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Involvement of lipid mediators in the pathogenesis of experimental nephrosis in rats: its pharmacological modulation.

The administration of a single-injection of Adriamycin (ADR) to rats results in marked proteinuria and glomerular morphological changes that are similar to minimal change disease in humans. We have hypothesized that Adriamycin, by itself or through the release of some mediators from resident glomerular cells, could provoke a damage to epithelial glomerular cells. Sprague-Dawley rats received a single injection of Adriamycin, 7.5 mg/kg bw, allocated randomly in several groups and treated throughout 2 weeks of follow-up. All control nontreated animals developed important nephrotic syndrome and degenerative lesions of epithelial glomerular cells. Isolated glomeruli from animals injected with adriamycin 14 days before synthesized thromboxane (TxB2) and platelet activating factor (PAF) in amounts above the rates of control glomeruli. Animals treated with three structurally different PAF receptor antagonists did not present proteinuria or only to a very low extent (p less than 0.0005). In these rats no alterations in epithelial cells were noted. Furthermore, no significant changes in the TxB2 production were noted in rats treated with BN 52021, a PAF receptor antagonist. Leukotrienes also seem to participate since treatment with a 5-lipoxygenase inhibitor partially corrected proteinuria. Moreover, glomeruli from animals with nephrosis and treated with this compound presented only a discrete reduction in the PAF synthesis. On the whole, these data suggest a key role for PAF in the pathogenesis of adriamycin nephropathy. Other lipid meditors, released in cascade simultaneously or thereafter, could perpetuate the renal damage.

Animals↗

The effect of feeding lovastatin and colestipol on production and cholesterol content of eggs.

The purpose of the present study was to determine whether feeding lovastatin or colestipol, or both, to laying hens would decrease the concentration of cholesterol in eggs. Forty-eight White Leghorn hens (69 wk of age) were allocated randomly to one of four groups. For 5 wk, the birds were fed: 1) a control diet; 2) diets supplemented with 35 mg of lovastatin per kg of feed; 3) 11.7 g of colestipol per kg of feed; or 4) both 35 mg of lovastatin and 11.7 g of colestipol per kg of feed. Drug feeding did not affect egg production or the concentration of cholesterol in the yolk, muscle, or liver. Lovastatin residue was found in liver samples from hens receiving lovastatin, but no lovastatin residue was found in the muscle, egg-white, or egg-yolk samples from hens on any treatment. These findings suggest that lovastatin or colestipol, or both, fed at relatively low amounts do not decrease the concentration of cholesterol in egg yolk and do not depress egg production.

Animal Feed↗

Effects of recent sexual experience and melatonin treatment of rams on plasma testosterone concentration, sexual behaviour and ability to induce ovulation in seasonally anoestrous ewes.

The aim of this study was to determine whether advancing the seasonal changes associated with rams by treatment with exogenous melatonin and allowing the rams previous sexual experience would increase the proportion of anoestrous ewes ovulating in early July. North Country Mule ewes (n = 225) were grouped by live body weight and body condition score and allocated randomly to the following treatments: (i) isolated from rams (control; n = 25); (ii) introduced to rams (treatment 2); (iii) introduced to rams that had mated with ewes during the previous 2 days (treatment 3); (iv) introduced to rams implanted with melatonin (treatment 4); and (v) introduced to rams that were implanted with melatonin and had mated with ewes during the previous 2 days (treatment 5). Treatments 2-5 were replicated (2 x 25 ewes) and two rams were introduced to each replicate group. Introductions began on 4 July and were completed by 11 July. The rams were withdrawn from the ewes after 8 days. Melatonin was administered as a subcutaneous implant (Regulin((R))) on 22 May and again on 20 June. Blood samples were taken from all rams to determine plasma melatonin and testosterone concentrations (19 samples in 6 h). The behaviour of the sheep was videotaped continuously during the first 3 h after the ram was introduced. Ovulation was detected by an increase in plasma progesterone concentrations from < 0.5 ng ml(-1) to > 0.5 ng ml(-1). Mean +/- SE plasma melatonin concentrations were 649.7 +/- 281.4 and 18.3 +/- 2.4 pg ml(-1) in rams with and without melatonin implants, respectively (P < 0.001). Melatonin implants also increased plasma testosterone concentrations from 4.30 +/- 1.88 to 10.10 +/- 1.10 ng ml(-1) (P < 0.01), the libido of the rams and the proportion of ewes that ovulated in response to the rams (43 and 56% (treatments 4 and 5) versus 24% (treatments 2 and 3)). In conclusion, implanting rams with melatonin before introducing them to seasonally anoestrous ewes increases the proportion of ewes that ovulate in response to introduction of a ram, but previous sexual experience of rams appears to have little or no effect.

