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Miguel Motola-Kuba, Angélica Escobedo-Arzate, Félix Tellez-Avila, José Altamirano, Nancy Aguilar-Olivos, Alberto González-Angulo, Felipe Zamarripa-Dorsey, Misael Uribe, Norberto C Tapia
:  Background. The Rockall, Glasgow-Blatchford, and AIMS65 are useful and validated scoring systems for predicting the outcomes of patients with nonvariceal gastrointestinal bleeding. However, there are no validated evidence for using them to predict outcomes on variceal bleeding. The aim of this study was to evaluate and compare the prognostic accuracy of different nonvariceal bleeding scores with other liver-specific scoring systems in cirrhotic patients. MATERIAL AND METHODS: A retrospective multicenter study that included 160 cirrhotic patients with acute variceal bleeding...
November 2016: Annals of Hepatology
Navin L Kumar, Aaron J Cohen, Jennifer Nayor, Brian L Claggett, John R Saltzman
BACKGROUND: Current guidelines advise that upper endoscopy be performed within 24 hours of presentation in patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). However, the role of urgent endoscopy (< 12 hours) is controversial. AIM: Our aim was to assess whether patients admitted with acute nonvariceal UGIB with lower-risk versus high-risk bleeding have different outcomes with urgent compared with non-urgent endoscopy. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital with nonvariceal UGIB...
September 29, 2016: Gastrointestinal Endoscopy
Rapat Pittayanon, Piyapan Prueksapanich, Rungsun Rerknimitr
BACKGROUND AND STUDY AIMS: Currently, conventional endoscopic treatments provide an unsatisfactory hemostatic outcome in upper gastrointestinal bleeding from tumor. Hemospray has been shown to be useful in many active gastrointestinal bleeding conditions. This study aimed to compare the efficacy of Hemospray and conventional endoscopic hemostasis. PATIENTS AND METHODS: Fourteen patients with active upper gastrointestinal bleeding from tumor were recruited. Hemospray was applied at the bleeding site until hemostasis was achieved...
September 2016: Endoscopy International Open
Khalid Abusaada, Fnu Asad-Ur-Rahman, Vladimir Pech, Umair Majeed, Shengchuan Dai, Xiang Zhu, Sally A Litherland
Background. Blatchford and AIMS65 scores were developed to risk stratify patients with upper gastrointestinal bleed (UGIB). We sought to assess the performance of Blatchford and AIMS65 scores in predicting outcomes in elderly patients with nonvariceal UGIB. Methods. A retrospective cohort study of elderly patients (over 65 years of age) with nonvariceal UGIB admitted to a tertiary care center. Primary outcome was a combined outcome of in-hospital mortality, need for any therapeutic endoscopic, radiologic, or surgical intervention, rebleeding within 30 days, or blood transfusion...
2016: Advances in Medicine
Rosa Ramaekers, Muhammad Mukarram, Christine A M Smith, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: Risk-stratification of emergency department (ED) patients with upper gastrointestinal bleeding (UGIB) using pre-endoscopic risk scores can aid ED physicians in disposition decision-making. We conducted a systematic review to assess the predictive value of pre-endoscopic risk scores for 30-day serious adverse events. METHODS: We searched MEDLINE, PubMed, Embase and the Cochrane Database of Systematic Reviews from inception to March 2015. We included studies involving adult ED UGIB patients evaluating pre-endoscopic risk scores and excluded reviews, case reports and animal studies...
September 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sunpyo Lee, Ji Yong Ahn, Hwoon-Yong Jung, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim, Seon-Ok Kim
AIM: There is limited data on whether scoring systems can be used to predict clinical outcomes in patients with upper gastrointestinal bleeding due to Mallory-Weiss syndrome (MWS). We evaluated whether the Glasgow-Blatchford score (GBS) could be effective in predicting clinical outcomes of bleeding MWS. We also investigated the predictive ability of the Forrest classification for rebleeding and assessed the effective endoscopic modalities for bleeding control in MWS. METHODS: From January 2004 to December 2012, 168 patients were diagnosed with MWS in Asan Medical Center emergency department...
September 13, 2016: Journal of Digestive Diseases
Christopher P Cannon, Savion Gropper, Deepak L Bhatt, Stephen G Ellis, Takeshi Kimura, Gregory Y H Lip, Ph Gabriel Steg, Jurriën M Ten Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll, Jonas Oldgren, Stefan H Hohnloser
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest-sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking...
