bluuebunny/crossref_metadata_2025 huggingface dataset:
Deficiencies in Leg Ulcer Care: A National Survey in Scotland
Authors: Armstrong S. H. , Ruckley C. V. , Prescott R. J. , Dale J. J. , Nelson E. A.
Published: January 2017

Objective:

To identify what specialist expertise and services are currently available, in Scotland, to support general practitioners (GPs) and community nurses in the management of leg ulcer patients and the perceived need for the improvement of the service.

Design:

Postal questionnaires to randomly selected samples of GPs and community nurses.

Setting:

All 15 Scottish Health Board areas.

Subjects:

Six hundred and seventy-three GPs and 441 community nurses were questioned.

Results:

Five hundred and twelve (76%) GPs replied. Barely half, 285 (56%), expressed satisfaction with the service and only 155 (30%) had access to a recognized leg ulcer specialist. GPs who had access to a specialist expressed a greater level of satisfaction with the leg ulcer service than those without a local specialist.

Community nurse questionnaire:

Three hundred and sixty (82%) nurses replied. Two hundred and forty six (68%) indicated that the diagnosis of the cause of ulceration was usually made by both the GP and the nurse but the choice of treatment was most often made by the nurse alone. The great majority (69%) did not have access to a local leg ulcer clinic and only 34 (9%) indicated that they had access to management protocols, almost 90% of nurses expressing a need for protocols. Both questionnaires revealed a lack of specialist support, dedicated leg ulcer clinics, better education and training, and leg ulcer management protocols.

Conclusion:

Serious deficiencies in the support available for community care of leg ulcer patients have been identified. The situation requires to be remedied if more cost-effective outcomes for leg ulcer patients are to be achieved.
Changes in Microcirculation in Patients with Atrophie Blanche Visualized by Laser Doppler Perfusion Imaging and Transcutaneous Oxygen Measurements
Authors: Maessen-Visch M. B. , Sommer A. , De Paepe J. A. , Neumann H. A. M.
Published: January 2017

Objective:

To quantify differences in microcirculation in atrophie blanche (AB) in patients with chronic venous insufficiency (CVI) and in healthy controls before and after venous occlusion.

Design:

Prospective study in a single patient group.

Setting:

Department of Dermatology, University Hospital Maastricht, The Netherlands.

Patients and methods:

Sixteen patients with CVI and large lesions of AB, 10 patients with CVI without AB and 10 healthy controls were enrolled in the study. Laser Doppler perfusion imaging (LDPI) measurements were performed in and outside large lesions of AB and in healthy controls. Transcutaneous oxygen (Tc Po2) measurements were performed in patients with CVI with and without AB and in healthy controls.

Results:

Median basal resting flow was higher in AB than in healthy controls (0.67 mV versus 0.21 mV, p = 0.002). The venoarteriolar response (VAR was increased significantly in AB (58% versus 43%, p = 0.04). A significant decrease in Tc Po2 values occurred in AB lesions with 40 mmHg, in CVI skin with 60 mmHg and in healthy controls with 80 mmHg.

Conclusion:

Basic resting flux in AB measured with LDPI is increased compared with clinically normal skin. The decrease in flux on venous occlusion is larger in AB than in healthy controls.
Capillary Filtration Rate, before and after Stripping of the Greater Saphenous Vein, Measured with Air-Plethysmography
Authors: van Geest A. J. , Veraart J. C. J. M. , Kitslaar P. J. E. H. M. , Neumann H. A. M.
Published: January 2017

Objective:

To investigate whether there is a decrease in the capillary filtration rate after stripping of the greater saphenous vein, measured by air-plethysmography.

Design:

Prospective study.

Setting:

Academic Hospital Maastricht, The Netherlands.

Patients:

Fourteen lower limbs of 10 patients in which duplex ultrasound demonstrated insufficiency of the sapheno-femoral junction and of the greater saphenous vein, before operation.

Interventions:

Stripping of the greater saphenous vein.

Main outcome measures:

Capillary filtration rate before and 6 weeks after stripping of the greater saphenous vein, measured by air-plethysmography.

Results:

The capillary filtration rate after stripping of the greater saphenous vein had decreased in 12 legs and increased in two legs. The mean capillary filtration rate before operation was 6.58 ml/min (SD 1.97). Six weeks after stripping of the greater saphenous vein the mean capillary filtration rate was 5.54 ml/min (SD 1.22). These values have a level of significance of p < 0.01.

Conclusion:

The significant decrease of the capillary filtration rate, 6 weeks after stripping of the greater saphenous vein, measured with air-plethysmography, signifies an improvement in the microcirculation, related to the filtration function of the capillaries.
Cellulitis in Venous Leg Ulcers Treated with a Hydrocolloid Dressing
Authors: Westh H. , Warburg F. E. , Madsen S. M. , Larsen S. O. , Danielsen L.
Published: January 2017

Objective:

To evaluate the development of cellulitis in patients with venous leg ulcers in relation to colonizing or infecting microorganisms and principles of ulcer dressing.

Design:

Patients were prospectively randomized to either a routine leg ulcer dressing principle or hydrocolloid dressing (HCD).

Setting:

Tertiary care university hospital.

Patients:

Fifty-seven consecutive patients followed for at least 6 months.

Main outcome measures:

Development of cellulitis related to isolation of microorganisms and the ulcer dressing principle.

