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Search Results: 1 - 10 of 113530 matches for " John W Eikelboom "
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Management of peripheral arterial disease in the elderly: focus on cilostazol
Travis M Falconer,John W Eikelboom,Graeme J Hankey,Paul E Norman
Clinical Interventions in Aging , 2008,
Abstract: Travis M Falconer1, John W Eikelboom2, Graeme J Hankey3, Paul E Norman11School of Surgery, University of Western Australia, Fremantle Hospital, Western Australia; 2Department of Medicine, McMaster University, Hamilton, Canada; 3Department of Neurology, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western AustraliaAbstract: Symptomatic and asymptomatic peripheral arterial disease (PAD) is a common problem in the elderly. The management of PAD includes the prevention of cardiovascular events and relief of symptoms – most commonly intermittent claudication (IC). Both require treatment of the causes and consequences of atherothrombosis, but some strategies are more effective for prevention of cardiovascular events and others are more effective for the relief of symptoms. Priorities for the prevention of cardiovascular events include smoking cessation, exercise, antiplatelet therapy, and the treatment of dyslipidemia, hypertension, and diabetes. Walking time and ability are improved by exercise. The benefit of numerous drugs in the treatment of IC has been assessed. The results have generally been disappointing, but there is some evidence that statins and cilostazol (an inhibitor of phosphodiesterase 3) are of benefit. Meta-analyses suggest that cilostazol increases maximum walking distance by 40%–50% and improves other objective measures of walking. The safety profile of cilostazol in patients with PAD appears to be acceptable although the mechanism for its effect on IC is unclear. In addition to risk factor management, treatment with cilostazol should be considered in patients with disabling IC.Keywords: peripheral arterial disease, intermittent claudication, risk factors, cilostazol
The effect of long-term homocysteine-lowering on carotid intima-media thickness and flow-mediated vasodilation in stroke patients: a randomized controlled trial and meta-analysis
Kathleen Potter, Graeme J Hankey, Daniel J Green, John Eikelboom, Konrad Jamrozik, Leonard F Arnolda
BMC Cardiovascular Disorders , 2008, DOI: 10.1186/1471-2261-8-24
Abstract: We conducted a sub-study of VITATOPS, a randomised, double-blind, placebo-controlled intervention trial designed to test the efficacy of long term B-vitamin supplementation (folic acid 2 mg, vitamin B6 25 mg and vitamin B12 0.5 mg) in the prevention of vascular events in patients with a history of stroke. We measured carotid intima-medial thickness (CIMT) and flow-mediated dilation (FMD) at least two years after randomisation in 162 VITATOPS participants. We also conducted a systematic review and meta-analysis of studies designed to test the effect of B-vitamin treatment on CIMT and FMD.After a mean treatment period of 3.9 ± 0.9 years, the vitamin-treated group had a significantly lower mean plasma homocysteine concentration than the placebo-treated group (7.9 μmol/L, 95% CI 7.5 to 8.4 versus 11.8 μmol/L, 95% CI 10.9 to 12.8, p < 0.001). Post-treatment CIMT (0.84 ± 0.17 mm vitamins versus 0.83 ± 0.18 mm placebo, p = 0.74) and FMD (median of 4.0%, IQR 0.9 to 7.2 vitamins versus 3.0%, IQR 0.6 to 6.6 placebo, p = 0.48) did not differ significantly between groups. A meta-analysis of published randomised data, including those from the current study, suggested that B-vitamin supplements should reduce CIMT (-0.10 mm, 95% CI -0.20 to -0.01 mm) and increase FMD (1.4%, 95% CI 0.7 to 2.1%). However, the improvement in endothelial function associated with homocysteine-lowering treatment was significant in short-term studies but not in longer trials.Although short-term treatment with B-vitamins is associated with increased FMD, long-term homocysteine-lowering did not significantly improve FMD or CIMT in people with a history of stroke.Clinical Trial Registration URL: http://www.actr.org.au/ webciteTrial Registration number: 12605000005651An elevated plasma homocysteine concentration (tHcy) is associated an increased risk of myocardial infarction and stroke [1-4]. It remains unclear, however, whether tHcy is a modifiable causal risk factor for vascular disease or simply a marker
Systematic Review of Observational Studies Assessing Bleeding Risk in Patients with Atrial Fibrillation Not Using Anticoagulants
Luciane Cruz Lopes, Frederick A. Spencer, Ignacio Neumann, Matthew Ventresca, Shanil Ebrahim, Qi Zhou, Neera Bhatnagar, Sam Schulman, John Eikelboom, Gordon Guyatt
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0088131
Abstract: Background Patients with atrial fibrillation considering use of anticoagulants must balance stroke reduction against bleeding risk. Knowledge of bleeding risk without the use of anticoagulants may help inform this decision. Purpose To determine the rate of major bleeding reported in observational studies of atrial fibrillation patients not receiving Vitamin K antagonists (VKA). Data Sources We searched MEDLINE, EMBASE and CINAHL to October 2011 and examined reference lists of eligible studies and related reviews. Study Selection All longitudinal cohort studies that included over 100 adult patients with atrial fibrillation not receiving VKA. Data Extraction Teams of two reviewers independently and in duplicate adjudicated eligibility, assessed risk of bias and abstracted study characteristics and outcomes. Data Synthesis Twenty-one eligible studies included 96,448 patients. Major bleeding rates varied widely, from 0 to 4.69 events per 100 patient-years. The pooled estimate in 13 studies with 78839 patients was 1.59 with a 99% confidence interval of 1.10 to 2.3 and median 1.42 (interquartile range 0.62–2.70). Pooled estimates for fatal bleeding and non-fatal bleeding from 4 studies that reported these outcomes were, respectively, 0.40 (0.34 to 0.46) and 1.18 (0.30 to 4.56) per 100 patient-years. In 9 randomized controlled trials (RCTs) the median rate of major bleeding in patients not receiving either anticoagulant or antiplatelet therapy was 0.6 (interquartile 0.2 to 0.90), and in 12 RCTs the median rate of major bleeding in patients receiving a single antiplatelet agent was 0.75 (interquartile 0.4 to 1.4). Conclusion Results suggest that patients with atrial fibrillation not receiving VKA enrolled in observational studies represent a population on average at higher risk of bleeding.
