The American journal of medicine
-
Assessment of the value of determination of antineutrophil cytoplasmic antibodies (ANCA) and its specificities for classification of patients with biopsy-proven necrotizing arteritis. ⋯ Determination of ANCA and its specificities is a useful adjunct to the classification of patients with biopsy-proven necrotizing arteritis. Within the spectrum of idiopathic vasculitides, 29-kd serine protease antibodies are associated with WG, MPO antibodies are associated with Churg-Strauss syndrome and systemic PAN, and PAN limited to the skin and the musculoskeletal system is not associated with ANCA.
-
Thirty-six patients were admitted to an open study designed to evaluate the long-term efficacy of gliclazide in the treatment of type II diabetes mellitus. Results from 27 of these patients were analyzed at 36 months, 21 at 48 months, and 16 at 60 months of follow-up. An overall reduction in fasting and postprandial blood sugar was observed (p less than 0.001). ⋯ Body weight remained stable over a period of observation ranging from 36 to 60 months. The incidence of subsequent failure of oral treatment was 2% per annum. These results show that long-term treatment of type II diabetes with gliclazide leads to satisfactory results, with practically no side effects.
-
Comparative Study
Comparison of efficacy of automatic implantable cardioverter defibrillator in patients older and younger than 65 years of age.
The efficacy of the automatic implantable cardioverter defibrillator (AICD) was compared in elderly patients and younger patients with life-threatening ventricular tachyarrhythmias. Clinical characteristics, surgical complications, and long-term survival rates were compared between the two age groups. ⋯ It is concluded that AICD is a very effective treatment for life-threatening ventricular tachyarrhythmias, and this benefit applies to elderly patients as well as younger patients.
-
Despite the demonstrated efficacy of traditional antihypertensive therapy in reducing blood pressure, hypertension continues to be a major cause of cardiovascular disease morbidity and mortality. Stepped-care therapy is a nonphysiologic approach that, due to potential metabolic derangements and stimulation of undesirable reflex responses, may not substantially reduce the cardiovascular and renal complications associated with hypertension or improve long-term survival in many hypertensive patients. ⋯ Certain classes of drugs are not only more effective but also more appropriate from a physiologic standpoint in specific types of patients. Therapy selection based in part on hemodynamic mechanisms and demographic patterns is a more rational approach to patient management and may contribute to a better overall outcome than has been observed with conventional treatment.