Results:

Development of cellulitis was only correlated to the isolation of haemolytic streptococci, predominantly belonging to Lancefield group G (2 p < 0.01). Staphylococcus aureus and Pseudomonas aeruginosa did not contribute to the development of cellulitis. One infection per 198 days was found in patients treated with HCD compared with one infection per 290 days in patients treated with chlorhexidine ointment with a vehicle of carbowax polyethylene glycol (not statistically different).

Conclusions:

Hydrocolloid dressing treatment was safe. Cellulitis was caused by haemolytic streptococci.
Leucocyte Rheology at Baseline and after Activation in Post-Phlebitic Syndrome
Authors: Caimi G. , Canino B. , Ferrara F. , Montana M. , Presti R. Lo
Published: January 2017

Objective:

To evaluate leucocyte rheology, expressed as leucocyte filtration, polymorphonuclear leucocyte (PMN) membrane fluidity and cytosolic Ca2+ concentration in subjects with post-phlebitic leg syndrome (PPS).

Methods:

In 22 subjects with PPS we determined leucocyte filtration [unfractionated, mononuclear (MN) and PMN cells], employing the St George Filtrometer, PMN membrane fluidity using the fluorescent probe 1-[4-(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene (TMA-DPH) and PMN cytosolic Ca2+ concentration using the fluorescent probe Fura 2-AM. Subsequently we determined the same PMN parameters after in vitro activation with 4-phorbol 12-myristate 13-acetate (PMA) and N-formyl-methionyl-leucyl-phenylalanine (fMLP).

Results:

At baseline we observed a difference in the filtration parameters of unfractionated and MN cells and an increase in PMN cytosolic Ca2+ concentration. After activation, a significant variation in PMN filtration parameters was evident both in normals and in PPS subjects, although in subjects with PPS this variation, especially with PMA, was significantly greater. We found a decrease in PMN membrane fluidity and an increase in PMN cytosolic Ca2+ concentration only in subjects with PPS.

Conclusion:

These results suggest that there is a functional alteration of systemic leucocytes in PPS, in which the mechanisms are not yet clear.
Haemorheological Proælein Chronic Venous Insufæciency
Authors: Azaceta G. , Romero S. , Lorente C. , Moreno J. A. , Olave T. , Vaquerizo A. , Azcona M. , Gutiérrez M.
Published: January 2017

Background:

In recent years, pathophysiological studies and treatment approaches of chronic venous insufficiency (CVI) have focused on haemorheology.

Objective:

To analyse erythrocyte aggregation (EA) and blood viscosity (BV) in mild and severe stages of CVI.

Methods:

In 147 patients (three severity stages), EA was measured with a photometric aggregometer, and BV with a cone-plate viscosimeter. Patients with concomitant pathologies affecting haemorheology were excluded.

Results:

EA was higher in patients (mean EA 10M: 16.4 vs 14.5 control), increasing progressively with the evolution of CVI ( p<0.001). Greatest differences were found for stage III (mean EA 10M: 17.6) vs stage II (15.7) and stage 0 (14.5) respectively ( p<0.001), but rheological abnormalities exist in early grades (I: 16.7) ( p<0.01). Fibrinogen and age had a strong influence on EA ( p<0.003 and p<0.001 respectively). When a covariance analysis avoided their effect, significant global differences between CVI groups persisted. BV at high shear rate was increased at advanced stages (III: mean 3.3 centipoise (cp); I: 3.1 cp) ( p<0.05).

Conclusions:

We found progressive impairment of the haemorheological profile with the worsening stages of CVI, related to age, severity stage and fibrinogen. Rheological impairment is likely to play a part in the pathophysiology of CVI, and perhaps may be useful in its management.
Pregnancy, Oral Contraception, Hormone Replacement Therapy and the Occurrence of Varicose Veins: Edinburgh Vein Study
Authors: Lee A. J. , Evans C. J. , Hau C. M. , Allan P. L. , Fowkes F. G. R.
Published: January 2017

Objective:

To determine the relationship between varicose veins and duration of menstrual life, age of menopause, pregnancy, oral contraceptive use and hormone replacement therapy (HRT).

Design:

Cross-sectional study.

Setting:

City of Edinburgh, UK.

Participants:

Eight hundred and sixty-seven women aged 18–64 years randomly selected from 12 general practices.

Methods:

After completing a questionnaire, which included questions on reproductive history, the women underwent a comprehensive clinical examination including the assessment of varicose veins (trunk, hyphenweb and reticular varices), followed by duplex scanning of their legs.

Results:

Women who had been pregnant at least once were more likely to have minor hyphenweb or reticular varices than women who had never been pregnant ( p ≤ 0.05). Women aged 35–54 years who were current users or ex-users of the oral contraceptive pill had a lower prevalence of trunk varicose veins than women who had never taken the pill ( p ≤ 0.10). HRT was also associated with a lower prevalence of trunk varices ( p ≤ 0.05).

