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https://www.readbyqxmd.com/read/27913537/what-to-do-after-the-bleed-resuming-anticoagulation-after-major-bleeding
#1
Daniel M Witt
Resuming anticoagulation therapy after a potentially life-threatening bleeding complication evokes high anxiety levels among clinicians and patients trying to decide whether resuming oral anticoagulation to prevent devastating and potentially fatal thromboembolic events or discontinuing anticoagulation in hopes of reducing the risk of recurrent bleeding is best. The available evidence favors resumption of anticoagulation therapy for gastrointestinal tract bleeding and intracranial hemorrhage survivors, and it is reasonable to begin postbleeding decision making with resuming anticoagulation therapy as the default plan...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#2
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27908516/small-bowel-bleeding-updated-algorithm-and-outcomes
#3
REVIEW
Lauren B Gerson
Patients previously classified with "obscure gastrointestinal hemorrhage" should now be classified as "suspected small bowel bleeding" according to the 2015 American College of Gastroenterology guidelines. This article provides algorithms for how to manage patients with suspected small bowel bleeding, including utilization of second-look endoscopy and/or colonoscopy, video capsule endoscopy, computed tomographic enterography, magnetic resonance enterography, angiography, and deep enteroscopy.
January 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27904106/fatal-hemorrhagic-gastrointestinal-angioectasia-after-bone-marrow-transplantation-for-dyskeratosis-congenita
#4
Jin Imai, Takayoshi Suzuki, Marie Yoshikawa, Makiko Dekiden, Hirohiko Nakae, Fumio Nakahara, Shingo Tsuda, Hajime Mizukami, Jun Koike, Muneki Igarashi, Hiromasa Yabe, Tetsuya Mine
Dyskeratosis congenita (DC) is a rare inherited disease in which the telomere complex cannot be maintained. Shortened telomeres can cause a number of clinical conditions. We herein report a case of unrelated bone marrow transplantation due to aplastic anemia associated with DC. The patient died of uncontrollable refractory intestinal bleeding. Three cases of DC with life-threatening hemorrhaging after transplantation have been reported; however, the bleeding origin could not be determined. Our case is the only patient in which a gastrointestinal bleeding point, jejunal multiple angioectasia, was determined...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27903389/-dabigatran-versus-warfarin-for-the-prevention-of-stroke-in-chinese-patients-with-nonvalvular-atrial-fibrillation-chinese-subpopulation-analysis-of-re-ly
#5
X Gao, Y M Yang, J Zhu, Y Dai, H Q Tan
Objective: This analysis was performed to evaluate the efficacy in stroke prevention and safety of dabigatran in Chinese nonvalvular atrial fibrillation(NVAF) patients enrolled in RE-LY trial. Methods: RE-LY was an prospective, open-label, randomized, multicenter study. From March 2006 to March 2009, 541 atrial fibrillation patients at risk of stroke were recruited from 13 medical centers in China. Patients randomly received, in a blinded fashion, fixed doses of dabigatran-110 mg or 150 mg twice daily or, in an unblinded fashion, adjusted-dose warfarin...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27902834/arteriography-for-lower-gastrointestinal-hemorrhage-reply
#6
Gregory Nadolski, Christina L Jacovides, Jose L Pascual
No abstract text is available yet for this article.
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902818/arteriography-for-lower-gastrointestinal-hemorrhage-clarity-needed-in-defining-evidence-supporting-algorithm-and-preceding-tests
#7
Hung Q Dam, Thomas B Kinney
No abstract text is available yet for this article.
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902808/arteriography-for-lower-gastrointestinal-hemorrhage-clarity-needed-in-defining-evidence-supporting-algorithm-and-preceding-tests
#8
Mark Tulchinsky
No abstract text is available yet for this article.
