Cerebrovascular Diseases

 

Incidence, Risk Factors and Prognosis of Stroke and TIA: The Need for High-Quality, Large-Scale Epidemiological Studies and Meta-Analyses

Rothwell P.M.

Author affiliations

Stroke Prevention Research Unit, Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK

Keywords: StrokeTransient ischaemic attackCholesterolHypertension

Related Articles for ""
Cerebrovasc Dis 2003;16(suppl 3):2–10
https://doi.org/10.1159/000070271

Log in to MyKarger to check if you already have access to this content.




Forgot your password
Sign up to MyKarger

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more
CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates

Select
* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: June 20, 2003
Issue release date: May 2003

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 1

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Stroke is a considerable clinical, social and economic burden. In recent clinical trials, a number of strategies have been shown to reduce the risk of stroke and transient ischaemic attack (TIA) in both primary and secondary prevention settings. Whether these treatments are leading to a significant reduction in the incidence of first and recurrent stroke in the clinic, however, remains unclear due to a paucity of high-quality epidemiological data. A similar lack of reliable epidemiological studies has undermined our understanding of the relationship between many potentially important vascular risk factors and stroke risk. Improvement in our knowledge of stroke epidemiology is a prerequisite for the planning of stroke services, the effective application of current stroke prevention strategies, the development of new strategies, and our understanding of the mechanisms of stroke. Future studies must take into account the clinical and pathological heterogeneity of TIA and stroke, and must be powered to allow subtype differences in risk factor relationships and prognosis to be determined reliably. In many cases, this will require meta-analysis of detailed individual patient data from multiple independent studies.

© 2003 S. Karger AG, Basel



Related Articles:

