Lancet
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The overnight urinary albumin excretion rate (AER) of 87 patients with insulin-dependent diabetes mellitus was measured in 1966-67, 14 years later information was obtained on 63 of the original cohort; those alive were restudied, and for those who had died relevant clinical information and case of death were recorded. The development of clinical diabetic nephropathy ('Albustix'positive proteinuria) was related to the 1966-67 AER values. Clinical proteinuria developed in only 2 of 55 patients with AER below 30 microgram/min but in 7 of 8 with AER between 30 and 140 microgram/min. ⋯ Mean duration of diabetes was longer, but not significantly so, in those with AER above 30 microgram/min. Thus, elevated levels of microalbuminuria strongly predict the development of clinical diabetic nephropathy. These levels of AER are potentially reversible, and their detection and treatment may prevent diabetic renal disease.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy of parenteral metkephamid acetate in treatment of postoperative pain.
The analgesic efficacy and side-effects of a single parenteral dose of metkephamid acetate 70 mg were compared with those of pethidine (meperidine) hydrochloride 100 mg and placebo in a double-blind, randomised, controlled clinical trial. 30 out of 32 postoperative patients completed the study--10 in the metkephamid group, 11 in the pethidine group, and 9 in the placebo group. The time-effect curves of summated pain measures and analyses of derived measures all indicated that the analgesic activity of metkephamid 70 mg was significantly greater than that of placebo and not less than that of pethidine 100 mg. The metkephamid group had a greater incidence of side-effects than the other two treatment groups. Some side-effects, such as sensations of heaviness of the extremities and nasal congestion, were peculiar to metkephamid but not distressing.