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At least 991 records · Page 55Linked to original sources

PubMed1980

Low dose heparin and compression stockings in the prevention of postoperative deep venous thrombosis.

The frequency of deep venous thrombosis (DVT) was studied in 98 patients undergoing major abdominal surgery. All the patients received low dose heparin prophylaxis 5000 i.u. every 12 h for 5-7 days. In each patient, a graduated compression stocking was also worn and randomly allocated to one of the legs and the other leg served as a control. DVT was diagnosed by the 125I-fibrinogen method. Four patients developed bilateral DVT and 8 patients unilateral DVT, all of whom developed it in the control leg. The difference in unilateral DVT between stockinged and control legs was significant (P < 0.004). It is concluded that a combination of low dose heparin and graduated compression stockings is more effective than low dose heparin alone in reducing the frequency of postoperative DVT. It is suggested that this combination of prophylaxis might be of value in high risk patients.

Abdomen↗

PubMed1992

Intrauterine PGF2 alpha infusion for termination of pregnancies with second-trimester rupture of membranes.

Intrauterine prostaglandin (PG) F2 alpha infusion and intravenous (IV) oxytocin infusion were compared to evaluate the effectiveness of the two methods for termination of pregnancies with second-trimester rupture of membranes. Twenty-two women with this complication were randomly allocated to receive either 20 mg PGF2 alpha, diluted in 500 mL of NaCl 0.9% and administered through a Foley catheter inserted through the cervix, or IV oxytocin infusion in increasing doses. All subjects in the PGF2 alpha group aborted after the first administration. Repeat infusion was necessary in three oxytocin-treated subjects. The mean (+/- SD) induction-abortion interval was significantly shorter in those receiving PGF2 alpha (6.7 +/- 1.2 hours) than in those receiving oxytocin (8.8 +/- 2.7 hours). Minor side effects, such as nausea and vomiting, were observed in three women during PGF2 alpha infusion and were treated symptomatically and by temporary interruption of the infusion. Uterine hypertonus, observed in one subject in each group, was treated by temporary cessation of the infusion. We conclude that intrauterine PGF2 alpha infusion seems more effective than IV oxytocin for termination of pregnancies with second-trimester rupture of membranes.

Abortion, Therapeutic↗

PubMed1983

A placebo-controlled trial of thymic hormone treatment of recurrent herpes simplex labialis infection in immunodeficient hosts.

Twenty-one immunodeficient patients with recurrent herpes simplex labialis (HSL) were randomly allocated to either saline or the bovine thymus extract thymostimulin (TS) and treated for a period of 6 months. An impressive reduction in both number and severity of the recurrences of the infection was observed in TS-treated patients during the trial and for up to 3 months afterward. A significant increase in total WBC, lymphocyte count, and T cells was detected in the TS group after 6 months. In vitro lymphoproliferative responses to herpes simplex virus antigen and natural killer cell activity were also significantly higher in the TS group, whereas no significant difference in antibody titers to herpes simplex could be detected between the two groups. TS can therefore help prevent viral reactivation in immunocompromised hosts by potentiating cell-mediated immune responses and should be considered for use in prophylaxis of infection in patients at risk and also in apparently normal subjects with recurrent HSL.

Adolescent↗

PubMed1986

Comparison of single dose with a five-day course of trimethoprim for asymptomatic (covert) bacteriuria of pregnancy.

Sixty consecutive pregnant women with asymptomatic (covert) bacteriuria detected between 16 and 30 weeks gestation were randomly allocated to treatment with either a single 600 mg dose or a standard five-day course of trimethoprim. Twenty-seven of 30 women were cured with a single dose. Six of these 27 women were reinfected later in the pregnancy. Twenty-four of 30 women treated with a five-day course of trimethoprim were cured, and five became reinfected later in the pregnancy. One women vomited the single dose. There were no detrimental effects on the outcome of the pregnancies. Single dose therapy should be considered as the treatment of choice for asymptomatic bacteriuria in pregnancy.

Adolescent↗

PubMed1989

Egg and breast milk based nitrogen sources compared.

A nitrogen source based on egg protein (Vamin 9 glucose) and an alternative with an amino acid profile more similar to breast milk (Vaminolact), were compared in 14 parenterally fed infants. Subjects were randomly allocated to receive one or other amino acid solution, but were otherwise given identical diets. At the start of the study the two groups did not differ significantly in postconceptual age, postnatal age, or weight. Over a six day study period on a stable intake of intravenous nutrients there was no significant difference in growth or nitrogen retention between the two groups. Plasma amino acid profiles in those receiving Vamin 9 glucose, however, were frequently abnormal. Notably, mean concentrations of potentially neurotoxic phenylalanine and tyrosine were significantly higher (140% and 420%, respectively) in patients fed Vamin 9 compared with those given Vaminolact. An amino acid solution based on the composition of breast milk protein therefore brings plasma amino acid profiles during parenteral nutrition closer to those found in breast fed infants, and reduces in particular, the risks of hyperphenylalaninaemia and hypertyrosinaemia.

