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https://www.readbyqxmd.com/read/29791429/-clinical-practice-guideline-for-the-evaluation-and-management-of-upper-gastrointestinal-bleeding-for-the-peruvian-social-security-essalud
#1
Jorge Vásquez-Quiroga, Alvaro Taype-Rondan, Jessica Hanae Zafra-Tanaka, Ericson Arcana-López, Luis Cervera-Caballero, Javier Contreras-Turin, Katherine Guzmán-Cáceres, Juan Llatas-Perez, Luis Marin-Calderón, Alejandro Piscoya, Daniel Vargas-Blácido, Nelly Vásquez-Valverde, Raúl Timaná-Ruiz
OBJECTIVE: To provide evidence-based clinical recommendations for the evaluation and management of patients with upper gastrointestinal bleeding (UGB) in the Peruvian Social Security (EsSalud). MATERIALS AND METHODS: A local guideline development group (local GDG) was established, including specialists in gastroenterology and methodologists. The local GDG formulated 11 clinical questions to be answered by this clinical practice guide (CPG). We searched and selected CPG of UGB published from 2012, which answered the posed questions and obtained a score higher than 60% in domains 1 and 3 of the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29700095/management-of-decompensated-cirrhosis
#2
Dina Mansour, Stuart McPherson
Decompensated cirrhosis is a common reason for admission to the acute medical unit, and such patients typically have complex medical needs and are at high risk of in-hospital death. It is therefore vital that these patients receive appropriate investigations and management as early as possible in their patient journey. Typical presenting clinical features include jaundice, ascites, hepatic encephalopathy, hepato-renal syndrome or variceal haemorrhage. A careful history, examination and investigations can help identify the precipitating cause (infections, gastrointestinal bleeding, high alcohol intake / alcohol-related hepatitis or drug-induced liver injury), so appropriate treatment can be given...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29610020/pharmacological-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasias-a-position-paper-of-the-italian-society-of-gastroenterology-sige
#3
REVIEW
Gerardo Nardone, Debora Compare, Alberto Martino, Alba Rocco
Angioectasias (AD) belong to benign vascular malformations of the gastrointestinal tract and are responsible for about 4-7% of upper non variceal bleeding, 30-40% of small bowel occult bleeding and 3-40% of colonic bleeding episodes. Gastrointestinal haemorrhage secondary to AD represents an important diagnostic and therapeutic problem that negatively impacts on the quality of life of patients and heath care costs. Endoscopic interventions are the mainstay in both diagnosis and treatment of vascular malformations...
February 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29593806/consequences-of-bleeding-after-thyroid-surgery-analysis-of-7805-operations-performed-in-a-single-center
#4
Beata Wojtczak, Michał Aporowicz, Krzysztof Kaliszewski, Marek Bolanowski
Introduction: Surgical treatment of thyroid gland diseases is associated with the possibility of severe complications. The most dangerous of them is bleeding. Current studies focus on its risk factors, rather than reoperation-related consequences. Material and methods: We analyzed 7805 thyroid operations performed from 1996 to 2014 in the Clinic of General, Gastroenterological and Endocrine Surgery of Wroclaw Medical University. Typical risk factors, symptoms and consequences of bleeding were analyzed...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29520555/financial-impact-of-intravenous-iron-treatments-on-the-management-of-anaemia-inpatients-a-1-year-observational-study
#5
Amina Delpeuch, Marc Ruivard, Armand Abergel, Olivier Aumaitre, Stéphane Boisgard, Sandrine Bagel, Valérie Sautou
Background Intravenous (IV) iron preparations bypass the difficulties (malabsorption and side effects) associated with oral iron for the treatment of iron deficiency anaemia (IDA). Ferric carboxymaltose (FCM) can be administered as a single infusion over short periods of time but is more expensive than iron sucrose (IS) when the patients are hospitalized. Objectives To evaluate the appropriateness of FCM prescriptions and to establish the economic impact of this management (including disease coding) compared to the use of IV IS...
