Moderate and high affinity serotonin reuptake inhibitors increase the risk of upper gastrointestinal toxicity.

Objective: Serotonin release from platelets is important for regulating hemostasis. Some prior studies suggest an association between use of selective serotonin reuptake inhibitors and gastrointestinal bleeding and a possible synergistic effect of these medications with non-steroidal anti-inflammatory drugs (NSAIDs). This study examined the effect of medications that inhibit serotonin uptake on upper gastrointestinal toxicity.

Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes.

Aims: Although underestimated by interventional cardiologists for a long time, radiation exposure of operators and patients is currently a major concern. The objective of the present operator-blinded registry was to compare related-peripheral arterial route radiation exposure of operators.

Methods And Results: During 420 consecutive coronary angiograms (CAs) and percutaneous coronary interventions (PCIs), four interventional cardiologists were blindly screened.

[Edema and protein-losing enteropathy complicating chronic constrictive pericarditis associated with an ascending aortic aneurysm].

Introduction: Chronic constrictive pericarditis is suspected on clinical and echocardiographic grounds. Its treatment is surgical.

Case: We report here the case of a 45-year-old man, admitted for edema characteristic of lymphatic obstruction.

Low-gradient aortic stenosis: impact of prosthesis-patient mismatch on survival.

Aims: To assess the prognostic impact of prosthesis-patient mismatch (PPM) in a large consecutive series of patients operated for low-gradient aortic stenosis (AS).

Methods And Results: Outcomes after surgery for low-gradient AS were prospectively assessed in 152 consecutive patients from seven institutions. There were 113 men (74%); mean age was 72 years (64-76); valve area, 0.

Effects of esomeprazole on acid output in patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion.

Objectives: To evaluate the efficacy and safety of oral esomeprazole in the control of gastric acid hypersecretion in patients with hypersecretory states.

Methods: In this 12-month, open-label, multicenter study, acid output (AO) was evaluated at baseline, day 10, and months 3, 6, and 12. The starting dose of esomeprazole was 40 mg or 80 mg twice daily.

Effect of pantoprazole in older patients with erosive esophagitis.

Several studies suggest that older adults with gastroesophageal reflux disease (GERD) are more likely to develop complications, including erosive esophagitis, but it is unclear whether erosive esophagitis is more difficult to treat in older patients. The purpose of this study was to determine if adults > or = 65 years with erosive esophagitis are more difficult to treat than younger adults. The study was a post hoc analysis of two double-blind, randomized, multicenter trials of patients with erosive esophagitis.

Competitive speed eating: truth and consequences.

Objective: The purpose of our investigation was to assess the stomachs of a world-class speed-eating champion and of a control subject during a speed-eating test in our gastrointestinal fluoroscopy suite to determine how competitive speed eaters are able to eat so much so fast.

Conclusion: Our observations suggest that successful speed eaters expand the stomach to form an enormous flaccid sac capable of accommodating huge amounts of food. We speculate that professional speed eaters eventually may develop morbid obesity, profound gastroparesis, intractable nausea and vomiting, and even the need for a gastrectomy.

Randomised comparison of femoral versus radial approach for percutaneous coronary intervention using abciximab in acute myocardial infarction: results of the FARMI trial.

Objective: To compare bleeding complications and results of percutaneous coronary intervention (PCI) between patients treated by radial and femoral approaches for acute myocardial infarction (AMI,) and using abciximab and 5 French guiding-catheters.

Patients: 114 consecutive patients with AMI were prospectively randomised. Exclusion criteria were a history of coronary artery bypass graft, cardiogenic shock, atrioventricular block, and contraindication to abciximab or a negative Allen test.

Noninvasive measurement of transit time in short bowel syndrome.

Background: Patients with short bowel syndrome (SBS) have limited absorption of nutrients, in part because of the rapidity with which chyme passes through the bowel. We sought to evaluate noninvasive measurements of intestinal transit time to aid in research questions where transit is measured repeatedly.

Methods: Three methods were compared in 8 patients with SBS: the time for blue food color to appear in ostomy effluent or stool, lactulose breath hydrogen testing, and the first radiopaque ring from a capsule in timed stool samples.

Percutaneous coronary intervention-induced variations in systemic parameters of inflammation: relationship with the mode of stenting.

Background: During percutaneous coronary intervention, the technique of stent implantation (both direct and complementary stenting) is guided using both clinical and angiographic features. We assessed potential relationships between procedural parameters and angioplasty-induced variations in inflammatory parameters in patients treated by these two different techniques.

Methods: A total of 85 consecutive patients due to undergo stent implantation were prospectively enrolled.

Long-term proton pump inhibitor therapy and risk of hip fracture.

Context: Proton pump inhibitors (PPIs) may interfere with calcium absorption through induction of hypochlorhydria but they also may reduce bone resorption through inhibition of osteoclastic vacuolar proton pumps.

Objective: To determine the association between PPI therapy and risk of hip fracture.

Design, Setting, And Patients: A nested case-control study was conducted using the General Practice Research Database (1987-2003), which contains information on patients in the United Kingdom.

On-demand therapy for gastroesophageal reflux disease.

The following pages summarize the proceedings of a symposium held in May 2006 on the emerging role of on-demand therapy for gastroesophageal reflux disease (GERD). Medical therapy for GERD has undergone significant change in recent years with the advent of effective, but expensive, antisecretory agents. On-demand (patient-driven) therapy is attractive to payers and patients, because it appears to be both cost-effective and convenient.

Development of a tool to assess past food insecurity of immigrant latino mothers.

Objective: The purpose is to describe the development and validation of a tool to measure the degree of past food insecurity in an immigrant US population.