Amino Acids↗

PubMed2002

Effects of feeder-trough space and variation in body weight within a pen of pigs on performance in a wean-to-finish production system.

Two studies were carried out with the same group of pigs within a wean-to-finish system. In Study 1 (weaning to wk 8 postweaning), the effect of feeder-trough space in pens that were double-stocked on pig growth was evaluated. In Study 2 (end of wk 8 to 112 +/- 1.5 kg BW), the effect of variation in pig BW within a pen on growth was investigated. In Study 1, a randomized block design was used to compare two feeder-trough space treatments (Double [4 cm/pig] vs Control [2 cm/pig]). Pigs (n = 1,728) were randomly allocated at weaning (5.4 +/- 0.01 kg BW; 16 d of age) to mixed-sex pens (8 pens/treatment) of 108 pigs/pen on the basis of BW. Floor-space (0.30 m2/pig) and drinker allocation (13 pigs/drinker) were the same for both treatments. Two six-place (35 cm/place) feeders were positioned together in the center of each pen and were accessible from both sides. For the Double treatment, both feeders contained feed, whereas for the Control only one feeder contained feed. In Study 2, a randomized block design was used to compare three BW/variation in BW treatments: 1) Heavy BW/Low variation, 2) Light BW/Low variation, and 3) Mixed BW/Normal variation. The double-stocked pens of pigs from within previous feeder-trough space treatment were split into two groups of 54 pigs (equal sex ratio) having either high or low BW variation within pen. Pigs had free access to feed and water throughout the studies. In Study 1, doubling feeder-trough space did not affect (P > 0.05) pig growth from weaning to the end of wk 6. From wk 6 to 8, pigs on the Double treatment compared to the Control treatment had higher (P < 0.05) ADG and were heavier (P < 0.05), but had similar (P > 0.05) ADFI and gain:feed ratio. In Study 2, pen-BW treatment did not impact (P > 0.05) ADG or gain:feed ratio; however, Heavy/Low had greater (P < 0.01) ADFI than Light/Low with Mixed/Normal being intermediate for ADFI. At 112 kg BW, CV of BW within a pen was similar (P > 0.05) across treatments; however, days to market BW was greater (P < 0.001) for Light/Low than Heavy/ Low with Mixed/Normal being intermediate. In summary, increasing feeder-trough space from 2 to 4 cm per pig increased daily gain after wk 6 postweaning in double-stocked pens of pigs; however, sorting pigs on the basis of BW when splitting pens did not impact growth rate or variation in BW within a pen at market BW.

Animal Husbandry↗

PubMed1990

Should neonates with specific "risk factors" be admitted to the special care nursery?

Existing criteria for admission of newborns to the special care nursery, Sarawak General Hospital, resulted in the admission of many neonates with certain risk factors ("at risk" neonates). To test whether such babies could be safely and better cared for in postnatal wards, 392 of these babies were randomly allocated into two groups. One group of 196 was admitted to the special care nursery and the other group of 196 was cared for with their mothers in the postnatal wards. The two groups were compared for mortality, morbidity and breastfeeding. There was no significant difference in mortality and morbidity between the two groups. While in hospital a larger proportion of babies cared for in postnatal wards were breastfed, compared to babies admitted to the special care nursery. In addition, they initiated their breastfeeding earlier. Babies with these risk factors should therefore be cared for with their mothers in the postnatal wards.

Breast Feeding↗

PubMed1980

Treatment of duodenal ulcer with antacids in combination with trimipramine or cimetidine.

Ninetyfive patients with endoscopically verified duodenal ulcer were randomly allocated in a double blind manner to 3 different treatments. Thirtyfive patients were treated with trimipramine 25 mg nocte, 32 patients with cimetidine 400 mg nocte and 26 patients with cimetidine 200 mg 3 times a day and 400 mg nocte (standard dose). In addition all patients got intensive antacid treatment with LinkR, 20 ml 1 and 3 hours after meals. Two patients were excluded from the trial. After 6 weeks of treatment re-endoscopy revealed healed ulcer in 35 patients (86%) in the trimipramine group, in 32 patients (85%) in the group treated with low dose of cimetidine and in 26 patients (100%) in the group treated with standard dose of cimetidine. The differences in healing rate were not significant. The time until complete relief of pain was significantly longer in the trimipramine group than in the cimetidine groups. The drugs were well tolerated but constipation was reported by 31% of the patients.

Adult↗

PubMed1986

Twice-daily verapamil for hypertension: a comparison with propranolol.

