8 research outputs found
A randomised trial to assess whether the addition of a beta blocker infusion (landiolol) to standard treatment in patients with septic shock, requiring prolonged (>24 hours) support with high-dose vasopressor agents, improves organ failure (The STRESS-L Trial)
No full textIntramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia : the UK FixDT RCT
No full textBackground
The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common.
Objectives
To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia.
Design
This was a multicentre randomised trial.
Setting
The trial was conducted in 28 UK acute trauma centres from April 2013 to final follow-up in February 2017.
Participants
In total, 321 adult patients were recruited. Participants were excluded if they had open fractures, fractures involving the ankle joint, contraindication to nailing or inability to complete questionnaires.
Interventions
IM nail fixation (n = 161), in which a metal rod is inserted into the hollow centre of the tibia, versus locking plate fixation (n = 160), in which a plate is attached to the surface of the tibia with fixed-angle screws.
Main outcome measures
The primary outcome measure was the Disability Rating Index (DRI) score, which ranges from 0 points (no disability) to 100 points (complete disability), at 6 months with a minimum clinically important difference of 8 points. The DRI score was also collected at 3 and 12 months. The secondary outcomes were the Olerud–Molander Ankle Score (OMAS), quality of life as measured using EuroQol-5 Dimensions (EQ-5D), complications such as infection, and further surgery. Resource use was collected to inform the health economic evaluation.
Results
Participants had a mean age of 45 years (standard deviation 16.2 years), were predominantly male (61%, 197/321) and had experienced traumatic injury after a fall (69%, 223/321). There was no statistically significant difference in DRI score at 6 months [IM nail fixation group, mean 29.8 points, 95% confidence interval (CI) 26.1 to 33.7 points; locking plate group, mean 33.8 points, 95% CI 29.7 to 37.9 points; adjusted difference, 4.0 points, 95% CI –1.0 to 9.0 points; p = 0.11]. There was a statistically significant difference in DRI score at 3 months in favour of IM nail fixation (IM nail fixation group, mean 44.2 points, 95% CI 40.8 to 47.6 points; locking plate group, mean 52.6 points, 95% CI 49.3 to 55.9 points; adjusted difference 8.8 points, 95% CI 4.3 to 13.2 points; p < 0.001), but not at 12 months (IM nail fixation group, mean 23.1 points, 95% CI 18.9 to 27.2 points; locking plate group, 24.0 points, 95% CI 19.7 to 28.3 points; adjusted difference 1.9 points, 95% CI –3.2 to 6.9 points; p = 0.47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS and EQ-5D scores at 3 and 6 months in favour of IM nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (13% in the locking plate group and 9% in the IM nail fixation group). Further surgery was more common in the locking plate group (12% in locking plate group and 8% in IM nail fixation group at 12 months). The economic evaluation showed that IM nail fixation provided a slightly higher quality of life in the 12 months after injury and at lower cost and, therefore, it was cost-effective compared with locking plate fixation. The probability of cost-effectiveness for IM nail fixation exceeded 90%, regardless of the value of the cost-effectiveness threshold.
Limitations
As wound dressings after surgery are clearly visible, it was not possible to blind the patients to their treatment allocation. This evidence does not apply to intra-articular (pilon) fractures of the distal tibia.
Conclusions
Among adults with an acute fracture of the distal tibia who were randomised to IM nail fixation or locking plate fixation, there were similar disability ratings at 6 months. However, recovery across all outcomes was faster in the IM nail fixation group and costs were lower
Study into the reversal of septic shock with landiolol (beta blockade): STRESS-L Study protocol for a randomised trial.
No full textINTRODUCTION
In 2013, a single-centre study reported the safe use of esmolol in patients with septic shock and tachycardia who required vasopressor therapy for more than 24 hours. Although not powered to detect a change in mortality, marked improvements were seen in survival (adjusted HR, 0.39; 95% CI, 0.26 to 0.59; p<0.001). Beta blockers are one of the most studied groups of drugs but their effect in septic shock is poorly understood; proposed mechanisms include not only the modulation of cardiac function but also immunomodulation.
METHODS AND ANALYSIS
STRESS-L is a randomised, open-label, non-blinded clinical trial which is enrolling a total of 340 patients with septic shock as defined by Sepsis-3 consensus definition and a tachycardia (heart rate ≥95 beats per minute (bpm)) after vasopressor treatment of at least 24 hours. Standard randomisation (1:1 ratio) allocates patients to receive usual care (according to international standards) versus usual care and a continuous landiolol infusion to reduce the heart rate between 80 and 94 bpm. The primary endpoint is the mean Sequential Organ Failure Assessment score over 14 days from entry into the trial and while in intensive care unit. Results will inform current clinical practice guidelines.
ETHICS AND DISSEMINATION
This trial has clinical trial authorisation from the UK competent authority, the Medicines and Healthcare products Regulatory Agency, and has been approved by the East of England-Essex Research Ethics Committee (reference: 17/EE/0368).The results of the trial will be reported first to trial collaborators. The main report will be drafted by the trial coordinating team, and the final version will be agreed by the Trial Steering Committee before submission for publication, on behalf of the collaboration.
REGISTRATION
The trial is funded by the National Institute for Health Research Efficacy and Mechanism Evaluation (EME) (Project Number: EME-14/150/85) and registered ISRCTN12600919 and EudraCT: 2017-001785-14
Landiolol and Organ Failure in Patients With Septic Shock The STRESS-L Randomized Clinical Trial
No full textIMPORTANCE:
Patients with septic shock undergo adrenergic stress, which affects cardiac, immune, inflammatory, and metabolic pathways. β-Blockade may attenuate the adverse effects of catecholamine exposure and has been associated with reduced mortality.
OBJECTIVES:
To assess the efficacy and safety of landiolol in patients with tachycardia and established septic shock requiring prolonged (>24 hours) vasopressor support.
