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In this study, patients with type 2 diabetes and nephropathy received either aliskiren, an oral direct renin inhibitor, or placebo, in addition to the maximal recommended dose of losartan and optimal antihypertensive therapy. Aliskiren was associated with a reduction in the mean urinary albumin-to-creatinine ratio. This direct renin inhibitor may be renoprotective independently of its blood-pressure–lowering effects in this patient population.
In this randomized trial of hypothermia in children with severe traumatic brain injury, severe disability, a persistent vegetative state, or death occurred in 31% of patients who were treated with hypothermia for 24 hours and in 22% of controls. These findings suggest that hypothermia is not a beneficial therapy for children with traumatic brain injury.
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Recently the heparin supply in 12 countries was found to be contaminated with a substance that caused hypotension and, in some cases, death. The contaminant has been identified as oversulfated chondroitin sulfate (OSCS). This study shows that OSCS can activate the kinin–kallikrein pathway and the complement system, which can result in the clinical syndrome.
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In this study of socioeconomic status and health in 22 European countries, mortality was higher in people with less education and lower income, and the magnitude of differences in mortality related to education and income varied among countries. Treatable diseases and diseases caused by smoking or alcohol use accounted for some of the differences in mortality, suggesting that health-related behavior and access to health care contribute to higher mortality in groups of lower socioeconomic status.
New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of patients at risk, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on our current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacologic interventions in its prevention and treatment.
A 59-year-old woman presented with a 6-week history of pain and swelling in her right knee, which necessitated the use of a cane. Two weeks before presenting for care, she began to experience pain in her left knee, followed by the onset of pain and swelling in her left ankle and left wrist. She also noted fatigue and progressive dyspnea on exertion.
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