Recent reports have confirmed that some slow calcium channel inhibitors have useful antihypertensive properties because they produce dilatation of the peripheral arterioles without reflex tachycardia. Verapamil is such a drug, but its clinical role in the management of hypertension is not clear. An open crossover trial was performed to compare the 24-hour profiles of blood pressure reduction after long-term therapy with a standard beta-adrenoceptor blocker, propranolol, and verapamil. Nineteen patients were studied by continuous ambulatory intraarterial recording and the order of drug administration was determined by random allocation. The drugs were administered 2 times a day and titrated according to casual clinic pressures (propranolol, 40 to 240 mg 2 times a day; verapamil, 120 to 240 mg 2 times a day). Mean hourly blood pressure and heart rate values were obtained over a 24-hour cycle and the responses to isometric and dynamic exercise were also examined. The drugs produced a uniform and comparable reduction in blood pressure throughout the day, together with a reduction in heart rate, which was greater with propranolol. Comparable effects were also seen on the pressor responses to exercise. Both drugs were equally well tolerated and caused no patient withdrawals. Thus, oral verapamil given 2 times a day shows a degree of efficacy similar to that of propranolol and provides 24-hour blood pressure control. This slow calcium channel inhibitor was well tolerated and may be used as initial therapy for hypertension.

Adult↗

PubMed1987

Chronic eczematous dermatitis of the hands: a comparison of PUVA and UVB treatment.

The efficacy of PUVA and UVB treatment in chronic eczematous dermatitis of the hands was compared in a randomised controlled study including 35 patients who were randomly allocated to PUVA or UVB treatment. One hand was exposed to light and the other served as an untreated control. The dermatitis cleared on the treated hand in all PUVA patients, but in 9 out of 14 there was a relapse within three months. In the UVB group clearing of the skin lesions was not achieved, but compared with the "untreated" hands a statistically significant improvement was found at 12 weeks of treatment. A statistically significant improvement of "untreated" hands was found in both groups. PUVA and UVB treatments are alternative treatment modalities in patients with recalcitrant chronic eczematous dermatitis of the hands. PUVA is superior to UVB.

Clinical Trials as Topic↗

PubMed1986

[Adjuvant chemotherapy in patients with radical resection of stomach cancer: 5-year results of a prospective randomized study].

102 patients with operable gastric carcinoma were randomly allocated to untreated control, polychemotherapy, chemoimmunotherapy. At a median follow-up of 5 years, chemotherapy did not improve the overall survival rate. However, in certain subgroups, patients with lymphnode metastases and intestinal tumor type showed a significant survival benefit when treated with adjuvant chemotherapy. Furthermore, we found the site of first recurrence very closely related to the type of tumor histology. Regardless of the positive effect of chemotherapy in retrospective subset-analysis, we do not generally recommend the use of polychemotherapy in operable gastric carcinoma.

Aged↗

PubMed1983

Controlled trial of monthly alternated courses of steroid and chlorambucil for idiopathic membranous nephropathy.

Forty-nine patients with membranous nephropathy (MN) and nephrotic syndrome (NS) were randomly allocated to supportive or specific therapy. The latter consisted of steroids or chlorambucil given in alternate months for a cumulative period of six months. Three patients in the experimental group were dropped from the study because of therapy related side-effects. At the end of follow-up there were significantly more patients in complete or partial remission in the experimental group than in the controls. The mean serum creatinine did not change in treated patients, but it significantly increased in controls.

Chlorambucil↗

PubMed1983

Treatment of tinea versicolor with sulfur-salicylic shampoo.

One week of nightly application of sulfur-salicylic acid shampoo as a lotion was evaluated for the treatment of tinea versicolor. One half of the randomly allocated patients used the active preparation and the other half used a bland oil-in-water lotion as a placebo. Three months after completing treatment, nineteen of twenty-two using sulfur-salicylic acid shampoo were still negative by KOH examination, whereas only one of sixteen controls was negative. Skin irritation occurred in a few patients but did not reduce the effectiveness of the treatment.

Adolescent↗

PubMed1989

[Comparative study of 2 dosages of a new antihypertensive agent, cicletanine, in elderly subjects].

Cicletanine chlorhydrate (C), a furopyridine derivative, is a new antihypertensive drug that acts mainly by enhancing endogenous prostacyclin release. It has been shown to induce a significant, progressive reduction in systolic and diastolic blood pressure in patients over 60 years of age at a daily dose of 150 mg in a placebo-controlled efficacy trial. As concurrent studies in adult hypertensive patients demonstrated an antihypertensive effect at even lower doses, we further compared the antihypertensive efficacy and tolerance of 50 mg vs 100 mg daily dose of C in elderly hypertensive patients in order to determine the lowest active posology. A prospective, double-blind randomized trial included 72 patients (56 female, 16 male) aged 65 years or more (mean age +/- 1 SD: 80.3 +/- 5.9 years, range 65-90) with moderate, essential hypertension, and normal-for-age renal function whose diastolic BP was greater than 95 mmHg and/or systolic BP was greater than 160 mmHg after 15 days of a single-blind placebo period. They were randomly allocated to either 50 mg (group I, 36 patients) or 100 mg (group II, 36 patients) C given in a single morning dose for 3 months with monthly surveillance. Of them, 60 achieved satisfactory BP control with C as monotherapy and completed full follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1986

Prospective controlled trial of transhepatic biliary endoprosthesis versus bypass surgery for incurable carcinoma of head of pancreas.