DESIGN, SETTING, AND PARTICIPANTS:
An open-label, multicenter, randomized trial involving 126 adults (≥18 years) with tachycardia (heart rate ≥95/min) and established septic shock treated for at least 24 hours with continuous norepinephrine (≥0.1 μg/kg/min) in 40 UK National Health Service intensive care units. The trial ran from April 2018 to December 2021, with early termination in December 2021 due to a signal of possible harm.
INTERVENTION:
Sixty-three patients were randomized to receive standard care and 63 to receive landiolol infusion.
MAIN OUTCOMES AND MEASURES:
The primary outcome was the mean Sequential Organ Failure Assessment (SOFA) score from randomization through 14 days. Secondary outcomes included mortality at days 28 and 90 and the number of adverse events in each group.
RESULTS:
The trial was stopped prematurely on the advice of the independent data monitoring committee because it was unlikely to demonstrate benefit and because of possible harm. Of a planned 340 participants, 126 (37%) were enrolled (mean age, 55.6 years [95% CI, 52.7 to 58.5 years]; 58.7% male). The mean (SD) SOFA score in the landiolol group was 8.8 (3.9) compared with 8.1 (3.2) in the standard care group (mean difference [MD], 0.75 [95% CI, −0.49 to 2.0]; P = .24). Mortality at day 28 after randomization in the landiolol group was 37.1% (23 of 62) and 25.4% (16 of 63) in the standard care group (absolute difference, 11.7% [95% CI, −4.4% to 27.8%]; P = .16). Mortality at day 90 after randomization was 43.5% (27 of 62) in the landiolol group and 28.6% (18 of 63) in the standard care group (absolute difference, 15% [95% CI, −1.7% to 31.6%]; P = .08). There were no differences in the number of patients having at least one adverse event.
CONCLUSION AND RELEVANCE:
Among patients with septic shock with tachycardia and treated with norepinephrine for more than 24 hours, an infusion of landiolol did not reduce organ failure measured by the SOFA score over 14 days from randomization. These results do not support the use of landiolol for managing tachycardia among patients treated with norepinephrine for established septic shock.
TRIAL REGISTRATION:
EU Clinical Trials Register Eudra CT: 2017-001785-14; isrctn.org Identifier: ISRCTN1260091
Landiolol and organ failure in patients with septic shock : The STRESS-L Randomized Clinical Trial
No full textImportance Patients with septic shock undergo adrenergic stress, which affects cardiac, immune, inflammatory, and metabolic pathways. β-Blockade may attenuate the adverse effects of catecholamine exposure and has been associated with reduced mortality.
Objectives To assess the efficacy and safety of landiolol in patients with tachycardia and established septic shock requiring prolonged (>24 hours) vasopressor support.
Design, Setting, and Participants An open-label, multicenter, randomized trial involving 126 adults (≥18 years) with tachycardia (heart rate ≥95/min) and established septic shock treated for at least 24 hours with continuous norepinephrine (≥0.1 μg/kg/min) in 40 UK National Health Service intensive care units. The trial ran from April 2018 to December 2021, with early termination in December 2021 due to a signal of possible harm.
Intervention Sixty-three patients were randomized to receive standard care and 63 to receive landiolol infusion.
Main Outcomes and Measures The primary outcome was the mean Sequential Organ Failure Assessment (SOFA) score from randomization through 14 days. Secondary outcomes included mortality at days 28 and 90 and the number of adverse events in each group.
Results The trial was stopped prematurely on the advice of the independent data monitoring committee because it was unlikely to demonstrate benefit and because of possible harm. Of a planned 340 participants, 126 (37%) were enrolled (mean age, 55.6 years [95% CI, 52.7 to 58.5 years]; 58.7% male). The mean (SD) SOFA score in the landiolol group was 8.8 (3.9) compared with 8.1 (3.2) in the standard care group (mean difference [MD], 0.75 [95% CI, −0.49 to 2.0]; P = .24). Mortality at day 28 after randomization in the landiolol group was 37.1% (23 of 62) and 25.4% (16 of 63) in the standard care group (absolute difference, 11.7% [95% CI, −4.4% to 27.8%]; P = .16). Mortality at day 90 after randomization was 43.5% (27 of 62) in the landiolol group and 28.6% (18 of 63) in the standard care group (absolute difference, 15% [95% CI, −1.7% to 31.6%]; P = .08). There were no differences in the number of patients having at least one adverse event.
Conclusion and Relevance Among patients with septic shock with tachycardia and treated with norepinephrine for more than 24 hours, an infusion of landiolol did not reduce organ failure measured by the SOFA score over 14 days from randomization. These results do not support the use of landiolol for managing tachycardia among patients treated with norepinephrine for established septic shock
0004
No full textDAILY PALO ALTO TIMES. TUESDAY. JAN. io, ion.
