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[Clinical study on experimental Theileria annulata infections of cattle. 1. Clinical-chemical studies].

The extent of liver and kidney damage in 10 young steers, infected with a stabilate of Theileria annulata, was estimated by the determination of enzymes (GOT, GPT, SDH, ALD), serum levels of bilirubin and urea. At the same time the effectiveness of some liver protecting medical agents was tested. The following results were obtained: Change in the activity of the enzymes GOT, SDH and ALD and the increase of bilirubin during the advanced course of the disease are indicative of severe tissue damage in the liver. The levels of urea were found to be in the normal range with only a few exceptions. This seems to exclude the involvement of the kidney in the disease. The group of animals receiving liver protecting medication did not show any difference compared with those animals without medication.

Animals

[Principles of the clinical study of new antitumor perparations].

Clinical studies on new antitumor drugs are characterized by a number of features different from testing other drugs and may be divided into 3 phases, each having its specific aims. Of greatest importance for adequate estimation of a new cytostatic is selecting a primary dosage and its increase, selecting of the so-called "signal" tumors, elaborating the regimen of using the drug which agrees with the mechanism of its action and pharmacokinetics. The methods of randomization and stratification may be used for the third phase, but some elements of the latter are essential for the second phase to compensate the effect of different factors (age and general patients' status, the degree of proliferation and intensity of the process) on the results of chemotherapy. To compare the results of clinical trials, it is necessary to have a unified system of estimating the effectiveness of new chemotherapeutic antitumor drugs.

Antineoplastic Agents

A clinical study: plastic lens warpage.

This clinical study of ophthalmic plastic lens warpage reviews prior work and confirms the presence of warpage. However, there were no patient symptoms related to the warpage, especially if within the ANSI Z80.1 standards.

Eyeglasses

On the agalactia post partum in the sow. A clinical study.

The purpose of the present investigation was to study the clinical symptoms of agalactic sows post partum in randomly selected swine herds. The study comprised 71 sows affected with agalactia post partum and 71 healthy sows from the same herds used as controls. Average morbidity of the disease in these 50 herds, consisting of an average of 25 sows, was 12.8%. Sixty-three per cent of the agalactic sows were affected within one day after farrowing. There was no difference in gestation length between healthy sows and agalactic sows. The body temperature was significantly higher for affected than for healthy sows. Mastitis was diagnosed in 35 out of 71 agalactic sows. The criteria for mastitis were swelling and herdening of one or several udder glands. Vaginal discharge was recorded for affected sows (55/57) as well as for healthy sows (51/58) and is therefore not significantly associated with agalactia. The temperament of the agalactic sows was moderately or severely affected in 62 out of 71 agalactic sows. Constipation was recorded for 13/59 agalactic sows and for 3/57 normal sows. The agalactic sows had significantly higher number of piglets per litter at birth while the litter size was higher for healthy sows at weaning. Numerically, more sows were culled among agalactic sows (16/48) than among normal sows (6/42). Moreover, sows affected with agalactia at the previous parturition were more inclined to meet with the disease at the next parturition. Further studies comprising large groups of animals are, however, necessary for evaluation of this question.

Animals

[A clinical study of PC-904 in pediatrics (author's transl)].

A clinical study of PC-904 was performed in children. The results were as follows; 1) Serum levels of PC-904 after single administration of 20 mg/kg were studied in patients by one-shot intravenous injection or drip infusion for 1 hour or 2 hours. The results obtained in this fundamental study led to the suggestion that the proper dosage in bacterial infections would be 50 approximately 100 mg/kg intravenously in 3 approximately 4 divided doses daily. 2) A clinical study of PC-904 was performed in 16 patients including acute pharyngitis and bronchitis (3 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), abscess with chronic granuloma (2 cases) and urinary tract infection (5 cases). About 50 approximately 100 mg/kg of PC-904 were administered in 3 approximately 4 divided doses daily by one-shot intravenous injection. The clinical effects of 2 cases out of 16 were impossible to be evaluated, and thses cases were excluded from the clinical evaluation. Ten cases out of 14 showed excellent or good responses (efficacy rate: 71.4%). 3) The bacteriological examinations were performed and the causative or isolated organisms were determined in 11 cases. The responses were "disappeared" in 6 cases, "decreased" in 2 cases and "not disappeared" in 3 cases. 4) No side effects were observed. Abnormalities of laboratory findings were not also noticed.

Age Factors

[Experimental and clinical studies on blood coagulation and lysis system after hepatic resection (author's transl)].

