The New England journal of medicine
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Randomized Controlled Trial Clinical Trial
A controlled trial of interferon gamma to prevent infection in chronic granulomatous disease.
Chronic granulomatous disease is an uncommon inherited disorder of phagocytes in which defective production of the reactive intermediates of oxygen predisposes patients to recurrent and severe pyogenic infections. Evidence from in vitro and in vivo studies indicates that interferon gamma can partially correct the metabolic defect in phagocytes. We assessed the efficacy of interferon gamma in decreasing the frequency of serious infections in patients with this disease. ⋯ For patients with chronic granulomatous disease, interferon gamma therapy is an effective and well-tolerated treatment that reduces the frequency of serious infections.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group.
HA-1A is a human monoclonal IgM antibody that binds specifically to the lipid A domain of endotoxin and prevents death in laboratory animals with gram-negative bacteremia and endotoxemia. ⋯ HA-1A is safe and effective for the treatment of patients with sepsis and gram-negative bacteremia.
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As part of an interdisciplinary study of medical injury and malpractice litigation, we estimated the incidence of adverse events, defined as injuries caused by medical management, and of the subgroup of such injuries that resulted from negligent or substandard care. ⋯ There is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care.