Virtual outreach: a randomised controlled trial and economic evaluation of joint teleconferenced medical consultations.

Objectives: To test the hypotheses that virtual outreach would reduce offers of hospital follow-up appointments and reduce numbers of medical interventions and investigations, reduce numbers of contacts with the health care system, have a positive impact on patient satisfaction and enablement, and lead to improvements in patient health status. To perform an economic evaluation of virtual outreach.

Design: A randomised controlled trial comparing joint teleconsultations between GPs, specialists and patients with standard outpatient referral.

Putting evidence into practice: how middle and low income countries "get it together".

The scarcity of resources in poorer countries means that ensuring health care is evidence based is particularly important. A group of workers active in the field describe their experiences of trying to do just that

Chlorproguanil-dapsone for treating uncomplicated malaria.

Background: In Africa, malaria is often resistant to chloroquine and sulfadoxine-pyrimethamine. Chlorproguanil-dapsone is a potential alternative.

Objectives: To compare chlorproguanil-dapsone with other antimalarial drugs for treating uncomplicated falciparum malaria.

Betamimetics for inhibiting preterm labour.

Background: Preterm birth is a major contributor to perinatal mortality and morbidity worldwide. Tocolytic agents are drugs used to inhibit uterine contractions. The most widely used tocolytic agents are betamimetics especially in resource-poor countries.

Topical umbilical cord care at birth.

Background: Umbilical cord infection caused many neonatal deaths before aseptic techniques were used.

Objectives: To assess the effects of topical cord care in preventing cord infection, illness and death.

Search Strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register (September 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003).

The DNA sequence and comparative analysis of human chromosome 10.

The finished sequence of human chromosome 10 comprises a total of 131,666,441 base pairs. It represents 99.4% of the euchromatic DNA and includes one megabase of heterochromatic sequence within the pericentromeric region of the short and long arm of the chromosome.

DNA sequence and analysis of human chromosome 9.

Chromosome 9 is highly structurally polymorphic. It contains the largest autosomal block of heterochromatin, which is heteromorphic in 6-8% of humans, whereas pericentric inversions occur in more than 1% of the population. The finished euchromatic sequence of chromosome 9 comprises 109,044,351 base pairs and represents >99.

The alpha-helical peptide nucleic acid concept: merger of peptide secondary structure and codified nucleic acid recognition.

A novel platform for nucleic acid recognition that integrates the alpha-helix secondary structure of peptides with the codified base-pairing capability of nucleic acids is reported. The resulting alpha-helical peptide nucleic acids (alpha PNAs) are composed of a repeating tetrapeptidyl unit, aa(1)-aa(2)-aa(3)-Ser(B), where aa(1) through aa(3) represent generic ancillary amino acids and B = nucleobases linked to Ser via a methylene bridge. Effective syntheses of constituent Fmoc-protected nucleoamino acids (Fmoc-Ser(B)-OH, where B = thymine, cytosine, and uracil) are described along with a protocol for the solid-phase synthesis of 21mer alpha PNAs containing five such nucleobases.

3-fluoro-6-tert-butyltetrahydropyranosyl trichloroacetamidates. "chiral auxiliary donors" for hydroxyalkyl radicals.

An improved THP-based chiral auxiliary for hydroxyalkyl radicals is reported. The key modifications involve introduction of a fluorine substituent at C-3 to make the acetal center more robust and the use of Schmidt's trichloroacetamidate glycosylation methodology for efficient attachment of the auxiliary to the radical precursor. The resulting chiral hydroxyalkyl radical equivalents add to methyl 2-trifluoroacetoxyacrylate with selectivities ranging from 9:1 (0 degrees C) to 15:1 (-78 degrees C).

The DNA sequence and analysis of human chromosome 13.

Chromosome 13 is the largest acrocentric human chromosome. It carries genes involved in cancer including the breast cancer type 2 (BRCA2) and retinoblastoma (RB1) genes, is frequently rearranged in B-cell chronic lymphocytic leukaemia, and contains the DAOA locus associated with bipolar disorder and schizophrenia. We describe completion and analysis of 95.

Artemether-lumefantrine for uncomplicated malaria: a systematic review.