Blood coagulation and lysis system was studied with other biochemical serum analysis in three groups of mongrel dogs; laparotomy without hepatic resection (group I), with 50% hepatic section (group II), and 70% hepatic resection (group III). In clinical studies, six cases of hepatic tumors and one case of hepatoma with cirrhosis were selected for examinations. All the data examined in group I were restored toward normal within 48 hours. Total serum protein level was significantly decreased after hepatic resection. The protein level in group III was lower than in group II on the 4th postoperative day (P less than 0.01). In clinical studies, low serum protein levels did not reach a preoperative value even 3 weeks after extended right hepatic lobectomy. Time course of Al-P and transaminase changes in clinical studies was similar to that in experimental study with dogs. Al-P and transaminase showed an abnormally high level in the patient with hepatic cirrhosis. Serum bilirubin levels were not increased after hepatic resection. In blood coagulation and lysis system, serum fibrinogen levels were markedly decreased: 50% reduction in group III and 30% reduction in group II on the first postoperative day. The degree of decrease in the fibrinogen level was proportional to the size of resected volume of the liver. On the other hand, in clinical studies fibrinogen levels were slightly decreased. In the case of hepatic resection with cirrhosis, however, the values were markedly decreased: 40% reduction on the 4th and 25% on the 21st postoperative days. Fibrinolysis system was accelerated group II and III. The acceleration continued until 3 weeks after hepatic resection. From these results it may be concluded that analysis of blood coagulation and lysis system after hepatic resection is useful in evaluating a residual hepatic function after partial resection and in selecting a treatment suitable for hepatic insufficiency.

Adolescent

Parenteral nutrition in carcinoma of the oesophagus treated by surgery: nitrogen balance and clinical studies.

Nitrogen balance studies and clinical observations were made on two groups of patients suffering from obstructive carcinoma of the oesophagus. In 10 patients (group A) parenteral nutrition with a high calorie and nitrogen content was given pre- and early postoperatively. Five patients (group B) received intravenous dextrose/saline solution pre- and postoperatively with no nitrogen supply. Patients in group A had a positive nitrogen balance before and after operation and had a satisfactory postoperative progress. The patients in group B had a negative nitrogen balance until the resumption of oral feeding and their postoperative progress was not as satisfactory as that of patients in group A.

Adult

[Fundamental and clinical studies on CS--1170 in pediatric field (author's transl)].

Fundamental studies and clinical evaluation of CS-1170 were carried out in the field of pediatrics, and the following results were obtained: 1) A high serum concentration of the drug was observed by 30 minutes after the commencement of intravenous drip infusion of 20 and 30 mg/kg, with the peak appearing at the end of the infusion. Serum level of 10.0 micrograms/ml or more was observed even 2 hours after the completion of the drip infusion. 2) The peak of serum concentration appeared at 30 minutes after intravenous injection of 20 mg/kg, and the blood level 4 hours after the injection was 4.3 micrograms/ml or more. 3) Excretion of the drug into the urine by 6 hours after intravenous drip infusion or one-shot injection was 60% or more on the average, with the major portion of the drug in the active state excreted by 4 hours after the administration. 4) Twenty-five children with acute infections (5 types of diseases) were treated with CS-1170 mainly by intravenous drip infusion, and the following clinical results were obtained: The overall clinical effective rate of 96.0% was obtained with the daily dosage of CS-1170 ranging mostly from 50 to 80 mg/kg in the total 25 cases including 7 cases of acute bronchitis (100%), 13 cases of bronchopneumonia (92.3%), 3 cases of acute urinary tract infections (100%), a case each of staphylococal exanthema and lymphadenitis in the neck (100%). 5) Thorough analyses of the liver and kidney functions and the hematological features at the time of, and about 10 days after the administration of CS-1170 in each case so far revealed no abnormality. The drug did not affect the site of injection or the whole body.

Age Factors

Phase I clinical study of quelamycin.

A phase I clinical study was done with quelamycin, a recently synthesized triferric derivative of adriamycin. Twenty-one good-risk patients were studied: 19 patients with non-small cell carcinoma of the lung and two patients with metastatic sarcoma. Acute toxicity occurred in all patients and consisted of high fever, flushing, hypertension, generalized body aches, tremors, and confusion, which lasted 3-6 hours. Potentially dangerous cardiotoxicity occurred in eight patients who had previous minor rhythm disturbances, and was characterized by tachycardia, atrial extrasystoles, atrial fibrillation, and branch block which lasted 6-14 hours. The dose-limiting hematologic toxicity was found to occur at 125 mg/m2 iv single-dose. Objective responses were observed in three of 19 patients with lung cancer and in one patient with metastatic osteogenic sarcoma resistant to adriamycin therapy. In conclusion, quelamycin is a new derivative of adriamycin with potential interest. However, the acute generalized toxicity and the immediate cardiotoxicity found in the presently used schedule are excessive. Further studies directed to suppress these side effects are in progress.

Adolescent

Initial clinical studies with bruceantin.

A phase I clinical study of bruceantin was conducted in 66 patients with various types of advanced solid tumors to evaluate its toxicity and efficacy. The initial dose of 0.2 mg/m2/day x 5 days repeated at 2-week intervals was progressively increased to a maximum dose of 4.5 mg/m2/day. Hypotension was the dose-limiting toxic effect; it was delayed, cumulative, and occurred more often in patients with abnormal pretreatment liver function. Nausea, vomiting, and fever were common at higher doses, and diarrhea, stomatitis, alopecia, paresthesia, and rash were observed in some patients. The hematologic toxicity of bruceantin was moderate at high doses and was manifested mainly as thrombocytopenia; it was more severe in patients with abnormal hepatic and renal functions. No objective tumor regressions were observed. The recommended dose of bruceantin is 3.5 mg/m2/day x 5 days for phase II studies.

