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Gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28445318/renal-failure-caused-by-a-partly-calcified-aortic-aneurysm-in-a-patient-with-dabigatran-therapy-a-case-report
#1
Philipp Jud, Thomas Gary, Kurt Tiesenhausen, Rupert Portugaller, Gerald Hackl, Marianne Brodmann
RATIONALE: Abdominal aortic aneurysms (AAAs) are mostly asymptomatic. If aortic aneurysms become symptomatic, complications include peripheral embolization, acute aortic occlusion, and aortic rupture. However, there are also unusual complications caused by aortic aneurysms. PATIENT CONCERNS: An 87-old male with dabigatran therapy presented with newly developed melena and acute renal failure. Radiological imaging revealed an AAA with thrombotic and calcified deposits which affected the renal arteries...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445299/endoscopic-ultrasonography-predicts-early-esophageal-variceal-bleeding-in-liver-cirrhosis-a-case-report
#2
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/28445167/spatial-features-of-dose-surface-maps-from-deformably-registered-plans-correlate-with-late-gastrointestinal-complications
#3
Calyn R Moulton, Michael J House, Victoria Lye, Colin I Tang, Michele Krawiec, David J Joseph, James W Denham, Martin A Ebert
This study investigates the associations between spatial distribution of dose to the rectal surface and observed gastrointestinal toxicities after deformably registering each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate brachytherapy (HDRBT) prostate cancer treatment. The study contains data for 118 patients where the HDRBT CT was deformably-registered to the EBRT CT. The EBRT and registered HDRBT TG43 dose distributions in a reference 2 Gy/fraction were 3D-summed. Rectum dose-surface maps (DSMs) were obtained by virtually unfolding the rectum surface slice-by-slice...
April 26, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28444452/ebola-virus-disease-in-children-during-the-2014-2015-epidemic-in-guinea-a-nationwide-cohort-study
#4
Mahamoud Sama Chérif, Nut Koonrungsesomboon, Diénaba Kassé, Sékou Ditinn Cissé, Saliou Bella Diallo, Fatoumata Chérif, Facély Camara, Alpha Koné, Eleonor Fundan Avenido, Mandiou Diakité, Mamadou Pathé Diallo, Edouard Le Gall, Mohamed Cissé, Juntra Karbwang, Kenji Hirayama
The most recent epidemic of Ebola virus disease (EVD) has resulted in more than 11,000 deaths in West Africa. It has threatened child health in the affected countries, including Guinea. This nationwide retrospective cohort study included all children under 20 years of age with laboratory-confirmed EVD in Guinea during the 2014-2015 Ebola outbreak for analysis. Of 8,448 children with probable or suspected EVD, 695 cases were laboratory-confirmed EVD. The overall case fatality rate (CFR) was 62.9%. Pediatric patients with younger age had a significantly higher rate of death (adjusted OR = 0...
April 25, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28441679/the-drivers-of-discretionary-utilization-clinical-history-versus-physician-supply
#5
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
#6
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/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#7
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439702/a-comparison-of-apixaban-and-dabigatran-etexilate-for-thromboprophylaxis-following-hip-and-knee-replacement-surgery
#8
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28438745/management-of-chronic-pain-using-complementary-and-integrative-medicine
#9
REVIEW
Lucy Chen, Andreas Michalsen
Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use...
April 24, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28437000/magnetically-guided-capsule-endoscopy
#10
REVIEW
Naveen Shamsudhin, Vladimir I Zverev, Henrik Keller, Salvador Pane, Peter W Egolf, Bradley J Nelson, Alexander M Tishin
Wireless capsule endoscopy (WCE) is a powerful tool for medical screening and diagnosis, where a small capsule is swallowed and moved by means of natural peristalsis and gravity through the human gastrointestinal (GI) tract. The camera-integrated capsule allows for visualization of the small intestine, a region which was previously inaccessible to classical flexible endoscopy. As a diagnostic tool, it allows to localize the sources of bleedings in the middle-part of the gastrointestinal tract and to identify diseases such as inflammatory bowel disease (Crohn's disease), Polyposis-Syndrome and tumors...
