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PubMed1992

A comparative study of 0.25% ropivacaine and 0.25% bupivacaine for brachial plexus block.

The present study compares the effectiveness of 0.25% ropivacaine and 0.25% bupivacaine in 44 patients receiving a subclavian perivascular brachial plexus block for upper extremity surgery. The patients were assigned to two equal groups in this randomized, double-blind study; one group received ropivacaine 0.25% (112.5 mg) and the other, bupivacaine 0.25% (112.5 mg), both without epinephrine. Onset times for analgesia and anesthesia in each of the C-5 through T-1 brachial plexus dermatomes did not differ significantly between the two groups. The mean onset time for analgesia ranged from 11.2 to 20.2 min, and the mean onset time for anesthesia ranged from 23.3 to 48.2 min. The onset of motor block differed only with respect to paresis in the hand, with bupivacaine demonstrating a shorter onset time than ropivacaine. The duration of sensory and motor block also was not significantly different between the two groups. The mean duration of analgesia ranged from 9.2 to 13.0 h, and the mean duration of anesthesia ranged from 5.0 to 10.2 h. Both groups required supplementation with peripheral nerve blocks or general anesthesia in a large number of cases, with 9 of the 22 patients in the bupivacaine group and 8 of the 22 patients in the ropivacaine group requiring supplementation to allow surgery to begin. In view of the frequent need for supplementation noted with both 0.25% ropivacaine and 0.25% bupivacaine, we do not recommend using the 0.25% concentrations of these local anesthetics to provide brachial plexus block.

Adult↗

PubMed1988

Treatment of urinary tract infections in Hong Kong: a comparative study of norfloxacin and co-trimoxazole.

The study compared the efficacy and safety of norfloxacin to those of co-trimoxazole in the treatment of urinary tract infections (UTI). A total of 172 adults, 42 men and 130 women were recruited and randomly allocated to norfloxacin or co-trimoxazole using a double-blind study design. Patients with lower UTI received norfloxacin 200 mg or co-trimoxazole (160 mg of trimethoprim plus 800 mg of sulphamethoxazole) b.i.d. for seven days. In patients with upper UTI, the norfloxacin dose was 400 mg b.i.d. for seven days. Eleven to 14 days after treatment, the bacteriological cure rates were 96.8% and 83.3% and the clinical cure rates were 96.9% and 89.9% for norfloxacin and co-trimoxazole, respectively. A few patients complained of gastrointestinal symptoms but there were few other side-effects and the treatments were well tolerated. In conclusion, both norfloxacin and co-trimoxazole were well tolerated but norfloxacin gave higher cure rates.

Adult↗

PubMed1991

Clinical features of breast cancer--Anglo-Japanese comparative study.

A comparative study was undertaken at Guy's Hospital in the UK and the Aichi Cancer Center in Japan of the clinical picture of breast cancer in the UK and Japan. Target patients were 221 UK and 200 Japanese primary operable patients who were recruited from April 1979 through August 1980. No difference was seen between the two countries in the side and site of the lesion and the size of the lesion. The localized tenderness of the tumor site was higher in Japanese patients than in UK patients (25.5% vs 0%). Difference was observed in tumor characteristics: breast cancers of the UK patients were irregular, ill-defined, and not so mobile, whereas those of the Japanese patients were round or oval, well-defined, and mobile. Skin fixation was higher in Japanese patients (71.0% vs 44.8%). Clinical node involvement was higher in UK patients (32.5% vs 19.0%).

Age Factors↗

PubMed1992

A comparative study of intramuscular ketorolac and pethidine in labour pain.

