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https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#1
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28089365/gastric-bleeding-risk-following-spleen-preserving-distal-pancreatectomy-with-excision-of-the-splenic-vessels-a%C3%A2-long-term-follow-up
#2
D Louis, A Alassiri, S Kirzin, S Blaye-Felice, M Chalret du Rieu, C H Julio, E Bloom, L Ghouti, B Pradère, G Portier, N Carrère
BACKGROUND: Spleen-preserving distal pancreatectomy with resection of the splenic vessels (VR-SPDP) is an effective procedure. However, hemodynamic changes in splenogastric circulation may lead to the development of gastric varices (GV) with a risk of gastrointestinal (GI) bleeding. This retrospective study aimed to assess the long-term postoperative clinical follow-up of patients and review the late postoperative abdominal computed tomography (CT) or endoscopic examination. METHODS: From 1988 to 2015, 48 consecutive VR-SPDP for benign or low-grade malignant disease were included...
January 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28089030/negative-result-of-capsule-endoscopy-in-obscure-gi-bleeding-searching-in-the-dark-despite-bright-lights
#3
EDITORIAL
Puneet Chhabra, Deepak K Bhasin
No abstract text is available yet for this article.
February 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28088607/transcatheter-aortic-valve-implantation-leads-to-a-restoration-of-von-willebrand-factor-vwf-abnormalities-in-patients-with-severe-aortic-stenosis-incidence-and-relevance-of-clinical-and-subclinical-vwf-dysfunction-in-patients-undergoing-transfemoral-tavi
#4
Alexander Sedaghat, Hannah Kulka, Jan-Malte Sinning, Nora Falkenberg, Julia Driesen, Barbara Preisler, Christoph Hammerstingl, Georg Nickenig, Bernd Pötzsch, Johannes Oldenburg, Hans-Jörg Hertfelder, Nikos Werner
BACKGROUND: In this study, we sought to analyze the incidence and relevance of von Willebrand factor (VWF) abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI), especially on perioperative bleeding. Furthermore, we hypothesized that, similar to aortic valve surgery, TAVI results in a restoration of VWF abnormalities. METHODS AND RESULTS: We performed a prospective analysis of periinterventional VWF parameters in 74 patients (80±7years, female in 37...
January 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28088460/ultrasound-mediated-delivery-of-rna-to-colonic-mucosa-of-live-mice
#5
Carl M Schoellhammer, Gregory Y Lauwers, Jeremy A Goettel, Matthias A Oberli, Cody Cleveland, June Y Park, Daniel Minahan, Yiyun Chen, Daniel G Anderson, Ana Jaklenec, Scott B Snapper, Robert Langer, Giovanni Traverso
BACKGROUND & AIMS: It is a challenge to deliver nucleic acids to gastrointestinal (GI) tissues due to their size and need for intracellular delivery. They are also extremely susceptible to degradation by nucleases, which are ubiquitous in the GI tract. We investigated whether ultrasound, which can permeabilize tissue through a phenomenon known as transient cavitation, can be used to deliver RNA to the colonic mucosa of living mice. METHODS: We investigated delivery of fluorescently labeled permeants to colon tissues of Yorkshire pigs ex vivo and mice in vivo...
January 11, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28070658/getting-the-gist-a-pictorial-review-of-the-various-patterns-of-presentation-of-gastrointestinal-stromal-tumors-on-imaging
#6
REVIEW
Dominic Scola, Lawrence Bahoura, Alexander Copelan, Ali Shirkhoda, Farnoosh Sokhandon
Gastrointestinal stromal tumors (GISTs), the most common mesenchymal tumors of the gastrointestinal tract, are a relatively recently described entity. Most exhibit a mutated tyrosine kinase receptor gene and in some capacity are treated by tyrosine kinase inhibitors. GISTs can occur across the age spectrum but are more common in patients older than 40 years. They exhibit a wide range of clinical presentations and imaging characteristics. All patterns of enhancement on contrast enhanced computed tomography (CECT) can be seen with GISTs, including hypoenhancing, isoenhancing, and hyperenhancing tumors...
