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https://www.readbyqxmd.com/read/28445299/endoscopic-ultrasonography-predicts-early-esophageal-variceal-bleeding-in-liver-cirrhosis-a-case-report
#1
Changjun Men, Guoliang Zhang
RATIONALE: Bleeding esophageal and gastric varices constitute a serious complication in liver cirrhosis. Previous studies have shown that endoscopic ultrasonography (EUS) can be used to predict early esophageal variceal bleeding in liver cirrhosis. PATIENT CONCERNS: We report a case of a 46-year-old man with hepatitis B liver cirrhosis (CTP score, 5; Child-Pugh class, A) who was admitted to our hospital due to a decreased appetite lasting 1 week. DIAGNOSIS: He was initially diagnosed with decompensated hepatitis B cirrhosis; an abdominal computed tomography (CT) scan indicated a diagnosis of liver cirrhosis and portal hypertension (PHT)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441679/the-drivers-of-discretionary-utilization-clinical-history-versus-physician-supply
#2
Gregory W Ruhnke, Willard G Manning, David T Rubin, David O Meltzer
PURPOSE: Because the effect of physician supply on utilization remains controversial, literature based on non-Medicare populations is sparse, and a physician supply expansion is under way, the potential for physician-induced demand across diverse populations is important to understand. A substantial proportion of gastrointestinal endoscopies may be inappropriate. The authors analyzed the impact of physician supply, practice patterns, and clinical history on esophagogastroduodenoscopy (EGD, defined as discretionary) among patients hospitalized with lower gastrointestinal bleeding (LGIB)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28440524/-clinical-epidemiological-characteristics-and-change-trend-of-upper-gastrointestinal-bleeding-over-the-past-15-years
#3
Jinping Wang, Yi Cui, Jinhui Wang, Baili Chen, Yao He, Minhu Chen
OBJECTIVE: To investigate the clinical epidemiology change trend of upper gastrointestinal bleeding (UGIB) over the past 15 years. METHODS: Consecutive patients who was diagnosed as continuous UGIB in the endoscopy center of The First Affiliated Hospital of Sun-Yat University during the period from 1 January 1997 to 31 December 1998 and the period from 1 January 2012 to 31 December 2013 were enrolled in this study. Their gender, age, etiology, ulcer classification, endoscopic treatment and hospitalization mortality were compared between two periods...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28435855/first-clinical-experiences-with-a-novel-endoscopic-over-the-scope-clip-system
#4
Marco Dinelli, Barbara Omazzi, Paolo Andreozzi, Nicola Zucchini, Alessandro Redaelli, Gianpiero Manes
We describe our experience with a new over-the-scope clip (OTSC) system (Padlock Clip?) in the treatment of 14 patients. Eight of the 14 patients were treated for closure of gastrointestinal fistulas (n?=?4), iatrogenic gastrointestinal perforations (n?=?2), or hemostasis of post-polypectomy bleeding (n?=?2). The site of clipping was the lower gastrointestinal tract in five patients and the upper gastrointestinal tract in three patients. The clip was successfully delivered in seven out of the eight patients and clinical success was achieved in all patients...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28433982/acute-on-chronic-gastrointestinal-bleeding-a-unique-clinical-entity
#5
Don C Rockey, Adam C Hafemeister, Joan S Reisch
Gastrointestinal bleeding is defined in temporal-spatial terms-as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined 'acute on chronic' gastrointestinal bleeding. We prospectively identified all patients who underwent endoscopic evaluation for any form of gastrointestinal bleeding at a University Hospital. Acute on chronic bleeding was defined as the presence of new symptoms or signs of acute bleeding in the setting of chronic bleeding, documented as iron deficiency anemia...
