Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Oct 2014
ReviewSystematic review: the effect of prunes on gastrointestinal function.
Prunes (dried plums) are high in fibre and are perceived to promote healthy gastrointestinal (GI) function. ⋯ In constipation, prunes appear superior to psyllium for improving stool frequency and consistency, however, the evidence for other outcomes and the effects in non-constipated subjects is weak. Although prunes may be a promising intervention for the management of constipation and increasing stool weight, this needs to be confirmed by further rigorous research.
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Aliment. Pharmacol. Ther. · Oct 2014
Review Meta AnalysisSystematic review with network meta-analysis: adjuvant therapy for resected biliary tract cancer.
Major adjuvant therapies for biliary tract cancer (BTC) include fluorouracil, gemcitabine and chemoradiation (CRT), but the optimum regimen remains inconclusive. ⋯ Chemotherapy with gemcitabine is the optimum adjuvant treatment with a balanced benefit-toxicity ratio for resected biliary tract cancer. Chemoradiation was more likely to cause toxic effects.
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Aliment. Pharmacol. Ther. · Oct 2014
Randomized Controlled Trial Multicenter StudyRandomised clinical trial: the long-term safety and tolerability of naloxegol in patients with pain and opioid-induced constipation.
Opioid-induced constipation (OIC) is a common adverse effect of opioid therapy. ⋯ In patients with noncancer pain and opioid-induced constipation, naloxegol 25 mg/day up to 52 weeks was generally safe and well tolerated.
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Aliment. Pharmacol. Ther. · Oct 2014
ReviewSystematic review: the combined surgical and medical treatment of fistulising perianal Crohn's disease.
The management of perianal Crohn's fistulas represents a significant challenge. A combination of medical and surgical therapy, guided by radiology, is often required. ⋯ Combined surgical and medical (anti-TNF-α ± immunomodulators) therapy may have additional beneficial effects on perianal fistula healing in patients with Crohn's disease, compared with surgery or medical therapy alone. A well-designed Crohn's perianal fistula clinical trial is required in a multidisciplinary medical and surgical setting, with clearly defined end points of clinical (and likely patient reported outcomes) and radiological healing.
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Aliment. Pharmacol. Ther. · Oct 2014
Controlled Clinical TrialReflux pattern and role of impedance-pH variables in predicting PPI response in patients with suspected GERD-related chronic cough.
Gastro-oesophageal reflux disease (GERD) may contribute to the onset of chronic cough (CC); however, the multichannel intraluminal impedance-pH (MII-pH) monitoring is often within the normal range and the response to proton pump inhibitors (PPIs) unsatisfactory. The measure of impedance baseline (IB) increases the sensitivity of MII-pH in patients with typical symptoms. ⋯ The presence of a pathological AET or pathological IB in CC patients is associated with a greater probability of PPI response. IB is a promising variable in patients with CC, as it increases the diagnostic yield of MII-pH and allows confirmation of the GERD diagnosis in these patients.