Nursing

Download ABC of the Upper Gastrointestinal by Robert Logan, Adam Harris, J. J. Misiewicz, J. H. Baron PDF

By Robert Logan, Adam Harris, J. J. Misiewicz, J. H. Baron

(BMJ Books) Univ. medical institution, Nottingham, united kingdom. offers a concise advisor to problems of the higher gastrointestinal tract. hugely illustrated with charts, diagrams, and colour pictures. displays most up-to-date advances in figuring out the pathophysiology and pathogenesis of this affliction. For clinical scholars, nurses, and clinicians. Softcover.

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Sample text

Pharmacological, endoscopic, radiological, and surgical treatments are used. 4 Endoscopic treatment for non-variceal bleeding Thermal x Heater probe x Multipolar electrocoagulation Injection x Adrenaline (1:10000 to 1:100000) x Alcohol (98%) x Sclerosants (ethanolamine, 1% polidoconal) x Procoagulants (thrombin, fibrin glue) Mechanical x Clips x Sutures x Staples Combination Treatments Drugs Non-variceal haemorrhage—There is increasing evidence to support the use of intravenous omeprazole, which in clinical trials reduces the risk of rebleeding and the need for surgical operation.

The recently described stool antigen test may be an alternative in future. “Near patient tests” or laboratory based blood serology tests are not suitable because antibody titres take at least six months to decrease. Treatment of H pylori is difficult because of the rapid development of resistance to antibacterial drugs, especially to nitroimidazoles, which occurs more commonly in women and patients from developing countries because of previous treatment for gynaecological infections or infective diarrhoeas.

The need for good compliance needs special attention, as it is crucial to the success of treatment. First line treatment—In areas with a low prevalence ( < 30%) of metronidazole resistant strains of H pylori one week of low dose triple therapy consisting of a proton pump inhibitor, metronidazole, and clarithromycin is currently recommended. Patients’ compliance with treatment is likely to be good because of twice daily dosing and few side effects. If metronidazole resistance is likely a proton pump inhibitor in combination with amoxicillin and clarithromycin given for one week is preferable.

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