A single dose block randomised double-blind study comparing intramuscular ketorolac, 50 mg of pethidine and 100 mg pethidine was carried out in multiparous women. Pain intensity and sedation effect were recorded at inclusion to the study, half hourly for the first 2 h, then hourly until 6 h after delivery. Maternal and neonatal side effects were noted including the Apgar scores and the baby's requirements for resuscitation. All three treatments are relatively ineffective in relieving labour pain. There was no difference in the analgesic efficacy between the two doses of pethidine but both doses of pethidine were statistically more effective compared with ketorolac. There was no difference in the retrospective assessment of the three groups or when comparison was made with the previous labour. A similar number of patients required further analgesia in each group. In all three groups, no adverse effect occurred in the mother or fetus. Maternal sedation and fetal depression were statistically less in the ketorolac group. Although ketorolac had inferior analgesic effect, its use was not associated with clinically significant sequelae and it showed a superior safety profile compared with either dose of pethidine. The study was not powerful enough to detect a difference between 50 mg and 100 mg of pethidine.

Adolescent↗

PubMed1989

A comparative study of the strength of aluminous porcelain and all-ceramic crowns.

This study compared the breaking strengths of all-ceramic crowns constructed with aluminous porcelain, the Cerestore system, and the Dicor system on an anterior tooth preparation. Fifteen crowns from each group were constructed to comparable dimensions on dies from the same master die. Ten crowns from the same group were cemented on the master die and loaded until catastrophic failure. Five crowns from each group were embedded and sectioned to examine internal adaptation. No significant difference was found between the load necessary to produce failure in the aluminous porcelain and Dicor crowns and the load needed to initiate crack formation in the Cerestore crowns. However, seven of the 10 Cerestore crowns showed a two-phase failure pattern; the difference between crack initiation and catastrophic failure was significant. Within the limitation of this study, neither the Cerestore (high alumina core) nor the Dicor (castable glass-ceramic) produced an all-ceramic crown superior to the current aluminous porcelain crown.

Aluminum↗

PubMed1992

Reinforced vascular grafts: a comparative study.

Reinforced vascular grafts are designed to resist compression and flexion forces, for example in axillo-femoral or below-knee femoropopliteal reconstruction. This study compared eight types of 6-mm reinforced grafts (five polytetrafluoroethylene (PTFE) and 3 Dacron). On a specially designed rig, graft diameter and flow were measured during compression by a standard series of weights up to 3.6 kg, and on another rig grafts were flexed through 135 degrees. Meadox Microvel graft resisted compression best (p less than 0.05) but there were no important differences between the other grafts (Vascutek; Bard; Goretex Standard, Thin Walled and Removable Ring; Impra Standard and Thin Wall). Flexion produced no significant changes in flow through the grafts. In addition, five general surgeons were asked to score the ease of removal of reinforcement, passage of sutures, and the tendency of sutures to cut out of each graft. Removal of reinforcement and passage of sutures were easier with the PTFE grafts, but the Dacron was more resistant to sutures cutting out. This study shows that these grafts resist flexion and compression well. Their different handling characteristics and data on patency at different sites should remain the main determinants in choice of graft.

Blood Flow Velocity↗

PubMed1989

Effects of adrenergic agents on alpha-chymotrypsin-induced ocular hypertension in albino and pigmented rabbits: a comparative study.

Alpha-chymotrypsin-induced ocular hypertension in albino rabbits is widely used as an experimental model to screen potential antiglaucoma drugs. The present study compares the intraocular pressure (IOP) response following the ocular application of single or repeated adrenergic agents in conscious albino and pigmented rabbits. A single instillation of clonidine was not as effective in lowering the IOP in pigmented hypertensive rabbit eyes as in albino hypertensive eyes. Similarly, betaxolol moderately lowered the IOP in albino rabbits but induced a slight response when pigmented rabbits were used as an experimental model. Twice-a-day applications of betaxolol in pigmented hypertensive eyes permitted an identical level of IOP decrease to be reached, as observed in a one-day study in albino rabbits, after at least 6 days of treatment. It has been suggested that the pigmented layers of the iris-ciliary body may act as sites for topically applied antiglaucoma drugs. Non-specific binding could explain in part the frequent discrepancy observed between the preclinical results obtained in albino hypertensive rabbit eyes and clinical results obtained in glaucomatous human eyes.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Proximal gastric vagotomy. A comparative study between the standard technique and the extended technique associated with denervation of the greater curvature.