A Very Solid Fuel: Ferrous Iron Oxide as a Geochemical Energy Source  [PDF]
John W. Halloran
Natural Resources (NR) , 2015, DOI: 10.4236/nr.2015.62010
Abstract: Ferrous iron oxides, present in abundant minerals such as olivines, can be oxidized to ferric iron oxide to produce more energy per unit oxygen than carbon and hydrogen. These “geofuels” are essentially inexhaustible. Energy might be extracted from geofuels by using the ferrous iron oxide to reduce fluids for use in a fuel cell. Water can be reduced by geofuels, producing hydrogen fuel. Ferrous iron oxide containing rocks are abundant, but diluted with inert oxides. Exploiting them requires new technologies to extract the energy and handle the oxidized mineral residues.
Improved Efficiency of Heat Exchange Using KELEA Activated Water  [PDF]
W. John Martin
Open Journal of Energy Efficiency (OJEE) , 2015, DOI: 10.4236/ojee.2015.42004
Abstract: An environmental force termed KELEA (kinetic energy limiting electrostatic attraction) is postulated to reduce the strength of intermolecular (hydrogen) bonding of water molecules, resulting in increased kinetic activity of the water. While regular water does not directly absorb KELEA from the environment, various dipolar compounds with separated electrical charges can seemingly act as a primary antenna for KELEA, with secondary transfer of energy into nearby water. Moreover, once sufficiently activated, the separated electrical charges in activated water can apparently function as a receiver for KELEA, leading to further activation of the water and also to the activation of added water. Prior publications have addressed the agricultural and potential clinical benefits of using KELEA activated water. This article is intended as the first in a series of papers describing useful industrial applications of KELEA activated water. The focus of the present paper is on the improved efficiency of industrial water heating and cooling systems by using KELEA activated water provided by pelleted, ground and heated volcanic rock as supplied by Kiko Technology.
KELEA: A Natural Energy That Seemingly Reduces Intermolecular Hydrogen Bonding in Water and Other Liquids  [PDF]
W. John Martin
Open Journal of Biophysics (OJBIPHY) , 2015, DOI: 10.4236/ojbiphy.2015.53006
Abstract: The alternative cellular energy (ACE) pathway was initially identified as a non-immunological defense mechanism against virus infections. It is particularly relevant to the suppression of stealth adapted viruses, which are not normally recognized by the cellular immune system. Many of the methods able to enhance the ACE pathway are consistent with the transfer of a natural energy to the body’s fluids. Additional support for this premise is provided in this paper. The vapor pressure and rate of evaporation of activated water, ethanol and gasoline increase to beyond atmospheric pressure over time. The term KELEA (kinetic energy limiting electrostatic attraction) is proposed for a natural energy that increases the volatility of fluids, seemingly through the loosening of intermolecular hydrogen bonding. KELEA activated fluids have many potential health, agricultural and industrial applications, as well as providing the opportunity for fundamental research.
