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upper gastrointestinal bleeding 2016

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https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#1
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#2
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28493238/cold-polypectomy-for-duodenal-adenomas-a-prospective-clinical-trial
#3
Daisuke Maruoka, Tomoaki Matsumura, Shingo Kasamatsu, Hideaki Ishigami, Takashi Taida, Kenichiro Okimoto, Tomoo Nakagawa, Tatsuro Katsuno, Makoto Arai
Background and study aims Endoscopic resection is effective in treating nonampullary duodenal adenomas but has a high incidence of complications. Cold polypectomy, including cold forceps polypectomy (CFP) and cold snare polypectomy (CSP), is safe and effective in treating colorectal polyps. However, its utility in sporadic nonampullary duodenal adenomas has not been investigated. The purpose of this prospective study was to examine the safety and efficacy of cold polypectomy for sporadic nonampullary duodenal adenomas...
May 10, 2017: Endoscopy
https://www.readbyqxmd.com/read/28458008/risk-of-gastrointestinal-bleeding-in-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-a-systematic-review-and-meta-analysis
#4
Corey S Miller, Alastair Dorreen, Myriam Martel, Thao Huynh, Alan N Barkun
BACKGROUND AND AIMS: Non-vitamin K antagonist oral anticoagulants (NOACs) are convenient and effective in prevention and treatment of venous thromboembolism and prevention of stroke in patients with atrial fibrillation. However, these drugs have been associated with increased risk of gastrointestinal (GI) bleeding. We conducted a systematic review and meta-analysis to determine the risk of GI bleeding in patients receiving these drugs. METHODS: We searched the EMBASE, Medline, Cochrane, and ISI Web of knowledge databases through January 2016 for randomized trials that compared NOACs to conventional anticoagulants for approved indications...
April 27, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28397699/restrictive-versus-liberal-blood-transfusion-for-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#5
Ayodele Odutayo, Michael J R Desborough, Marialena Trivella, Adrian J Stanley, Carolyn Dorée, Gary S Collins, Sally Hopewell, Susan J Brunskill, Brennan C Kahan, Richard F A Logan, Alan N Barkun, Michael F Murphy, Vipul Jairath
BACKGROUND: Acute upper gastrointestinal bleeding is a leading indication for red blood cell (RBC) transfusion worldwide, although optimal thresholds for transfusion are debated. METHODS: We searched MEDLINE, Embase, CENTRAL, CINAHL, and the Transfusion Evidence Library from inception to Oct 20, 2016, for randomised controlled trials comparing restrictive and liberal RBC transfusion strategies for acute upper gastrointestinal bleeding. Main outcomes were mortality, rebleeding, ischaemic events, and mean RBC transfusion...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28394786/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-upper-gastrointestinal-bleeding
#6
Taeyoung Kong, Sangkook In, Yoo Seok Park, Hye Sun Lee, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: The delta neutrophil index (DNI), reflecting the fraction of circulating immature granulocytes, is associated with increased mortality in patients with systemic inflammation. It is rapidly and easily measured while performing a complete blood count. This study aimed to determine whether the DNI can predict short-term mortality in patients presenting to the emergency department (ED) with upper gastrointestinal hemorrhage (UGIH). METHODS: We retrospectively identified consecutive patients (>18 years old) with UGIH admitted to the ED from January 1, 2015 to February 28, 2016...
