Help for Crohns Disease

Cured My Crohns

If you've ever gotten the fateful diagnosis you've got Crohns, you will know the massive upset that it can have on your way of life and how you feel about yourself and your relationship to other people. If you talk to your doctor about natural diets or some other method of curing your Crohns disease they will tell you that there is no way to fix it. However, there is often more to the story than modern medicine will tell you. New Age medicine is not a bunch of nonsense that hokey people subscribe to; New Age medicine fills in the gaps of knowledge that we have with modern medicine and helps us understand what is going on with our bodies. You will learn how to cure Crohns from someone who has cured it himself and has lived for over 10 years completely free of disease!

Cured My Crohns Overview

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Breakthrough Crohns Disease Guide

In Breakthrough Crohn's Disease Guide, you'll learn how your digestive system really works absorbing nutrients and fluids from the foods you eat while compacting and sending waste products along their way. You'll discover how your own immune system, in trying to fight a perceived threat, has sent white blood cells to the smooth lining of your digestive tract where they do their best to root out infection.

Breakthrough Crohns Disease Guide Overview

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Author: Sharon Dobson
Official Website: www.natural-crohns-disease-relief.com
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No More Crohn's Disease

If you are looking for an easy, safe, and affordable way to get rid of Chron's disease, you need No More Crohn's Disease by Cathy Rubert. Cathy used to suffer from this terrible disease too, but when she discovered the techniques she shares in No More Crohn's Disease, she was able to heal herself in the safest and most natural way. You will learn about these 4 main natural steps that will immediately get rid of the pain in your lower abdomen. You will learn the single cheap ingredient that will bring your body's digestive system back in balance. This ingredient has the power to eliminate your pain in just days, no matter how bad your condition is. You too can start living a life free from Chrons disease with the help of her book.

No More Crohns Disease Overview

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Author: Cathy Rubert
Official Website: livecrohnsfree.com
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Recurrent Crohns Disease

At 25 years of age resection of Crohn's disease of the ileum. Severe diarrhea continued despite medical treatment. Resection of terminal ileum (40 cm) for recurrent Crohn's disease (Figure 50.1). Severe diarrhea continued (14-15 day, 3-4 night). Figure 50.1 shows the involvement of the terminal ileum. Resection of right colon (25 cm) and ileum (40 cm) for recurrent Crohn's disease associated with large inflammatory mass. Diarrhea continued (8 day, 0 night). formed for advanced Crohn's disease with stricture formation causing chronic obstruction. Remaining small bowel measured 115 cm. 1998 Pyelotomy for renal calculus and infection.

Mycobacterium paratuberculosis and Crohns disease

Because the pathological changes that occur in the small intestines of people with Crohn's disease are similar to those observed in cattle suffering from Johne's disease, it has been postulated that MAP is the aetiological agent responsible for Crohn's disease (Chiodini and Rossiter, 1996 Hermon-Taylor et al., 2000). Crohn's disease is a chronic inflammatory disease of humans that most commonly affects the distal ileum and colon. However, it can occur in any part of the gastrointestinal tract. There is no known cure for Crohn's disease and it is a life-long debilitating illness, the symptoms of which generally first appear in people aged 15 to 24. The illness is often cyclical, with patients undergoing intermittent remission followed by recurrence. Surgical intervention is necessary in a large proportion of sufferers. Management of the disease has become easier with the advent of drugs such as aminoslaicylates, budesonide and immunosuppressive drugs (Achkar and Hanauer, 2000 Prantera...

Crohns Disease

The most characteristic features of Crohn's disease of the small intestine are the variety of its radiological appearances and the multiplicity of radiological features often present in the majority of patients. Categorization of these radiological features has been defined in terms of stenotic and non-stenotic forms, active and chronic, early and late or advanced, or into superficial, transmural and extramural changes. Most information on the sequence of progression of the pathological lesions in Crohn's disease is derived from radiological descriptions. The early lesions of Crohn's disease are blunting, flattening, thickening, distortion and straightening of the valvulae conniventes. These changes are followed by discrete ulcers and by longitudinal and transverse ulcers. The stenotic phase eventually develops and the involved segment is transformed into a rigid, castlike tube fistulae may be seen at this stage. Deep ulcers precede sinuses and fistulae to other organs. Discrete...

