Alimentary pharmacology & therapeutics
-
Aliment. Pharmacol. Ther. · Feb 2003
Gallstones--an increasing problem: a study of hospital admissions in England between 1989/1990 and 1999/2000.
The number of operations for cholelithiasis increased from the 1950s to the 1990s. ⋯ There has been a steady increase in admission rates for cholelithiasis over the study period. Whilst the frequency of operation has declined, the proportion of patients undergoing therapeutic endoscopy has increased.
-
Aliment. Pharmacol. Ther. · Feb 2003
ReviewReview article: NSAIDs, gastroprotection and cyclo-oxygenase-II-selective inhibitors.
In patients at high risk of NSAID-associated serious upper gastrointestinal complications, gastroprotection with misoprostol or a proton pump inhibitor should be considered. Only misoprostol, 800 micro g/day, has been shown to reduce serious upper gastrointestinal complications in a large clinical outcome trial. The benefit of Helicobacter pylori eradication in reducing NSAID-associated gastrointestinal toxicity is controversial, and routine testing for and eradication of H. pylori in NSAID users are not currently advised. ⋯ However, longer term gastrointestinal data from the celecoxib study (CLASS) and cardiovascular adverse event data from the rofecoxib study (VIGOR) have questioned the risk-benefit profile of these new drugs and, until they are better understood, it seems sensible not to use them routinely in large numbers of individuals. The gastrointestinal safety of meloxicam and etodolac has not been adequately assessed in such trials. Therefore, evidence for their use instead of non-selective NSAIDs, or instead of celecoxib or rofecoxib, is not robust.
-
Aliment. Pharmacol. Ther. · Feb 2003
Sandostatin LAR (long-acting octreotide acetate) for malignant carcinoid syndrome: a 3-year experience.
Somatostatin analogues are the best therapy for controlling the symptoms of malignant carcinoid syndrome. Octreotide acetate given as subcutaneous injection up to three times daily, intramuscular Lanreotide injection given once per 1-2 weeks and monthly intramuscular Sandostatin LAR have demonstrated similar efficacy in short-term studies. ⋯ Sandostatin LAR provides good long-term symptomatic control in patients with malignant carcinoid syndrome; it is well tolerated and patients expressed improved satisfaction in their management.