keyword
https://read.qxmd.com/read/38517201/review-article-upper-gastrointestinal-bleeding-review-of-current-evidence-and-implications-for-management
#1
REVIEW
Dennis L Shung, Loren Laine
BACKGROUND: Acute upper gastrointestinal bleeding (UGIB) is a common emergency requiring hospital-based care. Advances in care across pre-endoscopic, endoscopic and post-endoscopic phases have led to improvements in clinical outcomes. AIMS: To provide a detailed, evidence-based update on major aspects of care across pre-endoscopic, endoscopic and post-endoscopic phases. METHODS: We performed a structured bibliographic database search for each topic...
March 22, 2024: Alimentary Pharmacology & Therapeutics
https://read.qxmd.com/read/38385942/aga-clinical-practice-update-on-high-quality-upper-endoscopy-expert-review
#2
Satish Nagula, Sravanthi Parasa, Loren Laine, Shailja C Shah
DESCRIPTION: The purpose of this Clinical Practice Update (CPU) Expert Review is to provide clinicians with guidance on best practices for performing a high-quality upper endoscopic exam. METHODS: The best practice advice statements presented herein were developed from a combination of available evidence from published literature, guidelines, and consensus-based expert opinion. No formal rating of the strength or quality of the evidence was carried out, which aligns with standard processes for American Gastroenterological Association (AGA) Institute CPUs...
February 21, 2024: Clinical Gastroenterology and Hepatology
https://read.qxmd.com/read/38103747/clinical-predictive-value-of-renalase-in-post-ercp-pancreatitis
#3
JOURNAL ARTICLE
Thiruvengadam Muniraj, Gary Desir, Fred Sanford Gorelick, Xiaojia Guo, Maria Ciarleglio, Yanhong Deng, Priya A Jamidar, James J Farrell, Harry R Aslanian, Loren Laine
BACKGROUND & AIMS: Plasma levels of renalase decrease in acute experimental pancreatitis. We aimed to determine if decreases in plasma renalase levels after ERCP predict the occurrence of post-ERCP pancreatitis (PEP). METHODS: In this prospective cohort study at a tertiary hospital, plasma renalase was determined before ERCP (baseline), at 30 and 60 min after ERCP. Native renalase levels, acidified renalase, and native/acidified renalase proportions were analyzed over time using a longitudinal regression model...
December 14, 2023: Gastrointestinal Endoscopy
https://read.qxmd.com/read/37913510/management-of-bleeding-due-to-small-intestinal-angiodysplasias
#4
EDITORIAL
Loren Laine
New England Journal of Medicine, Volume 389, Issue 18, Page 1718-1720, November 2023.
November 2, 2023: New England Journal of Medicine
https://read.qxmd.com/read/37753930/achieving-value-by-risk-stratification-with-machine-learning-model-or-clinical-risk-score-in-acute-upper-gastrointestinal-bleeding-a-cost-minimization-analysis
#5
JOURNAL ARTICLE
Dennis L Shung, John K Lin, Loren Laine
INTRODUCTION: We estimate the economic impact of applying risk assessment tools to identify very-low-risk patients with upper gastrointestinal bleeding (UGIB) who can be safely discharged from the emergency department using a cost minimization analysis. METHODS: We compare triage strategies (Glasgow-Blatchford Score (GBS)=0/0-1 or validated machine-learning model) to usual care using a Markov chain model from a U.S. healthcare payer perspective. RESULTS: Over 5 years, the GBS triage strategy produced national cumulative savings over usual care of over $2...
September 27, 2023: American Journal of Gastroenterology
https://read.qxmd.com/read/37696350/trends-in-upper-gastrointestinal-bleeding-in-patients-on-primary-prevention-aspirin-a-nationwide-emergency-department-sample-analysis-2016-2020
#6
JOURNAL ARTICLE
Darrick K Li, Loren Laine, Dennis L Shung
BACKGROUND: Recent guidelines do not recommend routine use of aspirin for primary cardiovascular prevention (ppASA) and suggest avoidance of ppASA in older individuals due to bleeding risk. However, ppASA is frequently taken without an appropriate indication. Estimates of the incidence of upper gastrointestinal bleeding due to ppASA in the United States are lacking. In this study, we provide national estimates of upper gastrointestinal bleeding incidence, characteristics, and costs in ppASA users from 2016-2020...