Stealth Adapted Viruses: A Bridge between Molecular Virology and Clinical Psychiatry  [PDF]
W. John Martin
Open Journal of Psychiatry (OJPsych) , 2015, DOI: 10.4236/ojpsych.2015.54035
Abstract: Cytopathic “stealth-adapted” viruses bypass the cellular immune defense mechanisms because of molecular deletion or mutation of critical antigen coding genes. They, therefore, do not provoke the inflammatory reaction typical of infections with the conventional viruses from which stealth adapted viruses are derived. Stealth adapted viruses establish persistent, systemic virus infections, which commonly involve the brain. The brain damage can cause major mood and cognitive disorders, fatigue, seizures and various manifestations of an impaired autonomic nervous system. Symptoms can also result from: 1) induced autoimmunity, 2) antibody formation against virus antigens, 3) virus-induced cellular damage to non-brain tissues and 4) induced heightened overall immune reactivity, such that normally unrecognized components of the virus begin to become targeted by the cellular immune system. This last mechanism is relevant to the reported neurological and psychiatric adverse effects of vaccination in certain individuals. It is also appropriate to consider the infectious component of stealth adapted virus infections since family members and others may be at risk for becoming infected.
Interacting Light Paths Attract KELEA (Kinetic Energy Limiting Electrostatic Attraction) and Can Lead to the Activation of Water  [PDF]
W. John Martin
Open Journal of Biophysics (OJBIPHY) , 2015, DOI: 10.4236/ojbiphy.2015.54010
Abstract: Water can acquire a kinetic activity, which is attributed to the absorption of an environmental force termed KELEA (kinetic energy limiting electrostatic attraction). This activity can lead to increased volatility of the water that can be measured as the progressive weight loss in closed but not completely sealed containers. It has been proposed that KELEA is a natural force required to prevent the fusion and possible annihilation of electrostatically attracted opposite electrical charges. As such, it may be especially available where there is a convergence of force fields of opposing electrical charges. At least conceptually, this may arise with facing light sources with centrally directed light beams. An oscillating attraction and release of KELEA may be facilitated by repetitively disrupting the light paths using an overhead flashing light source. This paper reports on preliminary studies that are based on this premise. Although not proving the premise, the reported experiments do indicate a simple method for activating water. Moreover, the described procedure should allow for further exploration of the underlying mechanism of water activation. The procedure involves the use of four, diagonally placed regular LED traffic lights, with an overhead strobe light. The volatility of water samples in closed but not completely sealed glass vials placed within the lighted area significantly increases in a manner that persists well beyond the periods of light exposure. The paper further shows that activated water can indirectly lead to the activation of nearby water. The reported observations are of both practical and theoretical importance.
KELEA Activation of Water and Other Fluids for Health, Agriculture and Industry  [PDF]
W. John Martin
Journal of Water Resource and Protection (JWARP) , 2015, DOI: 10.4236/jwarp.2015.716108
Abstract: Water is a critical component in the functioning of the earth and of all living creatures. An important insight into the variable physical and biological properties of water has been provided by studies consistent with an external force termed KELEA (kinetic energy limiting electrostatic attraction) that weakens the intermolecular bonding of water molecules. Simple methods are described in this paper for producing and testing KELEA activated water. A summary is also provided of many major applications of KELEA activated water in health, agriculture and industry. While several of the proposed applications require more rigorous scientific documentation and further optimization, collectively they present the compelling opportunity for KELEA activated water to immediately transform medical, agricultural and industrial practices. A coordinated endeavor is proposed to better understand the science of KELEA and to develop simplified protocols for utilizing KELEA activated water and other fluids in the presently described and likely numerous additional applications. This ambitious undertaking envisions the cooperation among a range of specialized philanthropic organizations, working within different countries and with the strong support of national governments.
KELEA, Cosmic Rays, Cloud Formation and Electromagnetic Radiation: Electropollution as a Possible Explanation for Climate Change  [PDF]
W. John Martin
Atmospheric and Climate Sciences (ACS) , 2016, DOI: 10.4236/acs.2016.62015
Abstract: The basic premise of this article is that human generated electromagnetic radiation is contributing to global warming. It may do so by diverting an energy force termed KELEA (kinetic energy limiting electrostatic attraction) from its presumed association with cosmic rays. Cosmic ray delivered KELEA is viewed as normally participating in the formation of cloud condensation nuclei (CCN). It may do so by transforming electrostatically inert particles into electrostatic aerosols capable of acting as CCN. The resulting clouds act as a reflective barrier to some of the infrared radiation from the sun and, thereby, reduce the earth’s heat. This article proposes that increasing levels of electromagnetic radiation in the atmosphere is reducing the capacity of cosmic rays to deliver adequate KELEA to maintain climate stability through optimal cloud formation. Specifically, the fluctuating electrical fields accompanying electromagnetic radiation may do so by competitively withdrawing some of the KELEA from the incoming cosmic rays. Previously described studies by Dr. Wilhelm Reich attributed to an energy force termed orgone, are consistent with weather activity being inducible using a device that likely delivers KELEA to the atmosphere. In addition to the foregoing consideration, there are many agricultural and industrial applications of KELEA activated fluids that can reduce carbon emissions. It is important that the scope of climate science be broadened to include a detailed understanding of KELEA and of its many potential practical applications in addressing global warming.
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