Analysis of Variance↗

Minimal prophylactic concentration of dietary zinc compounds in a mouse model of swine dysentery.

Dietary supplementation with 6000 mg of Zn2+/kg of feed has been shown to modify the clinicopathologic expression of Brachyspira hyodysenteriae infection in a laboratory mouse model of swine dysentery. However, this concentration impaired the body weight gain of the mice. The purpose of the present study was to determine a minimal prophylactic concentration of feed-grade zinc compounds that would not affect the growth of mice challenge-exposed with B. hyodysenteriae. A total of 440, 6- to 8-week-old, C3H/HeN mice were allocated randomly to groups and fed either a defined diet or a defined diet containing either 1000, 2000 or 4000 mg/kg ZnO, ZnSO4 or zinc-methionine for 7 days before intragastric inoculation with B. hyodysenteriae. From days 7 to 35 after inoculation, mice in each group were necropsied at weekly intervals for determination of body weight, presence of B. hyodysenteriae in the cecum, and histological assessment of cecal lesions. Only ZnO fed at 2000 mg/kg had a prophylactic effect against B. hyodysenteriae infection without affecting the body weight gain of the mice. The prophylactic effect of Zn2+ against infection with B. hyodysenteriae was also affected by the relative concentration of Fe2+ and Zn2+/Fe2+ ratio of the diet.

Animal Feed↗

A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients.

BACKGROUND: Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. METHODS: We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. RESULTS: After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. INTERPRETATION: The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible.

Aged↗

[Comparison of corneal wound healing of photorefractive keratectomy and laser in situ keratomileusis in rabbits].

OBJECTIVE: To compare effects of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on the cornea and corneal wound healing and to investigate the possible mechanism of corneal haze and myopic regression histopathologically. METHODS: Twenty-four New Zealand white rabbits were allocated randomly to correct -4.00 and -8.00 diopters and were operated with PRK on right eyes and LASIK on left eyes. At 10 days and 1, 3, and 6 months, corneal haze was observed, refraction was evaluated, and 3 rabbits were randomly selected for each time point to be enucleated, and corneas to be bisected. One half of each cornea was evaluated using transmission electron microscopy, and the other half was evaluated using either light microscopy or immunohistochemical staining for collagen type III, IV, fibronectin (FN) and transforming growth factor-beta(1) (TGF-beta(1)). RESULTS: Different degrees of corneal haze and myopic regression were observed after PRK: the higher the desired myopic correction, the heavier the haze. Corneal wound healing response was greater and lasted longer after PRK than after LASIK. Various pathological findings such as epithelial hyperplasia, basal membrane reforming and extracellular matrix deposits were found in the ablation zone and repair mechanisms were still active at 6 months after PRK. Whereas after LASIK, the interface between the flap and stromal bed was transparent except for growing epithelial plugs and lightly proliferating stroma coinciding with the flap margins. After both PRK and LASIK, all corneal cell types were consistently positive for TGF-beta(1) antibody during the corneal wound healing time. TGF-beta(1) antibody positivity decreased as the wound healing approached completion. The histopathological changes of corneal haze and myopic regression are as follows: epithelial hyperplasia, basal membrane immaturity, anterior stromal keratocyte increase and activity, new collagen III production and irregular arrangement thereof, and FN deposition in the extracellular matrix under the epithelium. CONCLUSIONS: Compared with PRK, LASIK ensures refractive stability with quick wound healing and minimal tissue proliferation resulting in a more promising corneal refractive surgery to correct myopia, especially more severe cases of myopia. The corneal wound healing especially the stromal healing is the key to the cause of haze and myopic regression. TGF-beta(1) may be involved in scar formation during wound healing by stimulating expression of collagen III and FN and is believed to be an important regulating factor.

Animals↗

[Study on the insulin and insulin receptor in the progression of renal ischemic and reperfusion].

