoeconomic implications...

..start of QRS to peak of T wave) is easier to measure. Therefore, we tested the hypothesis that long QT peak was associated with left ventricular hypertrophy and assessed its cost-effectiveness at diagnosing left ventricular hypertrophy...

..However, there was increased risk of cardiovascular morbidity in patients with treated primary hypothyroidism and dysrhythmias in treated hyperthyroidism...

..Coeliac disease is more prevalent than was previously thought. The association between coeliac disease and cardiovascular outcome is not clear...

..CONCLUSION: In this study a rise in HDL independently predicted reduced cardiovascular risk in patients taking lipid lowering treatment who had not been hospitalised previously for cardiovascular disease...

..It has been suggested that the introduction and use of acid suppression therapy may be a factor in the rising incidences of Barrett's oesophagus and oesophageal adenocarcinoma...

..A recent study from Tayside found a reduced risk of all-cause mortality with vaccination in patients with COPD. The Health Improvement Network (THIN) database was used to test this hypothesis in a different data source...

..8%) patients on valsartan and in 586 (11.8%) on amlodipine (OR 0.82, 95% CI 0.72-0.93, P = 0.0015). CONCLUSION: Compared with amlodipine, valsartan reduces the risk of developing diabetes mellitus in high-risk hypertensive patients...