Current medical research and opinion
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Randomized Controlled Trial
Comparison of intrathecal bupivacaine and levobupivacaine combined with opioids for Caesarean section.
To date, racemic bupivacaine is the most popular local anaesthetic for spinal anaesthesia in parturients undergoing elective Caesarean delivery. However, data suggests that S-enantiomers like levobupivacaine may produce differential sensory and motor blockade. The aim of the present study was to compare fixed doses of intrathecal hypertonic levobupivacaine 0.5% (10 mg) and bupivacaine 0.5% (10 mg) combined with either intrathecal fentanyl (10 and 20 microg), or sufentanil (5 microg) in terms of sensory and motor block characteristics. ⋯ Based on our data, 10 mg of hypertonic levobupivacaine 0.5% combined with sufentanil 5 microg was the most appropriate anaesthetic regimen in parturients undergoing elective Caesarean delivery in spinal anaesthesia.
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Comparative Study
Economic evaluation of etoricoxib versus non-selective NSAIDs in the treatment of ankylosing spondylitis in the UK.
To evaluate the cost-effectiveness of etoricoxib, a cyclooxygenase (COX)-2 selective inhibitor, versus non-selective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in the treatment of ankylosing spondylitis (AS). ⋯ Given the underlying assumptions and data used, this economic evaluation demonstrated that, compared to nsNSAIDs, etoricoxib is a cost-effective therapy for AS patients in the UK.
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To assess the effectiveness of oseltamivir in reducing the risks of influenza-related secondary complications in otherwise healthy adolescent and adult patients aged > or = 13 years. ⋯ Secondary complications of influenza, such as respiratory disease and otitis media, were reduced in patients treated with oseltamivir. The risk of hospitalization for respiratory diseases was not reduced, although there was a reduction in the risk of hospitalization for any reason. Clinical benefits observed with oseltamivir were not associated with a change in healthcare costs.
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Many patients with Type 2 diabetes mellitus (DM) delay and/or discontinue the use of insulin. This study determined patient-perceived barriers to the initiation of, and persistence with, insulin therapy. ⋯ These findings suggest that issues related to insulin injection are the primary reason patients with Type 2 DM discontinue insulin therapy. Understanding these patterns is important to develop interventions to overcome barriers to treatment and improve the medical outcomes of patients with Type 2 DM.
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Atypical antipsychotics are playing an increasing role in the treatment of bipolar disorder. The objective of this study was to assess the medication treatment patterns and costs associated with different atypical antipsychotics. ⋯ Antipsychotic medication use patterns were statistically significantly different among atypical antipsychotics in the usual treatment of bipolar disorder. Olanzapine appears to be more likely used as a monobipolar medication compared with risperidone, quetiapine, and ziprasidone. The annual healthcare costs associated with the treatment of bipolar disorder by olanzapine and risperidone were similar, and the costs of these treatments were lower than with quetiapine or ziprasidone.