bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Familiarity with School Increase Adjustment?
Authors: Itskowitz Rivka , Strauss Helen , Fruchter Dafne
Published: January 2017

The present study investigated the impact of familiarity with the school setting on kindergarten children's expectations of school and on adjustment of first graders to the school setting. The assumptions were that familiarity with the school setting would lead to a greater amount of valid information about school, which would decrease the anxiety of kindergarten children's role expectations of school. Previous exposure to the school setting would also lead to better adjustment in the first grade. Subjects were nineteen kindergarten children and twenty first graders from infant-school settings, and thirty-three kindergarten children and twenty-six first graders from regular educational settings, the sexes being evenly represented. All subjects came from middle socio-economic backgrounds. On the whole, the results corroborated the assumptions.
Tubular Compression in the Treatment of Venous Ulcers of the Leg: A New Graduated Tubular Device
Authors: Gardon-Mollard C.
Published: January 2017

Background:

Compression treatment remains an effective method of healing of venous ulceration. Traditional bandaging techniques require considerable nursing time to apply. Elastic stockings are comfortable but patients find these difficult to put on over dressings.

Aim:

To develop a tubular compression bandage system that can be easily applied to patients with venous leg ulceration.

Methods:

A tubular bandage has been designed (Tubulcus) which applies 30-40 mmHg compression at the ankle with graduated compression above this. An applicator system has been designed (Tricolore) which allows the compression bandage to be applied over ulcer dressings. The device has been evaluated on a cylindrical former and an anatomical model of a leg, in order to assess its suitability for clinical trials. It has been compared with three types of compression bandage.

Results:

The tubular bandaging system provides sustained compression to be applied to leg ulcers whilst facilitating dressing changes. The graduated compression profile achieved with this system is more easily obtained than when using any of the three types of bandage.

Conclusion:

A system of application of elastic compression has been designed specifically for use in patients with venous ulceration. Clinical trials are now required to demonstrate the efficacy of this system.
Systematic Reviews of Prevention of Venous Ulcer Recurrence
Authors: Nelson E. A.
Published: January 2017

Aim:

To illustrate and discuss the role of systematic reviews in assessing the effect of interventions used in preventing recurrence of venous ulceration.

Method:

Systematic review of randomised controlled trials (RCTs) reporting the recurrence of venous ulcers. We searched the Cochrane Wounds Group specialised trial register in June 2000. This contains results of searches for RCTs in 18 electronic databases and hand searches. Trials were assessed for inclusion by two people and data extraction was performed using a standard proforma.

Synthesis:

We found weak evidence that wearing compression hosiery reduces recurrence rates. There was insufficient evidence for the effectiveness of drugs, vein surgery, exercise or leg elevation.

Conclusions:

Where systematic reviews provide clear implications for practice are found, clinicians can incorporate these into treatment regimens. Where results indicate that there is clinical uncertainty, as in the prevention of recurrence, this can assist commissioners and researchers in prioritising research questions.
A Simple Way to Improve DVT Protocol Compliance
Authors: Birks M. E. , Aiono S. , Magee T. R. , Galland R. B.
Published: January 2017

Objective:

To assess the impact on deep vein thrombosis (DVT) protocol violations of the introduction of a label attached to the patient's drug chart, which specifically allows low-dose subcutaneous heparin or thromboembolic deterrent stockings (TEDS) to be prescribed as appropriate.

Design:

An audit study.

Setting:

Department of General Surgery of a District General Hospital in the United Kingdom.

Method:

All adult general surgical inpatients on a Weekday were studied. Staff were not forewarned of the studies. Patient details and risk factors for DVT were noted. Details of administered DVT prophylaxis were recorded. In total four separate studies were undertaken, namely: with original protocols (I), with refined protocol 1 and 3 years later (II, III) and finally after introduction of the label (IV).

Results:

Protocol violations were defined as being ‘acceptable’ or ‘unacceptable’. Raising awareness between studies I and II reduced acceptable violations to zero. There was no statistically significant reduction in unacceptable violations (24 in 80 patients, 1; 17 in 75, II; 13 in 60, III). In study IV, following introduction of the label, there were only 6 violations in 51 patients ( p<0.02).

Conclusion:

Combining increased awareness with the attachment of a label to the drug chart reduced unacceptable violations by 63%.
Randomized Trial of an Occlusive Dressing in the Treatment of Chronic Non-Healing Leg Ulcers
Authors: Moffatt C. J. , Franks P. J. , Oldroyd M. I. , Greenhalgh R. M.
Published: January 2017

Objective:

To determine whether an occlusive dressing improves healing in chronic resistant venous ulceration.

Design:

Prospective controlled randomized trial.

Setting:

Hospital outpatients and community ulcer

Patients:

Sixty patients with chronic non-healing venous ulceration. Patients had either been treated for 12 weeks and their ulcer had failed to reduce by 20% of their original size, or had failed to completely heal within 24 weeks of treatment with the four-layer bandage.

Interventions:

Patients continued treatment with the four-layer bandage, and randomized to receive either an occlusive dressing or a simple non-adherent (NA) dressing.

Main outcome measure:

Time to complete healing analysed by life tables up to 12 weeks from randomization.

Results:

At the end of the trial 43% of the patients randomized to an occlusive dressing and 23% to an NA dressing had completely healed. Life table analysis failed to show a significant difference (relative risk = 2.25; 95% confidence interval 0.88–5.75; p=0.077).

