Current medical research and opinion
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Abstract Background and objective Both nateglinide and acarbose can decrease postprandial plasma glucose through different mode of action, therefore may improve oxidative stress and inflammation in patients with type 2 diabetes mellitus (T2DM). There is lack of comprehensive data on effects of nateglinide versus acarbose on plasma glucose level, lipid profiles and inflammatory response of postprandial status in drug naïve Chinese patients with T2DM, therefore we conducted a clinical trial to answer these questions. Methods In a 4-week, randomized, active-control, open-label, parallel-group, multicenter trial, 160 anti-diabetic drug-naïve T2DM patients were randomized to receive either nateglinide or acarbose for 4 weeks. ⋯ Conclusions Nateglinide and acarbose were similar in controlling the postprandial glucose in Chinese drug naïve patients with T2DM. In addition, nateglinide had better performance on improving lipids metabolism under postprandial status in comparison with acarbose. Overall, nateglinide had a safety profile similar to acarbose in this study.
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Parapneumonic effusions (PPE) and empyema, secondary to bacterial pneumonia, are relatively uncommon but their prevalence is increasing lately. Even if their prognosis is generally good, they may still cause significant morbidity. The traditional treatment of PPE has been intravenous antibiotics and, when necessary, chest tube drainage. Open thoracotomy with decortication has usually been applied in case of failure of the traditional approach. Lately, the use of fibrinolysis and/or video-assisted thoracoscopic surgery (VATS) are utilized in the management of PPE; however, there is still little consensus on the most effective primary treatment. ⋯ The main steps in treatment are diagnostic thoracocentesis and imaging, small percutaneous drainage, and considering fibrinolysis in complicated PPE. In case of failure, VATS should be the surgical method to be applied.
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To date, there are no systematic reviews of epidemiological studies of chronic pain in the developing world. ⋯ The review provides further evidence that the prevalence of chronic pain in the general population is high. However, there was insufficient reliable data to estimate with any certainty the prevalence of chronic pain in countries with an HDI < 0.9 with variability in estimates between surveys being of concern. Subtle differences in review and survey methodology appeared to impact markedly on estimates. There is a need for epidemiological studies that estimate the prevalence of chronic pain in developing countries to determine the scale of the problem.
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Multicenter Study
Use of darbepoetin alfa in European clinical practice for the management of chemotherapy-induced anaemia in four tumour types: final data from the CHOICE study.
The CHOICE study was a prospective, multicentre, observational study designed to assess levels of adherence in current clinical practice to the European product label and EORTC guidelines for the treatment of chemotherapy-induced anaemia (CIA) with darbepoetin alfa (DA). Here we present data split by tumour types: breast, colorectal, ovarian and lung. ⋯ This study demonstrates that the recommendations are adhered to in clinical practice, with the mean starting Hb level <10 g/dL irrespective of tumour type. Furthermore, DA is likely to be effective and well tolerated for the treatment of CIA in patients with breast, colorectal, ovarian or lung cancer.
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To compare adherence to second-generation tyrosine kinase inhibitors (TKIs) dasatinib and nilotinib in patients with imatinib resistant or intolerant chronic myeloid leukemia (CML) receiving second-line therapies. ⋯ The study was subject to common limitations of claims data, which lack clinical information, may contain inaccuracies in diagnosis and procedure coding, and may not truly reflect actual drug consumption. Moreover, daily doses calculated based on refill records may not reflect accurate dosing regimens.