Treatment of Menorrhagia with Tranexamic Acid. A Double-blind Trial

In a double-blind trial tranexamic acid (Cyclokapron) 1 g. four times a day for the first four days of menstruation, significantly decreased menstrual blood loss in women with menorrhagia for which no organic cause had been found. No difference in side-effects was noted between the active and placebo treatment.     

Double-blind Cross-over Trial of Flurbiprofen and Phenylbutazone in Ankylosing Spondylitis

A double-blind cross-over study in 35 patients with ankylosing spondylitis was carried out comparing flurbiprofen (150 mg daily)—a new non-steroidal anti-inflammatory agent—with phenylbutazone (300 mg daily) over a four-week period. Flurbiprofen was well tolerated and shown to have therapeutic efficacy approaching that of phenylbutazone. The results suggest that flurbiprofen may prove a valuable alternative in the treatment of ankylosing spondylitis, and longterm efficacy and tolerance studies are clearly indicated.     

Monitoring and Evaluating the Quality Consistency of Compound Bismuth Aluminate Tablets by a Simple Quantified Ratio Fingerprint Method Combined with Simultaneous Determination of Five Compounds and Correlated with Antioxidant Activities

A combination method of multi-wavelength fingerprinting and multi-component quantification by high performance liquid chromatography (HPLC) coupled with diode array detector (DAD) was developed and validated to monitor and evaluate the quality consistency of herbal medicines (HM) in the classical preparation Compound Bismuth Aluminate tablets (CBAT). The validation results demonstrated that our method met the requirements of fingerprint analysis and quantification analysis with suitable linearity, precision, accuracy, limits of detection (LOD) and limits of quantification (LOQ). In the fingerprint assessments, rather than using conventional qualitative “Similarity” as a criterion, the simple quantified ratio fingerprint method (SQRFM) was recommended, which has an important quantified fingerprint advantage over the “Similarity” approach. SQRFM qualitatively and quantitatively offers the scientific criteria for traditional Chinese medicines (TCM)/HM quality pyramid and warning gate in terms of three parameters. In order to combine the comprehensive characterization of multi-wavelength fingerprints, an integrated fingerprint assessment strategy based on information entropy was set up involving a super-information characteristic digitized parameter of fingerprints, which reveals the total entropy value and absolute information amount about the fingerprints and, thus, offers an excellent method for fingerprint integration. The correlation results between quantified fingerprints and quantitative determination of 5 marker compounds, including glycyrrhizic acid (GLY), liquiritin (LQ), isoliquiritigenin (ILG), isoliquiritin (ILQ) and isoliquiritin apioside (ILA), indicated that multi-component quantification could be replaced by quantified fingerprints. The Fenton reaction was employed to determine the antioxidant activities of CBAT samples in vitro, and they were correlated with HPLC fingerprint components using the partial least squares regression (PLSR) method. In summary, the method of multi-wavelength fingerprints combined with antioxidant activities has been proved to be a feasible and scientific procedure for monitoring and evaluating the quality consistency of CBAT.     

Practolol in Treatment of Angina Pectoris. A Double-blind Trial

Twenty-four patients with angina pectoris entered a double-blind trial of the cardioselective beta-adrenergic blocking agent practolol. Seventeen experienced less angina and consumed fewer glyceryl trinitrate tablets when on the active preparation. There was also a decrease in the mean number of attacks suffered by patients while on practolol and a reduction in the number of glyceryl trinitrate tablets taken. These results are of statistical significance at, at least, the 5% level.     

Comparative Double-blind Trial of Cephalexin and Ampicillin in Treatment of Urinary Infections

Cephalexin was compared with ampicillin in the treatment of urinary tract infections by a random double-blind technique. Both drugs were found to be equally effective. In 21 out of 31 patients treated with cephalexin and in 20 out of 31 treated with ampicillin the urine was sterile three weeks after starting therapy. The bacteriological findings at one and eight weeks were also similar in both groups. No serious adverse reactions were attributable to cephalexin, which seemed to be tolerated rather better than ampicillin.     

Treatment of Acne Vulgaris with Tetracyline Hydrochloride: a Double-blind Trial with 51 Patients

Fifty-one patients with acne vulgaris were included in a double-blind trial to assess the therapeutic effect of 250 mg. tetracycline hydrochloride twice daily for three months. The results, assessed clinically and photographically, showed that tetracycline hydrochloride had a statistically significant beneficial effect. Hence, since it is cheap and rarely has side-effects in healthy young adults, its use is suggested, as well as local therapy, in the more severe forms of acne.     

Using Stool Antigen to Screen for Helicobacter pylori in Immigrants and Refugees from High Prevalence Countries Is Relatively Cost Effective in Reducing the Burden of Gastric Cancer and Peptic Ulceration

Objectives

Refugees and immigrants from developing countries settling in industrialised countries have a high prevalence of Helicobacter pylori (H. pylori). Screening these groups for H. pylori and use of eradication therapy to reduce the future burden of gastric cancer and peptic ulcer disease is not currently recommended in most countries. We investigated whether a screening and eradication approach would be cost effective in high prevalence populations.

Methods

Nine different screening and follow-up strategies for asymptomatic immigrants from high H. pylori prevalence areas were compared with the current approach of no screening. Cost effectiveness comparisons assumed population prevalence''s of H. pylori of 25%, 50% or 75%. The main outcome measure was the net cost for each cancer prevented for each strategy. Total costs of each strategy and net costs including savings from reductions in ulcers and gastric cancer were also calculated.

Results

Stool antigen testing with repeat testing after treatment was the most cost effective approach relative to others, for each prevalence value. The net cost per cancer prevented with this strategy was US$111,800 (assuming 75% prevalence), $132,300 (50%) and $193,900 (25%). A test and treat strategy using stool antigen remained relatively cost effective, even when the prevalence was 25%.

Conclusions

H. pylori screening and eradication can be an effective strategy for reducing rates of gastric cancer and peptic ulcers in high prevalence populations and our data suggest that use of stool antigen testing is the most cost effective approach.     

Double-blind Trial of Linoleate Supplementation of the Diet in Multiple Sclerosis

Seventy-five patients in London and Belfast with multiple sclerosis were given daily supplements of a vegetable oil mixture containing either linoleate or oleate for two years in a double-blind control trial. Relapses tended to be less frequent and were significantly less severe and of shorter duration in the linoleate-supplemented group than in those receiving the oleate mixture, but clear evidence that treatment affected the overall rate of clinical deterioration was not obtained.     

Double-blind Cross-over Trial Comparing Intranasal Beclomethasone Dipropionate and Placebo in Perennial Rhinitis

Twenty-five patients with perennial rhinitis completed a double-blind cross-over trial of intranasal beclomethasone dipropionate 200 μg daily and placebo. Of these patients 19 preferred the active drug and two preferred placebo. There were significant reductions in symptom scores for nasal obstruction and rhinorrhoea and in the use of decongestant nasal drops when using the active drug. No changes in morning plasma cortisol levels occurred during the three-week treatment period.