Abstract:
OBJECTIVE:To determine whether diurnal variation occurs in the onset of stroke. DESIGN:Community based study over four years. SETTING:Oxfordshire, United Kingdom. SUBJECTS:105,000 people, of whom 675 had a first ever stroke. 545 had a cerebral infarction, 66 had primary intracerebral haemorrhage, 33 had subarachnoid haemorrhage, and in 31 the type of stroke was not known. MAIN OUTCOME MEASURES:Time of stroke and degree of activity at onset. RESULTS:In the 578 patients for whom it was known whether onset occurred while asleep or awake, the proportion with onset during sleep was 25% (135/545) for cerebral infarction, 17% (11/66) for primary intracerebral haemorrhage, and 0% (0/33) for subarachnoid haemorrhage. This difference persisted if patients in whom it was not known whether they were asleep or awake at onset were classed as asleep. For all stroke types together there was a significant (chi 2 = 218.7, p less than 0.001) diurnal variation with a morning peak between 0800 and 1000, which persisted even after allowing for strokes first noted on waking by redistributing the hour of onset through the preceding eight hours (chi 2 = 47, p less than 0.001). A significant diurnal variation was also found in the onset of cerebral infarction (peak 0800-1000, chi 2 = 208.4, p less than 0.001). Fewer patients had other forms of stroke and the diurnal variations for primary intracerebral haemorrhage (peak 1000-1200) and subarachnoid haemorrhage (peaks 0800-1000 and 1800-2000) were not significant. There seemed to be a second smaller peak for all types of stroke. CONCLUSIONS:All types of stroke are most likely to occur after waking in the morning. The cause of the circadian variation requires further study.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Wroe SJ,Sandercock P,Bamford J,Dennis M,Slattery J,Warlow Cdoi
10.1136/bmj.304.6820.155subject
Has Abstractpub_date
1992-01-18 00:00:00pages
155-7issue
6820eissn
0959-8138issn
1756-1833journal_volume
304pub_type
杂志文章abstract:OBJECTIVE:To analyse the risk of second primary cancers during long term follow up of patients with Hodgkin's disease. DESIGN:Cohort study. SETTING:The British National Lymphoma Investigation (a collaborative group of over 60 participating centres in Britain treating lymphomas). PATIENTS:2846 patients first treated ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6835.1137
更新日期:1992-05-02 00:00:00
abstract:OBJECTIVES:To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design T...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c1594
更新日期:2010-04-20 00:00:00
abstract:OBJECTIVE:To investigate the association between long term intake of dietary and supplemental calcium and death from all causes and cardiovascular disease. DESIGN:Prospective longitudinal cohort study. SETTING:Swedish mammography cohort, a population based cohort established in 1987-90. PARTICIPANTS:61 433 women (bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f228
更新日期:2013-02-12 00:00:00
abstract:OBJECTIVES:To understand the approaches to learning of practising physicians in their workplace and to assess the relation of these approaches to their motivation for, preferred methods of, and perceived barriers to continuing medical education. DESIGN:Postal survey of 800 Ontario physicians. PARTICIPANTS:373 physici...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7374.1218
更新日期:2002-11-23 00:00:00
abstract::Elderly and disabled people have been led to expect great improvements in the quality of community care after April 1993. The choice to live safely at home is to be offered as an alternative to residential care. The financial and organisational relationships are all intended to support this in practice. The Tomlinson ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6866.1418
更新日期:1992-12-05 00:00:00
abstract::Objectives To estimate the short term effect of particulate air pollution (particle diameter <10 μm, or PM10) on mortality and explore the heterogeneity of particulate air pollution effects in major cities in China.Design Generalised linear models with different lag structures using time series data.Setting 38 of the ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j667
更新日期:2017-03-14 00:00:00
abstract::Ruben Meerman and Andrew Brown explain why the answer might not be what you expect. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7257
更新日期:2014-12-16 00:00:00
abstract:UNLABELLED:OBJECTIVE-To assess the risk of cardiorespiratory symptoms and mortality in non-smokers who were passively exposed to environmental smoke. DESIGN:Prospective study of cohort from general population first screened between 1972 and 1976 and followed up for an average of 11.5 years, with linkage of data from p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6696.423
更新日期:1989-08-12 00:00:00
abstract:OBJECTIVES:To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation. DESIGN:Meta-analysis and systematic review of prospective cohort studies. DATA SOURCES:PubMed and Embase up to December 20...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f3706
更新日期:2013-06-27 00:00:00
abstract:OBJECTIVE:To assess adjustment practices for primary outcomes of randomized controlled trials and their impact on the results. DESIGN:Meta-epidemiologic study. DATA SOURCES:25 biomedical journals with the highest impact factor according to Journal Citation Reports 2009. STUDY SELECTION:Randomized controlled trials p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f4313
更新日期:2013-07-12 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVE:To determine whether inhaled salmeterol, a new long acting inhaled beta adrenergic agonist, reduces nocturnal bronchoconstriction and improves sleep quality in patients with nocturnal asthma. DESIGN:Randomised, double blind, placebo controlled crossover study. SETTING:Hospital outpatient clinics in Edinburg...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.301.6765.1365
更新日期:1990-12-15 00:00:00
abstract:OBJECTIVES:To develop a systematic method for both summative and formative audit of practice audits, and to use the method to review Oxfordshire practice audits and to plan improvement. DESIGN:Development of a coding system for the audit cycle subsequently used prospectively to assess audits reported to medical audit ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.303.6812.1247