Background: The World Health Organization (WHO) is promoting artemether-lumefantrine for treating uncomplicated malaria. The objective of this review is to summarize available evidence of its effects compared with other antimalarial regimens.

Methods: We sought randomized and quasi-randomized studies comparing artemether-lumefantrine with any other antimalarial drug regimen.

Evidence-based obstetric care in South Africa--influencing practice through the 'Better Births Initiative'.

Ensuring that health professionals practise according to evidence-based standards is important since it affects the quality and cost of care patients receive. The purpose of this research was to use a focused change programme (the Better Births Initiative) to influence obstetric practice of 10 hospitals in Gauteng, South Africa. The findings show some important improvements in practice following the implementation of the BBI; providers at some sites reduced the use of enemas, shaving and episiotomy, and increased use of oral fluids and companionship during labour.

Albendazole for lymphatic filariasis.

Background: Mass treatment with albendazole, co-administered with another antifilarial drug, is being promoted as part of a global programme to eliminate lymphatic filariasis.

Objectives: To assess the effects of albendazole on patients or populations with filarial infection, and on morbidity in patients with filarial infection; and to assess the frequency of adverse events for albendazole both given singly or in combination with another antifilarial drug (diethylcarbamazine or ivermectin).

Search Strategy: We searched the Cochrane Infectious Disease Group's trial register (September 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2003), MEDLINE (September 2003), EMBASE (September 2003), LILACS (September 2003); and checked the reference lists and contacted experts, international organizations, and a pharmaceutical company.

Unintended pregnancy and induced abortion among unmarried women in China: a systematic review.

Background: Until recently, premarital examination for both men and women was a legal requirement before marriage in China. Researchers have carried out surveys of attendees' sexual activity, pregnancy and abortion before their marriages, trying to map out reproductive health needs in China, according to this unique population-based data. To systematically identify, appraise and summarise all available studies documenting pregnancy and induced abortion among unmarried Chinese women attending premarital examinations.

Artesunate combinations for treatment of malaria: meta-analysis.

Background: Addition of artemisinin derivatives to existing drug regimens for malaria could reduce treatment failure and transmission potential. We assessed the evidence for this hypothesis from randomised controlled trials.

Methods: We undertook a meta-analysis of individual patients' data from 16 randomised trials (n=5948) that studied the effects of the addition of artesunate to standard treatment of Plasmodium falciparum malaria.

The DNA sequence and analysis of human chromosome 6.

Chromosome 6 is a metacentric chromosome that constitutes about 6% of the human genome. The finished sequence comprises 166,880,988 base pairs, representing the largest chromosome sequenced so far. The entire sequence has been subjected to high-quality manual annotation, resulting in the evidence-supported identification of 1,557 genes and 633 pseudogenes.

Considering resistance in systematic reviews of antibiotic treatment.

Context: Microorganisms resistant to antibiotic drugs are a threat to the health and chances of survival of patients. Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences.

Objectives: To examine whether systematic reviews of antibiotic treatment consider resistance; if not, to find out whether data on resistance were reported in the original trials; and based on that, to offer a framework for taking resistance into account in systematic reviews.

Open general medical wards versus specialist psychiatric units for acute psychoses.

Background: As international healthcare policy has moved away from treating people with severe mental illness in large inpatient psychiatric institutions, beds for people with acute psychiatric disorders are being established in specialised psychiatric units in general hospitals. In developing countries, however, limited resources mean that it is not always possible to provide discrete psychiatric units, either in general hospitals or in the community. An alternative model of admission, used in the Caribbean, is to treat the person with acute psychosis in a general hospital ward.

Artemether-lumefantrine for treating uncomplicated falciparum malaria.

Background: Artemether-lumefantrine is being recommended by the World Health Organization for treating uncomplicated malaria. It is expensive. We sought evidence of its superiority over existing treatment regimens.

S-(2-pyridinyl)-1,1,3,3-tetramethylthiouronium hexafluorophosphate. A new reagent for the synthesis of 2-pyridinethiol esters.

[reaction: see text] A new thiouronium-based reagent for the synthesis of 2-pyridinethiol esters under non-nucleophilic conditions from the corresponding carboxylic acids was developed. The resulting procedure enables the preparation of previously unavailable alpha,beta-unsaturated 2-pyridinethiol esters as well as their aliphatic and aromatic counterparts.