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Gastrointestinal bleeds

Do Hoon Kim, Gwang Ha Kim, Chang Min Cho, Chang Hwan Park, Soo-Young Na, Tae Hyeon Kim, Yu Kyung Cho, Ji Hyun Kim, Dong-Wan Seo
BACKGROUND: Endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) may facilitate tissue acquisition for a definitive diagnosis of gastrointestinal subepithelial tumors (SETs). This study aimed to determine the diagnostic yield of EUS-FNB using a novel 20-gauge ProCore needle with a coiled sheath in tissue sampling of gastrointestinal SETs. METHODS: Between July 2016 and February 2017, 39 patients with gastrointestinal SETs were prospectively recruited from six university hospitals in Korea...
October 19, 2018: BMC Gastroenterology
Sake J van der Wall, Nienke van Rein, Bart van den Bemt, Marieke J H A Kruip, Karina Meijer, Liane C J Te Boome, Tim A Simmers, A Marco W Alings, Robert Tieleman, Frederikus A Klok, Menno V Huisman
Aims: Because practice-based data on the usage of idarucizumab for urgent dabigatran reversal is unavailable, we evaluated the appropriateness of idarucizumab usage, its haemostatic effectiveness and clinical outcomes. Methods and results: An observational cohort study was performed including consecutive patients who were treated with idarucizumab between 2016 and 2018. Appropriate usage was assessed with predefined criteria. Post-reversal effectiveness was evaluated according to International Society on Thrombosis and Haemostasis (ISTH) recommendations...
October 17, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ceren Durer, Seren Durer, Mohamad Sharbatji, Isin Y Comba, Ilan Aharoni, Umair Majeed
Hemangiomas of the small intestine are rare and very difficult to diagnose preoperatively. Clinical presentations may include occult or massive gastrointestinal (GI) bleeding, obstruction, intussusception, and perforation. We report a 66-year-old Caucasian male patient with severe anemia secondary to occult GI bleeding from a cavernous hemangioma in the jejunum. A double balloon enteroscopy following capsule endoscopy was performed to obtain biopsy samples, which established the final diagnosis.
August 6, 2018: Curēus
Raquel Ballester-Clau, Gisela Torres Vicente, Tania Voltà-Pardo, Laura López-Barroso, Mercedes Cucala-Ramos, Josep M Reñé-Espinet, Montse Planella de Rubinat
OBJECTIVE: The aim of this study was to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) following hospitalization for acute gastrointestinal bleeding (AGIB) in the context of a restrictive transfusion strategy. PATIENTS AND METHODS: A retrospective single-center study analyzed patients with AGIB (excluding AGIB secondary to portal hypertension) administered a single FCM dose with or without blood transfusion. RESULTS: Eighty-six episodes in 84 patients were analyzed...
October 17, 2018: European Journal of Gastroenterology & Hepatology
Asiya K Shakir, Zhongxin Yu, Muhammad Adnan Altaf
Multifocal lymphangioendotheliomatosis with thrombocytopenia is a rare disease characterized by multiple cutaneous and gastrointestinal (GI) vascular lesions and thrombocytopenia refractory to platelet and blood cell transfusions. GI bleeding can become life-threatening in this condition. We report a case of multifocal lymphangioendotheliomatosis with thrombocytopenia in a male infant with isolated GI involvement, diagnosed when he was 3 months old. The patient was managed with daily aminocaproic acid, octreotide drip, and corticosteroids for 13 months after diagnosis; he had complete resolution of symptoms by 2 years of age and showed adequate height and gain by 5 years of age...
October 16, 2018: Journal of Pediatric Hematology/oncology
Samer Al Said, Christoph Bode, Daniel Duerschmied
The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12 -receptor antagonists, some patients with artery disease continue to experience recurrent cardiovascular ischaemic events due to excessive thrombin generation beyond the acute period...
October 17, 2018: Hämostaseologie
Christine G Kohn, Thomas J Bunz, Jan Beyer-Westendorf, Craig I Coleman
OBJECTIVES: To assess the association between rivaroxaban and warfarin and major bleeding risk in unprovoked venous thromboembolism (VTE) patients. METHODS: Using US MarketScan claims from 1/2012-12/2016, we identified patients who had ≥1 primary hospitalization/emergency department visit diagnosis code for an unprovoked VTE, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and ≥12-months of insurance coverage prior to the VTE. Differences in baseline covariates were adjusted using inverse probability-of-treatment weights based on propensity scores (residual absolute standardized differences <0...
