Procedures

Radiofrequency coagulation for osteoblastic osteoma – pro

Osteoid osteoma is a benign osteoblastic tumor. The literature suggests a history of resolving pain and healing of the lesions, but the course can be variable. The course of this disease is unpredictable and protracted, with intervals of resolution of pain that sometimes last 6-15 years. Initial treatment of osteoid osteoma remains non-operative, with medications consisting of aspirin or other NSAIDs. There is a variety of operative approaches. Surgical

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Neupogen for Stem Cell Mobilization: Dose and Duration – pro

Neupogen is often used to mobilize hematopoietic progenitor cells into the peripheral blood for collection by leukophereses for members who are undergoing peripheral blood progenitor cell". It is FDA approved: "NEUPOGEN® (filgrastim) is indicated for the mobilization of hematopoietic progenitor cells into the peripheral blood for collection by leukapheresis. Mobilization allows for the collection of increased numbers of progenitor cells capable

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TACE for Liver Metastases from Ovarian Cancer – pro

Transcatheter arterial chemoembolization (TACE) of the liver is a proposed alternative to conventional systemic or intra-arterial chemotherapy, and to various nonsurgical ablative techniques, to treat resectable and nonresectable tumors. The rationale for TACE is that infusions of viscous material containing one or more antineoplastic agents may exert synergistic effects: cytotoxicity from the chemotherapy, potentiated by anoxia in the infarcted

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Combined Resection for Anal Cancer – pro

While a combined resection of rectal cancer and partial hepatectomy are well established, the same is not the case for anal cancer. Metastatic anal cancer is not well studied in regard to combined resection. NCCN recommends only 5FU and cisplatin or cisplatin for metastatic anal cancer. A recent review states: " Metastatic disease develops in 10%–17% of patients treated with chemoradiation therapy. The most common site of distant metastasis is

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Sacroiliac Injection – pro

Sacroiliac injection can be used diagnostically or therapeutically. There are no prospective a controlled trials to support this procedure. Most support comes from case reports or case series. Case series are unreliable evidence due to the variable natural history of back pain, the presence of confounders of outcome, and the potential for a placebo effect. In general, the literature regarding injection therapy on joints in the back is of poor quality.

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Routine MCP or ERCP surveillance for Cholagniocarcinoma or Liver Cancer in Patients with Primary Biliary Cirrhosis – pro

Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease characterized by inflammation and fibrosis of both intrahepatic and extrahepatic bile ducts. It is thoughtto be an immune mediated, progressive disorder that eventually develops into cirrhosis, portal hypertension and hepatic decompensation, in the majority of patients. Guidelines do not recommend routine MRCP or ERCP to screen for chalngiocarcinoma or hepatocellular carcinoma.

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