Forty-six patients in the postoperative period of proximal gastric vagotomy (PGV) for duodenal ulcer (DU) were studied comparatively to verify whether the dividing of the gastroepiploic nerves (Rosati's maneuver) can reduce or not the occurrence of recurrent ulcer as it was proposed. Twenty-one patients who underwent PGV associated with Rosati's maneuver (PGV-R) were compared to 25 after standard PGV (PGV-S), according to several criteria: (1) clinical evaluation; (2) pre and postoperative basal and pentagastrin-stimulated gastric acidity; (3) postoperative basal and pentagastrin-stimulated serum pepsinogen; (4) postoperative basal and sham feeding-stimulated serum gastrin; (5) postoperative endoscopy; (6) endoscopic Congo red test. Both groups were similar (P greater than 0.05) as to age, sex, levels of preoperative gastric acidity and had a 24.4 month average follow-up (12 to 58 months). There has been no significant difference between the techniques studied as to clinical, secretory, morphological or hormonal gastric tests, although PGV-R proved more effective in reducing basal gastric acidity than PGV-S (P less than 0.05). We concluded that Rosati's maneuver does not improve the results obtained with PGV, although it provided greater reduction of basal gastric acidity than PGV-S.

Adult↗

PubMed1992

A comparative study of black South African children from three different contexts.

This study compares family characteristics and developmental outcomes of black children (N = 300) from 3 rural contexts in South Africa: the homeland, the resettlement, and the white-owned farms. Parents in the homeland were more likely to be married and had more education, less household crowding, and lower mobility than parents in the other 2 areas, and higher occupational status than parents from the farms. Child outcomes paralleled these differences in material resources and family stability. Children from the homeland scored higher than children from the resettlement or farms on head circumference, vocabulary, quantitative skill, and self-concept, with no significant differences between the latter 2 areas on these outcome variables. Children from the homeland also scored higher than resettlement children on weight, copying skill, and height, with children from the farms measuring lowest on height. Child outcomes were highly intercorrelated in all 3 residence areas, but correlations among family variables, and between family and child variables, showed different patterns across areas. Parent education, occupation, and crowding were the most consistent predictors of physical development, cognitive development, and self-concept. Family mobility and marital status, however, showed different relationships to other family variables and to child outcomes across the 3 environments. These results highlight the importance of studying children in multiple environmental contexts, because family characteristics are not associated uniformly across residence areas.

Achievement↗

PubMed1987

A double-blind comparative study of alprazolam and dothiepin hydrochloride in the treatment of anxiety associated with depression.

One hundred patients with mixed symptoms of anxiety and depression were enrolled into a prospective, multi-centre, randomized, double-blind study comparing the response to, and the side-effects of, alprazolam and dothiepin hydrochloride over 4 weeks of treatment. Mean daily doses were 2.33 mg alprazolam and 115 mg dothiepin. Data on 96 patients were evaluated for tolerance, and data for 85 patients were analyzed for therapeutic response. In each case, the groups were similar in numbers, mean ages and sex ratios. Both groups experienced satisfactory responses to therapy, with highly statistically significant changes (p less than 0.001) in the means of all efficacy measures within each group. No statistical difference was demonstrated in favour of either treatment group. Both dothiepin and alprazolam exhibited a similar profile of mild minor side-effects, but more patients suffered moderate to severe reactions to dothiepin, leading to a greater drop-out rate in the dothiepin-treated group. It is concluded that, as both treatments produced equally satisfactory responses in this study, alprazolam should be considered for the treatment of anxiety associated with depression in patients for whom tricyclic antidepressant drugs are either contra-indicated or poorly tolerated.

Adolescent↗

PubMed1991

[Comparative study of cefpirome and ceftazidime in complicated urinary tract infections].

