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https://www.readbyqxmd.com/read/29095860/red-cell-distribution-width-as-a-novel-marker-for-predicting-high-risk-from-upper-gastro-intestinal-bleeding-patients
#1
Kyeong Ryong Lee, Sang O Park, Sin Young Kim, Dae Young Hong, Jong Won Kim, Kwang Je Baek, Dong Hyuk Shin, Young Hwan Lee
BACKGROUND: In upper gastrointestinal bleeding (UGIB) patients, early risk stratification allows appropriate therapy that may be helpful for reducing morbidity and mortality. OBJECTIVES: to evaluate the efficacy of red-cell distribution width (RDW) for prediction of high-risk in UGIB patients. METHODS: We conducted a clinical retrospective observational study based on data for UGIB patients from 2012 to 2013. The primary outcome was the high-risk UGIB, defined as those who required urgent intervention and/or 30-days mortality...
2017: PloS One
https://www.readbyqxmd.com/read/29023527/dose-escalated-radiotherapy-for-unresectable-or-locally-recurrent-pancreatic-cancer-dose-volume-analysis-toxicity-and-outcome-of-28-consecutive-patients
#2
Sebastian Zschaeck, Bibiana Blümke, Peter Wust, David Kaul, Marcus Bahra, Hanno Riess, Fritz Klein, Marianne Sinn, Uwe Pelzer, Volker Budach, Pirus Ghadjar
PURPOSE: The role of radiotherapy for unresectable pancreatic cancer is controversial. A benefit of additional radiotherapy is supported by some observations. A dose-effect relationship was recently found by dose escalation employing image guided and intensity modulated radiotherapy. METHODS: We retrospectively evaluated 28 consecutive patients, all with history of extensive prior therapies for unresectable locally advanced/ recurrent pancreatic cancer (LAPC/LRPC)...
2017: PloS One
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#3
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28905803/diagnosis-and-treatment-of-gastroesophageal-reflux-disease-complicated-by-barrett-s-esophagus
#4
Andriy Stasyshyn
The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett's esophagus in 46 patients. MATERIALS AND METHODS: A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Intestinal metaplasia of the epithelium in the lower third of the esophagus was assessed using videoendoscopy, chromoscopy, and biopsy...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28851249/bacterial-pneumonia-in-patients-with-liver-cirrhosis-with-or-without-hiv-co-infection-a-possible-definition-of-antibiotic-prophylaxis-associated-pneumonia-apap
#5
Gianluca Cuomo, Giuseppina Brancaccio, Gianfranca Stornaiuolo, Daniela Manno, Giuseppe L Gaeta, Cristina Mussini, Massimo Puoti, Giovanni B Gaeta
Introducion: Bacterial infections frequently complicate liver cirrhosis. The aim of this study was to identify risk factors and clinical impact of bacterial pneumonia in patients with cirrhosis. MATERIALS AND METHODS: Bacterial infection prevalence study: consecutive patients with cirrhosis were enroled over a six-month period in 13 Italian centres. Pneumonia and other infections were diagnosed by standard methods. Pneumonia study: cirrhotic patients with pneumonia were enroled for an additional six-month period and HIV-positive patients were included...
August 29, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28818320/-use-of-a-delphi-survey-to-assess-the-hospital-economic-impact-of-innovative-products-the-example-of-idarucizumab-a-dabigatran-specific-reversal-agent
#6
N Jamet, A P Thivilliers, P Paubel, D Chevalier, S Bourguignon, Y Bézie
OBJECTIVES: The economic impact of therapeutic innovations on the hospital patient management cannot be easily estimated. The objective of this study is to illustrate the use of a Delphi survey as a support tool to identify the changes following the use of idarucizumab in dabigatran-treated patients with uncontrolled/life-threatening bleeding or who required emergency surgery/urgent procedures. METHODS: The Delphi questionnaires have been administrated to 8 emergency physicians or anesthetists from 6 different hospital centers...
November 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28816341/clinical-impact-of-major-bleeding-in-patients-with-venous-thromboembolism-treated-with-factor-xa-inhibitors-or-vitamin-k-antagonists-an-individual-patient-data-meta-analysis
#7
Suzanne M Bleker, Marjolein P A Brekelmans, Elise S Eerenberg, Alexander T Cohen, Saskia Middeldorp, Gary Raskob, Harry R Büller
Factor Xa (fXa)-inhibitors are as effective and safer than vitamin-K-antagonists (VKA) in the treatment of venous thromboembolism (VTE). We previously classified the severity of clinical presentation and course of all major bleeding events from the EINSTEIN, AMPLIFY and HOKUSAI-VTE trials separately. The current aim was to combine these findings in order to increase precision, assess a class effect and analyse presentation and course for different types of bleeding, i. e. intracranial, gastro-intestinal, and other...
