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Gastrointestinal bleeding

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https://www.readbyqxmd.com/read/29140849/endoscopic-submucosal-dissection-for-superficial-proximal-esophageal-neoplasia-is-highly-successful
#1
Yi-Qun Zhang, Tao Chen, Chen Zhang, Quan-Lin Li, Wei-Feng Chen, Li-Qing Yao, Ping-Hong Zhou, Mei-Dong Xu
OBJECTIVE: The aim of this study was to evaluate the outcomes of endoscopic submucosal dissection (ESD) for superficial proximal esophageal neoplasia. SUMMARY OF BACKGROUND DATA: The surgery for a tumor located in proximal esophagus is relatively difficult and leads to a high morbidity and mortality. ESD is a minimally invasive endoscopic treatment of superficial neoplasia of the gastrointestinal tract allowing en block resection with low recurrence rates; however, ESD for superficial proximal esophageal neoplasia is little known...
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29137907/primary-aortoesophageal-fistula-a-fatal-outcome
#2
Yang Yang, Die Hu, Daoquan Peng
Aortoesophageal fistula is a rare but life-threatening cause of massive gastrointestinal bleeding. We reported a case of primary aortoesophageal fistula associated with thoracic aortic pseudoaneurysm. Esophagogastroduodenoscopy demonstrated a bulging erosive lesion coated with fibrin. The patient was therefore diagnosed as malignant esophageal mesenchymoma initially. An emergency contrast-enhanced computed tomography revealed an out-pouching saccular aneurysm protruding toward the esophagus at the level of T8-9...
November 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137017/prognostic-value-of-glucose-metabolism-for-non-st-segment-elevation-infarction-patients-with-diabetes-mellitus-and-single-concomitant-chronic-total-occlusion-following-primary-percutaneous-coronary-intervention
#3
Zhi Xing, Lei Zhang, Zhiqiang Liu, Pengyi He, Yuchun Yang, Muhuyati Wulasihan
Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29133254/characteristics-and-progression-of-preclinical-inflammatory-bowel-disease
#4
Iago Rodríguez-Lago, Olga Merino, Irene Azagra, Ainara Maiz, Eva Zapata, Rebeca Higuera, Isabel Montalvo, María Fernández-Calderón, Paz Arreba, Juan Carrascosa, Ainara Iriarte, Isabel Portillo, Urko Aguirre, Manuel Barreiro-de Acosta, Miguel Muñoz-Navas, José Luis Cabriada
BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is a chronic disease usually diagnosed after the appearance of gastrointestinal symptoms. Little is known about IBD progression during its early and even preclinical phases. We aimed to determine the number of new incidental diagnoses of IBD in an older population, and evaluate disease progression from its early stages. METHODS: We performed a retrospective analysis of 31,005 colonoscopies performed during colorectal cancer screening of patients with positive results from fecal immunochemical tests, at 11 centers in the Basque Country (Spain) from 2009 through 2014...
