Bibliographic record
Abstract
Background and Purpose-An increasing number of reports have linked infections to atherosclerosis and thrombosis.Thus, use of antibiotics may lower the risk of developing cerebrovascular disease.We investigated whether antibiotic use is associated with the risk of stroke in elderly individuals treated for hypertension.Methods-A cohort of 29 937 elderly subjects initiating antihypertensive therapy between 1982 and 1995 was formed from the Quebec healthcare insurance database.A nested case-control design was used in which each subject hospitalized with a primary discharge diagnosis of stroke between 1987 and 1995 was matched on calendar time to 5 randomly selected controls from the cohort.Conditional logistic regression was used to estimate odds ratios of stroke after adjustment for predisposing factors.Results-We identified 1888 cases and 9440 controls.The overall adjusted odds ratio for current antibiotic use was 0.80 (95% confidence interval, 0.63 to 1.01), and that for recent use was 0.81 (95% confidence interval, 0.70 to 0.94).Penicillin was the only individual antibiotic class that showed a protective association across different time windows.No significant association was found between stroke risk and the use of fluoroquinolones, macrolides, tetracyclines, or cephalosporins.Conclusions-Although no clear, consistent associations between overall antibiotic use and cerebrovascular disease could be found, an intriguing association between penicillin use and stroke should be explored further.(Stroke.2003;34:e163-e167.)Key Words: antibiotics Ⅲ atherosclerosis Ⅲ case-control studies Ⅲ infection Ⅲ primary prevention Ⅲ strokeA n increasing number of reports are linking infections to atherosclerosis and thrombosis.The proposed mechanisms are their common interaction with the inflammatory process, involving endothelial injury, macrophage transformation, and perhaps antigenic mimicry.An intriguing hypothesis sees arteriosclerosis as a chronic inflammatory condition with a possible treatable infective component that may be responsible either for disease initiation or progression or as a precipitating event contributing to plaque rupture resulting in acute ischemic events.[1][2][3] Under that assumption, subjects treated with antibiotics may be at lower risk of developing clinical manifestations such as cerebrovascular disease than untreated subjects.To test this hypothesis, we evaluated the effect of antibiotic use, regardless of the clinical indication or specific antibacterial activity, in the primary prevention of stroke in a general population of elderly patients initiating pharmacological treatment for hypertension.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.029 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.007 | 0.003 |
| Open science | 0.006 | 0.002 |
| Research integrity | 0.044 | 0.031 |
| Insufficient payload (model declined to judge) | 0.012 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".