The present study tested the hypothesis that inadequate Zn intake might be responsible for failure to thrive and impaired catch-up growth in young rural Gambian children, and that Z n supplements might be beneficial. Gambian children might be deprived of Zn because of its poor availability from their predominantly plant-based diet. Rural Gambian children (1 10; fifty boys, sixty girls) aged between 057 and 2.30 years were divided into two matched groups, one to receive 70 mg Zn twice weekly for 1.25 years, and the other a placebo. Growth and mid-upper-arm circumference were measured at weekly intervals throughout the study and illnesses were monitored. Capillary blood and urine samples were collected a t 0, 2 and 8 weeks. Body weights and arm circumferences showed a linear increase, plus a seasonal effect (rainy season faltering). For body weight there was no significant overall effect of the supplement. For arm circumference, a very small (2%) but significant (P < 0.01) difference favoured the supplemented group. Plasma thymulin was much lower at the first clinic than at the second and third clinics, and in vitvo Zn stimulation was greater a t the first clinic. There was, however, no effect of Zn in vivo.

Objective: To investigate whether early intervention with recombinant human growth hormone (hGH) after hip fracture improves functional recovery and long-term outcome. Subjects and methods: Functional recovery after hip fracture is often incomplete. The catabolic situation that develops after the hip fracture accident, and a state of malnutrition either pre-existing or developing after surgery, are main contributing factors for the poor clinical outcome. hGH has been used to promote anabolism in a variety of clinical catabolic situations. The study design was randomized, double-blind and placebo-controlled. A total of 111 patients older than 60 years with an accidental hip fracture (mean age 78X5^9X1 (S.D.) years) were randomized to receive either hGH (20 mg/kg per day) or placebo for a period of 6 weeks, starting within 24 h after the hip fracture accident. Thereafter patients were followed up for an additional period of 18 weeks. Efficacy was assessed by comparing the changes in the Barthel Index score of activities of daily living and in a patient's living situation between the hGH-and the placebo-treated subjects. Results: Eighty-five (78.5%) patients completed the first 8 weeks of the study and 76 (68.5%) the entire study period of 24 weeks. When split according to age, a trend was found that for patients older than 75 years the changes in Barthel Index score from baseline were less in the hGH group than in the placebo group 218X6^18 vs 228X1^26 at 6 weeks after surgery P , 0X075X There was an overall trend to a higher rate of return to the pre-fracture independent living situation in the hGH group than in the placebo group. Analysis by age revealed a significantly higher proportion of hGHthan placebo-treated patients returning to the pre-fracture living situation for subjects older than 75 years (93.8 vs 75.0%, P 0X034X hGH treatment increased IGF-I values to levels in the range of those of normal subjects of 50±60 years of age. Conclusions: A 6 week treatment with hGH (20 mg/kg per day) of otherwise healthy patients after an accidental hip fracture may be of benefit if given to subjects older than 75 years of age. The rate of return to the pre-fracture living situation in subjects of this age treated with hGH was significantly increased when compared with the placebo-treated group. The treatment intervention was well tolerated and no safety issues were recorded.

This multi‐national study was designed to examine the acceptability and safety of a new 3.0 ml pre‐filled insulin pen in clinical use. There were 74 patients (60 with type 1 and 14 with type 2 diabetes) who completed the eight week study during which all insulin injections were administered using the new pens. Patients were familiar with the use of insulin pens before the study and they maintained their pre‐study insulin regimens during the study. At the final visit each patient completed a questionnaire which assessed the ease of use of the new pen and compared it with the pre‐study delivery system. Features of the new pen which were ranked highly included: dose correction, re‐setting after dose delivery, cartridge visibility and dialling the insulin dose. More than 50% said that they would prefer to use the new pen in the future and 74% said that they would recommend the pen to other people with diabetes. Safety was assessed from adverse events, the vast majority of which were mild. Such clinical testing is important to ensure that technical improvements result in real patient benefits and this study demonstrated that the new pen had a high patient acceptability with a clinically acceptable safety profile.