PAGE FIVE
VARSITY THEATRE
TONIGHT
"The Man From Mexico"
LAMM. HKIHM.IV ermrmtx am
JOHN BARRYM ORE
In Du Sour-bet's comedy triumph to five reel* ot motion picture*
that are a feature unsurpassed. John Barry mo re fa too well
known to oeed aaj introduction, and hi* mrtblcal adventures tn
Mexico are Uaghab.e Indeed. Harold Lock wood, the popular
■tar In "Witdflower." alto eome* in for hit ahare ot the honors
ln tM*. play. *
ADMLS810*-*. 30 CCXTS. fllll.liKKN I MT.I1 TWEl.VK 10 i I'M*
Owe F'-et Tfceataws
{ la 1183 Um flrat theater tn tie Unit-
ed State waa o(P-enJ la the colour of
' Virginia at ota WllltonMbot****. The
originator waa aa n**agttoh actor, WU-
; ttau llsiiam. sr.. wbo bronchi We own
company from or«r eeaa aad preaeated
[ "Tbe Merchant et Venice** aa tbe Initial performance. Tbe tdea epread rap-
: idly, aad aoon New Tort. PhUad-sipble
: and ibe otber ssading communlti** of
1 eotocilal Amtrtc* eacb bad ita tbe
- atar. WbUe tbe Virginia playhoua*
. waa tbe flrat ta tbe United Btataa, ac*
; ton bad plajred la tbe colonies before
• thai data. The flrat ta eaid to bare
1 bees tbe Bacllafa ati-olllag player. An
tbooy Aston, wbo waa known aa Mat
' Medley. Tbe eetor aad bla art of tbat
j day wen* -taactmlly despised by tbe
] Puritanical eolonleta Tbe Uaaaacbu-
j aetta togtalatnre paaaed a taw ahortly
J after ana-owe bad given "The Or>
pbana" at tbe Coffee Houae ta Boston
tn 17*0 wblcb forbad* aucb perform*
ancea, preacribtnc a penalty for actor*
•nd epecUtoro alike of (35 eacb.
PERSONAL MENTION
l>*ovor 8 Churcb. a California graduated
Iiemocrattc robgrf-ssmaa represeot-
Ictc the seventh district, which Include* Stanislaus. Merced, Madera.
Fresno. Klnga. Tulare and Kern
count!**, ha* introduced a bill la
congresa to create a oonpartiaaa
com mis* Ion of expert* of the hlgh-
-eat atandln*- to collect data and form
ao equitable tariff law entirely apart
from politics, a representative on
tbe commission to be appointed from
each of tbe federal bank districts or
the country to struggle with tbe
4,000 item* of tbe tariff.
Evsiutisn af a Nam*
Innea. tn nla work oo ear*
aetnae. quotas an toatanoa ■bowing tbe
gradual tranafortnaUon of a (-atrooym-
u . . j le. "A reepertable rtttoso of Dublin
John Mulr. tbe Callforn.a natur- MOm| q^^^ Ihrw ta (^ «,
born in Scotland.; hh ebUdrao prevailed oo blm In bt*
Baron IC. P. *** von Gebren, who
wa* In Sweden at the outbreak of
tbe KuroiH-nn war. decided to return
to California and early In December
. purcbaaed a lot ln North Palo Alto,
frontage of 200 feet, and ordered
erected upon It a I .'..mm home for
the ["-im/-.rn-nt residence of hi*
mother and hlm»«]f. The house la
to be completed and ready for oeeu-
i-ijicy probably by March ISth.
North Palo Alto, formerly owned* by
the i ■■ oi-erativ- i-and Company, la
now controlled .h< the Alberton He-
ii.ty Company of San Francisco
• * *
Milt A. Hagen. Stanford senior
from t-os Angela* and editor of
Chaparral. Is president of a new
Stanford chapter of a new national
Yton
tbe I'nlveralty of Utter year* to change tbe name, which
Wisconsin, aad latterly for thirty tbey thought undlgntfled. and tnla be
yeei-e a resident of Martinet. le» an j J** ****** *» ^^H'JJi1*- '"* **2***
estate valued at 1250,000.
Be died and waa burled ss Mr. Balnea. Tbe fonun* of tbe family dad
m, ZlZ ..- mm-*.1,1** reeed*. and tbe eon of oor dtiu-n
MtoaMnry Curry I mt *T. 8.1 tbot-Abt (*rop-K to rt**-*oonc* r-i-uU daal-
Murray 16 are two Stanford atii-; \jt*r, uw] at tb* earn* time looked sbout
dents from Palo Alto who bave con* ] for a euphonious change of name. Ue
trlbutlon* ln the current issue of. made ao scruple of dropping the un-
the Stanford Sequoia, which ap- beceeaaiy "a* Tbat (Ming don* It waa
peered today. •*** to go Into tbe Cettie rage, whlcb
# . , Tbe Lady of tb* Lek*' bad juat raised
' , . ! to a greet betgbL So be who bad ran
Thomas Melody. * resident of. ^ ,treeu aa little Kenny Halfpenny
Palo Alto for nearly twenty five caia# oot st tbe t*ve-se ss Kenneth Mc-
years, received notice today from a [ aiptn. tbe deecendant of a hundred
New York lawyer that he ta one of 1 klnga."-l-oodoo Ohraolcie.
the seven or eight heir* to the *H0.-
000 estate of'his uncle, the Iste ,
;?""- jdP > rh*r i\^-SfcSE"jr..:s
Thomas Melody ts prestdeot or St.' ebe€Ur N#W1( ^ ftwjosotV goo*
Marys College la Oakland. across to HUrrita for ao aftaroooa of
* ■ | re-rv.-itl"!!
OU Tims Csinina On one occasion bs arrived at tb*
In tb* nitiH-ittb century a skilled cola* { atatlon t tiers and bailed a nacre. The
er. of whom tbere were bot few.-might! drlrer rwcognixed blm. and wben his
be able to tarn out by band flfty or majaaty aaked ar-kat tbe fan waa said.
elity coins a day. a i***nli totally ta- j "■** tb* king of Spain It wUl be 10
rraaea.** Tbe king amiltd and merely
paid tb* ordinary fir* _*s provided by
tbe tariff. Tu tbat amount, bow-rrer,
be added ■ tip of tba usual atae.