August 26, 2016: Clinical Cardiology
Ian Blatchford
There is a fascinating tradition of depicting solar eclipses in Western art, although these representations have changed over time. Eclipses have often been an important feature of Christian iconography, but valued as much for their biblical significance as for the splendour of the physical event. However, as Western culture passed through the Renaissance and Enlightenment the depictions of eclipses came to reflect new astronomical knowledge and a thirst for rational learning well beyond the confines of the church and other elites...
September 28, 2016: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
Masayasu Horibe, Tetsuji Kaneko, Naoto Yokogawa, Takuya Yokota, Osamu Okawa, Yukihiro Nakatani, Yuki Ogura, Juntaro Matsuzaki, Eisuke Iwasaki, Naoki Hosoe, Tatsuhiro Masaoka, John M Inadomi, Hidekazu Suzuki, Takanori Kanai, Shin Namiki
BACKGROUND: Assessment of the emergent endoscopy for upper gastrointestinal bleeding (UGIB) patients has important clinical implications. There is no validated criterion to triage. AIMS: To develop a simple score predicting an endoscopic intervention. METHODS: A prospective cohort study was conducted at a tertiary care centre. Primary outcome was the high-risk stigmata which were well-established endoscopic findings to determine the need for an endoscopic intervention...
October 2016: Digestive and Liver Disease
Ingrid A Binswanger, Patrick J Blatchford, Simon J Forsyth, Marc F Stern, Stuart A Kinner
OBJECTIVES: People in prison may be at high risk for infectious diseases and have an elevated risk of death immediately after release compared with later; their risk of death is elevated for at least a decade after release. We compared rates, characteristics, and prison-related risk factors for infectious disease-related mortality among people released from prisons in Queensland, Australia, and Washington State, United States, regions with analogous available data. METHODS: We analyzed data from retrospective cohort studies of people released from prison in Queensland (1997-2007, n=37,180) and Washington State (1999-2009, n=76,208) and linked identifiers from each cohort to its respective national death index...
July 2016: Public Health Reports
Jorge Espinoza-Ríos, Victor Aguilar Sánchez, Eduar Alban Bravo Paredes, José Pinto Valdivia, Jorge Huerta-Mercado Tenorio
OBJECTIVE: Identify the best score that predicts each variable outcome (mortality, rebleeding and need for transfusion for more than 2 red blood cells pack) in patients with upper gastrointestinal bleeding until 30 days of the event. Material y methods: Patients included were those over 18 years, who had upper gastrointestinal bleeding between January 2014 to June 2015 in a general hospital of third level. The data was analyzed by the area under the curve ROC (Receiver Operating Characteristic)...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Juan G Martínez-Cara, Rita Jiménez-Rosales, Margarita Úbeda-Muñoz, Mercedes López de Hierro, Javier de Teresa, Eduardo Redondo-Cerezo
OBJECTIVE: AIMS65 is a score designed to predict in-hospital mortality, length of stay, and costs of gastrointestinal bleeding. Our aims were to revalidate AIMS65 as predictor of inpatient mortality and to compare AIMS65's performance with that of Glasgow-Blatchford (GBS) and Rockall scores (RS) with regard to mortality, and the secondary outcomes of a composite endpoint of severity, transfusion requirements, rebleeding, delayed (6-month) mortality, and length of stay. METHODS: The study included 309 patients...
June 2016: United European Gastroenterology Journal
Sung Min Park, Seok Cheon Yeum, Byung-Wook Kim, Joon Sung Kim, Ji Hee Kim, Eun Hui Sim, Jeong-Seon Ji, Hwang Choi
BACKGROUND/AIMS: The AIMS65 score has not been sufficiently validated in Korea. The objective of this study was to compare the AIMS65 and other scoring systems for the prediction of various clinical outcomes in Korean patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). METHODS: The AIMS65 score, clinical and full Rockall scores (cRS and fRS) and Glasgow-Blatchford (GBS) score were calculated in patients with NVUGIB in a single center retrospectively...
July 15, 2016: Gut and Liver
Ivan Budimir, Marina Gradišer, Marko Nikolić, Neven Baršić, Neven Ljubičić, Dominik Kralj, Ivan Budimir
OBJECTIVE: To compare the performance of the Glasgow Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score in predicting specific clinical endpoints following variceal upper gastrointestinal hemorrhage (UGIH). MATERIAL AND METHODS: Between January 2008 and December 2013, we retrospectively analyzed 225 consecutive hospitalized patients managed for endoscopically confirmed UGIH. RESULTS: A total of 225 patients (mean age 61...