October 5, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28756907/universal-screening-for-alcohol-misuse-in-acute-medical-admissions-is-feasible-and-identifies-patients-at-high-risk-of-liver-disease
#8
Greta Westwood, Paul Meredith, Susan Atkins, Peter Greengross, Paul E Schmidt, Richard J Aspinall
BACKGROUND & AIMS: Many people who die from alcohol related liver disease (ARLD) have a history of recurrent admissions to hospital, representing potential missed opportunities for intervention. Universal screening for alcohol misuse has been advocated but it is not known if this is achievable or effective at detecting individuals at high risk of ARLD. METHODS: We systematically screened all admissions to the Acute Medical Unit (AMU) of a large acute hospital using an electronic data capture system in real time...
July 12, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28698005/meckel-s-diverticulum-in-the-adult
#9
J Lequet, B Menahem, A Alves, A Fohlen, A Mulliri
Meckel's diverticulum (MD) is the most common gastro-intestinal congenital malformation (approximately 2% in the overall population). The lifetime risk of related complications is estimated at 4%. These include gastro-intestinal bleeding, obstruction or diverticular inflammation. Diagnosis is difficult and rarely made, and imaging, especially in the case of complicated disease, is often not helpful; however exploratory laparoscopy is an important diagnostic tool. The probability of onset of complication decreases with age, and the diagnosis of MD in the adult is therefore often incidental...
September 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28688890/any-changes-in-recent-massive-transfusion-practices-in-a-tertiary-level-institution
#10
Romi Sinha, David Roxby
BACKGROUND & OBJECTIVES: A previous review of transfusion practices in our institution between 1998 and 2008 showed a trend of high ratios of red cells (RC) to plasma (FFP) and platelets to RC towards the later years of review period. The aim of the study was to further evaluate transfusion practices in the form of blood product usage and outcomes following massive transfusion (MT) METHODS: All adult patients with critical bleeding who received a MT (defined as ≥10 units of RC in 24h) in 2008 and between January 2010 and December 2014 were identified...
June 8, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28598564/withdrawn-celecoxib-for-rheumatoid-arthritis
#11
REVIEW
Sarah E Garner, Dogan Fidan, Ruth R Frankish, Maria Judd, Beverley Shea, Tanveer Towheed, Peter Tugwell, George A Wells
BACKGROUND: Rheumatoid arthritis (RA) is a systemic auto-immune disorder, involving persistent joint inflammation. NSAIDs are used to control the symptoms of RA, but are associated with significant gastro-intestinal toxicity, including a risk of potentially life threatening gastroduodenal perforations, ulcers and bleeds. The NSAIDs known as the selective Cox II inhibitors, of which celecoxib is a member, were developed in order to reduce the GI toxicity, but are more expensive. OBJECTIVES: To establish the efficacy and safety of celecoxib in the management of RA by systematic review of available evidence...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28423857/the-association-between-the-stopp-start-criteria-and-gastro-intestinal-track-bleedings-in-elderly-patients
#12
Anouk Veldhuis, Danielle Sent, Linette Bruin-Huisman, Erna Beers, Ameen Abu-Hanna
Potentially inappropriate prescribing is a common problem, especially in elderly care. To tackle this problem, Irish medical experts have developed a list of criteria when medication should be added or omitted based upon the patient's physical condition and medication use, known as the STOPP and START criteria. The STOPP and START criteria have been formulated to identify the prescribing of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). One of the most common problems of inappropriate prescribing is gastro-intestinal track bleedings...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28351521/three-dimensional-guided-perineal-based-interstitial-brachytherapy-in-cervical-cancer-a-systematic-review-of-technique-local-control-and-toxicities
#13
Lucas C Mendez, Yonatan Weiss, David D'Souza, Ananth Ravi, Lisa Barbera, Eric Leung
OBJECTIVE: To evaluate local control and toxicities of perineal-based interstitial brachytherapy (P-ISBT) in cervical cancers treated with three-dimensional (3D) image-based planning through a systematic review. The secondary objective of this review is to summarize the implant and dosimetric techniques in 3D P-ISBT. METHODS: Systematic review of the literature using the PRISMA guideline was conducted through a search of Medline, EMBASE and Cochrane databases. This search resulted in 19 relevant manuscripts...