Conclusions:

These results suggest that alterations in the balance of the sex hormones may have a role in the aetiology of varicose veins.
PET imaging of cannabinoid type 2 receptors with [11C]A-836339 did not evidence changes following neuroinflammation in rats
Authors: Pottier Geraldine , Gómez-Vallejo Vanessa , Padro Daniel , Boisgard Raphaël , Dollé Frédéric , Llop Jordi , Winkeler Alexandra , Martín Abraham
Published: January 2017

Cannabinoid type 2 receptors (CB2R) have emerged as promising targets for the diagnosis and therapy of brain pathologies. However, no suitable radiotracers for accurate CB2R mapping have been found to date, limiting the investigation of the CB2 receptor expression using positron emission tomography (PET) imaging. In this work, we report the evaluation of the in vivo expression of CB2R with [11C]A-836339 PET after cerebral ischemia and in two rat models of neuroinflammation, first by intrastriatal LPS and then by AMPA injection. PET images and in vitro autoradiography showed a lack of specific [11C]A-836339 uptake in these animal models demonstrating the limitation of this radiotracer to image CB2 receptor under neuroinflammatory conditions. Further, using immunohistochemistry, the CB2 receptor displayed a modest expression increase after cerebral ischemia, LPS and AMPA models. Finally, [18F]DPA-714-PET and immunohistochemistry demonstrated decreased neuroinflammation by a selective CB2R agonist, JWH133. Taken together, these findings suggest that [11C]A-836339 is not a suitable radiotracer to monitor in vivo CB2R expression by using PET imaging. Future studies will have to investigate alternative radiotracers that could provide an accurate binding to CB2 receptors following brain inflammation.
Youth Disclosure About Friendships Across the Transition to Middle School
Authors: Fletcher Anne C. , Blair Bethany L.
Published: January 2017

This longitudinal qualitative investigation considered youth disclosure to parents about friends as well as parents’ responses to such disclosure across the transition to middle school. African American and European American youth participated in qualitative interviews regarding their disclosure to parents about friendships in three consecutive years spanning the transition to middle school. Coding was completed in a two-step process that started with identifying themes regarding disclosure about friends as they reflected the experiences of all youth. Second, global categorizations of disclosure patterns during each year were used to categorize participants into four groups: stable complete disclosers, stable partial disclosures, increasing disclosers, and decreasing disclosers. We then identified themes regarding disclosure about friends as they distinguished these disclosure groups. Findings indicated that adolescent disclosure to parents about friends is embedded within the nature of adolescents’ relationships with parents and the manner in which parents respond to adolescent disclosure episodes across time.
Fluoroscopic-guided stent placement in failed tentative endoscopic approaches to malignant gastroduodenal obstructions
Authors: Kim Soo Hwan , Song Ho-Young , Park Jung-Hoon , Zhou Wei-Zhong , Cho Young Chul , Shin Ji Hoon , Kim Jin Hyoung
Published: January 2017

Background

Fluoroscopic or endoscopic placement of metallic stents is used as a safe, non-surgical, palliative treatment option for malignant gastroduodenal obstructions. However, endoscopic stent placement is not always feasible, due to the tight or tortuous stricture of the obstructed area and insufficient visualization of the stomach due to remnant food material.

Purpose

To assess the technical feasibility and clinical outcomes of fluoroscopic-guided stent placement in malignant gastroduodenal obstructions following the technical failure of endoscopic stent placement.

Material and Methods

In all, 19 patients (14 men, 5 women; age range, 36–85 years) were referred due to technical failures of tentative endoscopic stent placement. Indications were failure to pass the guide wire through the obstruction (n = 13), failure to reach the stricture lesion due to short endoscope (n = 5), and acute angulation of the stricture lesion (n = 1). Data were retrospectively collected regarding the technical and clinical success of the fluoroscopy, the dysphagia score before and after stent placement, and major complications and their management.

Results

Fluoroscopic stent placement was technically successful in 15/19 patients (79%). Failures were due to complete obstruction (n = 3) and acute angulation of the stricture lesion (n = 1). Clinical success was achieved in all 15 patients with successful stent placement. The dysphagia score significantly improved after stent placement ( P < 0.001). Complications occurred in 4/15 patients (27%), including tumor overgrowth (n = 2), stent collapse (n = 1), and jaundice (n = 1).

Conclusion

Fluoroscopic stent placement in malignant gastroduodenal obstructions following a technical failure of endoscopic stent placement is technically feasible and has an acceptable clinical outcome.
A General Practitioner Study of Dothiepin and Amitriptyline
Authors: Lambourn J , Rees J A
Published: January 2017

Forty-one patients completed a four-week double-blind study comparing dothiepin and amitriptyline. The anti-depressant effect of the two drugs was measured by the Hamilton depression rating scale and a five-point global scale. Side-effects were recorded as mild, moderate or severe.

Analysis of the results failed to demonstrate a statistically significant difference between the anti-depressant effect of the two drugs, but dothiepin was the favoured therapy in all assessments. Both drugs produced a significant improvement (p < 0·01) after only one week's therapy. The incidence and severity of side-effects were much less with dothiepin. An unexpected difference in the Hamilton scores at the end of the fourth week is to be investigated further.
Double-Blind Comparison of Alclofenac and Aspirin in the Treatment of Rheumatoid Arthritis
Authors: Bedi S S
Published: January 2017

In a double-blind short term cross-over study, designed to evaluate the analgesic efficacy of alclofenac, 500 mg thrice daily against aspirin, 866 mg thrice daily, fifty patients in a chronic stage of classical or definite rheumatoid arthritis (according to American Rheumatism Association ( 1959) criteria) were selected.

The criteria of assessment included pain, function and morning stiffness. The patients' and physician's overall preferences and opinion on tolerance were also recorded. Forty-eight patients completed the study successfully.

The study showed that both drugs were significantly effective in relieving pain but there was no difference between the two preparations and neither drug made any improvement to function or morning stiffness. The patients' and physician's preferences and opinion on the therapeutic efficacy were almost equally divided between the two drugs. However, the instances of side-effects were a little higher ( 44%) with aspirin than with alclofenac ( 34%).