References

  1. Bonita R: Epidemiology of stroke. Lancet 1992;339:342–344.
    External Resources
  2. MacDonald BK, Cockerell OC, Sander JWAS, Shorvon SD: The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 2000;123;665–676.
    External Resources
  3. Rothwell PM: The high cost of not funding stroke research: a comparison with heart disease and cancer. Lancet 2001;357:1612–1616.
    External Resources
  4. Dippel D, Koudstaal PJ: We need stronger predictors of major vascular events in patients with a recent TIA or non-disabling stroke. Stroke 1997;28:774–776.
    External Resources
  5. Sacco RL: Identifying patient populations at high risk of stroke. Neurology 1998;51(suppl 3):S27–S30.
  6. Murray CJL, Lopez AD: Mortality by cause for eight regions of the world: global burden of disease study. Lancet 1997;349:1269–1276.
    External Resources
  7. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C: A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–1986. 2. Incidence, case fatality and overall outcome at one year of cerebral infarction, primary intracerebral haemorrhage and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990;53:16–22.
    External Resources
  8. Bonita R, Anderson C, Broad J, Jamrozik K, Stewart-Wynne E, Anderson N: Stroke incidence and case-fatality in Australasia: a comparison of the Auckland and Perth population-based stroke registers. Stroke 1994;25:552–557.
    External Resources
  9. Bonita R, Broad J, Beaglehole R, Anderson N: Changes in incidence and case-fatality in Auckland, New Zealand, 1981–1991. Lancet 1993;342:1470–1473.
    External Resources
  10. Anderson CS, Jamrozik KD, Broadhurst RJ, Stewart-Wynne EG: Predicting survival for 1 year among different subtypes of stroke. Results from the Perth Community Stroke Study. Stroke 1994;25:1935–1944.
    External Resources
  11. Anderson CS, Linto J, Stewart-Wynne E: A population-based assessment of the impact and burden of caring for long-term survivors of stroke. Stroke 1995;26:843–849.
    External Resources
  12. Rothwell PM, Eliasziw M, Gutnikov SA, Fox AJ, Taylor W, Mayberg MR, Warlow CP, Barnett HJM, for the Carotid Endarterectomy Trialists’ Collaboration: Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 2003;361(9352):107–116.
  13. European Atrial Fibrillation Trial Study Group: Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993;342:1255–1262.
    External Resources
  14. Hart RG, Benavente O, McBride R, Pearce LA: Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med 1999;131:492–501.
    External Resources
  15. Antithrombotic Trialists’ Collaboration: Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high-risk patients. BMJ 2002;342:71–86.
  16. Staessen JA, Gasowski J, Wang JG, Lutgarde T, Hond ED, Boissel J-P, Ekbom T, Gueyffier F, Lisheng L, Kerlikowske K, Pocock S, Fagard RH: Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000;355:865–872.
    External Resources
  17. PROGRESS Collaborative Group: Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001;358:1033–1041.
    External Resources
  18. Heart Protection Study Collaborative Group: MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002;360:7–22.
    External Resources
  19. Ezzati M, Lopez AD, Rodgers A, Hoorn SV, Murray CJL, and the Comparative Risk Collaborating Group: Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347–1360.
    External Resources
  20. Kernan WN, Viscoli C, Brass LM, Makuch RW, Sarrel PM, Horwitz RI: Blood pressure exceeding national guidelines among women after stroke. Stroke 2000;31:415–419.
    External Resources
  21. Joseph LN, Babikian VL, Allen NC, Winter MR: Risk factor modification in stroke prevention: experience of a stroke clinic. Stroke 1999;30:16–20.
    External Resources
  22. Bonita R, Stewart A, Beaglehole R: International trends in stroke mortality: 1970–1985. Stroke 1990;21:989–992.
    External Resources
  23. Stegmayr B, Asplund K: Exploring the declining case fatality in acute stroke. Population-based observations in the northern Sweden MONICA Project. J Intern Med 1996;240:143–149.
    External Resources
  24. Gillum RF, Sempos CT: The end of the long-term decline in stroke mortality in the United States. Stroke 1997;28:1527–1529.
    External Resources
  25. Bonita R, Beaglehole R: Monitoring stroke: an international challenge. Stroke 1995;26:541–542.
    External Resources
  26. Jamrozik K, Broadhurst RJ, Lai N, Hankey GJ, Burvill PW, Anderson CS: Trends in the incidence, severity, and short-term outcome of stroke in Perth, Western Australia. Stroke 1999;30:2105–2111.
    External Resources
