Aims: To compare cilostazol with ticlopidine for long-term efficacy and safety as an adjunctive antiplatelet therapy after coronary stenting.
Methods: Using published clinical studies retrieved through Medline and other databases from 1986-2004, meta-analyses were employed to evaluate efficacy and adverse clinical events for cilostazol or ticlopidine coadministered with aspirin after coronary stenting. Major adverse cardiac events (MACE), quantitative coronary angiographic parameters (QCA) including minimal lumen diameter (MLD), late loss, loss index of diseased vessels, and net gain, or adverse clinical events after coronary stenting were compared between the two study arms and expressed with the mean difference or odds ratios (OR) specific for the individual studies and meta-analytic pooled estimate for the mean difference or OR.
Results: Five of the clinical studies we reviewed met the inclusion criteria and underwent metaanalysis. The cilostazol was found to be superior in the pooled estimate of the total clinical outcomes and QCA as compared to ticlopidine (OR [95% CI]: 0.59 [0.46, 0.75]), MLD (WMD [95% CI]: 0.27 mm [0.17, 0.37]), late loss (WMD [95% CI]: -0.36 mm [-0.51, -0.22]), loss index (WMD [95% CI]: -0.16 [-0.24, -0.08]), and net gain (WMD [95% CI]: 0.49 mm [0.30, 0.68]). The pooled estimate of all adverse clinical events in cilostazol was approximately the same as that seen for ticlopidine.
Conclusions: Our results suggest that cilostazol plus aspirin therapy, as compared to ticlopidine plus aspirin therapy, might be superior with regard to long-term efficacy, particularly in preventing late res tenosis. Although cilostazol exhibits few serious adverse clinical events, we must pay attention to increased heart rate or the occurrence of arrhythmias during treatments.

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Purpose: HMG-CoA reductase inhibitors (statins) have been widely used in the treatment of hypercholesteremia in Japan as well as in Western countries. Although statins have been shown to be effective in the prevention of coronary heart disease (CHD) in high-risk patients, the potential benefit of statins on the overall mortality has not been proven in subjects at lower risk for CHD. In this study, we investigated the risk factors and serum cholesterol concentrations in patients given pravastatin.
Methods: Patients who were given pravastatin during the period from June 2002 until May 2003 in the Hamamatsu University Hospital were studied. Data for height, body weight, age, gender, smoking and history of diabetes mellitus, hypertension and CHD in the patients were collected from their case records. Serum cholesterol concentrations were determined before and after the treatment with pravastatin. The ethics committee in the Hamamatsu University approved this study.
Results: There were 213 male (37.4%) and 356 female (62.6%) patients given pravastatin. The mean age of the patients was 63.9 yrs, and % of the patients aged under 50 yrs was 10.7%. Seventy-seven % of the patients had no history of CHD. Female patients without smoking, diabetes mellitus, hypertension and CHD constituted 17% of all patients. Total and LDL cholesterol levels in all groups were significantly decreased by 17.6% and 25.5%, respectively, after the administration of pravastatin. Treatment with pravastatin was started at the lower total cholesterol levels in male patients or patients with CHD than in female patients or patients without CHD.
Conclusion:Our results suggest that significant numbers of patients with a low risk for CHD were prescribed the statins, and that placebo-controlled large-scale trials should be conducted to demonstrate the benefit and safety of statin treatment on overall mortality in Japan.

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Background: Antianxiety agents can be used to pretreat dental outpatients with anxiety or fear of painful dental procedures. No studies, however, have focused on the effects of providing adequate predose information on a drug and its expected actions in reducing dental anxiety.
Methods: One-hundred and four dental outpatients aged 20-65 years were randomly assigned to four groups in a double-blinded comparison study to evaluate the antianxiety effects of lorazepam. Groups were given either the drug or a placebo, and were provided either detailed information about the drug and its actions or minimal information prior to dosing. The four groups were as follows: 1) well informed and treated with 0.5 mg of lorazepam; 2) minimally informed and treated with 0.5 mg of lorazepam; 3) well informed and treated with placebo and 4) minimally informed and treated with the placebo. Anxiety levels in patients were scored at baseline and at 35 min and 1 hr after dosing according to the following scales: state anxiety scale of state-trait anxiety inventory (STAI-S), visual analog scale (VAS), and face scale (FS). At the same timepoints, heart rate (HR) was determined as an additional parameter for evaluating anxiety level.
Results: Comparison between the lorazepam groups revealed significantly lower anxiety levels in the well informed patients than in the minimally informed patients, as evidenced by significantly decreased STAI-S, VAS, and FS scores at 35 min. The antianxiety effect of lorazepam was more prominent in the well informed group than in the minimally informed group, as evaluated by STAI-S and VAS scores at 1 hr after dosing. Similarly, comparison between the placebo groups showed significantly lower anxiety levels in the well informed patients than in the minimally informed patients, as evidenced by significantly decreased STAI-S and VAS scores at 35 min after dosing. In the placebo groups, HR was significantly lower at 35 min and 1 hr after dosing in the well informed patients than in the minimally informed patients.
Conclusion: In the treatment of dental anxiety with lorazepam, providing predose information on the drug and its expected actions to patients enhances the anxiety reducing effects of the drug in dental outpatients.

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