Current medical research and opinion
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Antipsychotic drugs have been available for more than 40 years. The invention of neuroleptics changed the overall treatment of schizophrenia dramatically. Nevertheless, the discussion on the importance and role of antipsychotic therapy still goes on. ⋯ The atypical antipsychotic agents have improved the quality of therapy and can also improve and support other aspects of treatment. When used with other treatment strategies, atypical antipsychotic agents could improve the overall outcome of this usually chronic disease. It is now necessary to implement these strategies as effectively as possible.
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Headache has a significant impact on public health in terms of quality of life and economic consequences, but in primary care, needs often remain unmet in terms of recognition, diagnosis and treatment. Our aim was to measure the prevalence of headache sufficient to affect the quality of life of undergraduate students who were entering the University of Exeter. ⋯ Headache has a considerable impact on the quality of life of students entering University which we speculate may have a deleterious effect on educational attainment. This study has confirmed the findings of other population groups that morbidity from headache is often unrecognised and under treated.
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Comparative Study
Differences in lipid profiles of patients given rosiglitazone followed by pioglitazone.
To compare the effects of rosiglitazone and pioglitazone on patient lipid levels in a clinical practice setting, we retrospectively examined charts of 20 patients in our practice. The patients had been treated for type 2 diabetes for 3 or more months with rosiglitazone (4 mg b.i.d.) followed immediately by 3 or more months' treatment with pioglitazone (45 mg once daily). Glycaemic control was excellent and essentially equivalent during the two treatments. ⋯ One patient receiving rosiglitazone and one receiving pioglitazone developed oedema that resolved without therapy discontinuation. Liver enzyme levels and blood pressure were unaffected in this group of patients. Because patients with diabetes are at risk for coronary artery disease, physicians should consider each agent's effects on lipid levels when choosing a specific thiazolidinedione.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy and tolerability profile of etoricoxib in patients with osteoarthritis: A randomized, double-blind, placebo and active-comparator controlled 12-week efficacy trial.
To evaluate the efficacy of 12 weeks of treatment with etoricoxib, a selective COX-2 inhibitor, in patients with osteoarthritis (OA) of the knee or hip. ⋯ Etoricoxib showed rapid and durable treatment effects in patients with OA of the knee or hip. Etoricoxib was generally well tolerated.
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A retrospective audit was carried out to investigate triptan usage over a period of one year among 360 adult patients with migraine in nine GP practices in the UK and the Republic of Ireland. Data from patient records were analysed, in conjunction with replies to a questionnaire about patients' perceptions of their migraine and its treatment. The majority of patients included in the audit were women (83%), and most patients (81%) were aged between 35 and 64 years. ⋯ The high usage predictors could be developed into a checklist of potential indicators for GPs to identify patients who may become high users if prescribed triptans and who might require closer monitoring. We recommend that patients identified as having a potential for high usage should be routinely reviewed, every 3-6 months, to ensure that they are using triptans appropriately to treat migraine. Although triptans are generally safe and well tolerated, unnecessary use of any medication should be avoided.