Welcome to the '96 Batch Medical College Trivandrum Blog Page!
"3M Co. said on Thursday the U.S. Food and Drug Administration has approved its Aldara (imiquimod) drug as a treatment for superficial basal cell carcinoma. The company had received approval in March to market Aldara for actinic keratosis."
"Capsaicin is safe and effective for the treatment of intractable pruritis ani, according to the results of a randomized, placebo-controlled, crossover study published in the September issue of Gut. 'Topical capsaicin is known to be effective and safe in the treatment of pain and itching,' write J. Lysy, from Hadassah University Hospital in Jerusalem, Israel, and colleagues. 'Although the precise mechanism of action is not fully understood, evidence suggests that capsaicin exercises an active depressant effect in the synthesis, storage, transport, and release of substance P.'"
"Depot naltrexone is effective for treating alcohol dependence, according to the results of a multicenter study published in the July issue of Alcoholism: Clinical and Experimental Research. 'Naltrexone has not been prescribed widely, in part because of poor compliance with the oral formulation,' lead author Henry R. Kranzler, MD, from the University of Connecticut Health Center in Farmington, says in a news release. 'This is the first multicenter study of depot naltrexone.... This is also the first multi-center study of naltrexone in the U.S. to show an advantage of the active medication over placebo.'"
"Dietary fruits and vegetables seem to protect against endometriosis, whereas red meat and ham seem to increase the risk, according to the results of two case-controlled studies published in the July issue of Human Reproduction."
"Of nine diagnostic screening questions, a three-item subset of disability, nausea, and sensitivity to light were most effective. These questions were phrased as follows: (1) Has a headache limited your activities for a day or more in the last three months? (2) Are you nauseated or sick to your stomach when you have a headache? (3) Does light bother you when you have a headache?"
I've always wondered what questions to ask someone who I suspect to have migraine. Guess this might be the answer.
"Community strains of MRSA are affecting athletes, prisoners and small children in growing numbers across the United States, infectious disease experts said on Wednesday. 'MRSA is showing up in places it had never been seen before - as a predominant cause of skin disease among children in some regions of the country, as clusters of abscesses among sports participants, as the most common cause of skin infections among inmates in some jails and among military recruits and rarely, as a severe and sometimes fatal lung or bloodstream infection in previously healthy people,' said Dr. Daniel Jernigan from the Centers for Disease Control and Prevention."
"High intake of niacin, particularly from food sources, may reduce the risk of Alzheimer's disease and age-related cognitive decline, according to a report in the August issue of the Journal of Neurology, Neurosurgery, and Psychiatry. Severe niacin deficiency is known to cause dementia. However, the researchers note that it is unclear if more subtle variations in niacin intake influence the risk of neurodegenerative decline."
"Despite concerns about side effects of beta-blockers, a recent overview of randomized trials has found that these drugs are generally well tolerated by patients with heart failure. In the July 12th issue of the Annals of Internal Medicine, a multicenter team led by Dr. Dennis T. Ko of the University of Toronto in Canada reports on its analysis of trials conducted between 1966 and 2002 in which patients with heart failure were randomized to treatment with beta-blockers or placebo. Using a random-effects model, the researchers combined the results of 9 individual trials involving almost 15,000 patients. The team found that beta-blocker therapy was indeed associated with significant absolute annual increases in risks of hypotension, dizziness, and bradycardia. They also found, however, that beta-blocker therapy was associated with reductions in all-cause withdrawal of medication, all-cause mortality, heart-failure associated hospitalizations, and worsening heart failure."
Purpose: The mechanism of action, pharmacokinetics, clinical efficacy, adverse effects, and availability of enfuvirtide are discussed.
Summary: To date, 20 antiretrovirals have been approved by FDA for the treatment of HIV infection. The recent approval of enfuvirtide offers a new and fourth class of antiretroviral agents called fusion inhibitors. Enfuvirtide is indicated for use in treatment-experienced patients who have evidence of viral replication despite receiving current therapy. The drug is a 36-amino-acid synthetic peptide that prevents completion of the HIV fusion sequence. Absolute bioavailability after subcutaneous injection is 84%. Clinical trials indicate that adding enfuvirtide to a salvage regimen in heavily treated patients may lead to an improved virologic response. Up to a 1.48 log decrease in the viral load was seen at 48 weeks when enfuvirtide was combined with an optimized background regimen. Patients who have at least two or more active drugs in the regimen, a CD4 cell count of >100 cells/mm3, and previous exposure to two or more antiretrovirals prior to start ing enfuvirtide appear to respond best. The most common adverse effect, occurring in 98% of all enfuvirtide recipients, is an injection-site reaction that generally can be managed nonpharmacologically. A much less common but more significant concern is an increased risk of bacterial pneumonia. Enfuvirtide is available through the Fuzeon Progressive Distribution Program. The an nual cost of therapy is about $24,000.
Conclusion: Enfuvirtide is the first fusion inhibitor available for the treatment of HIV infection. The drug is indicated for use with other antiretroviral agents in treatment-experienced patients who have evidence of HIV replication despite ongoing antiret roviral treatment.
Type 2 diabetes arises from a combination of impaired insulin action and defective pancreatic ?-cell function. Classically, the two abnormalities have been viewed as distinct yet mutually detrimental processes. The combination of impaired insulin-dependent glucose metabolism in skeletal muscle and impaired ?-cell function causes an increase of hepatic glucose production, leading to a constellation of tissue abnormalities that has been referred to as the diabetes "ruling triumvirate." Targeted mutagenesis in mice has led to a critical reappraisal of the integrated physiology of insulin action. These studies indicate that insulin resistance in skeletal muscle and adipose tissue does not necessarily lead to hyperglycemia, so long as insulin sensitivity in other tissues is preserved. Additional data suggest a direct role of insulin signaling in ?-cell function and regulation of ?-cell mass, thus raising the possibility that insulin resistance may be the overarching feature of diabetes in all target tissues. I propose that we replace the original picture of a ruling triumvirate with that of a squabbling republic in which every tissue contributes to the onset of the disease.
