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Related Concept Videos

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy01:16

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy

Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...
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Gastritis III: Clinical Manifestations and Management

The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Pharmacological management
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Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
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Intraperitoneal chemotherapy for gastric cancer.

Mingchun Mu1,2,3, Zhaolun Cai1,2,3, Yajun Hu4

  • 1Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.

The Cochrane Database of Systematic Reviews
|October 9, 2025
PubMed
Summary

Intraperitoneal chemotherapy (IPC) for gastric cancer shows potential survival benefits but lacks definitive evidence due to low-certainty results. Further high-quality trials are needed to confirm efficacy and safety for preventing and treating peritoneal metastasis.

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
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Area of Science:

  • Oncology
  • Gastroenterology
  • Clinical Trials
  • Chemotherapy

Background:

  • Gastric cancer with peritoneal metastasis has a poor prognosis and is often considered incurable.
  • Intraperitoneal chemotherapy (IPC) is explored for preventing and treating peritoneal metastasis, but clinical evidence is conflicting.
  • There is a need for a comprehensive evaluation of IPC's effects in gastric cancer.

Purpose of the Study:

  • To evaluate the benefits and harms of IPC in gastric cancer.
  • Specifically, to compare prophylactic IPC plus radical surgery versus radical surgery alone for high-risk patients.
  • Also, to compare therapeutic IPC plus cytoreductive surgery (CRS) versus CRS alone for patients with confirmed peritoneal metastasis.

Main Methods:

  • A systematic search of multiple databases (CENTRAL, MEDLINE, Embase, Chinese databases) and trial registries was conducted.
  • Included were parallel randomized controlled trials (RCTs) comparing IPC with no IPC for prophylactic or therapeutic use.
  • Meta-analysis was used to synthesize results for overall survival, disease-free survival (DFS), progression-free survival (PFS), and adverse events, with evidence certainty assessed by GRADE.

Main Results:

  • Nine RCTs involving 829 participants were included; most had high risk of bias or some concerns.
  • Very low-certainty evidence suggests prophylactic and therapeutic IPC may improve overall survival but may have little effect on DFS or anastomotic leakage.
  • Therapeutic IPC may delay tumor progression (PFS) but shows little to no difference in quality of life (QOL) or serious adverse events (SAEs).

Conclusions:

  • Current evidence for IPC in gastric cancer is limited and highly uncertain, precluding definitive conclusions.
  • IPC may offer survival benefits, but more high-quality, long-term RCTs, especially in non-Asian populations, are needed.
  • Ongoing studies may alter current findings; comprehensive safety and QOL data are also required.