Current medical research and opinion
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Review
Hypertension and vascular dementia in the elderly: the potential role of anti-hypertensive agents.
Vascular dementia (VaD) - a severe form of vascular cognitive impairment - and cognitive decline are associated with hypertension and therefore it seems logical to consider that reducing BP with anti-hypertensive therapy may protect against the development/onset of cognitive function impairment or dementia. ⋯ The protective effect of anti-hypertensive agents appears to depend on the specific drug used - positive effects have been observed with calcium channel blockers (CCBs), such as lercanidipine and nitrendipine, the combination perindopril-indapamide and telmisartan.
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Comparative Study Clinical Trial
Utilization of duloxetine and celecoxib in osteoarthritis patients.
To describe utilization patterns of duloxetine and celecoxib and subsequent opioid use among patients with osteoarthritis. ⋯ Osteoarthritis patients initiating duloxetine had better compliance and a lower likelihood of opioid utilization than those initiating celecoxib. Study limitations included lack of information on reasons for medication initiation and discontinuation, severity of disease symptoms, and use of over-the-counter medications.
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Randomized Controlled Trial Multicenter Study
Diclofenac epolamine medicated plaster in the treatment of minor soft tissue injuries: a multicenter randomized controlled trial.
To investigate the efficacy and safety of a topical plaster containing diclofenac epolamine (DHEP) 1.3% in the treatment of patients with acute minor soft tissue injuries in China. ⋯ A medicated plaster containing DHEP applied to the affected site in Chinese patients with minor soft tissue injury, such as sprains, strains and contusions, was significantly more effective than placebo at reducing pain scores. Onset of action was rapid and the DHEP plaster was safe and well tolerated. The main limitation was the use of a subjective, though validated, self-reported VAS to assess the primary endpoint.
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Comparative Study
Real-world comparative outcomes of US type 2 diabetes patients initiating analog basal insulin therapy.
To evaluate outcomes in insulin-naive patients with type 2 diabetes mellitus (T2DM) who initiated insulin glargine or insulin detemir. ⋯ Results from this real-world EMR analysis suggest that among T2DM patients, initiating insulin treatment with insulin glargine may be associated with better treatment persistence and glycemic control, with similar prevalence of hypoglycemia and weight change, compared with initiating with insulin detemir. This study is limited by the retrospective nature of the data collection using EMRs and inability to confirm accuracy and completeness of data by secondary chart review.
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Review Meta Analysis
Do prokinetics influence the completion rate in small-bowel capsule endoscopy? A systematic review and meta-analysis.
The use of purging for bowel cleansing prior to small-bowel capsule endoscopy (SBCE) has now been established in clinical practice. Despite that, the number of incomplete SBCEs is still around 15-20%. To date, the use of prokinetics in SBCE - aiming to improve completion rate (CR) - remains a contentious issue resulting in lack of consensus among capsule experts. ⋯ Our pooled data shows that the use of prokinetics for capsule ingestion improves CR in SBCE. This effect appears to be particularly evident with metoclopramide, when used concurrently with purging and/or use of real-time monitoring. In a small number of studies, erythromycin showed - through its gastrokinetic effect - marginal benefit. No prokinetic has a beneficial effect on SBCE DY.