March 8, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29519377/a-multidisciplinary-approach-on-the-perioperative-antithrombotic-management-of-patients-with-coronary-stents-undergoing-surgery-surgery-after-stenting-2
#6
REVIEW
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29503356/-eight-cases-of-percutaneous-endoscopic-gastrostomy-peg-in-patients-taking-oral-anticoagulants
#7
Kiyoshi Azakami
Patients who undergo percutaneous endoscopic gastrostomy (PEG) placement are often on antiplatelet therapy. There is a potential risk of infarction if these medications are discontinued.The guidelines of the Japan Gastroenterological Endoscopy Society, classify PEG as an operation associated with a high risk of bleeding; however, it is known that surgery can be performed without interruption when patients are treated with low-dose aspirin alone. Nevertheless, we experienced the case of severe bleeding at the incision site, which was accompanied by massive hematemesis and hemorrhagic shock the night after PEG using the modified introducer method in an 87-year-old male patient...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29486733/development-and-evaluation-of-a-risk-assessment-tool-to-improve-clinical-triage-accuracy-for-colonoscopic-investigations
#8
Anton R Lord, Lisa A Simms, Allison Brown, Katherine Hanigan, Krupa Krishnaprasad, Belinda Schouten, Anthony R Croft, Mark N Appleyard, Graham L Radford-Smith
BACKGROUND: Gastroenterology Departments at hospitals within Australia receive thousands of General Practitioner (GP)-referral letters for gastrointestinal investigations every month. Many of these requests are for colonoscopy. This study aims to evaluate the performance of the current symptoms-based triage system compared to a novel risk score using objective markers. METHODS: Patients with lower abdominal symptoms referred by their GPs and triaged by a Gastroenterology consultant to a colonoscopy consent clinic were recruited into the study...
February 27, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29470292/rectal-picking-masquerading-as-inflammatory-bowel-disease-in-prader-willi-syndrome
#9
Parisa Salehi, Dale Lee, Lusine Ambartsumyan, Natalie Sikka, Ann O Scheimann
Prader-Willi syndrome (PWS) is a genetic syndrome in which individuals have multisystem medical challenges. Gastroenterological difficulties in the syndrome include decreased vomiting, constipation, delayed gastric emptying, delayed colonic transit, dysphagia, increased choking, and increased risk of gastric dilation and rupture. In addition, self-injurious behavior such as rectal picking may be present and severe enough to lead to rectal ulceration and bleeding. Many patients have extensive gastroenterological workup and treatment before their ultimate diagnosis of severe rectal picking...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29453515/micro-fragmented-adipose-tissue-injection-for-the-treatment-of-complex-anal-fistula-a-pilot-study-accessing-safety-and-feasibility
#10
G Naldini, A Sturiale, B Fabiani, I Giani, C Menconi
BACKGROUND: The aim of the present study was to evaluate the safety and efficacy of autologous, micro-fragmented and minimally manipulated adipose tissue injection associated closure of the internal opening in promoting healing of complex anal fistula. METHODS: A pilot study was conducted on patients referred to our center with anal fistula, from April 2015-December 2016. Inclusion criteria were age over 16 years old and a diagnosis of complex anal fistula according to the American Gastroenterological Association classification The patients were divided into 2 groups; the "first time group" (Group I) in which micro-fragmented adipose tissue injection with closure of the internal opening was the first sphincter-saving procedure, and the "recurrent group" (Group II) consisting of patients who had failed prior sphincter-saving procedures...
February 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#11
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29402809/questionnaire-based-survey-on-gastrointestinal-bleeding-and-management-of-antithrombotic-agents-during-endoscopy-among-asian-countries
#12
Nanae Tsuruoka, Ryuichi Iwakiri, Yasuhisa Sakata, Kazuma Fujimoto, Takeshi Kamiya, Takashi Joh, Kengo Tokunaga, Shin'ichi Takahashi, Yoshikazu Kinoshita, Kazuhiko Uchiyama, Yuji Naito, Akihito Nagahara, Toshio Watanabe, Francis K L Chan, Ki-Baik Hahm, Udom Kachintorn, Kwong Ming Fock, Ari Fahrial Syam, Abdul Aziz Rani, Jose D Sollano, Qi Zhu
OBJECTIVE: Guidelines on the management of antithrombotic therapy for endoscopic procedures vary among countries. Differences in the management of antithrombotic agents for endoscopic procedures between Western and Eastern countries have already been reported. However, no study has investigated the differences among Asian countries. The aim of this study was to examine the differences in the etiology of gastrointestinal bleeding and management of antithrombotic agents during endoscopic procedures between Japan and other Asian countries (OAC)...
2018: Digestion
https://www.readbyqxmd.com/read/29283091/the-management-of-rectal-bleeding-following-transrectal-prostate-biopsy-a-review-of-the-current-literature
#13
Mark R Quinlan, Damien M Bolton, Rowan G Casey
INTRODUCTION: Since the advent of prostate-specific antigen (PSA)-based testing, transrectal ultrasound (TRUS)-guided prostate biopsy has become a standard part of the diagnostic pathway for prostate cancer (PCa). Rectal bleeding is one of the common side effects of this transrectal route. While rectal bleeding is usually mild and self-limiting, it can be life-threatening. In this article, we examine rectal bleeding post TRUS-guided prostate biopsy and explore the literature to evaluate techniques and strategies aimed at preventing and managing this common and important complication...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#14
REVIEW
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29186643/-s2k-guideline-gastrointestinal-bleeding-guideline-of-the-german-society-of-gastroenterology-dgvs
#15
Martin Götz, Mario Anders, Erwin Biecker, Christian Bojarski, Georg Braun, Thorsten Brechmann, Alexander Dechêne, Matthias Dollinger, Meinrad Gawaz, Ralf Kiesslich, Dieter Schilling, Frank Tacke, Alexander Zipprich, Jonel Trebicka
No abstract text is available yet for this article.
