Alimentary pharmacology & therapeutics
-
Aliment. Pharmacol. Ther. · Dec 2007
ReviewReview article: The prevalence and clinical relevance of cytochrome P450 polymorphisms.
Most drugs currently used in clinical practice are effective in only 25% to 60% of patients, while adverse drug reactions (ADRs) as a consequence of treatment are estimated to cost billions of US dollars and tens of thousands of deaths. ⋯ In the future genotyping should be considered to identify patients who might be at risk of severe toxic responses, in order to guide appropriate individual dosage. Medical therapy should be a close cooperation between clinicians, pharmacologists and laboratory specialists, leading to reduced therapeutic errors, ADRs and health care costs.
-
Aliment. Pharmacol. Ther. · Dec 2007
ReviewReview article: Probiotics in gastrointestinal and liver diseases.
Probiotics, defined as live micro-organisms with beneficial effects for the host, are widely applied in gastrointestinal and liver diseases. ⋯ Further insight into disease entities and the functioning of probiotic strains is required to be able to select disease-specific strains, which have to be tested in well-designed placebo-controlled studies.
-
The incidence and therefore complications of (sigmoid) diverticular disease are increasing. ⋯ Uncomplicated diverticulitis is treated medically. Complicated diverticulitis with small abscesses is treated with antibiotics while larger abscesses are drained with computerised tomography-guided puncture. Emergency surgery is reserved for peritonitis, elective surgery for fistula/stenosis. Surgery to prevent recurrence is indicated only in selected cases (e.g. immune compromised).