Catheter Balloon Tip Position

Positive contrast CTE in 29-year-old male with Crohn's disease with allergy to iv contrast. a Coronal reformat showed low-grade small bowel obstruction with sharp transition point (black arrowhead). The cause of the obstruction was a long segment of fibrostenosis (arrows). b Sagittal reformat showed enteric fistula (white arrowheads). In view of fi-brostenosis, patient was not treated with inflix-imab (inhibitor of tumor necrosis factor-alpha)

Inflammatory Disorders Ulcerative Colitis

On CT, these mural changes produce a target or halo appearance when axially imaged the lumen is surrounded by a ring of soft tissue density (mucosa, lamina propria, hypertrophied muscularis mucosae). This is surrounded by a low-density ring (fatty infiltration of the submucosa), which in turn is surrounded by a ring of soft tissue density (muscularis propria). This mural stratification is not specific and can also be seen in Crohn's disease, infectious enterocolitis, pseudomembranous colitis, ischemic and radiation enterocolitides, mesenteric venous thrombosis, bowel edema and graft-versus-host disease 1-3 . There are certain CT findings that can help differentiate granulomatous and ulcerative colitis. Mural stratification, that is, the ability to visualize individual layers of bowel wall, is seen in 61 of patients with chronic ulcerative colitis but only in 8 of patients with chronic granulomatous colitis. In addition, mean colon wall thickness in chronic ulcerative colitis is 7.8...

Proinflammatory Cytokines and Their Receptors

Anti-TNF-a therapies are approved for the treatment of RA and Crohn's disease. However, monoclonal antibodies against TNF-a induce SLE, and lead to increased and prolonged exacerbations in MS patients. Further, there is some clinical trial evidence that etanercept, a soluble recombinant TNF receptor Fc protein, designed as a TNF-a inhibitor, may actually lead to the upregulation of TNF-a expression in some MG patients - leading to worsening of the disease. Monoclonal antibodies against IL-12 are currently being tested in clinical trials for MS and Crohn's disease. A monoclonal antibody to the IL-2 receptor daclizumab functions as an IL-2 antagonist. Daclizumab inhibits IL-2-mediated stimulation of lymphocytes, is approved for use in kidney transplant patients, and is being tested in clinical trials as a therapy for RRMS.

Autoimmune Pancreatitis

Autoimmune pancreatitis (AIP) is a relatively new syndrome of clinical and histologic findings and has also been described as 'lymphoplasmocytic sclerosing pancreatitis with cholangitis', 'nonalcoholic duct-destructive chronic pancreatitis' and 'chronic sclerosing pancreatitis'. A number of features can be found, including hypergammaglobulinemia, elevation of serum IgG4, IgG4-containing immune complexes and a number of antibodies, such as antinuclear antibodies, antibodies against lactoferrin, carbonic anhydrase type II, and rheumatoid factors. Histological features include fibrosis with lym-phoplasmacytic infiltration of interlobular ducts. The majority of lymphocytes are CD8+ and CD4+ T-lympho-cytes, while B-lymphocytes are less frequent. In general, diagnosis of AIP is established by clinical signs and laboratory and morphological findings. An association with other autoimmune disease such as Sjogren-syndrome, primary biliary cirrhosis, primary sclerosing cholangitis, Crohn's...

Inflammatory Bowel Disease Introduction

Inflammatory bowel disease includes Crohn's disease and ulcerative colitis with similar signs and symptoms but with different intestinal pathology. Actual cause of either disease is unknown but they are associated with immunologic, nutritional, and infectious disturbances with psychogenic factors responsible for severity and exacerbation of the disease. Crohn's disease affects the small and or large intestine with the terminal ileus the most common site. It involves all layers of the bowel and results in a thickening and eventual obstruction. Lesions from this disease are patchy with areas of normal tissue while lesions from ulcerative colitis are continuous in the affected bowel. Ulcerative colitis also affects the mucosa and submucosa of the large intestine and rectum in a hyperemia and edema of which effects absorption of nutrients and eventually a narrowed, inflexible, scarred bowel. Both diseases are characterized by remissions and exacerbations and occur in children of school...