A few days later he waa again In
Blarrtu and alao took a flacrv. But oa
thla occasion tbe eocber waa mora diplomatic. Whco asked tbe amount of
the far* be replied. "Your majeaty
KUabeth. ~Aftor-* aere^'triata' nd j ow" **• noUlin» fof •*■ ?__S **"lc!
abaadonmenta tbe mill snd prase were «■»-*• »«* *• «■" ^JT^^
college journalUtir society called ; *«tabl:.bed permanently under Charles' n*" »«)eety repil**d to thl* roartewo*
II.. wbose golden guln«s. struck tn ! •**«* b^ I**-*0"**- «*• *=•"*» *«* ■
iflttt. w*r* tbe flret rogulsr issues of, *°° frmnc "oU*
machln* coins mad* north of lb* channel.—Argonaut
adecost* to cope wltb the raat qoan
tlty of treasure. chWQy allver. that ■
abortly began to Arrive from AmerVa i
To mulUplrr colnsrs waa to multiply
forgers, and thns tb* coining machine'
became s necessity of auts. A laminat ,
Ing milt and screw coining praaa waa I
tDTeoted In Italy KMT. Spain IM\,
France 15&3 and Hnglsnd 1601, relgu .
Money Savers
Annual Clearance Sale Prices
MEN'S SUITS and OVERCOATS
New Prices 24.95 .
BOYS' SUITS and OVERCOATS
Priced at from 7.95 up
MEN'S HATS
2.95 1.95
MEN'S SHIRTS
1.50 kind
CHILDREN'S HATS
Formerly 2.00; now 55c and 95c
Christy, Rhodes & Co.
PHONE 200
Sigma Delta Chi Ford 11 editor
Of Sequoia, and Hughes '18 and
Bennett 'Ifl, of Its staff, aod *-*•*■>
'It. (Jrlffln IT and Cross 'I?, or the
Chaparral staff, are among the charter members, while IMrld Starr Jordan and Charles K. Field '**■'• are
among the honorary Btanford members, }ust as are Oeorge Adc ami
rubers ntnong eastern writers.
* * *
Episcopal Bishop \V T Sumner
of Oregon was served with papaa in
u eult for 1.0.000 damage* while
oo a westbound train pas-tlax
tbrouah lowa. .The complainant is
one Calvin Murray of Calvin county, lowa. The charge la that the
lip-hop published an nffldarlt to the
effect that the Episcopal minister
who married Murray at Chicago did
not know at the lime tbat Murray
was a divorced man.
» • •
Mrs. George C. Ros« of San .Mateo bad her residence entered at t
o'clock yesterday morning by a
burglar who departed so hurriedly
ihat be abandoned hts pair of old
**hoe* and nn accumulation of sbout
$1,000 worth of Jewelry and silver-'
ware that he had assembled on a
-rouch In the reception ball. Th*
shoes bave been alien to tbp po-
■*«•
*.* *
Edwin i: Grant's recall election
Investigation now being conducted
by a committee from the state **n-
nte, found In San Francisco yesterday five person* wbo pronounced
Their alleged signatures on the recall petition to be forgeries. Th*
inquiry 1> *U11 on.
* • a
Marguerite Clark, who took the
part of '.Vlldftower In Ihe beautiful
movie play of tbat name, ta a new
actress In tbe movies. "Tbe Goose
Girl." soon to be shown In Palo
Alto, will be .mother story featuring Marguerite Clark.
* • •
Colonel James JsHtson. Im-pectot
general ot Oregon's ro.litis slnrc
1698. has rexl-Ened. aged HO.
* * *
Mr*. Alice Park of Palo AHo is
now on a visit ro Honolnin. where
there i* in lw> a midwinter mld-
•riek* From Babylon
' Tbere 1* a law 'in tbe Turkish em
Why Tha, Ml M*er I •***•» Pw('lW,1« £• •,p°rt*°?° °f £
Prrhsps tbe limit of bymnle fatuitylS«S2fBS 55s T° at '?"
wo re*cbed by th* writer of byW old* «« «*■ f*rt tt« J ta 00 ** 9tat
6-S In tb* -Andent and Modern- col- nt» *•**■ fi* "^* to the common
lection. Uere I. tbe fourth ■lanaa: ' ■■ *?g" ot otr'ria* W-*>o« ■rttelea to
Tbsr-)onolh^r.h«,h.sr«atas.1 I ^^^ «•* ^t. of flit Of Of
Is rlagtna o*«ha*d. j •nfflcleni age to h* of rain* are rarely
Ther car.!--.*-, ties sad r„m* to diorcb ' to be purchased, aud tbe general dealt**
Wttb ««. for tb*r ars dssd ] „f |Iw ^Wtor, (betwfore. mwoi fo be to
Tbe list of thine* which **tbc*r are: obtain stunM uf pieces of clay from
unabl* to do might lie Indefinitely ex the site* of ancient ruins or bricks
tended, and It seem* a thing Incredlbl* I with inscriptions. Tb* rormer can
tbat tbe author of to* above vers* i probably be obtained, but tbey are
should beve written ao baantifn] and [ prarOcally iiluilym. aa ua* piece or
moving • hymn as "There to a green; tiaj from Babylon la quite like anotb
bill far away ."—London Chronicle. er from Musol. Brtck* rrom either of
j tbeee ptac-M tbat ar* kuowo to be gvn
Cans-is'* flise | uiM „„. onoblalnabl*.
Tbe area of the Dominion of Canada ,
I* 3.»i> :• Xtl • -nar,- miles The area of j wrth Milttary Hnnora
continental Cnlted States ts 3.02.VUW it H not universally known what Is
square miles Canada to aa big aa the meant hy a runeral "wlUi fnll mUlury
lulled Stales wltb a territory lo spar* jiiouor*.*' In such a funeral the coffln
tbat to aa large aa three Qermaa -in i is borne oa a guo can-lag*,
ptrea and lb* state of New Vork.—New j if tb* dead soldier waa *n Infantry
Vork Amerk-sn. aaan bla iwvnJ aod helmet r**t on bto
—■ teaffla.
