Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Aug 2006
Review Meta AnalysisReview article: scoring systems for assessing prognosis in critically ill adult cirrhotics.
Cirrhotic patients admitted to intensive care units (ICU) still have poor outcomes. Some current ICU prognostic models [Acute Physiology and Chronic Health Evaluation (APACHE), Organ System Failure (OSF) and Sequential Organ Failure Assessment (SOFA)] were used to stratify cirrhotics into risk categories, but few cirrhotics were included in the original model development. Liver-specific scores [Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD)] could be useful in this setting. ⋯ General-ICU models had better performance in cirrhotic populations compared with CTP score; OSF and SOFA had the best predictive ability. Further prospective and validation studies are needed.
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Aliment. Pharmacol. Ther. · Jul 2006
Randomized Controlled Trial Multicenter StudyRandomized trial of rifabutin-based triple therapy and high-dose dual therapy for rescue treatment of Helicobacter pylori resistant to both metronidazole and clarithromycin.
The clinical management of Helicobacter pylori infected patients who failed standard eradication therapies remains a challenge. ⋯ Triple therapy with esomeprazole, rifabutin and amoxicillin and high-dose omeprazole/amoxicillin are comparable and effective and safe for rescue therapy of H. pylori regardless of the patient's CYP2C19 genotype.
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Aliment. Pharmacol. Ther. · Jul 2006
ReviewReview article: moderate sedation for endoscopy: sedation regimens for non-anaesthesiologists.
Moderate sedation is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands with or without light tactile stimulation. Moderate sedation is typically accepted in the anaesthesia community as an appropriate target for sedation by non-anaesthesiologists. ⋯ Moderate sedation provides a safety margin when compared with deep sedation and general anaesthesia. Development of protocols that target agents such as propofol to moderate sedation will expand the sedation agents available to non-anaesthesiologists and help ensure that this expansion occurs safely.
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Aliment. Pharmacol. Ther. · Jul 2006
Utility of red flag symptom exclusions in the diagnosis of irritable bowel syndrome.
Studies suggest that the positive predictive value of the Rome II criteria for diagnosing irritable bowel syndrome can be enhanced by excluding red flag symptoms suggestive of organic diseases. ⋯ Red flags may be useful for identifying patients who require additional diagnostic evaluation, but incorporating them into the Rome criteria would not improve sensitivity and would result in too many missed irritable bowel syndrome diagnoses.
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Aliment. Pharmacol. Ther. · Jun 2006
Determinants of healthcare-seeking behaviour among subjects with irritable bowel syndrome.
Doctor visits for irritable bowel syndrome are associated with high medical costs. Predictors of medical consultation for irritable bowel syndrome remain poorly understood. ⋯ Healthcare-seeking behaviour among irritable bowel syndrome patients was determined by presence of comorbidities and extent that irritable bowel syndrome affected quality of life, not physical symptoms or mental health status.