Presse Med
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Septic shock remains a true challenge to modern therapeutics. The quality and earliness of antibiotic administration are both fundamental elements. ⋯ The pharmacokinetic indicators and predicted resistance of the bacteria targeted determine the choice of treatment, often empirical. Radical treatment of the source of infection, especially by surgery, should be combined with antibiotic treatment whenever possible.
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Among the symptoms that may occur with smoking withdrawal, constipation is relatively frequent, but little studied. ⋯ This constipation sometimes produces serious functional disorders and can induce relapse. It occurs especially among women and those predisposed to it. Nicotine, by acting on the parasympathomimetic system, increases intestinal peristalsis, and a cigarette can appear to be effective self-medication. Magnesium salts are the first-line treatment for this problem. If they fail, neostigmine, an anticholinesterase with parasympathomimetic activity, appears remarkably effective in correcting this disorder.
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Review Comparative Study
[Statins in patients with kidney failure: efficacy, tolerance, and prescription guidelines in patients with chronic kidney disease and renal transplant].
Chronic kidney disease (CKD) is extremely common in adults, although often undiagnosed and thus untreated. Cardiovascular disease is the leading cause of death among patients with CKD and reducing its risk in this population is an important priority. Dyslipidemia is almost always present when proteinuria is above 3 gr/24 hours. Roughly two thirds of all patients with end-stage renal failure and kidney transplants suffer from dyslipidemia and should receive lipid-lowering therapy, as suggested by recent Afssaps (French drug agency) and NKF-K/DOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) guidelines. We reviewed recent studies on efficacy, tolerability and prescription recommendations of statins in CKD and renal transplant patients. ⋯ Statins at appropriately adapted doses have the same efficacy in CKD patients as in subjects with normal kidney function, and tolerance is not a problem. Their effectiveness in cardiovascular prevention in this population has not been demonstrated to date. Results about statin-induced kidney protection are encouraging but further and more specific studies are needed.
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Randomized Controlled Trial Multicenter Study Comparative Study
[Treatment of acute maxillary sinusitis in adults. Comparison of cefpodoxime-proxetil and amoxicillin-clavulanic acid].
The aim was to demonstrate the equivalence of the clinical efficacy and safety of cefpodoxime-proxetil (200 mg bid for 5 days) to that of amoxicillin-clavulanic acid (1 g/125 mg bid for 8 days) in adults with acute maxillary sinusitis. ⋯ In this study, a 5-day course of cefpodoxime-proxetil at 200 mg bid was as clinically effective as amoxicillin-clavulanic acid 1 g/125 mg bid for 8 days with a significantly better safety profile and compliance.
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Inhibition of viral assembly (protease inhibitors) and of fusion of viral and target membranes (fusion inhibitors) are general approaches to antiviral treatment, not specific for HIV. Nonetheless, the agents that induce these phenomena are most often specific for a given virus or virus family. ⋯ The epidemiologic methods used to assess this drug's efficacy are not robust. Preliminary results for SARS treatment with protease and entry inhibitors, although at early stages of development, are promising.