Tegaserod and the risk of cardiovascular ischemic events: an observational cohort study.

Objectives: Tegaserod, a partial 5-HT(4) agonist previously approved for treatment of irritable bowel syndrome with constipation and chronic idiopathic constipation, was suspended from US marketing in 2007, based on pooled clinical trial results which contained a signal suggesting increased risk of cardiovascular ischemic events (CVIEs). We sought to evaluate whether there was an association between tegaserod and CVIE in a setting of routine clinical practice.

Methods: This was a matched cohort study conducted within a large US health insurance database, involving 52 229 patients who initiated tegaserod and 52 229 patients with similar characteristics who did not initiate tegaserod.

Tegaserod treatment for dysmotility-like functional dyspepsia: results of two randomized, controlled trials.

Objectives: Therapies for dysmotility-like functional dyspepsia (FD) are limited. We studied tegaserod, a selective serotonin type 4 receptor agonist, in patients with FD.

Methods: Two identical multicenter, double-blind, randomized, placebo-controlled trials enrolled women >/=18 yr with recurring mid-upper abdominal discomfort characterized by postprandial fullness, early satiety, and/or bloating.

Assessment of potential risk factors associated with ischaemic colitis.

Ischaemic colitis (IC) has been associated with a number of diverse disorders and risk factors, including irritable bowel syndrome (IBS) and constipation. We sought to assess, through a large-scale population study, the potential risk factors associated with IC. Patients with IC and matched controls without IC were identified using the medical and pharmacy claims data from the HealthCore Managed Care Database from 1st January 2000 to 31st May 2005.

Significant enhancement of esophageal pre-epithelial defense by tegaserod: implications for an esophagoprotective effect.

Background & Aims: Tegaserod, a serotonin 5-hydroxytryptamine (5-HT)4 receptor agonist, is thought to stimulate intestinal secretions. The aim of the current study was to assess the effect of tegaserod vs placebo on salivary and esophageal protective factors in patients with gastroesophageal reflux disease (GERD).

Methods: This study was a randomized, double-blind, placebo-controlled, cross-over trial in 38 GERD patients treated with tegaserod 6 mg twice a day vs placebo.

Patients with irritable bowel syndrome or constipation have an increased risk for ischaemic colitis.

Aims: To estimate the relative risk for ischaemic colitis in patients with and without irritable bowel syndrome or constipation, and to evaluate the role of irritable bowel syndrome and constipation as confounders in the relationship between commonly used gastrointestinal medications and ischaemic colitis.

Methods: Patient cohorts were identified with the use of longitudinal MarketScan research databases from 1 January 1999 to 31 December 2002. Patients in each study cohort were matched 1:1 with comparable control patients using a propensity score.

Chronic constipation: a survey of the patient perspective.

Background: Constipation is a common, often chronic, gastrointestinal motility disorder characterized by such symptoms as straining, hard stool, and infrequent defecation. Published literature is limited regarding symptom prevalence, healthcare-seeking behaviour, and patient satisfaction with traditional therapies for chronic constipation.

Aim: To assess the prevalence of chronic constipation among a random sample of Americans, to identify the frequency, severity and bothersomeness of their symptoms, and to assess satisfaction levels with traditional treatments.

Effect of tegaserod on esophageal pain threshold, regurgitation, and symptom relief in patients with functional heartburn and mechanical sensitivity.

Background & Aims: Tegaserod, a 5-HT4-receptor partial agonist, effectively treats irritable bowel syndrome with constipation. The role of tegaserod in functional disorders of the upper gastrointestinal (GI) tract is unclear. The aims of this study were to determine if tegaserod improves esophageal pain with mechanical and chemical stimuli, GI symptom profile, and global preference in patients with functional heartburn.

Somatostatinoma of the ampulla of vater in celiac sprue.

The increased incidence of gastrointestinal lymphoma and adenocarcinoma in patients with celiac sprue is well recognized, with 10% to 15% developing a gastrointestinal malignancy. Somatostatinomas are rare neuroendocrine tumors that occur most commonly within the pancreatic head or duodenum. Although fewer than 100 cases have been reported, somatostatinomas are often associated with multiple endocrine neoplasia-1 syndrome and von Recklinghausen's disease.

Malignant pericardial diseases: diagnosis and treatment.

Malignant pericardial disease is a common neoplastic entity that is often difficult to diagnose and even more difficult to treat successfully. The pathophysiology of malignant percardial disease is reviewed in this article and the various treatment options discussed.

Malignant pericardial diseases: diagnosis and treatment.

Pericardial involvement in malignant disease is fairly common. Usually the various clinical presentations--effusion, tamponade, constriction--occur in patients with known malignancy. Primary malignancy of the pericardium is rare, whereas secondary tumor involvement of the pericardium is more frequently observed.