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corticosteroids gi bleeding

Yukari Watanabe, Kenya Kamimura, Tomohiro Iwasaki, Hiroyuki Abe, Shunsaku Takahashi, Ken-Ichi Mizuno, Manabu Takeuchi, Atsushi Eino, Ichiei Narita, Shuji Terai
Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS...
November 16, 2016: World Journal of Clinical Cases
Ying Zhou, Ying Huang
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62...
November 2016: Experimental and Therapeutic Medicine
K Bettahar, A Pinton, T Boisramé, V Cavillon, S Wylomanski, I Nisand, D Hassoun
OBJECTIVE: Updated clinical recommendations for medical induced abortion procedure. METHODS: A systematic review of French and English literature, reviewing the evidence relating to the provision of medical induced abortion was carried out on PubMed, Cochrane Library and international scientific societies recommendations. RESULTS: The effectiveness of medical abortion is higher than 95% when the protocols are adjusted to gestational age (EL1)...
November 3, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Jasbir Makker, Bharat Bajantri, Sailaja Sakam, Sridhar Chilimuri
Involvement of gastrointestinal tract by cytomegalovirus (CMV) is common. CMV infections mainly run their course without any clinical signs in immunocompetent hosts. In contrast, CMV can cause severe infections with serious consequences in a immunocompromised state typically associated with organ transplants, highly immunosuppressive cancer chemotherapy, advanced HIV infection or treatment with corticosteroids. The incidence and severity of these manifestations of CMV is directly proportional with the degree of cellular immune dysfunction, i...
August 21, 2016: World Journal of Gastroenterology: WJG
Ulf Müller-Ladner
BACKGROUND: Although the gastrointestinal (GI) tract including its related organs is not generally regarded as one of the primary organ systems of primary and secondary vasculitic disorders, there are numerous mechanisms of these diseases operative in or around the different structures and compartments of the GI tract. KEY MESSAGES: A majority of the respective clinical symptoms and problems are linked to an alteration of (peri)vascular homeostasis. Alteration of perivascular matrix metabolism can also affect the functional integrity and motility of the GI tract...
2016: Digestive Diseases
Minoru Tomizawa, Fuminobu Shinozaki, Rumiko Hasegawa, Yoshinori Shirai, Yasufumi Motoyoshi, Takao Sugiyama, Shigenori Yamamoto, Naoki Ishige
Lower gastrointestinal (GI) bleeding can be caused by colorectal polyps or cancer. The aim of the present study was to identify blood test variables and medications that can predict lower GI bleeding, which would allow for appropriate colonoscopy. The medical records of patients who underwent colonoscopy from September 2014 to September 2015 were retrospectively analyzed. The selected patients included 278 men (mean age, 67.0±11.5 years) and 249 women (mean age, 69.6±12.0 years). The diagnosis, medications, and blood test variables were compared between patients with and without bleeding...
June 2016: Biomedical Reports
Mohammad A Y Alqudah, Sayer Al-Azzam, Karem Alzoubi, Mohammad Alkhatatbeh, Neda' Rawashdeh
OBJECTIVE: To determine the frequency of inappropriate proton pump inhibitor (PPI) prescriptions during hospitalization for stress ulcer prophylaxis on the general medical ward in a tertiary Jordanian hospital. MATERIALS AND METHODS: A retrospective chart review was executed on 236 patient admissions prescribed any PPI in a tertiary Jordanian hospital. For each patient, a detailed range of demographic and clinical variables was recorded. Patient's clinical variables were clustered into major vs...
August 2016: International Journal of Clinical Pharmacology and Therapeutics
Kameshwar Prasad, Mamta B Singh, Hannah Ryan
BACKGROUND: Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. OBJECTIVES: To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe disability in people with tuberculous meningitis...
April 28, 2016: Cochrane Database of Systematic Reviews
Alesa Y Courson, John R Lee, Meredith J Aull, Jennifer H Lee, Sandip Kapur, Jennifer K McDermott
Surgical stress, corticosteroids, and mycophenolate may contribute to gastrointestinal ulcers/bleeding after kidney transplantation. Prophylactic acid suppression with H2RAs or PPIs is often utilized after transplantation, although unclear if truly indicated after early corticosteroid withdrawal (CSWD). PPIs have been associated with increased risks of Clostridium difficile infection (CDI), pneumonia, and acute rejection. This retrospective cohort study investigated benefits and risks of prolonged PPI use following kidney transplantation and included 286 kidney recipients undergoing CSWD within five d of transplant who were maintained on tacrolimus and mycophenolate mofetil/sodium...
June 2016: Clinical Transplantation
Per Stål, Antti Oksanen
Acute-on-chronic liver failure (ACLF) is a condition that may develop in up to one third of patients with chronic liver disease who exhibit clinical signs of acute decompensation, i.e. ascites, gastrointestinal bleeding, hepatic encephalopathy or bacterial infection. ACLF implies the combination of acute hepatic decompensation with organ failure in kidney, brain, liver, lungs, circulation and/or coagulation. The prognosis worsens with the number of failing organs, renal involvement, advanced age and elevated leukocyte blood count...
2016: Läkartidningen
Veronika Belanová, Martin Gřiva
BACKGROUND: The incidence of acute upper gastrointestinal bleeding is about 85-108/100,000 inhabitants per year, nonvariceal bleeding accounts for 80-90%. Antiplatelet and anticoagulation treatment are the significant risk factors for upper gastrointestinal bleeding. OBJECTIVES: To evaluate the occurrence of upper gastrointestinal bleeding in the general community of patients in a county hospital. And to compare the role played by antiplatelet and anticoagulation drugs and other risk medication...
