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Non Variceal Bleed

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https://www.readbyqxmd.com/read/30107378/nontumorous-portal-vein-thrombosis-in-liver-cirrhosis-possible-role-of-%C3%AE-blockers-br-br
#1
Lydia Giannitrapani, Walter Granà, Anna Licata, Cosima Schiavone, Giuseppe Montalto, Maurizio Soresi
OBJECTIVE: Non-selective β-blockers (NSBBs) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the incidence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. SUBJECTS AND METHODS: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed...
August 14, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/30058470/diagnostic-and-therapeutic-approach-to-upper-gastrointestinal-bleeding
#2
Ujjal Poddar
BACKGROUND: There is a lack of clarity about the approach to and management of upper gastrointestinal (UGI) bleeding in children. AIM: To examine the recent literature on UGI bleeding in children in order to outline the diagnostic approach and management. METHODS: The English language literature was searched for articles on UGI bleeding in children. Special attention was paid to its prevalence, risk factors, clinical approach and management...
July 30, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/30049580/efficacy-and-safety-of-anticoagulation-in-non-malignant-portal-vein-thrombosis-in-patients-with-liver-cirrhosis
#3
Tomas Artaza, Miriam Lopes, Marta Romero, Ana-Zaida Gómez, Gema de la Cruz, Juan José Sánchez, Concepción González, Rafael Gómez
BACKGROUND AND AIM: Treatment for portal vein thrombosis (PVT) is not well established. Nevertheless, anticoagulation therapy can seemingly be used as first-line therapy. However, there are limited data on the role of this treatment in patients with PVT and cirrhosis. We sought to assess the safety and efficacy of anticoagulation therapy in a series of patients with non-malignant PVT and liver cirrhosis. METHODS: We analyzed the data of 32 patients with cirrhosis and PVT between March 2009 and September 2015...
July 24, 2018: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/30045395/transjugular-intrahepatic-portosystemic-shunt-tips-pathophysiologic-basics-actual-indications-and-results-with-review-of-the-literature
#4
REVIEW
Holger Strunk, Milka Marinova
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a non-selective portosystemic shunt created using endovascular techniques. During recent years technical improvements and new insights into pathophysiology have modified indications for TIPS placement. In this article we therefore want to discuss current knowledge. METHOD: A literature review was performed to review and discuss the pathophysiology, indications and results of the TIPS procedure. RESULTS: Established TIPS indications are persistent bleeding despite combined pharmacological and endoscopic therapy and rebleeding during the first five days...
August 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/30022452/both-full-glasgow-blatchford-score-and-modified-glasgow-blatchford-score-predict-the-need-for-intervention-and-mortality-in-patients-with-acute-lower-gastrointestinal-bleeding
#5
Asad Ur-Rahman, Jian Guan, Sameen Khalid, Alvina Munaf, Mohammad Sharbatji, Evgeny Idrisov, Xiaoping He, Archana Machavarapu, Khalid Abusaada
BACKGROUND: Glasgow-Blatchford score (GBS) has been developed for risk stratification in management of acute upper gastrointestinal (GI) bleeding. However, the performance of GBS in patients with lower GI bleeding is unknown. AIM: To evaluate the performance of full or modified GBS and modified GBS in prediction of major clinical outcomes in patients with lower GI bleeding. METHODS: A retrospective study of patients admitted to a tertiary care center with either non-variceal upper GI bleeding or lower GI bleeding was conducted...
July 19, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/30003386/%C3%AE-blockers-improve-presinusoidal-portal-hypertension
#6
Michael Sørensen, Lars P Larsen, Gerda E Villadsen, Niels K Aagaard, Henning Grønbæk, Susanne Keiding, Hendrik Vilstrup
BACKGROUND: Presinusoidal portal hypertension is a clinically important cause of gastric and gastroesophageal varices. Whereas β-blockers have an established prophylactic role against bleeding from esophageal and gastric varices in portal hypertension due to cirrhosis, the effect on presinusoidal portal hypertension is unknown. AIMS: To evaluate the hemodynamic effect of β-blockers in non-cirrhotic patients with presinusoidal portal hypertension. METHODS: We measured the blood pressure gradient from spleen pulp to free hepatic vein in 12 patients with presinusoidal portal hypertension by combined hepatic vein catheterization and spleen pulp puncture while on and off β-blocker treatment (random sequence)...
