Clinical Trial Service Unit

About: Clinical Trial Service Unit is a based out in . It is known for research contribution in the topics: Population & Stroke. The organization has 428 authors who have published 1387 publications receiving 181920 citations.

Smoking and dementia in male British doctors: prospective study.

Abstract: Objective To assess the possible association between smoking and dementia. Design Prospective study. Setting Cohort of British male doctors followed up since 1951. Subjects 34 439 male British doctors, with 24 133 deaths recorded. Results For all types of dementia combined the relative risk was 0.96 (95% confidence interval 0.78 to 1.18), based on 473 deaths at a mean age of 81 years. For probable or definite Alzheimer's disease, the relative risk in continuing smokers was 0.99 (0.78 to 1.25), based on 370 deaths at a mean age of 82 years. In aggregate, however, the other prospective studies indicate a direct, although not clearly significant, association between smoking and the onset of dementia in general and of Alzheimer's disease in particular. Conclusions Contrary to previous suggestions persistent smoking does not substantially reduce the age specific onset rate of Alzheimer's disease or of dementia in general. If anything, it might increase rather than decrease the rate, but any net effect on severe dementia cannot be large in either direction.

Body mass index and mortality in China: a 15-year prospective study of 220 000 men

Abstract: (HRs) and 95% confidence intervals (95% CIs) per 5 kg/m 2 calculated within either a lower (15 to <23.5 kg/m 2 ) or higher (23.5 to <35 kg/m 2 ) range. Results The association between BMI and all-cause mortality was U-shaped with the lowest mortality at � 22.5–25 kg/m 2 . In the lower range, 5 kg/m 2 higher BMI was associated with 14% lower mortality (HR 0.86, 95% CI 0.82–0.91); in the upper range, it was associated with 27% higher mortality (HR 1.27, 95% CI 1.15–1.40). The absolute excess mortality in the lower range was largely accounted for by excess mortality from specific smoking-related diseases: 54% by that for COPD, 12% other respiratory disease, 13% lung cancer, 11% stomach cancer. The excess mortality in the upper BMI range was largely accounted for by excess mortality from specific vascular diseases: 55% by that for stroke, 16% CHD. In this range, 5 kg/m 2 higher BMI was associated with � 50% higher mortality from stroke (HR 1.61, 95% CI 1.36–1.92) and CHD (HR 1.48, 95% CI 1.12–1.95). Conclusions For China, previous evidence may have overestimated the excess mortality at low BMI but underestimated that at high BMI. The main way obesity kills in China appears to be stroke.

Cancer incidence and mortality: A cohort study in China, 2008–2013

Abstract: The National Central Cancer Registry of China (NCCR) was the only available source of cancer monitoring in China, even though only about 70% of cancer registration sites were qualified by now. In this study, based on a national large prospective cohort-the China Kadoorie Biobank (CKB), we aimed to provide additional cancer statistics and compare the difference of cancer burden between urban and rural areas of China. A total of 497,693 cancer-free participants aged 35-74 years were recruited and successfully followed up from 2004 to 2013 in 5 urban and 5 rural areas across China. Except for traditional registration systems, the national health insurance system and active follow-up were used to determine new cancer incidents and related deaths. The mortality-to-incidence ratio (MIR) was used to compare the differences of cancer burden between urban and rural areas of China. We found that cancer mortality coincided well between our cohort and NCCR, while the incidence was much higher in our cohort. Based on CKB, we found the MIR of all cancers was 0.54 in rural areas, which was approximately one-third higher than that in urban areas with 0.39. Cancer profiles in urban areas were transiting to Western distributions, which were characterized with high incidences of breast cancer and colorectal cancer; while cancers of the esophagus, liver and cervix uteri were still common in rural areas of China. Our results provide additional cancer statistics of China and demonstrate the differences of cancer burden between urban and rural areas of China.

Outcome for children with relapsed acute myeloid leukaemia following initial therapy in the Medical Research Council (MRC) AML 10 trial. MRC Childhood Leukaemia Working Party.

Abstract: Between May 1988 and March 1995, 359 children with acute myeloid leukaemia (AML) were treated in the MRC AML 10 trial. Three risk groups were identified based on cytogenetics and response to treatment. One hundred and twenty-five children relapsed--103 in the bone marrow only, 12 in the bone marrow combined with other sites, and six had isolated extramedullary relapses (site was not known in four cases). Eighty-seven children received further combination chemotherapy, one all-trans retinoic acid for acute promyelocytic leukaemia, and one a matched unrelated donor allograft in relapse, and 61 achieved a second remission. One patient with no details on reinduction therapy also achieved second remission. Treatment in second remission varied--44 children received a BMT (22 autografts, 12 matched unrelated donor allografts, 10 family donor allografts), and 17 were treated with chemotherapy alone. The overall survival rate for all children (treated and untreated) was 24% at 3 years, with a disease-free survival of 44% for those achieving a second remission. Length of first remission was the most important factor affecting response rates--children with a first remission of less than 1 year fared poorly (second remission rate 36%, 3 year survival 11%), whereas those with longer first remissions had a higher response rate (second remission rate 75%, 3 year survival 49%, P < 0.0001).