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https://www.readbyqxmd.com/read/27889951/performance-of-the-high-dimensional-propensity-score-in-a-nordic-health-care-model
#1
Jesper Hallas, Anton Pottegård
The high-dimensional propensity score (hdPS) is increasingly used as a tool to adjust for confounding in observational studies of drug effects. It was developed within very rich data sources, e.g., the American claims databases. Thus, it is unknown whether it can be applied in settings that provide little more than prescriptions and diagnoses from hospital contacts, as in the Nordic data sources. Our objective was to evaluate the performance of hdPS under such circumstances. As our model, we chose the association between use of selective cyclooxygenase-2 inhibitors (coxibs) and traditional NSAIDs (tNSAIDs) and the risk of upper GI bleeding...
November 27, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27887981/predictors-of-mortality-in-the-critically-ill-cirrhotic-patient-is-the-model-for-end-stage-liver-disease-enough
#2
Alagappan Annamalai, Megan Y Harada, Melissa Chen, Tram Tran, Ara Ko, Eric J Ley, Miriam Nuno, Andrew Klein, Nicholas Nissen, Mazen Noureddin
BACKGROUND: Critically ill cirrhotics urgently require liver transplantation but are at high risk for perioperative mortality. The Model for End-Stage Liver Disease (MELD) score, recently updated to incorporate serum sodium, estimates survival probability in patients with cirrhosis but needs further evaluation in the critically ill. The purpose of this study was to evaluate the predictive power of intensive care unit (ICU) admission MELD scores and identify clinical risk factors associated with increased mortality...
November 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27885818/the-impact-of-bevacizumab-in-metastatic-colorectal-cancer-with-an-intact-primary-tumor-results-from-a-large-prospective-cohort-study
#3
Belinda Lee, Hui-Li Wong, Mark Tacey, Jeanne Tie, Rachel Wong, Margaret Lee, Louise Nott, Jeremy Shapiro, Ross Jennens, Natalie Turner, Ben Tran, Sumitra Ananda, Desmond Yip, Gary Richardson, Phillip Parente, Lionel Lim, Greg Stefanou, Matthew Burge, Mahesh Iddawela, Jeremy Power, Peter Gibbs
BACKGROUND: Debate continues regarding the benefits versus risks of initial resection of the primary tumor in metastatic colorectal cancer (mCRC) patients with an asymptomatic primary tumor. Although the benefit of the anti-vascular endothelial growth factor agent bevacizumab alongside first-line chemotherapy in mCRC is established, the impact of bevacizumab on the intact primary tumor (IPT) is less well understood. METHODS: Data from an Australian mCRC registry were used to assess the impact of bevacizumab-based regimens in the presence of an IPT, to see if this differs from effects in resected primary tumor (RPT) patients and to understand the safety profile of bevacizumab in patients with IPT...
November 25, 2016: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27863356/left-ventricular-assist-devices-and-gastrointestinal-evaluation-results-of-a-consecutive-case-series
#4
Sultan Alotaibi, Raimund Erbel, Till Neumann
AIMS: To evaluate the benefit of preoperative gastrointestinal endoscopic evaluation in patients undergoing continuous flow left ventricular assist devices (CF-LVADs) implantation. METHODS AND RESULTS: A retrospective review of all fifty-three patients undergoing CF-LVADs at West-German Heart and Vascular Center, University of Duisburg-Essen was performed. A routine preoperative esophagogastroduodenoscopy was performed in seven patients to assess gastrointestinal (GI) bleeding...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27846246/systematic-review-and-meta-analysis-of-randomised-trials-to-ascertain-fatal-gastrointestinal-bleeding-events-attributable-to-preventive-low-dose-aspirin-no-evidence-of-increased-risk
#5
Peter C Elwood, Gareth Morgan, Julieta Galante, John W K Chia, Sunil Dolwani, J Michael Graziano, Mark Kelson, Angel Lanas, Marcus Longley, Ceri J Phillips, Janet Pickering, Stephen E Roberts, Swee S Soon, Will Steward, Delyth Morris, Alison L Weightman
BACKGROUND: Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin...
2016: PloS One
https://www.readbyqxmd.com/read/27844452/urgency-surgical-treatment-for-duodenal-gists-analysis-of-aged-patients-and-review-of-the-literature
#6
Carlo Boselli, Roberto Cirocchi, Alessandro Gemini, Francesco Barberini, Veronica Grassi, Stefano Avenia, Andrea Polistena, Alessandro Sanguinetti, Daniele Pironi, Alberto Santoro, Renata Tabola, Nicola Avenia
INTRODUCTION: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms (85%) of the gastrointestinal (GI) tract; duodenal GISTs constitute 3-5% of all GISTs and represent 10-30% of all malignant tumours of the duodenum. Rarely, patients present severe bowel obstruction, perforation or severe bleeding. The radical resection with complete removal of the tumour remains the main therapeutic approach. We performed a local resection in patients with suspected GIST admitted for emergency treatment for GI bleeding...