  27. McGowern PG, Burke GL, Sprafka JM, Xue S, Folsom AR, Blackburn H: Trends in mortality, morbidity and risk factor levels for stroke from 1960–1990: the Minnesota Heart Survey. JAMA 1992;268:753–759.
  28. Broderick JP: Stroke trends in Rochester, Minnesota, during 1945 to 1984. Ann Epidemiol 1993;3:476–479.
    External Resources
  29. Chang CC, Chen CJ: Secular trend of mortality from cerebral infarction and cerebral hemorrhage in Taiwan, 1974–1988. Stroke 1993;24:212–218.
    External Resources
  30. Feigin VL, Wiebers DO, Whisnant JP, O’Fallon M: Stroke incidence and 30-day case fatality rates in Novosibirsk, Russia, 1982 through 1992. Stroke 1995;26:924–929.
    External Resources
  31. Numminen H, Kotila M, Waltimo O, Aho K, Kaste M: Declining incidence and mortality rates of stroke in Finland from 1972 to 1991:results of 3 population-based stroke registers. Stroke 1996;27:1487–1491.
    External Resources
  32. McGovern PG, Shahar E, Sprafka JM, Pankow JS: The role of stroke attack rate and case fatality in the decline of stroke mortality: the Minnesota Heart Survey. Ann Epidemiol 1993;3:483–487.
    External Resources
  33. Stegmayr B, Asplund K, Wester PO: Trends in incidence, case fatality rate, and severity of stroke in Northern Sweden, 1985–1991. Stroke 1994;25:1738–1745.
    External Resources
  34. Wolf PA, D’Agostino RB, O’Neal MA, Sytkowski P, Kase CS, Belanger AJ, Kannel WB: Secular trends in stroke incidence and mortality: the Framingham Study. Stroke 1992;23:1551–1555.
    External Resources
  35. Ryglewicz D, Polakowska M, Lechowicz W, Broda G, Roskiewicz M, Jasinski B, Hier DB: Stroke mortality rates in Poland did not decline between 1984 and 1992. Stroke 1997;28:752–757.
    External Resources
  36. Terent A: Increasing incidence of stroke among Swedish women. Stroke 1988;19:598–603.
    External Resources
  37. Jørgensen HS, Plesner A-M, Hübbe P, Larsen K: Marked increase of stroke incidence in men between 1972 and 1990 in Frederiksberg, Denmark. Stroke 1992;23:1710–1704.
  38. Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO: Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke 1996;27:373–380.
    External Resources
  39. WHO MONICA Project (prepared by Thorvaldsen P, Kuulasma K, Rajakangas AM, Rastenyte D, Sarti C, Wilhemsen L): Stroke trends in the WHO MONICA project. Stroke 1997;28:500–506.
    External Resources
  40. Malmgren R, Warlow C, Bamford J, Sandercock P: Geographical and secular trends in stroke incidence. Lancet 1987;2:1196–1200.
    External Resources
  41. Sudlow CLM, Warlow CP: Comparing stroke incidence worldwide: What makes studies comparable? Stroke 1996;27:550–558.
    External Resources
  42. The Intercollegiate Working Party for Stroke: National Clinical Guidelines for Stroke. London: Royal College of Physicians, 2000.
  43. Scottish Intercollegiate Guidelines Network. SIGN guidelines: Management of patients with stroke. Edinburgh: SIGN, 1997 (www.sign.ac.uk).
  44. Feinberg WM, Albers GW, Barnett HJM, Biller J, Caplan LR, Carter LP, Hart RG, Hobson RW, Kronmal RA, Moore WS, Robertson JT: Guidelines for the management of transient ischaemic attacks. From the Ad Hoc Committee on Guidelines for the Management of Transient Ischaemic Attacks of the Stroke Council of the American Heart Association. Stroke 1994;25:1320–1335.
    External Resources
  45. Johnston SC, Smith WS: Practice variability in management of transient ischaemic attacks. Eur Neurol 1999;42:105–108.
    External Resources
  46. Gubitz G, Phillips S, Dwyer V: What is the cost of admitting patients with transient ischaemic attacks to hospital? Cerebrovasc Dis 1999;9:210–214.
    External Resources
  47. Warlow CP, Dennis MS, van Gijn J, Sandercock PAG, Bamford JM, Wardlaw JM: Preventing recurrent stroke and other serious vascular events. Stroke: a practical guide to management, pp 653–722. Oxford: Blackwell Science Ltd, 2001.
  48. Hankey GJ: Impact of treatment of people with transient ischaemic attacks on stroke incidence and public health. Cerebrovasc Dis 1996;6(suppl 1):26–33.
  49. Johnston SC, Gress DR, Browner WS, Sidney S: Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000;284:2901–2906.
    External Resources
  50. Lovett J, Dennis M, Sandercock PAG, Bamford J, Warlow CP, Rothwell PM: The very early risk of stroke after a first transient ischaemic attack: Implications for public education. Stroke (in press).
  51. Whisnant JP, Matsumoto N, Elveback LR: Transient cerebral ischemic attacks in a community. Rochester, Minnesota, 1955 through 1969. Mayo Clin Proc 1973;48:194–198.
    External Resources
