Pharmacologic treatment of fibromyalgia

Fibromyalgia is a syndrome of widespread pain, nonrestorative sleep, disturbed mood, and fatigue. Optimal treatment involves a multidisciplinary approach with a team of health care providers using pharmacologic and nonpharmacologic treatment. Because of the heterogeneity of the illness, management should be individualized for the patient. Pharmacologic treatment should address issues of pain control, sleep disturbance, fatigue, and any underlying coexisting mood disorder. Nonpharmacologic treatment should include patient education, a regular exercise and stretching program, and cognitive behavioral therapy. All of these are essential to improving functional capacity and quality of life. This review provides general guidelines in initiating a successful pharmacologic treatment program for patients with fibromyalgia.     

Soluble triggering receptor expressed on myeloid cells-1 in acute respiratory infections.

Levels of the soluble form of the triggering receptor expressed on myeloid cells (sTREM)-1 are elevated in severe sepsis. However, it is not known whether sTREM-1 measurements can distinguish milder bacterial infections from noninfectious inflammation. The present authors studied whether serum sTREM-1 levels differ in community-acquired pneumonia, exacerbations of chronic obstructive pulmonary disease (COPD), asthma and controls, and whether sTREM-1 may be used as a surrogate marker for the need for antibiotics. Serum sTREM-1 levels in 150 patients with pneumonia, COPD and asthma exacerbations and 62 healthy controls were measured. Serum sTREM-1 levels were significantly elevated in pneumonia (median 295.2 ng x mL(-1)), COPD (280.3 ng x mL(-1)) and asthma exacerbations (184.0 ng x mL(-1)) compared with controls (83.1 ng x mL(-1)). Levels were higher in pneumonia and Anthonisen type 1 COPD exacerbations than in type 2 and 3 COPD and asthma exacerbations. The area under the receiver operating characteristics curve for sTREM-1 as a surrogate marker for the need for antibiotics was 0.77. Serum levels of the soluble form of the triggering receptor expressed on myeloid cells-1 were elevated predominantly in pneumonia and Anthonisen type 1 COPD exacerbations versus type 2 and 3 chronic obstructive pulmonary disease exacerbations, asthma and controls. Serum levels of the soluble form of the triggering receptor expressed on myeloid cells-1 has moderate but insufficient accuracy as a surrogate marker for the need for antibiotics in lower respiratory tract infections.     

益气补血活血法治疗阳痿病57例临床观察

目的:观察中医益气补血活血法治疗阳痿病的临床疗效。方法:将符合诊断的114例阳痿病患者随机分为治疗组和对照组各57例,患者入院后分别进行阴茎硬度测试和FSH(促滤泡激素)、HCG(人绒毛膜促性腺激素)、PRL(泌乳素)测定。对照组予温肾壮阳中药加常规西药治疗;治疗组予自拟益气补血活血法方药加减治疗,并辅以精神疏导。对两组病例的疗效进行总结和随访。结果:114例病例全部得到随访,治疗组治愈率63.12%,总有效率91.23%;对照组分别为50.87%;68.41%。两组比较,治疗组优于对照组(P<0.05)。结论:采用中医益气补血活血法治疗阳痿病疗效显著,尤对血管性阳痿病显效。     

重视老年高血压病人的非药物治疗

针对老年高血压病人的治疗，要积极采取药物和非药物治疗措施，既要保持血压稳定在正常或接近正常水平，又要最大限度地降低心脑血管病的并发率、病残率和死亡率。在临床工作中，除采取必要的药物控制血压外，帮助老年高血压患者安排好日常生活，树立正确地防治观念，养成按时作息和定时排便的习惯；合理的饮食，限制食盐量，戒烟戒酒，控制热量摄入；以及根据老年高血压病人的身体情况，选择有规律的适当运动，坚持循序渐进的锻炼：同时，要保持乐观开朗的心怀和积极健康的心态，生活要安排张弛有度，又多姿多彩，努力营造一个感情融洽，和睦相处的温馨美好的家庭环境。这些非药物治疗措施，都能取得了令人满意的效果，是治疗老年高血压病的最佳保健良方。