Non-selective beta blockers are very useful drugs in preventing first variceal bleeding and re-bleeding in patients with cirrhosis. These drugs work in two ways: 1) by blocking beta1 receptors and reducing cardiac output, and 2) by blocking beta2 receptors, producing splanchnic vasoconstriction and reducing portal flow. Consequently, they reduce portal pressure. In primary prophylaxis, beta blo...

Three recently concluded large randomized clinical trials have compared the preventive effects of diuretic agents and beta-blockers in the treatment of approximately 22,000 subjects with hypertension. In the Medical Research Council trial, bendrofluazide (10 mg daily) was compared with a dose of propranolol (as much as 240 mg daily), a nonselective beta-blocker without intrinsic sympathomimetic...

Hypersplenism in chronic liver diseases (CLD) is characterized by splenomegaly and thrombocytopenia. Thrombocytopenia is a contraindication to percutaneous liver biopsy, which is an important procedure for diagnostic work-up of liver disease. In children, the etiologies of CLD are more diverse than in adults, and include congenital, metabolic and infiltrative diseases as well as viral hepatitis...

Non-selective β-blockers (NSBBs) could eff ectively prevent the development of fi rst variceal bleeding in cirrhotic patients with medium/large varices. However, as recently reviewed by Giannelli et al [1], the clinical benefi t of NSBBs remains controversial in cirrhotic patients with small varices. In line with their considerations, we would like to further comment on the controversy. A previ...

INTRODUCTION According to the convincing evidence, a decline in mortality rate has been achieved with beta-blockers in patients with an acute myocardial infarction and in post-infarction follow-up. In fact, there has been a clear reduction of sudden coronary death. The necessary condition for the efficiency of beta-blockers is an early use. They are also a medication of choice for angina after ...

BACKGROUND American College of Cardiology and American Heart Association (ACC/AHA) guidelines on perioperative assessment recommend perioperative beta blockers for non-cardiac surgery, although results of some clinical trials seem not to support this recommendation. We aimed to critically review the evidence to assess the use of perioperative beta blockers in patients having non-cardiac surgery...

Although personalized medicine is an ideal concept, there remains little training or discussion to its applicability for the primary care provider. Psychiatric, cardiac, gastrointestinal, and pain are common complaints/conditions seen in care, treatment options have genomic implications. This article provides experienced clinician with background, clinical utility, of pharmacogenetics medicatio...

BACKGROUND To investigate the association between post-diagnostic beta-blocker usage and risk of cancer-specific mortality in a large population-based cohort of female breast cancer patients. METHODS A nested case-control study was conducted within a cohort of breast cancer patients identified from cancer registries in England(using the National Cancer Data repository) and diagnosed between 1...

For more than 3 decades beta blockers have been widely used in the treatment of hypertension and are still recommended as first line agents (1,2). Beta blockers have been in use not only in hypertension but in other cardiovascular conditions. Since long period, beta blockers have assumed a guideline-recommended treatment option for hypertension. However, recent meta-analyses have questioned whe...