Conclusions:

Good response of patients to an occlusive dressing has indicated the need for a larger study. A trial of 180 patients could detect a significant difference if crude rates are maintained in a larger study (80% Power, 5% significance).
Selective Saphenous Vein Repair: A 5-Year Follow-up Study
Authors: Belcaro G. , Errichi B. M.
Published: January 2017

objective:

To evaluate the effect of selective saphenous vein repair (SSVR) in a 5-year follow-up study.

Design:

Prospective, randomized study of 44 subjects randomized to an SSVR group and a control group.

Setting:

University Clinic, Chieti, and Angiology and vascular Surgery Clinic, Pescara, Italy.

Patients:

Twenty-two patients in the SSVR group and 22 in the control group. Inclusion criteria were incompetence of the saphenofemoral junction (SFJ) with presence of valve cusps and two to five venous sites in the long saphenous vein.

interventions:

SFJ plication and selective interruption of the incompetent sites under general anaesthetic.

Main outcome measures:

Ambulatory venous pressure measurements (refilling time) and colour duplex scanning to detect the number of incompetent sites.

Result:

After 5 years, 18 patients in the SSVR group and 19 in the control group completed the study. SSVR increased refilling time ( p<0.02) and the number of incompetent sites was decreased ( p<0.02); in the control group, refilling time remained short and the number of incompetent sites increased ( p<0.05).

Conclusion:

SSVR is an effective treatment with good 5-year results on incompetence and the development of new incompetent venous sites.
Physical Examination, Doppler Ultrasound and Colour Flow Duplex Scanning: Guides to Therapy for Primary Varicose Veins
Authors: DePalma R. G. , Hart M. T. , Zanin L. , Massarin E. H.
Published: January 2017

Objective:

To compare physical examination (PE) and continuous-wave hand-held Doppler (CWD) examination with colour flow duplex scanning as a gold standard for greater saphenous vein (GSV) reflux.

Design:

Prospective performance of PE and CWD by two clinical examiners and subsequent duplex scanning by two vascular laboratory technicians unaware of the results of the PE and CWD examinations. Tapes were then reviewed; results of the duplex scanning were compared with physical and CWD findings.

Patients:

Thirty-one women and nine men, aged 27–64 years, with symptomatic class I primary varicosities in distribution of the GSV. Eighty limbs were evaluated Prospectively in 40 consecutive patients, including 22 limbs in 14 patients with a history of prior GSV stripping.

Interventions:

GSV ligation and stripping in 50 limbs when duplex demonstrated saphenofemoral or truncal reflux; 30 limbs were treated by stab avulsion, cluster excision and sclerotherapy.

Main outcome measures:

Demonstration of saphenofemoral reflux by duplex was confirmed by operative findings. Sensitivity, specificity and positive and negative predictive values of PE and CWD were calculated in comparison to duplex scans.

Results:

For PE, sensitivity ad specificity were 48% and 73%; positive predictive and negative predictive values were 75% and 46%. For CWD, sensitivity and specificity were 48% and 83%; positive predictive and negative predictive values were 83% and 44%. CWD was falsely positive for saphenofemoral reflux in 10 instances. The GSV was spared in these 10 limbs and in 20 other limbs based on negative colour flow duplex examinations. At 12–18 months clinical results were similar in 50 limbs treated by ligation and GSV stripping as compared with 30 treated by stab avulsion, cluster and sclerotherapy.

Conclusion:

Sensitivity and negative predictive values for PE and CWD were low while specificity and postitive predictive values were high. CWD false postitives were due to insonation of veins close to the bulb or upper superficial femoral vein reflux subsequently detected by duplex scans. Colour flow duplex scanning is recommended prior to intervention for primary saphenous varicosities; exceptions occur in slender subjects where PE and CWD are more specific and predictive for reflux.
Sclerotherapy or Surgery as Treatment for Varicose Veins: A Prospective Randomized Study
Authors: Einarsson E. , Eklöf B. , Neglén P.
Published: January 2017

Objective:

To compare the long-term results following radical surgery or compression sclerotherapy (CST) of primary varicose veins.

Design:

Prospective, randomized study of 164 patients. The patients were assessed with clinical tests and foot volumetry, before the 6 months, 1, 3 and 5 years after treatment.

Setting:

Department of Surgery, University of Lund, Sweden.

Patients:

164 patients referred to the clinic for treatment of symptomatic primary varicose veins. Eighty patients were randomized to surgery and 84 to CST.

Interventions:

Sclerotherapy was applied using the ‘empty vein’ technique followed by compression bandage for 6 weeks. The extent of surgery was determined by each patient's disease and included flush ligation of the long or short saphenous veins and subsequent stripping, ligation of incompetent perforating veins and resection of local varicosities.

Main outcome measures:

The recurrence rate of varicose veins and incompetence of perforators and saphenous veins.

Results:

Good results were achieved in both treatment groups immediately after the procedure, but the failures appeared earlier in the CST group and the number was higher compared with the surgery group. After 5 years only 10% of the operated patients were considered as treatment failures compared with 74% of the patients treated with CST. The clinical results were supported by the foot volumetry measurements.

Conclusions:

This study clearly indicates that patients with primary varicose veins and incompetent saphenous veins should be treated with surgery, and CST should be confined to local varicosities, isolated insufficient perforators or recurrences after adequate surgery.
Long Saphenous Vein Stripping in the Treatment of Varicose Veins: Self- and Surgeon-Assessed Results after 10 Years
Authors: Laurikka J. , Sisto T. , Salenius J.-P. , Tarkka M. , Auvinen O.
Published: January 2017

Objective:

To establish the 10-year results of long saphenous vein stripping in the treatment of varicose veins.

