Postgraduate medicine
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Postgraduate medicine · Jan 2016
CommentA novel multitarget stool DNA test for colorectal cancer screening.
Review of: Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, Ahlquist DA, Berger BM. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med 2014;370(14):1287-97. ⋯ The sensitivity of mt-sDNA testing for detection of CRC was 92.3%, compared with 73.8% for FIT (p = 0.002). Sensitivity for detecting advanced precancerous lesions was 42.4% for mt-sDNA testing and 23.8% for FIT (p < 0.001). The specificities of mt-sDNA testing and FIT were 86.6% and 94.9%, respectively (p < 0.001). mt-sDNA testing thus may be a first-line screening option for asymptomatic individuals at average risk for CRC who do not want to have a colonoscopy.
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Postgraduate medicine · Aug 2015
Randomized Controlled Trial Comparative StudyBioequivalence of diclofenac sodium 2% and 1.5% topical solutions relative to oral diclofenac sodium in healthy volunteers.
Topical formulations of nonsteroidal anti-inflammatory drugs (NSAIDs) are generally considered to be safer alternatives to oral NSAIDs due to lower systemic absorption. We conducted randomized, crossover studies that compared the pharmacokinetics (PK), bioequivalence and safety of topical diclofenac sodium 2% twice daily (BID), diclofenac sodium 1.5% four times daily (QID) and oral diclofenac sodium in healthy subjects. ⋯ The steady-state PK profile of topical diclofenac 2% solution administered BID is similar to that of the 1.5% solution administered QID. Systemic exposure to diclofenac is substantially lower after topical application as compared to oral administration. (Study 2 was registered with ClinicalTrials.gov; NCT01202799; https://clinicaltrials.gov/ct2/results?term=01202799&Search=Search).
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Postgraduate medicine · Aug 2015
Review Meta AnalysisPhysical urticaria: Review on classification, triggers and management with special focus on prevalence including a meta-analysis.
Physical urticaria (PU) is a subset of chronic urticaria (CU) induced by physical stimuli. To date, there is no consensus in the literature on the prevalence of PU among patients with CU. ⋯ Our results must be viewed with circumspection because of the small number of eligible articles and heterogeneity among studies. Even so, the results suggest that PU is an important subset of CU and that physicians should be aware of this important condition in order to manage patients appropriately.
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Postgraduate medicine · Aug 2015
EditorialImportance of the Hispanic heritage regarding diagnosis and management of hypertension.
Hypertension (HTN) is a very prevalent and growing clinical problem that is not always promptly diagnosed and ∼6% of U. S. adults remain undiagnosed. Though numerous risk factors have been linked to the development of HTN, ethnicity has traditionally been simply considered as a significant risk among non-Hispanic Blacks. ⋯ A., might have rates of uncontrolled HTN that significantly exceeds the rates observed for non-Hispanic whites. Unfortunately, paucity of a significant Hispanic representation in major clinical trials has raised significant healthcare concerns regarding our true understanding of the meaning of HTN and associated cardiovascular consequences among this ethnic group. Consequently, there is urgency not only in having a better understanding of HTN among Hispanics, but also to examine the potential factors that may play a role in regulating the expression of HTN and its associated cardiovascular manifestations in this ethnic group.
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Postgraduate medicine · Jun 2015
Randomized Controlled Trial Multicenter StudyLow-dose SoluMatrix diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.
Diclofenac is used for the treatment of osteoarthritis (OA); however, like other nonsteroidal anti-inflammatory drugs (NSAIDs) it can be associated with serious dose-related adverse events (AEs). Low-dose SoluMatrix® diclofenac has been developed to provide efficacy at lower diclofenac doses. A recently published Phase III study evaluated the efficacy and safety of SoluMatrix diclofenac 35 mg twice daily (b.i.d.) and thrice daily (t.i.d.) in patients with OA pain treated for 12 weeks. ⋯ SoluMatrix diclofenac treatment for up to 1 year was generally well tolerated in patients with OA pain and associated with improvement in quality of life measures.