Lancet
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study.
Calcium antagonists are a first-line treatment for hypertension. The effectiveness of diltiazem, a non-dihydropyridine calcium antagonist, in reducing cardiovascular morbidity or mortality is unclear. We compared the effects of diltiazem with that of diuretics, beta-blockers, or both on cardiovascular morbidity and mortality in hypertensive patients. ⋯ Diltiazem was as effective as treatment based on diuretics, beta-blockers, or both in preventing the combined primary endpoint of all stroke, myocardial infarction, and other cardiovascular death.
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We report an outbreak of sepsis from contaminated disinfectant in a neonatal and paediatric intensive-care unit. 28 infants were infected with Klebsiella oxytoca and basic measures to control the outbreak failed. The resistance of K. oxytoca against the disinfectant was probably mediated by capsule formation, visible as mucoid colonies.
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We estimated infant and early child mortality rates among Palestinian refugees using maternal and child services in Jordan, Gaza, Lebanon, and Syria. Early childhood mortality per 1000 live births was 35 in Jordan, 36 in Gaza, 37 in Lebanon, and 32 in Syria. Infant mortality rates were 32 in Jordan, 33 in Gaza, 35 in Lebanon, and 29 in Syria.
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Worsening drug resistance in Plasmodium falciparum malaria is a major threat to health in tropical countries. We did a prospective study of malaria incidence and treatment in an area of highly multidrug-resistant P. falciparum malaria. ⋯ In this area of low malaria transmission, early diagnosis and treatment with combined artesunate and mefloquine has reduced the incidence of P. falciparum malaria and halted the progression of mefloquine resistance. We recommend that antimalarial drugs should be combined with artemisinin or a derivative to protect them against resistance.