Current medical research and opinion
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Multicenter Study Clinical Trial Observational Study
Weight loss through adjustable gastric banding and improvement in daytime sleepiness: 2 year interim results of APEX study.
Obesity is one factor associated with an increased risk of obstructive sleep apnea (OSA). This study reports the investigator-reported resolution or improvement of OSA and improvements in sleep-related quality of life (QOL) 2 years after surgical placement of the LAP-BAND AP * (LBAP) system. ⋯ These data support that surgically facilitated weight loss can improve sleep-related QOL and may result in resolution or improvement of OSA; the degree of weight loss may be related to these changes.
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'Disuse' and 'Deconditioning' in relation to low back pain (LBP) are terms often used interchangeably. Discussions of 'disuse' refer to general physical inactivity, which evidence suggests does not differ between symptomatic and asymptomatic persons. 'Deconditioning' refers to a decrease in function, commonly both cardiovascular/aerobic fitness and muscular strength/endurance, again noting little difference. However, examination of decreased function relating specifically to lumbar extensor musculature deconditioning has yet to be examined, corroborating all possible methods. Thus, this review attempts to reappraise the deconditioning hypothesis in LBP, specifically considering lumbar extensor deconditioning. ⋯ The hypothesis of specific lumbar extensor deconditioning as being a causal factor in LBP is presently well supported. It is by no means the only causative factor and further research should more rigorously test this hypothesis addressing the methodological issues highlighted regarding previous studies. However, its role suggests specific exercise may be a worthwhile preventative and rehabilitative approach.
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Randomized Controlled Trial Multicenter Study
Saxagliptin versus glipizide as add-on therapy to metformin: assessment of hypoglycemia.
To compare characteristics of hypoglycemic episodes in patients with type 2 diabetes receiving saxagliptin or glipizide add-on therapy to metformin. ⋯ Saxagliptin + metformin was associated with fewer patients reporting hypoglycemia and fewer and less severe hypoglycemic events in those experiencing hypoglycemia compared with glipizide + metformin. ClinicalTrials.gov registration number: NCT00575588.
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To perform a systematic up-to-date review and critical discussion of potential clinical applications of cangrelor based on its pharmacologic properties and the main findings from randomized clinical studies. ⋯ With its pharmacokinetic and pharmacodynamic advantages, allowing consistent and strong P2Y12 inhibition, and with its rapid onset and swift reversal of action devoid of need for an antidote, cangrelor might improve clinical outcomes in clopidogrel-treated patients by reducing ischemic events, while maintaining a favorable safety profile. However, further studies, addressing the safety and efficacy of cangrelor on top of novel oral P2Y12 inhibitors, are warranted.
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Randomized Controlled Trial
Low central venous pressure versus acute normovolemic hemodilution versus conventional fluid management for reducing blood loss in radical retropubic prostatectomy: a randomized controlled trial.
To compare acute normovolemic hemodilution versus low central venous pressure strategy versus conventional fluid management in reducing intraoperative estimated blood loss, hematocrit drop and need for blood transfusion in patients undergoing radical retropubic prostatectomy under general anesthesia. ⋯ Maintaining low central venous pressure reduced estimated blood loss compared to conventional fluid management and acute normovolemic hemodilution in patients undergoing radical retropubic prostatectomy but there was no difference in allogeneic blood transfusion between the groups.