OBJECTIVE: To evaluate the effect of insulin and it's receptor on the kidney of rabbit with acute ischemic/reperfusion injury. METHODS: Twenty three Japanese white rabbits were allocated randomly into the control group, ischemic/reperfusion group(IR group), and insulin treatment group(Ins-IR group). The IR group received clamping for 1 h followed by 2 h or 48 h of reperfusion. In the Ins-IR group, insulin injection (Ins 3U/kg, glucose 1.5 g/kg, K+ 4 mg/kg, Mg2+ 1.7 mg/kg) was administered intravenously twice a day for two days, whereas only normal saline in equal amount was given to the IR group and control group. At 2 h or 48 h after reperfusion, glucose and insulin in serum were determined. Rough plasma of renal tissue was prepared by repeated centrifugation. Insulin receptor in renal tissue was analyzed by radiologand binding assay. The binding data were calculated according to Scatchard using the ligand program. Statistical significance was analyzed with the paired t-test. RESULTS: The level of blood glucose increased after 2 h reperfusion in three groups, but the level in IR group increased much higher than those in control and Ins-IR groups(P < 0.05). The level of serum insulin of IR group after 2 h reperfusion was significantly higher than that of control (P < 0.05). Scatchard analysis showed curvilinear profiles, indicating that there are two classes of receptors with different affinity or the presence of a single class of receptors with a negative cooperative hormone-receptor interaction. Data analyzed by a two-site model showed that the values of Bmax1 (high affinity site), Bmax2 (low affinity site) and Kd1, Kd2 after 2 h reperfusion were significantly lower than those of control (P < 0.05). In IR-Ins group, only Bmax2 decreased (P < 0.05, compared with control). 48 h after IR there was no difference in Bmax1, Kd1 between the 3 groups, but Bmax2 of IR-Ins group was still lower than that of control (P < 0.001) and IR group (P < 0.05). The Kd2 of IR group increased (P < 0.05 compared with control and IR-Ins group). CONCLUSION: The results indicate that the effect of intrinsic insulin decreases during renal ischemic/reperfusion. The extrinsic insulin can protect renal tissue through its high affinity receptor. There exits down-regulation of low affinity receptor but none of high affinity receptor during insulin treatment.

Animals↗

The role of the liver, kidney and duodenum in tolerance in the copper-loaded rat.

The purpose of this study was to help characterize the pathway of copper in the liver, kidney and duodenum during copper loading and unloading in the rat. Male Wistar rats were allocated randomly into four groups: Group A (control) was composed of 16 animals fed a normal rodent diet. Group B had 16 animals fed a high copper diet (1500 ppm copper). Four rats from each group were killed at 1, 5, 10 and 15 weeks. Group C had 4 animals fed the high copper diet for 5 weeks and normal diet for 5 weeks. Group D consisted of 4 animals fed the high copper diet for 5 weeks, normal diet for 5 weeks, followed by 5 weeks of high copper diet. At termination of each experimental period liver, kidney and duodenum were collected for histochemistry and copper analysis by atomic absorption spectrophotometry. Hepatic copper concentration in Group B rose to 726 +/- 170 micrograms/g after 5 weeks; renal and duodenal copper levels were 285 +/- 14 micrograms/g and 134 +/- 49 micrograms/g, respectively. A significant (P < 0.005) decrease in copper concentration was observed after 15 weeks in all three organs. Duodenal copper concentration in group C was similar to control rats. Changes in copper tissue distribution and efficient unloading were demonstrated in all copper-loaded groups in the three organs studied.

Animals↗

[Experimental study of Chinese Agkistrodon acutus venom in activation of rabbit platelets in vivo].

Fourteen Albino rabbits, male and female, were allocated randomly into two groups: control group which had intravenous infusion of normal saline, and experimental group which had intravenous infusion of Chinese Agkistrodon Acutus venom (CAAV) 0.075 mg/kg. Platelet was reduced, plasma PF4 activity and 5-HT concentration increased, 5-HT content in platelets was reduced in the experimental group 10, 20, and 50 minutes after the infusion. It had a significant difference (P < 0.01), compared with that in the control group. Platelets were aggregated into masses under electron microscope 10 minutes after the infusion of CAAV. The study has proved that blood platelets in rabbits are activated by Chinese Agkistrodon Acutus venom.