July 12, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29977995/use-of-over-the-scope-clip-otsc-improves-outcomes-of-high-risk-adverse-outcome-hr-ao-non-variceal-upper-gastrointestinal-bleeding-nvugib
#7
Ravishankar Asokkumar, Roy Soetikno, Andres Sanchez-Yague, Lim Kim Wei, Ennaliza Salazar, Jing Hieng Ngu
Background and study aims : Endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB) with high-risk adverse outcome (HR-AO) features has a high risk of failure. We studied the safety and efficacy of over-the-scope clips (OTSC) to treat these lesions. Patients and methods : We included patients who were treated using OTSC for NVUGIB from January 2015 to October 2017. We studied rebleeding and mortality rates and used the Rockall data and our institution's prior data for comparison...
July 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29954332/comparison-of-aims65-glasgow-blatchford-and-rockall-scoring-approaches-in-predicting-the-risk-of-in-hospital-death-among-emergency-hospitalized-patients-with-upper-gastrointestinal-bleeding-a-retrospective-observational-study-in-nanjing-china
#8
Lei Gu, Fei Xu, Jie Yuan
BACKGROUND: This study aims to compare the performance of AIMS65, Glasgow-Blatchford (GBS) and Rockall scores (RS) in predicting the death risk among emergency-hospitalized patients with upper gastrointestinal bleeding (UGIB) in regional China. METHODS: A retrospective study was implemented between January 2014 and December 2015. Eligible participants were those who were hospitalized with UGIB. The outcome variable was in-hospital death, while explanatory variables were AIMS65, GBS and RS scores...
June 28, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29927862/over-the-scope-clips-for-treatment-of-acute-non-variceal-gastrointestinal-bleeding-in-children-is-safe-and-effective
#9
Paul Tran, Joshua Carroll, Bradley A Barth, Nandini Channabasappa, David M Troendle
OBJECTIVE: There is little published experience with the use of over the scope clips (OTSCs) in pediatric patients. The aim of this study is to present our single center experience utilizing OTSCs for non-variceal gastrointestinal bleeding METHODS:: This is a retrospective case series of pediatric patients who underwent endoscopic management of gastrointestinal bleeding during which OTSCs were utilized. RESULTS: 11 cases of OTSC utilization for hemostasis were identified in 10 unique patients between 11/2014 and 5/2016...
June 20, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29915780/gastrostomy-tube-insertion-in-pediatric-patients-with-autosomal-recessive-polycystic-kidney-disease-arpkd-current-practice
#10
Kathrin Burgmaier, Joy Brandt, Rukshana Shroff, Peter Witters, Lutz T Weber, Jörg Dötsch, Franz Schaefer, Djalila Mekahli, Max C Liebau
Introduction: Autosomal recessive polycystic kidney disease (ARPKD) is a severe hepatorenal disorder of childhood. Early renal disease in ARPKD may require renal replacement therapy and is associated with failure to thrive resulting in a need for nasogastric tube feeding or gastrostomy. In ARPKD patients, the benefit of a gastrostomy in nutrition and growth needs to be weighed against the potential risk of complications of congenital hepatic fibrosis (CHF) and portal hypertension like variceal bleeding. CHF in ARPKD has thus been considered as a relative contraindication for gastrostomy insertion...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29904721/surveillance-for-portal-hypertension-in-the-course-of-liver-cirrhosis
#11
REVIEW
Anna Piekarska, Ewa K Berkan, Kamila M Wójcik
Non-invasive liver fibrosis assessment techniques are under development for evaluating the severity of liver disease and portal hypertension. The paper presents practical arrangements for the diagnosis and treatment of portal hypertension in patients with chronic liver disease, established in the Baveno VI Consensus Workshop for diagnosis and treatment of portal hypertension. Currently, the diagnostic standard of liver disease severity is transient elastography, which can identify patients with clinically significant portal hypertension (liver stiffness > 20 kPa)...
June 2018: Clinical and experimental hepatology
https://www.readbyqxmd.com/read/29791429/-clinical-practice-guideline-for-the-evaluation-and-management-of-upper-gastrointestinal-bleeding-for-the-peruvian-social-security-essalud
#12
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/29773783/cholesteryl-ester-storage-disease-fatal-outcome-without-causal-therapy-in-a-female-patient-with-the-preventable-sequelae-of-progressive-liver-disease-after-many-years-of-mild-symptoms
#13
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#14
Mona Haj, Mary Hart, Don C Rockey
Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. The primary outcome was inpatient mortality with focus on cirrhosis-related complications: non-bleeding esophageal varices, variceal hemorrhage, ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS)...