September 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29090267/perioperative-patient-blood-management-programme-multidisciplinary-recommendations-from-the-patient-blood-management-initiative-group
#16
Daniela Filipescu, Răzvan Bănăţeanu, Mircea Beuran, Traean Burcoş, Dan Corneci, Dan Cristian, Mircea Diculescu, Alina Dobrotă, Gabriela Droc, Dănuţ Isacoff, Doina Goşa, Ioana Grinţescu, Anca Lupu, Liliana Mirea, Corina Posea, Oana Stanca, Mihai Ştefan, Dana Tomescu, Cristina Tudor, Daniela Ungureanu, Gabriel Mircescu
Patients with untreated anaemia or iron deficiency who undergo surgical procedures have an increased risk for mortality and morbidity. Patient Blood Management programmes address this issue worldwide and try to improve patient outcomes through a complex set of measures targeting anaemia correction, minimisation of bleeding and improvement of anaemia tolerance, in all phases of perioperative care. The Patient Blood Management Initiative Group is a multidisciplinary team of physicians from specialties including anaesthesiology, nephrology, surgery, orthopaedics, haematology, gastroenterology and transfusion medicine...
October 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29067152/are-patients-in-the-ibd-clinic-at-risk-of-proctitis-secondary-to-sexually-transmitted-infections
#17
Maximillian Groome, Emma M Robinson, Craig Mowat, Alix M L Morieux, Sarah Allstaff
OBJECTIVE: To gauge the potential risk of sexually transmitted infection (STI) as a cause of proctitis in a cohort of patients with inflammatory bowel disease (IBD) and to gauge whether this cohort could benefit from STI testing in the future. DESIGN: Patients attending the IBD clinic were given an anonymous questionnaire recording demographics, sexual behaviour, rectal symptoms, history of receptive anal intercourse (RAI), STIs and attitudes towards sexual health screening...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29050150/-diagnostic-value-analysis-of-capsule-endoscopy-in-obscure-gastrointestinal-bleeding-patients-of-different-ages
#18
C S E Wang, J N Li, Y N Wang, H Yang, J M Qian
Objective: To evaluate the diagnostic value of capsular endoscopy in patients with obscure gastrointestinal bleeding (OGIB) in different age groups, and assess its effectiveness and safety. Methods: A total of 216 patients who were diagnosed with OGIB between March 2005 and March 2016 at Department of Gastroenterology of Peking Union Medical College Hospital were retrospectively reviewed. They were assigned into three groups: young adults, middle-aged and elderly. The demographic characteristics, clinical manifestations, working performance as well as endoscopic features in each group were collected and analyzed...
September 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29018538/replacement-of-warfarin-with-a-novel-oral-anticoagulant-in-endoscopic-mucosal-resection-a-multicentre-open-label-randomised-controlled-trial
#19
Takuya Yamada, Akiko Kada, Toshio Uraoka, Toshio Kuwai, Noriko Watanabe, Yoshihiro Sasaki, Katsuhiro Mabe, Yasuo Takahashi, Takashi Kagaya, Toshihisa Kimura, Hiroshige Hamada, Akiko M Saito, Naohiko Harada
INTRODUCTION: This randomised controlled trial aims to compare the efficacy of warfarin replacement with apixaban without postoperative resumption of heparin with that of conventional heparin bridging in patients taking warfarin and scheduled to undergo endoscopic mucosal resection (EMR): specifically, by checking for reduction in proportion of postoperative bleeding following EMR. METHODS AND ANALYSIS: The multicentre, open-label randomised parallel-group, controlled intervention study regards patients taking warfarin who are scheduled to undergo colon EMR...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28994870/predictive-scores-of-early-mortality-from-variceal-gastrointestinal-bleeding-in-cirrhotic-patients
#20
Leila Mouelhi, Hend Ayadi, Yosra Zaimi, Oussama Daboussi, Mohamed Salem, Radhouane Debbech, Fatma Houissa, Taoufik Najjar
INTRODUCTION: The variceal bleeding, main complication of portal hypertension during cirrhosis, is associated with high early mortality riskestimated between 15 and 20%. This highlights the necessity of predictive models that allow identifying high-risk patients raising the issue of amore aggressive therapeutic care. OBJECTIVE: To assess the performance of four scores for the prediction of cirrhotic patients' high early mortality risk due to digestive hemorrhageand to compare them to the Child-Pugh reference score...
November 2016: La Tunisie Médicale
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