Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Aug 2020
ReviewClinical assessment for high-risk patients with non-alcoholic fatty liver disease in primary care and diabetology practices.
Primary care practitioners (PCPs) and diabetologists are at the frontline of potentially encountering patients with NASH. Identification of those at high risk for adverse outcomes is important. ⋯ Due to the growing burden of NAFLD and NASH, PCPs and diabetologists are faced with increased patient encounters in their clinical practices necessitating referral decisions. To assist in identifying high-risk NASH patients requiring specialty care, we provide a simple and easy to use algorithm.
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Aliment. Pharmacol. Ther. · Jul 2020
ReviewReview article: prevention, diagnosis and management of COVID-19 in the IBD patient.
The current COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune-based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID-19. ⋯ IBD patient management presents a challenge in the current COVID-19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.
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Aliment. Pharmacol. Ther. · Jul 2020
Meta AnalysisSystematic review with meta-analysis: efficacy and safety of treatments for opioid-induced constipation.
When opioid-induced constipation is treated with centrally acting opioid antagonists, there may be opioid withdrawal or aggravation of pain due to inhibition of μ-opioid analgesia. This led to the development of peripherally acting μ-opioid receptor antagonists (PAMORAs). ⋯ Therapeutic response in opioid-induced constipation is best achieved with the PAMORAs, methylnaltrexone, naloxegol and naldemidine, which are associated with low risk of serious adverse events.
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Aliment. Pharmacol. Ther. · Jun 2020
Meta AnalysisSystematic review with meta-analysis: the efficacy of tranexamic acid in upper gastrointestinal bleeding.
Upper gastrointestinal bleeding is a common medical emergency associated with substantial mortality. Tranexamic acid may be effective for reducing mortality in upper gastrointestinal bleeding. ⋯ Moderate-quality evidence shows that tranexamic acid is superior to placebo for the reduction in mortality in patients with upper gastrointestinal bleeding. While our findings lend further support to the use of tranexamic acid for treating patients with upper gastrointestinal bleeding, additional higher-quality trials are needed.
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Aliment. Pharmacol. Ther. · May 2020
ReviewReview article: gastrointestinal features in COVID-19 and the possibility of faecal transmission.
There is little published evidence on the gastrointestinal features of COVID-19. ⋯ Gastrointestinal symptoms are common in patients with COVID-19, and had an increased prevalence in the later stage of the recent epidemic in China. SARS-CoV-2 enters gastrointestinal epithelial cells, and the faeces of COVID-19 patients are potentially infectious.