1.Sleep Position and Infant Care Practices in an Urban Community in Kuala Lumpur
R J Raja Lope ; W K Kong ; V W M Lee ; W T Tiew ; S Y Wong
The Medical Journal of Malaysia 2010;65(1):45-48
Several modifiable risk factors for sudden infant death
syndrome (SIDS) have been identified such as sleeping prone
or on the side, sleeping on a soft surface, bed-sharing, no
prenatal care and maternal ante-natal smoking. A crosssectional survey of infant sleep and care practices was conducted among parents of babies aged below 8 months to determine the prevalence and predictors of non-supine sleep position and the prevalence of other high-risk infant care practices for SIDS. Of 263 infants, 24.7% were placed to sleep in the non-supine position and age of infants was a factor positively associated with this (adjusted odds ratio 1.275, 95% CI=1.085, 1.499). The most common modifiable risk factor was the presence of soft toys or bedding in the infants’ bed or cot (89.4%). Results from this study indicate that although the predominant sleep position of Malaysian
infants in this population is supine, the majority of infants were exposed to other care practices which have been shown to be associated with SIDS.
2.Incidental Statin Use and the Risk of Stroke or Transient Ischemic Attack after Radiotherapy for Head and Neck Cancer
Daniel ADDISON ; Patrick R LAWLER ; Hamed EMAMI ; Sumbal A JANJUA ; Pedro V STAZIAKI ; Travis R HALLETT ; Orla HENNESSY ; Hang LEE ; Bálint SZILVESZTER ; Michael LU ; Negar MOUSAVI ; Matthew G NAYOR ; Francesca N DELLING ; Javier M ROMERO ; Lori J WIRTH ; Annie W CHAN ; Udo HOFFMANN ; Tomas G NEILAN
Journal of Stroke 2018;20(1):71-79
BACKGROUND AND PURPOSE: Interventions to reduce the risk for cerebrovascular events (CVE; stroke and transient ischemic attack [TIA]) after radiotherapy (RT) for head and neck cancer (HNCA) are needed. Among broad populations, statins reduce CVEs; however, whether statins reduce CVEs after RT for HNCA is unclear. Therefore, we aimed to test whether incidental statin use at the time of RT is associated with a lower rate of CVEs after RT for HNCA. METHODS: From an institutional database we identified all consecutive subjects treated with neck RT from 2002 to 2012 for HNCA. Data collection and event adjudication was performed by blinded teams. The primary outcome was a composite of ischemic stroke and TIA. The secondary outcome was ischemic stroke. The association between statin use and events was determined using Cox proportional hazard models after adjustment for traditional and RT-specific risk factors. RESULTS: The final cohort consisted of 1,011 patients (59±13 years, 30% female, 44% hypertension) with 288 (28%) on statins. Over a median follow-up of 3.4 years (interquartile range, 0.1 to 14) there were 102 CVEs (89 ischemic strokes and 13 TIAs) with 17 in statin users versus 85 in nonstatins users. In a multivariable model containing known predictors of CVE, statins were associated with a reduction in the combination of stroke and TIA (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.2 to 0.8; P=0.01) and ischemic stroke alone (HR, 0.4; 95% CI, 0.2 to 0.8; P=0.01). CONCLUSIONS: Incidental statin use at the time of RT for HNCA is associated with a lower risk of stroke or TIA.
Cohort Studies
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Data Collection
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Female
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Follow-Up Studies
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Head and Neck Neoplasms
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Head
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Ischemic Attack, Transient
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Neck
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Proportional Hazards Models
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Radiotherapy
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Risk Factors
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Stroke