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My understanding was that the 'infectious theory' has more recently been re-proven "not" wrong and that patients with inflammatory arthropathies, presumably in the main RA in the UK have been very successfully trialled on simple low dose prophylactic antibiotics with equal success to NSAID's for symptom control. The theories of infectious exacerbation is proliferating it seems at an equally 'infectious' rate, to cover a wide range of disease including coronary artery disease and arterial disease in general (arteritis associated disease), CFS, fibromyalgia, regional pain syndromes, prostatic disease etc. etc. Indeed immuno-reactivity to a range of organisms - bacterial, chlamydial and viral - seems to be not dissimilar. We have certainly had reasonable results with gold, albeit not dramatic enough to warrant the unpopular regular attendance for injections (from the patients' point of view). The comments of Nico (from his primary care perspective) would be of interest. Jon Wilcox, General Practioner, Auckland. ----- Original Message ----- From: N.P. van Duijn <[log in to unmask]> To: Djulbegovic, Benjamin <[log in to unmask]> Cc: <[log in to unmask]> Sent: Wednesday, February 02, 2000 5:48 AM Subject: Re: RCTs that changed medical practice.... > > A peculiar category is the 'tomato effect'', in fact a type 4 error. > The example - as far as I can recall it - is the efficacy of gold > injections in R.A. based on a infectious theory. When that > infectious theory was proven wrong, the gold therapy was > abandonned and with that the real efficacy of that therapy, untill the > efficacy of gold was rediscovered, and proven in properly designed > studies. > > Nico van Duijn > Dr.N.P. van Duijn, General Practitioner > Department of General Practice > Division Public Health > Academic Medical Centre > University of Amsterdam > Meibergdreef 15 > 1105 AZ Amsterdam > & Primary Health Care Centre 'de Haak' > Almere > the Netherlands %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%