A randomized, double-blind, placebo-controlled, parallel-group trial performed at 5 residential units of the Finnish Defence Forces was conducted to assess the antiviral activity, efficacy and safety of inhaled zanamivir for the treatment of naturally acquired influenza. Conscripts were recruited within 2 d of onset of typical influenza symptoms and received inhaled zanamivir 10 mg via a Diskhaler twice daily for 5 d or matching placebo. Time to alleviation of clinically significant symptoms of influenza was the primary endpoint. Viral load measurements were made using quantitative real-time polymerase chain reaction assays. 435/588 patients (74%) had laboratory-confirmed influenza infection. The mean area under the curve for viral load during the first 48 h of treatment was 8.48 [95% confidence interval (95% CI) 2.85 to 14.11] log10 vRNA copies/ml x h lower in the zanamivir group compared with placebo (p = 0.003). Zanamivir reduced the time to alleviation of symptoms versus placebo in the influenza-positive group (medians 2.0 vs 2.33 d; 95% CI-0.17 to 1.0 d, p = 0.08). Zanamivir rapidly reduced viral load following the start of therapy compared with placebo and was well tolerated.
We have used the radioallergosorbent test (RAST) to determine IgE antibodies specific to wheat flour proteins in the sera of seven groups of patients. In some cases ryespecific IgE was also determined. Wheat and rye RAST scores showed a good correlation, presumably due to cross-reactions. Among bakers with asthma, positive scores, 0-5-3, occurred with a prevalence of 43%, and among children with eczema, scores in the range 0'5-4 were found with a prevalence of 54%. A score of 0-5 was a marginal value which was also occasionally encountered with sera from patient groups with no history of immediate hypersensitivity to wheat or rye. These groups included adults and children with allergic rhinitis and asthma, children from the general population and children with coehac disease. The RAST appeared useful in the diagnosis of allergy to inhaled flour dust among bakers. Among children with eczema, positive wheat and rye RAST results were a common finding, which only occasionally could be linked to strong and unequivocal reactions to the foods in question. Both in bakers and children with eczema, wheat and rye RAST results showed good agreement with intracutaneous skin test results.
The present work deals with the effects of psychotropic drug therapy on the operation of psychomotor functions used in a clinical examination of suspected drunken drivers. 100 psychiatric mental, but otherwise health, patients were examined; the type of medication and the number of drugs used varied greatly. In 71 cases the mean degree of error in the clinical examination was higher, and, in several of these, markedly higher than the reference values obtained earlier on suspected drunken drivers when the blood contained very small amounts of alcohol or none at all. In 18 cases coarsely-divided nystagmus was registered in patients on psychotropes. This is an obvious sign of a marked side-effect of medication but was present more infrequently than in subjects with after ingestion of alcohol. The present results indicate that application of the clinical examination method, which was originally developed for and related to the examination of alcohol cases, to subjects on psychotropes is adequate, and it is possible with clinical examination to obtain valuable medicolegal information on the impairment of physiological functions. The present review of suspected drugged drivers examined in Helsinki in 1969--1972 also supports this view.
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