No abstract

The efficacy and safety of aceclofenac (100 mg bid), a new nonsteroidal anti-inflammatory/anti-rheumatic agent, were compared with those of naproxen (500 mg bid) in a multi-centre, twelve-week, randomized, double-blind, parallel-group clinical trial in outpatients with active osteoarthritis of the knee. 190 patients received aceclofenac, 184 naproxen. The two treatments were compared on the basis of several characteristic clinical features of osteoarthritis of the knee, including various pain measurements. In both groups, the treatment resulted in a significant reduction of the pain at rest, pain on movement and the pain from pressure on the joint, 76-86% of aceclofenac patients reporting reduction in pain after 12 weeks. Three-quarters of the aceclofenac-treated patients had an accompanying reduction in joint swelling and 81.4% in knee function capacity, up to complete freedom of movement. Joint stiffness, which at baseline lasted 20 minutes, was reduced in the aceclofenac group to 10 minutes. A statistically significant difference in the efficacy of the two drugs was not found. The 34 adverse drug effects documented in 24 (12.6%) of the aceclofenac patients were fewer than the 43 events in 30 patients (16.3%) reported for naproxen. The trend towards better tolerability of aceclofenac manifested itself above all in a lower total incidence of gastrointestinal side-effects. Aceclofenac is as effective as naproxen in the symptomatic treatment of osteoarthritis of the knee and is well tolerated in general.

Background Although rhythm control has failed to demonstrate long‐term benefits over rate control in longstanding episodes of atrial fibrillation (AF), there is little evidence concerning recent‐onset ones. We analyzed the benefits of rhythm and rate control in terms of symptoms alleviation and need for hospital admission in patients with recent‐onset AF. Methods This was a multicenter, observational, cross‐sectional study with prospective standardized data collection carried out in 124 emergency departments (EDs). Clinical variables, treatment effectiveness, and outcomes (control of symptoms, final disposition) were analyzed in stable patients with recent‐onset AF consulting for AF‐related symptoms. Results Of 421 patients included, rhythm control was chosen in 352 patients (83.6%), a global effectiveness of 84%. Rate control was performed in 69 patients (16.4%) and was achieved in 67 (97%) of them. Control of symptoms was achieved in 396 (94.1%) patients and was associated with a heart rate after treatment ≤ 110 beats/min (odds ratio [OR] = 14.346, 95% confidence interval [CI] = 3.90 to 52.70, p < 0.001) and a rhythm control strategy (OR = 2.78, 95% CI = 1.02 to 7.61, p = 0.046). Sixty patients (14.2%) were admitted: discharge was associated with a rhythm control strategy (OR = 2.22, 95% CI = 1.20‐4.60, p = 0.031) and admission was associated with a heart rate > 110 beats/min after treatment (OR = 29.71, 95% CI = 7.19 to 123.07, p < 0.001) and acute heart failure (OR = 9.45, 95% CI = 2.91 to 30.65, p < 0.001). Conclusion In our study, recent‐onset AF patients in whom rhythm control was attempted in the ED had a high rate of symptoms' alleviation and a reduced rate of hospital admissions.

No abstract

We determined the linezolid concentrations in serum samples and aqueous humors (AHs) from 21 patients undergoing cataract extraction. Cataract removal was performed at various times (from 60 to 270 min) after the end of a 30-min infusion of 600 mg of linezolid. Serum samples were obtained 1 h after the end of linezolid administration to determine the maximum concentration of linezolid (C max ); AHs and a second serum sample were taken simultaneously during the operation, and the concentrations of linezolid in AH (C AH ) and serum (C S ) were determined. The mean C AH 1 h after linezolid administration was 4.94 g/ml, and the mean ratio of C AH to C S (R ‫؍‬ C AH /C S ) was 0.43. All patients had a C AH of >2 g/ml, which was higher than the MIC at which 90% of Staphylococcus epidermidis strains are inhibited.Bacterial endophthalmitis is an infection of the interior of the eye that despite appropriate therapeutic intervention frequently results in loss of vision. Thus, treatment represents a challenge to preserve vision (7).Penetration of antibiotics into the eye is variable, as the anterior chamber and the vitreous are avascular and the latter is also isolated from systemic circulation by the blood-ocular barrier (2). Thus, systemic antibiotics do not usually enhance visual outcomes, and intravitreal administration remains a key part of the clinical management of endophthalmitis.Linezolid is a synthetic oxazolidinone antimicrobial that binds to the ribosome and inhibits protein synthesis (6). Surveys have shown almost 100% susceptibility among staphylococci, including methicillin-resistant strains. Orally administered linezolid is virtually completely bioavailable (5). Its elimination half-life allows dosing twice per day. Maximum concentrations in plasma (C max ) are achieved 1 to 2 h after an oral dose of the drug. The drug has low serum plasma protein binding (approximately 31%) and is freely distributed to wellperfused tissues. The volume of distribution is 40 to 50 liters.There are some clinical data on the use of linezolid in meningitis due to Enterococcus sp. in humans, and a recent study using the rabbit meningitis model showed good penetration into the cerebrospinal fluid. There are no clinical data on the penetration of linezolid into the anterior chamber (aqueous humor) of the human eye.From clinical and bacteriological data, it is evident that linezolid is effective against gram-positive bacteria. Since many of these susceptible organisms are frequently the causative agents in intraocular infections, information on the ability of linezolid to penetrate into the aqueous humor is important. This study was designed to determine the characteristics of linezolid penetration of the aqueous humor of the noninflamed human eye.(The abstract and preliminary results of this study were presented at the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy, September 2003, in Chicago, Illinois.)A total of 21 patients who underwent cataract extraction during the period from December 2002 to February ...