Khairulorama. Life and Work Notes.

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..Journals update..

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1. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial

Lancet. 2007; 370(9586):493-503

“These data support the use of anticoagulation therapy for people aged over 75 who have atrial fibrillation, unless there are contraindications or the patient decides that the benefits are not worth the inconvenience”

2. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes.

N Engl J Med. 2007; 356(24):2457-71

Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance.

3. Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review.

BMJ. 2007; 335(7622):711

Electrocardiographic criteria should not be used to rule out left ventricular hypertrophy in patients with hypertension.

4.Prescribing amiodarone: an evidence-based review of clinical indications.

JAMA. 2007; 298(11):1312-22

Amiodarone should be used with close follow-up in patients who are likely to derive the most benefit, namely those with atrial fibrillation and left ventricular dysfunction, those with acute sustained ventricular arrhythmias, those about to undergo cardiac surgery, and those with implantable cardioverter-defibrillators and symptomatic shocks.

Amiodarone has a number of serious adverse effects, including corneal microdeposits (>90%), optic neuropathy/neuritis (< or =1%-2%), blue-gray skin discoloration (4%-9%), photosensitivity (25%-75%), hypothyroidism (6%), hyperthyroidism (0.9%-2%), pulmonary toxicity (1%-17%), peripheral neuropathy (0.3% annually), and hepatotoxicity (elevated enzyme levels, 15%-30%; hepatitis and cirrhosis, <3% [0.6% annually]).

5.Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis.

JAMA. 2007; 298(2):194-206

Incretin therapy offers an alternative option to currently available hypoglycemic agents for nonpregnant adults with type 2 diabetes, with modest efficacy and a favorable weight-change profile. Careful postmarketing surveillance for adverse effects, especially among the DPP4 inhibitors, and continued evaluation in longer-term studies and in clinical practice are required to determine the role of this new class among current pharmacotherapies for type 2 diabetes.


Written by M Khairul Z

January 10, 2008 at 12:30 am

Posted in Medical Life

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