Workers compensation.
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Biomedical subjects
Publications and source records attributed to G McDonald.
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OBJECTIVE: To determine if a dextrose-saline solution manufactured under commercial conditions and containing 1 IU per ml of heparin prolongs the use of infusion sites in children. DESIGN: Double-blind randomized trial. PATIENTS: Eighty children in a medical ward. OUTCOME MEASURES: Failure of infusion sites from phlebitis and/or extravasation. INTERVENTION: Duration of use of infusion sites was calculated to the nearest hour. STATISTICS: Univariate survival analysis. RESULTS: The median time to failure when solutions contained the heparin (97 hours) was significantly increased (p < 0.0001) compared with control solutions (43 hours). CONCLUSIONS: Use of solutions containing low-dose heparin is recommended for children who might have problems with venous access.
We undertook a study of 13-cis-retinoic acid to evaluate its use as an adjuvant to laser surgery in the management of recurrent respiratory papillomatosis. In a double-blind study using placebo, four of the six subjects treated with this agent experienced recurrence while receiving therapy, with two requiring further surgical intervention. All six experienced toxicity, necessitating the withdrawal from therapy of two and dose reduction in three. When it became apparent that the therapy was ineffective, and caused toxicity, the study was closed.
Designed to provide information about patients with schizophrenia who switch from depot neuroleptics to the oral, atypical antipsychotic risperidone, this multicenter observational study enrolled patients who wished to stop the depot, had an unsatisfactory response, or experienced unacceptable side effects. Individuals remained on depot medication for 4 weeks and then received risperidone monotherapy for 3 months. Of the 143 patients who entered the study, 130 received risperidone, 109 completed the initial 16-week study, and 88 entered an optional 12-week follow-up. Symptoms and side effects did not change significantly during the depot phase (mean Positive and Negative Syndrome Scale [PANSS] score 72.2 at baseline, 71.6 at visit 2), but PANSS scores, global assessment of functioning, parkinsonism, and dyskinesia improved significantly during the risperidone phase (mean PANSS score decreased from 71.6 to 55.5 after 3 months). The number of contacts with healthcare professionals fell significantly during the risperidone phase; in addition, symptomatic improvements were maintained during follow-up, and movement disorders continued to decrease significantly. The investigators considered that 81% of patients had switched successfully. Patient acceptance of risperidone was significantly higher than for depot medication (83% vs 23%; P < .001), and 65% considered risperidone better than their previous treatment. Indications for depot medication should be reviewed, and patients may benefit from a switch to risperidone.
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