Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Reviews



Bowel preparation for colonoscopy : Efficacy, tolerability and safety


Price: €10,00

Adequate cleansing of the bowel is important for a reliable and diagnostic colonoscopy. Proper bowel preparation is directly correlated to the diagnostic performance of colonoscopy, procedure time, cost price and the complication rate. The ideal bowel preparation agent should be efficient, safe and well tolerated by the patient. Numerous agents have become commercially available overtime. Current agents can be classified according to their tonicity, as being isotonic or hypertonic. Poly-ethylene glycol based solutions balanced with electrolytes are the prototype of isotonic bowel preparations. Poly-ethylene solutions are safe and efficient in cleaning the bowel. Volume related side-effects are common, leading to innovations such as split dosing, and low volume solution combined with another laxative. Sodium phosphate and magnesium oxide are hypertonic agents. They are efficient and well tolerated, but safety issues regarding sodium phosphate has hampered its success. Because most physician are likely to prescribe bowel preparation agents for colonoscopy, they should be aware of the range of preparations commercially available and their limitations. This review focuses on the efficacy, tolerability and safety of current available bowel preparation agents. (Acta gastroenterol. belg., 2014, 77, 249-255). [Product Details...]



Use of antiemetics in the prevention of chemotherapy-induced nausea and vomiting : review and focus on the Belgian situation


Price: €10,00

Chemotherapy-induced nausea and vomiting (CINV) is a common, distressing, debilitating and costly side effect, experienced by up to 90% of patients receiving highly emetogenic drugs. During the last 20 years great advances have been made in the prevention and treatment of CINV. Aprepitant (a neurokinin-1 antagonist) and palonosetron (a 5-HT3 antagonist) are the most recent additions to the available armamentarium. The aim of this paper is to review the most recent findings concerning the pathophysiology and prevention of CINV, and the international guidelines currently in place for its prevention and treatment. Among the treatments available, 5-HT3 antagonists and NK-1 antagonists are compared. In a large meta-analysis (8 studies in 3 592 patients) statistically significant differences in favour of palonosetron compared with first-generation 5-HT3 antagonists have been demonstrated in the prevention of acute, delayed and overall CINV. A recent, large phase III randomized, gender-stratified, double-blind trial in 848 patients receiving a broad range of moderately emetogenic chemotherapy regimens with a variety of tumour types showed superiority of an aprepitant triple regimen compared to a control regimen of ondansetron and dexamethasone. A new combined 5-HT3/ NK-1 treatment, called NEPA (palonosetron/netupitant), has provided very promising preliminary data and is awaited with great anticipation by clinicians. The specific Belgian situation in terms of Health Authorities recommendations and reimbursement policies is also presented. It is concluded that further improvements are still desirable, particularly in the prevention and treatment of delayed emesis. (Acta gastroenterol. belg., 2014, 77, 240-248). [Product Details...]


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