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Although we have recently enjoyed the FDA approval of two agents for treatment of diabetic peripheral neuropathic pain (duloxetine [Cymbalta], pregabalin [Lyrica]), as yet we have no treatment for diabetic peripheral neuropathy itself.
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Several classes of pharmacological agents have demonstrated benefits in hypertensive patients with CAD, but most published studies have, of necessity, enrolled only patients with an elevated or borderline elevated blood pressure. Recent clinical trials have demonstrated benefits for both angiotensin-converting enzyme inhibitors and calcium channel blockers (in patients with coronary artery disease with relatively normal or borderline elevated blood pressures.
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These studies note that: . . .sub-clinical thyroid dysfunction is a common clinical problem with many controversial issues regarding screening, evaluation, and management.
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Moderate consumption of alcohol in women (about 1 drink daily) was associated with better cognitive scores at 2-year average follow-up in women aged 70 to 81 in the Nurses Health Study compared to nondrinkers, while excessive drinkers did not show any association with either improvement or decline.
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Sleep apnea can exacerbate diabetes, and Continuous Positive Airway Pressure (CPAP) can improve glucose control in diabetic patients with sleep apnea.
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Pregabalin has been approved for the management of neuropathic pain. It is the second drug to be approved for the treatment of painful diabetic neuropathy (after duloxetine) and the first drug to be approved for both diabetic neuropathy and postherpetic neuralgia.
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The lead II rhythm strip shown in the Figure was taken from a patient in atrial flutter. Although difficult to see due to artifact in the baseline, an underlying sawtooth pattern is nevertheless present. In addition, there is something distinctly unusual about this example of atrial flutter. What is it? What clinical diagnosis is suggested as a possible cause of this ECG finding?
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Solifenacin succinate has been approved for the treatment of overactive bladder, the third new agent to be approved for this indication in the last 7 months.
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In selected patients with community-acquired pneumonia, outpatient treatment with levofloxacin was as safe and effective as hospitalization.
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Administration of sterile viable Trichuris suis eggs to patients with active Crohns disease led to impressive clinical improvement.