We carried out a randomized multi-center study comparing cefpirome (CPR) 0.5 g b.i.d. (1 g group), 1.0 g b.i.d. (2 g group) and ceftazidime (CAZ) 1.0 g b.i.d. (CAZ group) in the treatment of complicated urinary tract infections. Patients who were over 16 years old and had underlying urinary tract disease, with bacteriuria of more than 10(4) cells ml or more and pyuria of more than 5 WBCs/hpf (x 400) or more were randomly allocated to receive either 0.5 g of CPR, 1.0 g of CPR or 1.0 g of CAZ twice a day for 5 days by intravenous drip infusion. The overall clinical efficacy of the treatment was evaluated by the criteria of the Japanese UTI Committee as excellent, moderate or poor, on the basis of the changes in pyuria and bacteriuria. A total of 530 patients were treated. Of these, 141 patients in the 1 g group, 136 in the 2 g group, and 140 in the CAZ group were evaluable for clinical efficacy. No significant differences in background characteristics were observed among the treatment groups. The overall clinical efficacy rate of the 1 g group, the 2 g group and the CAZ group was 80.1%, 76.5% and 71.4%, respectively. The differences were not statistically significant. The overall bacteriological eradication rate of the 1 g group, the 2 g group and the CAZ group was 81.0%, 88.1% and 83.8%. The differences were not statistically significant either. Against the enterococcus group, however, eradication rates were higher significantly in the 1 g and 2 g groups than in the CAZ group. The incidence of adverse reactions was 2.2% in the 1 g group, 0.6% in the 2 g group and 2.9% in the CAZ group. Abnormal laboratory data after medication were observed in 10.8% of the 1 g group, 12.1% of the 2 g group and 10.2% of the CAZ group, the difference not being statistically significant. There were no serious untoward reactions to medication. From the results obtained in this study, we consider that CPR is at least as useful as CAZ in the treatment of complicated urinary tract infections.

Adolescent↗

PubMed1986

A comparative study between injectable low-temperature (70 degrees C) gutta-percha and silver amalgam as a retroseal.

This study compared two different dental materials used in endodontic retrosealing procedures. One of these materials was a new low-temperature gutta-percha product, manufactured by the Hygenic Corporation, that involved an injection technique. The second of these materials was silver amalgam. Silver amalgam was selected because it has been recognized by many clinicians as the most effective apical sealing material. Two groups of ten recently extracted teeth were endodontically prepared with one of each of the materials being tested, and the effectiveness of these materials as sealants was determined by their ability to inhibit the penetration of methylene blue dye for a predetermined period of time through the apically sealed root tips. Preliminary results obtained indicated that, although these materials were not 100% effective in inhibiting the dye penetration, each was as effective as the other when evaluated by two observers following completion of the study as determined by its experimental design. No significant difference was exhibited between the amalgam group and the gutta-percha group. The leakage of the dye that was observed in each of the groups might have been caused by the ineffectiveness of, or the ineffective use of, the nail polish or cyanoacrylate used to coat all but the apically sealed tips of the endodonticalled prepared teeth. The function of these coating materials was to prevent penetration of the dye through the surface of the body of the root.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Amalgam↗

PubMed1992

A comparative study of a new food supplement, ViviScal, with fish extract for the treatment of hereditary androgenic alopecia in young males.

A controlled, randomized, double-blind, parallel-group study compared the effects of ViviScal (a new food supplement incorporating special marine extracts and a silica compound) with those of a fish extract in the treatment of young males with hereditary androgenic alopecia. The pretreatment histological diagnosis was alopecia with a mild to moderate perifollicular inflammation zone. The study consisted of 20 subjects who received two tablets of ViviScal once daily and 20 who received two tablets of fish extract once daily for 6 months. The mean patient age and mean duration and severity of baldness compared well between the two groups. Most patients had been treated with long-term topical 2% minoxidil for 1 year or more prior to the study. At baseline and after 6 months' treatment, a biopsy was taken for histological examination. A non-vellus hair count was performed at baseline and after 2, 4 and 6 months. In the fish extract treatment group three patients withdrew from the study before the fourth month due to lack of therapeutic effect. After 6 months' treatment, patients receiving ViviScal showed a mean increase in non-vellus hair of 38% compared with a 2% increase in the fish extract treatment group (P < 0.0001). In the ViviScal group, 19 (95%) subjects showed both clinical and histological cure, whereas none treated with fish extract showed any clinical or histological difference after 6 months' treatment (P < 0.0001). In both groups, a minimal decrease in the erythemal index was observed. In conclusion, ViviScal appears to be the first highly active treatment for androgenic alopecia in young males.