September 9, 2023: American Journal of Medicine
https://read.qxmd.com/read/37061896/presentation-of-the-julius-m-friedenwald-medal-to-sheila%C3%A2-e-%C3%A2-crowe-md
#7
EDITORIAL
Loren Laine, Gail Hecht
No abstract text is available yet for this article.
June 2023: Gastroenterology
https://read.qxmd.com/read/36697349/plasma-renalase-levels-are-associated-with-the-development-of-acute-pancreatitis
#8
JOURNAL ARTICLE
Melinda Wang, Frank Ulrich Weiss, Xiaojia Guo, Thomas Kolodecik, Jan Philipp Bewersdorf, Loren Laine, Markus M Lerch, Gary Desir, Fred S Gorelick
BACKGROUND/OBJECTIVES: Severe acute pancreatitis is associated with significant morbidity and mortality. Identifying factors that affect the risk of developing severe disease could influence management. Plasma levels of renalase, an anti-inflammatory secretory protein, dramatically decrease in a murine acute pancreatitis model. We assessed this response in hospitalized acute pancreatitis patients to determine if reduced plasma renalase levels occur in humans. METHODS: Plasma samples were prospectively and sequentially collected from patients hospitalized for acute pancreatitis...
March 2023: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://read.qxmd.com/read/36394111/deprescription-of-aspirin-for-primary-prevention-is-uncommon-at-discharge-in-hospitalised-patients-with-gastrointestinal-bleeding
#9
JOURNAL ARTICLE
Darrick K Li, Shawn Y Ong, Michelle L Hughes, Kenneth W Hung, Ritu Agarwal, Jamil Alexis, John Damianos, Shreyak Sharma, Jacqueline Pires, Michael Nanna, Loren Laine
BACKGROUND: Guidelines recommend against aspirin for primary prevention of cardiovascular events in individuals with a history of gastrointestinal bleeding (GIB). It is unknown how often patients on primary prevention aspirin hospitalised with GIB have aspirin discontinued at discharge. AIMS: To determine the rate of aspirin deprescription and explore long-term outcomes in patients taking aspirin for primary prevention of cardiovascular events. METHODS: We evaluated all patients hospitalised at Yale-New Haven Hospital between January 2014 and October 2021 with GIB who were on aspirin for primary prevention...
January 2023: Alimentary Pharmacology & Therapeutics
https://read.qxmd.com/read/36327440/response-to-graham
#10
JOURNAL ARTICLE
Loren Laine, Prateek Sharma, Darcy J Mulford, Barbara Hunt, Eckhard Leifke, Neila Smith, Colin W Howden
No abstract text is available yet for this article.
November 1, 2022: American Journal of Gastroenterology
https://read.qxmd.com/read/36228735/disparities-in-access-to-endoscopy-for-patients-with-upper-gastrointestinal-bleeding-presenting-to-emergency-departments
#11
JOURNAL ARTICLE
Nicolette J Rodriguez, Neil Zheng, Catherine Mezzacappa, Maureen Canavan, Loren Laine, Dennis Shung
No abstract text is available yet for this article.