Agkistrodon↗

Efficacy of ivermectin in a beef-based chewable formulation against Ancylostoma caninum and Uncinaria stenocephala in dogs.

The effective dosage of a chewable formulation of ivermectin was determined in 35 young dogs with induced infections of Ancylostoma caninum and Uncinaria stenocephala. Dogs were inoculated with these parasites and held until the infections were patent. Within each of 7 replicates, dogs were allocated randomly to 1 of 5 treatment groups: vehicle control, or ivermectin at 6, 12, 18, or 24 micrograms/kg. Chewable treatments were tailored to body weight. Seven or 8 days after treatment, parasites were recovered using standard techniques. All 7 controls had adult A. caninum (geometric mean = 35.5) and U. stenocephala (geometric mean = 82.6). Against A. caninum, the efficacy of ivermectin was 52%, 98%, 95%, and 97% at 6, 12, 18, and 24 micrograms/kg, respectively. The statistical model that best described the dose response was linear to 12 micrograms/kg with a plateau thereafter. Using this model, the estimated reduction from the predicted control mean was 97.2%; the estimated dose to eliminate 90% of the worms (ED90) was 8.4 micrograms/kg, and the ED95 was 10.5 micrograms/kg. Against U. stenocephala, the dose response was linear in the range studied, with an ED90 of 20.8 micrograms/kg; it was estimated that 93.2% of the worms would be eliminated.

Administration, Oral↗

Effects of selective head cooling on brain cell membrane activity during postischemic reperfusion.

OBJECTIVE: To examine the effect of selective head cooling (SHC) on brain cell membrane activity involving ATPase, phospholipase A2, content of total membrane phospholipids during postischemic reperfusion, so as to elucidate the possible underlying mechanism on resuscitating effect of SHC. MATERIALS AND METHODS: Complete cerebral ischemia (CCI) was induced by the four-vessel model. 56 New Zealand rabbits were allocated randomly into two groups, non-ischemic control group had 30, 180 and 360 minutes reperfusion after CCI (n = 8); and SHC group with the same ischemic-reperfusion insult were all treated with SHC (28 degrees C, surface cooling method). Changes of Na+, K(+)-ATPase, Ca2+, Mg(2+)-ATPase, phospholipase A2, total phospholipids of brain cell membrane were observed. Comparison of data between two groups was made by Students' t test. RESULTS: Compared with non-ischemic controls following 30 minutes CCI, activities of Na+, K(+)-ATPase stepwisely decreased at 30, 180 and 360 minutes, Ca2+, Mg(2+)-ATPase dropped at 180 and 360 minutes, phospholipidase A2 increased markedly at 30, 180, 360 minutes, and total phospholipids decreased at 180 and 360 minutes reperfusion (P < 0.01). Selective head cooling inhibited all the above changes significantly (P < 0.01). CONCLUSION: The results suggest that selective head cooling initiated soon after reperfusion is beneficial for brain cell membrane function recruitment, which provides favourable effects on the damaged but still remediable brain cells for their resuscitation.

Animals↗

Congenital undescended testes in neonatal pigs and the effect of exogenous calcitonin gene-related peptide.

PURPOSE: We investigated the neonatal piglet as a possible animal model for cryptorchidism and to determine whether calcitonin gene-related peptide (CGRP), which has been proposed to regulate inguinoscrotal testicular descent, could induce testicular descent in piglets with congenital cryptorchidism. MATERIALS AND METHODS: We examined 38 cryptorchid piglets to document the anatomy in 8 and to investigate the role of CGRP in 30. The 2-week-old piglets were allocated randomly to receive a mini-osmotic pump containing CGRP at various concentrations or phosphate buffered saline. The pump was inserted surgically into the ipsilateral scrotum, with the contents blinded to the surgeon. The positions of the testes, pump and anatomical landmarks were measured and photographed. The pigs were sacrificed and dissected 2 weeks later, and the positions were remeasured and photographed. The testes were examined histologically. RESULTS: The 3 variants of cryptorchidism observed were intra-abdominal in 20 cases, inguinal in 9 and lateral inguinal ectopic in 9. CGRP had no effect on intra-abdominal or ectopic testes. In contrast, for inguinal testes exogenous CGRP caused a slight but significant 10 +/- 7.9 mm. descent towards the pump in 5 cases compared to -2.9 +/- 5.8 mm. in 4 controls. CONCLUSIONS: Exogenous CGRP stimulated migration of inguinal testes that had been arrested in the line of descent while ectopic testes did not respond. These results support a role for CGRP in testicular descent and suggest that a slow release depot preparation might be useful as a possible treatment in some forms of cryptorchidism.