Disorders of the Large Intestine and Rectum

Ulcerative colitis is a type of chronic inflammatory bowel disease. It is similar to Crohn's disease (see previous page), but it affects only the intestinal lining and is almost always restricted to the large intestine. Ulcerative colitis starts at the rectum and spreads upward through the large intestine. The disease causes chronic diarrhea that is usually bloody as the intestinal lining dies and sloughs off, ulcers form that release mucus, pus, and blood into the colon. Other symptoms include abdominal pain, fatigue, weight loss, loss of appetite, and rectal bleeding. The nonintestinal symptoms that can occur with Crohn's disease also can occur with ulcerative colitis. People whose ulcerative colitis extends throughout the entire colon are at much greater risk of developing colon cancer than are those whose disease is limited to the rectum and the sigmoid (lower) colon. Ulcerative colitis develops most frequently between ages 15 and 40. Most people with ulcerative colitis can...

Inhibitors of Tetrahydrofolate Synthesis

Trimoxazole

Although initially developed as an antirheumatic agent (p. 320), sulfasala-zine (salazosulfapyridine) is used mainly in the treatment of inflammatory bowel disease (ulcerative colitis and terminal ileitis or Crohn's disease). Gut bacteria split this compound into the sulfonamide sulfapyridine and mesala-mine (5-aminosalicylic acid). The latter is probably the anti-inflammatory agent (inhibition of synthesis of chemotactic signals for granulocytes, and of H2O2 formation in mucosa), but must be present on the gut mucosa in high concentrations. Coupling to the sulfon-amide prevents premature absorption in upper small bowel segments. The cleaved-off sulfonamide can be absorbed and may produce typical adverse effects (see above).

Induction of TNBS Colitis in Mice

Many diseases, including those characterized by inflammation of the gastrointestinal tract (e.g., Crohn's disease) are due to an array of factors that act in concert to produce pathologic change. The immunologic factors that mediate the development of such mucosal inflammation have been at the center of intense research. Recently, a better understanding of the mechanisms involved in mucosal homeostasis and the occurrence of inflammatory bowel disease (IBD) has been achieved with the advent of animal models of mucosal inflammation, which has given researchers a better understanding of the mechanisms involved in the pathogenesis of inflammatory bowel disease. One such model is that of TNBS colitis, an experimental colitis induced in susceptible strains of mice by rectal instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS). This material haptenates autologous colonic proteins with a trinitrophenyl (TNP) moiety and induces an IL-12-mediated TH1 T cell transmural colitis, which...

Postcapsule Endoscopy

A neutral enteral contrast CTEs (a) performed within two weeks of each other in a 54-year-old female with suspected Crohn's disease. Fluoroscopic study showed aphtae in small bowel loops (arrowheads). b Double contrast carbon dioxide-barium small bowel fluoroscopic enteroclysis. CTE of same loop (arrowhead) showed no abnormality. Note incidental abdominal wall mesh on image b (arrow) Fig. 7. A neutral enteral contrast CTEs (a) performed within two weeks of each other in a 54-year-old female with suspected Crohn's disease. Fluoroscopic study showed aphtae in small bowel loops (arrowheads). b Double contrast carbon dioxide-barium small bowel fluoroscopic enteroclysis. CTE of same loop (arrowhead) showed no abnormality. Note incidental abdominal wall mesh on image b (arrow) ther characterization to make a precise diagnosis in some instances. We have unpublished data of an air double contrast barium enteroclysis carried out following WCE and interpreted by experienced endoscopists...

Drug and disease interactions

Renal diseases such as uremia may result in decreased renal clearance of certain drugs.16 Gastrointestinal diseases, such as Crohn's disease, result in increased plasma protein binding of several drugs due to increased levels of binding proteins. Further, respiratory diseases such as cystic fibrosis increase the renal clearance of some drugs.

Experimental Disease Models

The Mdr1a mouse model is one of the few genetic disease models that develop a colitic phenotype in the absence of immune dysfunction. This is in contrast to virtually all other genetically targeted mice, which develop colitis as a result of either impaired immune function, a cytokine imbalance, or colitis that can be induced by reconstituting naive (CD4 + CD45Rbhi) T cells into severe combined immunodeficiency (SCID) mice. Most of the experimental models of IBD in mice have inflammation only in the colon and resemble UC. The one striking exception to this is the SAMP1 Yit mouse and the derivative SAMP1 YitFc strain. These mice spontaneously develop a Crohn's-like transmural ileitis as early as 10 weeks of age, accompanied by prominent muscular hypertrophy, fibrosis, and activation of mesenteric lymph node lymphocytes, which produce high levels of interferon g (IFN-g). Furthermore, a subgroup of SAMP1 YitFc mice ( 5 ) also develops perianal fistulating disease.

