Gastroenterology

Prophylaxis for stress ulcers – pro

A variety of medical factors can create stress and place a patient at at risk of gastroduodenal ulcerations and bleeding. Among teh most common are prolonged mechanical ventilation, coagulopathy, multiple injuries, spinal cord injury, injury, acute renal failure, and administration of high-dose steroids. The latter usually ocurrs in the setting of chemotherapy. A variety of interventions have been studied, including: Histamine-2 receptor antagonists,

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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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Interferon for VIPoma – pro

The VIPoma syndrome is rare and difficult to treat and for this reason, ti is not well studied. It is usually caused by a neuroendocrine tumor located in the pancreas or other organs and present primarily with diarrhea. Treatment relies on resection and octreotide but occasionally interferon or steroids can be used as adjuncts (Best Practice, Eppocrates). On the other hand, other reviews do not mention interferon or mention it in combiantion with

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Octreotide for Malignant Bowel Obstruction – pro

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 – pro

Telaprevir 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 accomplished

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Treatment of Sclerosing Mesenteritis – pro

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 outcomeThere are few data on the natural history and therapeutic options for this condition. Tamoxifen in combination with prednisone is teh most common treatment,

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