Romanian journal of internal medicine = Revue roumaine de médecine interne
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The Streptokinase (SK) regimen (1.5 MU/60 minutes) has remained unchanged for the past 20 years in patients with ST-segment elevation acute myocardial infarction (STEMI) due to fear of hypotension (a specific effect of this thrombolytic agent) and of hemorrhagic complications. ⋯ 1. Despite a very high incidence (44.55%) the SK-hTA has not a detrimental effect in pts. treated with accelerated SK regimens for STEMI. 2. Streptokinase can be rapidly administered without an increased risk.
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Inflammation is considered a crucial step in the pathogenesis of acute coronary syndromes (ACS). C-reactive protein (CRP) is proposed to be included in risk stratification of ACS patients. However, it is not yet known if CRP is only a risk marker, or merely a risk factor in the development of ACS. Our study looked at the links between inflammation and the prothrombotic factors present in patients with ACS without ST elevation. ⋯ Inflammation, as quantified by CRP, appears to be associated with a significant prothrombotic status and endothelial dysfunction (as reflected by high von Willebrand factor).
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Endothelial dysfunction (ED) is regarded as an early functional marker and intima-media thickness (IMT) as an early morphological marker of atherosclerosis. The aim of this study was to evaluate whether peripheral endothelial function and common carotid IMT are impaired in type 2 diabetic patients with inadequate glycemic control. ⋯ In diabetic patients with inadequate glycemic control and without clinical evidence of atherosclerosis endothelial function assessed by FMD is significantly impaired and IMT is significantly greater compared to nondiabetic healty subjects. Large clinical trials should evaluate if in clinical practice FMD and IMT are useful in identification of high-risk subjects.
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Randomized Controlled Trial Comparative Study Clinical Trial
Humalog Mix 25 in patients with type 2 diabetes which do not achieve acceptable glycemic control with oral agents: results from a phase III, randomized, parallel study.
Humalog Mix 25 (Mix 25) is a premixed insulin mixture of 25% lispro and 75% neutral protamine lispro. Insulin lispro is an analog of human insulin. It is created when the amino acids at positions 28 and 29 of the B-chain of insulin are reversed. The natural sequence in human insulin at this position is proline at B28 and lysine at B29. The pharmacokinetic and pharmacodynamic profiles of insulin lispro indicate that it is more rapid acting, and therefore more physiological mealtime insulin than regular human insulin. ⋯ When glycemic control can no longer be achieved by oral antidiabetic agents, treatment with insulin should be considered as the next therapeutic option. Mix 25 provided good overall glycemic control, as well as patient treatment satisfaction.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of metoclopramide on antral emptying of a semisolid meal in patients with functional dyspepsia. A randomized placebo controlled sonographic study.
The aim of this study was to investigate the effect of metoclopramide on the antral emptying of a semisolid meal. Twenty-five patients with functional dyspepsia received in a prospective randomized trial either metoclopramide 10 mg t.i.d. (n = 14) or placebo (n = 11) for 7 days. The antral emptying was measured by real-time ultrasound with a 3.5 MHz probe from the antral area recordings in the aorto-mesenteric plane. ⋯ Antral emptying was accelerated by metoclopramide compared with placebo. Fasting antral emptying was not changed by metoclopramide and the postprandial antral area had a trend to decrease. These data suggest that the effect of metoclopramide is less due to the enhancement of antral motility but rather to the reduction of postprandial fundus relaxation.