Assessing Disease Activity

In CD, the use of the Crohn's disease activity index (CDAI) predominates. This index is constructed from eight domains that are given a relative weighting, and involves the collection of patient data through the use of a diary. Disease severity bands have been constructed within a scale of 0-750. Disease remission has been attributed to a score of less than 150 and clinical improvement defined as a reduction of greater than 70 points (or more recently 100 points), although the clinical significance of such a reduction in patients with severe disease is questionable. Used widely in clinical trials, criticisms still abound on the use of CDAI. These include the near reliance on subjective symptoms, the complexity of the index, and the need for a 1-week patient diary. Studies have also demonstrated substantial interobserver variation in scoring. The poor representation of parameters relating to perianal disease makes improvements in this troublesome presentation difficult to assess using...

Gastrointestinal Involvement

To normal within 2-4 weeks, even when therapy is continued. Severe hepatotoxic reactions resulting from retinoid use are rare and idiosyncratic. However, a correlation between long-term retinoid therapy and chronic liver toxicity has not been demonstrated. Nonspecific gastrointestinal side effects, such as nausea, diarrhea, and abdominal pain, have been reported with isotretinoin therapy but are infrequent. Although the oral administration of isotretinoin has been linked with inflammatory bowel disease flare-up, a causal relationship has not been established. In fact, isotretinoin has been given to patients with known Crohn's disease and ulcerative colitis without complications (Brecher and Orlow 2003, Ellis and Krach 2001, Katz et al. 1999, Peck and DiGiovanna 1999).

Mycobacterium paratuberculosis

The organism has been of concern due to its impact on milk and meat production and subsequent economic losses (EC, 2000). In recent years, there is an increasing concern about potential public health consequences of this organism as some scientists suspect the organism to be associated with the human Crohn's disease (Hermon-Taylor et al. 2000 EC, 2000 FSA, 2001). Crohn's disease (CD) is a highly debilitating chronic inflammation of gastrointestinal tract in humans but most commonly affecting the distal ileum and colon. It is a lifelong disease with no cure. It usually affects young people with the highest incidence rate in the age group 15-24. Genetic and immunologic factors seem to play an important role in the occurrence of the disease. A multi-centre European study has reported an incidence rate of 5.6 per 100000 individuals per year (Shivananda et al. 1996). The aetiology of the disease is not well known. The association of the disease with different infectious agents has been...

Calciphylaxis Calcific Uremic Arteriolopathy

Calciphylaxis Pictures

Patients developing calciphylaxis have end-stage renal disease, but some have milder renal insufficiency. Other cases have occurred in association with Crohn's disease (2), alcoholic cirrhosis (3), acute renal failure (4), metastatic breast cancer (5), and primary hyperparathyroidism (6). Most earlier literature on the subject regarded the disease as a form of metastatic calcification due to secondary hyperparathyroidism of end-stage renal disease. This view is not supported by data that show that only one third of patients with calciphylaxis have an elevated calcium-phosphate product. Additionally, the calcium-phosphate product of calciphylaxis patients and a control group of patients with end-stage renal disease without skin lesions is similar (7). Evidence of hyperparathyroidism is often lacking in patients with calciphylaxis, and treatment by parathyroidectomy results in clinical improvement in only a subset of patients. A group of patients with calci-phylaxis has been described...

Selective Adhesion Molecule Inhibitors

In Crohn's disease, an organ-specific autoimmune disease in which the immune system attacks the intestinal mucosa, the therapeutic target of natalizumab is a4 7 integrin, which, like a4pl integrin, is recognized by a4 integrin-specific antibodies. This integrin has multiple functions, including mediating migration of gut-homing T cells via its counter-receptor in the gut, MadCAM. Early in 2005, all dosing of natalizumab was voluntarily suspended by the sponsor after learning of two cases of progressive multifocal leukoencephalopathy (PML) in MS patients receiving natalizumab and IFN-P combination therapy a third case of PML was subsequently discovered in a patient with Crohn's disease receiving natalizumab following extensive therapy with various immunosuppressive medications. One of the two MS patients recovered however, the other two cases proved fatal. Following an exhaustive safety review, the US FDA approved the use of natalizumab in open-label monotherapy clinical trials. The...