April 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28431779/propranolol
#6
Abdulrahman A Al-Majed, Ahmed H H Bakheit, Hatem A Abdel Aziz, Fahad M Alajmi, Haitham AlRabiah
Propranolol is a noncardioselective β-blocker. It is reported to have membrane-stabilizing properties, but it does not own intrinsic sympathomimetic activity. Propranolol hydrochloride is used to control hypertension, pheochromocytoma, myocardial infarction, cardiac arrhythmias, angina pectoris, and hypertrophic cardiomyopathy. It is also used to control symptoms of sympathetic overactivity in the management of hyperthyroidism, anxiety disorders, and tremor. Other indications cover the prophylaxis of migraine and of upper gastrointestinal bleeding in patients with portal hypertension...
2017: Profiles of Drug Substances, Excipients, and related Methodology
https://www.readbyqxmd.com/read/28418549/glasgow-blatchford-score-predicted-intervention-or-death-better-than-4-other-prediction-models-in-upper-gi-bleeding
#7
Nicholas Talley, Michael Potter
No abstract text is available yet for this article.
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28416166/two-year-outcomes-of-balloon-occluded-retrograde-transvenous-obliteration-of-gastric-varices-in-liver-transplant-recipients-a-multi-institutional-study
#8
W E Saad, J F B Chick, R N Srinivasa, N Saad, S Kim, A Fischman, G Frey, A Al-Osaimi, S Caldwell
PURPOSE: To assess the 2-year effectiveness and safety of balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GVs) in liver transplant recipients. MATERIALS AND METHODS: Eleven liver transplant recipients underwent consecutive BRTO for GVs at four institutions. Patients included eight (73%) men and three (27%) women with mean age of 56 years±12 (SD) (range: 26-67 years). Underlying cause of liver transplantation was hepatitis C virus (HCV)-related cirrhosis in five (45%), alcohol- and HCV-related cirrhosis in three (27%), primary biliary cirrhosis in two (18%), and alcoholic cirrhosis in one (9%)...
April 13, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#9
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411763/is-timing-everything-in-the-management-of-acute-upper-gi-bleeding
#10
EDITORIAL
John C T Wong, James Y W Lau
No abstract text is available yet for this article.
May 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28410791/gastrointestinal-safety-of-celecoxib-versus-naproxen-in-patients-with-cardiothrombotic-diseases-and-arthritis-after-upper-gastrointestinal-bleeding-concern-an-industry-independent-double-blind-double-dummy-randomised-trial
#11
Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Kelvin Lam, Grace L H Wong, Siew C Ng, Vivian Lee, Kim W L Au, Pui Kuan Cheong, Bing Y Suen, Heyson Chan, Ka Man Kee, Angeline Lo, Vincent W S Wong, Justin C Y Wu, Moe H Kyaw
BACKGROUND: Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. METHODS: For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28405538/henoch-sch%C3%A3-nlein-purpura-presenting-as-severe-gastrointestinal-and-renal-involvement-with-mixed-outcomes-in-an-adult-patient
#12
Raj Shah, Madhuri Ramakrishnan, Alexis Vollmar, Amanda Harrell, Richard Van Trump, Amgad Masoud
Henoch-Schönlein purpura (HSP) is typically seen as a self-limiting disease in children, but can present more severely in adults, especially when there is renal involvement. Management of HSP in adults also remains a controversial topic with very few studies evaluating available therapies. In this case, HSP presenting as a combination of severe gastrointestinal involvement and a rapid decline in renal function in an adult patient directed our therapy. The patient was a 48-year-old Caucasian male with no known past medical history, who presented with a combination of purpuric rash over the lower extremities, severe abdominal pain with upper gastrointestinal bleeding and a rapidly increasing serum creatinine, with hematuria...
