Pharmacotherapy
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Antianginal response to once-daily diltiazem CD in patients receiving concomitant beta-blockers, long-acting nitrates, or both. Diltiazem CD Study Group.
To determine the safety and efficacy of diltiazem CD 180 mg administered once/day in patients with chronic stable angina inadequately controlled with P-blockers, long-acting nitrates, or both. ⋯ Diltiazem CD 180 mg once/day is an effective, safe, and beneficial initial dosage when added to existing antianginal therapy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery parameters after sevoflurane and isoflurane anesthesia.
We compared recovery times in patients with American Society of Anesthesiologists physical status I-III receiving sevoflurane or isoflurane during surgical procedures longer than 1 hour in duration. Of the 50 patients enrolled, 23 received sevoflurane and 27 received isoflurane. Anesthetic gases were discontinued abruptly at the end of the surgical procedure. ⋯ The time to emergence was significantly less with sevoflurane than with isoflurane (5.6 vs 11.2 min, respectively). There were no significant differences in time to extubation, response to verbal command, or orientation between the groups. Our data support more rapid emergence with sevoflurane than with isoflurane in surgical procedures longer than 1 hour in duration.
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Kaposi's sarcoma (KS) is a highly vascularized neoplasm that primarily results in raised, highly vascularized lesions. Before the 1980s, KS was a rare disorder that occurred predominantly in elderly men of Mediterranean or Eastern European Jewish descent. With the advent of the acquired immunodeficiency syndrome (AIDS) epidemic, its occurrence has increased dramatically. ⋯ Classic KS usually follows an indolent and benign clinical course that rarely requires treatment. In contrast, AIDS-KS is a fulminant disease that requires aggressive pharmacotherapy, especially when it involves visceral organs. The epidemiology, clinical presentation, pathogenesis, and management strategies of AIDS-KS are reviewed, including recent pharmacologic advances.
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Comment Comparative Study Clinical Trial
Comparison of two formulations of nifedipine during 24-hour ambulatory blood pressure monitoring--a comment.
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Droperidol and haloperidol have demonstrated efficacy and safety in the treatment of acute delirium in critically ill patients. We conducted MEDLINE and manual searches of literature published from 1966-1996 to identify articles describing conduction disturbances associated with the drugs. The objectives were to describe the proposed mechanisms of acquired long QTc interval syndrome and torsades de pointes, and to recommend how critically ill patients receiving these agents should be monitored. ⋯ If the baseline QTc interval is 440 msec or longer, and they are receiving other drugs that may prolong the QTc interval or they have electrolyte disturbances, a butyrophenone antipsychotic should be prescribed with caution. All critically ill patients receiving droperidol or haloperidol should undergo electrocardiogram monitoring and QTc interval measurement; special attention should be given to those receiving doses greater than 50 mg/24 hours, as these patients appear to be at greatest risk for development of conduction disturbances. Based on the currently available literature, in any critically ill patient receiving droperidol or haloperidol therapy whose QTc interval lengthens by 25% or more over baseline, therapy should be discontinued or the dosage reduced.