Surgical Major Small and Large Bowel Procedures with CC

Crohn's disease (CD), also known as granulomatous colitis or regional enteritis, is a chronic, nonspecific inflammatory disease of the bowel that occurs most commonly in the terminal ileum, jejunum, and the colon, although it may affect any part of the gastrointestinal (GI) system

Other Conditions

Abuse, compared to 10 of those being seen for organic disorders. Of those who reported a history of sexual abuse, 88 reported constipation. A more recent study by Hobbis et al36 used a matched case-control design to find that in two sets of age- and gender-matched controls (Crohn's disease patient controls and healthy controls) there were no differences in the rates of abuse between patients with functional bowel disorders and controls.

Adenocarcinoma

Most always symptomatic, with non-specific clinical presentation and a dismal prognosis, mainly due to a late diagnosis. Its appearances on enteroclysis reflect its pattern of growth and include annular constricting lesions, filling defects, polypoid and or ulcerated masses, or a combination of the above. Infiltrative adenocarcinomas are the most common type. Adenocarcinoma appears on CT as a solitary, focal, sharply outlined mass, causing thickening of the intestinal wall and narrowing of its lumen. The tumor may be homogeneous or heterogeneous when ulcerated and shows moderate contrast enhancement. Infiltration of the mesentery is seen with advanced disease, whereas associated lymphadenopathy is found in almost 50 of patients at presentation. Predominantly ulcerated adenocarcinomas may simulate lymphomas, malignant gastorintestinal stromal tumors (GISTs) or metastatic melanomas, whereas annular-type lesions will need to be differentiated from secondary adenocarcinoma, carcinoid,...

Lymphoma

Lymphoma represents 20 of primary small intestinal malignancies. Clinical presentation is variable, depending on whether involvement is primary or secondary, or whether it is preceded by other disorders, such as adult celiac disease, immunoproliferative disease or immunodeficiency syndromes. Radiological appearances mirror the pattern of growth. Enteroclysis can define a wide spectrum of features, including luminal narrowing with mucosal destruction, multiple intra-luminal polypoid filling defects, broad-based ulceration, aneurysmal dilatation, a large excavated mass and fistula formation. Infiltrative lymphomas may cause thickening of the intestinal wall without eliciting a desmoplastic reaction. A combination of different signs is rather frequent and multi-centricity of involvement is seen in almost one fourth of patients. CT appearances of intestinal lymphoma are also variable and may be categorized as aneurysmal, nodular, ulcerative and constrictive, while mesenteric involvement...

Menetrier Disease

Thickening are often non-specific and difficult to distinguish from normal variation when relatively mild. Erosions through the epithelium that do not breach the muscularis mucosae, separating the mucosa from the submucosa, may be detected with double contrast barium technique (Fig. 6). Aphthous lesions suggest granulomatous disease, especially Crohn's disease, but are not specific.

Precapsule Endoscopy

Nsaid Enteropathy Enteroclysis

Except for emergent clinical investigation for possible small bowel diseases where abdominal CT will remain the primary method of investigation, the role of imaging is likely to undergo reassessment based on results of WCE in the elective work-up of patients 1 . In the patient without risk factors for a potentially obstructing small bowel lesion, radiology has a limited role. As stated earlier, where the indication raises the possibility of early Crohn's or NSAID enteropathy, air double-contrast enteroclysis is the most reliable method of imaging (Fig. 7). CTE should otherwise suffice for all pre-capsule radiologic investigations where there is a possibility of a potentially obstruct- Fig.4. Axial image of neutral enteral contrast CTE in a 62-year-old female with Crohn's disease showing a long fistulous track (black arrowheads) extending from the inflamed cecum (black arrow) to an abscess (white arrow). Prior terminal ileal resection is evidenced by surgical clips (white arrowhead)....