It appears from this study that in chronic rheumatoid arthritis the analgesic activity of 1·5 g alclofenac is equivalent to 2·6 g (approx.) of aspirin.
The Effect of Tinidazol in Amoebic Proctosigmoiditis: A Study of Thirty-Six Cases
Authors: de Esesarte Gerardo
Published: January 2017

A total of thirty-six patients with amoebic proctitis were treated with 2,000 mg of tinidazole administered once daily for two days. Clinical, endoscopic and parasitological examinations were carried out on two occasions subsequently; namely five to ten days and thirty days respectively, following commencement of treatment.

A cure rate of 91·1 per cent was achieved with two treatment failures, one possible re-infection and two drop-outs from the study.

Side-effects were minimal with only two patients complaining of slight nausea whilst on treatment.
Urinary Hormone Excretion Patterns during Low-Dose Progestogen Administration
Authors: Varga L , Tamme E
Published: January 2017

The effects on pituitary-ovarian function of long-term administration of 0·5 mg of lynestrenol and 0·35 mg of norethisterone in continuous daily doses were investigated in 9 female subjects. The parameters employed were the basal body temperature charts and urinary assays of LH, total oestrogen and pregnanediol.

At the start of administration, ovulation was usually inhibited, but as a rule this effect disappeared as administration continued. Corpus luteum function appeared to be reduced.
Induction of Labour with Prostaglandin E2 Tablets
Authors: Basu H K , Rajan K T J
Published: January 2017

Prostaglandin E2 tablets were administered orally following amniotomy to 46 primagravid and 54 multiparous women at or near term. Of these, 96 women had vaginal delivery with an average induction-delivery interval of 8 1/2 hours. Vomiting and or diarrhoea occurred in 9 women. No adverse effects on the foetus were apparent. The safety, ease and convenience of administration were obvious to the patients and staff.
Patient Preference for a Combined Diuretic/Potassium Regimen: Burinex K
Authors: Murphy J E , Maneksha S , Brodie N H
Published: January 2017

A cross-over investigation was performed to compare patient preference of potassium supplement tablets. Seventy-seven patients requiring diuretics for the long-term management of congestive heart failure were randomly allotted to two therapeutically equivalent regimens; either Burinex K tablets + a placebo Burinex tablet or Slow K tablets + an active Burinex tablet.

Forty-two patients found Burinex K easier to swallow, 9 found Slow K easier to swallow, and 26 patients expressed no preference. There was an appreciably higher incidence of gastro-intestinal upset when patients were taking Slow K.

These results indicate that when long-term diuretic/potassium supplement therapy is required, Burinex K is a more acceptable regimen to the patient than one in which diuretic + Slow K are given separately.
Aspects of Long-Term Treatment with Neuroleptics Historical and Literature Review—Personal Experience with Fluspirilene and Penfluridol
Authors: Floru Lucian
Published: January 2017

The literature on neuroleptics with substance-specific long-term effects (fluspirilene, penfluridol) is reviewed in tabular form. This is followed by a report of personal investigations on 76 schizophrenics who were treated with fluspirilene initially within the hospital and later on an out-patient basis, on 86 patients who were treated with it exclusively at the out-patients' department, as well as on 123 schizophrenic psychoses treated with penfluridol in the out-patients' department. The side-effects caused by the two substances are compared. Pre-requisites for effective long-term therapy with a few complications are discussed.
Lorazepam in the Management of Gastro-Intestinal Neuroses
Authors: Roubi A El
Published: January 2017

Thirty-seven patients showing objective evidence of psychosomatic symptoms or gastro-intestinal neuroses, were given lorazepam 1 mg t.i.d. for one week and 3·5 mg/day for two subsequent weeks. Response, measured weekly by the Hamilton Rating Scale for anxiety showed that 23 patients were much improved, 11 were moderately improved and 3 were slightly improved. The improvement between pre-treatment assessment and final rating was significantly different (p > 0·001). Side-effects were mild and transient.
Assessment of Metoprolol, a Cardioselective Beta-Blocking Agent, during Chronic Therapy in Patients with Angina Pectoris
Authors: Borer J S , Comerford M B , Sowton E
Published: January 2017

Ten patients with typical angina pectoris and without hypertension, congestive heart failure or other disease were treated with alternating four-week courses of metoprolol ( a β1 cardioselective beta-blocking agent), propranolol and placebo. Midway through each four-week period, drug dosage was doubled; thus, regimes were metoprolol, 150 and 300 mg/day, propranolol, 120 and 240 mg per day and placebo, 3 and 6 tablets per day.

Serum concentrations of metoprolol increased with increasing dosage in a proportion very similar to that seen with propranolol.

Statistically significant reductions in angina frequency/nitroglycerin consumption, and statistically significant increases in total work performed on a bicycle ergometer, were found with both active compounds when compared with placebo. No significant differences were noted between the two active compounds.

Though most patients showed greatest improvement on the higher of the two drug dosages, three patients with metoprolol and two with propranolol responded best on the lower dose regime.

Both compounds reduced heart rate at rest and during exercise. Neither reduced arterial pressure at rest, but both reduced arterial pressure during excercise.

