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acute upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/27807586/a-rare-case-of-hepatitis-c-associated-cryoglobulinemic-duodenal-vasculitis
#1
Shivali R Berera, Alexandra Gomez, Kevin Dholaria, Leopoldo R Arosemena, Marco A Ladino-Avellaneda, Laura Barisoni, Kalyan R Bhamidimarri
Intestinal involvement of cryoglobulinemia is an uncommon manifestation and marker of severe vasculitis. We describe the case of a woman admitted to our service for management of acute renal failure and progressive gastrointestinal symptoms after initiating hepatitis C virus treatment with ribavirin and sofosbuvir 4 weeks prior. With an undetectable hepatitis C viral load and persistent symptoms despite hepatitis C virus therapy cessation, an upper endoscopy revealed duodenal sloughing, erythema, and bleeding, sparking suspicion for recurrence of cryoglobulinemic vasculitis...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27793353/cost-effectiveness-of-low-dose-submicron-diclofenac-compared-with-generic-diclofenac
#2
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
https://www.readbyqxmd.com/read/27789550/obscure-upper-gastrointestinal-haemorrhage-haemosuccus-pancreaticus
#3
Prateush Singh, Asim Khan, Manuel Jasper, Javaid Subhani
A Caucasian man aged 28 years with a history of pancreatitis presented with fatigue, intermittent melaena and severe anaemia. Symptomatic treatment for anaemia was coupled with thorough investigation to localise the source of gastrointestinal haemorrhage. Two oesophagogastroduodenoscopies and colonoscopies failed to identify a cause. CT abdomen revealed splenomegaly secondary to splenic vein thrombosis with evidence of portal hypertension and small collateral vessels. A CT mesenteric angiogram revealed a splenic artery pseudoaneurysm as the likely source of bleeding...
October 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27788611/helicobacter-pylori-liver-cirrhosis-and-portal-hypertension-an-updated-appraisal
#4
Raffaele Licinio, Giuseppe Losurdo, Sonia Carparelli, Andrea Iannone, Floriana Giorgio, Michele Barone, Mariabeatrice Principi, Enzo Ierardi, Alfredo Di Leo
OBJECTIVE: Helicobacter pylori (H. pylori) is the most common cause of gastritis and peptic ulcer. However, H. pylori is even involved in extragastric diseases, and it has been hypothesized that H. pylori could be a risk factor for several hepatic diseases. For instance, a direct involvement of H. pylori in the development of portal hypertension (PH) in cirrhotic patients has been postulated. METHODS: We performed a literature search in major databases to elucidate the relationship between H...
October 27, 2016: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/27786543/assessment-of-safety-of-performing-percutaneous-coronary-intervention-after-a-recent-episode-of-gastrointestinal-bleeding
#5
Saima Karim, Sweetheart T Ador-Dionisio, Munira Karim, Mohammad Karim, Sadaf S Khan, Ashish Atreja, Stephen Ellis
BACKGROUND: Little literature exists on the risk of performing coronary intervention (PCI) on patients who have had recent gastrointestinal bleeding (GIB), although bleeding after PCI has been identified as a risk factor for long-term mortality. METHODS: Patients within the Cleveland Clinic PCI database who had acute GIB within 30 days preceding PCI during the same hospitalization (n = 79) were retrospectively compared to those who had PCI without recent GIB (n = 10 979) for mortality and need for revascularization...
October 27, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27784430/-prognostic-value-of-a-logistic-regression-model-based-on-keratin-18-in-patients-with-hbv-related-liver-failure
#6
Q R Gan, X Y Jiang, X Zhang, M S Chen, C Pan
Objective: To investigate the association between serum keratin 18 (K18) level and prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF). Methods: A total of 120 patients who visited Department of Hepatology in Fuzhou Infectious Disease Hospital and were diagnosed with HBV-related ACLF from December 2012 to March 2014 were enrolled and followed up for 3 months. The patients were divided into death group and survival group. The serum levels of K18 fragments (M30 and M65) were measured and related laboratory data were collected to analyze the differences in M30, M65, M30/M65, and other laboratory markers...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27776486/bleeding-downhill-esophageal-varices-associated-with-benign-superior-vena-cava-obstruction-case-report-and-literature-review
#7
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27749768/emergency-readmission-following-acute-upper-gastrointestinal-bleeding
#8
Martin Strömdahl, Johan Helgeson, Evangelos Kalaitzakis
OBJECTIVE: To assess the occurrence, clinical predictors, and associated mortality of all-cause emergency readmissions after acute upper gastrointestinal bleeding (AUGIB). PATIENTS AND METHODS: All patients with AUGIB from an area of 600 000 inhabitants in Sweden admitted in a single institution in 2009-2011 were retrospectively identified. All medical records were scrutinized and relevant data (such as comorbid illness and medications, endoscopy, rebleeding, inhospital mortality, and 30-day emergency readmission) were extracted...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27737411/primary-aortoduodenal-fistula-first-you-should-suspect-it
#9
Mircea Beuran, Ionut Negoi, Ruxandra Irina Negoi, Sorin Hostiuc, Sorin Paun
A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition...
