Medical Rehabilitation: Guidelines to Advance the Field With High-Impact Clinical Trials

The purpose of this Special Communication is to summarize guidelines and recommendations stemming from an expert panel convened by the National Institutes of Health, National Center for Medical Rehabilitation Research (NCMRR) for a workshop entitled The Future of Medical Rehabilitation Clinical Trials, held September 29-30, 2016, at the NCMRR offices in Bethesda, Maryland. The ultimate goal of both the workshop and this summary is to offer guidance on clinical trials design and operations to the medical rehabilitation research community, with the intent of maximizing the effect of future trials.     

Evaluation of safety and tolerance of microencapsulated Lactobacillus reuteri NCIMB 30242 in a yogurt formulation: A randomized,placebo-controlled,double-blind study

Probiotic organisms have shown promise in treating diseases. Previously, we have reported on the efficacy of microencapsulated Lactobacillus reuteri NCIMB 30242 in a yogurt formulation at lowering serum cholesterol levels in otherwise healthy hypercholesterolemic adults. This study investigates the safety and toxicology of oral ingestion of microencapsulated L. reuteri NCIMB 30242 in a yogurt formulation. A randomized group of 120 subjects received a dose of 5 × 10¹⁰ CFU microencapsulated L. reuteri NCIMB 30242 in yogurt (n = 59) or placebo yogurt (n = 61) twice/day for 6 weeks. Clinical chemistry and hematological parameters of safety were analyzed. Fecal samples were collected at these time points for the analysis of deconjugated bile acids. The frequency, duration and intensity of adverse events (AEs) and clinical significance of safety parameters were recorded for both groups. No clinically significant differences between the probiotic yogurt and placebo yogurt treated groups were detected in either the blood clinical chemistry or hematology results and there was no significant increase in fecal deconjugated bile acids (P > 0.05) between treated and control groups. The frequency and intensity of AEs was similar in the two groups. These results demonstrate the safe use of this formulation in food.     

Comparative studies on the ocular and dermal irritation potential of surfactants.

Comparative studies on the irritation potential of 18 surfactants were performed using the same stock solution of surfactant for each study. The ocular irritation potential of surfactants was studied using the red blood cell test (RBC), the hen's egg test-chorioallantoic membrane (HET-CAM) and the Skinethic ocular tissue model. The skin irritation potential was assessed based on data obtained from human studies using a 24h epicutaneous patch test (ECT) and a soap chamber test (SCT). The same pH and active substance (AS) content for all surfactants tested was used depending on the test conducted. In general, clusters of substances with varying irritation potential were identified similarly by most tests. These results show that when using standardized test conditions in which pH and % AS are the same for each surfactant tested, there is a good correlation between the in vitro ocular irritation assays themselves as well as between the dermal and ocular irritation assays. In particular the RBC test seems to be not only highly predictive for ocular irritation (H(50)/DI) but also for dermal irritation and changes in barrier function (DI) induced by surfactants.     

计算机系统与药物临床试验管理规范——临床研究机构的角色和临床试验中计算机系统的职责

在临床研究中计算机系统常常用于受试者的诊断与管理,药物的调配和执行临床试验方案中规定的实验室检查。确保这些计算机系统每次都严密可控且可信地执行任务非常重要。国际法规要求这些系统均有很好的工作记录方能符合要求。临床基地的稽查和核察人员要按照药物临床试验管理规范要求审查这些系统,确保它们在研究中的可靠性以及数据的可信度。研究组长对所有方案中使用的工作系统以及从书面或计算机中收集的试验数据的质量与可靠性负责。     

实施GCP管理规范存在的问题与对策探讨

概述实施《药物临床试验质量管理规范》（简称GCP）的意义，分析我国实施GCP的现状与存在的问题，并提出加强实施GCP管理的对策。     

Evaluation of clinical safety and tolerance of a Lactobacillus reuteri NCIMB 30242 supplement capsule: A randomized control trial

A significant number of human clinical trials have reported no adverse effects associated with consumption of Lactobacillus reuteri (L. reuteri). In the present study, the clinical safety and toxicology of oral ingestion of supplement capsules containing L. reuteri NCIMB 30242 was investigated. A randomized group of 131 subjects received a dose of 2.9 × 10⁹ CFU L. reuteri NCIMB 30242 capsules (n = 67) or placebo capsules (n = 64) twice daily for 9 weeks. Clinical chemistry and hematological parameters of safety were analyzed. The frequency, duration and intensity of adverse events (AE)s and clinical significance of safety parameters were recorded for both groups. No clinically significant differences between the probiotic capsule and placebo capsule treated groups were detected in either the blood clinical chemistry or hematology results. The frequency and intensity of AEs was similar in the two groups. These results demonstrate that administration of a twice daily dose of 2.9 × 10⁹ CFU was safe and well tolerated in the population evaluated over 9 weeks.     

Prognostic factors in carcinoma of the vulva

The clinical and pathologic characteristics of epidermoid carcinoma of the vulva in 84 women treated by vulvectomy were evaluated in relation to inguinal node status and survival. Tumor diameter, depth of invasion, clinical node status, vascular invasion, and pattern of invasion were all individually correlated with the pathologic status of the inguinal nodes. However, when evaluated in combination, only the clinical status of the inguinal nodes, the depth of invasion, and the pattern of invasion (in this order of significance) were predictive of pathologic inguinal node status. Tumor diameter, inguinal node status, depth of invasion, pattern of invasion, and vascular invasion were individually correlated with survival. When evaluated in combination, the clinical diameter of the lesion was the most important predictor of survival; depth of invasion and vascular invasion contributed additional information.     

药物临床试验记录文件中常见问题及规范实施办法探讨

目的:总结临床试验记录文件中常见的问题,提出规范的文件记录做法,为提高药物临床试验数据记录质量提供参考。方法:参照药物临床试验质量管理规范,结合作者从事药物临床试验质量控制工作的经验,对实际工作中发现的临床试验记录文件中存在的问题进行分析,并探讨符合药物临床试验规范的文件记录做法和相关措施建议。结果:研究者和监察员的综合素质是影响药物临床试验记录文件质量的主要原因。结论:加强对研究者和监察员的试验资质考察、GCP和SOP培训,对临床试验进行项目组、专业组和机构办公室三级质量控制监管,引入国外SMO管理模式、聘请CRC,建立药物临床数据信息化系统是提高药物临床试验记录文件质量的办法。     

GCP与临床试验质量管理

通过研究天津市传染病医院在药物临床试验工作中具体实施《药物临床试验质量管理规范》(Good Clinical Practice,GCP)的实际情况,探讨如何提高临床试验质量的具体措施.药品的安全、有效关乎人民的生命健康,因此药物临床试验的科学性与真实性绝对不容质疑.做好药物临床试验工作必须保证试验质量,医院必须高度重视药物临床试验机构的发展,紧紧把握工作重点,按照GCP及相关法律法规要求开展工作,建立完善且行之有效的管理体制,规范试验流程,加强对医护人员的GCP培训及科研队伍建设,不断增强管理意识、提高药物临床试验质量.