In a general practice study using ketoprofen (Orudis®) in a twice-daily dosage regimen for the treatment of patients with articular and non-articular rheumatic conditions, data were collected on 2, 644 patients, over one-third of whom had been previously treated with other anti-rheumatic preparations. More than 80% showed a clinical improvement and the overall incidence of side-effects was relatively low. Three patients suffered a haematemesis – the most serious side-effect encountered. It was concluded that 50 mg or 100 mg twice-daily therapy was equally as effective as the 50 mg thrice daily regimen previously recommended and that the tolerability of ketoprofen was not adversely affected by this concentration of the daily requirement.
Since 1973, 12 patients in the Cambridge-King's College Hospital liver transplant programme have received livers from donors dying in hospitals considerable distances from the transplant centre in Cambridge. The method of preservation used to transport these livers from 35 to 110 miles was flush perfusion with plasma protein fraction and hypothermic storage in ice. The ischaemia times ranged from 2 hr and 42 min to 4 hr and 22 min. All of the recipients had good or excellent postoperative function of the grafts and 6 of the 12 recipients are alive, the longest survival being 29 months. The preservation technique is simple and easily portable and has given reliable 4-hr preservation of the human liver.
A three-month open, multicentre trial was carried out in 2132 hypertensive patients under uncontrolled conditions in general practice, to assess the effectiveness and tolerance of acebutolol when given orally as a single morning dose, in the range of 200 to 1200 mg/day. Concomitant antihypertensive therapy was given to 702 patients. Forty-five patients, out of 1893 who were eligible for analysis, showed inadequate blood pressure control and were withdrawn from the study. There were 602 reports of side-effects of adverse reactions attributed to acebutolol in 584 patients, necessitating 120 withdrawals from the trials. The results showed that acebutolol given once daily produces a substantial and progressive reduction in blood pressure over the three months of the trial. The changes from pre-trial values of all haemodynamic assessments measured were statistically significant (p less than 0.001).
SummaryAn open multi-centre study was carried out in general practice to assess the effectiveness and tolerance of ketoprofen in the treatment of 1997 patients with inflammatory arthritic conditions. Patients were treated with 100 mg ketoprofen twice daily for 4 weeks and subjective assessments were made before and after treatment of the clinical symptoms of pain and/or stiffness. The results showed that ketoprofen produced a statistically significant relief of symptoms in painful joints, regardless of whether these were thought to be affected primarily by rheumatoid or osteoarthritic processes. Joint stiffness also improved in the majority of cases. The side-effects reported related mainly to gastro-intestinal symptoms: there were no cases of overt haemorrhage and no serious adverse reactions.
One thousand four hundred and two patients with essential hypertension were treated by their general practitioners for 3 months with one tablet daily consisting of 200 mg acebutolol plus 12·5 mg hydrochlorothiazide: 813 were newly diagnosed and 589 were known hypertensives already on treatment. There was no ‘wash-out’ period before the latter changed to the study treatment. Newly diagnosed hypertensives had an average initial mean arterial pressure (MAP) of 129·9 mm Hg which fell on average by 18·2% during the study: 79% of patients had good results with final MAP levels less than 113 mm Hg (equivalent to e.g., 160/90 mm Hg), and a further 7% also had good results in that MAP fell more than 15%, another 12·5% had moderate results (falls of 5% to 15%): and only 1·5% had poor results (fell less than 5%). Known hypertensives had an average MAP of 127 mm Hg on previous treatment, which fell on average by 15·4% during this study: 70% of patients had good results with final MAP levels less than 113 mm Hg and a further 7% also had good results in that MAP fell more than 15%: 18% had moderate results and 3% poor results. Pulse rate fell by 12·5% in newly diagnosed and 10% in known treated hypertensives. If allowance is made for withdrawals due to side-effects and to the need for more than one tablet of Secadrex daily, then over all 75·7% had a good blood pressure response to study medication, 13·7% a moderate response and 10·7% a poor response. Adverse effects caused the withdrawal of 4% of newly diagnosed and 5% of treated hypertensives, predominantly nausea/vomiting, lassitude/fatigue and malaise. Adverse symptoms not causing withdrawal occurred in newly diagnosed patients with a frequency of 17·1 per 100 patients prior to the study when untreated and 14·1 during the study: in treated hypertensives the figures were 53·1 per 100 patients on previous treatment and 18·2 during the study.
In an open study of fifteen patients with essential hypertension, acebutolol, a cardioselective β 1 -adrenoceptor antagonist given orally once daily at dosages of between 400 mg and 1200 mg, produced a substantial and progressive reduction in systolic and diastolic arterial pressure and in the tension time index both in the lying and standing position over the 3 months of the trial. The changes from pre-trial values of blood pressure assessments were statistically significant (p<0.001). No side-effects were reported and laboratory monitoring of biological parameters revealed no untoward effects of treatment.
A trial was carried out at seven centres using metronidazole suppositories prophylactically in the prevention of post-operative anaerobic infections. One hundred and ninety-seven patients were included of whom only two developed an anaerobic infection at the site of operation. Although the trial was open in design, it is considered that the low incidence of post-operative sepsis and morbidity indicates the effectiveness of metronidazole in providing cover against anaerobic infection during gastro-intestinal and gynaecological surgery.
An open multicentre study was carried out under uncontrolled conditions in general practice to investigate the efficacy and acceptability of twice daily acebutolol in patients with mild to severe hypertension. Data from 1007 patients were analyzed. Most (901) had been treated previously with other hypertensive agents before starting on acebutolol. Oral dosages of acebutolol ranged from 200 mg to 1200 mg/day, according to individual requirements, and 331 patients received concomitant therapy, usually with a diuretic, either from the start of therapy or after 4 to 8 weeks. A significant reduction (p less than 0.001) was observed in mean diastolic blood pressure over the 12-week assessment period, and response increased with treatment duration. There were 280 reports of side-effects and 63 patients were withdrawn from the study for this reason.
A trial was carried out at seven centres using metronidazole suppositories prophylactically in the prevention of post-operative anaerobic infections. One hundred and ninety-seven patients were included of whom only two developed an anaerobic infection at the site of operation. Although the trial was open in design, it is considered that the low incidence of post-operative sepsis and morbidity indicates the effectiveness of metronidazole in providing cover against anaerobic infection during gastro-intestinal and gynaecological surgery.
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