November 14, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27842442/the-validity-of-suspected-blood-indicator-software-in-capsule-endoscopy-a-systematic-review-and-meta-analysis
#7
Diana E Yung, Catherine Sykes, Anastasios Koulaouzidis
Software tools have been developed as capsule endoscopy (CE) reading aids. The suspected blood indicator (SBI) tags possible areas of haemorrhage in the gastrointestinal (GI) tract. This meta-analysis aims to investigate the diagnostic accuracy of SBI in CE. Areas covered: A systematic literature search was conducted for studies on the use of SBI in CE. Sensitivity, specificity and diagnostic odds ratio (DOR) of SBI in diagnosing GI bleeding was evaluated. 2040 patients from 16 studies underwent 2049 CE examinations...
November 21, 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27834008/severe-gastrointestinal-haemorrhage-summary-of-a-national-quality-of-care-study-with-focus-on-radiological-services
#8
Simon J McPherson, Martin T Sinclair, Neil C E Smith
PURPOSE OF STUDY: To identify the remediable factors in the quality of care provided to patients with severe gastrointestinal (GI) bleeding. METHOD: All hospital admissions in the first four months of 2013 with ICD10 coding for GI bleeding who received a transfusion of 4 units or more of blood. Up to five cases/hospital randomly selected for structured case note peer review. National availability of GI bleeding services data derived from organisational questionnaire completed by all hospitals...
November 10, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27829764/chlorhexidine-varnish-implemented-treatment-strategy-for-chronic-periodontitis-a-clinical-and-microbial-study
#9
D Manikandan, V R Balaji, Tanvir Mohamad Niazi, G Rohini, B Karthikeyan, P Jesudoss
AIM: The aim of the present study was to evaluate the short-term clinical and microbiological effect of chlorhexidine varnish when used as an adjuvant to scaling and root planing in the treatment of chronic periodontitis. MATERIALS AND METHODS: A split-mouth design was conducted in 11 patients suffering from chronic periodontitis. The control site underwent scaling and root planing, and the experimental site was additionally treated with chlorhexidine varnish application...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/27829600/two-cases-of-aortoenteric-fistula-with-gastrointestinal-bleeding
#10
Yuu Matsubara, Tomoyuki Ohta, Ryoji Tatsumi, Takuma Takasaka, Jun Sakamoto, Ryu Sato, Keisuke Kimura
Aortoenteric fistula (AEF) is a life-threatening condition that can present with gastrointestinal (GI) bleeding. AEFs have been classified into primary and secondary types. Primary AEF (PAEF) is a direct communication between the aorta and the GI tract. Secondary AEF (SAEF) is the result of a previous abdominal aortic aneurysm repair involving placement of a synthetic aortic graft. Diagnosis of AEF, especially PAEF, is difficult largely because AEF is so rarely encountered in practice. Computed tomography (CT) and endoscopic gastroduodenoscopy (EGD) are most frequently used to diagnose AEF, with abdominal contrast-enhanced CT being the preferred initial diagnostic test of choice...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27816427/causes-of-death-in-184-patients-with-type-1-gaucher-disease-from-the-united-states-who-were-never-treated-with-enzyme-replacement-therapy
#11
Neal J Weinreb, Deborah S Barbouth, Robert E Lee
Treatment for type 1 Gaucher disease (GD1) decreases morbidity from hematological cytopenias, hepatosplenomegaly and bone complications. Consequently, untreated symptomatic patients for study of late outcomes are hard to find. We identified 184 untreated GD1 patients (67.4% Ashkenazi; splenectomy 51.1%) who died between 1950 and 2010. Here, we report confirmed causes of death for these patients compared with the overall US population. Median age of death 66years (2-97years); causes of death (COD) with a high proportional mortality rate (PMR) included malignancies (PMR 1...
October 24, 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27811624/training-in-gi-bleeding-therapeutic-endoscopy-rethinking-knowledge-and-skill-acquisition
#12
Cary G Sauer, Douglas S Fishman
No abstract text is available yet for this article.