April 24, 2017: Medical Physics
https://www.readbyqxmd.com/read/28435855/first-clinical-experiences-with-a-novel-endoscopic-over-the-scope-clip-system
#11
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/28435651/a-pediatric-case-of-meckel-diverticulum-with-uncommon-presentation-showing-no-lower-gastrointestinal-bleeding
#12
Sanaz Mehrabani, Soheil Osia
Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Painless intestinal hemorrhage is a frequently occurring complication that relates to MD in children. Bowel obstruction is a rare complication of MD in children. We report on the case of a four-year old male child who presented with abdominal pain and hematemesis. Finally, bowel obstruction due to MD was confirmed at surgery.
March 22, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28434081/the-outcomes-of-pediatric-liver-retransplantation-from-a-living-donor-a-17-year-single-center-experience
#13
Kohei Miura, Seisuke Sakamoto, Keita Shimata, Masaki Honda, Takashi Kobayashi, Toshifumi Wakai, Yasuhiko Sugawara, Yukihiro Inomata
PURPOSE: Liver retransplantation is the only therapeutic option for patients with graft failure after liver transplantation. The aim of this study is to evaluate the outcomes of pediatric retransplantation from living donor at a single center. METHODS: Between December 1998 to August 2015, retransplantation from a living donor was performed for 14 children (<18 years of age) at Kumamoto University Hospital. The characteristics of the retransplantation recipient and the clinicopathological factors between primary transplantation and retransplantation were analyzed to detect the prognostic factors...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28433982/acute-on-chronic-gastrointestinal-bleeding-a-unique-clinical-entity
#14
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/28431980/shear-stress-alterations-in-the-celiac-trunk-of-patients-with-a-continuous-flow-left-ventricular-assist-device-as-shown-by-in-silico-and-in-vitro-flow-analyses
#15
Francesco Scardulla, Salvatore Pasta, Leonardo D'Acquisto, Sergio Sciacca, Valentina Agnese, Christian Vergara, Alfio Quarteroni, Francesco Clemenza, Diego Bellavia, Michele Pilato
BACKGROUND: The use of left ventricular assist devices (LVADs) to treat advanced cardiac heart failure is constantly increasing, although this device leads to high risk for gastrointestinal bleeding. METHODS: Using in-silico flow analysis, we quantified hemodynamic alterations due to continuous-flow LVAD (HeartWare, Inc., Framingham, MA) in the celiac trunk and major branches of the abdominal aorta, and then explored the relationship between wall shear stress (WSS) and celiac trunk orientation...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28431872/plasma-copeptin-levels-in-the-patients-with-gastrointestinal-bleeding
#16
Ömer Salt, Polat Durukan, S Ozkan, R Saraymen, A Sen, M A Yurci
INTRODUCTION: Gastrointestinal bleeding is a significant cause of morbidity and mortality worldwide. In addition, it constitutes an important part of health expenditures. In this study, we aimed to determine whether there is a relationship between plasma copeptin levels and the etiology, location and severity of gastrointestinal bleeding. MATERIALS AND METHODS: This study was performed prospectively in 104 consecutive patients who were admitted to an emergency department with complaints of bloody vomiting or bloody or black stool...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431779/propranolol
#17
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/28430920/rates-and-predictors-of-hospital-readmission-after-transcatheter-aortic-valve-implantation
#18
Anna Franzone, Thomas Pilgrim, Nicolas Arnold, Dik Heg, Bettina Langhammer, Raffaele Piccolo, Eva Roost, Fabien Praz, Lorenz Räber, Marco Valgimigli, Peter Wenaweser, Peter Jüni, Thierry Carrel, Stephan Windecker, Stefan Stortecky
Aims: To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and Results: Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive of hospital readmission within 1 year after TAVI with bootstrap analysis for internal validation. Of 868 patients alive at discharge, 221 (25.4%) were readmitted within 1 year...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#19
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#20
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
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