Administration, Oral↗

PubMed1992

Isokinetic arm and leg strength of adults with Down syndrome: a comparative study.

This study compared isokinetic arm (elbow flexion and extension) and leg (knee flexion and extension) strength of individuals with Down syndrome (DS), with mental retardation without DS (NDS), and sedentary young adults with no mental retardation (NMR). Eighteen individuals with DS, NDS, and NMR (11 men and seven women in each group) performed strength tests on a Cybex 340 isokinetic dynamometer. Parameters measured were peak torque (ft/lb), peak torque percent body weight (%BW), average power (watts), and average power %BW. Subjects with mental retardation (ie, DS and NDS groups) performed the test on two separate days with best test results chosen for statistical comparisons. The NMR group performed the test once. In all isokinetic strength parameters measured for arm strength, the NMR group demonstrated significantly higher scores than subjects with DS and NDS. Subjects with DS and NDS displayed similar test results. Similarly, for all the isokinetic strength parameters measured for leg strength, NMR demonstrated significantly higher scores than subjects with DS and NDS. Subjects with NDS, however, averaged significantly higher test results than subjects with DS for leg strength. The results of this study indicate that both subject populations who were mentally retarded exhibited lower arm and leg strength than the NMR subjects. Additionally, subjects with DS demonstrated inferior leg strength when compared to their peers with NDS.

Adult↗

PubMed1991

Prevention of postmenopausal osteoporosis. A comparative study of exercise, calcium supplementation, and hormone-replacement therapy.

BACKGROUND: Osteoporosis among older women is a major public health problem. We studied the effects of three approaches to the prevention of osteoporosis in women with low bone density. METHODS: One hundred twenty postmenopausal women (mean [+/- SD] age, 56 +/- 4) who were selected because they had low forearm bone density were enrolled in a double-blind, placebo-controlled, randomized study comparing the effects of an exercise regimen (exercise group, n = 41), exercise plus dietary calcium supplementation (exercise-calcium group, n = 39), and exercise plus continuous replacement of estrogen and progesterone (exercise-estrogen group, n = 40). Periodically during the two-year study period, we measured the women's bone density at three forearm sites, measured indexes of calcium metabolism, and recorded symptom scores. A comparison group of 42 women (mean age, 55.5 +/- 3.1) with normal bone density was also followed for two years. RESULTS: Significant bone loss in the distal forearm occurred in the group with normal bone density (control group) and the exercise group (change, -2.7 percent and -2.6 percent of the base-line value per year, respectively). Bone loss at the distal forearm site was significantly lower in the exercise-calcium group (-0.5 percent of the base-line value per year), and bone density increased at this site in the exercise-estrogen group (+2.7 percent of the base-line value per year). Bone loss at the median forearm site was significantly lower in the exercise-calcium group (-1.3 percent of the base-line value per year) than in the exercise group (-2.4 percent), and bone density at this site increased significantly in the exercise-estrogen group (+0.8 percent of the base-line value per year). Breast tenderness occurred in 47 percent of the women in the exercise-estrogen group but in only 20 percent in the other two treatment groups. Vaginal bleeding occurred at some time in 52 percent of the women who had not had a hysterectomy in the exercise-estrogen group, as compared with 11 percent and 12.5 percent, respectively, in the exercise and exercise-calcium groups. CONCLUSIONS: In postmenopausal women with low bone density, bone loss can be slowed or prevented by exercise plus calcium supplementation or estrogen-progesterone replacement. Although the exercise-estrogen regimen was more effective than exercise and calcium supplementation in increasing bone mass, it also caused more side effects.