Ths Osntls Estsrl*r j At tb* fuueral or « cavalry sokllor
"What I admire." said ibe states tito sword nod helmet are Tasuned to
man. "la tbe nnnd of ironln theglorejm,. nddle uf bis tr-ora*. wbk-b to tod
of velvet** Immediately behind lb* gun carrlag*.
"Tee. indeed.' replied Ml** Cayenne.; sod bla top boota. wltb spun attached.
"It to much more unusual tban tb*; are fastened tn tb* stirrups, wltb tb*
bead of bone la tbe tun of aiik*. " - Wa«ii ! toes pointing backward
ingtoo Star. i a Ortng party, drawn. If poaalbl*.
1 * from tb* decesscd'a r«glm*nt. Are three
Mrs. Grmon Wall N*i**i-sd > *-jUeys over tba grave, and tbe "Last
Mra. Gr*J*-Tbe window In my ball Port- ta then eo«ind«d by l*m(letm.-
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baa stained glass In II Mr* Oi
Too bad: Can't you And nnytblng tbat
will Uke the autoa out?—New Haven
Begtoter.
reen- pear-eon'" Weekly.
T* Bs Cxpected
Tve been reading Snakesn*****.
Hadn't poor flamlet a dog** lifer*
"Well, wasn't he a Great Danef-
Baitlmon- American.
Ceeitrsdis-tery • >
Thst big. fat slob to the black sheep
of the rsmlty. to be *.".:■"
-Vep. He's tb* family skeleton. *-
Houston Pout
Why Ha Didnt Cry
Motbwr-Goodness, now did yoa hurt
your eager aor
Utile Boo-Wltb ■ baminer. '
"Wbenr
"A good wbll* ego."
"1 didn't hear yoo cry **
"No. B>otb*r. I thought yoo wore
oot"—Stray Stortea.
Back Number Wanted
We need one copy of the Weekly
Palo Allan for June St, ISH. In order to rompkate our file for binding.
We * hall be glad to pay 10 cents for
ibis ropr tf anybody has one.
TIMES PCBUgHIN'G CO
tafvrgl. <DVttWimU-t,1|f
Splrella roraeu **nd Wm. Frank
f waleta. Mrs.Blar-k. 4;<J Homer.Ph:i.'
• • •
Money to Loan—l»»..*.0f) in small
"They can't make me. I'm no mon. j -am*. Apply Monroe Thomas, .3.1
Child-Labor Law
Willie used to weed the lawn.
Now. though Willie ha« more brawn.
Willie saya, and with a yawn.
Wisdom
Uope and success make a finer tonic
tban medldoe.
Tbe best tonic to freeb air.
Tbe beat -rrstorarlv* ts sleep.
Tbe best stlmaisnt to exercise.
Fatigue call* lor rest add net tb*
spur—Wisconsin State Journal.
On. View of Golf
"Pop. what to golfT
"Gotf. my son. to yost tbe aama aa
work; eteepi tbat you get paid for
work."— Pltuborgb Pre**.
A 0**d Start.
"He offers me a pis ton k- stJection."
"Well. Uke it. A Diatonic aOectSoo
often leads lo the real thing.*— Pitta-
Dorgh Host.
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YOU
Can Talk to
Practically all
the People
in Palo Alto
THROUGH
THIS
PAPER
• ••••••«••••**•*eooeoeto* ••*o**oooeee***********e*****eeee*««oee«eaoeooeooooo»
Scared chlld-lsbor law—I'm on!'
Madtaon ThoiU Building, l-l'.-fit*
Experteoce teacbe* a lot of
we never rnreA to learn.—Jndg
6
No full textTo tbe Furniture Buyers
of Palo Alto
Wa nriah to call your att*a.tkm to the exc ep-
uotially fine atock of furniture sea cany, and tba aa-
v-sntages to you of bvyinj In our atore. Wa have on*
of the best aad most '•up-to-the-hour" atocki to be
found OO this cosit. and can furnish every room fa)
your house for at laaat to per cent less than you can
buy in Sen francisco.
Our Carpet stock la particularly complete, com
prising, treaty desirable weave, grade and price. Parlor, library, dining room and bedroom furniahings to
suit every purse and isatc; Braaa and Iron Beds in an
infinite variety of itylei; Arm Chairs. Rockers and
Davenports in every choice and desirable wood and
pattern. A beautiful line of Draperies and Portieres.
You will simply have to inapect our immense itock
to appreciate It
For two weeks, bssfonlna; Hay 15, we have a
QUICK CASH SALE on: during that time everything
in the bouse ia marked down from 10 to *o par cent.
Round fare to every Palo Alto customer purchasing lie worth or mora from ua. All goods delivered
free of charge. Come snd see us snd let us prove what
sea say.
Madsen Furniture Co.
Neat Victory Theatre BAN JOSE, CAL.
"Tba One Prioe Btsren
THINGS THEATRICAL
Gs-oc-tr Atie * "Tlie Coals-go Wba*\Tm
baa barn almsdy burl—quad 1
tltl* at "Tb* College WWowtrr.
Eaatlbttasoaa of tbe Jipaaaw
atuw aystttas. jlu Jlfsa. 1
tw be cxplotte-1 a* s rmaaarXOa Boratty.
Etbsti Bsr-^more stay* *be Aotaaft
■ Its
Il Is suMuoe-o.1 tbst sarty ant Jaa*
haymaSatd-Hitrricack and Hon 7-ataeil*
ar* to ta aurrlad la Pari* Miaa Ta-
belle la tb* leading lady of "Tbs Taa
base CO*>«lil "
r*rl« has a ti-arle* union ot baOm
SSsBcsn-s uiisl-T the -irote.-ti..n of a i-j-ly
squiiassnit ta whet la knawa bora as
th* Knlerallon of Labor Tha -.ir*a
yonrnallata call lb* inrt-pt-etlag
sT day as
Kitchen Hints
Tbers is beat enough In a kitchen In Summer. Why add
to it by oslnt coal T
USE BAS
I Ufbt at II
W, Cook wllb II
lor Information call at
Oaa Offlo, 547 Hl|h 81.