October 16, 2018: European Journal of Haematology
Murtaza Cakir, Ali Ahiskalioglu, Erdem Karadeniz, Mehmet Dumlu Aydin, Umit Ali Malcok, Celaleddin Soyalp, Cagatay Calikoglu, Goksin Sengul, Sare Sipal, Ahmet Murat Yayik
Stress ulcers is a trouble complication of subarachnoid hemorrhage (SAH). Although gastrointestinal ulcerations may be attributed to increased HCL secretion in SAH; the exact mechanism of that complication has not been investigated definitively. We studied if vagal network degeneration may cause intestinal atrophy following SAH. Study was conducted on 25 rabbits, with 5 control group (Group-A), 5 SHAM group (Group-B), and 15 SAH group via injection of autologue blood to cisterna magna. Seven animals followed for seven days (Early Decapitated-Group-C) and eight animals followed 21 days (Late Decapitated-Group-D)...
October 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Bertha E García-Ramírez, Carlos M Nuño-Guzmán, Ricardo E Zaragoza-Carrillo, Hugo Salado-Rentería, Audrey Gómez-Abarca, Jorge L Corona
Bezoars are conglomerations of undigested foreign material retained in the gastrointestinal tract. Trichobezoar is a compact conglomeration of swallowed hair and constitutes less than 6% of all bezoars. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Many patients may remain asymptomatic or present a mild form of the disease characterized by abdominal pain, early satiety, nausea, and vomiting. Complications may manifest as gastric outlet obstruction or bleeding, and intestinal obstruction...
September 2018: Case Reports in Gastroenterology
Milly Buwenge, Gabriella Macchia, Alessandra Arcelli, Rezarta Frakulli, Lorenzo Fuccio, Sara Guerri, Elisa Grassi, Silvia Cammelli, Francesco Cellini, Alessio G Morganti
Locally advanced pancreatic carcinoma (LAPC) has a poor prognosis and the purpose of treatment is survival prolongation and symptom palliation. Radiotherapy has been reported to reduce pain in LAPC. Stereotactic RT (SBRT) is considered as an emerging radiotherapy technique able to achieve high local control rates with acceptable toxicity. However, its role in pain palliation is not clear. To review the impact on pain relief with SBRT in LAPC patients, a literature search was performed on PubMed, Scopus, and Embase (January 2000-December 2017) for prospective and retrospective articles published in English...
2018: Journal of Pain Research
Yuting Qian, Tingting Bai, Juanjuan Li, Yi Zang, Tong Li, Mingping Xie, Qi Wang, Lifu Wang, Ruizhe Shen
Objective: This study aimed at investigating the clinical value of magnetic-guided capsule endoscopy (MGCE) in the diagnosis of gastrointestinal diseases in minors. Methods: Eighty-four minor patients hospitalized in the pediatric department at Ruijin Hospital between June 2015 and January 2018 were enrolled for this study. Following bowel preparation, all patients underwent MGCE. The feasibility, safety, diagnostic yield, and sensitivity of MGCE were analyzed. Patients were followed up for more than 2 weeks...
2018: Gastroenterology Research and Practice
Ho Pan Sham, Mark Bazett, Momir Bosiljcic, Hyungjun Yang, Beryl Luk, Hong T Law, Vijay Morampudi, Hong B Yu, Jim Pankovich, Simon Sutcliffe, Brian Bressler, John K Marshall, Richard N Fedorak, Jenny Chen, Michelle Jones, Hal Gunn, Shirin Kalyan, Bruce A Vallance
Background: Current ulcerative colitis (UC) treatments are focused on symptom management primarily via immune suppression. Despite the current arsenal of immunosuppressant treatments, the majority of patients with UC still experience disease progression. Importantly, aggressive long-term inhibition of immune function comes with consequent risk, such as serious infections and malignancy. There is thus a recognized need for new, safe and effective treatment strategies for people living with UC that work upstream of managing the symptoms of the disease...
2018: Frontiers in Immunology
Neha Nischal, Deepak Balachandra, Anil Kumar Agarwal, Sunil Kumar Puri
Segmental dilatation of ileum (SDI) is a less known uncommon entity with a confusing clinical scenario and no definite etiopathogenesis. The preoperative diagnosis is of exclusion. However, it has an excellent prognosis after surgery. We describe a case of a young patient who presented with anemia without any overt gastrointestinal (GI) bleed. Thorough radiological examinations were needed to reach the diagnosis of SDI which was confirmed postoperatively.