January 10, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28070235/bevacizumab-and-gastrointestinal-bleeding-in-hereditary-hemorrhagic-telangiectasia
#7
George Ou, Cherry Galorport, Robert Enns
We report a case of severe, refractory gastrointestinal (GI) bleeding in a patient with hereditary hemorrhagic telangiectasia (HHT) whose massive transfusion dependence was lifted shortly after treatment with bevacizumab, an anti-vascular endothelial growth factor. The patient's bleeding had been refractory to repeated endoscopic interventions, tranexamic acid, and tamoxifen. However, following treatment with bevacizumab at 5 mg/kg every other week, nearly 300 units of packed red blood cell transfusions were avoided in one year's time...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28065528/a-comprehensive-evaluation-of-the-gastrointestinal-tract-in-iron-deficiency-anemia-with-predefined-hemoglobin-below-9mg-dl-a-prospective-cohort-study
#8
Xavier Bosch, Elisabet Montori, Mar Guerra-García, Jaime Costa-Rodríguez, Mariano H Quintanilla, Paula E Tolosa-Chapasian, Pedro Moreno, Neus Guasch, Alfons López-Soto
BACKGROUND: Anemia is defined as hemoglobin below the cutoff of normal in studies examining the gastrointestinal (GI) tract in iron-deficiency anemia (IDA). Although the risk of GI cancer (GIC) increases as hemoglobin decreases, guidelines do not usually recommend hemoglobin thresholds for IDA investigation. METHODS: To elucidate whether underlying GI disorders explain the different hemoglobin values and clinical outcomes observed initially in IDA patients referred for GI workup, we prospectively investigated the diagnostic yield of a thorough GI examination in consecutive IDA adults with predefined hemoglobin <9g/dL and no extraintestinal bleeding...
December 21, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#9
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28056333/-recommendation-for-the-prevention-and-treatment-of-non-steroidal-anti-inflammatory-drug-induced-gastrointestinal-ulcers-and-its-complications
#10
(no author information available yet)
Non-steroidal anti-inflammatory drugs (NSAIDs) are a broad class of non glucocorticoid drugs which are extensively used in anti-inflammatory, analgesic, and antipyretic therapies. However, NSAIDs may cause many side effects, most commonly in gastrointestinal(GI) tract. Cardiovascular system, kidney, liver, central nervous system and hematopoietic system are also involved. NSAID-induced GI side effects not only endanger the patients' health, increase mortality, but also greatly increase the cost of medical care...
January 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28051053/simultaneous-occurrence-of-intussusception-and-duodenal-haematoma-in-a-patient-with-glanzmann-s-thrombasthenia
#11
Iftikhar Ahmad Jan, Saif Khalfan AlKaabi, Awadh AlMughadam, D Sreenivas Murthy, Basmah AlHamoudi
Glanzmann's thrombasthenia (GT) is a rare autosomal recessive disorder in which the platelets have anomalies of fibrinogen receptors causing bleeding tendencies. The disease usually presents with mucosal bleeding, petechial haemorrhages or gastrointestinal (GI) bleeding. Only sporadic cases of intussusception or duodenal haematoma have been reported with GT. We present a case of 5-year-old girl admitted with non-bilious vomiting, watery diarrhoea and abdominal pain. She is a known patient of Glanzmann's thrombasthenia...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28043907/gastrointestinal-safety-of-direct-oral-anticoagulants-a-large-population-based-study
#12
Neena S Abraham, Peter A Noseworthy, Xiaoxi Yao, Lindsey R Sangaralingham, Nilay D Shah
BACKGROUND & AIMS: Direct oral anticoagulant (DOAC) agents increase the risk of gastrointestinal (GI) bleeding. We investigated which DOAC had the most favorable GI safety profile and compared differences among these drugs in age-related risk of GI bleeding. METHODS: We conducted a retrospective, propensity-matched study using administrative claims data from the OptumLabs Data Warehouse of privately insured individuals and Medicare Advantage enrollees. We created 3 propensity-matched cohorts of patients with non-valve atrial fibrillation with incident exposure to dabigatran, rivaroxaban, or apixaban, from October 1, 2010 through February 28, 2015...
December 30, 2016: Gastroenterology
https://www.readbyqxmd.com/read/28032204/gastrointestinal-bleeding-due-to-gastrointestinal-tract-malignancy-natural-history-management-and-outcomes
#13
Richard A Schatz, Don C Rockey
BACKGROUND: Gastrointestinal (GI) tumor bleeding can vary from occult bleeding to massive hemorrhage and can be the presenting sign of malignancy. AIMS: Our primary aims were to: (1) characterize the natural history, treatment, and outcomes in patients with GI tumor bleeding and (2) compare and contrast bleeding in upper GI (UGI)/small bowel (SB) and lower GI malignancies. METHODS: Patients with endoscopically confirmed tumor bleeding were identified through search of consecutive electronic medical records: Bleeding was determined by the presence of melena, hematochezia, hematemesis, or fecal occult blood...
December 28, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28024166/an-east-asian-perspective-on-the-interaction-between-proton-pump-inhibitors-and-clopidogrel
#14
Duowu Zou, Khean-Lee Goh
Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for ARDs (Acid Related Disorders) including gastroesophageal reflux disease (GERD). They are also co-prescribed with oral anticoagulant agents (OAAs)and with dual-antiplatelet therapy (DAPT) for the treatment and prevention of gastrointestinal (GI) bleeding. Clopidogrel belongs to the drug class of thienopyridines, and is currently the most widely prescribed OAA either alone or in combination with aspirin...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28019112/-indications-diagnoses-and-quality-markers-in-upper-and-lower-endoscopies-in-2010-and-2011-at-the-1st-department-of-medicine-semmelweis-university-budapest
#15
Lóránt Gönczi, Zsuzsanna Kürti, Petra Golovics, Zsuzsanna Végh, Barbara Lovász, Andrea Dorkó, Anna Seres, Liza Sümegi, Orsolya Menyhárt, Lajos Kiss, János Papp, Krisztina Gecse, Péter László Lakatos
INTRODUCTION AND AIM: The aim was to assess the incidence of endoscopic findings based on the indication of the procedures in upper/lower endoscopies, and measuring quality indicators of colonoscopies at the 1st Department of Medicine, Semmelweis University, Budapest. METHOD: Data of 2987 patients (male/female:1361/1626, mean age: 60.7 years(y), SD: 16.7y) between 01.01.2010 and 31.12.2011 were analyzed. Both inpatient and outpatient records were collected. RESULTS: Incidence of peptic ulcer disease, esophageal varices, gastric polyps and gastric cancer were 10...