PALO ALTO OAS CO.
Paper-Hanging
Talaphona Blub 14, sod let us give you an sstiroate on your Paper-
Hanging, Tinting and Painting.
OMEGA PAINT CO
CHICAGO
«S EA5T
and over Tha Oaly OoaWe-Track Railway between tbe Missouri
Klrsr and Chicagio.
THREE PAST TRAlNS.DAJLY
—Vtasr—
.•MHJTMERN PACIFIC, UNION PACIFIC AND
CHICAGO ft NORTHWEATKRN RAILWAV5
CtrtrlUsa UmlttoL VtstiiwiaM. ^-^ r^£?££ i£
artaws Train la tbe WeeM. EJootri* Ugh tad Thtn-aghoot. Do-abh. Draw
toa-Boota. Bootsac Cor*, CoaBBaal»«>7o%eif ■tah.ua, BuM B-ooklng aad
Library Car. Dtaiaa- Can. Haa** a k Carta. Less tbsa thre* days to
Cbtssteo without obaagw.
p. as. Dally. Through Pullaaan
Tnurtal Stweplag Car* to Chicago. Dtalag Car. Fraa RsSbhV
Eautera Eiyrttt. V-nttkasM. J*£- **-*
>KltwS)sad
lag Chair Cars.
Atlantic la-rrt-ttv yjyUbj*!** l-foX!*?^ S
Tourin tUaaaers.
PERSONALLY CONDUCTED EXCURSIONS
WadaMdaye, ThuMdaya aad rridaf. Ta. bart ol .ra^saju.
R. R. RITCHIE. G A. P. C. CHICAGO if NORTH*.
617 Market at , Ssn Francieco H-£S7EXHJiy.
(Pal*** HaaaT) ' Or 5. P. COMPaNva AOBNT.
Clarion's Coffees aid Teas
323 UnlT-nity Are.
J. P MILLS
University Restaurant
ON TUB OIROLB
T
■vioailt* at All Hours
Tborntcso. tb* wall known
assatiliagao artist, bas stlgn*d ■ cnot
Iran pMg* with a pa-wart In New Tort
to a taa tain from latoxtc nls for tba Mil
tern years A wasltby routtr* af
Thornton ottrrmi bin »W.OM) ta make
tha coat-net and hoop It.
CURRENT COMMENT.
Tb g mamm at traathmm at a am
Erlaoatly in bulldtag aabway* wa
sre tMng gggbAaataJ *<* rraaata paatar-
tty a* wall sa our own ge»>*tstloti If. ss
Dr. KUat says, tboy will ba lb* ai-chae-
•wogtot'i msl-i dev-tnleiK-e XtsfJD roar*
b*api,~a-s*-a-**po TrsMCrtpt
Tuition ehargaa st aoas* of tba big
aslrs-rsttlsa are .taring adrsaead ta tha
paint whore It will be eheapar far
yosssg warn to aatar pt-lltk-s sad hare
m tbsa thaa M
esaa* bars mamai tl
bar* li too ta raerat it. iMtUara w oaf*
la th* Logan tentpps far the tine b**-*g
But UBiptsa that ar* tha 0*0,-10*17 at
sruoi bar* been los-atad baftva asew.
sad wbat bas bsoa stay ba again-son
FYatKlsHo tall
COLLEGE AND SCHOOL.
Oar of tba girt paplla at the New-
bttryssr-rt High *ebool wsa ai-»aNlad Inr
cutting ap an csalsa and patting la aa
(-sw.ro--* la tb* bbrtary of tnadarn art
win ba Intr-jd-jr-tsj at Dartsaoatb twt*
ks-ft. at tha bstartaalag of tba ssen ace-
ooaaW- yoar nnder tba dltoetMa of IItan
•* Baton Kayo*.
Dr. A. L. PetSs-assB at Kash elite,
Tonu.. bos l-rsm t emlers-1 th* preaUsleu
ry of GrabBBt trMtatr. UrahtaSS. Ta.
He |s whirls known as as odarater,
lasturar. adltor sad author.
At tb* midwinter -Matins ta* tbs
tru*ii-*-*i of Hymi-na* nnlT*ralty tt wss
eotetl lo i-oimirtu I wltb lb* tss-s-ije-s*
made to the m-iref-itr by tb* lata
rahn Lysssa. wbleb bi aald ta agaro-
gnta -noes thaa ♦»■!.'«*'. a baUdlng la
he keown as ths J**nn I.jtnoa Lsb-
etatwy *f Natorsl lltat-sry.
JINGLES AND JE3T3.
BDUCATIONAL
Sa wsntad ta -Barry aa tight atrsy.
Bat I said than was an brjrry.
Mlsw Pm-Tbe Idea: Aad you got
Hog older erery aslautal — Catltailat
tjuletlj aba* came jp boblnd 1
-Will yoa M am heva |in. doarl
"1 ass laipihud." ha Mid. that yea
oaaM strtha a mas behind his bsvd "
Uru* am„. .
LHtw tviiue. ~] Xarm yam."
Cbaimltaf Susie "Qtr* ta m*
Half rour a(.|.ir 11..i, lu taa"
tJitle Willie -Tsko il Ba*,~
Ullla- Saa. "||trW I Isn* )»y"
-Mow Torh Tin
Pan not-I baar that Ca-tor uaa bai *
rt>Us-ataaB-Wb-eb tf yi
thlaOght?
One or the BrUlgtarsatav-Ho did
dog pltcbod Into tnl-as-.fblcogo
GOWN GOSSIP.
ta wash Bastertsls th* *b in wslst sett
la sb a*onr*d fsshloa.