Design:

Single patient group study of patients who received surgical treatment for varicose veins 10 years earlier.

Setting:

Department of Surgery, University Hospital of Tampere, Finland.

Patients:

All men and a randomly picked sample of women were invited to attend for a follow-up examination; 81% (52 men, 74 women) participated.

Intervention:

Long saphenous vein stripping in all Patients.

Main outcome measures:

The presence of visible varicose veins as graded in four categories by clinical examination.

Results:

Seventy per cent of the operated legs in women free of varicosities or showed only minor varicose veins compared with 51% in men; 28% of the patients required further treatment (mostly sclerotherapy) for varicose veins.

Conclusions:

Long saphenous vein stripping combined with additional procedures results in a relatively low rate of severe recurrent varicose veins in 10 years.
The Australian Polidocanol (Aethoxysklerol) Study: Results at 1 Year
Authors: Conrad P. , Malouf G. M. , Stacey M. C.
Published: January 2017

Objective:

To evaluate the complications of polidocanol and compare its effectiveness and complications with sodium tetradecyl sulphate (STD) and hypertonic saline.

Design:

A single-arm prospective study of polidocanol complications and its effectiveness as a sclerosant. This was compared with each investigator's previous experience with other sclerosing agents.

Setting:

Multiple investigators in both private practices and hospital settings.

Patients:

Patients had either varicose veins or venule ectasias and/or spider veins (telangiectasia). A total of 8177 limbs were injected by 75 investigators.

Interventions:

Sclerotherapy was performed with 0.5% or 1% polidocanol for telangiectasias or spider veins, and with 3% polidocanol for varicose veins. The effectiveness of the sclerotherapy and any complications were reported during a 12-month period.

Results:

There were very few complications reported with polidocanol. There were no reported deaths or anaphylaxis. The investigators with previous experience of other sclerosants considered that the effectiveness of polidocanol was superior to STD (77%) and hypertonic saline (75%). Ninety-one per cent of investigators considered that polidocanol had less frequent complications than STD, and 96% considered that these were less severe. Sixty-nine per cent considered that polidocanol had fewer side-effects than hypertonic saline, and 71% considered that these were less severe.

Conclusions:

Polidocanol is an effective sclerosant that has few complications.
Venous Disease: The New International Challenge
Authors: Bosanquet N. , Franks P.
Published: January 2017

This paper reviews data on the socio-economic aspects of venous disease and venous insufficiency. It will cover data on the burden of disease and the effects of venous insufficiency on quality of life. It will also cover varicose veins, chronic venous insufficiency and venous ulcers of the leg. The use of the WHO International Classification of Diseases allows for comparisons across countries, with costs expressed not only in local currency, but also in terms of ECUs and as a percentage of health care costs.

The paper presents estimates on the costs of venous disease in the UK, France and Germany. Using standard diagnoses, costs are estimated to amount to 1.5–2.0% of total health care expenditure in these three countries. This is divided between inpatient, outpatient and community nursing programmes. Prescribing costs for venous diseases range from 0.26% of the total in the UK to 5.38% in France, with Germany in the middle of the range at 2.87%. The paper also summarizes costs in terms of reduced quality of life and loss of work-time. In Germany venous diseases contributed significantly to total disability, accounting for 1.2% of invalidity days in the late 1980s.

As a result of dissatisfaction with current treatment programmes there have been moves towards new ones. The paper sets out the evidence on innovations in care through investment programmes aimed at reducing costs and improving efficacy. Current developments in Britain, Germany and France are set out, summarizing likely costs and benefits.
Amoxycillin in the Treatment of Typhoid and Paratyphoid Fever
Authors: Qureshi Saeeda , Niazi Shabnam
Published: January 2017

Thirty-one patients suffering from typhoid and paratyphoid have been treated with amoxycillin. Success was achieved in 86.6% of cases. Fever settled within 24 hours in 36.6% and within 5 days in all the remainder except 2 in whom normal temperature was delayed until the 8 th day. The relapse rate of 3.2% is lower than that normally seen with chloramphenicol. One patient developed a hypersensitivity reaction to amoxycillin which settled on withdrawal of the drug.
Diflunisal, a New-Acting Analgesic and Prostaglandin Inhibitor: Effect of Concomitant Acetylsalicylic Acid Therapy on Ototoxicity and on Disposition of Both Drugs
Authors: Schulz P , Perrier C V , Ferber-Perret F , VandenHeuvel W J A , Steelman S L
Published: January 2017

Intermittent and concomitant acetylsalicylic acid (ASA) therapy was superimposed onto a 21-day regimen with diflunisal 250 mg b.i.d. Low doses of ASA (600 mg single dose or 300 mg q.i.d.) did not influence significantly diflunisal blood levels whereas a 600 mg q.i.d. dosing caused a small significant drop, especially at trough level. This drop is not expected to be clinically significant. No ototoxicity could be demonstrated with any treatment of diflunisal though four of fourteen subjects reported mild tinnitus during concomitant therapy at the higher doses of ASA.

