Migraine treatment with nicardipine

A novel calcium entry blocker, nicardipine, has been tested using a dosage of 20 mg twice a day against placebo on 30 patients suffering from migraine without aura, according to a double-blind, cross-over design; overall duration of the study was four months (two with nicardipine and two with placebo). Migraine parameters such as monthly frequency, mean intensity and mean duration of attacks were monitored. Two indexes were also calculated: index A (monthly frequency x mean intensity) and index B (monthly frequency x mean intensity x mean duration). All the parameters considered and the two indexes showed a marked and significant improvement after nicardipine treatment in comparison to both placebo and pre-study scores. Detailed analysis of the cross-over results showed that improvement obtained with nicardipine lasted some time after the drug was discontinued. Nicardipine did not alter the blood and attention tests performed and caused few side effects.     

Leishmaniasis--oral treatment with hexadecylphosphocholine

Hexadecylphosphocholine (HDPC, Miltefosine, Impavido) was synthesized at the Max-Planck-Institut für Biophysikalische Chemie in G?ttingen, Germany and successfully used for the therapy of cancer metastases. At the Institute of General and Tropical Hygiene of G?ttingen University the antiparasitic efficacy--earlier mentioned by Croft et al. (1987)--could be established for the first time in animals after oral administration. In India Impavido has been recently registered for the treatment of visceral leishmaniasis as the first oral medication in this indication. Clinical studies in India--actually a phase IV study is running--and Columbia (cutaneous leishmaniosis) demonstrated the excellent efficacy of this oral treatment also in patients with Antimon resistance. The cure rates are above 90% with low side effects (Impavido twice 50 mg capsules daily over 28 days).     

Long-term treatment with slow-release frusemide compared with thiazide treatment in arterial hypertension

The effect of 30 mg/day slow-release frusemide given orally for 12 months was studied in 64 patients previously treated with thiazides for mild to moderate essential hypertension. Frusemide had a significant antihypertensive effect (P less than 0.001), and compared to thiazides significantly reduced fasting serum glucose (P less than 0.015), haemoglobin A1c (P less than 0.025), albumin (P less than 0.025) and serum calcium (P less than 0.025), and significantly increased serum sodium and chloride concentrations (P less than 0.0001). There was also a non-significant trend for frusemide to reduce serum total cholesterol, triglycerides and urate, and to increase serum potassium. Frusemide was well tolerated in all but three patients. It is concluded that slow-release frusemide has a comparable antihypertensive effect to that of thiazide diuretics, but has fewer metabolic side-effects, and should be used in-preference to thiazides for the treatment of arterial hypertension when a diuretic is indicated.     

Compliance with hypertension treatment

Along with advances in the detection and treatment of hypertension has come a greater focus on methods for long-term control. Extremely important for such control is patient compliance with prescribed drug regimens and life-style practices. Several simple, fairly reliable methods for detecting patients with adherence problems and for improving compliance are available to the clinician, as outlined here by Ms McDonald and Dr Grimm.     

小儿毛细支气管炎抗感染治疗的探讨

目的探讨小儿毛细支气管炎是否需要使用抗生素或抗病毒治疗。方法 111例毛细支气管炎患儿随机分为非抗感染组、抗病毒组和抗生素组。三组均常规给予按需吸氧、吸入沙丁胺醇、普米克令舒及口服孟鲁司特等治疗,抗病毒组加用利巴韦林静滴,抗生素组加用头孢曲松静滴。观察三组间的退热天数、平喘天数和住院天数以及治疗后出现白细胞下降、腹泻等发生情况的差异。结果非抗感染组与抗病毒组和抗生素组的退热天数分别为(3.24±1.52)d、(3.13±2.00)d和(3.02±2.14)d;平喘天数分别为(5.52±1.38)d、(5.13±2.01)d和(5.24±1.83)d,非抗感染组与另两组比较,无显著差异(P均>0.05);而住院天数分别为(5.55±1.44)d、(5.42±2.11)d、(7.32±3.31)d,非抗感染组与抗生素组比较,差异有统计学意义(t=-2.918,P<0.05);发生白细胞计数下降分别为3/35例(8.57%)、8/38例(21.05%)、和4/38例(10.53%),非抗感染组与另两组比较,无显著差异(P均>0.05);出现腹泻分别为5/35例(14.28%)、6/38例(15.79%)、14/38例(36.84%),非抗感染组与抗生素组比较,差异有统计学意义(χ2=4.795,P<0.05)。结论小儿毛细支气管炎如果没有明显的细菌感染证据或存在潜在心肺疾病,不需给予抗病毒及抗生素治疗。     

针灸治疗鸡眼

鸡眼是常见病、多发病,也是临床上用药难以治愈的一种顽固性疾病,用激光、手术治疗也很难根治。笔者自1993年至今采用针灸治疗鸡眼2 89例,疗效显著,现总结如下。1　一般资料　　共治疗鸡眼2 89例,男2 16例,女73例,年龄最大的75岁,最小的12岁;病程最短0 .5a ,最长的2 0a。本病多发于足趾、足底、手指等部位。单足单个91例,单足多个79例,双足单个60例,双足多个3 5例,单手13例,双手11例。2　治疗方法　　病人取仰卧或伏卧位或坐位,局部用碘酒和酒精严格消毒后,取2cm长的毫针,根据鸡眼的大小决定针数,一般5根～9根不等,围鸡眼周围快速刺入,方向…     

骨质疏松症伴骨关节炎的康复治疗

骨质疏松症与骨关节炎有着密切的关系。骨质疏松伴骨关节炎好发于负重大、活动多的关节,多表现为受累关节的疼痛、活动受限,晚期可出现关节的畸形。康复原则为改善骨质疏松、缓解疼痛、提高运动功能。本文回顾了骨质疏松伴骨关节炎的表现、诊断及治疗,重点介绍了康复治疗方法。     

高血压合并糖尿病的治疗方法选择

1 病例 患者,男性,70岁。因患糖尿病和高血压10年入院。最高血压为180/90mmHg。经口服降压药后,血压控制在140/80mmHg左右。患病以来,血糖一直未得到理想控制。3年前出现双下肢水肿,同时查血发现肾功能异常。3年前患脑梗塞,