International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2007
Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease.
To report data from a multinational survey investigating the relationship between gastro-oesophageal reflux disease (GERD) symptoms, treatment and subjective well-being. ⋯ These findings attest to the severity and impact of GERD symptoms, highlighting the need to improve the management of GERD in routine practice. Many symptomatic and long-term sufferers, for example, may benefit from taking steps towards a healthier lifestyle (e.g. weight reduction) in addition to optimisation of acid-suppressive therapy.
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Int. J. Clin. Pract. · Jul 2007
Review Multicenter StudyOpioid-induced bowel dysfunction: prevalence, pathophysiology and burden.
As a result of the undesired action of opioids on the gastrointestinal (GI) tract, patients receiving opioid medication for chronic pain often experience opioid-induced bowel dysfunction (OBD), the most common and debilitating symptom of which is constipation. Based on clinical experience and a comprehensive MEDLINE literature review, this paper provides the primary care physician with an overview of the prevalence, pathophysiology and burden of OBD. Patients with OBD suffer from a wide range of symptoms including constipation, decreased gastric emptying, abdominal cramping, spasm, bloating, delayed GI transit and the formation of hard dry stools. ⋯ Physicians should have greater appreciation of the prevalence, symptoms and burden of OBD. In light of the serious negative impact OBD can have on QoL, physicians should encourage dialogue with patients to facilitate optimal symptomatic management of the condition. There is a pressing need for new therapies that act upon the underlying mechanisms of OBD.
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Int. J. Clin. Pract. · Jul 2007
ReviewEminence-based guidelines: a quality assessment of the second Joint British Societies' guidelines on the prevention of cardiovascular disease.
The quality and independence of clinical practice guidelines developed by professional societies has previously been assessed as unsatisfactory. Calls for explicit methodological standards have lead to international consensus on standards for guideline development. The methodological quality of current British cardiovascular guidelines produced by six professional societies is assessed with reference to internationally recognised criteria (Appraisal of Guidelines Research and Evaluation) for evaluating the quality of clinical guidelines. When evaluated with reference to a recognised quality framework for guideline development, current Joint British Societies guidelines for the prevention and treatment of cardiovascular disease contain serious deficiencies, are of low quality and should not be recommended for clinical practice.
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Int. J. Clin. Pract. · Jul 2007
ReviewThe change in zoster-associated pain treated with oral valaciclovir in immunocompetent patients with acute herpes zoster.
We have analysed zoster-associated pain treated with valaciclovir (VCV) in immunocompetent patients with acute herpes zoster over 6 months, and evaluated the safety of VCV. We know of no reports that evaluate postherpetic neuralgia (PHN) treated with VCV for 6 months. ⋯ Timing of the administration of VCV before or after the onset of rash did not influence the incidence of PHN. No serious adverse reactions were observed during the administration of VCV.