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Institution

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.


Papers
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Journal ArticleDOI
01 Feb 2008-Leukemia
TL;DR: Statistically significant risk factors for the development of AVN were age and treatment with chemotherapy, and patients receiving prolonged chemotherapy without stem cell transplant were at significantly greater risk of developing AVN.
Abstract: Avascular necrosis (AVN) is a serious complication of acute lymphoblastic leukaemia (ALL) therapy. Little is known of the scope and magnitude of this problem among adults with ALL. We analysed the incidence and risk factors for AVN in 1053 patients on the UKALLXII/ECOG2993 study. AVN affected 99 joints in 42 patients at a median of 2.2 years post-diagnosis, giving a crude incidence rate of 4.0%. Statistically significant risk factors for the development of AVN were age and treatment with chemotherapy. Patients receiving prolonged chemotherapy without stem cell transplant were at significantly greater risk of developing AVN than stem cell transplant recipients (P 20 years old; P=0.0004; odds ratio 0.28 (95% CI=0.14-0.56).

88 citations

Journal ArticleDOI
TL;DR: Investigation of the association between diet and kidney stone risk in a population with a wide range of diets found vegetarians have a lower risk of developing kidney stones compared with those who eat a high meat diet.
Abstract: The lifetime prevalence of kidney stones is around 10 % and incidence rates are increasing. Diet may be an important determinant of kidney stone development. Our objective was to investigate the association between diet and kidney stone risk in a population with a wide range of diets. This association was examined among 51,336 participants in the Oxford arm of the European Prospective Investigation into Cancer and Nutrition using data from Hospital Episode Statistics in England and Scottish Morbidity Records. In the cohort, 303 participants attended hospital with a new kidney stone episode. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and their 95 % confidence intervals (95 % CI). Compared to those with high intake of meat ((100 g/day), the HR estimates for moderate meat-eaters (50-99 g/day), low meat-eaters (\50 g/day), fish-eaters and vegetarians were 0.80 (95 % CI 0.57-1.11), 0.52 (95 % CI 0.35-0.8), 0.73 (95 % CI 0.48-1.11) and 0.69 (95 % CI 0.48-0.98), respectively. High intakes of fresh fruit, fibre from wholegrain cereals and magnesium were also associated with a lower risk of kidney stone formation. A high intake of zinc was associated with a higher risk. In conclusion, vegetarians have a lower risk of developing kidney stones compared with those who eat a high meat diet. This information may be important to advise the public about prevention of kidney stone formation.

87 citations

Journal ArticleDOI
TL;DR: The results are in line with the concept that HPV‐specific immunity protects against SCC and support primary prevention of SCC by vaccination against the HPVs.
Abstract: Human papillomavirus (HPV) types 16 and 18 are the major risk factors for cervical carcinoma, whereas HPV types 6 and 11 cause benign genital lesions. We wanted to study the joint effect of simultaneous infections with the oncogenic and non-oncogenic HPV types on risk of subsequent development of cervical carcinoma. A cohort of 530,000 women who had donated blood samples to Nordic serum banks between 1973 and 1994 was followed up by linkage to national cancer registries. We identified 182 prospective cases with invasive cervical carcinoma and selected 538 matched controls at random. HPV 6, 11, 16, 18 and 33 seropositivity was used as a marker for the different HPV infections, and seropositivity for Chlamydia trachomatis and cotinine were used as markers for risk-taking sexual behavior and smoking respectively. The adjusted odds ratio (OR) of cervical squamous-cell carcinoma (SCC) was 2.2 for HPV6/11 among HPV16 seronegatives and 5.5 for HPV16 among HPV6/11 seronegatives. Assuming multiplicative joint effect, the expected OR for seropositivity to both HPV6/11 and HPV16 would have been 12, but the observed OR was 1.0. The antagonistic interaction was statistically significant (p = 0.001) and present also under deterministic considerations of possible misclassification bias. Antagonistic interactions were also detected for combinations of HPV16 and HPV18 and of HPV16 and HPV33. The results are in line with the concept that HPV-specific immunity protects against SCC and support primary prevention of SCC by vaccination against the HPVs.

87 citations

Journal ArticleDOI
TL;DR: In this article, a meta-analysis of published results of eight homocysteine-lowering trials for preventing vascular disease was conducted, and the results showed that B vitamins had no statistically significant effect on the risks of cardiovascular events, total mortality rates, or cancer.
Abstract: Moderately elevated homocysteine levels have been associated with a higher risk of cardiovascular disease in observational studies, but whether these associations are causal is uncertain. Randomized trials of dietary supplementation with B vitamins were set up to assess whether lowering homocysteine levels could reduce the risk of vascular disease. This review is based on a meta-analysis of published results of eight homocysteine-lowering trials for preventing vascular disease. The eight trials comprised a total of 37,485 individuals and provided comparisons of the effects of B vitamins on 5,074 coronary heart disease (CHD) events, 1,483 stroke events, 2,692 incident cancer events, and 5,128 deaths. Our meta-analysis assessed the effects of lowering homocysteine levels by about 25% for about 5 years. Allocation to B vitamins had no beneficial effects on any cardiovascular events, with hazard ratios (95% confidence intervals) of 1.01 (0.96–1.07) for CHD and 0.96 (0.87–1.07) for stroke. Moreover, allocation to B vitamins had no significant adverse effects on cancer [1.08 (0.99–1.17)], or for death from any cause [1.02 (0.97–1.07)]. Thus, supplementation with B vitamins had no statistically significant effects on the risks of cardiovascular events, total mortality rates, or cancer. A meta-analysis based on individual participant data from all available trials will assess the effects of lowering homocysteine levels on a broader range of outcomes, overall and in all relevant subgroups. However, available evidence does not support the routine use of B vitamins to prevent cardiovascular disease.

87 citations

Journal ArticleDOI
03 Nov 2021-BMJ
TL;DR: In this paper, the authors estimate the changes in life expectancy and years of life lost in 2020 associated with the seasonal influenza epidemic in 2015, and find that more than 28 million excess life lost more than expected (17.8m to 17.5m) in men and 10.4m to 11.3m in women.
Abstract: Objective To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. Design Time series analysis. Setting 37 upper-middle and high income countries or regions with reliable and complete mortality data. Participants Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. Main outcome measures Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. Results Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: −2.33, 95% confidence interval −2.50 to −2.17; women: −2.14, −2.25 to −2.03), the United States (men: −2.27, −2.39 to −2.15; women: −1.61, −1.70 to −1.51), Bulgaria (men: −1.96, −2.11 to −1.81; women: −1.37, −1.74 to −1.01), Lithuania (men: −1.83, −2.07 to −1.59; women: −1.21, −1.36 to −1.05), Chile (men: −1.64, −1.97 to −1.32; women: −0.88, −1.28 to −0.50), and Spain (men: −1.35, −1.53 to −1.18; women: −1.13, −1.37 to −0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. Conclusion More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.

86 citations


Authors

Showing all 428 results

NameH-indexPapersCitations
Salim Yusuf2311439252912
Richard Peto183683231434
Cornelia M. van Duijn1831030146009
Rory Collins162489193407
Naveed Sattar1551326116368
Timothy J. Key14680890810
John Danesh135394100132
Andrew J.S. Coats12782094490
Valerie Beral11447153729
Mike Clarke1131037164328
Robert Clarke11151290049
Robert U. Newton10975342527
Richard Gray10980878580
Braxton D. Mitchell10255849599
Naomi E. Allen10136437057
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
2021136
2020116
2019122
201894
2017106
201688