It is concluded that metoprolol is as effective as propranolol in the reduction of angina attacks and improvement in exercise tolerance during chronic therapy in patients with uncomplicated angina pectoris. It is now appropriate to study the effects of metoprolol in patients with coronary artery disease in whom the harmful effects of non-selective beta-blockade heretofore have precluded optimal therapy with beta-blocking drugs.
Intermediate Use of Triazolam: A Sleep Laboratory Study
Authors: Roth Thomas , Kramer Milton , Lutz Thomas
Published: January 2017

The present study was undertaken to evaluate the intermediate effects of triazolam 0.5 mg on the sleep of insomniac patients. The results showed that triazolam is effective in inducing and maintaining sleep without producing any major effects on sleep staging. Triazolam did not lead to significant subjective complaints or any deterioration in the physical condition of the patients. The effectiveness of triazolam did not vary over a two-week period.
Statistical Evaluation of Polygraphic Investigations of Pentoxifylline
Authors: Jovanović U J
Published: January 2017

Changes in the electro-encephalogram, and in the electro-oculogram electromyogram, ECG, blood supply, blood pressure, electrical skin activity and neurological/psychiatric findings, were investigated in 100 patients given single administrations of 200 mg of pentoxifylline (BL 191). It is concluded from the changes in the EEG wave patterns that pentoxifylline produces a beneficial effect on the cerebral processes contributing to bio-electrical brain activity. Pentoxifylline can be classed as a substance with microcirculatory/metabolic effects on the brain, which lead to stimulation of psychomotor behaviour.
Efficacy of Amikacin in Septic Abortion: Serum and Urine Antibiotic Concentrations
Authors: Bravo-Sandoval Jorge , Cinco-Espinoza Gonzalo , Ramírez-López Donato , Becerra-Muñoz Enrique , Galindo-Hernández Emma , Flores-Mercado Francisco
Published: January 2017

Septic abortion is a frequent cause of maternal death in our patient population. The great majority of bacteria isolated were enterobacteria. Since antibiotics capable of destroying the cell wall release endotoxins (producing vasoconstriction and tissue hypoxia) antibiotics which do not destroy bacteria like amikacin are preferred. Amikacin, 500 mg intramuscularly every twelve hours, was used concomitantly with uterine curettage and fluid and electrolyte restoration in thirty septic abortion patients. All the patients responded, obviating the need for more heroic surgical treatment such as hysterectomy. Previously used antibiotics have not been as effective in our patient population.
A Comparative Clinical Evaluation of a New Topical Steroid “Halcinonide” and Hydrocortisone in Steroid-Responsive Dermatoses
Authors: Fattah A Abdel , Shiemy S El , Faris Rifky , Tadros S S
Published: January 2017

Fifty patients with symmetrical, bilateral lesions of psoriasis, eczematous dermatitis, atopic dermatitis, or neurodermatitis participated in a double-blind paired comparison study in which 0·1 % halcinonide (in a cream formulation containing also neomycin and nystatin) was applied to the lesions on one side of the body and 1% hydrocortisone cream to those on the opposite side for two to three weeks. The number of excellent responses to therapy showed the halcinonide combination to be significantly superior (p >0·01) to the control cream in all diagnostic categories if considered collectively, and in psoriasis if the responses were grouped according to diagnosis. No adverse reactions occurred during the trial.
Fentiazac as a Therapeutic Aid in the Treatment of Tuberculosis
Authors: Natale F , Perna G
Published: January 2017

The authors point out the clinical usefulness and optimal tolerability of Fentiazac in patients suffering from tuberculosis and whose condition requires therapeutic intervention with non-steroid anti-inflammatory drugs.
An Open Comparative Trial of Vanquin Tablets and Pripsen Granules in the Treatment of Threadworm Infestation
Authors: Molla A Layes , Donald J F
Published: January 2017

Thirty-eight patients presenting to their general practitioner with threadworm infestation were admitted to an open, comparative, multicentre trial of Vanquin tablets and Pripsen granules. Efficacy and tolerance were assessed. Twelve of nineteen patients treated with Vanquin had positive results from a peri-anal skin test at the start of treatment, all results were negative after twenty-one days. Fourteen of nineteen patients treated with Pripsen had positive results at the start of treatment and two of these had positive results after twenty-one days. One patient treated with Vanquin and five treated with Pripsen reported side-effects.
A Clinical Assessment of Locabiotal in the Treatment of Infections of the Nose and Throat
Authors: Osman M F
Published: January 2017

One hundred and twenty patients suffering from diseases of the nose and throat were admitted to an open clinical trial of the aerosol inhaler Locabiotal which contains the antibiotic fusafungine. The patient population was derived from three sources—out-patients, patients subjected to surgery and emergencies. The aerosol was administered five times daily to the throat or into the nose. The aerosol was highly effective in controlling infection and in relieving the various symptoms of the diseases treated. Variation in particle size was considered to be an advantage in penetrating various parts of the upper respiratory tract. Thirty-three patients experienced minor side-effects. These were thought to be due to misuse of the inhaler, or possible allergy to the antibiotic. This form of medication is recommended for a variety of diseases of the nose and throat.
Timolol and Bendroflumethiazide in the Treatment of Hypertension
Authors: Karatzas N B , Papazachos G , Clouva P , Tsaknakis T
Published: January 2017

The effects on mild to moderate essential hypertension of 20 mg timolol and 5 mg bendroflumethiazide daily were compared in a randomized double-blind, crossover study in twenty-seven out-patients with pre-treatment diastolic blood pressure ranging from 100 to 130 mm Hg. After a four-week placebo period, a six-week treatment period for each drug followed, with one week on placebo before the crossover. All the patients then received a combination tablet containing the two drugs for another six weeks, using the same doses, except in those patients whose diastolic blood pressure had fallen to 90 mm Hg or below with either timolol or bendroflumethiazide alone, in whom the daily doses were halved.