July 2018: Indian Journal of Radiology & Imaging
M H Liu, F Zhou, X B Wang, L P Chen, G Z Li, Q Zhao
Objective: To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Methods: Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure...
August 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Baseer Sultan Ahmad, Mansoor Ul Haq, Abeera Munir, Saiyed Abdullah Abubakar Mohsin Ehsanullah, Pervez Ashraf
Gastrointestinal (GI) bleeding, is the life threating presentation of many diseases in emergency room. Aortoenteric fistula (AEF) is one of the rare causes of GI bleeding that can be fatal if not diagnosed and treated promptly. We present a case of a86 years old hypertensive male with the history of fresh bleeding per rectum, dizziness, fatigability and palpitation for last 12 hours who came to the emergency room in January 2015 He was stabilized and resuscitated. On lab investigation and abdominal CT scan he was diagnosed as aortic aneurysm with AEF...
October 2018: JPMA. the Journal of the Pakistan Medical Association
Yu Xia, Stephen Forest, Patricia Friedmann, Lin-Chiang Chou, Snehal Patel, Ulrich Jorde, Daniel Goldstein
BACKGROUND: Limited data exists on factors predicting prolonged survival in left ventricular assist device (LVAD) recipients. We sought to identify patient characteristics and complications associated with prolonged survival. METHODS: We conducted retrospective review of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), including primary continuous flow LVAD recipients between May 2012 and March 2013. Patients were identified as having survived with a device in place after three years or not conditional on having initially survived six months...
October 11, 2018: Annals of Thoracic Surgery
Lucas C Mendez, Pencilla Lang, Chirag Patel, David D'Souza, Adam Gladwish, Laura D'Alimonte, Amandeep Taggar, Elizabeth Barnes, Lisa Barbera, Eric Leung
PURPOSE: Perineal interstitial brachytherapy (P-ISBT) is an important component in the treatment of locally advanced gynecological cancers. However, there are concerns about potential acute complications from catheter needles. The goal is to evaluate the safety of P-ISBT by studying acute complications and radiological organ needle intrusions. MATERIALS AND METHODS: Forty-eight patients with gynecological cancers treated with P-ISBT at a single institution from September 2014 to April 2016 were included in a prospective registry trial...
October 10, 2018: Brachytherapy
Amit Iyengar, Yas Sanaiha, Esteban Aguayo, Young-Ji Seo, Vishal Dobaria, William Toppen, Richard J Shemin, Peyman Benharash
Improvements in technology and operator experience have led to exponential growth of transcatheter aortic valve implantation (TAVI) programs. Late bleeding complications were recently highlighted after TAVI with a high impact on morbidity. The purpose of the present study was to assess the incidence and financial impact of late Gastrointestinal (GI) bleeding after TAVI, and compare with the surgical cohort. Retrospective analysis of the National Readmissions Database was performed from January 2011 to December 2014, and patients who underwent TAVI or surgical aortic valve replacement (SAVR) were identified...
August 29, 2018: American Journal of Cardiology
Angelo Sala, Ewgenij Proschak, Dieter Steinhilber, G Enrico Rovati
Chronic inflammation and pain is a major global health problem, and nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most frequently prescribed drugs and common option for the treatment of inflammatory pain. However, they have the potential to cause serious complications, such as gastrointestinal (GI) lesions, bleeding and cardiovascular (CV) problems. NSAIDs exert their anti-inflammatory, analgesic and anti-pyretic actions by inhibiting the cyclooxygenases (COX)-1 and COX-2, key enzymes of the arachidonic acid (AA) cascade...
October 10, 2018: Biochemical Pharmacology
Carlos Ferre Aracil, Laura Núñez Gómez, Luis Téllez Villajos, Agustín Albillos Martínez
INTRODUCTION: Epistaxis in cirrhotic patients is a common issue. However, the literature published to date is very scarce. MATERIAL AND METHODS: Retrospective case series of patients with cirrhosis who presented with a significant epistaxis, between 2006 and 2016. RESULTS: Data were collected from 39 cirrhotic patients with a mean age of 61.4 (±14) years, 75% of which were males. The main comorbidities were hypertension (33%) and diabetes mellitus (26%)...
October 9, 2018: Gastroenterología y Hepatología
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