Diflunisal at 375 mg b.i.d. failed to alter the metabolism of a single dose of labelled ASA (600 mg) as judged by plasma levels, urinary excretion and plasma binding. Daily urinary excretion of prostaglandins E1 and E2 major metabolite was decreased by about 70% by diflunisal.
Multicentre Study of ‘Flagyl’ in the Prevention of Post-Operative Anaerobic Infection
Authors: Goulton J , Wilkinson M A , Baker P G
Published: January 2017

In a study carried out with 565 patients undergoing gynaecological and general surgical procedures, metronidazole ('Flagyl') was used pre- and postoperatively and the incidence of post-operative infection, particularly that due to anaerobic organisms, was recorded. This was not a controlled study but, by comparison with other series, it would appear that the use of oral metronidazole had substantially reduced the likelihood of supervention of anaerobic sepsis. It is probable that the use of intravenous metronidazole therapy would have reduced the incidence of anaerobic sepsis still further had this preparation been available at the time.
Ketoprofen (Orudis®) Twice Daily Dosage in Arthritis and Tissue Injuries: A General Practice Study
Authors: Baker P G , Goulton J
Published: January 2017

In a general practice study using ketoprofen (Orudis®) in a twice-daily dosage regimen for the treatment of patients with articular and non-articular rheumatic conditions, data were collected on 2, 644 patients, over one-third of whom had been previously treated with other anti-rheumatic preparations. More than 80% showed a clinical improvement and the overall incidence of side-effects was relatively low. Three patients suffered a haematemesis – the most serious side-effect encountered. It was concluded that 50 mg or 100 mg twice-daily therapy was equally as effective as the 50 mg thrice daily regimen previously recommended and that the tolerability of ketoprofen was not adversely affected by this concentration of the daily requirement.
Comparison of a New Hypnotic (Finorgal) with Placebo in a Double-Blind Trial
Authors: Baiotti Gianni
Published: January 2017

The hypnotic effects of Finorgal (ethchlorvynol with diphenhydramine) were compared with those of placebo in a double-blind study with crossover of treatments in thirty-five hospital in-patients. During the four-week period of Finorgal treatment there was a significant reduction in the mean time elapsing between the administration of the hypnotic and the onset of sleep, and a significant increase in the duration of sleep, compared with the four weeks of placebo treatment. There was also a significant increase in the proportion of nights when the patients felt they had slept well, and in the incidence of morning ‘hangover’ and nocturnal confusion during the Finorgal treatment periods. Patients had to be actively woken in the morning significantly more often following Finorgal administration.

In patients experiencing pain in the night there was a significant reduction in the occurrence of pain during the nights when Finorgal had been given.
A Double-Blind Controlled Trial of Betamethasone Dipropionate 0·05% (Diproderm®) in Comparison with Fluocinolone Acetonide 0·025% (Synalar®) in Psoriasis and other Steroid-Responsive Dermatoses
Authors: Afzelius Hans-Wilhelm , Jacobsen K U
Published: January 2017

In a double-blind randomized study, sixty-two patients suffering from psoriasis or eczema were treated, twice daily for three weeks, either with 0.05% betamethasone 17, 21-dipropionate cream or with 0.025% fluocinolone acetonide cream.

The results showed that both topical corticosteroid preparations were effective, well tolerated and cosmetically acceptable.

Fifty-seven per cent of the patients treated with betamethasone dipropionate were rated as being ‘much better’ in the overall assessment of response at the end of the trial period compared to only 25% of those in the fluocinolone acetonide group.
A Clinical Trial of Choline Theophyllinate versus Salbutamol with Placebo Control
Authors: Prime F J
Published: January 2017

Using a randomized double-blind procedure, seventeen patients with chronic airways obstruction completed a placebo-controlled study to compare bronchodilator effects of single doses of choline theophyllinate 400 mg and salbutamol 4 mg. As determined by a range of spirometric measurements, the effects of the two drugs were remarkably similar and there were no statistically significant differences in any of the parameters measured. Both drugs produced highly significant differences in comparison with placebo response. Side-effects were mainly complaints of digital tremor; this was seen in four of the patients after salbutamol and in less pronounced form in two patients after choline theophyllinate.
Experiences with Metoprolol Durules®, A Slow-Release Formulation in Hypertension
Authors: Tuomilehto Jaakko , Nissinen Aulikki
Published: January 2017

The antihypertensive effect and the tolerability of metoprolol Durules® have been studied in fifty-five patients with mild to moderate hypertension. The patients' diastolic blood pressure was ≥95 mm Hg in order to qualify for entry.

Thirty-seven out of fifty-three patients completing the study (70%) were treated with metoprolol Durules® monotherapy throughout the study. The mean blood pressure was reduced from 153/101 to 138/92 mm Hg after metoprolol Durules® compared to placebo (p < 0.001). Twenty-seven patients received one Durules® daily and ten patients received two Durules® daily as the final dose.

Of the sixteen patients not responding on metoprolol Durules®, six patients achieved satisfactory control, i.e. a diastolic blood pressure below 95 mm Hg, when given 200 mg metoprolol + 25 mg hydrochlorothiazide (HCT).

The results indicate that most patients with, mild or moderate hypertension can be controlled with metoprolol Durules® monotherapy given once daily. The addition of HCT gives a significant benefit in moderate hypertension, where metoprolol monotherapy is not sufficient.
The Effect of Piracetam on Volunteers in a Low-Pressure Tank
Authors: Demay F , Bande J
Published: January 2017

Twelve volunteers were subjected to a double-blind crossover test to evaluate their concentration in conditions of hypoxemia after treatment with piracetam or with a placebo.