October 10, 2022: Gastroenterology
https://read.qxmd.com/read/36228734/vonoprazan-versus-lansoprazole-for-healing-and-maintenance-of-healing-of-erosive-esophagitis-a-randomized-trial
#12
RANDOMIZED CONTROLLED TRIAL
Loren Laine, Kenneth DeVault, Philip Katz, Stefan Mitev, John Lowe, Barbara Hunt, Stuart Spechler
BACKGROUND & AIMS: For decades, proton pump inhibitors (PPIs) have been the mainstay of treatment for erosive esophagitis. The potassium-competitive acid blocker vonoprazan provides more potent acid inhibition than PPIs, but data on its efficacy for erosive esophagitis are limited. METHODS: Adults with erosive esophagitis were randomized to once-daily vonoprazan, 20 mg, or lansoprazole, 30 mg, for up to 8 weeks. Patients with healing were rerandomized to once-daily vonoprazan, 10 mg, vonoprazan, 20 mg, or lansoprazole, 15 mg, for 24 weeks...
January 2023: Gastroenterology
https://read.qxmd.com/read/36173090/trends-in-characteristics-management-and-outcomes-of-patients-presenting-with-gastrointestinal-bleeding-to-emergency-departments-in-the-united-states-from-2006-to-2019
#13
JOURNAL ARTICLE
Neil S Zheng, Cynthia Tsay, Loren Laine, Dennis L Shung
BACKGROUND: Recent epidemiologic studies of trends in gastrointestinal bleeding (GIB) provided results through 2014 or earlier and assessed only hospitalised patients, excluding patients presenting to emergency departments (EDs) who are not hospitalised. AIMS: To provide the first U.S. nationwide epidemiological evaluation of all patients presenting to EDs with GIB METHODS: We used the Nationwide Emergency Department Sample for 2006-2019 to calculate yearly projected incidence of patients presenting to EDs with primary diagnoses of GIB, categorised by location and aetiology...
December 2022: Alimentary Pharmacology & Therapeutics
https://read.qxmd.com/read/35853234/rebleeding-in-peptic-ulcer-bleeding-a-nationwide-cohort-study-of-19-537-patients
#14
JOURNAL ARTICLE
Stig B Laursen, Adrian J Stanley, Loren Laine, Ove B Schaffalitzky de Muckadell
BACKGROUND: Rebleeding is a frequent complication of peptic ulcer bleeding (PUB). The associated prognosis remains rather unclear because previous studies generally also included non-ulcer lesions. OBJECTIVE: We aimed to identify predictors for rebleeding; clarify the prognostic consequence of rebleeding; and develop a score for predicting rebleeding. METHODS: Nationwide cohort study of consecutive patients presenting to hospital with PUB in Denmark from 2006-2014...
December 2022: Scandinavian Journal of Gastroenterology
https://read.qxmd.com/read/35679950/vonoprazan-triple-and-dual-therapy-for-helicobacter-pylori-infection-in-the-united-states-and-europe-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
William D Chey, Francis Mégraud, Loren Laine, Luis J López, Barbara J Hunt, Colin W Howden
BACKGROUND & AIMS: Novel, effective treatments for Helicobacter pylori infection are needed. This study evaluated the efficacy of vonoprazan, a potassium-competitive acid blocker, vs standard treatment on H pylori eradication in the United States and Europe. METHODS: In a randomized, controlled, phase 3 trial, treatment-naïve adults with H pylori infection were randomized 1:1:1 to open-label vonoprazan dual therapy (20 mg vonoprazan twice daily; 1 g amoxicillin 3 times daily), or double-blind triple therapy twice a day (vonoprazan 20 mg or lansoprazole 30 mg; amoxicillin 1 g; clarithromycin 500 mg) for 14 days...
September 2022: Gastroenterology
https://read.qxmd.com/read/35679879/association-of-antisecretory-drugs-with-upper-gastrointestinal-bleeding-in-patients-using-oral-anticoagulants-a-systematic-review-and-meta-analysis
#16
JOURNAL ARTICLE
Jacob E Kurlander, Geoffrey D Barnes, Aaron Fisher, Juan J Gonzalez, Danielle Helminski, Sameer D Saini, Neil Sengupta, Yu-Xiao Yang, James Scheiman, Loren Laine
BACKGROUND: The role of antisecretory drugs for the prevention of upper gastrointestinal bleeding in patients using anticoagulants is unclear. We investigated this question in a systematic review and meta-analysis. METHODS: We searched Embase, PubMed, Web of Science, Scopus, the Cochrane Library, and clinicaltrials.gov thru April 2021 for controlled randomized trials and observational studies evaluating the association of proton pump inhibitors (PPIs) or H2-receptor antagonists with overt upper gastrointestinal bleeding in patients using anticoagulants...
