There is ongoing controversy of how clinically significant it is that PPIs reduce the anti-platelet effect of clopidogrel. In this case-control of patients who had a stroke / TIA and who were started on clopidogrel, those who were also on a PPI did not have an increased risk of subsequent stroke or death, compared to those not on a PPI. Similar to the recommendations for patients on clopidogrel for cardiovascular protection, those on clopidogrel for cerebrovascular protection who also require a PPI should probably be on pantoprazole (instead of omeprazole or esomeprazole) (abstract)
This large systematic review found rectal NSAIDs significantly reduced the risk of post-ERCP pancreatitis compared to pancreatic duct stents (abstract).
This large population-based cohort found the most common causes of drug induced liver injury to be augmentin and diclofenac, followed by herbal and nutritional supplements (abstract).
This large trial of patients with a relative contraindication for enteral feeds were randomized to early TPN or usual care. There were no differences in the groups in 60 day mortality or LOS, but those on TPN did have a shorter time ventilated and less muscle/fat loss. It is unclear based on this trial if […]