Cologuard - j.b5z.net

Cologuard - j.b5z.net

Cologuard Where It Fits In Cologuard Screening test for colorectal cancer FIT-DNA : composite

of tests :(1) hemoglobin (2) molecular assays for DNA mutations (3) methylation biomarkers Colorectal

Neoplasms DNA shed into stool may reveal genetic mutations (KRAS) and epigenetic changes Test Procedure

Patient collects a stool sample in a special collection kit No dietary or medication restrictions Kit mailed back in 72 hours or less Repeat testing every 3 years (if negative) If positive, refer for colonoscopy Who is a Candidate?

Average risk patients Should not be used if: (1) history of colonic adenomas or cancer (2) history of IBD (3) family history of colon cancer/ Lynch Syndrome/FAP

Effectiveness Sensitivity (confirmed by colonoscopy) for CRC 92% Not affected by CRC stage or location of lesion Specificity for CRC was 87% Significance of a (+) Cologuard followed by a (-) colonoscopy is unknown

Colonoscopy Gold Standard-but not a perfect test prep needed and complications possible Miss rate of 2%

with large adenomas (>10mm), 25% <5 mm Positive Cologuard Changes screening colonoscopy to

diagnostic colonoscopy Proton Pump Inhibitors Potential Risks of PPIs Proton pump inhibitors have been

used on millions of patients since Prilosec was introduced in the USA in 1989 PPIs Changed GI Medicine

Mechanism of Action Binds to the H-KATPase on the luminal surface of the parietal cell Most effective after a prolonged fast and when the parietal

cell is stimulated after a meal Clinical Uses GERD-especially erosive esophagitis Peptic ulcer disease Eradication of H.

pylori Zollinger-Ellison syndrome Prevention NSAID ulcers Potential Adverse Effects

Increased risk of Clostridium difficile infection Calcium malabsorption and fracture risk Pneumonia Dementia Death Kidney Disease and PPIs

PPIs can cause acute interstitial nephritis Weak association with PPIs and chronic kidney disease (CKD)

Potential Malabsorption Iron malabsorption Magnesium malabsorption Vitamin B12 malabsorption Why Use PPIs

Inhibit gastric acid secretion much more effectively than H2 RAs Once-daily dosing decreases gastric acid secretion by 66%

Shortest Duration/< Dose Any Clinical Difference? rabeprazole omeprazole esomeprazole

lansoprazole pantoprazole PPIs and H2 Blockers H2RAs suppress acid much less effectively, but work more quickly-better

for prn use Taking them at the same time renders the PPI less effective

Recently Viewed Presentations

  • Focus 2010 2007 Listening Session Chancellor Charles W.

    Focus 2010 2007 Listening Session Chancellor Charles W.

    Focus 2010 2007 Listening Session Chancellor Charles W. Sorensen and the Strategic Planning Group Fall 2007
  • Poetic Forms - Administration

    Poetic Forms - Administration

    The wild and wooly walrus waits and wonders when we will walk by. Slowly, silently, now the moon Walks the night in her silver shoon; This way, and that, she peers, and sees Silver fruit upon silver trees… -- from...
  • Motion Transmission - Welcome to Science and Technology

    Motion Transmission - Welcome to Science and Technology

    Cam and Follower. Slider-Crank mechanism. Motion Transformation. 1. Rack and Pinion ... Cam and Follower Uses. Toys. ... The follower has a stamping-battery at the end which pounds on the ore. Motion Transmission. 4. Slider-crank mechanism. This is the mechanisms...
  • Taking Water From the Farm: A Framework for

    Taking Water From the Farm: A Framework for

    Mestas, A., 2008, Officials and farmers work Crowley County fields in attempt to retain topsoil. Pueblo Chieftain 02 MAY 2008 There are hundreds of references on water projects and project evaluation, and because this was the beginning of benefit-cost analysis,...
  • The Value of Family Health History in the Prenatal Care Setting

    The Value of Family Health History in the Prenatal Care Setting

    THE VALUE OF FAMILY HISTORY IN THE PRENATAL CARE SETTING INSERT PRESENTATION DATE Current Pregnancy: ACOG encourages providers to talk during the prenatal period about the importance of and the process for newborn screening (see ACOG Cmt Opinion #481 Newborn...
  • Welcome to A2 Law!! A brief introduction .

    Welcome to A2 Law!! A brief introduction .

    Content: Economic Loss, Negligent Misstatement, Psychiatric Harm, Occupiers Liability, Nuisance, Rylands V Fletcher torts. Naturally A2 law is more challenging than AS so you need to "up your game!" ...
  • Hypothesis Testing

    Hypothesis Testing

    Hypothesis Tests for Differences between Population Means. The comparison problem, where the difference between two population means is tested, is one of the most important problems analyzed with statistical methods. The form of the analysis depends on whether the two...
  • Christmas Traditions The Nativity  The scene of Jesus,

    Christmas Traditions The Nativity The scene of Jesus,

    Christmas Traditions The scene of Jesus, Mary and Joseph huddled in the stable is probably the most common visual image of the Christmas season St Francis of Assisi (d 1226) is credited with arranging the first nativity scene, complete with...