Current medical research and opinion
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Randomized Controlled Trial
Safety profile of semagacestat, a gamma-secretase inhibitor: IDENTITY trial findings.
Semagacestat, a γ-secretase inhibitor, demonstrated an unfavorable risk-benefit profile in a Phase 3 study of patients with Alzheimer's disease (IDENTITY trials), and clinical development was halted. To assist in future development of γ-secretase inhibitors, we report detailed safety findings from the IDENTITY study, with emphasis on those that might be mechanistically linked to γ-secretase inhibition. ⋯ Many of these safety findings can be attributed to γ-secretase inhibition, and may be valuable to researchers developing γ-secretase inhibitors.
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Opioid analgesics are commonly and increasingly prescribed by physicians for the management of chronic pain. However, strong evidence supports the need for strategies that reduce opioid use. The objective of this review is to outline limitations associated with opioid use and discuss therapeutic techniques that can be adopted to optimize the use of opioids in the management of chronic nonmalignant pain. ⋯ Appropriate patient selection through identification of risk factors, urine drug testing, and access to prescription monitoring programs has been shown to effectively improve care. Structured opioid therapy in a multimodal platform, including use of a low initial dose, prescription of alternative non-opioid analgesics including non-steroidal anti-inflammatory drugs and acetaminophen, as well as development of written care agreements to individualize and guide therapy has also been shown to improve patient outcomes. Implementation of opioid allocation strategies has the potential to encourage appropriate opioid use and improve patient care.
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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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To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey. ⋯ The results of this epidemiologic survey found high rates of LUTS and OAB, but low levels of medical consultation and very low use of medication treatment, despite high levels of improvement when medications were used.
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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.