Animals↗

The recovery of gases insufflated at laparoscopy.

The recovery of gases used for insufflation at gynaecological laparoscopy was investigated in 163 women who were randomly allocated to receive insufflation with nitrous oxide or carbon dioxide, the two most commonly used gases. No difference was detected and since nitrous oxide has dangerous side effects, the use of carbon dioxide is recommended. Methods of enhancing the recovery of gas were then investigated in a further 207 women, treatment being allocated in a random fashion. No merit was found in the use of these techniques and they have been abandoned.

Carbon Dioxide↗

A 10-year assessment of controlled trials of inpatient and outpatient treatment and of plaster-of-Paris jackets for tuberculosis of the spine in children on standard chemotherapy. Studies in Masan and Pusan, Korea. Ninth report of the Medical Research Council Working Party on Tuberculosis of the Spine.

Two hundred and eighty-three patients with tuberculosis of the thoracic and/or lumbar spine have been followed for 10 years from the start of treatment. All patients received PAS plus isoniazid daily for 18 months, either with streptomycin for the first three months (SPH) or no streptomycin (PH), by random allocation. There was also a second random allocation for all patients: in Masan to inpatient rest in bed (IP) for six months followed by outpatient treatment or to ambulatory outpatient treatment from the start (OP), and in Pusan to outpatient treatment with a plaster-of-Paris jacket (J) for nine months or to ambulatory treatment without any support (No J). A favourable status was achieved on their allocated regimen by 88% of patients at 10 years. Some of the remaining patients also attained a favourable status after additional chemotherapy and/or operation, and if these are included the proportion achieving such a status increases to 96%. There were five patients whose deaths were attributed to their spinal disease. A sinus or clinically evident abscess was present on at least one occasion in the 10-year period in 42% of the patients. Residual sinuses persisted at 10 years in two patients, at death at seven years in a third and at default in the seventh year in a fourth. Thirty-five patients had paraparesis at some time during the 10-year period, including two who died with paraplegia before five years. Complete resolution occurred in 26 patients (in six after additional chemotherapy and/or surgery). At 10 years two patients had severe paraplegia and one a moderate paraparesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

What is meant by intention to treat analysis? Survey of published randomised controlled trials.

OBJECTIVES: To assess the methodological quality of intention to treat analysis as reported in randomised controlled trials in four large medical journals. DESIGN: Survey of all reports of randomised controlled trials published in 1997 in the BMJ, Lancet, JAMA, and New England Journal of Medicine. MAIN OUTCOME MEASURES: Methods of dealing with deviations from random allocation and missing data. RESULTS: 119 (48%) of the reports mentioned intention to treat analysis. Of these, 12 excluded any patients who did not start the allocated intervention and three did not analyse all randomised subjects as allocated. Five reports explicitly stated that there were no deviations from random allocation. The remaining 99 reports seemed to analyse according to random allocation, but only 34 of these explicitly stated this. 89 (75%) trials had some missing data on the primary outcome variable. The methods used to deal with this were generally inadequate, potentially leading to a biased treatment effect. 29 (24%) trials had more than 10% of responses missing for the primary outcome, the methods of handling the missing responses were similar in this subset. CONCLUSIONS: The intention to treat approach is often inadequately described and inadequately applied. Authors should explicitly describe the handling of deviations from randomised allocation and missing responses and discuss the potential effect of any missing response. Readers should critically assess the validity of reported intention to treat analyses.

Data Collection↗

[Estimation on the number of drug users in Hongjiang, Hunan: a capture-recapture study].

