The impact of glucose-insulin-potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616]

Background

Stopping antipsychotic treatment can interrupt improvement and exacerbate the illness. The reasons for discontinuing treatment during controlled clinical trials were analyzed to explore this phenomenon.

Methods

A post-hoc, pooled analysis was made of 4 randomized, double-blind clinical trials, 24–28 weeks in duration, involving 1627 patients with schizophrenia or a related disorder. Analyses combined all the atypical antipsychotic treatment groups in the studies.

Results

The majority of patients (53%) stopped their treatment at an early stage. Poor psychiatric response along with worsening symptoms was the most frequently given reason for discontinuing the course (36%), which was substantially more common than discontinuation due to poor tolerability of the medication (12%). This phenomenon was corroborated by less improvement in patients who discontinued treatment compared with those who completed, based on the PANSS total scores. Discontinuation due to poor response was, apparently, more predominantly linked to patient perception than to physicians' conclusions alone (80% vs. 20%). Discontinuation due to patient perception of poor response appeared to occur particularly early in the course of treatment. Patients who discontinued due to poor toleration of the medication responded in a more comparable manner with completers.

Conclusion

Discontinuing treatment may lead to exacerbation of symptoms, undermining therapeutic progress. In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Our findings suggest that adherence may be enhanced by effective symptom control, as objectively measured and as subjectively perceived. Such strategies may improve patients' willingness to undertake long-term therapy and increase the likelihood of a better prognosis.     

A new pyeloureteral drainage catheter

We describe a new pyeloureteral drainage catheter that can be used for both genitourinary tract stenting and drainage, as well as tamponade of bleeding from the renal parenchyma or subcutaneous tissue. Primary indications for the use of this catheter and recommendations on insertion techniques are presented. With the exception of one case of minor kinking of the catheter, we have had no complications or failures with this catheter. While insertion through an unprotected tissue track is somewhat difficult, we have had good success introducing the catheter through a 24-F or larger Teflon working sheath. The catheter has excellent patient retention properties. It can be converted from external to internal drainage or vice versa simply and quickly on the ward.     

European cervical cancer screening：experiences and results

1　ＯｖｅｒｖｉｅｗｏｆｆｅｍａｌｅｍａｌｉｇｎａｎｃｉｅｓｉｎＥｕｒｏｐｅＣａｎｃｅｒｉｎｃｉｄｅｎｃｅａｎｄｍｏｒｔａｌｉｔｙｅｓｔｉｍａｔｅｓｆｏｒ 1995ｗｅｒｅｒｅｐｏｒｔｅｄｒｅｃｅｎｔｌｙｆｏｒ 38ｃｏｕｎｔｒｉｅｓｉｎＥｕｒｏｐｅ[1] .Ｔｈｅｒｅｗｅｒｅｅｓｔｉｍａｔｅｄ 2 .6ｍｉｌｌｉｏｎｎｅｗｃａｓｅｓｏｆｃａｎｃｅｒｉｎＥｕｒｏｐｅｉｎ 1995 ,ｒｅｐｒｅｓｅｎｔｉｎｇｏｖｅｒｏｎｅ ｑｕａｒｔｅｒｏｆｔｈｅｗｏｒｌｄｂｕｒｄｅｎｏｆｃａｎｃｅｒｗｈｉｌｅＥｕｒｏｐｅ’ｓｉｎｈａｂｉ…