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https://www.readbyqxmd.com/read/28416166/two-year-outcomes-of-balloon-occluded-retrograde-transvenous-obliteration-of-gastric-varices-in-liver-transplant-recipients-a-multi-institutional-study
#1
W E Saad, J F B Chick, R N Srinivasa, N Saad, S Kim, A Fischman, G Frey, A Al-Osaimi, S Caldwell
PURPOSE: To assess the 2-year effectiveness and safety of balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GVs) in liver transplant recipients. MATERIALS AND METHODS: Eleven liver transplant recipients underwent consecutive BRTO for GVs at four institutions. Patients included eight (73%) men and three (27%) women with mean age of 56 years±12 (SD) (range: 26-67 years). Underlying cause of liver transplantation was hepatitis C virus (HCV)-related cirrhosis in five (45%), alcohol- and HCV-related cirrhosis in three (27%), primary biliary cirrhosis in two (18%), and alcoholic cirrhosis in one (9%)...
April 13, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#2
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28410791/gastrointestinal-safety-of-celecoxib-versus-naproxen-in-patients-with-cardiothrombotic-diseases-and-arthritis-after-upper-gastrointestinal-bleeding-concern-an-industry-independent-double-blind-double-dummy-randomised-trial
#3
Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Kelvin Lam, Grace L H Wong, Siew C Ng, Vivian Lee, Kim W L Au, Pui Kuan Cheong, Bing Y Suen, Heyson Chan, Ka Man Kee, Angeline Lo, Vincent W S Wong, Justin C Y Wu, Moe H Kyaw
BACKGROUND: Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. METHODS: For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28405538/henoch-sch%C3%A3-nlein-purpura-presenting-as-severe-gastrointestinal-and-renal-involvement-with-mixed-outcomes-in-an-adult-patient
#4
Raj Shah, Madhuri Ramakrishnan, Alexis Vollmar, Amanda Harrell, Richard Van Trump, Amgad Masoud
Henoch-Schönlein purpura (HSP) is typically seen as a self-limiting disease in children, but can present more severely in adults, especially when there is renal involvement. Management of HSP in adults also remains a controversial topic with very few studies evaluating available therapies. In this case, HSP presenting as a combination of severe gastrointestinal involvement and a rapid decline in renal function in an adult patient directed our therapy. The patient was a 48-year-old Caucasian male with no known past medical history, who presented with a combination of purpuric rash over the lower extremities, severe abdominal pain with upper gastrointestinal bleeding and a rapidly increasing serum creatinine, with hematuria...
March 9, 2017: Curēus
https://www.readbyqxmd.com/read/28397699/restrictive-versus-liberal-blood-transfusion-for-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#5
Ayodele Odutayo, Michael J R Desborough, Marialena Trivella, Adrian J Stanley, Carolyn Dorée, Gary S Collins, Sally Hopewell, Susan J Brunskill, Brennan C Kahan, Richard F A Logan, Alan N Barkun, Michael F Murphy, Vipul Jairath
BACKGROUND: Acute upper gastrointestinal bleeding is a leading indication for red blood cell (RBC) transfusion worldwide, although optimal thresholds for transfusion are debated. METHODS: We searched MEDLINE, Embase, CENTRAL, CINAHL, and the Transfusion Evidence Library from inception to Oct 20, 2016, for randomised controlled trials comparing restrictive and liberal RBC transfusion strategies for acute upper gastrointestinal bleeding. Main outcomes were mortality, rebleeding, ischaemic events, and mean RBC transfusion...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396990/incidence-and-outcomes-of-early-left-ventricular-thrombus-following-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#6
Shafik Khoury, Sarit Carmon, Gilad Margolis, Gad Keren, Yacov Shacham
BACKGROUND: Since the advent of primary percutaneous coronary intervention (PCI), studies have reported a declining incidence of left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). We investigated the incidence and outcomes of early (pre-discharge) LVT in the contemporary era of PCI practice in a large cohort of STEMI patients. METHODS: We retrospectively studied 2071 consecutive STEMI patients who underwent successful primary PCI...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28396724/complementary-roles-of-interventional-radiology-and-therapeutic-endoscopy-in-gastroenterology
#7
REVIEW
David M Ray, Indu Srinivasan, Shou-Jiang Tang, Andreas S Vilmann, Peter Vilmann, Timothy C McCowan, Akash M Patel
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures...
March 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28396275/relationship-of-time-to-presentation-after-onset-of-upper-gi-bleeding-with-patient-characteristics-and-outcomes-a-prospective-study
#8
Loren Laine, Stig B Laursen, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
BACKGROUND & AIMS: We performed a prospective multi-national study of patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) and assessed the relationship of time to presentation after onset of UGIB symptoms with patient characteristics and outcomes. METHODS: Consecutive patients presenting with overt UGIB (red-blood emesis, coffee-ground emesis and/or melena) from March 2014 to March 2015 at 6 hospitals were included. Multiple pre-defined patient characteristics and outcomes were collected...
