SummaryConsecutive patients undergoing knee arthroplasty or tibial osteotomy at four participating hospitals received either enoxaparin, 30 mg subcutaneously every 12 h (n = 66) or an identicalappearing placebo (n = 65). All study medications started the morning after the operation and were continued up to a maximum of 14 days. Patients underwent surveillance with 125I-fibrinogen leg scanning and impedance plethysmography. Bilateral contrast venography was performed routinely at Day 14 or at time of discharge, if sooner. Deep vein thrombosis was detected by venography in 35 of 54 patients (65%) in the placebo group and in 8 of 41 patients in the enoxaparin group (19%), a risk reduction of 71%, P <0.0001. For the entire study group, deep vein thrombosis was detected by either venography of non-invasive tests in 37 of 64 patients (58%) in the placebo group and in 11 of 65 patients (17%) in the enoxaparin group, a risk reduction of 71%, P <0.0001. Proximal vein thrombosis was found in 19% of the placebo patients and in none of the enoxaparin patients, a risk reduction of 100%, P <0.001. Bleeding complications occurred in 5 of 65 patients (8%) in the placebo group and in 4 of 66 patients (6%) in the enoxaparin group, P = 0.71. There were no differences in the amount of blood loss, minimum hemoglobin levels and number of units of packed red cells given between the two treatment groups. We conclude that a fixed dose regimen of enoxaparin, started post-operatively, is an effective and safe regimen for reducing the frequency of deep vein thrombosis after major knee surgery.

The present study was undertaken to compare the efficacy of two antibiotics, spiramycin and tetracycline, with a placebo when used adjunctively with scaling and root planing in the treatment of advanced adult chronic Periodontitis. This was a double‐blind, parallel, randomized trial with one factor (drug) at three levels. Ninety–six patients (mean age 46 ± 1) were randomly assigned into one of three groups. All groups were scaled and root planed with each respective group receiving either spiramycin, tetracycline, or a placebo for 2 weeks. Two sites with probing depth of at least 7 mm were evaluated and the following clinical parameters were measured at baseline, 2, 8, 12, and 24 weeks: plaque index, bleeding on probing, crevicular fluid, probing depth, and change in the attachment level. The changes in the subgingival bacteria were monitored also using a differential staining technique. Seventy–nine patients completed the study. At the end of 24 weeks, although all three groups had shown clinical improvement when compared to the baseline data, there were no significant intergroup differences in any of the clinical parameters measured. While the proportion of spirochetes were significantly decreased (P < 0.05) at 2‐ and 8‐week intervals in both tetracycline and spiramycin groups (26% to 0.04% and 28% to 0.04%, respectively), compared to the placebo group (30% to 7%), only in the spiramycin group was the proportion of spirochetes significantly lower than the placebo group at the 24–week interval (3% and 11%, respectively). At week 24, the proportion of spirochetes in the tetracycline group had rebounded to 7%, which was not significantly different from the placebo group. We concluded that mechanical debridement with or without adjunctive spiramycin was effective in improving clinical parameters. Although the adjunctive use of antibiotics aided in preventing recolonization of spirochetes, the data did not support any short‐term clinical benefit since no statistical intergroup differences existed. (J Periodontol 1989;60:533–539)

A double-blind. placebo-controlled study was conducted with 100 adult patients presenting with acne rosacea. 50 patients were randomly assigned to treatment with metronidazole I % cream, while the other 50 patients received placebo cream. The cream was applied morning and evening in a dose of 0.25 cm 2 per application. Clinical assessments were performed prior to drug administration and after I and 2 months of treatment.The number and severity of rosacea lesions (papules and pustules) were significantly reduced with both treatments during the first month, but the response was significantly greater with metronidazole I % cream (p < 0.05). During the second month. lesion counts continued to decline with metronidazole I % cream. but remained the same or worsened with placebo. Metronidazole was significantly better than placebo (p < 0.05).Lesions occurring at all facial sites (forehead. cheeks. chin, nose) responded to metronidazole cream. The most dramatic effect occurred on the forehead. where lesions were eradicated in II of 19 patients (58%). At other sites, metronidazole eradicated lesions in approximately 25% of the patients versus approximately 10% with placebo.Other symptoms of acne rosacea, such as erythema, erythrosis and telangiectasiae improved slightly, but there were no significant differences between treatments. Metronidazole 1% cream was well tolerated throughout the study, with no serious adverse effects or laboratory abnormalities.Acne rosacea is a chronic skin condition affecting primarily the central part of the face causing severe erythema, papules, pustules and telangiectasiae. Rhynophyma, seen more often in men than women, consists of sebaceous hyperplasia of the nose and is usually seen in severe cases. Occasionally, blepharitis and conjunctivitis will accompany facial lesions. Although the condition is thought to be an inflammatory response, the pathogenesis is not fully understood. Some clinicians have linked the condition to an increase in the population of the skin mite, Demodex folliculorum, particularly in hyperseborrhoeic individuals. Rosacea has also been attributed to vitamin deficiencies, endocrine

Cellular potassium extrusion is now considered a natural protective mechanism following myocardial ischemia, and newly synthetized molecules mimicking cellular extrusion of K+ (potassium channel activators) appear promising for cardioprotection, although the underlying mechanisms for their beneficial effects have not been fully characterized. Indeed, the cardioprotective efficacy of K+ channel activators at low temperature or in the presence of the high K+ content of standard cardioplegic solution has never been addressed. Therefore the cardioprotective interaction of the thioformamide K+ channel activator aprikalim (RP 52891) and high K+ content, cold cardioplegia was studied in isolated ischemic rabbit hearts. Isolated hearts were perfused according to the Langendorff procedure at a constant pressure (85 cmH2O; 1 cmH2O = 98.1 Pa); systolic and diastolic left ventricular pressures, coronary flow, and heart rate were monitored throughout the study. Cardiac temperature was monitored through a thermocouple microprobe positioned in the left ventricular free wall. Global ischemia was carried out by completely shutting off the perfusate flow for 90 min, and reperfusion was monitored for 30 min. Several groups of isolated hearts (n = 6 per group) were treated before ischemia with either cold cardioplegia (St-Thomas' Hospital cardioplegic solution, 4 degrees C), aprikalim (10 microM), or glibenclamide (1 microM) alone, or with one of the following combinations: cold cardioplegia + aprikalim, cold cardioplegia + glibenclamide, or cold cardioplegia + both aprikalim and glibenclamide. A 10 microM infusion of aprikalim significantly increased coronary flow (33 to 63 mL/min, +90%) without negative chronotropic or inotropic effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Mouth occlusion pressure at 0.1 s (P_0.1) and minute ventilation (VE) were measured at rest and during progressive hypercapnia in 32 patients. Under double-blind conditions and according to a 2 × 2 Latin-square design, half the patients received one oral dose of diazepam and its placebo. Using the same design, the other half received zopiclone and its placebo. Normocapnic and moderately hypoxemic patients between the ages of 21 and 69 with moderate to severe chronic obstructive pulmonary disease were included in the study. Diazepam produced a statistically significant decrease (p < 0.05) over its placebo in ΔP_0.1/ΔPE_ΤCO2 values following CO₂ rebreathing. Zopiclone did not influence either ΔP₀.₁/ΔP_ETCO2 or ΔVE/ΔP_ETCO2, but produced a significant increase in respiratory frequency. However, no statistically significant differences were observed between the two active treatments