Medical regimens in short- and long-term ulcer management

Ferroptosis in cardiovascular disease

In the 21st century, cardiovascular disease (CVD) has become one of the leading causes of death worldwide. The prevention and treatment of CVD remain pressing scientific issues. Several recent studies have suggested that ferroptosis may play a key role in CVD. Most studies conducted thus far on ferroptosis and CVD have supported the link. Ferroptosis mediated by different signaling and metabolic pathways can lead to ischemic heart disease, myocarditis, heart failure, ischemia-reperfusion injury, and cardiomyopathy. Still, the specific mechanism of ferroptosis in CVD, the particular organ areas affected, and the stage of disease involved need to be further studied. Therefore, understanding the mechanisms regulating ferroptosis in CVD may improve disease management. Throughout this review, we summarized the mechanism of ferroptosis and its effect on the pathogenesis of CVD. We also predicted and discussed future research directions, aiming to provide new ideas and strategies for preventing and treating CVD.

Long term acid suppressing treatment in general practice

OBJECTIVE

To determine the current practice in selected general practices for prescribing long term (> 6 months) treatment to suppress gastric acid secretion.

SETTING

Seven general practices in the Harrow area that always or usually refer to Northwick Park Hospital.

SUBJECTS

60,148 patients on lists of the general practices.

DESIGN

Identification of patients receiving long term treatment through repeat prescribing data, followed by a manual and computer survey of patients' notes for indications and investigations. Patient compliance and views on treatment were sought by a postal questionnaire.

MAIN OUTCOME MEASURES

Indications for treatment, treatment given, investigations undertaken before and during treatment.

RESULTS

492 patients (0.82% of the population) were taking long term acid suppressing treatment. The most common diagnosis was duodenal ulcer disease (183 (37%) of all patients); oesophageal disease (118 (24%)) was also common. 93 patients (19%) were treated for abdominal pain where no diagnosis had been reached or who had only a diagnosis of gastritis on endoscopy. Ranitidine was prescribed in 394 (80%) patients. 298 (74%) patients found treatment helpful, but 108 (27%) had a poor understanding of their diagnosis. 317 patients (78%) took their drug as prescribed. 37 patients were also taking prescribed non-steroidal anti-inflammatory drugs and an additional 43 patients took regular aspirin or ibuprofen without prescription.

CONCLUSIONS

Long term acid suppressing treatment is common, and a substantial number of patients are taking these drugs long term without a diagnosis having been reached. It is hoped that protocols for investigation and treatment will improve these figures. Patients need to be better informed about their disease and the possible adverse effects of taking non-steroidal anti-inflammatory drugs in acid related upper gastrointestinal disease.

Treatment of peptic ulcer disease with sucralfate: a review

Sucralfate has been used widely for the treatment of peptic ulcer. Healing rates for duodenal ulcer range from 60 to 90% at 4-6 weeks and up to 90% at 12 weeks for gastric ulcer. The small number of maintenance trials suggest that relapse of duodenal ulcer is reduced comparably to H2 receptor antagonists. There has been considerable interest in the possibility of lower relapse ratios after initial healing with sucralfate compared with H2 receptor antagonists, but more studies of the possible mechanisms as well as larger trials are still needed to confirm these observations.