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Glyburide
Compared with Insulin for Gestational Diabetes
Women with gestational diabetes that is not well controlled by diet are
usually treated with insulin. In this study, 404 women with mild gestational
diabetes were treated with glyburide or insulin, starting in mid-gestation.
There were no differences between women treated with glyburide and those
treated with insulin in blood glucose concentrations or glycosylated hemoglobin
values during the remainder of the pregnancy. There were also no differences
between the groups in the time of delivery, birth weight of the infant,
or perinatal mortality or morbidity. Eight women had poor responses to glyburide
and were then treated with insulin.
Markers
of Myocardial Damage and Inflammation in Unstable Coronary Artery Disease
Markers of inflammation are associated with an increased risk of cardiac
events soon after the development of unstable coronary disease. Elevated
blood levels of cardiac troponin T are also associated with increased risk.
In this study of patients with unstable coronary artery disease, elevated
levels of C-reactive protein and fibrinogen (inflammatory markers) and troponin
T were independently related to the long-term risk of death from cardiac
causes.
Lipoprotein-Associated
Phospholipase A2 as an Independent Predictor of Coronary Events
 Lipoprotein-associated
phospholipase A2 is an enzyme involved in the release of oxidation products
of low-density lipoprotein, which are atherogenic in the arterial wall.
The activity of this phospholipase is increased by mediators of inflammation.
In this study, increased levels of lipoprotein-associated phospholipase
A2 were strongly and independently associated with an increased risk of
coronary events in men with hypercholesterolemia.
Mycophenolate
Mofetil for Diffuse Proliferative Lupus Nephritis
Patients with
severe lupus nephritis are often treated with cyclophosphamide and glucocorticoids,
a regimen that is beneficial but has considerable toxicity. In this one-year
study of 42 patients, the effects of the mycophenolate mofetil combined
with prednisolone were compared with the effects of standard immunosuppressive
regimens. In both groups, approximately 80 percent of patients had a complete
remission, and the frequency of side effects was similar in the two groups.
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