August 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29748820/trans-arterial-embolization-of-non-variceal-upper-gastrointestinal-bleeding-is-the-use-of-ethylene-vinyl-alcohol-copolymer-as-safe-as-coils
#15
Marcello Andrea Tipaldi, Gianluigi Orgera, Miltiadis Krokidis, Alberto Rebonato, Daniele Maiettini, Simone Vagnarelli, Cesare Ambrogi, Michele Rossi
PURPOSE: The safety of liquid embolics over the conventional coils for the treatment of non-variceal upper gastrointestinal bleeding (UGIB) approach is still unclear. Purpose of this study is to assess the safety of ethylene-vinyl alcohol copolymer (EVOH 6%) over coils in the treatment of UGIB. MATERIALS AND METHODS: All the upper gastrointestinal tract embolization procedures performed in a single center in a 6-year period were reviewed. Patients embolised with coils (Group A) versus those embolised with EVOH 6% (Group B) were compared...
September 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29719748/does-early-endoscopy-improve-mortality-in-patients-with-acute-non-variceal-gastrointestinal-bleeding-a-retrospective-review
#16
Umair Iqbal, Hafsa Anwar, Hunaiz Patel, Ahmad Chaudhary, Pascale Raymond
Introduction Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding the benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy within 24 hours of presentation. Methods From July 2013 to July 2016, 179 patients admitted with a diagnosis of non-variceal UGIB were retrospectively reviewed...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29691276/asia-pacific-working-group-consensus-on-non-variceal-upper-gastrointestinal-bleeding-an-update-2018
#17
Joseph Jy Sung, Philip Cy Chiu, Francis K L Chan, James Yw Lau, Khean-Lee Goh, Lawrence Hy Ho, Hwoon-Young Jung, Jose D Sollano, Takuji Gotoda, Nageshwar Reddy, Rajvinder Singh, Kentaro Sugano, Kai-Chun Wu, Chun-Yin Wu, David J Bjorkman, Dennis M Jensen, Ernst J Kuipers, Angel Lanas
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages...
April 24, 2018: Gut
https://www.readbyqxmd.com/read/29671414/non-variceal-upper-gi-bleeding
#18
REVIEW
(no author information available yet)
No abstract text is available yet for this article.
April 19, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29671413/non-variceal-upper-gastrointestinal-bleeding
#19
REVIEW
Angel Lanas, Jean-Marc Dumonceau, Richard H Hunt, Mitsuhiro Fujishiro, James M Scheiman, Ian M Gralnek, Helen E Campbell, Alaa Rostom, Càndid Villanueva, Joseph J Y Sung
Non-variceal upper gastrointestinal bleeding (NVUGIB) is bleeding that develops in the oesophagus, stomach or proximal duodenum. Peptic ulcers, caused by Helicobacter pylori infection or use of NSAIDs and low-dose aspirin (LDA), are the most common cause. Although the incidence and mortality associated with NVUGIB have been decreasing owing to considerable advances in the prevention and management of NVUGIB over the past 20 years, it remains a common clinical problem with an annual incidence of ∼67 per 100,000 individuals in the United States in 2012...
April 19, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29626014/glasgow-blatchford-score-and-risk-stratifications-in-acute-upper-gastrointestinal-bleed-can-we-extend-this-to-2-for-urgent-outpatient-management
#20
Kelly Chatten, Huw Purssell, Ashwini Kumar Banerjee, Stephanie Soteriadou, Yeng Ang
Upper gastrointestinal (GI) bleeds are a common presentation to emergency departments in the UK. The Glasgow Blatchford score (GBS) predicts the outcome of patients at presentation. Current UK and European guidelines recommend outpatient management for a GBS of 0. In the current study, our aim was to assess whether extending the GBS allows for early discharge while maintaining patient safety. We also analysed whether pathologies could be missed by discharging patients too early. Data were retrospectively collected on patients admitted with symptoms of an upper GI bleed between 1 October 2013 and 10 June 2016...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
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