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Roshini Claire Anthony, 4 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Tristan Manalac, 19 May 2018
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
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Tricyclic antidepressants help ease migraine

20 Jul 2017

Tricyclic antidepressants (TCA) significantly improve headache in adults with migraine compared with placebo, according to a new meta-analysis. Furthermore, TCAs have comparable efficacies with selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).

Pooled data from seven trials showed that TCAs were significantly more effective than placebo (standardized mean difference [SMD], -0.75; 95 percent CI, -1.05 to -0.46; p<0.00001). Similarly, patients receiving TCAs were more likely to experience ≥50 percent decrease in headache (risk ratio [RR], 1.40; 0.89 to 2.20; p=0.14).

Patients who received the TCA amitriptyline had experienced significantly greater improvements at 6 months (SMD, -0.77; -1.34 to -0.20; p=0.008) than at 1 month (SMD, -0.53; -0.97 to -0.10; p=0.02) indicating increasing efficacy of the medication over time.

Withdrawal due to adverse events was marginally higher in groups that received TCA than placebo (RR, 1.73; 1.00 to 2.99; p=0.05).

Compared to SSRIs, amitriptyline did not have significantly greater impacts on headache burden (SMD, 0.16; -0.32 to 0.63; p=0.52). Similarly, the efficacy of amitriptyline was comparable to that of SNRIs (SMD, -0.13; -0.51 to 0.25; p=0.51).

Based on only one eligible study, there was no significant difference in the response rates for SSRIs and amitriptyline (RR, 1.08; 0.41 to 2.83; p=0.87). However, withdrawal rate because of adverse events was modestly higher for amitriptyline than SSRIs or SNRIs (SMD, 2.85; 0.97 to 8.41; p=0.06).

The meta-analysis involved randomized controlled trials that compared TCAs with placebo or amitriptyline with other antidepressants. Those that were animal trials, employed combination therapies and enrolled patients with secondary headaches were excluded.

Outcomes were migraine frequency and index, treatment response rate, and withdrawal rate. The Cochrane Collaboration tool was used to evaluate methodological quality of the trials.

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Most Read Articles
Roshini Claire Anthony, 4 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Tristan Manalac, 19 May 2018
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
2 days ago
Patients with inflammatory bowel disease are at increased risk of developing acute myocardial infarction (AMI) or heart failure, although the prevalence of traditional risk factors for such cardiovascular disorders appears to be low, as reported in a recent study.
3 days ago
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.