Piracetam was administered in doses of 4.8 g per day for 4 days and 7.2 g on the 5th day.

The speed with which the test was carried out was not influenced to a statistically significant degree but the proportion of errors was. This effect of piracetam was more pronounced for the longer-lasting periods of hypoxemia.
Absorption of Penicillin V from Mixture Formulations. Comparison of Potassium and Benzathine Salts
Authors: Heikinheimo Markku , Hovi Tapani
Published: January 2017

The absorption rate and serum level curves of two commercial phenoxymethylpenicillin mixture preparations were compared in adult volunteers. Both the potassium salt (Primcilliri®) and the benzathine salt (V-Pen ped forte®) of V-penicillin were rapidly absorbed and the mean peak serum levels were obtained with both preparations within the first hour after single dose administration. The mean peak level obtained with the potassium salt was several-fold higher (p < 0.001) and was also reached within a shorter time than that of the benzathine preparation. These results confirm the earlier evidence, obtained with other formulae, for the superior bioavailability of the potassium salt of V-penicillin as compared to most other derivatives used in V-penicillin mixtures.
The Use of a Soy Isolate Based Formula in the Treatment of Infantile Diarrhoea
Authors: Naidoo B T , Chunterpurshad I , Mahyoodeen A B G , Pather G
Published: January 2017

Lactose intolerance interferes with the recovery phase in patients with severe diarrhoea. A controlled comparison of a lactose-free soy isolate formula (Isomil®) and a standard cow's milk-based formula in 112 infants with severe diarrhoea showed a significant advantage for the lactose-free formula. All the infants were dehydrated on admission and required initial intravenous therapy. The response rate in the two groups was, respectively, 93% and 75%.
Ketotifen in the Young Asthmatic – A Double-Blind Placebo-Controlled Trial
Authors: White M. P. , MacDonald T. H. , Garg R. A.
Published: January 2017

A double-blind placebo-controlled trial was carried out to assess the efficacy of ketotifen in the pre-school asthmatic. The trial period consisted of a 1-month run-in period followed by a 4-month treatment period. Symptom scores for asthma, rhinitis, eczema and, where possible, twice daily peak flow measurements (24 cases) were recorded on diary cards by the parents. All concomitant medication used in addition to the trial drug was noted. The only medication not allowed was disodium cromoglycate. A total of 37 children, 23 boys and 14 girls, mean age 4.1 years (range 1.3–5.9 years) completed the trial. They comprised 19 given ketotifen and 18 given placebo. All were atopic and had allergic rhinitis and 15 had eczema. Ketotifen dosage was 1 mg twice daily in the under 5-year-olds (23 cases) and 2 mg twice daily in the remainder. On analysing the results no significant benefit could be demonstrated for giving ketotifen in this group of patients.
Comparison of Miocamycin versus Amoxycillin in Lower Respiratory Tract Infections in Children. Clinical Response and Effect on Natural Killer Activity
Authors: Agostoni C. , Giovannini M. , Fraschini F. , Scaglione F. , Galluzzo C. , Riva E. , Ferrara F.
Published: January 2017

The clinical efficacies of 50 mg/kg·day miocamycin and 60 mg/kg·day amoxycillin were studied in 23 patients aged 3–11.5 years with presumed bacterial infection of the lower respiratory tract (bronchopneumonia and acute bronchitis). During the therapy, which continued for 10 days, non-specific immune function, represented by natural killer cell activity, was monitored by measurement of the rate of lysis induced on target K-562 51Cr-labelled tumour cells. The results confirmed the therapeutical efficacy of miocamycin and amoxycillin in the oral therapy of bronchopneumonia and acute bronchitis in paediatric patients. The natural killer cell activity of patients treated with miocamycin was increased on days 7 and 10 of therapy compared with baseline. This finding did not occur in patients treated with amoxycillin.
Salsalate in the Treatment of Rheumatoid Árthritis: A Double-Blind Clinical and Gastroscopic Trial versus Piroxicam. I – Clinical Trial
Authors: Montrone F. , Caruso I. , Cazzola M. , Porro G. Bianchi
Published: January 2017

A double-blind, double-dummy controlled study to compare the clinical efficacy and gastric tolerability of salsalate and piroxicam in the treatment of rheumatoid arthritis was performed. Twenty-three patients were treated with 1.5 g salsalate twice daily and 20 with 20 mg piroxicam (taken after the evening meal) for a period of 4 weeks. Patients were submitted to gastroscopy at the start and end of treatment; only patients who presented a normal baseline gastroscopy were admitted to the trial. At the end of the planned treatment period, a statistically significant improvement of all clinical variables was observed in both treatment groups, the difference between the two drugs not being statistically significant. Seven (37%) patients treated with salsalate complained of tinnitus. The results show that salsalate and piroxicam have equal efficacy in relieving the symptoms of arthritis.
Comparison of Slow-Release Piretanide and Bendroflumethiazide in the Treatment of Mild to Moderate Hypertension
Authors: Hegbrant J. , Skogström K. , Månsby J.
Published: January 2017