The lying diastolic blood pressure in the group of patients receiving timolol before bendroflumethiazide was 108 mm Hg on placebo, 90 mm Hg on timolol, 94 mm Hg on bendroflumethiazide and 86 mm Hg on the combination tablet. In the group of patients receiving bendroflumethiazide before timolol, it was 109 mm Hg on placebo, 95.5 mm Hg on bendroflumethiazide, 94 mm Hg on timolol and 84 mm Hg on the combination tablet. Of the twenty-seven patients, eleven achieved a diastolic blood pressure of 90 mm Hg or below with timolol, ten with bendroflumethiazide and twenty-three with the combination tablet. Two patients could not tolerate timolol, one because of bradycardia and the other because of bronchospasm, but in the rest, tolerance of all treatment regimens was excellent.
Comparative Clinical Trial of Amoxycillin and Chloramphenicol in the Treatment of Typhoid in Adults
Authors: Abengowe C U
Published: January 2017

A randomized clinical trial in sixty-two adult patients suffering from typhoid fever, proved by blood and marrow culture, showed that amoxycillin in a dosage schedule of 1 g 8-hourly orally for fourteen days was better than chloramphenicol with regard to clinical and temperature response and in respect of carriers and relapse rates. One patient developed a hypersensitivity reaction to amoxycillin which cleared on withdrawal of the drug. Success was achieved in 90% of cases. These findings lend very strong support to the value of amoxycillin as a superior alternative to chloramphenicol in the treatment of typhoid fever.
Clinical Effect of Encephabol (Pyritinol) in the Treatment of Cerebrovascular Disorders
Authors: Tazaki Yoshiaki , Omae Teruo , Kuromaru Shoshiro , Ohtomo Eiichi , Hasegawa Kazuo , Mori Atsuyoshi , Kurihara Masanao , Kutsusawa Naoyuki , Okada Tsugio
Published: January 2017

The results of a series of multicentre, controlled, double-blind trials of the clinical efficacy of Encephabol compared with placebo in patients with a variety of cerebrovascular disorders are reported.
An Open Comparison between Free and a Fixed Combination of Diuretic and β-Blocker in the Management of Essential Hypertension
Authors: Forrest W A
Published: January 2017

A total of 1,117 patients with inadequately controlled hypertension in spite of treatment with a combination of diuretic and β-adrenergic blocker were studied. Treatment was changed to one or two tablets daily of Trasidrex (160 mg oxprenolol hydrochloride in a sustained release formulation and 0.25 mg cyclopenthiazide) with a subsequent improvement, 4 weeks later, in blood pressure control.

Side-effects of treatment were uncommon and treatment was approved by the majority of patients. The majority of doctors participating thought a fixed combination would improve patient compliance with therapy.
The Antihypertensive and Biochemical Effects of Hydrochlorothiazide/Amiloride (Moduretic) versus Chlorthalidone
Authors: van Soeren F
Published: January 2017

In an open two-period crossover study hydrochlorothiazide/amiloride and chlorthalidone were compared with regard to their anti-hypertensive and biochemical properties in ambulatory patients with mild to moderate hypertension.

Twenty-five out of twenty-six patients completed the study. In the chlorthalidone group plasma potassium was consistently lower than in the hydrochlorothiazide/amiloride group, the difference achieved significance at 8 and 12 weeks after the start of treatment. With regard to the hypertension and other parameters no statistically significant differences were found.
A Comparison of Oral Metoprolol and Propranolol in Patients with Chronic Bronchitis
Authors: Anderson G , Jariwalla A G , Al-Zaibak M
Published: January 2017

A double-blind study of oral metoprolol and propranolol in nine patients with chronic bronchitis (Medical Research Council definition) showed no appreciable deterioration in lung function or significant differences between the two drugs.
Tolciclate versus Miconazole, a Double-Blind Trial in Patients with Dermatomycosis
Authors: Cucè L C , Assunção B F Contijo , Medawar L G A , Salibian A , Groppi W
Published: January 2017

Eighty-one patients with dermatomycosis such as tinea corporis, tinea cruris, tinea pedis and pityriasis versicolor were treated with tolciclate 1% cream or miconazole 2% cream. Parasitological cure was obtained in 100% of the patients given tolciclate and in 97.4% of those given miconazole.

Patients and investigator considered tolciclate treatment as excellent, respectively, in 76.2% and 73.8% of the cases. The corresponding figures for miconazole were 74.4% and 66.7%. Both treatments were well tolerated.
The Monitored Release of Buprenorphine: Results in the Young
Authors: Harcus A W , Ward A E , Smith D W
Published: January 2017

Temgesic Injection (buprenorphine), a potent analgesic agent, was given to 240 patients under 18 years of age during a year of monitored release. All but four had the product for the management of moderate or severe pain in the immediate post-operative period. Analgesia was reported as adequate or good in 90% of these young patients when it was assessed 2 and 4 hours after injection. There were no reports of side-effects commonly associated with strong analgesics and particularly antagonist-analgesics such as confusion, hallucination, blurred vision, dry mouth and lightheadedness. There were no serious respiratory or cardiovascular effects. The incidences of other events did not differ from those recorded in the much larger adult population of almost 8,000 patients. Buprenorphine is an effective analgesic suitable for use in the young post-operative patient.
Once Daily Dose Treatment with a Non-Steroidal Anti-Rheumatic Drug (Diclofenac) in Osteoarthrosis
Authors: Schubiger B I , Ciccolunghi S N , Tanner K
Published: January 2017