Adult

A clinical study of CAB lens wear.

A clinical study of 100 patients fit with gas permeable contact lenses (cellulose acetate butyrate) reveals a 79% success rate. The authors found good eye physiological response with minimum corneal edema, minimum corneal staining, no increase in follicular hypertrophy and minimum spectacle blur.

Adolescent

[Anti-ammonemic activity of the gamma-ethyl ester of glutamic acid. Controlled clinical study].

A controlled clinical trial was made of the anti-ammoniaemic properties of gamma-ethylester glutamic acid, arginine and placebo in a series of 45 patients with hepatic insufficiency characterized by hyperammonemia (excluding cases of pre-coma and coma) randomly assigned to three groups for treatment with: gamma-ethylester of glutamic acid (25 g), l-arginine (25 g) and physiological solution in identical 500 ml bottles. Various parameters were controlled. The results obtained were assessed with different statistical techniques, depending on the parameter concerned and the aims of the trial. Blood ammoniaemia was significantly decreased by both-ethylester of glutamic acid and arginine though the former was more effective quantitatively and in terms of time. SGOT and BSF values also followed the same pattern.

Ammonia

[Continuous and interrupted intestinal sutures. Experimental and clinical study (author's transl)].

The authors report a clinical study of 101 cases of continuous digestive suture and an experiment comparing intestinal healing after continuous and interrupted sutures. A certain discrepancy exists between the excellent clinical results and the pathological and microscopic findings with continuous sutures, and in particular the presence of pseudo-diverticular pouches in 20% of cases developing at the expense of a mucosal evagination within the suture. If carefully performed, continuous suture seems excellent, preventing by its watertightness, the onset of early fistula.

Animals

[Experimental and clinical study test of capreomycin].

Data on the experimental and clinical study of capreomycin in the treatment of tuberculosis are presented. It was shown that capreomycin had low activity with respect to the sensitive strain of Mycobacterium tuberculosis H37 Rv in vitro and the respective infection caused by it in mice. The activity of capreomycin in vitro with respect to streptomycin resistant strains was the same as that with respect to the sensitive strains, while in vivo it increased 3 times. Capreomycin showed a tendency to decreasing its activity with respect to strains highely resistant to canamycin only in vitro. The effect of capreomycin on tuberculosis infection caused by strains resistant to different concentrations of canamycin was the same as that on tuberculosis infection caused by sensitive strains. Cross resistance between florimycin (viomycin) and capreomycin was shown. Clinical trails of capreomycin revealed its moderate therapeutic efficiency, relatively low toxicity and an allergenizing effect on the host. Transient ventibulopatia without pronounced signs of ototoxic action was observed. The nephrotoxic effect was moderate and transient. It was observed predominantly at the peak of the allergic reactions to the antitubercle drugs. The data obtained during the study allow recommendation of capreomycin use in clinics as reserve drug when the causative agent is not resistant to florimycin. The drug should be used under regular control of the blood picture, electrolyte metabolism, state of the kidneys, auditory and vestibular apparatus.

Adult

Congenital and acquired cytomegalovirus infections. Virological and clinical studies on a Swedish infant population.

The study included two clinical materials. First, the frequency of cytomegalovirus and its clinical significance were studied among 661 Swedish children under one year of age admitted to a paediatric hospital. Before the age of one week 4/326 (1%) children excreted virus. At one month the frequency had risen to 6/52 (12%) and after this age the frequency was constant around 20--25%. Sixty per cent of infants born to immigrants were infected after one month of age. One of the four congenitally infected children had symptoms at birth followed by neurological sequelae. The majority of the infections acquired at birth or in early infancy seemed to be subclinical and without sequelae. Second, a retrospective investigation of 18 695 children born during a six-year period was performed. Two cases of virologically confirmed congenital cytomegalic inclusion disease was found. Regarding seven microcephalic patients in the retrospective study congenital CMV-infection could be excluded in four cases. In the remaining three cases the data did not permit any conclusions regarding the etiology.

Abnormalities, Multiple

[Clinical studies of cefamandole in children (author's transl)].

Clinical studies on cefamandole were carried out with the following results. (1) Cefamandole was administered 100 mg/kg/day (q.i.d.) by intravenous route to 29 cases of children. In 10 out of 29 cases bacteriological effect was observed. Bacteriological response was effective in 8 cases (80.0%). Clinical responses were effective in 27 cases (93.1%). (2) As to adverse reactions, granulocytopenia and elevation of S-GOT, S-GPT developed in each two cases.

Agranulocytosis

[Prevention of recurrence of bronchial carcinomas after surgery by means of the mistletoe extract Iscador. Results of a clinical study from 1969-1971].

The results of a clinical study performed between 1969 and 1971 are reported. For prophylactic treatment against possible recurrence the mistletoe preparation Iscador was used in cases with operated cancer of the bronchial tree. The comparability of this group with a control series is tested. The Wilcoxon test in the modification of GEHAN proves a statistically significant prolongation of survival time in the Iscador group.

Bronchial Neoplasms