EMBARGOED FOR RELEASE UNTIL 5 P.M., EDT, WEDNESDAY, APRIL 30, 1997
May 1, 1997, Tip Sheet
Annals of Internal Medicine is published by the American College of Physicians (ACP), more than 100,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.
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Recently Cloned Cell Activating Molecule Increases Platelet Production in Cancer Patients
A single intravenous dose of thrombopoietin, a recently cloned cytokine (a cell activating molecule), stimulates prolonged platelet production, a study shows. (Article, p. 673.) A cohort study of 12 patients with sarcoma and chemotherapy-induced bleeding episodes found that a single dose of thrombopoietin produced prolonged increases in platelet counts. Treatment with thrombopoietin before chemotherapy may provide cancer patients with a holdover period until platelet production is 1) resumed after chemotherapy and 2) possibly enhanced by further treatment given after chemotherapy, the authors state. These are preliminary study results and further studies are needed before thrombopoieten treatment is completely understood.
An accompanying editorial discusses clinical settings for which thrombopoietin may be useful and effective. (Editorial, p. 731.)
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Treatment Results in Remission of Liver Disease
Remission of primary biliary cirrhosis may occur in a limited number of patients in response to therapy with methotrexate, a study finds. (Article, p. 682.) A prospective case study of patients with precirrhotic primary biliary cirrhosis who received treatment for at least six years found their liver disease went into remission during treatment with low-dose oral methotrexate alone or in combination with colchicine or ursodiol. The results look promising for a disease previously resistant to treatment. While these preliminary results were studied in a small number of patients, further randomized trials are being conducted.
An accompanying editorial examines issues raised by the study, including the natural history of primary biliary cirrhosis, appropriate end points for trials of treatment of this disease.
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Chronic Nausea Can be Caused by Reflux Disease
Chronic nausea is not typically attributed to gastroesophageal reflux disease.
Patients who have unexplained nausea but normal findings on standard gastric
tests should consider a 24-hour esophageal pH study to determine if their
condition is associated with gastroesophageal reflux disease, a study shows.
(Article, p. 704.) Nausea related to gastroesophageal reflux disease can be
effectively treated with proton-pump inhibitors or promotility drugs.
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