“for initial treatment in adolescents and adults age over 12 monotherapy with an intranasal steroid is preferred: combining it with an oral antihistamine confers no additional benefit”
For moderate to severe allergic rhinitis, adding an intranasal antihistamine to an intranasal steroid can be beneficial.
An intranasal corticosteroid if used regularly is the most effective treatment for all allergic rhinitis symptoms
High blood sugar and oral treatment
When diagnosed with high blood sugar without ketoacidosis or hyperosmolar symptoms treatment with high dose oral medication may work and lessen the need for insulin therapy.
In an article in J. Clin Endocriology from jan 2016 100 persons with high blood sugar were put on 2 regimens of peroral drugs:
1. Glipizide 10mg extended release tablet.
2. 5mg Saxagliptin and 2000 mg of metformin.
Median fasting blood sugar was 19 mmol/L and A1C 11%
All patients rec. general info and were followed up in a diabetic center.
Nearly all pat. got better values and median fasting was 7.2 mmol/L and A1C 7%
Frequency of hypoglycemia was higher in the glipizide group but in neither were there serious sequelae or sugar under 2.8.
In Journal Watch april 2017 the effects og Testosterone gel on deficient men with symptoms provided no effect on cognition. Effect on coronary artery plaques: median noncalcified plaque volume increased significantly in the testo group.
Another randomized trial looking at anaemia and testo treatment increased Hb significantly in users. Might low testo be a cause of anaemia in some older men where another reason was not found?
Another T trial measured bone density and found significant increases but was to short to assess fracture risk.
Another industry funded Testo trial with about 300 men treated for 3 years changes in carotid intima-media thickness and coronary calcium score were similar in treatment and placebo group. Concerning muscle performance: chest-press but not leg-press strength increased. The difference was small and clinical meaningfulnes remains unclear.
A previous report on sexual function showed modest effect on sexual function.
A connection has been known but the scientific basis has not been strong. It is important information for women as negative consequences are often associated with contraceptive pills.
The pill has positive effects besides protecting against pregnancy says Elisabeth Angvall Lundqvist professor in gynekology.
The study also shows that the risk of uterine cancer lessens the longer period a woman takes the pill. After 5 years the risk is 25% less and after 10 years the risk is 50% less. After women stop taking the pill some prophylactic effect continues for at least 30 years. The exact reason for this effect is not known.
People with post traumatic brain damage and fibromyalgia who were treated in pressure chamber had much lesser symptoms of muscle pains.A change in brain activity could also be demonstrated.
A possible explanation is that the pressure induces neuroplasticity that repairs deranged function. Quality of life in people who have had stroke has even been seen.
The hypothesis was that the treatment would correct the abnormal brain activity that is seen in fibromyalgia a disease that causes muscle pain in many parts of the body.
Total freedom from symptoms
For two months patients with fibromyalgi got treatment in a pressure chamber and and all patients but three had lesser pain. A change in activity in certain areas of the brain that are connected to pain impulses could also be seen.
“We have seen that where fibromyalgia has been caused by traumatic brain injury a total regress of symptoms was seen that kept after the treatment. If the reason for the fibromyalgi was another for example an infection a follow up treatment is probably necessary said the doctor Shai Efrati chief for Sago, center for hyberbaric medicine and research in Israel and one of the authors of the study in a press release from Rice University in Texas.
48 women with fibromyalgia took part in the prospective clinical study. All got treatment in pressure chamber at 2 athmospheric pressure for 90 minutes 5 days a week for 2 months. For study og brain activity a SPECT was used.
As the study was small the scientists point out that more studies need to be done to verify the results.
Design, Setting, and Participants Randomized, double-blind, placebo-controlled clinical trial conducted from 2008 to 2013 in a large integrated health care delivery system in Northern California. Adults (n=269) with radicular pain for 3 months or less, an Oswestry Disability Index (ODI) score of 30 or higher (range, 0-100; higher scores indicate greater dysfunction), and a herniated disk confirmed by magnetic resonance imaging were eligible.
results: Pain did not change significantly, working ability was slightly better. Hardly benefit in giving steroids orally for acute disc prolaps.
Primary prevention with lipid lowering drugs and long term risk of vascular events in older people: population based cohort study
BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h2335 (Published 19 May 2015)
Participants 7484 men and women (63%) with mean age 73.9 years and no known history of vascular events at entry. Mean follow-up was 9.1 years.
Main outcome measures Adjusted hazard ratios of coronary heart disease and stroke in baseline lipid lowering drug users compared with non-users, calculated using multivariable Cox proportional hazard models adjusted for numerous potential confounding factors. Hazard ratios were estimated for use of any lipid lowering drug and for statin and fibrate separately.
Results Lipid lowering drug users were at decreased risk of stroke compared with non-users (hazard ratio 0.66, 95% confidence interval 0.49 to 0.90); hazard ratios for stroke were similar for statin (0.68, 0.45 to1.01) and fibrate (0.66, 0.44 to 0.98). No association was found between lipid lowering drug use and coronary heart disease (hazard ratio 1.12, 0.90 to 1.40). Analyses stratified by age, sex, body mass index, hypertension, systolic blood pressure, triglyceride concentrations, and propensity score did not show any effect modification by these variables, either for stroke or for coronary heart disease.
Conclusion
In a population based cohort of older people with no history of vascular events, use of statins or fibrates was associated with a 30% decrease in the incidence of stroke.
This study was done in 3 cities in France
Stress does not cause obesity
For a long time scientists have suspected that stress can cause obesity by redistributing fat depots. A new study puts this in doubt according to Annika Rosengren in “Dagens medicin” a swedish publication.
This study was large, 125.000 people from 17 different countries. Levels of stress did not seem to cause obesity. A variety of factors were analyzed.