Alimentary pharmacology & therapeutics
-
Aliment. Pharmacol. Ther. · Oct 2006
ReviewSystematic review: applications and future of gastric electrical stimulation.
Over the past 20 years, gastric electrical stimulation has received increasing attention among researchers and clinicians. ⋯ Great progress has been made during the past decades. Gastric electrical stimulation has been shown to be effective in normalizing gastric dysrhythmia, accelerating gastric emptying and improving nausea and vomiting. Implantable device has been made available for treating gastroparesis as well as obesity. However, development of a new device and controlled clinical studies are required to further prove clinical efficacy of gastric electrical stimulation.
-
Aliment. Pharmacol. Ther. · Sep 2006
Review Meta AnalysisMeta-analysis: terlipressin therapy for the hepatorenal syndrome.
The hepatorenal syndrome is a severe and well-known complication of end-stage liver disease, but its management is controversial. Recent reports have shown the efficacy of terlipressin therapy, a vasopressin analogue, in hepatorenal syndrome patients. ⋯ This meta-analysis shows efficacy and safety of terlipressin in the treatment of hepatorenal syndrome. However, a significant number of responder patients relapsed after terlipressin withdrawal. Further studies are in progress to address the link between terlipressin and survival in hepatorenal syndrome patients.
-
Aliment. Pharmacol. Ther. · Sep 2006
Randomized Controlled TrialDouble-blind, randomized, placebo-controlled study to evaluate the effects of tegaserod on gastric motor, sensory and myoelectric function in healthy volunteers.
The effects of tegaserod on gastric accommodation and postprandial satiety remain unclear. ⋯ While tegaserod decreased proximal gastric volume change after a meal, it does not appear to have significant effects on gastric motor and sensory function in healthy individuals. Further studies are required in patients with disturbances of gastric motor and sensory function.
-
Aliment. Pharmacol. Ther. · Aug 2006
Randomized Controlled TrialEvaluation of topical pharyngeal anaesthesia by benzocaine lozenge for upper endoscopy.
Among the randomized controlled trials evaluating the effect of pharyngeal anaesthesia only some suggest benefit. Spray is irritating for some people and leaves bitter taste in the throat. We hypothesized that delivering the local anaesthetic as a sucking lozenge would benefit the patients in terms of decreasing anxiety and will improve procedure performance and patient tolerance. ⋯ Topical pharyngeal anaesthesia with benzocaine/tyrothricin lozenges with conscious sedation has no advantages over conscious sedation alone in patients undergoing upper endoscopy.
-
Aliment. Pharmacol. Ther. · Aug 2006
ReviewPersonal view: crystalloid transfusion in acute gastrointestinal haemorrhage: is it beneficial? An historical perspective.
The conventional management of acute gastrointestinal haemorrhage mandates early repletion of blood volume with crystalloids and blood, as part of the initial management, where there is evidence of hypovolaemia. Meanwhile there is a major trend towards a restrained use of fluid to raise blood pressure to near normal for the bleeding patient in trauma and similar emergencies. This divergence of view requires analysis. ⋯ In addition to clear evidence from animal experiments that early restoration of blood volume perpetuates bleeding, there is considerable evidence in humans - both in war and civilian life - that rapid crystalloid infusion is harmful. I also report a personal series of benefit from restricted transfusion in acute upper gastrointestinal haemorrhage in humans. Given the lack of evidence of benefit for rapid blood volume repletion in acute gastrointestinal haemorrhage, there is need for controlled studies of the most appropriate approach to crystalloid transfusion in acute gastrointestinal bleeding.