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Mayo clinic 2010
Mayo clinic course 2010 Hepatitis C Fixed factors with poor response, genotype, RNA level, histology, race, HIV co infection, steatosis, body weight, insulin resistance, adherence IB 28b genotype. We cannot improve insulin resistance or elevated HOMA index are less likely to respond. Improving insulin resistance did not improve outcome in spite of improving [...]
Vitamin E warning and Efficacy of Selenium?
A new study that came out in JAMA suggested that patients taking high dose Vitamin E had a higher chance of developing prosate cancer. We still await more studies for the same. The study did not show any benefit with using Selenium.
New warnings!
New FDA warnings were issued today about TNF antagonists (Remicaide, Cimzia and Humira) Fatal infections have occured with Legionella and Listeria. This is especially true with patients on TNF plus another immunusuppresant. Simvastatin has drug warnings with interactions with amidarone, diltiazem, verapamil, antifungals including diflucan and other drugs. Dose reduction or NOT using them at [...]
Office handouts – Here it is incase you lose your copy!
SOME HELPFUL HINTS Heartburn: Avoid irritants such as tomato sauce, spicy and fatty foods, fried foods, citrus fruits, chocolates, alcohol, coffee, caffeine, and cigarettes. Eat small frequent meals. Do not lie down immediately after meals. Avoid tight fitting clothes. Medicines work best if taken 30 mins. before a meal. Bloating: Avoid milk, cheese, fruits, [...]
Hepatitis C and Telaprevir
Hepatitis C and Telaprevir Telaprevir · Safe to use in COMPENSATED liver disease. Do not use in patients which Childs score more than 7. · It can only be used on Type 1 HCV pts Contraindications · Cannot use in men or women who are planning pregnancy · Must use 2 [...]
Celiac Sprue and Gluten Sensitivity
There is a newer more accurate test for celiac sprue. It is called DGP – deamide gliadin peptide. It is in IgG and IgA. There are a fair number of patients who display gluten sensitivity – this means they do not test positive for gluten but feel better when they are on a gluten free [...]
DDW Update
1) A new prototype scope is being worked on. The scope is withdrawn in the retroflexed view. Preliminary data – polyp detection with new was 94% versus 74% with regular scope and for hidden polyps 92% versus 20% for conventional scopes 2) Melatonin 6 mg/ day maybe helpful in treating GERD 3) Sacchromyces Cervasae was [...]
Hep C and Telaprevir and Boceprevir
Yesterday on 4/28/2011 the FDA panel unanimously endorsed Telapravir as an additional drug for treatment of Hepatitis C. The 2 biggest side effects are – high incidence of rash and anemia. it is used as part of triple therapy for Hepatitis C – pegylated interferon, ribavarin and a protease inhibitor like Telapravir and in the [...]
Sniff it out
Dogs have been known to sniff humans and indicate the person has colon or rectal cancer. However, they get olfactory fatigue (tired of smelling). In an article published in Gut and Irish Medical times, they have made a device which can "smell" and detect colorectal cancer.
Qnexa – Is there hope?
Qnexa, an investigational drug, for weight loss showed promise. In one study published in Lancet, it helped patients lose 22 pounds, lowered their blood pressure and cholesterol. The drug was denied by FDA in October 2010 – they asked for additional studies.