This is really a great lecture for all future endocrinologists!
"Patients with atrial fibrillation (AF) and prior transient ischemic attack (TIA) have a lower (albeit 'still high') risk of subsequent stroke during aspirin therapy than do patients with prior ischemic stroke. The use of warfarin therapy instead of aspirin for secondary prevention in AF patients with either prior TIA or stroke substantially reduces the absolute risk of ischemic stroke."
"Further analysis of the results of the International Verapamil SR/Trandolapril Study (INVEST) has confirmed that while calcium channel blocker (CCB)-based and beta-blocker-based strategies were equally effective in controlling blood pressure and preventing adverse outcomes in hypertensive subjects with coronary artery disease (CAD), the risk of new-onset diabetes in these patients was lower with the CCB-based strategy.[1] Addition of the angiotensin converting-enzyme (ACE) inhibitor trandolapril to verapamil SR lowered the risk of the primary outcome (all-cause death, nonfatal myocardial infarction [MI], or nonfatal stroke) and the risk of diabetes development, whereas addition of the diuretic hydrochlorothiazide (HCTZ) to atenolol, while lowering the risk of the primary outcome, increased the risk of diabetes development."
"Results of a study published in the July issue of the Journal of the American Geriatric Society suggest that galantamine stabilizes or improves activities of daily living (ADL) performance in patients with Alzheimer's disease (AD), regardless of dementia severity."
A single dose of nevirapine given prepartum further reduced perinatal human immunodeficiency virus (HIV) transmission compared with third trimester dosing of zidovudine alone, according to the results of a randomized trial published in the July 15 issue of the New England Journal of Medicine. But adding nevirapine to the infants’ one-week regimen of zidovudine did not improve the outcome further. A second study showed that a single prepartum dose of nevirapine may reduce the mother's response to nevirapine-containing highly active antiretroviral therapy (HAART) regimens six months later.
"Intrapartum nevirapine reduces perinatal transmission of HIV, but the addition of one week of zidovudine treatment to nevirapine does not affect outcomes, according to the results of a randomized controlled trial published in the July 14 issue of JAMA. The findings were also presented at the XV International AIDS Conference in Bangkok, Thailand."
"Obstructive sleep apnea (OSA) is more common in patients with atrial fibrillation (AF) than in those with other cardiovascular diseases, according to a report published in the July 13th rapid access issue of Circulation: Journal of the American Heart Association."
Clinical Quiz - 15 Year Old With Multiple Cutaneous Carcinomas
Excellent stuff! Please go solve this case.
"A fall in systolic blood pressure (SBP) of at least 15 mm Hg appears to predict the development of Alzheimer's disease or dementia in elderly subjects with low blood pressure or vascular disease, new research suggests."
This is applicable for atherosclerotic patients as well?
"Specific expiratory muscle training (SEMT) improves strength, endurance and distance walked in patients with chronic obstructive pulmonary disease (COPD), according to the results of a randomized trial published in the August issue of Chest."
Never knew about this until now.
"Growth-hormone-releasing hormone (GHRH) may be a viable option for treating HIV-induced lipodystrophy, according to the results of a randomized controlled trial published in the July 14 issue of JAMA. The research was also presented this week at the XV International AIDS Conference in Bangkok, Thailand"
"Dual blockade of the renin-angiotensin system (RAS) is renoprotective in type 2 diabetes, according to the results of a double-blind, randomized trial published in the August issue of Diabetes Care. Adding an angiotensin II receptor blocker (ARB) to treatment with maximal recommended doses of an angiotensin-converting enzyme (ACE) inhibitor provided superior short-term renoprotection independent of systemic blood pressure changes."
New guidelines for evaluation of chronic stable angina are published in the July 6 issue of the Annals of Internal Medicine. The American College of Physicians (ACP) updated their 1999 guidelines, gearing the American College of Cardiology/American Heart Association (ACC/AHA) 2002 guidelines to the primary care physician.
Physicians take note!
The International AIDS Society–USA has updated their recommendations for antiretroviral management and published them in the July 14 issue of JAMA. The report was also presented this week at the XV International AIDS Conference in Bangkok, Thailand.
Very useful.
The risk of developing dementia is high after stroke, according to the results of a study published in the June issue of Neurology. The characteristics of post-stroke dementia appear to shift from an Alzheimer disease-type picture in the first years after stroke to a vascular dementia type in later years.
Raghu, check this out.
A vaccine for AIDS is still years away, warns a new report, with progress being hampered by a lack of scientific, political and economic interest.
Only one vaccine candidate has been tested fully to see if it can work in humans, says Seth Berkley, president and CEO of the International AIDS Vaccine Initiative (IAVI), which released its progress report on Monday. “That is a global disgrace,” he says. “There hasn’t been a serious effort.”
Data on so-called cell-mediated vaccines - which invoke the response of the body’s T-cell system - will be available by 2010. Providing the data are positive, this is the earliest point at which an AIDS vaccine will be close to becoming a reality, Berkley says. Read more >>
I'm a resident in Orthopaedics and am interested in computers, movies, music and books. I'm in a rock band and am an aspiring songwriter as well.
