Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Sep 2013
Meta AnalysisMeta-analysis: Lactobacillus GG for treating acute gastroenteritis in children--updated analysis of randomised controlled trials.
The efficacy of each probiotic should be evaluated separately. Previously, we have shown that Lactobacillus GG (LGG) is effective in treating acute gastroenteritis (AGE) in children. ⋯ Lactobacillus GG reduces the duration of diarrhoea. A subset of patients that is more likely to benefit includes subjects treated with a high daily dose of LGG (≥10¹⁰ CFU/day) who are either in-patients or out-patients from geographical Europe. Given the methodological limitations of many of the included trials, the evidence should be viewed with caution.
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Aliment. Pharmacol. Ther. · Sep 2013
ReviewReview article: the role of gastrointestinal hormones in the treatment of delayed gastric emptying in critically ill patients.
Delayed gastric emptying limits the administration of enteral nutrition, leading to malnutrition, which is associated with higher mortality and morbidity. Currently available prokinetics have limitations in terms of sustained efficacy and side effects. ⋯ Manipulation of endogenous secretion, physiological replacement and administration of gastrointestinal hormones in pharmacological doses is likely to have therapeutic potential in the treatment of delayed gastric emptying. Future challenges in this field will include the search for candidates with improved selectivity and favourable kinetic properties.
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Aliment. Pharmacol. Ther. · Sep 2013
Determinants of long-term outcome in severe alcoholic hepatitis.
Although short-term outcome in severe alcoholic hepatitis (SAH) is well described, its long-term course remains uncharacterised. ⋯ Estimated 5-year survival after index hospitalisation with SAH is 31.8% with alcohol relapse occurring in two-thirds of patients. Abstinence remains the only independent predictor of long-term survival. Novel strategies to improve abstinence after admission with SAH are urgently needed.
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Aliment. Pharmacol. Ther. · Sep 2013
Comparative StudyThe management of alcoholic hepatitis: a prospective comparison of scoring systems.
The assessment of alcoholic hepatitis remains controversial. Several scores have been developed or used for this purpose. ⋯ In this single-centre study, a GAHS ≥9 identified patients who may benefit from treatment of alcoholic hepatitis. Intention-to-treat randomised-controlled trials using a GAHS ≥9 as the threshold for treatment are needed to validate these findings. Response to corticosteroids can be assessed using the Lille Score or by a 25% fall in bilirubin.
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Evidence about the beneficial effects of statins on reducing infections is accumulating. Identifying ways to reduce infection risk in patients with cirrhosis is important because of increased mortality risk and costs associated with infections. ⋯ Infections are a major concern among cirrhotic patients and have the potential to seriously impact both life expectancy and quality of life. Statin use may potentially reduce the risk of infections among patients with cirrhosis.