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Macrolides a cardiac risk?Macrolide antibiotics prolong the QT interval and are therefore thought to increase the risk of potentially fatal arrhythmias. To clarify this issue these researchers studied the users of clarithromycin, roxithromycin, and penicillin V in Denmark between 1997 and 2011.The study cohort included 588,988 courses of roxithromycin, 160,297 courses of clarithromycin, and 4,355,309 courses of penicillin V. The researchers report a significantly increased risk of cardiac death associated with current use of clarithromycin, which is most pronounced among women; no increased risk of cardiac death was found with roxithromycin.Possible confounding factors such as smoking, body mass index and the reasons for the antibiotic use could not be evaluated because of lack of information.BMJ 2014;349:g4930. Comparison of varicose vein treatmentsUltrasound-guided foam sclerotherapy and thermal ablation techniques such as endovenous laser ablation have become widely used alternatives to surgery for the treatment of varicose veins. This report is of a trial comparing the effectiveness and safety of these techniques.798 patients with primary varicose veins were randomised to foam, laser and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success.All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. Quality of life measures were generally similar across the study groups.N Engl J Med 2014;371:1218–1227. Hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetesFailure to achieve treatment targets is common among people with type 2 diabetes. The study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months.Ninety-four adult patients with type 2 diabetes and a raised HbA1C were randomised to receive usual care plus 6 months of telephone coaching focusing on achieving treatment targets and complication screening, or usual care only. The primary outcome was HbA1C at 6 months; secondary outcomes included other physiological and monitoring measures.The intervention group demonstrated improvement in HbA1C, fasting glucose, diastolic blood pressure and physical activity at 6 months. Unfortunately these benefits were not sustained at the 12 month review.Internal Medicine Journal 2014;44:890–897.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

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Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
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View Article PDF

Macrolides a cardiac risk?Macrolide antibiotics prolong the QT interval and are therefore thought to increase the risk of potentially fatal arrhythmias. To clarify this issue these researchers studied the users of clarithromycin, roxithromycin, and penicillin V in Denmark between 1997 and 2011.The study cohort included 588,988 courses of roxithromycin, 160,297 courses of clarithromycin, and 4,355,309 courses of penicillin V. The researchers report a significantly increased risk of cardiac death associated with current use of clarithromycin, which is most pronounced among women; no increased risk of cardiac death was found with roxithromycin.Possible confounding factors such as smoking, body mass index and the reasons for the antibiotic use could not be evaluated because of lack of information.BMJ 2014;349:g4930. Comparison of varicose vein treatmentsUltrasound-guided foam sclerotherapy and thermal ablation techniques such as endovenous laser ablation have become widely used alternatives to surgery for the treatment of varicose veins. This report is of a trial comparing the effectiveness and safety of these techniques.798 patients with primary varicose veins were randomised to foam, laser and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success.All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. Quality of life measures were generally similar across the study groups.N Engl J Med 2014;371:1218–1227. Hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetesFailure to achieve treatment targets is common among people with type 2 diabetes. The study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months.Ninety-four adult patients with type 2 diabetes and a raised HbA1C were randomised to receive usual care plus 6 months of telephone coaching focusing on achieving treatment targets and complication screening, or usual care only. The primary outcome was HbA1C at 6 months; secondary outcomes included other physiological and monitoring measures.The intervention group demonstrated improvement in HbA1C, fasting glucose, diastolic blood pressure and physical activity at 6 months. Unfortunately these benefits were not sustained at the 12 month review.Internal Medicine Journal 2014;44:890–897.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

Macrolides a cardiac risk?Macrolide antibiotics prolong the QT interval and are therefore thought to increase the risk of potentially fatal arrhythmias. To clarify this issue these researchers studied the users of clarithromycin, roxithromycin, and penicillin V in Denmark between 1997 and 2011.The study cohort included 588,988 courses of roxithromycin, 160,297 courses of clarithromycin, and 4,355,309 courses of penicillin V. The researchers report a significantly increased risk of cardiac death associated with current use of clarithromycin, which is most pronounced among women; no increased risk of cardiac death was found with roxithromycin.Possible confounding factors such as smoking, body mass index and the reasons for the antibiotic use could not be evaluated because of lack of information.BMJ 2014;349:g4930. Comparison of varicose vein treatmentsUltrasound-guided foam sclerotherapy and thermal ablation techniques such as endovenous laser ablation have become widely used alternatives to surgery for the treatment of varicose veins. This report is of a trial comparing the effectiveness and safety of these techniques.798 patients with primary varicose veins were randomised to foam, laser and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success.All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. Quality of life measures were generally similar across the study groups.N Engl J Med 2014;371:1218–1227. Hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetesFailure to achieve treatment targets is common among people with type 2 diabetes. The study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months.Ninety-four adult patients with type 2 diabetes and a raised HbA1C were randomised to receive usual care plus 6 months of telephone coaching focusing on achieving treatment targets and complication screening, or usual care only. The primary outcome was HbA1C at 6 months; secondary outcomes included other physiological and monitoring measures.The intervention group demonstrated improvement in HbA1C, fasting glucose, diastolic blood pressure and physical activity at 6 months. Unfortunately these benefits were not sustained at the 12 month review.Internal Medicine Journal 2014;44:890–897.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

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