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902583/adverse-events-risk-associated-with-anti-vegfr-agents-in-the-treatment-of-advanced-nonsmall-cell-lung-cancer-a-meta-analysis
#9
Biao Gu, WenChuang Gao, HongJun Chu, Jian Gao, Zhi Fu, Hui Ding, JunJie Lv, QingQuan Wu
To perform this meta-analysis, we investigated the risk of the most clinically relevant adverse events related to antivascular endothelial growth factor receptor (VEGFR) agents in advanced nonsmall-cell lung cancer (NSCLC).A comprehensive literature search for studies published up to October 2015 was performed. Prospective randomized controlled phase II/III clinical trials that comparing therapy with or without anti-VEGFR agents for advanced NSCLC were included for analysis. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random effects or fixed effects according to the heterogeneity among included trials...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27899121/meta-analysis-of-the-clinical-and-laboratory-parameters-of-sfts-patients-in-china
#10
Miao-Miao Liu, Xiao-Ying Lei, Xue-Jie Yu
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever in East Asia, which is caused by a novel bunyavirus-SFTSV. Many studies have reported the clinical characters of SFTS patients, but the reports were not consistent and a systematic summary of clinical manifestations and laboratory parameters are not available. METHOD: A comprehensive literature research of Web of Science, PubMed, Wan Fang Data, and Chinese National Knowledge Infrastructure databases was conducted on articles which have described the clinical characters of SFTS patients...
November 29, 2016: Virology Journal
https://www.readbyqxmd.com/read/27896931/risk-of-empyema-in-patients-with-chronic-liver-disease-and-cirrhosis-a-nationwide-population-based-cohort-study
#11
Te-Chun Shen, Chia-Hung Chen, Hsueh-Chou Lai, Cheng-Li Lin, Chih-Yen Tu, Te-Chun Hsia, Chuen-Ming Shih, Wu-Huei Hsu, Fung-Chang Sung
BACKGROUND: Empyema is an important complication for patients with chronic liver disease and cirrhosis (CLDC). However, no study has investigated this relationship by using a population-based cohort study. METHODS: We used the National Health Insurance Research Data of Taiwan to identify a cohort of 76,027 CLDC patients newly diagnosed in 2000-2010 and a comparison cohort without CLDC of same size matched by age, gender and the year of diagnosis. The occurrence of empyema was monitored until the end of 2011...
November 29, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#12
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27894604/evaluation-of-the-efficacy-of-therapeutic-endoscopy-in-gastrointestinal-bleeding-secondary-to-angiodysplasias
#13
J Arribas Anta, C Zaera de la Fuente, R Martín Mateos, J A González Martín, A Cañete Ruiz, D Boixeda de Miquel, A Albillos Martínez
INTRODUCTION: Gastrointestinal angiodysplasias are defined as vascular dilations that communicate capillaries and veins in the walls of the digestive tract. The clinical presentation of these lesions varies from chronic occult bleeding to severe gastrointestinal hemorrhage. AIM: The primary aim of our study was to analyze lesion location, the efficacy of therapeutic endoscopy with argon plasma coagulation, and the factors associated with rebleeding in patients with gastrointestinal angiodysplasias...
November 25, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27891286/spontaneous-intramural-duodenal-hematoma-pancreatitis-obstructive-jaundice-and-upper-intestinal-obstruction
#14
Chalerm Eurboonyanun, Kulyada Somsap, Somchai Ruangwannasak, Anan Sripanaskul
Nontraumatic intramural duodenal hematoma can cause upper gastrointestinal tract obstruction, upper gastrointestinal hemorrhage, jaundice, and pancreatitis and may be present in patients with normal coagulation. However the pathogenesis of the condition and its relationship with acute pancreatitis remain unknown. We present a case of spontaneous intramural duodenal hematoma and a case of successful nonoperative treatments.
