“Objective: The American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) diabetes algorithm recommends a stratified approach to initial therapy to achieve a glycated Fedratinib order hemoglobin (HbA(1c)) goal of <= 6.5% in patients with type 2 diabetes mellitus (T2DM) who have inadequate glycemic control. Data from a double-blind study in drug-naive T2DM patients comparing initial monotherapy with metformin (MET)
with initial dual therapy with a fixed-dose combination of sitagliptin and MET (SITA/MET FDC) was used to determine AACE/ACE HbA(1c) goal attainment in these treatment groups.
Methods: A total of 1,250 patients (mean baseline HbA(1c) = 9.9%) were randomized 1:1 to SITA/MET FDC 50/500 mg twice daily (b.i.d.) or MET 500 mg b.i.d. for 18 weeks. SITA/MET FDC and MET were uptitrated over 4 weeks to 50/1,000 mg b.i.d. and 1,000 mg b.i.d., respectively.
Results: At week 18, a higher percentage of patients receiving SITA/MET FDC had HbA1c levels <= 6.5% and <7% than those receiving MET alone within each of the 3 AACE/ACE HbA(1c) categories (6.5-7.5%, >7.5-9.0%, and >9.0%). Of patients with a baseline HbA(1c) >7.5-9.0% who initiated SITA/MET FDC, 48.6% achieved an HbA(1c) <= 6.5% at week 18 compared
with 23.1% of patients who initiated MET monotherapy (P<.001). In patients with a baseline see more HbA(1c) >9.0%, 24.0% on SITA/MET FDC achieved an HbA(1c) <= 6.5% compared with 12.8% on MET alone (P<.001).
Conclusion: In T2DM patients with a baseline
HbA(1c) >7.5-9.0%, substantially more achieved the HbA(1c) goal of <= 6.5% with initial dual therapy (SITA/MET FDC) than with initial monotherapy (MET), which is in agreement with the AACE/ACE diabetes algorithm.”
“SETTING: Pleural adenosine deaminase (ADA) levels have been found to be useful in diagnosing ABT-737 inhibitor tuberculous pleuritis. Elevated ADA levels have been attributed to ADA(2) isoenzyme, although no comprehensive studies have evaluated ADA(2) as a diagnostic test.
OBJECTIVE: To estimate the diagnostic accuracy of ADA and ADA(2) in diagnosing tuberculous pleurisy.
METHOD: A 3-year retrospective study was carried out. ADA and ADA(2) were determined on patients diagnosed according to predetermined criteria.
RESULTS: A total of 951. samples were received, including 387 patients with tuberculosis (TB). ADA values >= 52.4 U/l yielded a sensitivity, specificity and positive (PPV) and negative predictive value (NPV) respectively of 93.7% (95%CI 90.0-96.0), 88.7% (95%CI 85.7-91.3), 85.5% (95%CI 81.7-88.8) and 95.2% (95%CI 92.9-96.9). ADA(2) values >= 40.6 U/l yielded a sensitivity, specificity and PPV and NPV of respectively 97.2% (95%CI 95.0-98.7), 94.2% (95%CI 91.8-96.0), 92.2% (95%CI 89.1-94.7) and 98.0% (95%CI 96.3-99.0). The chi(2) and McNemar tests proved the superiority of ADA(2) statistically.