Small Bowel

The composite diagram illustrates some of the morphological types of ulceration that may be seen in small bowel Crohn's disease. Although a number of these ulcer types may appear in a patient in a contiguous segment or in skip lesions, one would not expect to see the full spectrum of ulceration in any one patient. 6. Recent ulceration that is solitary, deep, and situated in normal mucosa. Such a lesion can be the only focus of Crohn's disease present in the intestinal tract. 8. Acute foci of ulceration surrounded by normal mucosa. The histological diagnosis of Crohn's disease may be difficult in this stage of the disease. 9. Acute severe and extensive ulceration usually affects only the terminal ileum in association with the fulminant form of acute Crohn's colitis. The mucosa is shredded by the severe inflammatory process, exposing the underlying muscle.

FollowUp2004

Biopsies showed inflammation not diagnostic of Crohn's disease although this diagnosis was accepted. The patient was treated with prednisolone for 5 months. Azathioprine and mesalazine were commenced in 2000 and are current therapy. The stricture in the second part of the duodenum has been treated at intervals with balloon dilatation. Now 15 years since operation, x-rays show persistence of the stricture in the second part of the duodenum and a moderate narrowing in the third part of the duodenum (Figure 51.3). Colonoscopy demonstrates persistence of the ileocolic anasto-motic stricture. The patient has infrequent bouts of distention and reflux sometimes accompanied by vomiting.

Appendicitis

Lateroconal Fascia Appendicitis

The combination of right lower quadrant inflammation, a phlegmon, and an abscess adjacent to the cecum is suggestive but not diagnostic of appendicitis. Indeed, if an abnormal appendix or an appendicolith is not shown, the differential diagnosis must also include Crohn's disease, cecal diverticulitis, ileal diverticulitis, perforated cecal carcinoma, and pelvic inflammatory disease. A barium enema is required to visualize the appendix and evaluate the colon and terminal ileum for primary intestinal disease. Abscesses may be found in locations distant from the ce-cum because of the length and position of the appendix and the patterns of fluid migration in the peritoneal cavity. Adnexal cysts, masses, salpingitis, and tubo-ovarian abscesses can be readily shown on US. Ureteral calculi and pyelonephritis can be detected on CT and US. Enlarged lymph nodes in the right lower quadrant suggest mesenteric adenitis or infectious ileitis mural thickening of the terminal ileum can be seen in...

Perianal Fistulas

Perianal fistulas primarily occur as the result of fistulous disease originating in the anal glands near the anal crypts (cryptoglandular hypothesis), or in patients with Crohn's disease 13 . Infection of the anal glands may result in abscess formation. It is a relatively common condition with a prevalence of approximately 0.01 , predominantly affecting young adults. Fig. 6. A male patient with Crohn's disease and perianal fistulas. a Axial T2-weight-ed turbo spin-echo demonstrates multiple tracks (arrowheads), both intersphincteric as well as outside the anal sphincter. At the right an abscess (A) is seen in the ischioanal space. b Coronal oblique T2-weight-ed TSE demonstrates the abscess with supralevator extension (arrow) Results of a prospective triple-blinded comparison of the accuracy of AES, pelvic MRI, and surgical EUA in perianal Crohn's disease showed that AES correctly classified fistulas in 91 of cases, compared with 87 for pelvic MRI, and 91 for surgical evaluation 15 ....

Antineoplastic Drugs

Thalidomide has recently been shown to be efficacious in treating a wide range of tumors (e.g., multiple myeloma, melanoma, prostatic cancer, Kaposi's sarcoma), as well as autoimmune disease (Crohn's disease) and inflammatory diseases (erythema nodosum leprosum). This drug is unique in that it is defined as a low-level toxic compound with the exception of being a well-known human teratogen. Thalidomide has profound immunomodulatory effects, including inhibition of monocyte macrophage function and decreased TNFa and IFNg production (Tavares et al. 1997 Rowland et al. 1998). This drug is also very effective in blocking the enhanced angiogenesis that is important in solid tumor development (D'Amato et al. 1994). Although designated as an orphan drug by the FDA, a limited license is available for use in life-threatening cases (e.g., cancer in AIDS patients) (Diggle 2001 Cattelan et al. 2002). Numerous preventive measures are recommended to prevent inadvertent thalidomide use by pregnant...