Gastroenterology

Antibodies to inflixumab

Antibodies to infliximab (ATIs) have been associated with loss of clinical response and lower serum infliximab (IFX) levels in some studies of patients with inflammatory bowel disease (IBD). Lower drug levels can mean less effect ont eh disease.  It is clinically useful to be able to  assess and predict diminishing response. A recent meta-analysis concluded that the presence of ATIs is associated with a significantly higher risk of loss of clinical

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Octreotide in gastrointentinal angiodysplasia – pro

Angiodysplasias are usually asymptomatic but they can cause of GI bleeding in 3–6% of all patients and are a more common cause of beeeding in the elderly. It is notoriously difficult to treat. A number of reports suggest that it is a valuable adjunct in the treatment of gastro-inestinal dysplasia and can decrease bleeding. There are no supportive guidelines to my knowledge but the role of somatostatin analogues for refractory bleeding GI angiodysplasias

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Treatment of sclerosing mesenteritis

Sclerosing mesenteritis, also called mesenteric panniculitis, is a rare non-neoplastic disease that affects the small bowel mesentery with chronic fibrosing inflammation. Although a relatively benign condition, sclerosing mesenteritis can have a prolonged debilitating course with a fatal outcome. There are few data on the natural history and therapeutic options for this condition. Tamoxifen in combination with prednisone is the most common treatment,

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Octreotide for Small Bowel Obstruction

Malignant bowel obstruction (MBO) is a common and very difficult problem to manage at the end of the course of ovarian cancer, Surgery can help but is not always possible and often only temporarily effective. It should not be undertaken in patients known to have poor prognostic criteria for surgical intervention such as intra-abdominal carcinomatosis, poor performance status and massive ascites. Nasogastric drainage should generally only be a temporary

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Incivik

Telaprevir(Incivik) is the first hepatitis C drug that has demonstrated activity in patients who have failed prior therapy. In patients who received peginterferon alfa-2a and ribavirin for a year, the addition of telapravir for 24 weeks achieved a sustained virologic response(SVR) of 53% compared to 14% in patients who did not receive telapravir.It is thought that some patients who accomplish this outcome may be cured of Hepatitis, a feat rarely

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