Comparison of the Efficacy and Safety of Fixed-dose S-Amlodipine/Telmisartan and Telmisartan in Hypertensive Patients Inadequately Controlled with Telmisartan: A Randomized, Double-blind, Multicenter Study.

PURPOSE: The objective of this study was to evaluate the efficacy and safety of the fixed-dose combination S-amlodipine plus telmisartan (S-AM/TEL) compared with TEL monotherapy in patients with hypertension inadequately controlled by TEL monotherapy. METHODS: this study was a randomized, multicenter, double-blind, parallel group, Phase III, 8-week clinical trial to compare the superiority of the S-AM/TEL 2.5/40-mg and S-AM/TEL 5/40-mg combinations with TEL 80-mg mono-therapy. The primary end point was the change in the mean sitting diastolic blood pressure from baseline (week 0) after 8 weeks of therapy between treatment groups. FINDINGS: Of 325 patients screened, 183 were randomly assigned to 3 groups (61 in the S-AM/TEL 2.5/40-mg group, 60 in the S-AM/TEL 5/40-mg group, and 62 in the TEL 80-mg group). Mean (SD) age was 53.9 (7.5) years, and male patients comprised 87%. No significant differences were found among the 3 groups in baseline characteristics. The primary end points, the changes of mean (SD) diastolic blood pressure at week 8 from the baseline were -10.56 (7.23) mm Hg in the S-AM/TEL 2.5/40-mg group, -12.32 (9.23) mm Hg in the S-AM/TEL 5/40-mg group, and -2.44 (7.92) mm Hg in the TEL 80-mg group. Both the S-AM/TEL 2.5/40-mg group and the S-AM/TEL 5/40-mg group had a statistically superior hypotensive effect compared with the TEL 80-mg group (P < 0.0001 for both). For evaluation of the safety profile, the frequencies of adverse events (AEs) among the groups were also not significantly different (S-AM/TEL 2.5/40-mg group, 18.6%; S-AM/TEL 5/40-mg group, 20%; and TEL 80-mg group, 22.6%), and the incidences of AEs were not different among the groups. The most common AEs were respiratory disorders, followed by headache, dizziness, and peripheral edema. IMPLICATIONS: Treatment with S-AM/TEL 2.5/40 mg and S-AM/TEL 5/40 mg was superior to increasing the TEL dose in terms of hypotensive effect in patients with hypertension inadequately controlled by TEL monotherapy. S-AM/TEL fixed-dose combinations are an effective and tolerable option for patients inadequately responding to TEL monotherapy and also a good option for improving patients' medication adherence. ClinicalTrials.gov identifier: NCT011426100.

Resorbable skeletal fixation systems for treating maxillofacial bone fractures.

OBJECTIVE: To evaluate the effectiveness of using resorbable plate and screw systems (RPSSs) compared with metal plate and screw systems (MPSSs) to treat maxillofacial bone fractures. DESIGN: Retrospective study. SETTING: Chuncheon Sacred Heart Hospital, Chuncheon, South Korea. PATIENTS: Eighty-two patients diagnosed as having zygomaticomaxillary fractures between February 1, 2004, and December 31, 2008. INTERVENTION: We used RPSSs in 56 patients and MPSSs in 26 patients. MAIN OUTCOME MEASURE: Complication rates. RESULTS: The 82 patients included 72 males and 10 females aged 16 to 83 years. Follow-up ranged from 3 to 12 months. The complication rate was 7% (4 of 56) with RPSSs and 4% (1 of 26) with MPSSs. Using RPSSs, 2 patients experienced device exposure and 1 accompanying infection. With device exposure, the plates were removed. One patient noted paresthesia in the premaxillary area. Using MPSSs, 1 patient had a loosened metal screw; the other patients had no problems. CONCLUSIONS: Based on the present experience, there are many advantages to RPSSs. Nevertheless, we should select the fixation system carefully depending on the fracture site and whether there is accompanying infection. It is important to select the method that best fits the patient's situation.

A balloon dilatation technique for the treatment of intramaxillary lesions using a Foley catheter in chronic maxillary sinusitis.

BACKGROUND: In chronic maxillary sinusitis, pathologic mucosas of the anterior and lateral walls of the maxillary sinus are difficult to remove. Trocar insertion to the canine fossa is the most commonly used procedure. In the present work, we report a method involving a balloon dilatation technique for treatment of intramaxillary lesions using a Foley catheter in chronic maxillary sinusitis and the outcomes of this approach. METHODS: Records of 34 patients with intramaxillary sinus lesions who underwent endoscopic sinus surgery were analyzed. After widening the natural ostium, a 10F Foley catheter was inserted through the widening ostium into the maxillary sinus. The intramaxillary lesion was removed by repeated balloon inflation and deflation of the Foley catheter. The patients were followed-up for at least 6 months after the surgery. RESULTS: There were no significant intraoperative or postoperative complications. We found that the postoperative symptoms and resolution of the lesions in comparison to classic functional endoscopic sinus surgery were not different in authors' experiences. CONCLUSION: The balloon dilatation technique using a Foley catheter is a minimally invasive and effective technique that is not associated with major complications in cases of intramaxillary lesions.

Endoscopic reduction of medial orbital wall fractures using the rolled silastic sheet technique.

BACKGROUND: Endoscopic reduction has become common for reducing medial orbital wall fractures because of its various advantages. Nevertheless, there is no standard method of nasal packing to support the orbital contents to maintain the reduction. We evaluated the outcomes of endoscopic reduction of medial orbital wall fractures using the rolled Silastic sheet technique. METHODS: Seventeen patients who underwent endoscopic reduction of medial orbital wall fractures were analyzed. They were diagnosed using 3-mm facial computed tomography and treated surgically under general anesthesia in our department between February 2006 and March 2008. Postoperatively, they were followed for at least 3 months. RESULTS: The 17 patients comprised 13 men and 4 women ranging in age from 18 to 71 years (mean, 40.8 years). There were no significant intraoperative or postoperative complications. All 17 patients showed complete resolution of their symptoms after surgery. CONCLUSION: The technique using the rolled Silastic sheet for medial orbital wall fractures supports the safety and efficacy of endoscopic reduction.

Borna disease virus and deficit schizophrenia.

BACKGROUND: It is controversial whether Borna disease virus (BDV) infects humans and causes psychiatric disorders. OBJECTIVES: The relationship between BDV infection and schizophrenia with deficit syndrome was investigated. STUDY DESIGN: Using the Schedule for the Deficit Syndrome, 62 schizophrenic in-patients were selected from three psychiatric hospitals. RNA was extracted from peripheral blood mononuclear cells and analyzed using nested reverse transcriptase-polymerase chain reaction with primers to detect BDV p24 and p40. RESULTS AND CONCLUSIONS: BDV transcripts were not detected in samples from any of the 62 schizophrenic patients. These data do not support an etiologic association between BDV infection and the deficit form of schizophrenia.