Search

Byline: Miguel A. Hernan (1), Giancarlo Logroscino (2), Luis A. Garcia Rodriguez (3) Keywords: alcoholism; Parkinson's disease; prospective studies Abstract: Abstract. The lower incidence of Parkinson's disease (PD) among smokers may be explained by a protective effect of cigarette smoke, or by a tendency to avoid addictive behaviors among future PD cases. We conducted an indirect test of the latter hypothesis by comparing the incidence of PD between alcoholics and nonalcoholics in the General Practice Research Database of the United Kingdom. Our case-control study included 1,019 cases and 10,123 matched controls. Overall, we did not find a lower incidence of PD among alcoholics compared with nonalcoholics (odds ratio: 1.09 95 % CI: 0.67, 1.78). Author Affiliation: (1) Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA (2) Department of Epidemiology, Harvard School of Public Health, Boston (MA), USA (3) Centro Espanol de Investigacion, Farmacoepidemiologica, Madrid, Spain Article History: Registration Date: 01/01/2004

Reviews evidence to the validity of the United Kingdom General Practice Research Database (GPRD), an office-based, computer-generated, medical resource designed from its inception to be used for epidemiological research. Protocol provided for medical practices participating in data collection; Intention in creating the computer-based data; Evaluation of data quality in medicine.

Presents letters to the editors related to pharmacokinetics. Treatment of ventricular arrhythmias with nonsedating antihistamines; Implication of the risk factors of terfenadine for ventricular arrhythmia; Binding effects of propofol on the blood components.

Presents information on a study which examined the association between selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding. Methodology of the study; Results and discussion on the study; Conclusions.

Examines the role of non-steroidal anti-inflammatory drugs in acute liver injury in Saskatchewan. Increase in serum liver activity to mild reversible hepatitis; Evaluation of the clinical features and incidence of acute infectious liver injury; Enumeration of symptoms associated with the disease.

Introduction: Vitamin K antagonists (VKA) are the standard of care for stroke prevention in non-valvular atrial fibrillation (SPAF), venous thromboembolism treatment (VTE-T) and VTE prevention after knee/hip replacement surgery. Rivaroxaban, a direct factor Xa inhibitor, is also approved for these indications. As many patients requiring anticoagulants have cardiovascular comorbidities, medication use at anticoagulant initiation is of interest. Methods: Data from the Health Improvement Network (UK), the PHARMO Database Network (Netherlands), the German Pharmacoepidemiological Research Database and the Swedish National public Health Registers were used in a post-authorization study program to characterize anticoagulant-naive rivaroxaban and VKA users aged ≥2 years and to assess drug utilization patterns. Results: Overall, 136,927 rivaroxaban and 248,694 VKA new users were anticoagulant-naïve. Across the databases, median age ranged from 69-72 years for rivaroxaban and 72-73 years for VKA users; 46-56% and 53-56%, respectively, were male. The most common indication for rivaroxaban use in all countries was SPAF (31-53%). Overall, SPAF patients had high cardiovascular risk (mean modified CHA2DS2VASc score: 2.9-3.9 for rivaroxaban, 3.2-4.0 for VKA). The most frequent comorbidities were hypertension, coronary artery disease and vascular disease. Beta blockers, aspirin and statins were the most common drugs used in the pre-index year (Table), likely reflecting patients' high cardiovascular risk profile. For VTE-T, higher use of low-molecular-weight heparin in VKA (24-70%) than rivaroxaban (15-22%) users may reflect use of heparin as a bridging therapy due to VKA's slow onset of action; this is not needed for rivaroxaban. Conclusions: Patients starting anticoagulation are often on several medications; this may reflect their high cardiovascular risk profile and the need for bridging therapies with heparin in VKA users following surgery. [ABSTRACT FROM AUTHOR]