Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · May 2008
Review Case ReportsReview article: psychological aspects of home parenteral nutrition, abnormal illness behaviour and risk of self-harm in patients with central venous catheters.
Home parenteral nutrition is established as standard management for patients with chronic severe intestinal failure. Although the treatment is welcomed by many patients, there are psychological consequences of living with a central venous catheter and there are associated restrictions to the lives of patients on home parenteral nutrition. A subgroup of home parenteral nutrition patients may use their central venous catheter for self-harm. ⋯ This paper concludes with recommendations for best practice with respect to the psychological management of home parenteral nutrition patients in whom central venous catheter abuse is suspected.
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Aliment. Pharmacol. Ther. · Apr 2008
Randomized Controlled Trial Multicenter StudyClinical trial: phase 2 study of lubiprostone for irritable bowel syndrome with constipation.
Analyses of a trial in constipated patients indicated that lubiprostone may be an effective treatment for irritable bowel syndrome with constipation. ⋯ Lubiprostone significantly improved gastrointestinal symptoms of irritable bowel syndrome with constipation at all doses. Higher doses of lubiprostone, especially the 48 microg/day group, were associated with more gastrointestinal adverse events. From these data, the 16 microg/day dose demonstrated the optimal combination of efficacy and safety. These results warrant further study of lubiprostone for treatment of irritable bowel syndrome with constipation patients.
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Aliment. Pharmacol. Ther. · Apr 2008
Randomized Controlled Trial Multicenter StudyClinical trial: a dose-response study of fospropofol disodium for moderate sedation during colonoscopy.
An effective agent is needed that provides rapid onset of sedation and quick recovery for patients undergoing colonoscopy. ⋯ The 6.5 mg/kg dose of fospropofol provides the ideal balance of efficacy and safety for patients undergoing colonoscopy and has been selected for phase 3 clinical development.
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Aliment. Pharmacol. Ther. · Jan 2008
Metabolic syndrome is associated with severe fibrosis in chronic viral hepatitis and non-alcoholic steatohepatitis.
The prevalence of metabolic syndrome and its possible impact on the severity of liver histological lesions have not been studied prospectively in chronic liver diseases. ⋯ Metabolic syndrome is more prevalent in non-alcoholic steatohepatitis than in chronic viral hepatitis; it is associated independently with more severe fibrosis but not with the severity of steatosis, both in chronic viral hepatitis and in non-alcoholic steatohepatitis.
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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.