53 patients with obstructive jaundice due to incurable carcinoma of the head of the pancreas were randomly allocated to percutaneous transhepatic placement of a permanent biliary endoprosthesis (PTE) or bypass surgery. After exclusions 25 patients in each group were treated. Technical success was achieved in 21 patients (84%) in the PTE group and 19 (76%) in the surgery group. The incidence of postprocedural complications (PTE 7, surgery 8) and 30-day mortality (PTE 2, surgery 5) were similar. Recurrent jaundice occurred more often in the PTE (8/21) than the surgery group (3/19). Duodenal obstruction developed in 3 patients in the PTE group. Although the initial median postprocedural hospital stay was significantly shorter in the PTE than the surgery group, the difference was no longer significant when readmissions for blocked endoprosthesis and gastric outlet obstruction were taken into account. There was no difference in the median survival time in the two groups (PTE 19 weeks, surgery 15 weeks).

Aged↗

PubMed1987

Comparative efficacy and safety of ceftizoxime, cefotaxime and latamoxef in the treatment of bacterial pneumonia in high risk patients.

One hundred and thirty-five patients with bacterial pneumonia who had risk factors (alcoholism, chronic obstructive pulmonary disease, corticosteroid therapy diabetes mellitus, advanced age, solid tumours) were randomly allocated in a double-blind fashion to receive either ceftizoxime (2-4 g every 8 h), cefotaxime (1-2 g every 4 h), or latamoxef (2-4 g every 8 h). Of the 84 patients evaluable for efficacy, clinical cure was achieved in 91%, 85%, and 89% of ceftizoxime- (20/22), cefotaxime-(23/27), and latamoxef-treated (31/35) patients, respectively. Adverse reactions occurred in one of 45 ceftizoxime-treated patients, one of 43 cefotaxime-treated patients, and seven of 47 latamoxef-treated patients. Abnormal laboratory values during therapy were seen in 50% of latamoxef-treated and 43% of cefotaxime-treated patients and in 29% of ceftizoxime-treated patients. Hypoprothrombinaemia occurred in five latamoxef-treated patients and one of these patients experienced an episode of haematemesis. In this study, ceftizoxime, cefotaxime, and latamoxef were similarly effective; however, the incidence of side effects was most frequent with latamoxef.

Aged↗

PubMed1988

Prevention of colonization and infection in critically ill patients: a prospective randomized study.

In a prospective randomized study to determine whether prevention of colonization of Gram-negative bacteria results in prevention of Gram-negative bacterial infections, 96 intensive care patients were randomly allocated into a control group and a study group. The study group received oral nonabsorbable antimicrobial agents (i.e., tobramycin, amphotericin B, and polymyxin E) in addition to parenteral antibiotics. Colonization with Gram-negative microorganisms in the oropharynx, and respiratory and digestive tracts increased in the control group during their stay, while the study group did not tend to colonize with Gram-negative bacteria. In the control group, 107 nosocomial infections were diagnosed, vs. 42 nosocomial infections in the study group. Nosocomial infections caused by Gram-negative bacteria were significantly less frequent in the study group. Mortality due to an acquired infection was significantly less frequent in the study group. We conclude that colonization, infection, and subsequent mortality by nosocomial Gram-negative bacteria can be prevented by a regime of topically applied nonabsorbable antibiotics.

Adult↗

PubMed1989

Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomized placebo-controlled trial.

Ultrasound and pulsed electromagnetic energy therapies are increasingly used for perineal trauma sustained during childbirth. The study included 414 women with moderate or severe perineal trauma randomly allocated to receive active ultrasound, or active pulsed electromagnetic energy, or corresponding placebo therapies; the allocation was double-blind for each machine. Overall, more than 90% thought that treatment made their problem better. There were no clear differences between the groups in outcome either immediately after treatment, or 10 days or 3 months postpartum, other than more pain associated with pulsed electromagnetic energy treatment at 10 days. Bruising looked more extensive after ultrasound therapy but then seemed to resolve more quickly. Neither therapy had an effect on perineal oedema or haemorrhoids. The place of these new therapies in postnatal care should be clarified by further controlled trials before they become part of routine care.

Adult↗