A study by the Department of Veterans Affairs has found laboratory monitoring and duration of therapy to be “sub-optimal” for patients with hepatitis C infection. An “excessive duration” of therapy led to increased costs and exposed patients to “unnecessary” potential toxicity, the researchers say.
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The researchers emphasized that excessive treatment exposes patients to unnecessary potential toxicity. These findings underscore the need for practitioners to adhere to the recommended guidelines for discontinuing therapy.

A new class of drugs called incretin mimetics is offering hope to patients with type-2 (non-insulin-dependent) diabetes who have not been able to control their blood glucose levels after taking common oral regimens. Patients in phase III trials who received the investigational drug exenatide (synthetic extendin-4, Amylin/Eli Lilly) had lower blood glucose levels as well as improvements in markers of beta-cell function—and they lost weight to boot.

Researchers presented their findings from three studies at the 64th Annual Scientific Sessions of the American Diabetes Association.

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A study from 2002 found that more than seven hours of sleep each night was associated with a shorter life span. When the subjects slept longer than seven hours a night, the risk of dying in that period rose. For people who slept for an average of eight hours each night, the chance of death rose by 12%. canadian antibiotics

Other researchers have found that life expectancy declines as the amount of sleep falls below seven hours but does not drop as steeply as with eight hours or more. Some think that people who sleep longer might have illnesses that cause fatigue and earlier death.

The FDA and Genentech, Inc., have issued an important warning to health care providers about bevacizumab (Avastin™) in relation to an increased risk of cerebrovascular accidents, myocardial infarctions, transient ischemic attacks, and angina. The risk of fatal arterial thrombotic events is also increased.

In studies of patients with metastatic colorectal cancer, the risk of a serious arterial thrombotic event was approximately two-fold higher in patients receiving infusional 5-fluorouracil-based chemotherapy plus the bevacizumab.

A revised package insert with more details on arterial thromboembolic events is under development.

The U.S. Food and Drug Administration (FDA) has approved trospium chloride tablets (Sanctura™, Pliva) for the treatment of overactive bladder. Symptoms include urge urinary incontinence, urgency, and urinary frequency.

As a quaternary ammonium compound, this agent belongs to a class of anticholinergic compounds known as muscarinic receptor antagonists. These compounds relax smooth muscle tissue found in the bladder, thus decreasing bladder contractions. Overactive or unstable detrusor muscle function is believed to be the cause of overactive bladder. Sanctura™ is currently marketed as a prescription drug in Europe. canadian discount drugs

Patients with urinary or gastric retention, uncontrolled narrow-angle glaucoma, or hypersensitivity to the product should not use it.

Sanctura™ is scheduled to be available for sale in the U.S. in late 2004.

A post hoc analysis of data from the Study on Cognition and Prognosis in the Elderly (SCOPE) suggests that candesartan cilexitil (Generic Atacand, AstraZeneca), an angiotensin receptor blocker, significantly reduces major cardiovascular events in the elderly, the cardiovascular mortality rate, and the total mortality rate.

At the annual meeting of the European Society of Hypertension, the researchers said that their reanalysis reflected the original intent of the study—which was to compare candesartan and placebo; for ethical reasons, however, candesartan and other antihypertensive treatments were also compared.

Patients in the three-step trial first received 8 mg of candesartan or placebo. In the second step, they received 16 mg of candesartan or placebo. In the third step, another drug could be added, including open-label antihypertensive treatment.

The researchers compared outcomes among the 1,253 drug candesarta and 845 placebo patients who did not receive addon therapy. The final difference in blood pressure reduction was 4.7 mm Hg in the treatment group and 2.6 mm Hg in the placebo group. The relative risk of a major cardiovascular event was 0.68; of cardiovascular mortality, 0.71; and of total mortality, 0.73.

It appears that hormone replacement therapy might be more dangerous than thought for older women with diabetes. Doctors studied 423 postmenopausal women who had atherosclerosis. The women who had abnormal glucose tolerance (diabetes or prediabetes) and who took hormones showed changes in their blood that suggested a higher risk of heart disease. The study was based on an analysis of the results of the Women’s Health Initiative.
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In another report from Yale University, doctors said younger women just entering menopause might be at risk for developing heart disease from the treatment.