Current medical research and opinion
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Randomized Controlled Trial
Addition of exenatide BID to insulin glargine: a post-hoc analysis of the effect on glycemia and weight across a range of insulin titration.
In a 30 week, double-blind, randomized, controlled Phase 3 study in patients with type 2 diabetes mellitus, the addition of fixed-dose exenatide twice daily (BID) to titrated insulin glargine resulted in significant glycated hemoglobin (HbA(1c)) lowering and weight loss without increased hypoglycemia risk versus titrated insulin glargine alone. Because individualized insulin titration contributed to these results, this post-hoc analysis examined the results in the context of the degree of insulin titration that occurred. ⋯ Addition of fixed-dose exenatide BID to optimized insulin glargine, regardless of the extent of insulin titration, significantly improved glycemia without increasing hypoglycemia risk, while mitigating insulin-induced weight gain in this post-hoc analysis.
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The present review was performed to identify possible differences observed between adults and elderly patients and between males and females in randomized clinical trials of breakthrough pain (BTP). ⋯ There is a need for more information regarding the use of opioids for BTP according to age and gender.
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Neuropathic pain (NP) is a common type of chronic pain in which 60% of patients present with localized symptoms. Early diagnosis of NP is often a challenge in primary care. Moreover, so far no standard diagnostic procedure for localized NP (LNP) is available. To help general practitioners, a screening tool was developed and evaluated. ⋯ The proposed screening tool was shown to be easy and useful for detecting NP and LNP in chronic pain patients as a fast first assessment tool in primary care, thus facilitating the choice of a topical treatment. LIMITATIONS AND STRENGTHS: The drop-out rate was high but was accounted for by using correction factors in the diagnostic accuracy calculations. A strength is the unselected chronic patient population: spectrum of disease correctly reflects day-to-day clinical practice and is not biased. Diagnostic accuracy of the tool therefore appears to be realistic.
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To estimate longitudinal trends in prevalence and incidence rates of adult ADHD 2006-2009. ⋯ Adult ADHD prevalence in this managed care organization appears low, but showed increasing prevalence and incidence rates over time.
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Poor adherence to treatment may contribute to the treatment gap in chronic obstructive pulmonary diseases (COPD). The aim of the current study was to describe the association between adherence to treatment and the risk of COPD moderate (ME) and severe (SE) exacerbations, and health care utilization. ⋯ Despite the typical limitations of an administrative database study, the results of this large population-based study have shown that reduced adherence to treatment with TIO and FSC is associated with increased risk for exacerbations and higher health care utilization in COPD patients.