Oesophageal cancer is a very serious form of cancer that, if not fatal, requires extensive surgery. A new study from Karolinska Institutet shows that when serious complications arise after surgery for oesophageal cancer, many patients suffer other health problems, such as breathlessness, fatigue, insomnia and eating problems, for five years afterwards. "Patients who suffer serious post-operative complications after surgery for oesophageal cancer need very close, long-term monitoring so that any problems that arise can be identified and targeted quickly, " says research team member Maryam Derogar, doctoral student at the Department of Molecular Medicine and Surgery. Oesophageal cancer is the eighth most common form of cancer in the world. The disease is often discovered at a late stage once the symptoms, such as difficulties swallowing and weight loss, have occurred.
Surgery need not be the first line of treatment for acute uncomplicated appendicitis, researchers from Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, England, reported in the BMJ (British Medical Journal). Often, the use of antibiotics may be a safe and viable alternative, the authors explained. As background information, the researchers explained that since 1889, appendicectomy - surgically removing the inflamed appendix - has been the standard treatment for acute appendicitis. Doctors have assumed that the risk of complications, such as infection or perforation, are too high without surgery. According to recent studies, however, antibiotic therapy results in fewer problems and complications than surgery for patients with uncomplicated appendicitis. However, the studies have not had compelling enough evidence either way, the researchers wrote.
Patients whose symptoms of Clostridium difficile infection (CDI) start outside of the hospital setting have a higher risk of colectomy due to severe infection, according to a large multicenter study funded by the Centers for Disease Control and Prevention (CDC) and published in Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. Infection from C. difficile is associated with antibiotic use and results in colitis and diarrhea. Severe cases can be life-threatening. Colectomy, or surgical removal of most or all of the large intestine, is the treatment of choice for patients who have life-threatening CDI that does not respond to medical therapy. However, it is associated with a high risk of death in these very sick patients. To assess rates of colectomy due to CDI, a team of researchers at 5 tertiary-care hospitals in the US collected data on CDI cases over a six year period from 2000 and 2006.
A new study offers the first evidence of a drug capable of preventing lethal damage to the gastrointestinal (GI) tract caused by exposure to high levels of ionizing radiation, such as those occurring during a nuclear incident. There are currently no FDA-approved treatments or prophylactics available to manage the condition, known as radiation gastrointestinal syndrome (RGS), which is associated with weight loss, vomiting, diarrhea, dehydration, systemic infection, and - in extreme cases - septic shock and death. The research was conducted in mice by investigators at Memorial Sloan-Kettering Cancer Center and The University of Texas MD Anderson Cancer Center and will be published in the May 2012 issue of The Journal of Clinical Investigation. The GI system is maintained through the continuous infusion of epithelial cells produced by specialized stem cells located in gland-like structures called crypts found in the epithelial lining of the small intestines and colon.
For obese patients, losing weight may require a different solution than calorie reduction and exercise, writes a formerly obese physician in CMAJ (Canadian Medical Association Journal). Despite having detailed knowledge of the negative health effects of obesity, Dr. Ben Williams, now a family medicine resident, could not lose weight beyond short-term losses. "Losing weight was the easy part, keeping it off was the challenge, " he writes. "Oh, and I exercised a lot too; I just ate a lot more." He credits bariatric surgery for his success at shedding 110 pounds and counting from his original weight of 320. "I was fat because I ate too much, and my surgeon helped me do what I had been unable to do on my own." Dr. Williams notes, from first-hand experience, that advice to patients to exercise more and cut calories may not be effective and that other solutions may be necessary.