Bone Density↗

PubMed1992

[Propofol for sedation during postoperative mechanical ventilation. A comparative study with Lytic Mixture].

Propofol infusion was found to provide excellent sedation and rapid recovery in intensive care. The present study compared Propofol with lytic solution (lytic solution = mixture of 100 mg Pethidine, 50 mg Promethazine and 0.6 mg Dihydroergotamine) during 6 hours of postoperative artificial ventilation. 60 patients after major abdominal surgical procedures were studied with ethical committee approval and informed consent. Patients were randomly allocated to receive either Propofol or lytic solution. We aimed at a sedation level of stage 5 according to the Ramsey score. The mean drug dosages were 3.9 mg/kg/h of Propofol and 4.2 ml/h of lytic solution. Hemodynamic values, blood gases as well as various biochemical measures did not show any difference between the groups. At the end of the sedation period triglyceride concentrations were significantly higher in patients receiving Propofol (166 + 79 mg/dl) compared to the control group (97 + 60 mg/dl). Significant and relevant differences were found for the times of recovery after discontinuation of the sedative. These times were very short in the Propofol group. Furthermore, in view of a longer recovery time after lytic solution in this group the respiratory rate was significantly slower up to the end of the observation period. We conclude that a major advantage of Propofol in the present study was the rapid recovery after 6 hour sedation. Patients gain vigilance rapidly and sufficient spontaneous respiration within minutes. Not at least thanks to these facts patient's safety can be improved in the recovery period.

Abdomen↗

PubMedDate not supplied

Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study.

A comparative study between percutaneous repair and open surgical repair of acute spontaneous Achilles tendon ruptures in young athletic patients is presented. Twenty-seven patients with acute Achilles ruptures were evaluated objectively and with subjective questionnaires. Fifteen of the patients were treated by reconstruction with a gastrocsoleus fascial graft (followup, 4.6 years) and 12 treated by percutaneous repair (followup, 1.8 years). Subjectively, both groups were very satisfied with the results of their treatment. Cybex II dynamometer measuring strength, power, and endurance revealed no statistical significant differences between groups, even in light of the shorter followup of the percutaneous group. The percutaneous repairs demonstrated significantly more symmetry in injured/uninjured tendon size than did the open surgical repairs. Two reruptures occurred in the percutaneous group. No other complications were noted. After evaluation of both subjective and objective data we recommend percutaneous repair in the recreational athlete and in patients concerned with cosmesis. Open repair is recommended for all high-caliber athletes who cannot afford any chance of rerupture.

Achilles Tendon↗

PubMed1990

Methods for measuring the renal uptake rate of 99mTc-dimercaptosuccinic acid (DMSA): a comparative study.

A comparative study of the renal uptake rate of 99mTc-dimercaptosuccinic acid (DMSA) was performed using a phantom study and clinical data from 100 patients (200 kidneys) with a variety of renal diseases. The measurement methods for renal uptake rate studied here include a posterior-view method, a conjugate-view method, and a method using single photon emission computed tomography (SPECT). The renal uptake rates obtained by the posterior-view method significantly (P less than 0.001) depended on kidney depth correction. With the SPECT method, the cut-off level for delineating the kidney was changed according to the background count ratio using the results of the phantom study. The renal uptake rates obtained by the SPECT method correlated significantly (P less than 0.001) with those obtained by other methods, and there were no significant differences as compared with those obtained by the conjugate-view method. An analysis of error with the above methods indicated that the error relating to the sensitivity to body thickness was smallest for the SPECT method and greatest for the posterior-view method. In terms of measurement of renal uptake rate only, the conjugate-view method is considered the most useful because it needs no kidney depth correction and requires very little additional effort or examination time.

Female↗