Thaysenwiberg3636

No significant difference in risks of stroke or TIMI non-CABG major bleeding (HR 1.24; 95% CI 0.90-1.73; P = .191; I2 = 0%) was observed between potent oral P2Y12 inhibitors and clopidogrel. CONCLUSION Potent oral P2Y12 inhibitors, especially ticagrelor, decrease the risk of ischemic events in MMACS patients as compared with clopidogrel, without significantly increasing major bleeding.Genetic factors play an important role in determining the susceptibility to ischemic stroke. Herein, we examined the association of an aldehyde dehydrogenase 2 (ALDH2) gene polymorphism with cerebral infarction. Patients with cerebral infarction (n = 963) and healthy controls (n = 921) were included. Genotyping was performed using gene chip platform analysis, and Sanger sequencing was used to confirm ALDH2 genotypes. The risk prediction of ALDH2 polymorphisms for cerebral infarction was examined under three genetic modes of inheritance. For males, ALDH2*2/*2 genotype was a significant risk factor for cerebral infarction in the co-dominant model (age-, smoking-, and drinking-adjusted OR 1.514, 95% CI 1.005-2.282, p = 0.047) and the recessive model (age-, smoking-, and drinking-adjusted OR 1.601, 95% CI 1.078-2.379, p = 0.020). However, for females, ALDH2*2/*2 genotype was a protective factor for cerebral infarction in the co-dominant model (age-, smoking-, and drinking-adjusted OR 0.450 95% CI 0.215-0.941, p = 0.034) and the recessive model (age-, smoking-, and drinking-adjusted OR 0.440, 95% CI 0.214-0.903, p = 0.025). Further, logistic regression analysis revealed that age, smoking, hypertension, hyperlipidemia, and hypercholesterolemia were significant risks for the presence of cerebral infarction. In conclusion, these findings support an association of ALDH2 gene polymorphisms with ischemic stroke in a Chinese Hakka population. In particular, homozygote ALDH2*2/*2 may be a risk factor for cerebral infarction in males, but contribute to reduced risk for cerebral infarction in females.Background Community pharmacists are increasingly recognized to have an important role in providing a convenient and accessible alternative support for patients with minor ailments. In view of the abilities of community pharmacists in managing minor ailments, some countries have started the pharmacy-based minor ailment schemes that offers public access to treatment and advice of minor ailments from their local pharmacist. Nevertheless, there is limited study in Malaysia that explore the current practice of community pharmacists in managing minor ailment. Objective This study aims to evaluate community pharmacists' perceptions, attitudes and barriers of pharmacist-led minor ailment services. Setting Community pharmacists in Malaysia. Methods A cross-sectional survey among community pharmacists practicing in Malaysia was conducted between December 2017 until March 2018. The self-administered survey was distributed online via email, Facebook and WhatsApp's group. Main outcome measure Community pharmacists' perceptions, attitude and barriers towards minor-ailment service in community pharmacy settings. Results A total of 305 community pharmacists had completed the survey. The majority of community pharmacists in Malaysia had positive perceptions and attitudes towards pharmacist-led minor ailment services. Ruboxistaurin molecular weight The most common perceived barriers were lack of patient's medical information, absence of dispensing separation and lack of support from other healthcare professionals. Ethnicity, position and years of working experience were found to have significant associations with community pharmacists' score of attitudes and barriers related to minor ailment treatment in community pharmacy settings. Conclusion Community pharmacists in Malaysia have positive perceptions and attitudes over benefits of minor ailment services to public, however the barriers towards the service must be overcome to ensure service is sustainable for public's benefits.Background Conventional therapy of inflammatory bowel disease with traditional immunosuppressant medication is increasingly being replaced by biological agents. However, the response to these biological agents may be lost over time, with discontinuation being a marker of loss of effectiveness. There are few published reports on the treatment drug survival of infliximab and adalimumab in patients with inflammatory bowel disease. Objective This study compared the drug survival of infliximab versus adalimumab as first- and second-line treatments, identified factors associated with drug survival, and described reasons for treatment withdrawal. Setting A pharmacy department of a university hospital in Spain. Method A retrospective single-centre cohort study of all patients with inflammatory bowel disease treated with biological agents between 2008 and 2017 at a regional referral hospital. The primary outcome was drug survival and associated factors during a follow-up of 52 months. Main outcome measure Drug surviva) and second-line treatment (HR 0.26; 95% CI 0.10-0.65). Secondary failure to treatment was the most frequent reason for withdrawal. Conclusion Infliximab and adalimumab showed similar drug survival as first- and second-line anti-tumour necrosis factor treatments. Therapeutic drug monitoring was associated with higher drug survival for both first- and second-line anti-tumour necrosis factor treatments.Participation in social behaviors that enhance group-level fitness may be influenced by mutations that affect patterns of social epistasis in human populations. Mutations that cause individuals to not participate in these behaviors may weaken the ability of members of a group to coordinate and regulate behavior, which may in turn negatively affect fitness. To investigate the possibility that de novo mutations degrade these adaptive social behaviors, we examine the effect of paternal age (as a well-established proxy for de novo mutation load) on one such social behavior, namely religious observance, since religiosity may be a group-level cultural adaptation facilitating enhanced social coordination. Using two large samples (Wisconsin Longitudinal Study and AddHealth), each of a different US birth cohort, paternal age was used to hierarchically predict respondent's level of church attendance after controlling for multiple covariates. The effect is absent in WLS (β = .007, ns, N = 4560); however, it is present in AddHealth (β = - .