Octreotide infusion or emergency sclerotherapy for variceal haemorrhage

Sung, Joseph J.Y.; Lai, Chi Wai; Chan, Francis K.L.; Leung, Joseph; Kassianides, Chris; Chung, S. C. S.; Yung, Man Yee; Li, A. K C

doi:10.1016/0140-6736(93)91758-e

Cited by 185 publications

(94 citation statements)

References 11 publications

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“…Hepatic artery vascular resistance (HAVR) was calculated using the following formula: HAVR dyn.s.cm À5 a 100 g Â 10 3 mean arterial pressure (mmHg)´80/ hepatic artery blood¯ow (mL.min/100 g).…”

Section: Haemodynamic Measurementsmentioning

confidence: 99%

Haemodynamic responses to a combination of terlipressin and octreotide in portal hypertensive rats

Moreau

Cailmail

Valla

et al. 1997

Aliment Pharmacol Ther

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INTRODUCTIONTerlipressin or somatostatin given alone are used as ®rst-line treatments of variceal haemorrhage. 1±9 These two substances act on the splanchnic circulation through different mechanisms. Terlipressin elicits a direct splanchnic vasoconstriction, 10 while somatostatin increases splanchnic vascular resistance by suppressing endogenous vasodilator peptides. 11 Therefore, a combination of terlipressin and octreotide may have more marked splanchnic haemodynamic effects than either substance alone. On the other hand, as both terlipressin 10 and somatostatin 12 decrease cardiac index, a combination of these drugs may result in a dangerous decrease in this value. Thus, more information is necessary on the haemodynamic effects of the combination of terlipressin and somatostatin. The aim SUMMARY Background: An enhancement of the haemodynamic effects of terlipressin by octreotide (and vice versa) may be useful in the treatment of portal hypertension. The aim of this study was to investigate the short-term effects of terlipressin, octreotide or a combination of these substances on splanchnic and systemic haemodynamics in rats with portal vein stenosis. Methods: Eight rats received an intravenous (i.v.) infusion of isotonic saline (10 lL/min for 15 min). Eight rats received terlipressin ®rst (0.05 mg/kg) and then an i.v. infusion of octreotide (8 lg.h/kg for 15 min) 15 min later. Eight other rats ®rst received an i.v. infusion of octreotide and then terlipressin 15 min later. Splanchnic and systemic haemodynamics (radioactive microsphere method) were measured after saline, after terlipressin or octreotide alone, and after the combined treatments. Results: Terlipressin and octreotide alone signi®cantly decreased portal pressure, portal tributary blood¯ow

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Section: Haemodynamic Measurementsmentioning

confidence: 99%

Haemodynamic responses to a combination of terlipressin and octreotide in portal hypertensive rats

Moreau

Cailmail

Valla

et al. 1997

Aliment Pharmacol Ther

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“…Estudos realizados (26,27,32,34,36,40) têm demonstrado que a somatostatina ou seu análogo sintético, o octreotide, é tão eficaz quanto a escleroterapia, tratamento considerado padrão na maioria dos centros médicos, no controle da HDA por ruptura de varizes esofágicas ou na prevenção do ressangramento precoce (17) . Deve-se, no entanto, ressalvar o fato de que o octreotide parece não ter a mesma eficácia que a somatostatina (2,4,9) .…”

Section: Discussionunclassified

“…Outros estudos obtiveram resultados semelhantes (32,36,40) . Assim, PLANAS et al (32) , quando estudaram 70 pacientes, observaram falha terapêutica em 20% no grupo da somatostastina e 17% no grupo da escleroterapia e mortalidade, em 1 semana, semelhante em ambos os grupos (11,5%).…”

Section: Discussionunclassified

“…O diagnóstico de sangramento decorrente da ruptura de varizes de esôfago foi realizado quando havia presença de sangramento ativo em jato ou em "babação", estigmas de sangramento recente (erosão ou coágulo sobre as varizes) ou presença de sangue no esôfago ou no estômago, e varizes esofágicas, como única causa potencial de sangramento (27,32,34,36) .…”

Section: Methodsunclassified

“…Estudos randomizados mostraram que a somatostatina e seu análogo sintético -o octreotide -são mais eficazes que a vasopressina (8,15,29) e têm eficácia semelhante à terlipressina (18,31,39,42) , ao balão de Sengstaken-Blakemore (1,25) e à escleroterapia (17,26,27,32,34,36,40) no controle do sangramento agudo por varizes esofágicas, tendo como principal mérito o fato de seus efeitos colaterais, quando presentes, serem discretos (12) .…”

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Escleroterapia versus somatostatina na hemorragia digestiva alta por ruptura de varizes esofágicas

Ramires

Zils

Mattos

2000

Arq. Gastroenterol.

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INTRODUÇÃOA prevalência de varizes gastroesofágicas (VGE) em pacientes cirróticos é de aproximadamente 60%. Uma vez presentes, observa-se risco médio de sangramento de 32% em 2 anos. Por outro lado, o risco de ressangramento é muito alto, atingindo um pico na primeira semana, mas permanecendo elevado até o terceiro mês, com índices de até 70% em um ano (21,22) . Paralelamente, observa-se que a mortalidade do paciente com sangramento é de 30% a 50% dos casos, ou seja, maior do que três vezes aquela por sangramento digestivo de outra causa (6,15,29,30) . Em decorrência da freqüência da hemorragia digestiva alta (HDA) por ruptura de VGE e do mau prognóstico que a

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Statistical reviewing for medical journals

Altman¹

1998

Statist. Med.

136

107

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This paper reviews the difficulties associated with being a statistical reviewer for a medical journal. As background, I consider first the use of statistical reviewers by medical journals, medical journals' policies on statistical peer review, and the limited evidence of its effectiveness. The assessment of a manuscript is considered under the headings of design, methods of analysis, presentation and interpretation, with many illustrative examples of the difficulties to be overcome. I emphasize the judgemental nature of many aspects. I suggest how to present and structure the reviewer's report to the editor. Finally, I consider wider issues, including the various other ways in which statisticians can interact with medical journals. © 1998 John Wiley & Sons, Ltd.

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Octreotide infusion or emergency sclerotherapy for variceal haemorrhage

Cited by 185 publications

References 11 publications

Haemodynamic responses to a combination of terlipressin and octreotide in portal hypertensive rats

Haemodynamic responses to a combination of terlipressin and octreotide in portal hypertensive rats

Escleroterapia versus somatostatina na hemorragia digestiva alta por ruptura de varizes esofágicas

Statistical reviewing for medical journals

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