Oxyphenbutazone (Tandearil?) in Rhinoplasty—A Clinical Evaluation of Effectiveness

To evaluate the effectiveness of Oxyphenbutazone as an anti-inflammatory agent, a double-blind study of Oxyphenbutazone and a placebo in a group of 42 patients who had nasal cosmetic operations involving osteotomy was carried out. The observations included direct objective measurement of the width of the palpebral fissure after operation, grading of the severity of postoperative edema and ecchymosis from photographs, and observations by the patients regarding the clearing of the postoperative discoloration. It appeared from the results of these observations that Oxyphenbutazone is not effective in preventing postoperative edema in such operations or in promoting more rapid resolution of postoperative edema. It did appear to enhance the clearing of postoperative periorbital ecchymosis.     

HYDROXYDIONE SODIUM (VIADRIL?) FOR ANESTHESIA—A Report of Clinical Experience

Hydroxydione sodium (Viadril®) is a new anesthetic agent, derived from a family of chemical compounds not previously associated with anesthetic properties—namely, the steroids. The use of Viadril in sixty operative procedures provided the basis of this communication, which reports the signs of anesthesia and the main pharmacophysiological effects of Viadril as observed clinically.     

A NEW ANTIHYPERTENSIVE AGENT—Clinical Evaluation of a Rauwolfia-Flumethiazide Combination (Rautrax?)

Twenty-eight patients were treated with Rautrax,® a combination of flumethiazide, rauwolfia and potassium chloride for from one to seven months. The average mean blood pressure for the group declined from 135 mm. of mercury to 107 mm. All but two of the patients had a decrease in blood pressure and 19 became normotensive. Associated symptoms of headache, dyspnea, edema and angina were completely relieved or improved in the majority of patients with these complaints. On the basis of the blood pressure response and the clinical effects seen in the patient, therapeutic results were classified as good to excellent in 22 of the 28 patients, fair in two, and poor in three. No evaluation was made in the remaining patient in the series because further adjustment in dosage was required.Three patients had side effects—moderate gastrointestinal upset in one case, headache and a sensation of the bladder''s having been “wrung out” in another, and headache and paresthesia of the legs in the third. Only the third patient had persisting symptoms after the drug was discontinued. In the other two reduction of dosage sufficed.     

TRIFLUOROETHYLVINYL ETHER (FLUOROMAR?)—A Preliminary Report on Clinical Experience and Animal Experiment

In observations of 80 cases in which Fluoromar was used for inhalation anesthesia it was noted that induction was rapid; maintenance although labile, was usually smooth; and recovery of reflexes was rapid. Anesthetic complications were minimal, and postanesthetic complications were limited to nausea and vomiting in no greater incidence than that expected to follow the use of most inhalation anesthetic agents.Fluoromar produces rapid, and not particularly unpleasant, loss of consciousness, and will produce complete anesthesia without supplement. However, the muscular relaxation afforded by Fluoromar is not complete, and delayed recovery from anesthesia may follow attempts to produce relaxation by deepening too greatly the level of anesthesia.The inflammability of Fluoromar is less than that of other inhalation agents.     

DEMO-II Trial. Aerobic Exercise versus Stretching Exercise in Patients with Major Depression—A Randomised Clinical Trial

Background

The effect of referring patients from a clinical setting to a pragmatic exercise intervention for depressive symptoms, cognitive function, and metabolic variables has yet to be determined.

Methods

Outpatients with major depression (DSM-IV) were allocated to supervised aerobic or stretching exercise groups during a three months period. The primary outcome was the Hamilton depression score (HAM-D₁₇). Secondary outcomes were cognitive function, cardiovascular risk markers, and employment related outcomes.

Results

56 participants were allocated to the aerobic exercise intervention versus 59 participants to the stretching exercise group. Post intervention the mean difference between groups was −0.78 points on the HAM-D₁₇ (95% CI −3.2 to 1.6; P = .52). At follow-up, the participants in the aerobic exercise group had higher maximal oxygen uptake (mean difference 4.4 l/kg/min; 95% CI 1.7 to 7.0; P = .001) and visuospatial memory on Rey’s Complex Figure Test (mean difference 3.2 points; 95% CI 0.9 to 5.5; P = .007) and lower blood glucose levels (mean difference 0.2 mmol/l; 95% CI 0.0 to 0.5; P = .04) and waist circumference (mean difference 2.2 cm; 95% CI 0.3 to 4.1; P = .02) compared with the stretching exercise group.