In a comparative, double-blind, between-patient, multicentre trial of 2 weeks' duration the efficacy and tolerability of diclofenac sodium 100 mg slow-release tablets, given either as a morning or an evening dose, were compared with that of diclofenac 50 mg enteric-coated tablets b.i.d. and placebo in 148 patients suffering from osteoarthrosis. Statistically significant differences in efficacy were shown between the two diclofenac slow-release regimes and placebo. Diclofenac 100 mg slow-release taken as a morning or an evening dose tended to be more effective than 50 mg enteric-coated tablets in a twice daily regime. The tolerability of diclofenac 100 mg slow-release and 50 mg enteric-coated b.i.d. regimes was similar and not statistically significantly different from placebo.
An Open Study of Acebutolol, Given as a Single Daily Dose in the Management of Hypertension in the Chulalungkorn Hospital, Thailand
Authors: Ongcharit C , Goulton J , Baker P G
Published: January 2017

In an open study of fifteen patients with essential hypertension, acebutolol, a cardioselective β1-adrenoceptor antagonist given orally once daily at dosages of between 400 mg and 1200 mg, produced a substantial and progressive reduction in systolic and diastolic arterial pressure and in the tension time index both in the lying and standing position over the 3 months of the trial. The changes from pre-trial values of blood pressure assessments were statistically significant (p<0.001). No side-effects were reported and laboratory monitoring of biological parameters revealed no untoward effects of treatment.
Performance in Students with Seasonal Allergy
Authors: Bentley S
Published: January 2017

Two treatments for summer grass pollen allergy have been studied in university students who undertook performance tests before and after treatment.
Blood Fluidity and Coagulation Phenomena in Chronic Arterial Occlusive Disease
Authors: Angelkort B , Boateng K , Maurin N
Published: January 2017

Blood fluidity depends on a number of factors of which especially the deformability of erythrocytes is of importance. Investigations reported in this paper have revealed an interdependence between blood fluidity and coagulability of blood. They confirm the significance of maintaining red cells deformability if an adequate microcirculation is to be provided in patients with occlusive vascular disease. High doses of oral pentoxifylline are able to improve erythrocyte flow rates in palients with occlusive vascular disorder. This agent also decreases platelet hyper-reactivity, a factor of importance in arresting the arteriosclerotic progression. In addition the hypercoagulability existing in such patients is reduced and the fibrinolytic system stimulated by treatment with the drug.
Triamcinolone Hexacetonide in the Treatment of Therapy-Refractory Gonitis
Authors: Jalava S , Virsiheimo B
Published: January 2017

Thirty-seven patients suffering from sustained gonitis with recurrent hydrops, not satisfactorily controlled by systemic treatment, participated in the study.

Twenty-three patients had bilateral and fourteen patients had unilateral gonitis. Controls were obtained through the use of the contra-lateral knee joint in the twenty-three patients with bilateral gonitis.

A total of 60 knees were randomized into three groups of 20 knees and received either 30 mg triamcinolone hexacetonide (TH), 60 mg methylprednisolone (MP) or 9 mg betamethasone (BM).

The clinical parameters evaluated were: recurrence of hydrops, pain, local tenderness, range of joint movement and joint circumference.

The period of time elapsing between the injection and the need for a new injection or other treatment was used as the criterion for the duration of effect.

Relief lasting for an average of 176 days was obtained in the 20 knees treated with local injections of TH, compared to 125 days for MP and 79 days for BM.

No general or local adverse effects were noted in the patients studied.

The observed long duration of effect and the absence of adverse effects justify the use of TH in cases of therapy-refractory gonitis.
Prevention of Platelet Hyperaggregation during Coronary Angiography
Authors: Ammaturo V , Perricone C , Zuccarelli B , Mininni N , Colussi L , Canazio A , Palumbo E
Published: January 2017

The authors previously reported an increase in platelet aggregation in the days after coronary angiography, accompanied at times by worrying cardiovascular disorders (ventricular fibrillation in one case, death in two others). In the present study, ten patients received a platelet antiaggregating drug (ticlopidin) 5 days before their coronary angiography. No significant changes were detected in the test for circulating platelet aggregates (CPA test) in these patients.
Temelastine, a New H1-Receptor Antagonist
Authors: Alexander Fred , Stote Robert M , Allison Nancy , Familiar Robert G , Tatoian Dianne , Dubb Jeffrey W
Published: January 2017

Temelastine is a selective, competitive histamine H1-receptor antagonist which does not penetrate the central nervous system. The effect of varying doses of temelastine was compared in a randomized, double-blind, controlled study by measuring the inhibition of cutaneous histamine wheals. In twelve subjects single oral doses of 50, 100 and 200 mg of temelastine produced dose-dependent reductions in wheal areas. The inhibition of wheal size was maximal by 2 hr after dosing and was present at 8 hr. At 2 hr the 50, 100, and 200 mg doses reduced the wheal size by 53, 64, and 78%, respectively. Chlorpheniramine, 4 mg, reduced wheal size by 32% at the same period. The ability of temelastine to antagonize the histamine-induced skin reaction over 20 hr was evaluated in a second randomized, double-blind study. Eight subjects participated. Temelastine, 100 mg, produced reductions of 64, 49, 56 and 51% in histamine wheal area at 8, 12, 16 and 20 hr, respectively. Plasma concentrations at these times were 4.04, 2.77, 1.88, and 1.44 μmol/l, respectively. These data suggest that blood levels as low as 1.44 μmol/l may be sufficient to produce an antihistaminic effect, and that daily or twice daily dosing with 100 mg may be adequate to control allergic symptoms.
Controlled Trial of the Action of a Toothpaste Containing Nicomethanol Hydrofluoride in the Treatment of Dentine Hypersensitivity
Authors: Lecointre Claude , Apiou Jean , Marty Patrick , Poitou Pierre
Published: January 2017