After 4 weeks of placebo treatment, 76 hypertensive patients were randomly allocated to 6 or 12 mg/day piretanide, or 2.5 mg/day bendroflumethiazide for 12 weeks in a double-blind study. Piretanide was given in a slow-release formulation and bendroflumethiazide as a tablet. All three treatments produced a significant reduction in supine and erect systolic and diastolic blood pressures after 2 weeks, and this effect was maintained throughout the study. Normotension (i.e. supine diastolic pressure ≤ 95 mmHg) was achieved in 73% of the patients receiving 12 mg/day piretanide and in 57% receiving 6 mg/day piretanide compared with 72% receiving bendroflumethiazide (not significant). Overall, five patients were withdrawn due to increased diuresis: two patients on each dosage of piretanide and one receiving bendroflumethiazide. Three patients receiving 6 mg/day piretanide were withdrawn due to diastolic blood pressure rising above 120 mmHg. Other side-effects reported were mild and transient. There were no significant changes in serum creatinine, glucose or high-density lipoprotein cholesterol. A small, but non-significant rise in uric acid level was seen in all three groups. Clinically relevant hypokalaemia requiring potassium supplementation occurred in three patients receiving bendroflumethiazide.
Double-blind Comparison of Diclofenac Potassium, Ibuprofen and Placebo in the Treatment of Ankle Sprains
Authors: Morán M.
Published: January 2017

In a double-blind, placebo-controlled comparative study in 60 patients with ankle sprains suffering from moderate to severe inflammation and tenderness, the efficacy and tolerability of 150 mg/day diclofenac potassium given for 7 days was superior to that of 1.2 g/day Ibuprofen which was, in turn, superior to placebo. Efficacy was assessed by volumetric evaluation of inflammation of the injured ankle, tenderness on finger pressure, pain on movement and the severity of the joint injury. Patients used visual analogue scales to assess severity of pain at rest and on walking before and during treatment. Diclofenac potassium was significantly superior ( P < 0.02) to Ibuprofen for all measures of efficacy (except severity of joint injury) and Ibuprofen was consistently superior to placebo. No serious adverse effects were reported. In conclusion, diclofenac potassium has been demonstrated to be effective in the treatment of acute ankle sprains and it had a rapid onset of action and good tolerability.
Diclofenac Potassium for the Treatment of Traumatic Joint Distortions: An Open Multicentre Study
Authors: Verstraeten A. , Bakshi R.
Published: January 2017

In an open multicentre study, 410 patients presenting with traumatic joint distortions, predominantly involving the ankle, were recruited for treatment with 50 mg diclofenac potassium given orally three times daily for 7 days. Due to various protocol violations, the number of patients eligible for efficacy and tolerability analysis were 340 and 344, respectively. Significant ( P < 0.001) improvement in mobility, swelling, local tenderness, functional impairment and pain intensity occurred after both 3 and 7 days of therapy. Overall efficacy was assessed as excellent/good in 83% and 87% of cases by the investigator and patient, respectively. Altogether, 66 (19.2%) patients complained of adverse effects, which were generally mild or moderate in severity. Gastrointestinal complaints accounted for around 70% of the reported side-effects. Premature discontinuation of therapy due to poor tolerability was necessary in 15 (4.4%) patients. In conclusion, diclofenac potassium was both effective and well-tolerated when used for the short-term treatment of traumatic joint distortions.

Dans cette étude ouverte multicentrique, 410 patients souffrant d'entorses, touchant essentiellement la cheville, ont été inclus pour traitement par trois comprimés à 50 mg de diclofénac potassium par jour pendant 7 jours. Du fait de différents écarts au protocole, 340 patients ont pu être analysés pour l'efficacité, et 344 pour la tolérance. Une amélioration significative ( P < 0,001) a pu être observée concernant la mobilité, l'oedème, la douleur à la palpation locale, l'impotence fonctionnelle et l'intensité de la douleur spontanée après 3 et 7 jours de traitement. A l'évaluation globale, l'efficacité a été jugée excellente ou bonne par le médecin dans 83% des cas, et par le patient dans 87% des cas. Au total, 66 (19,2%) patients ont rapporté des effets indésirables, qui étaient généralement de sévérité mineure ou modérée. Environ 70% des plaintes concernaient le système digestif. Quinze (4,4%) patients ont dû interrompre prématurément le traitement pour raison de mauvaise tolérance. En conclusion, le diclofénac potassium, en administration de courte durée, s'est avéré efficace et bien toléré pour le traitement des entorses.
A Comparison of Digoxin Concentration – Time Curves before and after Open-Heart Surgery
Authors: Acikel U , Guven H , Apaydin S , Silistreli E , Gidener S , Catalyurek H , Oto O
Published: January 2017

The effects of open heart surgery on serum digoxin concentration – time curves were investigated in 10 cardiac patients receiving 0.25 mg/day digoxin. Blood samples were obtained from the patients immediately before and 1, 2, 3, 5, 8, 16 and 24 h after digoxin administration, both before open-heart surgery and 7 days after surgery. Serum digoxin concentrations, determined by fluorescence polarization immuno-assay, significantly ( P < 0.05) increased after surgery, as did the maximum serum concentrations and the areas under the concentration – time curves. After surgery there was a significant increase in the serum γ-glutamyl transferase concentration and a significant reduction in the total protein concentration. A reduction of digoxin dose may be appropriate for patients who have undergone open-heart surgery.
Inhibitory Effects of Indomethacin on Implantation and its Related Phenomena
Authors: Kanayama K , Osada H , Nariai K , Endo T
Published: January 2017

