Current medical research and opinion
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Randomized Controlled Trial Multicenter Study
Impact of fatigue on outcome of selective serotonin reuptake inhibitor treatment: secondary analysis of STAR*D.
To explore relationships between baseline and changes in fatigue during treatment with outcomes in patients with major depressive disorder (MDD) receiving citalopram monotherapy. ⋯ Lower baseline fatigue and remission of fatigue during antidepressant treatment in patients with MDD are associated with higher rates of remission of depressive symptoms and better function and quality of life. Study limitations include use of the STAR*D Level 1 sample (citalopram as only antidepressant), use of a proxy measure of energy/fatigue (item 14 from the QIDS-SR16), and the secondary post-hoc analysis design.
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To investigate the long term smoking cessation behaviors in a population of Japanese current smokers (CS) and former smokers (FS). ⋯ In our survey, >70% of smokers used unaided smoking cessation methods, which may have resulted in a lower success rate. Participants relapsed after a median of 105 days of abstinence (25% within 7 days; the remainder had resumed smoking after 1260 days). As with all surveys, recall bias may have influenced the results. Our observations could be combined with other data in health economic models of smoking cessation to identify appropriate measures to reduce the prevalence of smoking in Japan.
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Randomized Controlled Trial
Standardized modulation of the injection site allows for insulin dose reduction without deterioration of metabolic control.
Use of an injection site modulation device (InsuPad) in intensive insulin treatment reduces frequency of hypoglycemia and prandial insulin requirements by enhancing subcutaneous microcirculation. This meal tolerance test (MTT) investigation was performed as a sub-study during the real-world BARMER study to demonstrate non-inferiority of the reduced insulin doses observed in this study with respect to metabolic control. ⋯ The results of this meal tolerance sub-study confirm that the observed prandial insulin dose reduction when using the injection site modulation device has no negative impact on postprandial metabolism.
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Observational Study
Tapentadol at medium to high doses in patients previously receiving strong opioids for the management of cancer pain.
The aim of this study was to assess the efficacy and tolerability of tapentadol (TP) for a period of 4 weeks in patients who were already treated by opioids. ⋯ In our sample, TP used in doses of 350-450 mg/day was well tolerated and effective in opioid tolerant patients with cancer pain and could be considered as a flexible drug to be used for the management of moderate to severe cancer pain. Like most studies in patients with cancer pain, it was limited by its open-label, uncontrolled design, the number of patients lost in follow-up, and discontinuation of the treatment for several reasons. Further studies in a large number of patients should confirm these preliminary results.
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To understand academic/clinician authors' perceptions regarding the value of professional medical writers. ⋯ Respondents to this survey were generally accepting of medical writing assistance and valued many aspects of the role, in particular editorial support. The survey was small, however, and potentially biased towards authors with experience of working with medical communication agencies. Although many medical writers come from a scientific background and have relevant expertise, this was not perceived as a value. It would be beneficial to educate authors and journal editors regarding medical writers' scientific expertise and role.