更新日期:1991-11-16 00:00:00
abstract:OBJECTIVES:To assess whether and how investigators of placebo controlled randomised trials inform participants of their treatment allocation at trial closure and to assess barriers to feedback. DESIGN:Postal survey with a semistructured questionnaire. PARTICIPANTS:All investigators who published a placebo controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7376.1329
更新日期:2002-12-07 00:00:00
abstract::The first call for applications to the NHS research and development programme on the interface between primary and secondary care was advertised in February 1994. A total of 674 outline proposals were submitted and 54 (8%) secured funding. Projects have been commissioned in 16 of the 21 priority areas and around 6m po...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7012.1080
更新日期:1995-10-21 00:00:00
abstract:OBJECTIVE:To compare the functional results after displaced fractures of the femoral neck treated with internal fixation or hemiarthroplasty. DESIGN:Randomised trial with blinding of assessments of functional results. SETTING:University hospital. PARTICIPANTS:222 patients; 165 (74%) women, mean age 83 years. Inclusi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39399.456551.25
更新日期:2007-12-15 00:00:00
abstract:OBJECTIVE:To study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus. DESIGN:Population based study of diabetic twins. SETTING:Danish population. SUBJECTS:18 monozygotic and 36 dizygotic twin pairs with one or both pa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7094.1575
更新日期:1997-05-31 00:00:00
abstract:OBJECTIVE:To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer. DESIGN:Randomised controlled trial. SETTING:Areas in New South Wales, Australia identified as socioeconomically disadvantaged (lo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5370
更新日期:2010-10-26 00:00:00
abstract:OBJECTIVES:To investigate current practice of screening children from abroad for infections after coming to the United Kingdom, and to make recommendations for future practice. DESIGN:A review of literature and a questionnaire sent to all health authorities and boards in the United Kingdom. SETTING:All health authori...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6755.800
更新日期:1990-10-06 00:00:00
abstract:OBJECTIVES:To quantify the relative contribution of premorbid and episode specific factors in determining the long term persistence of disabling symptoms of low back pain. DESIGN:Prospective cohort study. SETTING:Two general practices in the south Manchester area. PARTICIPANTS:180 patients, who previously participat...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.318.7199.1662
更新日期:1999-06-19 00:00:00
abstract:OBJECTIVE:To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN:Population based cohort study using within person analyses to control for confounding by indication. SETTING:Whole population of Sweden. PARTICIPANTS:7,917,436 people aged 15 and over, of whom 69,757 were t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h2388
更新日期:2015-06-02 00:00:00
abstract:OBJECTIVE:To determine whether use of tinzaparin, a low molecular weight heparin introduced for prophylactic management of deep vein thrombosis, increases the risk of serious postoperative bleeding leading to a higher than expected 28 day readmission rate after discharge for hysterectomy. DESIGN:Retrospective case-con...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38783.624444.55
更新日期:2006-04-08 00:00:00
abstract:OBJECTIVE:To describe the clinical circumstances in which psychiatric patients commit suicide. DESIGN:National clinical survey. SETTING:England and Wales. SUBJECTS:A two year sample of people who had committed suicide, in particular those who had been in contact with mental health services in the 12 months before de...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7193.1235
更新日期:1999-05-08 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy. DESIGN:Randomised controlled trial. SETTING:Neurology outpatient clinics in three Dutch hospitals. PARTICIPANTS:205 patients with symptoms and signs of cervica...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b3883
更新日期:2009-10-07 00:00:00
abstract:OBJECTIVE:To compare neonatal mortality and morbidity in term infants presenting by the breech and delivered vaginally or by caesarean section. DESIGN:Population based comparison of outcomes. Data derived from the St Mary's maternity information system. SETTING:North West Thames Regional Health Authority, 1988-90. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6856.746
更新日期:1992-09-26 00:00:00
abstract:OBJECTIVE:To evaluate participants' perceptions of the impact on them of an additional six months' training beyond the standard 12 month general practice vocational training scheme. DESIGN:Qualitative study using focus groups. SETTING:General practice vocational training in Northern Ireland. PARTICIPANTS:13 general ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7421.971
更新日期:2003-10-25 00:00:00
abstract::In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, prete...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g4929
更新日期:2014-10-06 00:00:00
abstract:OBJECTIVE:To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. DESIGN:Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7097.1791
更新日期:1997-06-21 00:00:00
abstract:OBJECTIVE:To assess the accuracy of the AbC-19 Rapid Test lateral flow immunoassay for the detection of previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Test accuracy study. SETTING:Laboratory based evaluation. PARTICIPANTS:2847 key workers (healthcare staff, fire and rescue of...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m4262
更新日期:2020-11-11 00:00:00
abstract:OBJECTIVES:To investigate the association between environmental tobacco smoke, plasma cotinine concentration, and respiratory cancer or death. DESIGN:Nested case-control study within the European prospective investigation into cancer and nutrition (EPIC). PARTICIPANTS:303,020 people from the EPIC cohort (total 500,00...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38327.648472.82
更新日期:2005-02-05 00:00:00