Current medical research and opinion
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Randomized Controlled Trial
Safety and pharmacokinetics of subcutaneous ceftriaxone administered with or without recombinant human hyaluronidase (rHuPH20) versus intravenous ceftriaxone administration in adult volunteers.
To compare pharmacokinetics and safety of recombinant human hyaluronidase (rHuPH20)-facilitated subcutaneous (SC) ceftriaxone administration versus SC ceftriaxone preceded by SC saline placebo or intravenous (IV) ceftriaxone administration. ⋯ Ceftriaxone AUC did not differ significantly between the three administration routes. C(max) was higher and t(max) shorter with rHuPH20-facilitated SC than SC preceded by placebo. rHuPH20-facilitated SC ceftriaxone was generally well tolerated. This study is limited by evaluation of healthy adults and absence of repeated-dose groups.
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Review Comparative Study
Iron supplementation in the non-dialysis chronic kidney disease (ND-CKD) patient: oral or intravenous?
The management of iron-deficiency anaemia in patients with non-dialysis chronic kidney disease (ND-CKD) remains controversial, particularly regarding the use of oral versus intravenous iron supplementation. ⋯ Intravenous iron offers an effective, feasible route towards reducing the heavy burden of iron-deficiency anaemia in the non-dialysis CKD patient, even in the absence of ESA therapy.
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To evaluate the clinical and microbiological outcomes of linezolid versus vancomycin in methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infection (cSSTI) using a meta-analysis. ⋯ Resolution of infection in CE and MITT patients were inconsistent; however, a sub-analysis revealed that linezolid was more likely to consistently achieve microbiologic eradication in MRSA ME patients. Apparent risks of thrombocytopenia, nausea, diarrhea, and possibly anemia may limit linezolid use in treating MRSA cSSTI. This study was limited due to an inability to assess for the effects of hetero-resistance and appropriate vancomycin dosing on outcomes. Moreover, the small number of studies made controlling for heterogeneity challenging.
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To determine the prevalence of painful diabetic peripheral neuropathy in adult patients with diabetes mellitus (type 1 and 2) attending outpatient clinics in Saudi Arabia and to determine the demographic profile and pharmaceutical management of these patients. ⋯ In patients with reduced pain intensity DN4 has not been directly compared with other tools to measure neuropathic pain; however, using the DN4 in this study 65.3% of adult outpatients with type 1 and 2 diabetes in Saudi Arabia were found to have painful diabetic peripheral neuropathy; far higher than anticipated.
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Randomized Controlled Trial Multicenter Study
Short- and long-term efficacy and safety of duloxetine in women with predominant stress urinary incontinence.
To evaluate short- and long-term safety and efficacy of duloxetine in women with predominant stress urinary incontinence (SUI). ⋯ Duloxetine seems to be an efficacious treatment with an acceptable safety profile for women with SUI. Achieved improvement is maintained over the longer term in those women who remain on therapy.