Clinical trials are research studies to determine whether drugs or treatments are both safe and effective for humans. All new medications and devices must undergo several clinical trials, usually involving thousands of people, before they can be released to the public.

Evidence from clinical trials helps identify which treatments work best. Without this evidence, there is a risk that people could be given treatments that have no advantage, waste NHS resources, and might even be harmful.
Clinical trials research is not just for researchers. Patients and the public can be involved too. New research cannot lead to reliable findings unless the right patients agree to join in.
Use this page to search for clinical trials. Information is provided by TrialReach.

How do clinical trials work - Dr Ben Goldacre

This News is Reprinted from blog http://www.patient.co.uk/clinical-trials
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A new study led and funded by the Centers for Disease Control and Prevention finds that in 2011, Clostridium difficile was responsible for almost half a million infections and more than 15,000 deaths in the US. The Centers for Disease Control and Prevention (CDC) say the findings, which are published in The New England Journal of Medicine, emphasize how improvements in antibiotic use and infection control in health care settings are critical for tackling C. diff infection.

C. diff is a bacterium that causes colitis - inflammation of the colon. Infection can occur through touching surfaces or items that are contaminated with feces, in which C. diff is shed.

Symptoms of C. diff infection include fever, nausea, diarrhea, loss of appetite and abdominal pain.

People who are taking antibiotics for other illnesses are most prone to C. diff infection. Antibiotics can destroy some of the friendly bacteria in the gut, meaning it may be less protected against C. diff.


According to the CDC, more than half of patients who stay in hospital are treated with antibiotics, which is why health care settings have been identified as the primary source of transmission.

What is more, past research has shown around 30-50% of antibiotics prescribed in hospitals are not needed or incorrect, meaning many patients are being unnecessarily put at risk of C. diff infection and are putting others at risk by carrying the infection to other settings, such as nursing homes.

The aim of this latest study was to assess the burden of C. diff across the US.

Lead author Dr. Fernanda C. Lessa, a medical epidemiologist at the CDC, and his team set out to identify cases of C. diff infection over 10 geographic areas in the US in 2011.

Based on their findings, the team estimates that in 2011, around 453,000 people were infected with C. diff, and around 29,300 deaths occurred within 30 days of diagnosis. Of these deaths, around 15,000 were estimated to be directly attributable to C. diff.

The study found that individuals aged 65 and older are particularly vulnerable to C. diff infection. Around 1 in 3 cases occurred among patients in this age group, and they also accounted for 2 in 3 health care-associated C. diff infections. What is more, around 80% of C. diff-attributable deaths occurred in patients aged 65 or older.

The researchers also identified an increased risk of C. diff infection among women and Caucasian individuals.

Better infection control and antibiotic use needed across all health care settings
Around two thirds of C. diff cases were associated with stays in a health care facility, according to the research. Of these, almost a quarter occurred during hospitalization, and a similar number occurred in nursing homes. Patients who were recently discharged from a health care facility accounted for the remaining cases.

These results, the CDC say, emphasize the need for better infection control and antibiotic use in health care settings.


The organization points to a 2014 Vital Signs report that found that if hospitals reduced high-risk antibiotic use by 30%, the number of deadly diarrhea infections - such as C. diff - could be reduced by 26%. Another study found a 10% decrease in antibiotic use in different hospital wards was linked to a 34% reduction in C. diff infections.

The CDC note that more than 150,000 of the cases identified were community-associated, meaning the infection was not acquired in health care settings.

However, the organization points to a 2014 study published in JAMA Internal Medicine that found around 82% of patients with community-associated C. diff infection had reported visiting an outpatient health care facility - such as a doctor's or dentist's office - in the 12 weeks prior to diagnosis.

The CDC say these results indicate that improved antibiotic use and infection control needs to be put in place for outpatient health care, as well as inpatient facilities.

Dr. Michael Bell, deputy director of the Division of Healthcare Quality and Promotion at the CDC, says:

"Overall, there are two main things that need to be improved. Number one is how antibiotics are being used, making sure that we use them when they're truly necessary and only for as long as necessary.

The second element is to ensure rigorous infection control in all health care settings. C. diff infections must be diagnosed quickly and correctly so that the infected patient can be cared for using the right infection control techniques."

What are the CDC doing to tackle C. diff in health care settings?
The CDC say they are helping hospitals to develop programs - called "antibiotic stewardship" programs - aimed at improving antibiotic prescription for patients.

In addition, the organization has set up a number of resources to help all health care settings improve antibiotic prescription - such as the "Get Smart: Know When Antibiotics Work" campaign.

Since 2013, the CDC have required all hospitals that are taking part in the Centers for Medicare & Medicaid Services' (CMS) Hospital Inpatient Quality Reporting Program to report all C. diff information to their National Healthcare Safety Network. "This now lets us track and report the nation's progress in controlling this disease. So far we've seen at least a 10% reduction in infections since 2011," notes Dr. Bell.

However, Dr. Bell admits that more needs to be done to control C. diff infection in the US. As such, he says that C. diff prevention is to be included in the value-based purchasing program of the CMS, known as "pay for performance." This is a program that offers financial incentives to clinicians for improving health outcomes.

"In preparation for that, CDC are using a targeting strategy that identifies which hospitals are having infection issues so we and our partners in state and local health departments and agencies like CMS can deliver assistance where it's needed most," he adds.

"To reduce the majority of infections we'll need to improve how antibiotics are being prescribed in hospitals and throughout health care. If we can improve antibiotic prescribing, we expect to see rates of C. diff infections improve dramatically."

Medical News Today recently reported on a study by researchers from the University of Michigan in Ann Arbor, which claims to reveal how C. diff interferes with the gut.

Written by Honor Whiteman


This new is reprinted from  site http://www.medicalnewstoday.com/articles/290034.php
Ragini Pal Medical Writer



Ragini Pal



I Ragini Pal, Medical Student, here i am to update Medical News from Various Site, hope you all love it.
People who sleep more than eight hours a night may have an increased risk of stroke, according to a new study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study found that people who slept more than eight hours a night, called long sleepers, were 46 percent more likely to have a stroke than people who slept six to eight hours a night, which was considered an average amount of sleep. People who shifted over time from sleeping less than six hours a night to sleeping more than eight hours a night were nearly four times as likely to have a stroke as people who consistently slept an average amount.

The study involved 9,692 people with an average age of 62 who had never had a stroke. They were asked about their sleeping habits once and then again about four years later. The participants were followed for an average of 9.5 years. During that time, 346 people had a stroke.

Of the 986 people who slept more than eight hours a night, 52 had a stroke, compared to 211 of the 6,684 people who slept an average amount. The relationship between long sleep and stroke stayed the same after researchers accounted for factors such as high cholesterol, high blood pressure, body mass index and physical activity.

"We don't know yet whether long sleep is a cause, consequence or early marker of ill health," said study author Yue Leng, M.Phil., of the University of Cambridge in the United Kingdom. "More research is needed to understand the relationship between long sleep and stroke."

Alberto Ramos, MD, MSPH, of the University of Miami Miller School of Medicine and a member of the American Academy of Neurology, who wrote a corresponding editorial, said, "Since people whose sleep patterns changed from short to long were nearly four times as likely to have a stroke, it's possible that this could serve as an early warning sign, suggesting the need for additional tests or for people to take steps known to reduce stroke risk, such as lowering blood pressure and cholesterol."

Leng and her colleagues also conducted a meta-analysis, which is a review of previous studies on sleep duration and stroke. Those results also found an association between long sleep and stroke.


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