March 9, 2017: Curēus
https://www.readbyqxmd.com/read/28397699/restrictive-versus-liberal-blood-transfusion-for-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#13
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/28396990/incidence-and-outcomes-of-early-left-ventricular-thrombus-following-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#14
Shafik Khoury, Sarit Carmon, Gilad Margolis, Gad Keren, Yacov Shacham
BACKGROUND: Since the advent of primary percutaneous coronary intervention (PCI), studies have reported a declining incidence of left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). We investigated the incidence and outcomes of early (pre-discharge) LVT in the contemporary era of PCI practice in a large cohort of STEMI patients. METHODS: We retrospectively studied 2071 consecutive STEMI patients who underwent successful primary PCI...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28396724/complementary-roles-of-interventional-radiology-and-therapeutic-endoscopy-in-gastroenterology
#15
REVIEW
David M Ray, Indu Srinivasan, Shou-Jiang Tang, Andreas S Vilmann, Peter Vilmann, Timothy C McCowan, Akash M Patel
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures...
March 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28396275/relationship-of-time-to-presentation-after-onset-of-upper-gi-bleeding-with-patient-characteristics-and-outcomes-a-prospective-study
#16
Loren Laine, Stig B Laursen, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
BACKGROUND & AIMS: We performed a prospective multi-national study of patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) and assessed the relationship of time to presentation after onset of UGIB symptoms with patient characteristics and outcomes. METHODS: Consecutive patients presenting with overt UGIB (red-blood emesis, coffee-ground emesis and/or melena) from March 2014 to March 2015 at 6 hospitals were included. Multiple pre-defined patient characteristics and outcomes were collected...
April 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28395384/laparoscopic-and-luminal-endoscopic-cooperative-surgery-can-be-a-standard-treatment-for-submucosal-tumors-of-the-stomach-a-retrospective-multicenter-study
#17
Tatsuo Matsuda, Souya Nunobe, Toshiyuki Kosuga, Hiroshi Kawahira, Noriyuki Inaki, Shuji Kitashiro, Nobutsugu Abe, Isao Miyashiro, Sayaka Nagao, Masahiko Nishizaki, Naoki Hiki
Background and study aims We have developed a combined laparoscopic and luminal endoscopic surgery technique for resection of gastric submucosal tumors (SMTs) that can be performed without excessive resection of the stomach. In a multicenter retrospective study we aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for gastric SMT resection. Patients and methods Between October 2007 and December 2011, 126 patients with gastric SMTs underwent LECS at 8 institutions...
April 10, 2017: Endoscopy
https://www.readbyqxmd.com/read/28394786/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-upper-gastrointestinal-bleeding
#18
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/28393330/external-validation-of-scoring-systems-in-risk-stratification-of-upper-gastrointestinal-bleeding
#19
Anna Cherian Anchu, Subair Mohsina, Sathasivam Sureshkumar, T Mahalakshmy, Vikram Kate
AIM: The aim of this study was to externally validate the four commonly used scoring systems in the risk stratification of patients with upper gastrointestinal bleed (UGIB). METHODS: Patients of UGIB who underwent endoscopy within 24 h of presentation were stratified prospectively using the pre-endoscopy Rockall score (PRS) >0, complete Rockall score (CRS) >2, Glasgow Blatchford bleeding scores (GBS) >3, and modified GBS (m-GBS) >3 scores. Patients were followed up to 30 days...
April 10, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28392699/comparison-of-prophylactic-effect-of-ugib-and-effects-on-platelet-function-between-ppis-and-h2ras-combined-with-dapt-systematic-review-and-meta-analysis
#20
Zhan-Miao Yi, Ting-Ting Qiu, Yuan Zhang, Zhi-Yan Liu, Suo-Di Zhai
OBJECTIVE: We compared prophylactic effects of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) on upper gastrointestinal bleeding (UGIB) associated with dual antiplatelet therapy (DAPT) and explored this influence on platelet function. METHODS: Randomized controlled trials and cohort studies comparing PPIs with H2RAs in adults receiving DAPT were collected from PubMed, EMBASE and Cochrane databases. Dichotomous data were pooled to obtain risk ratios (RRs) for UGIB, major adverse cardiovascular events (MACEs), poor responders to clopidogrel and rehospitalization, and continuous data were pooled to obtain mean differences (MDs) for P2Y12 reaction units (PRUs), with 95% confidence intervals (CIs)...
2017: Therapeutics and Clinical Risk Management
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