Chronic cough and esomeprazole: A double-blind placebo-controlled parallel study

Background and objective: Gastro-oesophageal reflux has been implicated in the pathogenesis of chronic cough. Guidelines on management suggest a therapeutic trial of anti-reflux medication. Esomeprazole is a proton pump inhibitor licensed for the long-term treatment of acid reflux in adults and we compared the effects of esomeprazole and placebo on patients with chronic cough. Methods: This was a prospective, single-centre, randomized, double-blind, placebo-controlled, parallel group study conducted over 8 weeks. Fifty adult non-smokers with chronic cough and normal spirometry were randomized. Patients completed cough-related quality-of-life and symptom questionnaires and subjective scores of cough frequency and severity at the beginning and end of the study. They also kept a daily diary of symptom scores. Citric acid cough challenge and laryngoscopic examination were performed at baseline and the end of the study. The primary outcome was improvement in cough score. Results: There were no differences in cough scores in the placebo and treatment arms of the study although some significant improvements were noted when compared to baseline. In the cough diary scores there was a trend towards greater improvement in the treatment arm in patients with dyspepsia. Conclusions: Esomeprazole did not have a clinically important effect greater than placebo in patients with cough. It suggests a marked placebo effect in the treatment of cough. There is paucity of evidence on which to base the treatment of reflux-associated cough. We demonstrate that acid suppressive therapy does not lead to a significant clinical effect in these patients. There may be some improvement in those with coexisting dyspeptic symptoms and therapy should be restricted to this group. © 2011 Asian Pacific Society of Respirology

Harry Pratter’s Wisdom

From 1950 to 1994 Harry Pratter taught law at Indiana University- Bloomington. One of his favorite sayings (he had many of these) was Maitland’s “[T]aught law is tough law,” a phrase that a forty-four year teaching career entitles you to utter with some frequency. In response to Sartre’s notorious challenge, “Do you have anything to say?” Pratter could certainly answer yes. He took Sartre literally. Pratter preferred to speak—that is to teach, and not to write. The source of Pratter’s strong preference for speech over writing must remain a mystery. The consequence is that a good deal of what he thought and said has not been preserved. That’s a shame because Harry Pratter had something to say that was well worth hearing. The hope is that this essay will be able to convey something of the flavor and tenor of Harry Pratter’s thought

Harry Pratter’s Wisdom

From 1950 to 1994 Harry Pratter taught law at Indiana University- Bloomington. One of his favorite sayings (he had many of these) was Maitland’s “[T]aught law is tough law,” a phrase that a forty-four year teaching career entitles you to utter with some frequency. In response to Sartre’s notorious challenge, “Do you have anything to say?” Pratter could certainly answer yes. He took Sartre literally. Pratter preferred to speak—that is to teach, and not to write. The source of Pratter’s strong preference for speech over writing must remain a mystery. The consequence is that a good deal of what he thought and said has not been preserved. That’s a shame because Harry Pratter had something to say that was well worth hearing. The hope is that this essay will be able to convey something of the flavor and tenor of Harry Pratter’s thought

Legal Implementation of a Satellite City Plan: The Planned Disposition of Public Land

Many metropolitan areas are preparing master plans to guide their future development. Such a plan has been prepared for the metropolitan area of Memphis, Tennessee, by the professional staff serving the combined Memphis and Shelby County Planning Commissions. Like most plans, the Memphis plan contains maps and text depicting future land uses, growth patterns, and population distribution. Like most plans, the Memphis plan does not discuss the legal problems of effectively implementing its goals. Also like many other plans, including the now-famous plan for the year 2000 for Washington, D. C.,4 the Memphis plan projects a pattern of regional growth along radial corridors which contemplates the development of a series of metropolitan subcenters. This paper will explore some of the legal difficulties associated with the implementation of plans for one of these subcenters-the development of a satellite city on 5000 acres of presently undeveloped public land

A Research Framework for the Impact of Cultural Differences on IT Outsourcing

Contracting Global Virtual Teams as part of global IT outsourcing is currently en vogue. As might be expected when virtual team members are from different countries, cultural factors play an important role in the success of outsourcing. However, there have been very few studies that assess the effect of culture on IT outsourcing and virtual teams. This conceptual paper addresses this oversight by looking at the effect of cultural differences on IT outsourcing and virtual teams\u27 performance. The applicable literature on outsourcing, virtual teams and culture is analyzed and a framework of offshore outsourcing success is developed. This framework includes the concept of psychic distance to better understand the phenomenon of virtual teams and outsourcing success. Adding this as a key research component provides a more realistic way of researching global virtual teams. Future directions for research based on the developed framework are also provided. By assessing the cultural differences of virtual teams in IT outsourcing, our research framework will help academics pursue this growing business phenomenon