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27890105/use-of-postmortem-computed-tomography-angiography-to-detect-vascular-injuries-accompanying-skull-base-fracture
#15
Hikaru Kuninaka, Yoichiro Takahashi, Rie Sano, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Hiroyuki Tokue, Sachiko Awata, Satoshi Hirasawa
A 58-year-old woman who had presented for upper gastrointestinal barium examination accidently slipped from the movable bed, and her head became compressed between the end of the bed and the side wall. She suffered massive bleeding from her nose and ear followed by cardiac arrest, and subsequent attempts at cardiopulmonary resuscitation failed. A medicolegal autopsy was performed to reveal the cause of death, as part of the investigation of the accident. During the autopsy, postmortem cerebral CT angiography was carried out by injection of 5% gelatin-barium emulsion as a radiopaque contrast medium into the bilateral common carotid arteries, demonstrating transudation of the contrast medium into the right acoustic meatus and the sphenoidal sinus cavity...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27888753/gastrointestinal-bleeding-and-intracranial-hemorrhage-in-concomitant-users-of-warfarin-and-antihyperlipidemics
#16
Charles E Leonard, Colleen M Brensinger, Warren B Bilker, Stephen E Kimmel, Xu Han, Young Hee Nam, Joshua J Gagne, Margaret J Mangaali, Sean Hennessy
BACKGROUND: Drug interactions, particularly those involving warfarin, are a major clinical and public health problem. Minimizing serious bleeding caused by anticoagulants is a recent major focus of the United States (US) Department of Health and Human Services. This study quantified the risk of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH) among concomitant users of warfarin and individual antihyperlipidemics. METHODS: The authors conducted a high-dimensional propensity score-adjusted cohort study of new concomitant users of warfarin and an antihyperlipidemic, among US Medicaid beneficiaries from five states during 1999-2011...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#17
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27878613/intermittent-low-dose-bevacizumab-in-hereditary-hemorrhagic-telangiectasia-a%C3%A2-case-report
#18
Florian Huemer, Martin Dejaco, Christoph Grabmer, Thomas Melchardt, Daniel Neureiter, Georg Mayer, Alexander Egle, Richard Greil, Lukas Weiss
BACKGROUND: Hereditary hemorrhagic telangiectasia is an inherited autosomal dominant disease presenting with recurrent bleeding episodes and iron deficiency anemia due to vascular malformations. Hereditary hemorrhagic telangiectasia is associated with an increased risk of stroke, gastrointestinal bleeding and pulmonary hypertension and life expectancy is significantly reduced. Excess vascular endothelial growth factor (VEGF) plays a key role in the pathophysiology of the disease. CASE PRESENTATION: Here we report about a male patient with hereditary hemorrhagic telangiectasia presenting with pulmonary and central nervous system involvement experiencing repetitive nosebleeds, necessitating frequent local cauterization and transfusion of more than 100 units of packed red blood cells...
November 23, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27876945/a-case-of-fatal-gastrointestinal-haemorrhage-due-to-hyperinfection-with-strongyloides-stercoralis
#19
Dina Abdallah Zaghlool, Amal Ali Hassan, Asmaa Moustafa Moustafa, Wael Ahmed Shahin
Strongyloides stercoralis is an intestinal nematode with a complex life cycle. It is usually asymptomatic in healthy host however it may be a life threatening condition in immunocompromised patients when hyperinfection is associated with disseminated disease. However, reports of gastric involvement are rare. This is a case report of fatal gastrointestinal hemorrhage due to hyperinfection with S. stercoralis in a Burmawi male patient after brief corticosteroid therapy.
December 2016: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/27872767/diffuse-alveolar-hemorrhage-associated-with-edoxaban-therapy
#20
Kenichi Nitta, Hiroshi Imamura, Akihiro Yashio, Satoko Kashima, Katsunori Mochizuki
Introduction. The main adverse effect of anticoagulant therapy is bleeding, and major bleeding, including intracranial, gastrointestinal, and retroperitoneal bleeding, has been reported as an adverse effect of edoxaban, a direct oral anticoagulant (DOAC). Bleeding during systemic anticoagulation with edoxaban presents a therapeutic conundrum, because there is currently no safe or efficacious reversal agent to stop major bleeding. Case Report. A 51-year-old woman had multiple traumatic injuries, including lower limb fractures...
2016: Case Reports in Critical Care
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