  52. Dennis M, Bamford J, Sandercock P, Warlow C: Prognosis of transient ischemic attacks in the Oxfordshire Community Stroke Project. Stroke 1990;21:848–853.
    External Resources
  53. Brown RD, Petty GW, O’Fallon WM, Wiebers DO, Whisnant JP: Incidence of transient ischaemic attacks in Rochester, Minnesota, 1985–1989. Stroke 1998;29:2109–2113.
    External Resources
  54. Feigin VL, Shishkin SV, Tzirkin GM, Vinogradova TE, Tarasov AV, Vinogradov SP, Nikitin YP: A population-based study of transient ischaemic attack incidence in Novosibirsk, Russia, 1987–1988 and 1996–1997. Stroke 2000;31:9–13.
    External Resources
  55. Lemesle M, Milan C, Faivre J, Moreau T, Giroud M, Dumas R: Incidence trends of ischaemic stroke and transient ischaemic attacks in a well defined French population from 1985 through 1994. Stroke 1999;30:371–377.
    External Resources
  56. Sempere AP, Duarte J, Cabezas C, Claveria LE: Incidence of transient ischaemic attacks and minor ischaemic strokes in Segovia, Spain. Stroke 1996;27:667–671.
    External Resources
  57. Ricci S, Celani MG, La Rosa F, Vitali R, Duca E, Ferraguzzi R, Paolotti M, Seppoloni D, Caputo N, Chiurulla C, Scaroni R, Signorini E: A community-based study of incidence, risk factors and outcome of transient ischaemic attacks in Umbria, Italy: the SEPIVAC study. J Neurol 1991;238:87–90.
    External Resources
  58. Hankey GJ, Slattery JM, Warlow CP: The prognosis of hospital-referred transient ischaemic attacks. J Neurol Neurosurg Psychiatry 1991;54:793–802.
    External Resources
  59. Farrell B, Godwin J, Richards S, Warlow C: The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991;54:1044–1054.
    External Resources
  60. The Dutch TIA trial: protective effects of low-dose aspirin and atenolol in patients with transient ischemic attacks or non-disabling stroke. The Dutch TIA Study Group. Stroke 1988;19:512–517.
    External Resources
  61. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 1998;351:1379–1387.
    External Resources
  62. Department of Health: National service framework for older people. London, Department of Health, 2001 (www.doh.gov.uk/nsf).
  63. Muuronen A, Kaste M: Outcome of 314 patients with transient ischaemic attacks. Stroke 1982;13:24–31.
    External Resources
  64. Larsen BH, Sorensen PS, Marquardsen J: Transient ischaemic attacks in young patients: a thromboembolic or migrainous manifestation. A 10-year follow-up study of 46 patients. JNNP 1990;53:1029–1033.
  65. Ueda K, Kiyohara Y, Hasuo Y, Yanai T, Kawano H, Wada J, Kato I, Kajiwara E, Omae T, Fujishima M: Transient cerebral ischemic attacks in a Japanese community, Hisayama, Japan. Stroke 1987;18:844–848.
    External Resources
  66. Clark T, Murphy M, Rothwell PM: Long-term risks of stroke, myocardial infarction, and vascular death in patients with a non-recent transient ischaemic attack. JNNP (in press).
  67. The Dutch TIA Trial Study Group: Predictors of major vascular events in patients with a transient ischemic attack or nondisabling stroke. Stroke 1993;24:4–31.
  68. Benavente O, Eliasziw M, Streifler JY, Fox AJ, Barnett HJ, Meldrum H: Prognosis after transient monocular blindness associated with carotid-artery stenosis. N Engl J Med 2001;345:1084–1090.
    External Resources
  69. Rothwell PM, Warlow CP: Prediction of benefit from carotid endarterectomy in individual patients: a risk modelling study. Lancet 1999;353:2105–2110.
    External Resources
  70. Marshall J: The natural history of transient ischaemic cerebrovascular attacks. Q J Med 1964;33:309–324.
    External Resources
  71. Bradshaw P, McQuaid P: The syndrome of vertebrobasilar insufficiency. Q J Med 1963;32:279–296.
    External Resources
  72. Turney T, Garraway WM, Whisnant JP: The natural history of hemispheric and brainstem infarction in Rochester, Minnesota. Stroke 1984;15:790–794.
    External Resources
  73. Cartlidge NE, Whisnant JP, Elveback LR: Carotid and vertebral-basilar transient cerebral ischemic attacks. A community study, Rochester, Minnesota. Mayo Clin Proc 1977;52:117–120.
    External Resources
  74. Acheson J: Factors affecting the natural history of ‘focal cerebral vascular disease’. Q J Med 1971;40:25–46.
    External Resources
  75. Kernan WN, Feinstein MD, Brass LM: A methodological appraisal of research on prognosis after transient ischaemic attacks. Stroke 1991;22:1108–1116.
    External Resources
  76. Flossmann E, Rothwell PM: Are vertebrobasilar territory TIA or minor strokes really more benign than carotid territory events? Cerebrovascular Diseases 2002;13(suppl 3):45.
