Current medical research and opinion
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Multicenter Study Clinical Trial
Efficacy and acceptability of fusafungine, a local treatment for both nose and throat infections, in adult patients with upper respiratory tract infections.
The objective of this study was to assess the effectiveness and acceptability of fusafungine in the treatment of patients with community-acquired, upper respiratory tract infections. These infections, although frequently of viral origin, may be conducive to bacterial superinfection. Fusafungine, a combination of several enniatins, has been shown to display bacteriostatic activity against many micro-organisms responsible for infections of the respiratory tract, along with anti-inflammatory activity. ⋯ In terms of tolerability, assessment by the investigators and the patients themselves demonstrated that fusafungine was extremely well tolerated. Acceptability of the treatment was considered poor by only one patient. Results of this study suggest that fusafungine, whatever the aetiology of the infection, gives rapid relief of nasal and pharyngeal symptoms and provides strong evidence of its efficacy and acceptability in treating URTIs.
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Existing oral insulin secretagogues, sulphonylureas, are associated with hyperinsulinaemia, risk of hypoglycaemia and weight gain. Furthermore, they are not able to offer durable glycaemic control in patents with type 2 diabetes and are associated with progressive decline of beta-cell function. New insulin secretagogues offer an exciting opportunity. ⋯ Early data, both in monotherapy and in combination with metformin, show that it is an effective agent in terms of lowering HbA1c, has a low risk of hypoglycaemia and potentially less risk of significant weight gain. These characteristics mean that it may be the ideal agent to be used very early in the disease process, or even in subjects with impaired glucose tolerance, in whom early-phase insulin response is already lost. However these concepts, at the present time, are unproven.
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Add-on therapy with omalizumab, an anti-immunoglobulin E antibody, is effective in improving disease control in patients with allergic asthma of varying severity. The aim of the present study was to determine the efficacy of omalizumab in a subgroup of patients at high risk of serious asthma-related morbidity and mortality. ⋯ In patients at high risk of serious asthma-related morbidity and mortality, treatment with omalizumab offers the potential to halve the rate of asthma exacerbations and improve disease control.
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HER2 overexpression occurs in 25% of breast cancers and seems to correlate with poor prognosis. HER2 overexpression may predict tamoxifen failure and different response rates to chemotherapeutic agents such as the taxanes and anthracyclines. The detection of HER2 and its overexpression is performed using fluorescent in situ hybridisation (FISH) and/or immunohistochemistry (IHC). ⋯ Herceptin is a well-tolerated drug and the side-effects that are commonly seen with chemotherapy, such as neutropenia, alopecia and mucositis, are rarely observed. The main risk factors for cardiotoxicity are concurrent or previous anthracycline exposure. The potential role of Herceptin in the adjuvant setting is currently being evaluated.
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Randomized Controlled Trial Clinical Trial
Magnetic pulse treatment for knee osteoarthritis: a randomised, double-blind, placebo-controlled study.
We assessed the efficacy and tolerability of low-frequency pulsed electromagnetic fields (PEMF) therapy in patients with clinically symptomatic knee osteoarthritis (OA) in a randomised, placebo-controlled, double-blind study of six weeks' duration. Patients with radiographic evidence and symptoms of OA (incompletely relieved by conventional treatments), according to the criteria of the American College of Rheumatology, were recruited from a single tertiary referral centre. 75 patients fulfilling the above criteria were randomised to receive active PEMF treatment by unipolar magnetic devices (Medicur) manufactured by Snowden Healthcare (Nottingham, UK) or placebo. Six patients failed to attend after the screening and were excluded from analysis. ⋯ There were no clinically relevant adverse effects attributable to active treatment. These results suggest that the Medicur unipolar magnetic devices are beneficial in reducing pain and disability in patients with knee OA resistant to conventional treatment in the absence of significant side-effects. Further studies using different types of magnetic devices, treatment protocols and patient populations are warranted to confirm the general efficacy of PEMF therapy in OA and other conditions.