November 2016: Scandinavian Journal of Gastroenterology
Cheryl L Gibbons, Bram A D van Bunnik, Oliver Blatchford, Chris Robertson, Thibaud Porphyre, Laura Imrie, Julie Wilson, J Ross Fitzgerald, Mark E J Woolhouse, Margo E Chase-Topping
BACKGROUND: Worldwide, there is a wealth of literature examining patient-level risk factors for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. At the hospital-level it is generally accepted that MRSA bacteraemia is more common in larger hospitals. In Scotland, size does not fully explain all the observed variation among hospitals. The aim of this study was to identify risk factors for the presence and rate of MRSA bacteraemia cases in Scottish mainland hospitals. Specific hypotheses regarding hospital size, type and connectivity were examined...
2016: BMC Infectious Diseases
Kessarin Thanapirom, Wiriyaporn Ridtitid, Rungsun Rerknimitr, Rattikorn Thungsuk, Phadet Noophun, Chatchawan Wongjitrat, Somchai Luangjaru, Padet Vedkijkul, Comson Lertkupinit, Swangphong Poonsab, Thawee Ratanachu-Ek, Piyathida Hansomburana, Bubpha Pornthisarn, Thirada Thongbai, Varocha Mahachai, Sombat Treeprasertsuk
BACKGROUND/AIM: The risk of upper gastrointestinal bleeding (UGIB) increases in patients with coronary artery disease (CAD) due to the frequent use of antiplatelets. There is some data reporting on treatment outcomes in CAD patients presenting with UGIB. We aim to determine the clinical characteristics and outcomes of UGIB in patients with CAD, compared with non-CAD patients. PATIENTS AND METHODS: We conducted a prospective multi-center cohort study (THAI UGIB-2010) that enrolled 981 consecutive hospitalized patients with acute UGIB...
May 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Joseph Jy Sung, Raymond Sy Tang, Jessica Yl Ching, Tim Rainer, James Yw Lau
BACKGROUND AND AIMS: Upper gastrointestinal bleeding (UGIB) still constitutes one of the major hospital admissions through emergency departments (EDs). This feasibility study aims to test whether capsule endoscopy can reduce unnecessary hospital admissions in patients with suspected UGIB. METHODS: This was a prospective randomized controlled trial in which patients who presented with symptoms or signs suggestive of UGIB were randomized to receive either standard treatment (ST) of hospital management or receive capsule endoscopy (CE), after which hospital admission was determined by the findings of CE...
May 5, 2016: Gastrointestinal Endoscopy
Çağdaş Kalkan, Irfan Soykan, Fatih Karakaya, Ali Tüzün, Zeynep Bıyıklı Gençtürk
AIM: Acute gastrointestinal bleeding is a potentially life-threatening condition that requires rapid assessment and dynamic management. Several scoring systems are used to predict mortality and rebleeding in such cases. The aim of the present study was to compare three scoring systems for predicting short-term mortality, rebleeding, duration of hospitalization and the need for blood transfusion in elderly patients with upper gastrointestinal bleeding. METHODS: The present study included 335 elderly patients with upper gastrointestinal bleeding...
April 14, 2016: Geriatrics & Gerontology International
Kevin S Quackenbush, Stacey Bagby, Wai Meng Tai, Wells A Messersmith, Anna Schreiber, Justin Greene, Jihye Kim, Guoliang Wang, Alicia Purkey, Todd M Pitts, Anna Nguyen, Dexiang Gao, Patrick Blatchford, Anna Capasso, Alwin G Schuller, S Gail Eckhardt, John J Arcaroli
BACKGROUND: Dysregulation of the canonical Wnt signaling pathway has been implicated in colorectal cancer (CRC) development as well as incipient stages of malignant transformation. In this study, we investigated the antitumor effects of AZ1366 (a novel tankyrase inhibitor) as a single agent and in combination with irinotecan in our patient derived CRC explant xenograft models. RESULTS: Six out of 18 CRC explants displayed a significant growth reduction to AZ1366...
May 10, 2016: Oncotarget
Chikara Iino, Tatsuya Mikami, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Jyuichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
BACKGROUND AND AIM: Multiple scoring systems have been developed to predict outcomes in patients with upper gastrointestinal bleeding. We determined how well these and a newly established scoring model predict the need for therapeutic intervention, excluding transfusion, in Japanese patients with upper gastrointestinal bleeding. METHODS: We reviewed data from 212 consecutive patients with upper gastrointestinal bleeding. Patients requiring endoscopic intervention, operation, or interventional radiology were allocated to the therapeutic intervention group...
November 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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