November 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27811622/therapeutic-endoscopy-for-the-control-of-non-variceal-upper-gastrointestinal-bleeding-in-children-a-case-series
#13
Anna M Banc-Husu, Nuzhat A Ahmad, Vinay Chadrasekhara, Gregory G Ginsberg, David L Jaffe, Michael L Kochman, Michael Rajala, Petar Mamula
INTRODUCTION: Gastrointestinal bleeding is one of the most common indications for urgent endoscopy in the pediatric setting. The majority of these procedures are performed for control of variceal bleeding, with very few performed for non-variceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are very sparse. The aims of our study were to review our experience with NVUGI bleeding, describe technical aspects and outcomes of therapeutic endoscopy, and determine gastroenterology fellows' training opportunities according to the national training guidelines...
November 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27808485/concomitant-use-of-proton-pump-inhibitors-and-dual-antiplatelet-therapy-for-cardiovascular-outcomes
#14
Alessandro Mandurino-Mirizzi, Sergio Leonardi, Chiara Melloni
INTRODUCTION: The aim of this review is to discuss the consequences of potential pharmacokinetic interactions between proton pump inhibitors (PPIs) and antiplatelet therapy on cardiovascular (CV) outcomes and provide guidance on the management of concomitant use of PPIs in patients on dual antiplatelet therapy (DAPT). EVIDENCE ACQUISITION: DAPT combining aspirin and oral P2Y12 receptor inhibitors increases the risk of gastrointestinal (GI) bleeding, with higher rates of morbidity and mortality in patients undergoing percutaneous coronary intervention (PCI)...
November 3, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27807715/impact-of-non-surgical-periodontal-therapy-on-saliva-and-serum-levels-of-markers-of-oxidative-stress
#15
Canan Önder, Şivge Kurgan, S Merve Altıngöz, Nilsun Bağış, Metin Uyanık, Muhittin A Serdar, Alpdoğan Kantarcı, Meral Günhan
OBJECTIVE: The purpose of this study was to determine the effect of non-surgical periodontal treatment on markers of oxidative stress in saliva and serum in patients with chronic periodontitis. MATERIALS AND METHODS: In total, 25 patients, who were diagnosed with generalized chronic periodontitis (11 females and 14 males), and 26 systemically and periodontally healthy individuals (15 females and 11 males) were included. The plaque index (PI), gingival index (GI), probing pocket depth (PPD), attachment loss (AL), gingival recession (GR), and bleeding on probing (BOP) were recorded at baseline and 6 weeks later...
November 2, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27803900/is-endoscopic-ultrasonography-useful-for-endoscopic-submucosal-dissection
#16
REVIEW
Ye Han, Siyu Sun, Jintao Guo, Nan Ge, Sheng Wang, Xiang Liu, Guoxin Wang, Jinlong Hu, Shupeng Wang
Endoscopic submucosal dissection (ESD) is an innovative advance in the treatment of early gastrointestinal (GI) cancer without lymph node metastases and precancerous lesions as it is an effective and safe therapeutic method. ESD has also been a promising therapeutic option for removal of submucosal tumors (SMTs) for improving the completeness of resection of a large lesion. Endoscopic ultrasonography (EUS) can be used to detect the depth of invasion during the preoperative evaluation because of its close proximity to the lesion...
September 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27803496/left-atrial-to-esophageal-fistula-a-case-report-and-literature-review
#17
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27802375/endoscopic-management-of-gastrointestinal-leaks-and-bleeding-with-the-over-the-scope-clip-a-prospective-study
#18
Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
Background/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. Methods: Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory...
October 31, 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27793502/detection-of-small-colon-bleeding-in-wireless-capsule-endoscopy-videos
#19
Muhammad Arslan Usman, G B Satrya, Muhammad Rehan Usman, Soo Young Shin
In the recent years, wireless capsule endoscopy (WCE) technology has played a very important role in diagnosing diseases within the gastro intestinal (GI) tract of human beings. The WCE device captures images of the GI tract of patient with a certain frame rate. Physicians examine these images in order to find abnormalities in the GI tract. This examination process is very time consuming and hectic for the physician as a WCE device captures around 60,000 images on the average. At present, there are no standards defined for the WCE image classification...
September 25, 2016: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/27793353/cost-effectiveness-of-low-dose-submicron-diclofenac-compared-with-generic-diclofenac
#20
Deirdre Mladsi, Naoko Ronquest, Dawn Odom, LaStella Miles, Kenneth Saag
PURPOSE: NSAIDs are commonly prescribed for the treatment of pain and inflammation. Despite the effectiveness of NSAIDs, concerns exist regarding their tolerability. Worldwide health authorities, including the European Medicines Agency, Health Canada, and the US Food and Drug Administration, have advised that NSAIDs be prescribed at the lowest effective dosage and for the shortest duration. Effective lowering of NSAID dosage without compromising pain relief has been demonstrated in randomized, controlled trials of the recently approved NSAID lower-dose submicron diclofenac...
October 25, 2016: Clinical Therapeutics
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