Current medical research and opinion
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Comparative Study
Changes in opioid use and healthcare costs among U.S. patients with diabetic peripheral neuropathic pain treated with duloxetine compared with other therapies.
To examine changes in opioid use and healthcare costs among commercially insured patients with diabetic peripheral neuropathic pain (DPNP) who initiated duloxetine versus other standard of care (SOC) medications (tricyclic antidepressants, venlafaxine, gabapentin, pregabalin). ⋯ Among commercially insured patients with DPNP, continuous treatment with duloxetine was associated with a reduction in opioid use between the 12-month pre- and post-index periods compared with treatment with SOC or non-continuous treatment with duloxetine. Duloxetine continuous patients also incurred lower subsequent healthcare costs than non-continuous duloxetine patients.
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To investigate the long-term efficacy of fibrate-statin combination therapy on cardiovascular events as opposed to lipid levels. ⋯ Fibrate-statin therapy in a population with mixed dyslipidaemia resulted in an improved lipid profile with few side-effects. Consistent with its effects, decreases in TG allied with modest decrease in cholesterol and an increase in HDL-C, were associated with better prognosis.
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Chronic respiratory failure (CRF) is a syndrome defined by certain disturbances in arterial blood gases. Non-invasive mechanical ventilation (NIMV) is an increasingly used treatment modality in respiratory failure. The aim of this study was to investigate the long-term effects of NIMV on pulmonary function and survival of patients with CRF. ⋯ NIMV therapy has some important and significant benefits in patients with hypercapnic chronic respiratory failure. This study has some limitations in terms of patient selection, power analysis and survival analysis. To assess the effects of NIMV on mortality and pulmonary functions, the authors believe that there is need for prospective, controlled, multicentre studies with longer follow-up periods, improved adherence and novel ventilator modes and settings.
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Randomized Controlled Trial Comparative Study
Comparison of the effects of nebivolol and valsartan on BP reduction and sleep apnoea activity in patients with essential hypertension and OSA.
To investigate the effect of nebivolol, a third generation beta-blocker, on blood pressure (BP) reduction and polysomnographic parameters in hypertensive patients with mild-to-moderate obstructive sleep apnoea (OSA). ⋯ Nebivolol has a significant BP reduction effect in patients with OSA that is similar to valsartan and reduces heart rate to a greater extent which may prove beneficial in selected patients.
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Randomized Controlled Trial Multicenter Study
Botulinum toxin type A in post-stroke upper limb spasticity.
To evaluate the efficacy and safety of one-time injections of botulinum toxin type A (BoNTA) in Japanese patients with post-stroke upper limb spasticity. ⋯ Higher-dose BoNTA reduced spasticity in upper limb muscles and improved ADL performance in terms of limb position and dressing. BoNTA is safe and effective in the treatment of post-stroke upper limb spasticity.