Lancet
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Randomized Controlled Trial Clinical Trial
Sputum-smear-negative pulmonary tuberculosis: controlled trial of 3-month and 2-month regimens of chemotherapy.
Of 1072 Chinese patients with radiographically active pulmonary tuberculosis and no microscopic evidence of acid-fast bacilli in sputum examinations, only 691 (64%) were sputum-culture negative. All patients were randomly allocated to selective chemotherapy (antituberculosis chemotherapy not being started until the activity of the disease had been confirmed), to daily streptomycin, isoniazid, rifampicin, and pyrazinamide for 2 months or 3 months, or to a standard 12-month control regimen. During the subsequent 12 months, 64% of the patients in the selective chemotherapy series started antituberculosis chemotherapy. Both 2-month and 3-month regimens were inadequate for patients whose pretreatment sputum cultures were positive (relapse-rates 14% and 7%, respectively, in patients with drug-sensitive strains) but in the patients whose first cultures were negative the relapse-rate was only 1% after both short-term regimens.
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357 babies weighing 501--1500 g were born alive at Hammersmith Hospital in 1961--75. 58.5% died in the neonatal period and 1.4% at 4--25 months of age. 1.4% of the total are untraced, 5.3% have major handicap, 5.6% have minor handicap, and 27.8% are apparently normal. There was no significant improvement in neonatal mortality in three 5-year periods, 1961--65, 1966--70, and 1971--75, except that more small-for-gestational-age babies survived in the last period than in the first. More of these babies survived than did babies whose birthweight was appropriate for gestational age. There was no significant improvement in the proportion of handicapped children among the very-low-weight liveborn babies throughout the 15-year period, despite increasing complexity of care.