Pneumococcal vaccines for sickle cell disease.

Background: People with sickle cell disease are particularly susceptible to pneumococcal infection, which may be fatal. Infants (children aged up to 23 months) are at particularly high risk, but conventional polysaccharide pneumococcal vaccines may be ineffective in this age group. New conjugate pneumococcal vaccines are now available, which may help to reduce the incidence of infection in people with sickle cell disease.

Drugs for preventing red blood cell dehydration in people with sickle cell disease.

Background: Sickle cell disease is an inherited disorder of haemoglobin, which results in abnormal red blood cells. These can deform and cause blockages in blood vessels, leading to acute crises such as pain, stroke and splenic sequestration, and chronic organ and tissue damage. Recently research has begun to focus on therapies which prevent the red blood cells deforming by reducing the loss of water and ions from the cells.

Splenectomy versus conservative management for acute sequestration crises in people with sickle cell disease.

Background: Acute splenic sequestration crises are a complication of sickle cell disease, with high mortality rates and frequent recurrence in survivors of first attacks. Splenectomy and blood transfusion, with their consequences, are the mainstay of long term management used in different parts of the world.

Objectives: To assess whether splenectomy (total or partial) to prevent acute splenic sequestration crises in people with sickle cell disease improved survival and decreased morbidity in patients with sickle cell disease, as compared with regular blood transfusion.

Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease.

Background: People with sickle cell disease are particularly susceptible to infection. Infants and very young children are especially vulnerable, and the Cooperative Study of Sickle Cell Disease observed an incidence rate of 10 per 100 patient years of pneumococcal septicaemia in children under the age of three. Vaccines, including customary pneumococcal vaccines, may be of limited use in this age group.

Blood transfusion for preventing stroke in people with sickle cell disease.

Background: Sickle cell disease is a common inherited haemoglobin disorder. The abnormal haemoglobin causes distortion of red blood cells, anaemia, vaso-occlusion and dysfunction in virtually any organ system in the body. Stroke occurs in around 10% of children with sickle cell anaemia, and recurrences after a first stroke are likely.

Preoperative blood transfusions for sickle cell disease.

Background: Sickle cell disease is one of the most common inherited diseases in the world, and causes haemolytic anaemia, vaso-occlusive crises and dysfunction in virtually any organ system in the body. Surgical procedures are often required. Blood transfusion regimes can be used preoperatively in an attempt to increase transport of oxygen around the body and dilute the sickled red blood cells, thus reducing the risk of vaso-occlusion.

A comparison of bupropion hydrochloride with dexamphetamine and amitriptyline in healthy subjects.

The effects of bupropion, a potential antidepressant drug, has been investigated in twelve healthy subjects, (six men and six women) in a double-blind controlled, balanced study, and compared with dexamphetamine and amitriptyline. Analysis of variance was used to assess significance of differences with < 0.05 taken as significant.

Effects of caffeine and cyclizine alone and in combination on human performance, subjective effects and EEG activity.

The effects of caffeine and cyclizine alone and in combination, on performance tests and subjective ratings have been examined in two groups of twelve volunteer subjects using a balanced design for order of administration of treatments, a lactose control and with double-blind conditions. In the second study the electroencephalograph (EEG) was recorded after subjective ratings. Results were analysed by analysis of variance and values of < 0.