April 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28395384/laparoscopic-and-luminal-endoscopic-cooperative-surgery-can-be-a-standard-treatment-for-submucosal-tumors-of-the-stomach-a-retrospective-multicenter-study
#9
Tatsuo Matsuda, Souya Nunobe, Toshiyuki Kosuga, Hiroshi Kawahira, Noriyuki Inaki, Shuji Kitashiro, Nobutsugu Abe, Isao Miyashiro, Sayaka Nagao, Masahiko Nishizaki, Naoki Hiki
Background and study aims We have developed a combined laparoscopic and luminal endoscopic surgery technique for resection of gastric submucosal tumors (SMTs) that can be performed without excessive resection of the stomach. In a multicenter retrospective study we aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for gastric SMT resection. Patients and methods Between October 2007 and December 2011, 126 patients with gastric SMTs underwent LECS at 8 institutions...
April 10, 2017: Endoscopy
https://www.readbyqxmd.com/read/28394786/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-upper-gastrointestinal-bleeding
#10
Taeyoung Kong, Sangkook In, Yoo Seok Park, Hye Sun Lee, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: The delta neutrophil index (DNI), reflecting the fraction of circulating immature granulocytes, is associated with increased mortality in patients with systemic inflammation. It is rapidly and easily measured while performing a complete blood count. This study aimed to determine whether the DNI can predict short-term mortality in patients presenting to the emergency department (ED) with upper gastrointestinal hemorrhage (UGIH). METHODS: We retrospectively identified consecutive patients (>18 years old) with UGIH admitted to the ED from January 1, 2015 to February 28, 2016...
April 7, 2017: Shock
https://www.readbyqxmd.com/read/28393330/external-validation-of-scoring-systems-in-risk-stratification-of-upper-gastrointestinal-bleeding
#11
Anna Cherian Anchu, Subair Mohsina, Sathasivam Sureshkumar, T Mahalakshmy, Vikram Kate
AIM: The aim of this study was to externally validate the four commonly used scoring systems in the risk stratification of patients with upper gastrointestinal bleed (UGIB). METHODS: Patients of UGIB who underwent endoscopy within 24 h of presentation were stratified prospectively using the pre-endoscopy Rockall score (PRS) >0, complete Rockall score (CRS) >2, Glasgow Blatchford bleeding scores (GBS) >3, and modified GBS (m-GBS) >3 scores. Patients were followed up to 30 days...
April 10, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28392699/comparison-of-prophylactic-effect-of-ugib-and-effects-on-platelet-function-between-ppis-and-h2ras-combined-with-dapt-systematic-review-and-meta-analysis
#12
Zhan-Miao Yi, Ting-Ting Qiu, Yuan Zhang, Zhi-Yan Liu, Suo-Di Zhai
OBJECTIVE: We compared prophylactic effects of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) on upper gastrointestinal bleeding (UGIB) associated with dual antiplatelet therapy (DAPT) and explored this influence on platelet function. METHODS: Randomized controlled trials and cohort studies comparing PPIs with H2RAs in adults receiving DAPT were collected from PubMed, EMBASE and Cochrane databases. Dichotomous data were pooled to obtain risk ratios (RRs) for UGIB, major adverse cardiovascular events (MACEs), poor responders to clopidogrel and rehospitalization, and continuous data were pooled to obtain mean differences (MDs) for P2Y12 reaction units (PRUs), with 95% confidence intervals (CIs)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28386950/gastrointestinal-disorders-in-curry-jones-syndrome-clinical-and-molecular-insights-from-an-affected-newborn
#13
Kristen Wigby, Stephen R F Twigg, Ryan Broderick, Katherine P Davenport, Andrew O M Wilkie, Stephen W Bickler, Marilyn C Jones
Curry-Jones syndrome (CJS) is a pattern of malformation that includes craniosynostosis, pre-axial polysyndactyly, agenesis of the corpus callosum, cutaneous and gastrointestinal abnormalities. A recurrent, mosaic mutation of SMO (c.1234 C>T; p.Leu412Phe) causes CJS. This report describes the gastrointestinal and surgical findings in a baby with CJS who presented with abdominal obstruction and reviews the spectrum of gastrointestinal malformations in this rare disorder. A 41-week, 4,165 g, female presented with craniosynostosis, pre-axial polysyndactyly, and cutaneous findings consistent with a clinical diagnosis of CJS...
April 6, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28377105/association-between-an-increase-in-blood-urea-nitrogen-at-24-hours-and-worse-outcomes-in-acute-nonvariceal-upper-gi-bleeding
#14
Navin L Kumar, Brian L Claggett, Aaron J Cohen, Jennifer Nayor, John R Saltzman
BACKGROUND AND AIMS: An increase in blood urea nitrogen (BUN) at 24 hours is a solitary and significant predictor of mortality in patients with acute pancreatitis, which may predict worse outcomes in the similarly resuscitation-requiring condition of acute nonvariceal upper gastrointestinal bleeding (UGIB). The aim of our study is to assess if an increase in BUN at 24 hours is predictive of worse clinical outcomes in acute nonvariceal UGIB. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital from 2004 to 2014...