October 2022: American Journal of Medicine
https://read.qxmd.com/read/35571482/international-multicenter-study-comparing-demographics-therapy-and-outcomes-in-bleeding-from-mallory-weiss-tears-and-peptic-ulcers
#17
JOURNAL ARTICLE
Jennifer E Tham, Lucy Lynch, Stig B Laursen, Loren Laine, Harry R Dalton, Jeffrey Ngu, Eduardo Redondo-Cerezo, Michael Schultz, Iain Murray, Nick Michell, Alan J Morris, Michael M Nielsen, Adrian J Stanley
Background and study aims  Mallory Weiss tears (MWTs) are relatively uncommon causes of upper gastrointestinal bleeding (UGIB), and patients are generally considered at low risk of poor outcome, although data are limited. There is uncertainty about use of endoscopic therapy. We aimed to describe and compare an international cohort of patients presenting with UGIB secondary to MWT and peptic ulcer bleeding (PUB). Patients and methods  From an international dataset of patients undergoing endoscopy for acute UGIB at seven hospitals, we assessed patients with MWT bleeding, including the endoscopic stigmata and endoscopic therapy applied...
May 2022: Endoscopy International Open
https://read.qxmd.com/read/35368325/american-college-of-gastroenterology-canadian-association-of-gastroenterology-clinical-practice-guideline-management-of-anticoagulants-and-antiplatelets-during-acute-gastrointestinal-bleeding-and-the-periendoscopic-period
#18
REVIEW
Neena S Abraham, Alan N Barkun, Bryan G Sauer, James Douketis, Loren Laine, Peter A Noseworthy, Jennifer J Telford, Grigorios I Leontiadis
We conducted systematic reviews of predefined clinical questions and used the Grading of Recommendations, Assessment, Development and Evaluations approach to develop recommendations for the periendoscopic management of anticoagulant and antiplatelet drugs during acute gastrointestinal (GI) bleeding and the elective endoscopic setting. The following recommendations target patients presenting with acute GI bleeding: For patients on warfarin, we suggest against giving fresh frozen plasma or vitamin K; if needed, we suggest prothrombin complex concentrate (PCC) compared with fresh frozen plasma administration; for patients on direct oral anticoagulants (DOACs), we suggest against PCC administration; if on dabigatran, we suggest against the administration of idarucizumab, and if on rivaroxaban or apixaban, we suggest against andexanet alfa administration; for patients on antiplatelet agents, we suggest against platelet transfusions; and for patients on cardiac acetylsalicylic acid (ASA) for secondary prevention, we suggest against holding it, but if the ASA has been interrupted, we suggest resumption on the day hemostasis is endoscopically confirmed...
April 2022: Journal of the Canadian Association of Gastroenterology
https://read.qxmd.com/read/35354773/management-of-patients-on-anticoagulants-and-antiplatelets-during-acute-gastrointestinal-bleeding-and-the-peri-endoscopic-period-a-clinical-practice-guideline-dissemination-tool
#19
JOURNAL ARTICLE
Alan N Barkun, James Douketis, Peter A Noseworthy, Loren Laine, Jennifer J Telford, Neena S Abraham
No abstract text is available yet for this article.
April 1, 2022: American Journal of Gastroenterology
https://read.qxmd.com/read/34904965/adapting-to-the-challenge-of-hospital-based-care-the-evolving-role-of-gastroenterology-hospitalists
#20
JOURNAL ARTICLE
Michelle L Hughes, Darrick K Li, Kenneth W Hung, Loren Laine
No abstract text is available yet for this article.
December 14, 2021: American Journal of Gastroenterology
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