  77. Prospective Studies Collaboration: Cholesterol, diastolic BP, and stroke: 13,000 strokes in 450,000 people in 45 cohorts. Lancet 1995;346:1647–1653.
    External Resources
  78. Eastern Stroke and Coronary Heart Disease Collaborative Research Group: Blood pressure, cholesterol, and stroke in eastern Asia. Lancet 2001;352:1801–1807.
    External Resources
  79. Rodgers A, MacMahon S, Gamble G, Slattery J, Sandercock P, Warlow C, for the UK-TIA Group: Blood pressure and risk of stroke in patients with cerebrovascular disease. BMJ 1996;313:147.
    External Resources
  80. Neaton JD, Wentworth DN, Cutler J, Stamler J, Kuller L: Risk factors for death from different types of stroke. Multiple Risk Factor Intervention Trial Research Group. Ann Epidemiol 1993;3:493–499.
    External Resources
  81. Davies MJ, Thomas AC: Plaque fissuring – the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. Br Heart J 1985;53:363–373.
    External Resources
  82. Fuster V, Badimon L, Badimon JJ, Chesebro JH: The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med 1992;326:242–250.
    External Resources
  83. Herman B, Schmitz PIM, Leyten ACM, van Luijk JH, Frenken CWGM, op de Coul AAW, Schulte BPM: Multivariate logistic analysis of risk factors for stroke in Tilburg, the Netherlands. Am J Epidemiol 1983;118:514–525.
    External Resources
  84. Lindenstrom E, Boysen G, Nyboe J: Risk factors for stroke in Copenhagen, Denmark. I. Basic demographic and social factors. Neuroepidemiology 1993;12:37–42.
    External Resources
  85. Spriggs DA, French JM, Murdy JM, Bates D, James OF: Historical risk factors for stroke: a case control study. Age Ageing 1990;19:280–287.
    External Resources
  86. Welin L, Svardsudd K, Wilhelmsen L, Larsson B, Tibblin G: Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med 1987;317:521–526.
    External Resources
  87. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Intracerebral hemorrhage versus infarction: stroke severity, risk factors, and prognosis. Ann Neurol 1995;38:45–50.
    External Resources
  88. Bikkina M, Levy D, Evans JC, Larson MG, Benjamin EJ, Wolf PA, Castelli WP: Left ventricular mass and risk of stroke in an elderly cohort. The Framingham Heart Study. JAMA 1994;272:33–36.
    External Resources
  89. Truelsen T, Lindenstrom E, Boysen G: Comparison of probability of stroke between the Copenhagen City Heart Study and the Framingham Study. Stroke 1994;25:802–807.
    External Resources
  90. Bogousslavsky J, Van Melle G, Regli F: The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke 1988;19:1083–1092.
    External Resources
  91. Arboix A, Morcillo C, Garcia-Eroles L, Oliveres M, Massons J, Targa C: Different vascular risk factor profiles in ischemic stroke subtypes: a study from the ‘Sagrat Cor Hospital of Barcelona Stroke Registry’. Acta Neurol Scand 2000;102:264–270.
    External Resources
  92. Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, Glahn J, Brandt T, Hacke W, Diener HC, on behalf of the German Stroke Data Bank Collaborators: Risk factors, outcome and treatment in subtypes of ischemic stroke. The German Stroke Data Bank. Stroke 2001;32:2559–2566.
    External Resources
  93. Lee BI, Nam HS, Heo JH, Kim DI: Yonsei Stroke Registry. Analysis of 1,000 patients with acute cerebral infarctions. Cerebrovasc Dis 2001;12:145–151.
    External Resources
  94. Yip PK, Jeng JS, Lee TK, Chang YC, Huang ZS, Ng SK, Chen RC: Subtypes of ischemic stroke. A hospital-based stroke registry in Taiwan (SCAN-IV). Stroke 1997;28:2507–2512.
    External Resources
  95. Inzitari D, Eliasziw M, Gates P, Sharpe B, Chan RKT, Meldrum HE, Barnett HJM: The causes and risk of stroke in patients with asymptomatic internal carotid artery stenosis. NEJM 2000;342:1693–1700.
  96. Sudlow CL, Warlow CP: Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration. Stroke 1997;28:491–499.
    External Resources
  97. Giroud M, Lemesle M, Quantin C, Vourch M, Becker F, Milan C, Brunet-Lecomte P, Dumas R: A hospital-based and a population-based stroke registry yield different results: the experience in Dijon, France. Neuroepidemiology 1997;16:15–21.
    External Resources
  98. Harrell FE, Lee KL, Mark DB: Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 1996;15:361–387.
    External Resources
  99. Altman DG, Royston P: What do we mean by validating a prognostic model? Stat Med 2000;19:453–473.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: June 20, 2003
Issue release date: May 2003

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 1

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Article Tools
Article Details

2003, Vol.16, Suppl. 3

May 2003

Article

Recommend This
TOP