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E with normal treatment active comparator: thalidomide standard of care and treatment using thalidomide drug: thalidomide medical therapy has been used to decrease upper gastrointestinal bleeding in cirrhotics non selective beta blockers have been shown to effectively decrease the portal venous pressure other names: propranolol nadolol timolol thalidomide detailed description: treatment duration with thalidomide will be for 16 weeks, beginning in the hospital setting immediately after the index bleed, and clinical follow-up additional six months. Follow-up in both the hepatology, outpatient clinic area and the endoscopy suite will occur. Step wise thalidomide dosing will be hundred mg/d once a day at night. If no evidence of toxicity is noted after 5 doses, the dose will be increased to cc mg/d, and continued on that dose as an outpatient until completion of the study protocol at 16 weeks. generic viagra online generic viagra online http://classicmotocrossimages.com/mbs-where-can-i-buy-viagra-locally-without-a-prescription-tl/ trusted on line sites to buy viagra female viagra for sale order generic viagra online cheap viagra on line order cheap viagra online classicmotocrossimages.com/mbs-order-cheap-viagra-online-jt/ buy viagra without prescription Patients will be followed daily while inpatients, and subsequently at two-week intervals upon discharge. Females of child-bearing potential will be seen weekly for the first month and must have a confirmed negative pregnancy test prior to being dispensed the next one week supply of study drug. After the first month, females of child-bearing potential will be seen every two weeks as will all other subjects. Standard follow-up medical care after esophageal variceal bleeding in patients who have undergone endoscopic therapy will include: follow-up endoscopy at regular intervals until variceal obliteration, using either endoscopic variceal ligation (evl) or sclerotherapy titrated dose of a nonselective beta blocker (propranolol). At each follow-up visit, patients will be assessed for development of any interim outcome of interest: overt upper gastrointestinal bleeding need for transfusion worsening clinical status patients will initially be followed daily while hospitalized. Outpatient visits will occur every two-week intervals upon discharge. Standard follow-up medical care after esophageal variceal bleeding in patients who have undergone endoscopic therapy will include: follow-up endoscopy at regular intervals until variceal obliteration, using either endoscopic variceal ligation (evl) or sclerotherapy titrated dose of a nonselective beta blocker (propranolol). At each follow-up visit, patients will be assessed for development of any interim outcome of interest: overt upper gastrointestinal bleeding need for transfusion worsening clinical status the need for tips, liver transplantati.