Tha fleba inrumt-d walat trfll ba a
■wSder fur tha t-atatng ams-m la t-ottsa
and uthor f atirks.
For young wacnsa the «itti|.l» abort
skirt sad boswra htrbM *arm tba trout
kliul of a attrtijg stsrsvl gowa.
A vsry sssart tn*i-l-4 la wothiog aulta
has th* -friar***** aklrt ami bssleesj, Tba*
to a tstyt* BMsr* bst-a-swatog wbon lh*
thaa whaa it * a-t
ptaltlug-i. s-s--*a>t-UUy lh* laitee. are bs-
svttsbls and ar* UR more daapty tans
a*at.— Nan York I'siati
STATE LINES.
"Old Mr. -■seirmr.ile s-ra-taa la Wt*
eeeh 0 natty wlt.-
"T*a; as-art of rough and rs-ady, yoa
might nr~ fllaW its- .r.l ll-rskJ
Ur. Da FBibloa Why did yua 1
■barga that aura* girl I
Hie. Da t'oihkm l*to kkawt m
UlUa lido loot fa* bit lag tba baby.
Aisbi-e -VTiifi that oiling on yonr
ftaaerforl
Trlln Oh. to rt-nilml m* that 1'ra
forgsHieti nitui-tblnt < lik-ag-i NasVs.
Tall -na." lit- j is .W. "wouM yae
Surry m*> tf I wi-rs- r^hr
"How rich'- she ersatrely au*w**ad.
r-*SWJtt aialwlleeahl.
MarylaBd wa* Br*t in tb* tea
alag lnduatry last year, with ladtaaa a
Now Turk la the cbstuploa aatata
SIAIn Tb*.mat i-*-al ot LoBg I*UaBd m
*** oa* potato patca. fawMB ar*—
oUty-ssti
? mm V!H °tTTm* ****??* J? T-» v.iet TVre la bad aoors. ma
*• •^^^-T^"-.!**' "* ** ** • •»«•■' fcer Issdy-aait. haa tasMt,
I«t«g--r*iattadls*.vmxtsa». | Hfc, Lard^lp--I"wl ^-e aw taka h-.
Tba C-atlfatwla atate boanl of trad* j bafck ant-unt V New Tort Pwwa.
hsa 1 i.t-s.1 tu rr-jiin.! tb* M-s-i-ton of ^^.
aiirli-ulture at tbe 1'oltnl KtatOS SO SB- I ahrra Wastier ts* Trwo.
point a spea-tal .---ni rulo*loner ta sscsr j R* yntttsa aotm 0 okit or t*»
tain aud i*aport ragsrdlag all a-rrtcui- | -SmJl*a "***** That *r, T-ua "
tarsi proalucts thit .-an t-^ r.list-d 'n the | e^*^a^»ei»'TtH't A™ 0*1 *'" **
■tat*.
CHURCH AND CLERGY —_
. **•* maa-
iBy ps-opte trwat tn lack -
The AB-ortcna ttbar .-t-rtetj laat yea* I ■**-»■ I-"** ***taa to bar* ei-s-ttat-st
ssst twrth astarty totfttwo lkt»t«aa. *Maaa%m awM Tarfc Praav
tha Rev. Gs-ctrg* Whlts^tsesd u ead *tr
tb* rtrot I*Ts-.b-rt--rtsn charrh af Saw | _ *
ssst-t, H. 1. has cVeeline-1 tbe enU r» —■ -
csrlred fl-tna tb* tittaton temple af
Wosfalngton.
la ■etrsral denomiMtron* the employ.
uicot of dt-acsmiiiara la lacroaalng
Ttotaa ws-tnen bar* a »in-ii»l tmtnltaf
aad wnrk cliieftr at-rang tbo pt-or aa a
sort of parish rlaltues.
Tbs Os-t-ttli- church of Egypt Is aald or
be rspedly dying oat It ta aa an titan*
tn Wsm
orm-Tr-u lr>ok happy
Worm-Ye- I Jest ■
Palo a\lto Academy
Preparatory to Stanford
Pupils of l-'tli sexos rec. ivi-si frum six years of sgv apsrard
Wuiie. tisTrmaD, Fretacb, Spanish, Drawing. Pl-va... al Coltare-
snd Eloctilion are included in tbe r-?s-ular curnculom. tbe
Utter being based on tbst of tbe Seats Clara Coanty Pnblic
llscbools.
ALSO EVENING: CLASSES IN ALL BRANCHES
including Bookkaepinj-, Rapid Calculation, Shorthsnd, Type
writing, Buslnea* Correspondence and Conimercial Law.
For further Information apply at the Acadxmy, oor. o[
Rsmons St. and Lytton Ave. (Tiro blocks from tbe Poet Office)
MRS. STOWEa SCHOOL
Primary sad grammar grades. Strc
t>nd term opens Jan 4 0*1 Ra-
moua itreet.
H. ROLAND ROBERTS
MRS. SARA BIBBY BROWN.
HISS AUGUSTA UPHAM
Teacher of Piano.
Studio 44J Kipling itreet.
I Pupil of Profeitor Lhstric, Parts:
Conic real oris ol Muiic.)
Voic* Culture. Correct Brssibing:
and Tone Production s specialty
Vocal trial Ire*. .Studio Ji« Byron ;
AdT-cnis* Ln tbe Pal* Alta Ttnsas.
** g* a* PROPB66IOP1AL > > >
JOHN O. VARIAN
Fttj-alilaaa nataaii* Wa trw
Haara. ^ta it. 1 is lit. ! la *.
DR. H. C PHELPS
Gradual* American School of Osteopathy. Kirkaville, Ms Call*
answered promptly day or sight.
