BMJ : British medical journal
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To test the hypothesis that non-diabetic dizygotic and monozygotic twin siblings of patients with type 1 diabetes have a similar high prevalence of islet cell autoantibodies, thus suggesting that islet cell autoimmunity is mainly environmentally determined. ⋯ Monozygotic and dizygotic twins differ in progression to diabetes and expression of islet cell autoantibodies. Dizygotic twin siblings are similar to non-twin siblings. These two observations suggest that genetic factors play an important part in determination of islet cell autoimmunity, thus rejecting the hypothesis. In addition, there is a high penetrance of islet cell autoimmunity in DQ8/DQ2 monozygotic twin siblings.
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Comment Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial.
To assess the effects of rivastigmine on the core domains of Alzheimer's disease. ⋯ Rivastigmine is well tolerated and effective. It improves cognition, participation in activities of daily living, and global evaluation ratings in patients with mild to moderately severe Alzheimer's disease. This is the first treatment to show compelling evidence of efficacy in a predominantly European population.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Migraine and stroke in young women: case-control study. The World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception.
To investigate the association between migraine and ischaemic or haemorrhagic stroke in young women. ⋯ Migraine in women of childbearing age significantly increases the risk of ischaemic but not haemorrhagic stroke. The coexistence of oral contraceptive use, high blood pressure, or smoking seems to exert a greater than multiplicative effect on the risk of ischaemic stroke associated with migraine.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Economic evaluation and randomised controlled trial of extracorporeal membrane oxygenation: UK collaborative trial. The Extracorporeal Membrane Oxygenation Economics Working Group.
To compare the resource implications and short term outcomes of extracorporeal membrane oxygenation and conventional management for term babies with severe respiratory failure. ⋯ Extracorporeal membrane oxygenation for term neonates with severe respiratory failure would increase overall survival without disability. Although the policy will increase costs of neonatal health care, it is likely to be as cost effective as other life extending technologies.
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Multicenter Study
Fatality outside hospital from acute coronary events in three British health districts, 1994-5. United Kingdom Heart Attack Study Collaborative Group.
To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. ⋯ Opportunities for reducing fatality from acute coronary attacks lie mainly outside hospital. These results and others imply that survival from cardiac arrest outside hospital might be trebled by improved ambulance and patient response. Proper application of secondary preventive measures for patients with coronary disease could have an even larger impact.