April 7, 2017: Shock
https://www.readbyqxmd.com/read/28367197/efficacy-of-early-endoscopy-and-colonoscopy-in-very-elderly-patients-with-gastrointestinal-bleeding
#7
Mustafa Celik
OBJECTIVE: We aimed to determine the efficacy and safety of early (within the first 24 hour from application) endoscopy and colonoscopy in very elderly patients with GIS bleeding. METHODS: In this study, 95 patients were included who underwent early endoscopy with the pre-diagnosis of upper GIS bleeding or endoscopy-colonoscopy with the pre-diagnosis of lower GIS bleeding between 2012 and 2016. Endoscopy and colonoscopy procedures were compared in terms of the development of complications, tolerance of procedure, detection of bleeding site, and rate of therapeutic interventions performed for bleeding...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28297771/-advances-in-basic-and-clinical-research-on-liver-cirrhosis-in-2016
#8
C Gu, M Y Song, W J Sun, X Y Xu, C Q Yang, D F Chen
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28293079/pediatric-gastrointestinal-bleeding-perspectives-from-the-italian-society-of-pediatric-gastroenterology
#9
REVIEW
Claudio Romano, Salvatore Oliva, Stefano Martellossi, Erasmo Miele, Serena Arrigo, Maria Giovanna Graziani, Sabrina Cardile, Federica Gaiani, Gian Luigi de'Angelis, Filippo Torroni
There are many causes of gastrointestinal bleeding (GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28278445/no-catheter-angiography-is-needed-in-patients-with-an-obscure-acute-gastrointestinal-bleed-and-negative-cta
#10
Pratik A Shukla, Adam Zybulewski, Marcin K Kolber, Erik Berkowitz, James Silberzweig, Morris Hayim
PURPOSE: To evaluate the negative predictive power of computed tomography angiography (CTA) for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with the intention to treat. MATERIALS AND METHODS: A retrospective chart review of patients was performed who underwent mesenteric angiography for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016...
May 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28256302/transcatheter-arterial-embolization-of-gastrointestinal-bleeding-with-n-butyl-cyanoacrylate-a-systematic-review-and-meta-analysis-of-safety-and-efficacy
#11
Pyeong Hwa Kim, Jiaywei Tsauo, Ji Hoon Shin, Sung-Cheol Yun
PURPOSE: To evaluate the safety and efficacy of transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA) for the treatment of gastrointestinal (GI) bleeding via a meta-analysis of published studies. MATERIALS AND METHODS: The MEDLINE/PubMed and EMBASE databases were searched for English-language studies from January 1990 to March 2016 that included patients with nonvariceal GI bleeding treated with transcatheter arterial embolization with NBCA with or without other embolic agents...
April 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28099341/laparoscopic-distal-splenoadrenal-shunt-for-the-treatment-of-portal-hypertension-in-children-with-congenital-hepatic-fibrosis-a-case-report
#12
Jin-Shan Zhang, Wei Cheng, Long Li
BACKGROUND: The distal splenorenal shunt is an effective procedure for the treatment of portal hypertension in children. However, there has been no report about laparoscopic distal splenorenal shunt in the treatment of portal hypertension in children. METHODS: From December 2015 to August 2016, 4 children with upper gastrointestinal bleeding underwent laparoscopic distal splenoadrenal shunt. Portal hypertension and splenomegaly were demonstrated on the preoperative computed tomography (CT) and sonography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27921360/mortality-in-patients-who-discontinue-low-dose-acetylsalicylic-acid-therapy-after-upper-gastrointestinal-bleeding
#13
Antonio González-Pérez, María Eugenia Sáez, Saga Johansson, Péter Nagy, Luis A García Rodríguez
PURPOSE: Discontinuing low-dose acetylsalicylic acid (ASA) therapy after upper gastrointestinal bleeding (UGIB) may increase the risk of cardiovascular-related death. Our aim was to compare mortality in UK primary care patients who discontinue ASA after UGIB with that in patients who continue therapy. METHODS: ASA users at the time of UGIB and who were alive 30 days after were selected using The Health Improvement Network. Predictors of survival were assessed using adjusted Cox proportional hazards regression models...