Telephone main 7v Hoars v ■ *"■
lo S P m. \j*Ay atlfwdaat. Mariposa bsauldiag. ros-tna t and 4, Pslo
Abo, Cal
atItS MARY C STEWART
Ha-arSa-
Facial Massage. Scalp Disease* a
Specialty Shampooing with dn-
tilled water. Rcmfaa s and
6 Marten building Phone Rett sot.
Palo Alio, Cal
DR. WALTER R- SCKOGGS
Phy*iciin and Surgeon
* a*** tl. MaaellMr. TUe-iH
StaastnT"
DR. DRKSRACH. D. O.
Ilyrlfoiherapr. rtlrctric " Lifht
Bath, Viltr*t:..n Specialtiss. Neu-
ras-benia and Stomach Troubles.
Room I. i'arkiiisiin Illt.sk. lliiiver-
*'■> ate. Palo Alio
Palo Alto Optical Parlor«
j.*t»i.o,.ni,ik,,r™,.
OEO. BLAEESLEY LITTLE
Dentiat
ssstta. Madlttoa-TMH* BolMIa*
l-aa* s... CaL
Money to
Loan
FLAT or IN8TALLMCMT
J. T. DUNN
Real Ktatc -*
Fioance Broker
Agent for Suits Clara
Building snd Loan Ass'n
521 I-.-Trt--T.iin St.
Storage Rooms j
FOR RENT *
Kmiuira of
j a F. HALL Palo Alto \
Tha Palo Altu Tbaae baa tbe
rgest paid circnlstion ol aay tMsp-tr
bsrtvroan Son Frsnchteo and San Joac
A pre.-fx.sitiiin which (or rarious
reason* does not looh gt-aod to Santa
Claran* ia thai now being coniid-
ered by the railroad cmnpany to coo-
iruct a bn.Jge scn>** the lower end
of San Francises, Bay. *,.-ncwhcrr
Redsrood City —Gilroy Telegram
ATTORNEYS.
WALTER RODGER*
SAMUEL W. CHARLES
Attorney at Las
Notary -**a*a at 1—4*4 to* r*t* Anas.
CONTRACTORS
Rrkh Layer amd Cootrsctar
OEO. H. BENTLEY
C on t rat tor for Plaaterina;
and general coatracior. All old and
new work, inaida and out aide,
promptly attended 10. I.inmate*
gia-en. Reaideac* 563 Hamilton
CHARLES ACELEY
lans. r*ne*. walla, aog ilk
rtfta work. Kail mat*. aisS r-t.1- f .>
nuhas-t ftanm. **m iiawiit*.--ias. ran*
Wblto II*.
CHARLES J. BROWN
Carpenier and Csbinil Sht-s>
Jobblna a^wooat Bssrl anal lia<-
We-od All O-SOSW* srss-spU- all.ttaSetl
1st- l:i Hlgb slfssa-l
a LAUHEISTER
MISCELLANEOUS.
Graduate of School nl Agriculture.
Plant*. Shrub* and Tree, aupplied.
Ilsniing and car* of lawn*, tyw
Warerly atreot. Palo Alto Pbooe
White _•.■-
MARSHALL BLACK
1"lit* i-iaw. waa*
THE FIRST NATIONAL BANK
Polo Attn. California
*S
C a l/kltda. Vr,^.least *■ B ltos.lt.. Vtsse
Ire.,,le. , nutsltsg. Co*Mer . : I..i.lt>*>
TRADES ATTENTION.
We have purchat-rd the wholesale
brjtin-at of D L. Isetim.-rse 4 Co, recently establisheel ta tht* City, and
hsmctrfortb w-.'I conduct ibe same natter our firm name of Raley k Cosft-
pany.
Henry Fl Pratt, who baa been with,
tu many years, and il well known to
all grocerymrn of Pslo Alto, will be
~t tne bead of thii branch of our bns-
nen, aiiiited by Orlando Sts-vena
who hai been conducting il lor Dsts-
hnone Si Co line* it opened
We unloaded oar firat car of oranges and bananas Ne-e yesterday
re tb* tride of s complete
at Irom this time on
RALEY St COMPANY.
Hesdanarters, Saa Joes
Follow-on RifAximin for the Prevention of recurrence following standard treatment of Infection with Clostridium Difficile (RAPID): A randomised placebo controlled trial
No full textBackground Clostridium difficile infection (CDI) recurs after initial treatment in approximately one in four patients. A single-centre pilot study suggested that this could be reduced using ‘follow-on’ rifaximin treatment. We aimed to assess the efficacy of rifaximin treatment in preventing recurrence.Methods A multisite, parallel group, randomised, placebo controlled trial recruiting patients aged ≥18 years immediately after resolution of CDI through treatment with metronidazole or vancomycin. Participants received either rifaximin 400 mg three times a day for 2 weeks, reduced to 200 mg three times a day for a further 2 weeks or identical placebo. The primary endpoint was recurrence of CDI within 12 weeks of trial entry.Results Between December 2012 and March 2016, 151 participants were randomised to either rifaximin or placebo. Primary outcome data were available on 130. Mean age was 71.9 years (SD 15.3). Recurrence within 12 weeks was 29.5% (18/61) among participants allocated to placebo compared with 15.9% (11/69) among those allocated to rifaximin, a difference between groups of 13.7% (95% CI −28.1% to 0.7%, p=0.06). The risk ratio was 0.54 (95% CI 0.28 to 1.05, p=0.07). During 6-month safety follow-up, nine participants died in each group (12%). Adverse event rates were similar between groups.Conclusion While ‘follow-on’ rifaximin after CDI appeared to halve recurrence rate, we failed to reach our recruitment target in this group of frail elderly patients, so the estimated effect of rifaximin lacks precision. A meta-analysis including a previous trial suggests that rifaximin may be effective; however, further, larger confirmatory studies are needed.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial
