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Posted by James
The pattern of illness in the U.S. has shifted from mostly acute disease to one in which chronic conditions predominate. Although there are many diseases that can shorten life expectancy, it is more likely that a disease will have adverse health consequences that result in dysfunction and decreased well-being. Hence, patient self-reports of functioning and well-being, or health-related quality of life (HRQOL), are increasingly viewed as important measures of therapeutic outcome. Sanders and colleagues found that the reporting of quality-of-life therapeutic endpoints in randomized controlled trials increased more than 650% between 1980 and 1997.
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Posted by James
Speaker: Andrew Dowson, MD, Director of the Headache Clinic, Kings College Hospital, London, United Kingdom.
Six-month follow-up results from a large-scale phase III clinical study demonstrate that zolmitriptan nasal spray (Zomig®, AstraZeneca) 5 mg is safe, well tolerated, and reliably effective when used for the long-term acute treatment of multiple migraine attacks. High pain-free rates have been maintained over time.
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Posted by James
REVIEW PROCESS
The authors of this article—academic-affiliated neurologists and physiatrists with experience in the use of neurotoxins for spasticity, pain, headache, and other conditions—were recruited by a health care consultant under a grant from Allergan. Most of us met twice in person to review the evidence and to arrive at a consensus. Several telephone conferences and electronic communications aided the development of our Consensus Statement (see page 674).
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Posted by James
A multicenter, randomized, double-blind, placebo-controlled, active-controlled trial was conducted to compare the analgesic efficacy and safety of oxymorphone ER with placebo and oxycodone controlled release (CR) in ambulatory patients with moderate-to-severe chronic low back pain who required opioid therapy. Patients received oxymorphone ER 10 to 110 mg or oxycodone CR 20 to 220 mg every 12 hours during a seven-day to 14-day dose-titration phase.
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Posted by James
Manufacturer: Novo Nordisk, Princeton, NJ Indications:
Pediatric Patients: Norditropin is indicated for the long-term treatment of children with growth failure due to inadequate secretion of endogenous growth hormone (GH). GH is also known as somatotropin.
Adult Patients: Norditropin injection cartridges (soma-tropin) can replace endogenous GH in adults with GH deficiency who meet either of these criteria:
Adult onset: Patients with GH deficiency, either alone or associated with multiple hormone deficiencies (hypopituitarism), as a result of pituitary disease, hypothalamic disease, surgery, radiation therapy, or trauma.
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Posted by James
The most common complaint in people with fibromyalgia is that they “feel bad”. One third to one half of patients with fibromyalgia relate the onset of the condition to a traumatic experience often can recount the day and time the condition started. Chronic widespread pain not associated with inflammation is considered the hallmark of the disease. Chronic fatigue, cold fingers and feet, impaired memory, frequency and awareness of urination, depression (stipulated as reactive and not clinical), sleep and balance disturbance, muscle twitching, muscles aches, pain, dry mouth, headache and sore throat are all common symptoms associated with fibromyalgia. Symptoms occur daily, but vary in severity. Patients are never symptom free, but at times may reach functional levels in which time they typically see no need for treatment. Symptoms of the condition and the body awareness eventually become a large part of the person’s life. Desires to get better and full awareness of the abnormalities differentiate this entity from depression. A search for normalcy and a focus on the symptoms often aggravate intrafamily relationships and get the affected individual labeled as an “emotional vacuum cleaner” and worsen otherwise minor family issues.
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Posted by Alex
ACUTE ONSET OF HEMIPLEGIA is a common presentation of cerebrovascular accident. Rapid reversal of this focal neurologic deficit may occur with transient ischemic attacks. However, hypoglycemia has been reported only rarely as a cause of reversible motor deficits. We now report the first case of a patient with alternating right and left dense hemiplegia related to episodes of hypoglycemia.
Report of a Case
A 69-year-old African American male with a medical history of hypertension, congestive heart failure, chronic renal insufficiency, anemia, and myocardial infarction in 1988, was diagnosed as having type II diabetes mellitus. One week prior to admission, he was started on glyburide 5 mg orally once a day. There was no prior history of cerebrovascular insufficiency, migraine headache, or seizure disorder. His family history was noncontributory.
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