December 2015: Vnitr̆ní Lékar̆ství
Pedram Paragomi, Kamran Moradi, Pejman Khosravi, Reza Ansari
Crohn's disease (CD) is rarely presented with lower GI bleeding (LGIB) which eludes the clinician. A 25-year-old lady with severe rectorrhagia was presented with no history of constipation, diarrhea or abdominal pain. Colonoscopy revealed ulcers in the rectum, sigmoid colon, and terminal ileum. Crohn's pathologic features were detected in the terminal ileum. The bleeding was controlled via supportive care and IV corticosteroid. Recurrent LGIB was managed by prednisolone and azathioprine. The patient had an uneventful recovery...
November 2015: Acta Medica Iranica
Katsunori Iijima, Tooru Shimosegawa
Nowadays, low-dose aspirin is widely administered at low dose as an antithrombotic drug for the prevention of cerebrovascular and cardiovascular diseases. However, aspirin, even at a low dose, can induce varying degrees of gastroduodenal mucosal injury (erosion, ulcer, ulcer bleeding). Hence, co-prescription of proton pump inhibitors with low-dose aspirin is recommended for those at high risk for adverse gastroduodenal events. At present, a history of peptic ulcer, especially that of complicated ulcer, is the most important risk factor for low-dose aspirin-associated gastroduodenal adverse events...
2015: Current Pharmaceutical Design
Chana I C Chin, Shirleen Loloyan Kohn, Thomas G Keens, Monique F Margetis, Roberta M Kato
BACKGROUND: Idiopathic pulmonary hemosiderosis (IPH) is a rare disorder of unknown etiology characterized by chronic pulmonary hemorrhage and presents with a triad of anemia, hemoptysis and pulmonary infiltrates. IPH is a diagnosis of exclusion with a variable and disparate clinical course. Despite existing therapies, few children achieve full remission while others have recurrent hemorrhage, progressive lung damage, and premature death. METHODS: We surveyed physicians who care for patients with IPH via a web-based survey to assess the most common practices...
2015: Orphanet Journal of Rare Diseases
Bashar S Hmoud, Kershaw Patel, Ramon Bataller, Ashwani K Singal
BACKGROUND & AIMS: Prednisolone is the first-line therapy for severe alcoholic hepatitis (AH). Patients with severe alcoholic hepatitis often develop severe infections that negatively impact short-term prognosis. METHODS: We performed this meta-analysis to assess the effect of corticosteroids on the occurrence of and mortality from infections in patients with severe alcoholic hepatitis. Randomized controlled trials examining the use of corticosteroids in severe alcoholic hepatitis and reporting data on infection rates and mortality were included...
May 2016: Liver International: Official Journal of the International Association for the Study of the Liver
J Lemale, L Dainese, P Tounian
Eosinophilic gastrointestinal disorders are a heterogeneous group of disorders characterized by no specific digestive symptoms associated with dense eosinophilic inflammation of the gastrointestinal tract in the absence of known causes for such tissue eosinophilia. Among these diseases, eosinophilic gastroenteritis (EGE) and colitis (EC) are less common than esophagitis, but their incidence and prevalence have been increasing over the past decade due in part to increased disease recognition. The exact pathophysiology is not clear: EGE and EC are immune-mediated diseases implicating adaptive T-helper cell type 2 immunity...
July 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Berit Elin S Jensen, Jane M Hansen, Anders B Junker, Jens F Lassen, Svend E Jensen, Ove B Schaffalitzky de Muckadell
INTRODUCTION: Dual antiplatelet therapy is standard treatment following percutaneous coronary intervention (PCI) and stenting. However, such therapy increases the risk of upper gastrointestinal bleeding (UGIB). The risk factors of UGIB are well-documented and proton pump inhibitor (PPI) treatment reduces the risk. The aim was to describe the prevalence of risk factors of UGIB in dual antiplatelet-treated patients. METHODS: A questionnaire was used to assess the prevalence of risk factors of upper gastrointestinal bleeding among dual antiplatelet-treated first-time PCI patients in Western Denmark...
June 2015: Danish Medical Journal
Stella D Bouziana, Konstantinos Tziomalos
Clopidogrel is a widely used antiplatelet agent for the secondary prevention of cardiovascular events in patients with stable coronary heart disease, acute coronary syndromes and ischemic stroke. Even though clopidogrel is safer than aspirin in terms of risk for gastrointestinal (GI) bleeding, the elderly, and patients with a history of prior GI bleeding, with Helicobacter pylori infection or those who are also treated with aspirin, anticoagulants, corticosteroids or nonsteroidal anti-inflammatory drugs are at high risk for GI complications when treated with clopidogrel...
May 6, 2015: World Journal of Gastrointestinal Pharmacology and Therapeutics
Ines W Soukoulis, Marilyn G Liang, Victor L Fox, John B Mulliken, Ahmad I Alomari, Steven J Fishman
OBJECTIVES: The aim of the present study was to document the clinical presentation, diagnostic studies, and therapy of gastrointestinal infantile hemangiomas. METHODS: This is a retrospective analysis of children with gastrointestinal hemangiomas culled from our Vascular Anomalies Center database. We detailed the location of visceral and cutaneous tumors, as well as radiologic and procedural methods used for diagnosis and treatment. RESULTS: A total of 9 of the 16 children (14 girls and 2 boys) with hollow visceral hemangiomas also had cutaneous lesions...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
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