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A multi-centre evaluation of the test strip analyser, Rapimat, was performed by four laboratories following the ECCLS 2nd draft guidelines for the evaluation of analysers in clinical chemistry. Using the Rapignost urine test strip with the test fields for bilirubin, urobilinogen, acetoacetate, ascorbic acid, glucose, protein, nitrite, pH and haemoglobin, the Rapimat was found to be analytically reliable in comparison with other, in most cases quantitative procedures. During the observation period of about 6 months no breakdown occurred in any laboratory. Interferences and sensitivity as discussed for the bilirubin and urobilinogen test field are more related to the test strip than to the instrument. Several improvements for further developments are suggested. This multi-centre study has shown that the ECCLS protocol is applicable to analytical procedures leading to discrete results. PMID:4056663

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PMID:21820543

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Objective To compare the efficacy and safety of three polyspecific antivenoms for bites by pit vipers.Design Randomised double blind comparative trial of three antivenoms.Setting...Full Text Available

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Transplantation has emerged as the therapy of choice for many patients with end organ failure. One of the major goals is to tailor immunosuppressive therapy to the individual needs of every patient to balance the risk for rejection and over-immunosuppression. This will require diagnostic tools that can detect harmful processes in the allograft early, and that can be measured repeatedly. This review will consider recent advances in our understanding of the molecular nature of these processes and how this information is being utilized to design novel diagnostic assays to non-invasively monitor allografts. Highlighted is the need for large-scale prospective multi-centre studies to validate assays that show early promise in single centre studies.

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PMID:20417857

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Summary Objective- To evaluate the role of prophylactic trimethoprim-sulfamethoxazole (co-trimoxazole) antibacterial prophylaxis in reducing morbidity and mortality in HIV-infected post-natal women in southern Africa. Methods- Double-blind placebo-controlled trial. HIV-infected women with WHO stage 2 or 3 HIV disease who had recently delivered in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia were randomised to receive daily co-trimoxazole (cotox) or matched placebo daily for the duration of the trial. Participants were followed up for a minimum of 1-year. Primary outcome measures were mortality from any cause or hospital admission and serious adverse events. Results- Of 600 women randomised, follow-up information was available from 355 (18...

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Background: Chloroquine has in-vitro activity against influenza and could be an ideal candidate for worldwide prevention of influenza in the period between onset of a pandemic with a virulent influenza strain and the development and widespread dissemination of an effective vaccine. We aimed to assess the efficacy of such an intervention. Methods: In this randomised, double-blind, placebo-controlled trial done at a single centre in Singapore, we randomly assigned (1:1) healthy adults to receive chloroquine phosphate (500 mg/day for 1 week, then once a week to complete 12 weeks) or matching placebo by use of a computer-generated randomisation list. Participants filled an online symptom diary every week, supplemented by daily diaries and self-administered nasal swabs when unwell. Haemagglutin...

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Objectives:The supermarket industry now services many customers through online food shopping over the Internet. The Internet shopping process offers a novel opportunity...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAdhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVE--To examine the effect of a reduced sodium and increased potassium and magnesium intake on blood pressure. DESIGN--Randomised double blind placebo controlled trial. SETTING--General population...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveTo test whether a disclosure intervention improves subjective health and reduces medical consumption and sick leave in somatising patients in general practice.DesignNon-blind...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveTo assess the efficacy and safety of low dose adrenaline injected subcutaneously to prevent acute adverse reactions to polyspecific antivenom serum in patients admitted...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundCompared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large....Full Text Available

UK PubMed Central (United Kingdom)

Objectives To assess the effectiveness of calcium supplementation for improving bone mineral density in healthy children and to determine if any effect is modified by other factors and...Full Text Available

UK PubMed Central (United Kingdom)

Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThis study examines the prevalence and nature of bereavement help-seeking among the population who experienced an "expected" death in the five years before their survey...Full Text Available

UK PubMed Central (United Kingdom)

The existence and importance of an accelerated adjacent segment disc degeneration (ASD) after lumbar fusion have previously not been demonstrated by RCTs. The objectives of this study were, to determine...Full Text Available

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BackgroundMost traditional Chinese herbal formulas consist of at least four herbs. Four-Agents-Decoction (Si Wu Tang) is a documented eight hundred year old formula containing four...Full Text Available

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Abuzakuk T, Coward P, Shenava Y, Kumar VS, Skinner JA. The management of wounds following primary lower limb arthroplasty: a prospective, randomised study comparing hydrofibre and central pad dressings. Abstract Wound care following lower limb arthroplasty has not been subject to in-depth clinical research, primarily because such wounds usually heal without complication. However, when prosthetic implants are used, serious wound problems can be disastrous (Whitehouse et al. Infect Control Hosp Epidemiol 2002;23:183-9; Lindwell OM. Clin Orthop Relat Res 1986;211:91-103). We report the results of a prospective, randomised, controlled trial comparing a hydrofibre (Aquacel) and central pad (Mepore) dressing in the management of acute wounds following primary total hip or knee arthroplasty left ...