The dose-response relationship for the inhibitory effect of indomethacin on implantation and continuance of pregnancy was examined in four groups of rabbits administered with indomethacin (2.5, 5.0, 7.5 and 10.0 mg/kg) during the implantation period and compared with a control group. Implanted fetuses and corpora lutea were counted by laparotomy, and the number of offspring born was noted. The inhibitory effect of indomethacin on implantation was found to be dose–dependent, and the birth rate decreased in the indomethacin groups compared with the control group. As a result, even where implantation had been achieved, death of the implanted fetuses occurred at a high rate in rabbits administered with indomethacin during the implantation period.
Treatment of Branch Retinal Arterial Occlusion with Sodium Ozagrel, a Thromboxane A2Synthetase Inhibitor
Authors: Kato H , Emura S , Takeuchi N , Enoki M , Oogushi K , Takashima T , Ohmori K , Saito I
Published: January 2017

A 47-year-old woman with branch retinal arterial occlusion treated with sodium ozagrel is described. The patient presented with acute visual field loss in her right eye. Blood tests demonstrated the elevation of β-thromboglobulin and platelet factor 4. Sodium ozagrel, a thromboxane A2 synthetase inhibitor, 160 mg daily was administered for 14 days. This treatment prevented exacerbation of retinal arterial thrombosis and produced a marked improvement in the visual field loss. Sodium ozagrel may be a useful drug in the treatment of acute retinal arterial occlusion thought to be caused by thrombosis.
Triple Anti-TNF-α Therapy in Early Sepsis: A Preliminary Report
Authors: Schattner A , El-Hador I , Hahn T , Landau Z
Published: January 2017

Ten of 26 patients with sepsis were given a combination of dexamethasone (0.15 mg/kg, intravenously, once on admission), colchicine (0.5 mg, orally, daily, for 3 days) and pentoxifylline (DCP) (400 mg, orally, daily, for 3 days), together with best medical therapy. Serum tumour necrosis factor-alpha (TNF-α) levels were undetectable at 24 h compared with about 4 IU/ml (mean) in 16 similar control patients who were not given DCP ( P < 0.06). Although the clinical course in the two groups was not significantly different, this simple, well-tolerated and inexpensive regimen should be further evaluated as a possible means of preventing the deleterious effects of TNF-α in sepsis.
Investigation of the Influenza-Like Symptoms Associated with Recombinant Human Erythropoietin Therapy
Authors: Takemasa A , Yorioka N , Yamakido M
Published: January 2017

The mechanism by which fever and influenza-like symptoms occur, after the administration of recombinant human erythropoietin (rHuEPO) to patients on continuous ambulatory peritoneal dialysis, was investigated. Peripheral blood mononuclear cells, obtained from two patients with fever and/or influenza-like symptoms related to the administration of rHuEPO for the treatment of anaemia were cultured with or without rHuEPO (100, 200, and 300 U/ml). Production of interleukin-1 β and tumour necrosis factor-α was higher in cultures with rHuEPO than in cultures without rHuEPO, although the dose relationships were not clear. These findings suggest that increased production of interleukin-1 β and tumour necrosis factor-α, induced by administration of rHuEPO, may cause fever and influenza-like smptoms.
A Light and Electron Microscopic Study of a Normal Adrenal Medulla and a Pheochromocytoma from a Horse
Authors: Gelberg H. , Cockerell G. L. , Minor R. R.
Published: January 2017

The outer medullary (juxtacortical) zone of a normal equine adrenal gland had columnar chromaffin-positive cells arranged with their long axes perpendicular to fine vascular channels. The deeper medullary regions were composed of smaller irregularly round to polygonal chromaffin positive cells in small packets. Both cell types contained two types of membrane-bound cytoplasmic secretory granules. Osmiophilic granules with a homogeneous core, crenated membrane and narrow submembranous halo predominated in the columnar juxtacortical cells. The rounder, central medullary cells contained predominantly electron dense granules with a wide irregular electron lucent space between an eccentric core and the granule membrane. In contrast, irrespective of cell type or zone, cells from a pheochromocytoma contained only one type of granule similar to that described for the juxtacortical region of the normal equine adrenal medulla. The tumor cells could be classified into three subtypes based on density of granule packing but the granules were morphologically similar in all tumor cells.
The Pathomorphology of Malignant Catarrhal Fever
Authors: Liggitt H. D. , DeMartini J. C.
Published: January 2017

A histologic, ultrastructural and immunohistochemical study of the vasculitis in the rete mirabile of 18 calves with experimental and two calves with spontaneous malignant catarrhal fever showed lesions similar to those reported in graft rejection and some other lymphocyte-associated vasculopathies. The calves were examined at early, mid and late stages of clinical disease. Vascular lesions in the carotid rete were representative of those in other tissues examined. The magnitude of the arterial wall mononuclear cell infiltrate and the degree of arterial wall necrosis and degeneration increased with progression of the clinical disease. The predominant site of mononuclear cell accumulation was the adventitia. There was less medial and intimal involvement. The mononuclear infiltrate was composed of lymphocytes and macrophages with neutrophils and plasma cells rarely present. Endothelial hyperplasia, fibrinoid change and thrombosis were uncommon. Many changes contrasted with those recognized in an active Arthus reaction where adventitial change was minimal and most inflammatory cells were neutrophils or plasma cells. IgG and C3 rarely were detected in vessel walls with fluorescent antibody techniques. Serum immunoglobulins as measured by radial immunodiffusion were not elevated. Viral structures were not seen in tissues examined ultrastructurally.
Pathology of an Ulcerative Dermatitis in Belgian Landrace Sows
Authors: Coignoul F. L. , Bertram T. A. , Martineau G. P.
Published: January 2017

Chronic ulcers of the skin were observed in three Belgian Landrace sows. Lesions were located on ears, limbs, and in the mammary region and were resistant to treatment that included corticosteroid therapy.