November 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#5
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132879/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-coronary-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#6
Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. METHODS: In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132153/outcomes-of-dabigatran-and-warfarin-for-atrial-fibrillation-in-contemporary-practice-a-retrospective-cohort-study
#7
Alan S Go, Daniel E Singer, Sengwee Toh, T Craig Cheetham, Marsha E Reichman, David J Graham, Mary Ross Southworth, Rongmei Zhang, Rima Izem, Margie R Goulding, Monika Houstoun, Katrina Mott, Sue Hee Sung, Joshua J Gagne
Background: Dabigatran (150 mg twice daily) has been associated with lower rates of stroke than warfarin in trials of atrial fibrillation, but large-scale evaluations in clinical practice are limited. Objective: To compare incidence of stroke, bleeding, and myocardial infarction in patients receiving dabigatran versus warfarin in practice. Design: Retrospective cohort. Setting: National U.S. Food and Drug Administration Sentinel network...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29130232/-clinical-study-of-preserving-left-colic-artery-during-laparoscopic-total-mesorectal-excision-for-the-treatment-of-rectal-cancer
#8
Xiaolan You, Yuanjie Wang, Zhiyi Chen, Wenqi Li, Ning Xu, Guiyuan Liu, Xiaojun Zhao, Chuanjiang Huang
OBJECTIVE: To evaluate the feasibility, safety, radicality and short-term outcome of preserving left colic artery (LCA) during laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer. METHODS: From January 2013 to December 2016,136 patients with mid-lower rectal cancer received laparoscopic TME in the Gastrointestinal Surgery Department of Taizhou People's Hospital of Jiangsu Province. Patients with rectal tumor within 10 cm to the anal verge were enrolled into the study...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29130004/gastrointestinal-involvement-of-testicular-germ-cell-tumor-a-case-report-and-literature-review
#9
Oluwaseun Shogbesan, Abdullateef Abdulkareem, Asad Jehangir, Sunila Byreddy, Sharon Swierczynski, Anthony Donato
Testicular germ cell tumors (GCT) are the commonest solid tumors in young men. Typical presentation is with painless scrotal swelling; however, symptoms related to complications or metastasis may be the initial presentation. Gastrointestinal (GI) metastasis is seen in about 5% of patients with germ cell tumors and presentation is commonly with GI bleed. It is important to have GCT as a differential diagnosis of GI bleed in young men presenting with unexplained anemia as direct questioning about scrotal swelling and genital examination when appropriate will guide further investigation and facilitate prompt diagnosis...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29129469/does-the-use-of-volumetric-modulated-arc-therapy-reduce-gastrointestinal-symptoms-after-pelvic-radiotherapy
#10
K L White, E Varrassi, J A Routledge, L H Barraclough, J E Livsey, J McLaughlin, S E Davidson
AIMS: Growing numbers of patients with cancer are surviving after treatment with pelvic radiotherapy. We evaluated the technique of volumetric modulated arc therapy (VMAT), which delivers a decreased dose to the organs at risk. We aimed to determine outcomes of this technique in terms of patient-reported acute toxicity and late effects and correlate the frequency of gastrointestinal symptoms with the volume of bowel receiving radiation dose. MATERIALS AND METHODS: Patients who were to receive VMAT for gynaecological malignancy completed patient-reported outcomes at baseline, the end of treatment, 8 weeks and 1 year...
November 9, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29126072/an-unusual-case-of-giant-ileal-diverticulum-a-case-report
#11
Fang Ju Koh, Jen Lock Khor, Min Hoe Chew
Small bowel diverticulosis is rare with an incidence of 1-2% in the general population. It is an uncommon cause of gastrointestinal bleeding that ranges from obscure to overt bleeding. Large ileal diverticula are extremely rare and bleeding complications can result in high overall mortality. A young gentleman presented with persistent per-rectal bleeding and drop in hemoglobin level. He was recently diagnosed with acute myeloid leukemia and was undergoing chemotherapy. A computed tomography scan of the abdomen and pelvis revealed a giant ileal diverticulum...
November 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29125213/gastrointestinal-spray-coagulation-with-snare-tip-as-a-rescue-therapy-to-argon-plasma-coagulation-for-bleeding-jejunal-angioectasia
#12
H H Yen
No abstract text is available yet for this article.
December 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29124127/effectiveness-of-tc-325-hemospray-for-treatment-of-diffuse-or-refractory-upper-gastrointestinal-bleeding-a-single-center-experience
#13
Oscar Cahyadi, Markus Bauder, Benjamin Meier, Karel Caca, Arthur Schmidt
Background and study aims:  TC-325 (Hemospray, Cook Medical) is a powder agent for endoscopic hemostasis in patients with upper gastrointestinal bleeding (UGIB). Although most publications are based on case-reports and retrospective studies, data on efficacy are promising. Here we report our experience with TC-325 for diffuse or refractory UGIB. Patients and methods:  Data on patients receiving TC-325 for endoscopic hemostasis from November 2013 to February 2017 at our center were analyzed retrospectively...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#14
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29123168/clinical-parameters-and-gut-microbiome-changes-before-and-after-surgery-in-thoracic-aortic-dissection-in-patients-with-gastrointestinal-complications
#15
Shuai Zheng, Shulin Shao, Zhiyu Qiao, Xue Chen, Chunmei Piao, Ying Yu, Feng Gao, Jie Zhang, Jie Du
Thoracic aortic dissection (TAAD) is one of the most common types of aortic diseases. Although surgery remains the main method of treatment, the high rate of postoperative gastrointestinal complications significantly influences the effects of surgery and the recovery process. Moreover, the mechanisms underlying this disease remain unclear. To address these problems, we examined changes in the gut microbiota in 40 thoracic aortic dissection patients with abdominal complications after surgery. Levels of white blood cells (WBC), neutrophile granulocytes (NE), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were higher in all patients after surgery...