December 6, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27906917/efficacy-and-safety-of-tc-325-hemospraytm-for-non-variceal-upper-gastrointestinal-bleeding-at-middlemore-hospital-the-early-new-zealand-experience
#14
Hannah Giles, Dinesh Lal, Stephen Gerred, Paul Casey, Alasdair Patrick, Derek Luo, Ravinder Ogra
AIMS: A case series to review early experiences with HemosprayTM for a variety of non-variceal upper gastrointestinal bleeding (UGIB) at Middlemore Hospital. METHODS: HemosprayTM was administered therapeutically as first line or rescue at the discretion of the endoscopist. All cases of UGIB requiring HemosprayTM at Middlemore Hospital were identified to the investigator who undertook analysis of electronic and hard copy notes. RESULTS: Between October 2013 and July 2016, 36 patients were treated endoscopically with HemosprayTM...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27895403/first-line-endoscopic-treatment-with-over-the-scope-clips-significantly-improves-the-primary-failure-and-rebleeding-rates-in-high-risk-gastrointestinal-bleeding-a-single-center-experience-with-100-cases
#15
Hans-Jürgen Richter-Schrag, Torben Glatz, Christine Walker, Andreas Fischer, Robert Thimme
AIM: To evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB). METHODS: A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 (n = 93) who underwent FLET and SLET with OTSCs...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#16
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27720369/extubation-failure-in-neonates-after-cardiac%C3%A2-surgery-prevalence-etiology-and%C3%A2-risk-factors
#17
Shinya Miura, Nao Hamamoto, Masaki Osaki, Satoshi Nakano, Chisato Miyakoshi
BACKGROUND: The purpose of this study was to explore the prevalence, etiology, and risk factors of extubation failure (EF) in post-cardiac surgery neonates. METHODS: Neonates (30 days old or younger) who underwent cardiac surgery and were admitted to the cardiac intensive care unit between September 2010 and February 2016 were included. The prevalence and etiology of EF, defined as reintubation within 48 hours, were reviewed. Demographic, operative, and perioperative data were retrospectively collected...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27418432/design-and-analysis-choices-for-safety-surveillance-evaluations-need-to-be-tuned-to-the-specifics-of-the-hypothesized-drug-outcome-association
#18
Susan Gruber, Aloka Chakravarty, Susan R Heckbert, Mark Levenson, David Martin, Jennifer C Nelson, Bruce M Psaty, Simone Pinheiro, Christian G Reich, Sengwee Toh, Alexander M Walker
BACKGROUND: We reviewed the results of the Observational Medical Outcomes Research Partnership (OMOP) 2010 Experiment in hopes of finding examples where apparently well-designed drug studies repeatedly produce anomalous findings. OMOP had applied thousands of designs and design parameters to 53 drug-outcome pairs across 10 electronic data resources. Our intent was to use this repository to elucidate some sources of error in observational studies. METHOD: From the 2010 OMOP Experiment, we sought drug-outcome-method combinations (DOMCs) that met consensus design criteria, yet repeatedly produced results contrary to expectation...
September 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27182692/pancreatic-duct-guidewire-placement-for-biliary-cannulation-for-the-prevention-of-post-endoscopic-retrograde-cholangiopancreatography-ercp-pancreatitis
#19
REVIEW
Frances Tse, Yuhong Yuan, Majidah Bukhari, Grigorios I Leontiadis, Paul Moayyedi, Alan Barkun
BACKGROUND: Difficult cannulation is a risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). It has been postulated that the pancreatic duct guidewire (PGW) technique may improve biliary cannulation success and reduce the risk of PEP in people with difficult cannulation. OBJECTIVES: To systematically review evidence from randomised controlled trials (RCTs) assessing the effectiveness and safety of the PGW technique compared to persistent conventional cannulation (CC) (contrast- or guidewire-assisted cannulation) or other advanced techniques in people with difficult biliary cannulation for the prevention of PEP...
May 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27140030/timing-or-dosing-of-intravenous-proton-pump-inhibitors-in-acute-upper-gastrointestinal-bleeding-has-low-impact-on-costs
#20
Yidan Lu, Viviane Adam, Vanessa Teich, Alan Barkun
OBJECTIVES: High-dose intravenous proton pump inhibitors (PPIs) post endoscopy are recommended in non-variceal upper gastrointestinal bleeding (UGIB), as they improve outcomes of patients with high-risk lesions. Determine the budget impact of using different PPI regimens in treating non-variceal UGIB, including pre- and post-endoscopic use, continuous infusion (high dose), and intermittent bolus (twice daily) dosing. METHODS: A budget impact analysis using a decision model informed with data from the literature adopting a US third party payer's perspective with a 30-day time horizon was used to determine the total cost per patient (US$2014) presenting with acute UGIB...
October 2016: American Journal of Gastroenterology
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