OLORECTAL CANCER IS THE second most prevalent cancer worldwide. 1 There were about 1 million new cases and 500 000 deaths due to colorectal cancer in 2002. 1 It has been estimated that 1 in 20 healthy individuals will eventually develop colorectal cancer. Coronary artery disease (CAD) is the single leading cause of death in the United States and other industrialized countries. 2 We previously published a retrospective study that reported a strong Author Affiliations: Departments of Medicine (Drs A.

Summary Background:  In average‐risk patients, the new anti‐platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high‐risk patients. Aim:  To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. Methods:  During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non‐aspirin‐related peptic ulcer disease or a history of aspirin‐related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end‐point. Results:  After a median follow‐up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel‐associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007; odds ratio, 1.3; 95% confidence interval, 1.1–1.5). Conclusions:  Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high‐risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.

SUMMARYBackground: Clopidogrel causes significantly less symptomatic peptic ulcer disease and gastrointestinal bleeding than low-dose aspirin in average-risk patients. The gastrotoxicity of clopidogrel in patients with active peptic ulcer disease is unknown. Aim: To compare the incidence of unhealed ulcers in patients receiving clopidogrel or aspirin. Methods: Patients with aspirin-induced peptic ulcer disease treated with omeprazole (20 mg/day) were randomized to receive clopidogrel (75 mg/day) or to continue with low-dose aspirin. Success was defined as ulcer/erosion healing at the eighth week. Results: One hundred and twenty-nine patients were recruited (69 received clopidogrel and 60 continued with aspirin). Thirty-one (45%) in the clopidogrel group and

The [13C]-UBT protocols without prior fasting and either with or without test meal produce highly accurate and reliable results in the Chinese population.

SUMMARYAim: Pyogenic liver abscesses result in substantial morbidity and mortality. Antimicrobial regimens using sequential intravenous=oral therapy may reduce the length of hospital stay. In this retrospective analysis, the efficacy of continuous intravenous antibiotic therapy (group I) vs. sequential intravenous=oral antibiotic therapy (group II) was studied in patients with pyogenic liver abscess. Methods: One hundred and twelve consecutive patients (55 in group I and 57 in group II) with pyogenic liver abscess were analysed. Clinical response, length of hospital stay and relapse rates were examined.Results: Group II had a significantly shorter duration of intravenous antibiotic treatment (3.2 weeks vs. 5.9 weeks, P < 0.01) and a shorter length of hospital stay (28 days vs. 42 days, P < 0.01) when compared to group I. Oral antibiotics were prescribed for a median duration of 2.9 weeks in group II after discharge. No relapse occurred within 6 weeks after the completion of treatment in both groups. The cost of therapy was significantly lower in group II than in group I by 33%. Conclusions: A sequential intravenous=oral antibiotic regime is a safe and effective treatment for pyogenic liver abscess. This reduces the cost of therapy and the length of hospital stay.