Gastrointestinal Diseases

Xifaxin

Xifaxin ( rifaximin) is approved by the U.S. Food and Drug Administration to treat traveler's diarrhea caused by E. coli. It is especially effective for prophylaxis. It is not effective against Campylobacter jejuni, and there is no evidence of efficacy against Shigella or Salmonella species. It is, therefore, narrower in scope than other drugs used for these conditions. There is evidence that it may be efficacious in relieving chronic functional

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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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Stem and mesenchymal cell transplantation for Crohn’s disease and Ulcerative colitis – pro

The incidence and prevalence of Crohn’s disease (CD) and ulcerative colitis (UC), the two major forms of inflammatory bowel diseases (IBD), are rising in western countries. At the same time, stem cell therapies are gaining a prominent place of interest among clincal investigator. at this time, only phase I studies have been performed and are ongoing in patients with Crohn's disease. Clinical improvements in some IBD patients have been reported

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CA-19-9 for gastric cancer – pro

CA 19-9 is elevated in some cases of gastric cancer and in those cases it is often used to monitor response to chemotherapy. Approximately one third of patients with gastric cancer will have elevated levels of CEA and one third will have elevated levels of CA 19-9; Ca 19-9 is more commonly elevated in pancreatic and biliary cancer. It can be used for detecting early relapse or to monitor therapy. Unfortinately, there is not much credible medical

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PET for pancreatic cancer – pro

Pancreatic carcinoma is common in the United States, with approximately 30,000 patients each year diagnosed with pancreatic adenocarcinomas. Patients with inflammatory processes in the pancreas (pancreatitis) but no cancer can sometimes have high FDG uptake that is indistinguishable from cancers and, thus, must be differentiated from patients with cancer. FDG PET is being applied increasingly in pancreatic cancer diagnosis. A recent literature review

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Gemcitabine and irinotecan for pancreatic cancer – pro

Lay Summary: Gemcitabine and irinotecan appears to be no better than gemcitabine alone The combination of irinotecan and gemcitabine has been studied in pancreatic cancer. Rocha Lima and colleagues randomized 360 patients to either gemcitabine 1000 mg/m2 and irinotecan 100 mg/m2 on days 1 and 8 every 21 days (gem/irino) or the standard gemcitabine regimen (gem). The arms were well balanced as to age, performance status, metastatic disease, and prior

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PET for GIST – pro

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract (GIT). About 5000 to 6000 new cases of GISTs are diagnosed in the United States annually. Response to conventional chemotherapeutic agents and radiation therapy is disappointing. Early experience with the tyrosine kinase inhibitor, STI-571 (Gleevec, imatinib mesylate), has been extremely encouraging and it is now an FDA approved treatment. The role

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Pancreatic cancer treatment based on BRCA mutations status – pro

The concept of individualized therapy is being tested ina  clinical trial. One such trial  in patients with pancreatic cancer is being run by researchers at Johns Hopkins University: Olaparib in gBRCA Mutated Pancreatic Cancer Whose Disease Has Not Progressed on First Line Platinum-Based Chemotherapy (POLO) NCT02184195. There are other clinical trials of the strategy to target BRCA in pancreatic cancer. A recent report showed that Olaparib produced

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Intrahepatic chemotherapy for colon cancer metastases – pro

The potential value of hepatic intra-arterial chemotherapy (HIAC) can be considered from several different perspectives. A fundamental assumption for this discourse requires that, in this evaluation, HIAC is being provided with the intent of providing regional hepatic therapy for metastatic hepatic disease. Despite advances in colon cancer (CRC) screening, surgical techniques, and several novel adjuvant agents, CRC continues to be a significant medical

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