Dr. Raj santan. k Prof. Dr. G. Vasumathi unit

stanley medical college

Medicine Journal updates

clindamycin versus trimethoprim- sulfamethoxazole for uncomplicated skin infections

There was no significant difference between clindamycin and tmp-smx with respect to either efficacy or side effect profile in both children and adults.

NEJM-MARCH,19,2015

Efficacy and safety of canagliflozin when used in conjunction with insulin therapy in type 2 DM

Canagliflozin when added to insulin therapy improved glycemic control and decreased body weight

S.E: genital mycotic infections, uti diabetes care , 2015

BLOOD PRESSURE SHOULD BE MEASURED IN BOTH ARMS

DIFFERENCE >10 mmhg IN INTER ARM BLOOD PRESSURE LINKED TO GREATER RISK OF FUTURE CARDIOVASCULAR EVENTS.

AMERICAN JOURNAL OF MEDICINE,MARCH

SPUTUM BACTERIOLOGY AND ANTI BIOTIC SENSITIVITY PATTERN OF PATIENTS HAVING ACUTE EXACERBATION OF COPD IN INDIA

Streptococcus pneumoniae is the most common pathogen in patients with AECOPD.

Piperacillin +Tazobactum should be the first choice empirical antibiotic.

Quinolones are less effective journal of pulmonary and respiratory medicine, january

26,2015

EFFICACY OF PIRFENIDONE FOR IDIOPATHIC PULMONARY FIBROSIS

Pirfenidone reduces the rate of annual FVC decline in patients with IPF.

Pirfenidone has well-established anti fibrotic and anti inflammatory properties

 downregulates the production of growth factors and procollagens I and II.

LOW RISK DIET AND LIFE STYLE HABITS IN THE PRIMARY PREVENTION OF MI IN MEN

Almost 4 out of 5 MI in men may be preventable with a combined low risk behaviour.

JACC,FEBRUARY,17,2015.

Low risk behaviour :

1.Healthy diet2.Moderate alcohol consumption

10-30g/day3.No smoking4.Being physically active,walking

/bicycling>=40mins/day and exercising>=1 hour/week

5.No abdominal adiposity(waist circumference <95 cm.)

IVABRADINE

Approved for treatment of chronic heart failure.

Indicated to reduce the risk of hospitalization for worsening heart failure in patients with :

Stable , symptomatic chronic heart failure with lvef <=35%, who are in sinus rhythm with resting heart rate >=70 beats / minute and either on maximal tolerated dose of beta blockers or in whom beta blocker is contrindicated

FDA approval, APRIL,2015.

M.0.A OF IVABRADINE

Inhibits if channels

Recommended dosage: 5 mg b.d 2

weeks

7.5 mg b.d

MONGERSEN:AN ORAL SMAD -7 ANTI SENSE OLIGONUCLEOTIDE AND CROHNS DISEASE

Crohns disease

High levels of SMAD 7

Reduced levels of TGF –BETA ( immuno suppressive cytokine)

NEJM-MARCH,19,2015

Prednisolone or pentoxyfylline for alcoholic hepatitis

Pentoxyfylline did not improve survival in patients with alcoholic hepatitis

Prednisolone was associated with a reduction in 28 day mortality that did not reach significance and no improvement in outcomes at 90 days or 1 year

NEJM, APRIL 23, 2015

The Path to an Angiotensin Receptor Antagonist-Neprilysin Inhibitor in the Treatment of Heart Failure

This new molecule is named LCZ-696,is a combination of ARB and neprilysin inhibitor

Neprilysin is a zinc-dependent  metalloprotease  that cleaves peptides at the amino side of hydrophobic residues and inactivates several peptide hormones 

JACC MARCH 2015

Thank you