Conclusions

The results of this trial does not support any antidepressant effect of referring patients with major depression to a three months aerobic exercise program. Due to lower recruitment than anticipated, the trial was terminated prior to reaching the pre-defined sample size of 212 participants; therefore the results should be interpreted in that context. However, the DEMO-II trial does suggest that an exercise program for patients with depression offer positive short-term effects on maximal oxygen uptake, visuospatial memory, fasting glucose levels, and waist circumference.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00695552","term_id":"NCT00695552"}}NCT00695552     

The anthropology of ontology (religious science?)

Through engagement with a range of recent publications, this article offers a mini‐ethnography of wonder discourses in the anthropology of ontology, leading to a rethink of the concept of religion. It has sometimes been suggested that science and religion are antithetical orientations to the experience of wonder: whereas science seeks to banish wonder by replacing it with knowledge, religion remains open to wonder in the face of the unknowable. With this criterion of difference in view, this article identifies certain trends in the anthropology of ontology that appear to enjoin and pursue open‐ended wonder in ways that might be read as constituting anthropology as religious science. This coincidence of supposed opposites recommends, I conclude, a relational account of religion.     

The Tiotropium Safety and Performance in Respimat? (TIOSPIR?) Trial: Spirometry Outcomes

Background

Tiotropium Safety and Performance in Respimat® (TIOSPIR®) compared the safety and efficacy of tiotropium Respimat® and tiotropium HandiHaler® in patients with chronic obstructive pulmonary disease (COPD). A prespecified spirometry substudy compared the lung function efficacy between treatment groups.

Methods

TIOSPIR® was a large-scale, long-term (2.3-year), event-driven, randomized, double-blind, parallel-group trial of 17,135 patients with COPD. In the spirometry substudy, trough forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) were measured at baseline and every 24 weeks for the duration of the trial.

Results

The substudy included 1370 patients who received once-daily tiotropium Respimat® 5 μg (n = 461), 2.5 μg (n = 464), or tiotropium HandiHaler® 18 μg (n = 445). Adjusted mean trough FEV₁ (average 24–120 weeks) was 1.285, 1.258, and 1.295 L in the Respimat® 5 μg, 2.5 μg, and HandiHaler® 18 μg groups (difference versus HandiHaler® [95 % CI]: −10 [−38, 18] mL for Respimat® 5 μg and, −37 [−65, −9] mL for Respimat® 2.5 μg); achieving noninferiority to tiotropium HandiHaler® 18 μg for tiotropium Respimat® 5 but not for 2.5 μg (prespecified analysis). Adjusted mean trough FVC was 2.590, 2.544, and 2.593 L in the Respimat® 5 μg, 2.5 μg, and HandiHaler® 18 μg groups. The rates of FEV₁ decline over 24 to 120 weeks were similar for the three treatment arms (26, 40, and 34 mL/year for the tiotropium Respimat® 5-μg, 2.5-μg, and HandiHaler® 18-μg groups). The rate of FEV₁ decline in GOLD I + II patients was greater than in GOLD III + IV patients (46 vs. 23 mL/year); as well as in current versus ex-smokers, in patients receiving combination therapies at baseline versus not, and in those experiencing an exacerbation during the study versus not.

Conclusions

The TIOSPIR® spirometry substudy showed that tiotropium Respimat® 5 μg was noninferior to tiotropium HandiHaler® 18 μg for trough FEV₁, but Respimat® 2.5 μg was not. Tiotropium Respimat® 5 μg provides similar bronchodilator efficacy to tiotropium HandiHaler® 18 μg with comparable rates of FEV₁ decline. The rate of FEV₁ decline varied based on disease severity, with a steeper rate of decline observed in patients with moderate airway obstruction.

Trial registration

{"type":"clinical-trial","attrs":{"text":"NCT01126437","term_id":"NCT01126437"}}NCT01126437.

Electronic supplementary material

The online version of this article (doi:10.1186/s12931-015-0269-4) contains supplementary material, which is available to authorized users.