Design: Focus group discussions and a structured interview. As a first step, focus group discussions were conducted among immigrant Latino mothers.

Radiation-induced bilateral coronary ostial stenosis in a 17-year-old patient.

Mediastinal irradiation can induce coronary artery disease characterized by the localization of lesions at the proximal segment of the arteries. We report the case of a 17-year-old patient who underwent a mediastinal irradiation for pulmonary sarcoma and developed 15 years later an asymptomatic ischemic cardiopathy. Bilateral coronary ostial stenosis was discovered by a transthoracic echography and coronary angiography showed isolated bilateral ostial stenosis.

Discovery of aminoquinazolines as potent, orally bioavailable inhibitors of Lck: synthesis, SAR, and in vivo anti-inflammatory activity.

The lymphocyte-specific kinase (Lck) is a cytoplasmic tyrosine kinase of the Src family expressed in T cells and natural killer (NK) cells. Genetic evidence in both mice and humans demonstrates that Lck kinase activity is critical for signaling mediated by the T cell receptor (TCR), which leads to normal T cell development and activation. Selective inhibition of Lck is expected to offer a new therapy for the treatment of T-cell-mediated autoimmune and inflammatory disease.

Intravenous pantoprazole as initial treatment in patients with gastroesophageal reflux disease and a history of erosive esophagitis: a randomized clinical trial.

We sought to evaluate safety and efficacy of IV pantoprazole when used as initial therapy in patients with gastroesophageal reflux disease (GERD) and a history of erosive esophagitis (EE) in a double-blind, placebo-controlled, randomized, parallel-group study. Patients were randomized to 7 days of once-daily IV or oral pantoprazole (40 mg) or placebo. Efficacy variables included maximal acid output, basal acid output, and changes from baseline in frequency/severity of GERD symptoms, and frequency of antacid usage.

Novel 2-aminopyrimidine carbamates as potent and orally active inhibitors of Lck: synthesis, SAR, and in vivo antiinflammatory activity.

The lymphocyte-specific kinase (Lck) is a cytoplasmic tyrosine kinase of the Src family expressed in T cells and NK cells. Genetic evidence in both mice and humans demonstrates that Lck kinase activity is critical for signaling mediated by the T cell receptor (TCR), which leads to normal T cell development and activation. A small molecule inhibitor of Lck is expected to be useful in the treatment of T cell-mediated autoimmune and inflammatory disorders and/or organ transplant rejection.

Successful aspiration and ethanol sclerosis of a large, symptomatic, simple liver cyst: case presentation and review of the literature.

Simple liver cysts are congenital with a prevalence of 2.5%-4.25%.

Analysis of the acidity index and integrated intragastric acidity in 645 patients presenting with gastroesophageal reflux disease symptoms.

Objective: In a recent study of patients receiving proton-pump inhibitor (PPI) therapy, a new parameter, the acidity index, was described as being less complicated to calculate and of comparable accuracy (r = 0.93) to integrated intragastric acidity (IA) in assessing intragastric pH control. The aim of this study was to correlate AI with IA using a large database of ambulatory 24-h pH-metry studies in untreated patients presenting with gastroesophageal reflux disease (GERD) symptoms.

Lansoprazole regimens that sustain intragastric pH > 6.0: an evaluation of intermittent oral and continuous intravenous infusion dosages.

Background: Orally and intravenously administered proton pump inhibitors have been shown to reduce rebleeding rates, surgery and transfusion requirement.

Aim: To compare lansoprazole intravenous and orally disintegrating tablet (Prevacid SoluTab) regimens with a pantoprazole intravenously administered regimen in sustaining intragastric pH >6.0.

Dose-response evaluation of the antisecretory effect of continuous infusion intravenous lansoprazole regimens over 48 h.

Background: Attainment of intragastric pH < 6.0 may require high-dose continuously infused proton pump therapy.

Aim: To assess the pharmacokinetic and pharmacodynamic dose-responses of continuous infusion regimens of lansoprazole.

Liver transplantation for metastatic neuroendocrine tumor: a case report and review of the literature.

Neuroendocrine tumors are divided into gastrointestinal carcinoids and pancreatic neuroendocrine tumors. The WHO has updated the classification of these lesions and has abandoned the term "carcinoid". Both types of tumors are divided into functional and non-functional tumors.

Three-year oral pantoprazole administration is effective for patients with Zollinger-Ellison syndrome and other hypersecretory conditions.

Background: Zollinger-Ellison syndrome and idiopathic hypersecretion are gastrointestinal hypersecretory conditions requiring long-term maintenance.

Aims: The safety and efficacy data for short-term (6-month) treatment of Zollinger-Ellison syndrome and idiopathic hypersecretion with oral pantoprazole were previously published. This study extends the initial observations to 3 years.

Effect of syllable-initial voicing on vowel duration during simultaneous communication.

Unlabelled: Vowel durations following the production of voiced and voiceless stop consonants produced during simultaneous communication (SC) were investigated by recording sign language users during SC and speech alone (SA). Under natural speaking conditions, or speaking alone (SA), vowels following voiced stop consonants are longer in duration than vowels following voiceless stops. Although the results indicated longer sentence durations for SC than SA, they showed no differences in the relative duration of vowels following voiced or voiceless stops.

Advances in gastrointestinal pharmacotherapy.

The medical management of patients with gastrointestinal diseases is advancing rapidly. At a recent symposium held during Digestive Disease Week in Chicago in May of 2005, specific attention was given to the future prospects for medical management of 3 common gastrointestinal disease areas: antisecretory therapy, chronic hepatitis C, and inflammatory bowel disease. Antisecretory approaches include drug combinations including a proton pump inhibitor, potassium competitive acid blockers, and antigastrin agents.