Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Sep 2004
Meta AnalysisReduced incidence of upper gastrointestinal ulcer complications with the COX-2 selective inhibitor, valdecoxib.
In a predefined analysis, data were pooled from eight blinded, randomized, controlled trials, and separately from three long-term, open-label trials to determine the rate of upper gastrointestinal ulcer complications with the cyclo-oxygenase-2 selective inhibitor, valdecoxib, vs. non-selective non-steroidal anti-inflammatory drugs. ⋯ Valdecoxib, including above recommended doses, is associated with a significantly lower rate of upper gastrointestinal ulcer complications than therapeutic doses of non-selective non-steroidal anti-inflammatory drugs.
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Aliment. Pharmacol. Ther. · Sep 2004
ReviewReview article: future indications for terlipressin therapy.
Vasoconstrictor agents such as terlipressin (Glypressin) have been shown to have beneficial effects in the treatment of hepatorenal syndrome (HRS), in terms of improving renal function and subsequent survival rates. Patients with HRS have also been shown to have improved survival after liver transplantation if they receive terlipressin treatment prior to transplantation. In addition, studies show that terlipressin may have beneficial effects in treating other indications, including paracentesis-induced circulatory dysfunction and endotoxic shock. A positive effect has also been demonstrated with vasopressin in cardiopulmonary resuscitation.
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Aliment. Pharmacol. Ther. · Sep 2004
ReviewReview article: a critical comparison of drug therapies in currently used therapeutic strategies for variceal haemorrhage.
Vasoactive drugs are safe and easy to administer, and universal treatment is the first-line approach for all patients with suspected variceal bleeding. There are strong arguments that the combination of vasoactive drugs, started as soon as possible, and endotherapy later on is the best therapeutic option, particularly in cases of ongoing bleeding at the time of endoscopy. The main action of vasoactive drugs is to reduce variceal pressure. ⋯ As such, terlipressin is the most potent of the various vasoactive drugs. Somatostatin significantly reduces portal and variceal pressure and azygos flow, is superior to placebo in controlling variceal haemorrhage, and improves the success of sclerotherapy. The effect of octreotide is well established for preventing the increase in portal pressure after a meal (similar to blood in the intestines) though the effect of ocreotide on variceal pressure is controversial.
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Aliment. Pharmacol. Ther. · Jun 2004
Randomized Controlled Trial Clinical TrialInfluence of a lipase inhibitor on gastric sensitivity and accommodation to an orally ingested meal.
Intraduodenal administration of lipids, through lipid digestion and release of cholecystokinin (CCK), induces viscero-visceral reflexes that affect gastric tone and sensitivity. It is unclear whether the same mechanisms control gastric function after an orally ingested meal. ⋯ Administration of a lipase inhibitor does not affect gastric compliance, sensitivity to distension and accommodation to an orally ingested meal, and does not influence meal-induced satiety.
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Aliment. Pharmacol. Ther. · Jun 2004
Comparative Study Clinical Trial Controlled Clinical TrialComparison of transarterial chemoembolization and percutaneous acetic acid injection as the primary loco-regional therapy for unresectable hepatocellular carcinoma: a prospective survey.
Transarterial chemoembolization (TACE) and percutaneous acetic acid injection (PAI) are effective loco-regional therapies for hepatocellular carcinoma (HCC). ⋯ Patients with large HCC undergoing TACE tend to have a more favourable long-term outcome. For small HCC, either TACE or PAI therapy could be recommended as the primary treatment modality.