Major histologic changes were located at the dermo-epidermal junction. Ulcers were deep, and the adjacent epidermis had marked hyperkeratosis, acanthosis, and intracellular edema. Dermatitis was prominent, essentially located in the superficial dermis.

By electron microscopy, basal lamina appeared disrupted. Dermo-epidermal separation occurred beneath the basal lamina. Collagen was morphologically normal. Desmosomes, hemidesmosomes, and anchorage fibers were present in areas adjacent to lesions.

Ulcerative dermatitis of sows is morphologically similar to pemphigus, pemphigoid, systemic lupus erythematosus, epidermolysis bullosa simplex, erythema multiforme, toxic epidermal necrolysis, and drug eruption. However, significant differences exist between ulcerative dermatitis and these conditions.
No Laughing Matter
Authors: Uys Pieter-Dirk
Published: January 2017

SOUTH AFRICA'S FOREMOST SATIRICAL PERFORMANCE ARTIST TAKES A LOOK AT THE SOUTH AFRICAN GOVERNMENT'S TREATMENT OF AIDS
Taking on the Government
Authors: Achmat Zackie
Published: January 2017

A SOUTH AFRICAN AIDS ACTIVIST CHALLENGES HIS GOVERNMENT'S AIDS POLICY AND MAKES A STAND FOR DEMOCRACY IN THE PROCESS
The Secret Epidemic
Authors: Levenson Jacob
Published: January 2017

FIFTY-FIVE PER CENT OF ALL NEW HIV CASES IN THE US ARE AFRICAN-AMERICANS AND THE NEW EPICENTRE OF THE DISEASE HAS SHIFTED FROM THE COASTS TO THE SOUTH
The play of war
Authors: Aleksiyevich Svetlana
Published: January 2017

'A man lies fallen on the ground, killed by another man. Not by a beast, nature, or destiny but by another man. In Yugoslavia, Afghanistan, Tajikistan or Chechnya'
The Method of Payment Decision in Australian Takeovers: An Investigation of Causes and Effects
Authors: Da Rosa Raymond Silva , Izan H. Y. , Steinbeck Adam , Walter Terry
Published: January 2017

We research and document that the abnormal returns earned by Australian bidders and targets over the bid announcement period are not significantly associated with the proposed medium of exchange, i.e. cash or shares. However, over the long-term post-bid period, bidders who offer shares significantly under-perform regardless of bid outcome. Importantly, this result is after controlling for firm size, survival bias and method of return computation. Finally, the size of the target relative to the bidder firm and the variability of bidding firms' share price prior to the bid announcement are both positively associated with the probability of a share offer.
Determinants of the perceived importance of organisational adaptation to climate change in the Australian energy industry
Authors: Bremer Josephine , Linnenluecke Martina K.
Published: January 2017

Climate change will pose considerable risk to organisations in the 21st century. However, organisational adaptation to climate change has not yet received much attention in the management literature. Drawing on strategic choice theory, we put forward a model proposing that environmental attitudes and climate change knowledge are antecedents of how important adaptation is perceived to be by organisational decision-makers and that the perceived risk towards climate change acts as a mediator in this relationship. We tested the model with responses from 101 managers in the Australian energy industry. Findings of the study show that both environmental attitudes and climate change knowledge have a significantly positive effect on the perceived importance of climate change adaptation and that this relationship is mediated by risk perception. The study highlights the need to draw climate knowledge to the attention of executives and discusses avenues for future research, including the extension of the findings to other industries and settings.
A Spectrum of Antibody (IgG, IgG1, IgM) Response in Mice Infected with Trichinella Spiralis Treated with L-Mimosine
Authors: Frydas S. , Papaioannou N. , Papazachariadou M. , Xatzistilianou M. , Vlemmas I. , Merlitti D. , Castellani M.L. , Schiavone C. , Tulli A. , Di Gioacchino M.
Published: January 2017

The purpose of this study was to demonstrate the anti-inflammatory effects of L-mimosine on chronic inflammation, by investigating its effect on the immunological response of BALB/c mice infected with the nematode parasite Trichinella spiralis. Specific anti-parasite immunoglobulins (IgG, IgG1 and IgM) were detected by the ELISA method in the serum of both the treated and the untreated animals at different periods of time for 60 days post infection. Two groups consisting of 18 mice each were used. The mice were 6 weeks of age. Both groups were infected with 220 larvae (L1 - T. spiralis) per os: one group was administered an intraperitoneal injection of L-mimosine (200 μg/100 ml/dose) for 27 days (the first injection started 7 days before infection) and the second group was administered an intraperitoneal injection of saline solution (100 μI/dose).

Parasite specific IgG, IgG1 and IgM levels were determined in the sera of infected, untreated mice. The levels of IgG and IgG1 were increased following infection and remained elevated throughout the experimental period, while IgM was significantly decreased on the 50th day post-infection. These levels were found to be lower in the L-mimosine treated infected mice, compared to the untreated mice. The inhibition started from the 10th day and continued until the 60th day. In healthy animals, the production of immunoglobulins was not measurable. Non-infected animals treated with L-mimosine also showed no detectable anti-parasite specific immunoglobulins.

The results in this study show that the course of IgG, IgG1 and IgM production in BALB/c mice infected with T. spiralis may be influenced by the administration of L-mimosine.