OBJECTIVE: To estimate the number of drug users in Hongjiang, Hunan and to develop strategy for drug reduction in the future. METHODS: Two capture-recapture methods were used to estimate the numbers of drug addicts. Random stratified sampling survey was used to verify the optimum allocation. The first capture-recapture method (CR1) referred to the number from optimum allocation random stratified sampling survey conducted in the communities and the number from local Public Security Bureau list being the second capture. The second capture-recapture method (CR2) referred to the collection of records in the detoxification unit with an interval of 4 months. The estimated number was calculated under Seber's adjustment formula. Face to face interview was carried out during the optimum allocation random stratified sampling survey process. RESULTS: Of 1388 interviewed in the communities, 24 (1.73%) were identified as drug addicts under the optimum allocation random stratified sampling survey. When the figure 1.73% was applied to the total population (72,709) in Hongjiang, the result yielded an estimation of 1258 drug addicts. The estimated numbers of CR1 and CR2 were 904 and 1069 respectively. However, the number was 1.3 to 1.6 fold higher than the reported number (687) by local Public Security Bureau. CONCLUSION: The capture-recapture method seemed a better method in estimating the number of drug addicts.

China↗

Clinical field efficacy and safety of pyrantel pamoate paste (19.13% w/w pyrantel base) against Anoplocephala spp. in naturally infected horses.

Clinical field trials were conducted at five geographical locations in the USA (Oklahoma, Wisconsin, Tennessee, Virginia and Idaho) to evaluate the efficacy and safety of pyrantel pamoate paste (19.13%, w/w, pyrantel base) administered at the recommended dosage of 13.2 mg pyrantel base/kg (6.0 mg pyrantel base/lb) body weight (b.w.) against tapeworm infections of Anoplocephala spp. in naturally infected horses. Horses at each study site were allocated by restricted randomization based on the cestode status (positive or negative) of pre-treatment fecal egg counts to complete sets of four animals each or incomplete sets of fewer than four animals. Within sets comprising of two to four horses, one animal was randomly allocated to receive placebo vehicle paste and the remaining horse(s) received pyrantel pamoate paste administered orally at a minimum dosage of 13.2 mg pyrantel base/kg b.w. on Test Day (TD) 0. Single animal sets received pyrantel pamoate paste. Fecal samples of horses were collected and examined for equine tapeworm (Anoplocephala spp.) eggs a minimum of four times (once or thrice between TD -28 and -14, twice between TD -14 and -7, and once on TD 0) prior to treatment on TD 0. Fecal samples of horses that were positive for cestode infection pre-treatment were examined for cestode eggs on TD 7, 8, 9, 14, 15 and 16. Cestode-negative pre-treatment horses were not sampled again after treatment. A total of 241 horses (141 mares, 16 stallions and 84 geldings; 6 months-30 yrs of age; 173-646 kg; 13 recognized breeds and various crossbreds) were evaluated. The prevalence of Anoplocephala spp. determined by pre-treatment fecal examination ranged from 38.3% in Idaho to 68.1% in Tennessee with an overall prevalence of 52.3%. Ninety cestode-positive and 88 cestode-negative horses were treated with pyrantel pamoate paste, 36 cestode-positive and 27 cestode-negative horses were treated with placebo vehicle paste. Overall, 178 horses were treated with pyrantel pamoate paste, and 63 horses were treated with placebo paste. Of the 178 horses treated with pyrantel pamoate paste, no drug related, adverse clinical or neurological health events were observed. No doses of pyrantel pamoate paste were refused or lost during dosing. At each post-treatment time sampling interval, significantly fewer cestode eggs (P < 0.0115) were passed by cestode-positive horses treated with pyrantel pamoate paste compared to cestode-positive horses that received placebo paste. Efficacy of the pyrantel pamoate paste treatment ranged from 92 to 96% from TD 7 to TD 16 with an overall efficacy of 95%. The results of these trials demonstrated that pyrantel pamoate paste (19.13%, w/w, pyrantel base) administered orally at a dosage of 13.2 mg pyrantel base/kg b.w. is highly efficacious (95%) against Anoplocephala spp. and safe for use in horses with no adverse clinical or neurological health events observed under field use conditions.

Administration, Oral↗

Randomization and efficiency in Zelen's single-consent design.

The "single-consent design" was devised by Zelen to circumvent the reluctance of some patients and physicians to participate in certain types of randomized clinical trials. Crucial to the validity of Zelen's design is randomized allocation of patients. Randomization theory is therefore the key theoretical base of the approach taken in this paper to an examination of the efficiency of this design.

Analysis of Variance↗