December 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/28012715/hospital-costs-of-complications-after-esophagectomy-for-cancer
#16
L Goense, W A van Dijk, J A Govaert, P S N van Rossum, J P Ruurda, R van Hillegersberg
OBJECTIVE: The purpose of this study was to estimate the economic burden of postoperative complications after esophagectomy for cancer, in order to optimally allocate resources for quality improvement initiatives in the future. METHODS: A retrospective analysis of prospectively collected clinical and financial outcomes after esophageal cancer surgery in a tertiary referral center in the Netherlands was performed. Data was extracted from consecutive patients registered in the Dutch Upper GI Cancer Audit between 2011 and 2014 (n = 201)...
December 5, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28012690/embolization-for-bleeding-after-hepatic-radiofrequency-ablation
#17
Jong Woo Kim, Ji Hoon Shin, Pyo Nyun Kim, Yong Moon Shin, Hyung Jin Won, Gi-Young Ko, Hyun-Ki Yoon
PURPOSE: To evaluate safety and clinical efficacy of embolization for management of bleeding after hepatic radiofrequency (RF) ablation. MATERIALS AND METHODS: From January 2000 to December 2014, 5,196 patients with 9,743 tumors underwent 8,303 RF ablation sessions. Of these patients, 62 experienced bleeding after hepatic RF ablation; 15 patients (12 men and 3 women; mean age 62 y; range, 49-76 y) underwent embolization and composed the final study cohort. Tumors were hepatocellular carcinomas in 13 (87%) patients and metastatic adenocarcinomas from colorectal cancer in 2 (13%) patients...
December 21, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28011279/association-of-prophylactic-endotracheal-intubation-in-critically-ill-patients-with-upper-gi-bleeding-and-cardiopulmonary-unplanned-events
#18
Umar Hayat, Peter J Lee, Hamid Ullah, Shashank Sarvepalli, Rocio Lopez, John J Vargo
BACKGROUND: Prophylactic endotracheal intubation (PEI) is often advocated to mitigate the risk of cardiopulmonary adverse events in patients presenting with brisk upper gastrointestinal bleed (UGIB). However, the benefit of such a measure remains controversial. Our study aimed to compare the incidence of cardiopulmonary unplanned events (CUE) between patients who underwent endotracheal intubation versus those who didn't, in critically ill patients with brisk UGIB. METHODS: Patients aged 18 years or older who had presented at Cleveland Clinic between 2011 and 2014 with hematemesis and/or patients with melena with consequential hypovolemic shock were included...
December 20, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28004062/optimal-timing-of-vitamin-k-antagonist-resumption-after-upper-gastrointestinal-bleeding-a-risk-modelling-analysis
#19
Ammar Majeed, Niklas Wallvik, Joakim Eriksson, Jonas Hoijer, Matteo Bottai, Margareta Holmström, Sam Schulman
The optimal timing of vitamin K antagonists (VKAs) resumption after an upper gastrointestinal (GI) bleeding, in patients with continued indication for oral anticoagulation, is uncertain. We included consecutive cases of VKA-associated upper GI bleeding from three hospitals retrospectively. Data on the bleeding location, timing of VKA resumption, recurrent GI bleeding and thromboembolic events were collected. A model was constructed to evaluate the 'total risk', based on the sum of the cumulative rates of recurrent GI bleeding and thromboembolic events, depending on the timing of VKA resumption...
December 22, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28000652/laparoscopic-resection-of-duodenal-gastrointestinal-stromal-tumour
#20
Tammy Zioni, Vitaliy Dizengof, Boris Kirshtein
Only a few studies have revealed using laparoscopic technique with limited resection of gastrointestinal stromal tumour (GIST) of the duodenum. A 68-year-old man was admitted to the hospital due to upper gastrointestinal (GI) bleeding. Evaluation revealed an ulcerated, bleeding GI tumour in the second part of the duodenum. After control of bleeding during gastroduodenoscopy, he underwent a laparoscopic wedge resection of the area. During 1.5 years of follow-up, the patient is disease free, eats drinks well, and has regained weight...
December 21, 2016: Journal of Minimal Access Surgery
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