Current medical research and opinion
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Clinical Trial
Long-term efficacy of insulin glargine therapy with an educational programme in type 1 diabetes patients in clinical practice.
To investigate the effect of initiating insulin glargine (glargine: LANTUS), a once-daily basal insulin analogue, plus an educational programme, on glycaemic control and body weight in patients with type 1 diabetes in clinical practice. ⋯ In this retrospective study of medical records, patients with type 1 diabetes treated with insulin glargine over 30 months in combination with educational support and close clinical supervision decreased their HbA(1c) levels without weight gain versus previous treatment with NPH insulin or insulin lente. Further studies in a larger cohort of patients would help to confirm these results.
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The objective of the study was to compare the level of HbA(1c) reduction between a once-daily basal insulin analogue (glargine, GLG) and two twice-daily premixed insulin analogue formulations (premixed insulin lispro 75/25, PIL; premixed human insulin 70/30, PHI) in patients with type 2 diabetes mellitus (T2DM) initiating insulin therapy. ⋯ In clinical practice settings, greater reductions in HbA(1c) were found in patients with premixed insulin than with a basal insulin analogue with the greatest reduction observed with premixed insulin lispro 75/25, confirming the observations of randomized, controlled trials.
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Comparative Study
Economic evaluation of etoricoxib versus non-selective NSAIDs in the treatment of ankylosing spondylitis in the UK.
To evaluate the cost-effectiveness of etoricoxib, a cyclooxygenase (COX)-2 selective inhibitor, versus non-selective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in the treatment of ankylosing spondylitis (AS). ⋯ Given the underlying assumptions and data used, this economic evaluation demonstrated that, compared to nsNSAIDs, etoricoxib is a cost-effective therapy for AS patients in the UK.
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Randomized Controlled Trial
Comparison of intrathecal bupivacaine and levobupivacaine combined with opioids for Caesarean section.
To date, racemic bupivacaine is the most popular local anaesthetic for spinal anaesthesia in parturients undergoing elective Caesarean delivery. However, data suggests that S-enantiomers like levobupivacaine may produce differential sensory and motor blockade. The aim of the present study was to compare fixed doses of intrathecal hypertonic levobupivacaine 0.5% (10 mg) and bupivacaine 0.5% (10 mg) combined with either intrathecal fentanyl (10 and 20 microg), or sufentanil (5 microg) in terms of sensory and motor block characteristics. ⋯ Based on our data, 10 mg of hypertonic levobupivacaine 0.5% combined with sufentanil 5 microg was the most appropriate anaesthetic regimen in parturients undergoing elective Caesarean delivery in spinal anaesthesia.
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To assess the effectiveness of oseltamivir in reducing the risks of influenza-related secondary complications in otherwise healthy adolescent and adult patients aged > or = 13 years. ⋯ Secondary complications of influenza, such as respiratory disease and otitis media, were reduced in patients treated with oseltamivir. The risk of hospitalization for respiratory diseases was not reduced, although there was a reduction in the risk of hospitalization for any reason. Clinical benefits observed with oseltamivir were not associated with a change in healthcare costs.