Internal medicine journal
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Internal medicine journal · Dec 2019
Meta AnalysisEfficacy and tolerability of duloxetine in patients with knee osteoarthritis: a meta-analysis of randomised controlled trials.
Knee osteoarthritis (OA) is one of the most common joint diseases, and pharmacotherapy is necessary to control its symptoms. ⋯ Duloxetine is effective in the management of chronic pain and loss of physical function in knee OA with acceptable adverse events despite having no advantage in treating joint stiffness. Future trials should focus on determining the optimal treatment regimen.
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Internal medicine journal · Dec 2019
ReviewDrug-eluting versus bare-metal stents for saphenous vein graft lesions.
A best evidence topic was written addressing the question 'in patients with saphenous vein graft lesions requiring percutaneous coronary intervention, do long-term clinical outcomes differ between drug-eluting and bare-metal stents?' Altogether 1466 papers were found, of which seven represented the best evidence. Although one major recent randomised trial was neutral, the weight of earlier evidence supports drug-eluting stents as standard of care. Bare-metal stents may represent a reasonable, efficacious, and less expensive alternative to drug-eluting stents in well selected patient groups.
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Diabetes can lead to a myriad of microvascular and macrovascular complications - with the leading cause of mortality in diabetes being cardiovascular disease. Low-density lipoprotein cholesterol, along with non-high-density lipoprotein cholesterol and triglycerides are proven, modifiable risk factors for cardiovascular disease. This article will focus on lipid-lowering agents in individuals with diabetes. ⋯ Similarly, a relatively novel agent proprotein-convertase subtilisin-kexin type 9 will be reviewed and details around the Pharmaceutical Benefits Scheme criteria governing its usage in Australia will be reported. Finally, this review will touch on agents still on the horizon such as icosapent ethyl, high-density lipoprotein mimetics, bempedoic acid, omega-3 free fatty acids, bromodomain and extra-terminal protein inhibitors and inclisiran - a long-acting ribonucleic acid interference agent. In the appropriately selected population of individuals with diabetes, these agents can assist to improve further lipid profile and reduce cardiovascular events.
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Internal medicine journal · Dec 2019
Multicenter StudyDischarge treatment with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker after a heart failure hospitalisation is associated with a better prognosis irrespective of left ventricular ejection fraction.
Medical therapy could improve the prognosis of real-life patients discharged after a heart failure (HF) hospitalisation. ⋯ Discharge treatment with ACE inhibitor/ARB after a HF hospitalisation is associated with a reduction in all-cause and refractory HF mortality, irrespective of LVEF.