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An annotation on the pulse in aortic regurgitation: Thomas Cuming, 1822.

The classic bounding pulse of aortic regurgitation was described by several authors before Corrigan made his comprehensive study of the disorder in 1832. The case report of Thomas Cuming, published 10 years earlier, is worthy of review. This Dublin practitioner not only presented signs and symptoms of aortic regurgitation proved at autopsy, but also attempted with considerable success to relate the signs to circulatory dynamics.

Adult

Recruitment experience in clinical trials: literature summary and annotated bibliography.

A literature review was conducted to determine what problems exist in accruing adequate numbers of patients for clinical trials. Accrual rates are often not clearly reported, and most studies report that the time period for accrual was extended. Delays in recruitment have an impact on costs and workload throughout the trial. Other problems with the recruitment outcomes include miscalculations in the number of eligible participants in the total population, variations in yield from different types of recruitment sources, and level of community awareness. Planning for recruitment should be part of the overall trial design. Ideally, recruitment planning should be conducted in harmony between the national and local levels. Local community members should be involved. Data-based management of recruitment is necessary and should include a comprehensive data monitoring system with strong administrative support at both central and local levels. Recruitment goals and provisions for corrective action if recruitment lags should be included. Socioeconomic characteristics and attitudes of patients and physicians should be considered in recruitment efforts because they can affect patient participation during all phases of the study.

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