May 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28240787/newly-diagnosed-immune-thrombocytopenia-adults-clinical-epidemiology-exposure-to-treatments-and-evolution-results-of-the-carmen-multicenter-prospective-cohort
#14
MULTICENTER STUDY
Guillaume Moulis, Johanne Germain, Thibault Comont, Natacha Brun, Claire Dingremont, Brice Castel, Sophie Arista, Laurent Sailler, Maryse Lapeyre-Mestre, Odile Beyne-Rauzy, Bertrand Godeau, Daniel Adoue
The clinical epidemiology of immune thrombocytopenia (ITP) is not well known in adults. This study was aimed at assessing the clinical epidemiology of incident ITP adults, the factors associated with chronicity and exposure to treatments. This study was conducted in the CARMEN registry, a multicentric prospective cohort aimed at including all newly diagnosed ITP adults in the French Midi-Pyrénées region, South of France (3 million inhabitants) from June 2013. Descriptive analyses and multivariate logistic regression models were conducted...
June 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28191810/gist-institutional-experience-at-srms-ims-india
#15
Shubhanshu Gupta, Keshri Amit, Ashish Gupta, Tanu Argawal
Gastro-Intestinal Stromal Tumors (GIST) is a malignant, non-epithelial, mesenchymal tumor of the digestive tract that is not uncommon in clinical practice nowadays; diagnosis being based upon immuno-histo-chemical analysis of the resected or biopsied (FNAC) specimen. Abdominal lump with or without intra-luminal bleed is a common mode of presentation. Early diagnosis and appropriate management with surgery and/or Imatinib therapy improves recurrence free survival and may impact overall survival. We present here our institutional experience of four patients, admitted in Onco-Surgery Dept...
September 2016: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28102426/improved-anticoagulant-effect-of-fucosylated-chondroitin-sulfate-orally-administered-as-gastro-resistant-tablets
#16
Roberto J C Fonseca, Isabela D Sucupira, Stephan Nicollas M C G Oliveira, Gustavo R C Santos, Paulo A S Mourão
Fucosylated chondroitin sulfate (FucCS) is a potent anticoagulant polysaccharide extracted from sea cucumber. Its anticoagulant activity is attributed to the presence of unique branches of sulfated fucose. Although this glycosaminoglycan exerts an antithrombotic effect following oral administration, high doses are necessary to achieve the maximum effect. The diminished activity of FucCS following oral administration is likely due to its degradation in the gastrointestinal tract and its limited ability to cross the intestinal cell membranes...
April 3, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#17
RANDOMIZED CONTROLLED TRIAL
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
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
#18
REVIEW
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/28044954/haemobilia-a-rare-cause-of-upper-gastro-intestinal-bleeding
#19
Daniel Ion, Carmen Iuliana Mavrodin, Mihai Bogdan Șerban, Tudor Marinescu, Dan Nicolae Păduraru
Haemobilia is a rare cause of upper gastrointestinal bleeding that consists of haemorrhage within the biliary tree. Most cases of haemobilia are due to iatrogenic cause, laparoscopic or open cholecystectomy, abdominal trauma, gallstones, hepatic tumours, vascular aneurism. We present the case of a male patient admitted in the surgery department for epigastric and right hypochondria pain, nausea and vomiting. Open cholecystectomy was performed with a trans-cystic tube drainage. Postoperative outcome was favourable but with a continuous decrease in haemoglobin level...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/27823757/how-does-a-concurrent-diagnosis-of-cancer-influence-outcomes-in-emergency-general-surgery-patients
#20
Adil A Shah, Syed Nabeel Zafar, Awais Ashfaq, Alyssa B Chapital, Daniel J Johnson, Chee-Chee Stucky, Barbara Pockaj, Richard J Gray, Mallory Williams, Edward E Cornwell, Lori L Wilson, Nabil Wasif
BACKGROUND: A significant proportion of hospital admissions in the US are secondary to emergency general surgery (EGS). The aim of this study is to quantify outcomes for EGS patients with cancer. METHODS: The Nationwide Inpatient Sample (2007 to 2011) was queried for patients with a diagnosis of an EGS condition as determined by the American Association for the Surgery of Trauma. Of these, patients with a diagnosis of malignant cancers (ICD-9-CM diagnosis codes; 140-208...
December 2016: American Journal of Surgery
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