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Summary Background- Treatments that achieve sustainable steroid-free clinical remission in Crohn-s disease are needed; however, long-term steroid-sparing efficacy data are limited. Aim- To evaluate steroid-sparing efficacy and the impact of steroid discontinuation on adverse events during treatment of Crohn's disease with adalimumab in the phase III randomised, double-blind 1-year CHARM trial and for an additional 2-years in its open-label extension ADHERE. Methods- Steroid-free remission and response and steroid-sparing (-50% steroid dose reduction) remission rates were evaluated over 3-years in patients who were taking corticosteroids at CHARM baseline. Results- Of 778 patients randomised in CHARM (including those who did not achieve clinical response to open-label induction therapy), 31...

UK PubMed Central (United Kingdom)

BackgroundDue to improvements in cancer survival the number of people of working age living with cancer across Europe is likely to increase. UK governments have made commitments...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundChildren aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundIn an effort to promote healthy ageing and preserve health and function, the government of Chile has formulated a package of actions into the Programme for Complementary...Full Text Available

UK PubMed Central (United Kingdom)

1. The acute haemodynamic effects of intravenous nisoldipine (1, 2, 4 microg kg(-1)) and nifedipine (2.5, 5, 10 microg kg(-1)) were compared in a randomised, within-patient crossover study. Fifteen...Full Text Available

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This is an independent reanalysis of a randomised, placebo-controlled parallel-group study on the efficacy and tolerability of a special butterbur root extract (Petadolex) for the prophylaxis of migraine. The original protocol and analysis had a number of major shortcomings. In order to follow regulatory requirements, an independent reanalysis of the original data was performed. Following a 4-week baseline phase, 33 patients were randomised to treatment with two capsules 25 mg butterbur twice a day and 27 to placebo. The mean attack frequency per month decreased from 3.4 at baseline to 1.8 after 3 months (p = 0.0024) in the verum group and from 2.9 to 2.6 in the placebo group (n.s.). The responder rate (improvement of migraine frequency > or =50%) was 45% in the verum group and 15% in the placebo group. Butterbur was well tolerated. This small trial indicates that butterbur may be effective in the prophylaxis of migraine. PMID:14752215

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Summary Background Treatment of localised renal cell carcinoma consists of partial or radical nephrectomy. A substantial proportion of patients are at risk for recurrence because no effective adjuvant therapy exists. We investigated the use of an autologous, tumour-derived heat-shock protein (glycoprotein 96)-peptide complex (HSPPC-96; vitespen) as adjuvant treatment in patients at high risk of recurrence after resection of locally advanced renal cell carcinoma. Methods In this open-label trial, patients were randomly assigned to receive either vitespen (n=409) or observation alone (n=409) after nephrectomy. Randomisation was done in a one to one ratio by a computer-generated pseudo-random number generator, with a block size of four, and was stratified by performance score, lymph node stat...

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Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript provides an overview of randomised controlled trials investigating the effect of IGL. Furthermore, systematic glucose?insulin?potassium infusion (GIK) has been studied to improve outcome after AMI. In spite of positive findings in some early studies, GIK did not show any beneficial effects in recent clinical trials and thus this concept has been abandoned. While IGL targeted to achieve normoglycaemi...

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AbstractBackground Randomised controlled trials (RCTs) in the 1970s and early 1980s showed the polysaccharide serogroup A vaccine (SgAV) prevented serogroup A meningococcal meningitis (SGAMM). Subsequent non-RCTs suggested significant variations in the age-specific duration of protection among children. Objectives To determine the protective effect, duration of protection, age-specific effects and the effect of booster doses in children of the SgAV against SGAMM. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (January 1950 to May Week 3, 2010) and EMBASE (January 1974 to May 2010). Selection criteria We included RCTs. Non-RCTs ...

International Nuclear Information System (INIS)

Background and purpose: To assess the effectiveness of radiotherapy in preventing tumour seeding after chest drain or pleural biopsy in patients with malignant mesothelioma and to determine, if tract metastases appear, whether they are tender or troublesome to patients. Patients and methods: Patients with a histological diagnosis of pleural mesothelioma and an invasive procedure within the preceding 21 days were stratified by age, performance status and treatment centre. Randomisation was performed between immediate drain site radiotherapy 21 Gy in three fractions (XRT arm) or best supportive care (BSC) with follow-up to 12 months. Patients were asked to complete questionnaires on treatment toxicity and on symptoms from any tract metastases detected. Results: Sixty-one patients were recruited from two centres between 1998 and 2004; 56 men, 5 women, median age 70. 31 were allocated to drain site radiotherapy. Seven patients developed tract metastases associated with ...

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This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced at least one panic attack in the previous 6 months, with two ...

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A prospective pilot trial was performed in 20 patients randomised to receive either {sup 131}I-Lipiodol therapy alone (n=10) or {sup 131}I-Lipiodol combined with a short low-dose cisplatin infusion (n=10), the aim being to evaluate the possible positive influence of a radiosensitiser on toxicity and tumour response. An activity of 1,354-2,128 MBq (mean 1,824 MBq) [36.6-57.5 mCi (mean 49.3 mCi)] {sup 131}I-labelled Lipiodol was administered by selective instillation in the hepatic artery. Cisplatin was given in a dose of 30 mg/m{sup 2} at day -1 and day +6 (day 0: {sup 131}I-Lipiodol). The primary endpoint of this trial was toxicity of therapy; points of secondary interest were tumour response and survival at 6 months. With the use of cisplatin we found a higher percentage of stable or diminished tumour size (90%, vs 40% without). A benefit in group survival at 6 months was not evident. Low-grade stomatitis in one patient and minor changes in peripheral blood count ...