Current medical research and opinion
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Insulin and incretin agents (dipeptidyl peptidase-4 inhibitors [DPP4is] and glucagon-like peptide-1 receptor agonists [GLP1 RAs]) are second-line treatment options in patients with type 2 diabetes (T2D) not achieving glycemic targets with metformin. Combinations of insulin with incretin agents have been explored in randomized controlled trials (RCTs) and retrospective studies. However, the optimal approach is still elusive; numerous combination regimens can be envisioned, differing in composition and in order of addition. ⋯ Insulin/incretin combination therapy comprises a variety of efficacious, weight-sparing regimens and may be considered for many patients who do not achieve glycemic targets when treated with insulin or an incretin agent.
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Randomized Controlled Trial
Can a high reloading dose of atorvastatin prior to percutaneous coronary intervention reduce periprocedural myocardial infarction?
Periprocedural myocardial infarction (MI) is a common complication following percutaneous coronary intervention (PCI) and statins have been shown to reduce MI in statin-naïve patients. We aimed to identify whether a high reloading dose of atorvastatin can prevent MI following PCI in patients who were already being treated with statins. ⋯ Administration of a high reloading dose of atorvastatin within 24 hours before PCI could significantly reduce the frequency of periprocedural MI. CLINICAL TRIAL REGISTRATION CODE: IRCT201205209768N1.
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To investigate the effect of spinal anesthesia on cerebral rSO2 during elective cesarean delivery (CD). ⋯ Women undergoing CD under spinal anesthesia may present decreases in cerebral rSO2. The clinical impact of these results remains to be determined.
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Previous studies have raised concerns around the transparency and disclosure rates of clinical trial results on clinical trial registries and in the scientific literature. The objective of this study was to assess the timely disclosure in the public domain of results of company-sponsored clinical trials related to all new medicines approved by the European Medicines Agency (EMA) over a recent 3 year period. ⋯ Results of over three-quarters of all company-sponsored clinical trials related to new medicines recently approved by the EMA were disclosed within a year of completion or regulatory approval, and almost 90% were disclosed by 31 January 2013, suggesting transparency is now better than has sometimes been reported previously.
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Under-treatment or lack of appropriate treatment for chronic pain remains an ongoing major healthcare problem. Opioids are being increasingly recognized as an effective option for chronic pain management. The objective of this survey was to understand the perspective of patients treated with opioids on quality of treatment, preferences, and possibilities to improve treatment and communication between patients and physicians. ⋯ The results of the survey suggest that patients prefer a convenient dosing scheme, which may have a positive impact on compliance. Physicians may have to communicate more closely with patients about their needs.