April 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28374310/what-does-lesion-blood-flow-tell-us-about-risk-stratification-and-successful-management-of-non-variceal-ugi-bleeding
#15
REVIEW
Kevin A Ghassemi, Dennis M Jensen
PURPOSE OF REVIEW: There has been a decline in mortality associated with upper gastrointestinal (UGI) hemorrhage as the use of urgent endoscopy has increased. This review will examine endoscopic risk stratification of non-variceal UGI bleeding (e.g., ulcers, Dieulafoy lesions, and Mallory-Weiss tears), including the use of the Doppler endoscopic probe (DEP). RECENT FINDINGS: Prospective studies evaluating the use of DEP in non-variceal UGI hemorrhage showed that lesions with high-risk stigmata of recent hemorrhage (SRH) have a higher rate of a positive DEP signal compared to those with intermediate-risk SRH...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28372456/paraesophageal-hernia-and-gastric-volvulus-an-uncommon-etiology-of-vomiting-and-upper-gastrointestinal-bleeding
#16
Gonçalo Nunes, Marta Patita, Vítor Fernandes, Jorge Fonseca
The authors report the case of a 75 year-old woman admitted to the emergency room with abdominal pain and coffee ground vomiting. Marked epigastric distension with tenderness and signs of severe dehydration were present. Upper GI endoscopy showed a black esophagus covered by a large amount of dark fluid, diffuse hyperaemia and superficial erosions. Marked distortion of gastric anatomy caused by stomach rotation and a large paraesophageal hernia was observed and the pylorus was not identified. Chest X-ray and CT scan confirmed the presence of an organoaxial gastric volvulus with antero superior rotation and incarceration of the gastric antrum, which was located above the diaphragm...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28372451/effectiveness-of-arterial-embolization-in-recurrent-bleeding-due-to-duodenal-ulcer-during-postoperative-cardiac-surgery
#17
Caridad Marín Hernández, Pablo Ramírez Romero, Rubén Jara, Daniel Carbonell, Pascual Parrilla
Upper gastrointestinal bleeding is one of the most frequent complications after cardiac surgery and endoscopic treatment (ET) is often the first-choice procedure. When it fails, surgery can be an option but has significant mortality and morbidity. We propose arterial embolization (TAE: transcatheter arterial embolization) as an alternative treatment in selected cases.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28367340/postural-syncope-and-constipation-an-unusual-presentation-of-a-duodenal-dieulafoy-s-lesion
#18
Ahmed Dirweesh, Alvarez Chikezie, Muhammad Yasir Khan, Sana Zia, Muhammad Tahir
Dieulafoy lesions are a rare etiology of gastrointestinal bleeding from a large caliber-persistent tortuous submucosal artery. They account for 1-2% of all causes of acute gastrointestinal hemorrhage with 80%-95% of these lesions located in the stomach along the lesser curvature. One-third of these lesions present at an extragastric location, with the proximal duodenum accounting for 15% of them. We present a 21-year-old male with no significant past medical history or risk factors, who presented with repeated syncopal episodes followed by hematemesis, found to have a Dieulafoy lesion located at the duodenal bulb...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28367197/efficacy-of-early-endoscopy-and-colonoscopy-in-very-elderly-patients-with-gastrointestinal-bleeding
#19
Mustafa Celik
OBJECTIVE: We aimed to determine the efficacy and safety of early (within the first 24 hour from application) endoscopy and colonoscopy in very elderly patients with GIS bleeding. METHODS: In this study, 95 patients were included who underwent early endoscopy with the pre-diagnosis of upper GIS bleeding or endoscopy-colonoscopy with the pre-diagnosis of lower GIS bleeding between 2012 and 2016. Endoscopy and colonoscopy procedures were compared in terms of the development of complications, tolerance of procedure, detection of bleeding site, and rate of therapeutic interventions performed for bleeding...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28363584/upper-gastrointestinal-toxicity-associated-with-long-term-aspirin-therapy-consequences-and-prevention
#20
Carl J Lavie, Colin W Howden, James Scheiman, James Tursi
Antiplatelet therapy represents a fundamental part of preventive management for patients who are at risk of a secondary cardiovascular disease (CVD) event. In most cases, the antiplatelet regimen is based on low-dose aspirin, a drug that is highly effective in reducing the incidence of CVD events, but is associated with a substantial risk of gastrointestinal (GI) toxicity. The dyspeptic symptoms, which can result from aspirin administration, and which may occur with or without associated ulceration and bleeding, may lead patients to discontinue therapy, thus increasing their CVD risk...
May 2017: Current Problems in Cardiology
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