Showing papers by "Ochsner Medical Center published in 2004"
TL;DR: Inhaled insulin appears to be effective, well tolerated, and well accepted in patients with type 2 diabetes and provides glycemic control comparable to a conventional subcutaneous regimen.
Abstract: OBJECTIVE — Glycemic control using inhaled, dry-powder insulin plus a single injection of long-acting insulin was compared with a conventional regimen in patients with type 2 diabetes, which was previously managed with at least two daily insulin injections. RESEARCH DESIGN AND METHODS — Patients were randomized to 6 months’ treatment with either premeal inhaled insulin plus a bedtime dose of Ultralente ( n = 149) or at least two daily injections of subcutaneous insulin (mixed regular/NPH insulin; n = 150). The primary efficacy end point was the change in HbA 1c from baseline to the end of study. RESULTS — HbA 1c decreased similarly in the inhaled (−0.7%) and subcutaneous (−0.6%) insulin groups (adjusted treatment group difference: −0.07%, 95% CI −0.32 to 0.17). HbA 1c CONCLUSIONS — Inhaled insulin appears to be effective, well tolerated, and well accepted in patients with type 2 diabetes and provides glycemic control comparable to a conventional subcutaneous regimen.
302 citations
University of Massachusetts Medical School1, Harvard University2, Cubist Pharmaceuticals3, University of Wisconsin-Madison4, Ochsner Medical Center5, University of Washington6, University of Maryland, Baltimore7, University of Pittsburgh8, University of Texas MD Anderson Cancer Center9, University of Minnesota10, Wayne State University11
TL;DR: The bulk of the evidence supports the concept that, in treating endocarditis and meningitis, it is important to use antibacterial agents with in vitro bactericidal activity.
Abstract: Background. Although a considerable amount of research has gone into the study of the role of bactericidal versus bacteriostatic antimicrobial agents in the treatment of different infectious diseases, there is no accepted standard of practice. Methods. A panel of infectious diseases specialists reviewed the available literature to try to define specific recommendations for clinical practice. Results. In infections of the central nervous system, the rapidity with which the organism is killed may be an important determinant, because of the serious damage that may occur during these clinical situations. The failure of bacteriostatic antibiotics to adequately treat endocarditis is well documented, both in human studies and in animal models. Conclusion. The bulk of the evidence supports the concept that, in treating endocarditis and meningitis, it is important to use antibacterial agents with in vitro bactericidal activity. This conclusion is based on both human and animal data. The data to support bactericidal drugs' superiority to bacteriostatic drugs do not exist for most other clinical situations, and animal models do not support this concept in some situations. Clinicians should be aware that drugs that are bacteriostatic for one organism may in fact be bactericidal for another organism or another strain of the same organism.
206 citations
TL;DR: A verapamil SR-based antihypertensive treatment strategy is an alternative to a &bgr;-blocker–based strategy in adults with CAD and diabetes and resulted in similar rates of cardiovascular outcomes in coronary artery disease (CAD) patients with diabetes.
Abstract: The INternational VErapamil SR-Trandolapril study (INVEST) had 6400 of 22 576 (28.3%) participants with diabetes at entry. The objectives of this prespecified analysis were to compare antihypertensive treatment strategies in the diabetes cohort (verapamil SR-based [n=3169] versus atenolol-based [n=3231]) and identify predictors for the primary outcome (a composite of first occurrence of all-cause death, nonfatal myocardial infarction, or nonfatal stroke). During a mean follow-up of 2.7 years, 913 participants with diabetes experienced a primary outcome event, with no significant difference between treatment strategies (14.6%, verapamil SR versus 13.9%; atenolol hazard ratio, 1.05; 95% confidence interval, 0.92 to 1.19). Risk for the primary outcome increased with presence of baseline heart failure, renal impairment, US residency, age, previous stroke/transient ischemic attack, previous myocardial infarction, peripheral vascular disease, or smoking. High systolic and diastolic pressures during follow-up also were associated with increased risk, as were low diastolic pressures. Antihypertensive treatment with a verapamil SR or atenolol strategy resulted in similar rates of cardiovascular outcomes in coronary artery disease (CAD) patients with diabetes. Thus, a verapamil SR-based antihypertensive treatment strategy is an alternative to a β-blocker–based strategy in adults with CAD and diabetes.
128 citations
TL;DR: Results showed that l-arginine stimulates cell migration through NO and FAK dependent pathways and that combination therapy with arginine and BSC may enhance intestinal restitution via separate and convergent pathways.
Abstract: Background: l-Arginine is a nutritional supplement that may be useful for promoting intestinal repair. Arginine is metabolised by the oxidative deiminase pathway to form nitric oxide (NO) and by the arginase pathway to yield ornithine and polyamines.
Aims: To determine if arginine stimulates restitution via activation of NO synthesis and/or polyamine synthesis.
Methods: We determined the effects of arginine on cultured intestinal cell migration, NO production, polyamine levels, and activation of focal adhesion kinase, a key mediator of cell migration.
Results: Arginine increased the rate of cell migration in a dose dependent biphasic manner, and was additive with bovine serum concentrate (BSC). Arginine and an NO donor activated focal adhesion kinase (a tyrosine kinase which localises to cell matrix contacts and mediates β1 integrin signalling) after wounding. Arginine stimulated cell migration was dependent on focal adhesion kinase (FAK) signalling, as demonstrated using adenovirus mediated transfection with a kinase negative mutant of FAK. Arginine stimulated migration was dependent on NO production and was blocked by NO synthase inhibitors. Arginine dependent migration required synthesis of polyamines but elevating extracellular arginine concentration above 0.4 mM did not enhance cellular polyamine levels.
Conclusions: These results showed that l-arginine stimulates cell migration through NO and FAK dependent pathways and that combination therapy with arginine and BSC may enhance intestinal restitution via separate and convergent pathways.
115 citations
Duke University1, Leeds General Infirmary2, Imperial College London3, Bayer4, Vita-Salute San Raffaele University5, Katholieke Universiteit Leuven6, University of Antwerp7, University of Paris8, St George's Hospital9, University of Milan10, University of Pisa11, University of Trieste12, Sapienza University of Rome13, Radboud University Nijmegen14, VU University Amsterdam15, Gdańsk Medical University16, Medical University of Warsaw17, Karolinska Institutet18, Washington University in St. Louis19, Tampa Bay Water20, University of Nebraska–Lincoln21, McGill University22, Dartmouth College23, University of Florida24, Ochsner Medical Center25, Virginia Mason Medical Center26, Tulane University27, Harvard University28, Veterans Health Administration29, University of Illinois at Chicago30, University of Alabama at Birmingham31, New York University32, Yeshiva University33
TL;DR: Vardenafil improves EF in men with ED irrespective of investigator-determined classification and baseline ED severity, and the greatest improvements relative to placebo were noted in patients with more severe ED.
40 citations
TL;DR: The first known case of primary cutaneous cryptococcosis in a lung transplant recipient, a 57-year-old man, who underwent left single-lung transplantation and presented with a nonhealing ulcer 50 months later is reported.
Abstract: :Cryptococcal skin lesions are found in 10 to 15% of patients with disseminated cryptococcosis. Primary skin inoculation by Cryptococcus neoformans is rare but has been reported. We report the first known case of primary cutaneous cryptococcosis in a lung transplant recipient. Our patient, a
22 citations