Current medical research and opinion
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Measurement of glycosylated hemoglobin (HbA1c) remains the gold standard for the assessment of glycemic control in patients with type 2 diabetes. Recent investigations have studied the correlations between HbA1c levels and other aspects of glucose metabolism, specifically, postprandial glucose (PPG) and fasting plasma glucose (FPG). The results suggest that PPG is also important to overall glycemic control and may be a better index of glucose regulation than FPG. ⋯ Many patients receive combination therapy, thereby benefiting from multiple mechanisms of glucose control, although in most cases insulin must later be added to the regimen in order to effectively suppress FPG. Thus, all aspects of glucose metabolism appear to be clinically relevant and should be monitored for effective diabetes management. Further study will more precisely define the clinical significance of PPG.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the therapeutic efficacy and tolerability of etoricoxib and diclofenac in patients with osteoarthritis.
To evaluate and compare the efficacy and tolerability of etoricoxib and diclofenac in patients with osteoarthritis of the knee or hip. ⋯ Etoricoxib is clinically effective in the therapy of osteoarthritis providing a magnitude of effect comparable to that of the maximum recommended daily dose of diclofenac. The onset of clinical benefit with etoricoxib on day one is more rapid than that of diclofenac. Both drugs were generally well tolerated.
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Comparative Study
Esmolol versus diltiazem in atrial fibrillation following coronary artery bypass graft surgery.
Atrial fibrillation (AF) is the most common arrhythmic complication following coronary artery bypass graft surgery (CABG). The efficacy and safety of esmolol and diltiazem were compared in patients with post-CABG AF. ⋯ Esmolol is significantly more effective than diltiazem in the management of post-CABG AF. More patients converted to sinus rhythm with esmolol as compared to diltiazem. Esmolol was associated with fewer adverse effects than diltiazem, including adverse effects leading to drug discontinuance. Due to study design limitations (retrospective data collection), an adequately powered randomised, controlled trial is needed to confirm these preliminary findings.
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Clinical Trial
An open-label study of a second course of hylan G-F 20 for the treatment of pain associated with knee osteoarthritis.
To evaluate the efficacy and tolerability of a second course of hylan G-F 20 for the treatment of osteoarthritic knee pain in patients who experienced a clinical benefit with an initial course of therapy. ⋯ A second course of hylan G-F 20 therapy is an appropriate therapy for the treatment of OA knee pain in patients who had a previous favorable clinical response. For continued relief of osteoarthritis knee pain, this study supports repeat use of hylan G-F 20 in these patients.
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Persisting pain is demoralising and debilitating for patients and their carers. Most patients with chronic pain do not need the services of a specialised pain clinic and are appropriately managed by their general practitioner (GP). ⋯ Most GPs believe that the management of chronic pain can be improved. Further education of all healthcare professionals who manage patients in pain is needed to bring about such a change.