Summary The optimal management of menorrhagia among women with abnormal laboratory haemostasis is uncertain. In a crossover study, 116 women with menorrhagia [pictorial blood assessment chart (PBAC) score >100], negative gynaecological evaluation and abnormal laboratory haemostasis were randomly assigned to either intranasal desmopressin (IN‐DDAVP) or tranexamic acid (TA) therapy for two menstrual cycles. The subjects then crossed over to the second study drug for two additional cycles. Menstrual blood loss (MBL) was measured by PBAC scores at baseline and after each menstrual cycle. Quality of life (QOL) was assessed with four validated instruments. There was a statistically significant decrease in PBAC scores for both treatments. On average, the estimated decrease in the PBAC from baseline was −64·1 [95% confidence interval (CI) = −88·0, −40·3] for IN‐DDAVP and −105·7 (95% CI = −130·5, −81·0) for TA. The decrease in PBAC score was greater for TA than IN‐DDAVP (a difference of 41·6, P‐value = 0·0002, 95% CI = 19·6, 63·6). The test for treatment‐type effect was significant (P < 0·0001) suggesting a greater reduction in PBAC score with TA. Use of both IN‐DDAVP and TA improved QOL by all four instruments. We conclude that both medications reduced MBL and improved QOL among females with menorrhagia and abnormal laboratory haemostasis, but TA proved more effective.

Young people with chronic disorders need help understanding that they can prevent complications. We identified key messages for a hemophilia prevention campaign, including exercising to ensure healthy joints and treating bleeding episodes early and adequately.

Aims-To compare the tolerability and eYcacy of a fixed combination solution of dorzolamide/timolol (Cosopt), administered twice daily with the concomitant administration of its components, dorzolamide (Trusopt) twice daily and timolol (Timoptic) twice daily. Methods-After a 2 week timolol run in, patients with open angle glaucoma or ocular hypertension were randomised (1:1) to receive treatment with either the dorzolamide/timolol combination solution twice daily (combination) or the dorzolamide solution twice daily plus timolol maleate solution twice daily (concomitant) for 3 months. Results-299 patients were entered and 290 patients completed the study. Compared with the timolol baseline, additional IOP lowering of 16% was observed at trough (hour 0) and 22% at peak (hour 2) at month 3 in both the concomitant and combination groups. The IOP lowering eVects of the two treatment groups were clinically and statistically equivalent as demonstrated by the extremely small point diVerences (concomitant − combination) observed in this study−0.01 mm Hg at trough and 0.08 mm Hg at peak. The safety variables of the concomitant and combination groups were very similar. Both combination and concomitant therapy were well tolerated and few patients discontinued due to adverse eVects. Conclusions-Thedorzolamide/timolol combination solution administered twice daily is equivalent in eYcacy and has a similar safety profile to the concomitant administration of the components administered twice daily. (Br J Ophthalmol 1998;82:1249-1253 The safety and eYcacy of timolol maleate (Timoptic) and dorzolamide hydrochloride (Trusopt) as monotherapy agents to lower intraocular pressure (IOP) has been demonstrated in previous clinical investigations. 1 Timolol maleate remains the most widely prescribed treatment for elevated IOP in patients with open angle glaucoma or ocular hypertension. However, since open angle glaucoma is a chronic progressive disease, the majority of patients eventually require additional medication for control of IOP. In previous clinical studies, dorzolamide demonstrated a clinically significant additive eVect ranging from a 13-21% further reduction in IOP when added to ophthalmic blockers.2 3 This additive effect supported the development of a combination solution of dorzolamide and timolol (Cosopt), which is administered twice daily. Other agents additive to timolol (such as pilocarpine, adrenaline (epinephrine), and oral carbonic anhydrase inhibitors) have side eVects which may often result in discontinuation. However, the discontinuation rate due to side eVects has been low with dorzolamide and timolol.4 5 In a crossover study, patients preferred therapy with dorzolamide and timolol to therapy with pilocarpine and timolol by more than 7:1. 4 This combination product may also improve patient compliance with therapy since compliance decreases as the dosing frequency increases. Thus, a twice daily combination solution should lead to improved compliance compared with concomitant therapy with timolol and eit...

Rinderpest is a highly contagious ruminant viral disease manifested by a rapid course and greater than 90% mortality. Infectious vaccinia virus recombinants were constructed that express either the hemagglutinin or the fusion gene of rinderpest virus. All cattle vaccinated with either recombinant or with the combined recombinants produced neutralizing antibodies against rinderpest virus and were protected against the disease when challenged with more than 1000 times the lethal dose of the virus.

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