November 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29122470/accuracy-of-computed-tomographic-enterography-for-obscure-gastrointestinal-bleeding-a-diagnostic-meta-analysis
#16
Bosheng He, Jushun Yang, Jing Xiao, Jinhua Gu, Feixiang Chen, Lin Wang, Junbo Qian, Shenchu Gong
RATIONALE AND OBJECTIVES: Obscure gastrointestinal bleeding (OGIB) is the bleeding from the gastrointestinal tract without definite source that persists and recurs after a negative endoscopic evaluation. The study aimed to systematically evaluate the diagnostic accuracy of computed tomography enterography on OGIB detection by meta-analysis. MATERIALS AND METHODS: Studies were searched in relevant databases. With predefined inclusion criteria, eligible studies were included, followed by quality assessment using the Quality Assessment of Diagnostic Accuracy Studies scoring system...
November 6, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29122112/prehospital-transfusion-for-gastrointestinal-bleeding
#17
Maile E Parker, Mohammad A Khasawneh, Cornelius A Thiels, Kathleen S Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
OBJECTIVE: Gastrointestinal (GI) bleeding is a common medical emergency with significant morbidity and mortality. Many patients are coagulopathic, which may perpetuate bleeding. Remote damage control resuscitation, including early correction of coagulopathy and anemia, may benefit exsanguinating patients with GI bleeding. METHODS: We conducted a retrospective review of patients with acute GI bleeding who received packed red blood cells (pRBC) and/or plasma during transportation to our institution between 2010 and 2014...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29119251/postoperative-complications-and-long-term-functional-outcome-in-children-operated-for-idiopathic-rectal-prolapse
#18
Elin Albertsdottir, Niels Qvist
PURPOSE: The aim of the present study was to evaluate the postoperative complications and the long-term gastrointestinal functional outcome after surgical treatment for rectal prolapse on a strategy with stapled anopexy for short (< 5 cm) prolapse and Delormes procedure for longer (> 5 cm) rectal prolapse. METHODS: A total of 38 patients were included with a postoperative follow-up period ranging from 1 month to 9.1 years. Thirty patients (83%) completed the Rome III questionnaire on gastrointestinal function, with the follow-up period ranging from 2 months to 7 years...
November 8, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29118868/efficacy-of-video-capsule-endoscopy-in-the-management-of-suspected-small-bowel-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#19
Thomas A Zikos, Jennifer Pan, Berkeley Limketkai, Dipanjan Banerjee, Nielsen Fernandez-Becker
Background: Continuous flow left ventricular assist device (CF-LVAD) patients have a high prevalence of gastrointestinal bleeding from the small bowel. Video capsule endoscopy (VCE) is often used for diagnosis in these patients, but efficacy has yet to be determined. In this study, we evaluated the efficacy of VCE in the management of CF-LVAD patients with suspected small bowel bleeding by comparing to a non-VCE CF-LVAD control group. Methods: We retrospectively reviewed the charts of all patients with CF-LVADs implanted at Stanford Hospital from January 2010 to October 2015...
October 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29118689/postpolypectomy-intramural-colonic-hematoma-the-conservative-management-of-a-potentially-fatal-complication
#20
Ravinder Mankoo, Vanessa Kuwajima
Most medical professionals consider colonoscopy to be a safe procedure with a low rate of severe complications such as bowel perforation, gastrointestinal tract bleeding, or mortality. Bowel wall hematoma is a rare complication associated with colonoscopy that can result in significant morbidity and even mortality. We present a case of postpolypectomy hematoma diagnosed with CT imaging and successfully managed in a conservative fashion.
September 2017: Case Reports in Gastroenterology
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