Indications of combined vitamin K antagonists and aspirin therapy.

Based on their mode of action, it is reasonable to expect that the combination therapy of aspirin and a vitamin K antagonist (VKA) may be more beneficial in preventing (athero) thrombotic complications in high-risk patients for cardiovascular events. However, there is no consensus about additional aspirin use in the most common indications for VKA or the use of VKAs to be added to the most common aspirin indications. The variation in clinical outcomes and bleeding complications suggests that extrapolating from one indication to another may not be appropriate.

Duodenal metastasis: an uncommon cause of occult small intestinal bleeding.

Duodenal metastases are a very uncommon and peculiar cause of upper gastrointestinal bleeding. However, they should be considered in a patient presenting with upper gastrointestinal bleeding and a previous history of malignancy. The importance of recognising the unusual presentation of duodenal metastasis has to be emphasised.

Splenic abscess caused by Peptostreptococcus species, diagnosed with the aid of abdominal computerized tomography and treated with percutaneous drainage and antibiotics: a case report.

We describe herein a 63-year-old patient with a splenic abscess due to Peptostreptococcus spp., diagnosed with the aid of abdominal computerised tomography and treated with ultra-sound guided percutaneous drainage and antibiotics. The bacteriological characteristics of splenic abscesses are discussed.

Ticlopidine-induced thrombocytopenia.

A case is presented of a 58-year-old woman developing profound thrombocytopenia within one week after starting treatment with ticlopidine. Ticlopidine was prescribed following coronary artery stenting. The patient recovered rapidly after discontinuation of the drug, suggesting a possible relationship between ticlopidine and thrombocytopenia.

Cholestyramine influences meal-stimulated pancreaticobiliary function and plasma cholecystokinin independent of gastric emptying and food digestion.

Background: Cholestyramine enhances gallbladder emptying and plasma cholecystokinin responses to oral ingestion of a mixed meal. It is not known whether this effect occurs independently of alterations in gastric emptying or maldigestion of nutrients.

Methods: We perfused 15 g of an amino acid meal intraduodenally for 60 min in seven healthy volunteers, once with and once without cholestyramine.