ABSTRACT
We report the case of a 60-year-old woman with metastatic breast cancer whose intractable nausea and vomiting were effectively managed with a hyoscine hydrobromide (scopolamine) patch. Contrast swallow revealed oesophageal spasm to be the underlying cause. Symptom relief may be attributed to the antimuscarinic properties of the patch, allowing lower oesophageal sphincter relaxation. Following patch use she was able to enjoy small meals and fluids without symptoms. This is the first time this mechanism of action of scopolamine for alleviating nausea and vomiting has been described in the literature.
Subject(s)
Breast Neoplasms/complications , Esophageal Spasm, Diffuse/complications , Muscarinic Antagonists/therapeutic use , Nausea/drug therapy , Scopolamine/therapeutic use , Vomiting/drug therapy , Administration, Cutaneous , Breast Neoplasms/secondary , Female , Humans , Middle Aged , Muscarinic Antagonists/administration & dosage , Nausea/etiology , Scopolamine/administration & dosage , Treatment Outcome , Vomiting/etiologyABSTRACT
Internet-derived health care information is increasingly accessed by patients, yet its quality and accuracy is variable and unregulated. The aim of this study was to assess the information available regarding common gastrointestinal cancers via three internet search engines (Google, Yahoo and Bing). The top 30 websites for each of the terms: oesophageal, gastric, pancreatic, colon and rectal cancer were evaluated (University of Michigan Consumer Health Website Checklist) and scored [-80 (poor) to 90 (excellent)]. The median score was 53 (-7 to 81) and was significantly higher for oesophageal (61) and pancreatic (65) cancer websites, compared with gastric (49), colon (48) and rectal cancer (50) (p = 0.014). Median scores related to charitable organisations were significantly better than academic, commercial, news agency, care provider, layperson and medical information websites collectively (79 vs. 42, p < 0.0001). Overall quality of internet-derived gastrointestinal cancer information remains poor and patients and clinicians should be aware.
Subject(s)
Information Dissemination , Information Services/standards , Internet/standards , Medical Informatics/standards , Neoplasms , Quality of Health Care , Databases, Factual , Humans , Patient Education as TopicABSTRACT
Pancreatitis is a serious and common presentation to general surgery departments. There are many complications associated with pancreatitis and we present an undescribed presentation of a pancreatic pseudocyst and include its management strategy.
