Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Oct 2006
ReviewReview article: the effect of aminosalicylates and immunomodulation on cancer risk in inflammatory bowel disease.
Ulcerative colitis and, maybe to a similar extent, Crohn's disease are associated with an increased risk of colorectal carcinoma. As a consequence of this increased risk, surveillance strategies have been proposed to prevent colorectal carcinoma through early detection of dysplasia, which may herald malignant disease. ⋯ It may be concluded from the relevant studies that regular use of at least 1.2 g of mesalazine per day may effectively prevent about two out of three colon cancers in ulcerative colitis. In contrast, there seems to be no role for either mercaptopurine or folic acid in protection from colon cancer.
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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.
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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.
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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.
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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.