A double-blind clinical trial was performed on 76 patients with dentine hypersensitivity. For four weeks the patients used either a toothpaste containing nicomethanol hydrofluoride or one containing potassium nitrate and sodium monofluorophosphate. After one, two and four weeks the pain responses of the teeth to three types of stimuli were assessed. In normal conditions of oral hygiene, the nicomethanol hydrofluoride toothpaste was found at least as effective as the potassium nitrate/sodium monofluorophosphate preparation.
The Lugano Statements on Controlled Clinical Trials
Authors: Blum A. L. , Chalmers T. C. , Deutsch E. , Koch-Weser J. , Rosén A. , Tygstrup N. , Zentgraf R.
Published: January 2017

During a consensus conference in Lugano, Switzerland, 175 statements on controlled clinical trials were drafted by 47 representatives from academia, governmental registration agencies and industry in nine countries. Their opinion on these statements was similar to that of 47 ‘matched pairs’ who did not attend the conference. Thus, the opinion of participants and non-participants appears to reflect the general opinion of those currently involved in designing, conducting and analysing controlled clinical trials. The Lugano statements give answers to the following questions: Is the controlled clinical trial in a crisis? What is the motivation to perform controlled clinical trials? Is it possible for a physician participating in a controlled clinical trial to act in the patient's best interest? Is it possible to obtain truly informed consent in a controlled clinical trial? When is it ethical to withhold active treatment in a controlled clinical trial? What are the controversial issues in the design of a good controlled clinical trial? Is there a double standard with respect to efficacy and adverse drug reactions in controlled clinical trials? What are the alternatives to controlled clinical trials and when should they be performed? How can sponsor bias be minimized? How should an ethics committee decide whether a controlled clinical trial is Should? ethical registration agencies become directly involved in the planning and conduct of controlled clinical trials? Do the declarations of Tokyo and Helsinki facilitate the conduct of ethically valid controlled clinical trials? Is it possible to create an international standard for the conduct and regulation of controlled clinical trials? Why do messages from controlled clinical trials filter into medicine so slowly? Is it possible to bridge the gap between controlled clinical trials and clinical reality? What are the costs of doing and not doing controlled clinical trials? When should drug companies decide to start a trial programme with a specific compound? Is there public hostility against controlled clinical trials? If so, how can it be reduced? The respondents almost unanimously felt that controlled clinical trials are a must; the public must be told that progress in medicine depends on controlled clinical trials, that patients often benefit from participating in them and that the alternative, practising in the face of constant uncertainty, is worse than the possible disadvantages related to the conduct of the trial.
Intramuscular Treatment of Migraine Attacks Using Diclofenac Sodium: A Crossover Clinical Trial
Authors: Del Bene E. , Poggioni M. , Garagiola U. , Maresca V.
Published: January 2017

This was a double-blind clinical trial, with a crossover design, to compare the efficacy of a non-steroidal anti-inflammatory drug, diclofenac sodium, intramuscularly administered, and placebo in the treatment of migraine attacks. The drug was administered to 40 patients once a day in three consecutive migraine attacks. If pain still remained after 6 h following administration the patient was given a 100 mg diclofenac sodium suppository, in open condition. Evaluation was by a complete medical examination performed by the physician and by the patient completing a specially designed self-assessment card. A total of eight patients dropped out of the trial (all during placebo administration): three due to poor compliance, four for refusal to continue and one because no further migraine attacks developed. Results were analysed after having checked the absence of both period and carry-over effects. In all cases diclofenac sodium was more effective than placebo ( P < 0.01). This was also confirmed by data obtained from the patient self-assessment cards ( P < 0.001) and by preferences expressed by patients at the end of the trial ( P < 0.001). Tolerance to the drug was similar to that of placebo.
A Clinical Evaluation of Clavulanate-Potentiated Amoxycillin in the Management of Moderate to Severe Respiratory Tract Infections
Authors: Anyanwu C. H. , Umeh B. U. O.
Published: January 2017

This study investigated the effects of clavulanate-potentiated amoxycillin in the management of moderate to severe respiratory tract infections. A total of 34 patients aged 10–70 years were studied to establish the clinical and bacterial efficacy of treatment and screened for unwanted effects and abnormal laboratory findings. Clavulanate-potentiated amoxycillin was given in dosages of 375 or 750 mg twice daily, orally, for a mean of 13 days (range 3–30 days). Patients were assessed at the end of 2 weeks and again on discharge from hospital (if later) for up to 6 months. Overall diminution in the number of symptoms was recorded at the end of the study; 78% of symptoms had disappeared after 2 weeks. The treatment proved highly effective in controlling respiratory tract infections in 94% of patients. The necessity for multiple drug therapy and parenteral administration was also avoided.