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27730597/acute-esophageal-necrosis
#10
Beatriz Deoti E Silva Rodrigues, Raniere Dos Santos, Magda Maria Profeta da Luz, Flávia Chaves E Silva, Igor Guedes Nogueira Reis
Acute esophageal necrosis (AEN) or "black esophagus" is a rare condition presented by patients with critical state of health and characterized by a darkened esophagus, usually the distal third, in upper digestive endoscopy. The main clinical manifestation is upper gastrointestinal bleeding and there may be abdominal pain, dysphagia, nausea, vomiting, fever and syncope associated. The diagnosis depends on clinical suspicion and performing endoscopy, the biopsy not being required. In this article we present a case of a patient who had lots of comorbidities and developed AEN during a post-operative period, and discuss the importance of AEN in an increasingly ageing population...
October 11, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27723988/-late-complications-of-liver-cirrhosis-management-of-gastrointestinal-bleeding-in-the-presence-of-portal-hypertension
#11
Václav Hejda
Cirrhosis is the end stage of progressive development of different liver diseases and is associated with significant morbidity and mortality rates. Cirrhosis is associated with a number of potential complications, in particular with development of portal hypertension. Portal hypertension with the production of ascites, hepatic and gastric varices bleeding in the upper part of the gastrointestinal tract, presents the breakpoint in the natural course of cirrhosis, and it is associated with a considerably worse prognosis of patients, with a dramatically increased risk of mortality...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27698969/factors-associated-with-outcome-in-patients-with-acute-upper-gastrointestinal-bleeding-in-a-tertiary-referral-center-in-northern-iran
#12
Fatemeh Baradaran, Alireza Norouzi, Samaneh Tavassoli, Abdolvahab Baradaran, Gholamreza Roshandel
BACKGROUND Upper gastrointestinal bleeding (UGIB) is a major healthcare problem and is the most frequent gastrointestinal reason for admission to hospital. We aimed to investigate the prognosis of patients with UGIB referred to a referral hospital in northern Iran in 2013. METHODS All patients with UGIB who admitted to Sayyad Shirazi Hospital, in Gorgan, northern Iran, in 2013 were enrolled. The patients' demographic data as well as data about admission, diseases, drug history, and patients' prognosis were collected by structured questionnaire using information in hospital files...
July 2016: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27693643/timing-of-upper-endoscopy-influences-outcomes-in-patients-with-acute-nonvariceal-upper-gi-bleeding
#13
Navin L Kumar, Aaron J Cohen, Jennifer Nayor, Brian L Claggett, John R Saltzman
BACKGROUND: Current guidelines advise that upper endoscopy be performed within 24 hours of presentation in patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). However, the role of urgent endoscopy (< 12 hours) is controversial. AIM: Our aim was to assess whether patients admitted with acute nonvariceal UGIB with lower-risk versus high-risk bleeding have different outcomes with urgent compared with non-urgent endoscopy. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital with nonvariceal UGIB...
September 29, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27662496/acute-gastrointestinal-bleeding-cases-presenting-to-the-emergency-department-are-associated-with-age-sex-and-seasonal-and-circadian-factors
#14
Henrike Lenzen, Eliane Musmann, Martina Kottas, Bastian Schönemeier, Thomas Köhnlein, Michael P Manns, Tim O Lankisch
BACKGROUND: Gastrointestinal bleeding (GIB) is one of the most common emergencies in gastroenterology. The aim of this study was to investigate the association between the incidence of GIB and seasonal, circadian and meteorological patterns in the emergency department (ED) of a tertiary hospital. PATIENTS AND METHODS: From January 2007 until December 2012, we retrospectively evaluated patients presenting to the ED with respect to the number and location of GIB, season, time of day and weather...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27650234/prevalence-risk-factors-and-in-hospital-outcomes-of-qtc-interval-prolongation-in-liver-cirrhosis
#15
Jiancheng Zhao, Xingshun Qi, Feifei Hou, Zheng Ning, Xintong Zhang, Han Deng, Ying Peng, Jing Li, Xiaoxi Wang, Hongyu Li, Xiaozhong Guo
BACKGROUND: QTc interval prolongation is an electrocardiographic abnormality in liver cirrhosis. The objective of this study was to evaluate the prevalence, risk factors and in-hospital outcomes of QTc interval prolongation in Chinese patients with liver cirrhosis. METHODS: This was a retrospective analysis of a total of 1,268 patients with liver cirrhosis who were consecutively admitted to our hospital between January 2011 and June 2014. QTc interval data were collected from the medical records...
September 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27643979/clinical-application-and-pharmacodynamic-monitoring-of-apixaban-in-a-patient-with-end-stage-renal-disease-requiring-chronic-hemodialysis
#16
Wesley D Kufel, Adam S Zayac, David F Lehmann, Christopher D Miller
Despite prescribing guidance, limited data exist to describe the use of apixaban in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD). Current apixaban dosing recommendations for this patient population are based largely on a single-dose pharmacokinetic study of eight patients. We describe the clinical application and pharmacodynamic monitoring of apixaban in a 62-year-old 156-kg African-American woman with nonvalvular atrial fibrillation and ESRD requiring hemodialysis who developed calciphylaxis while receiving warfarin therapy...
September 19, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27642529/an-unusual-cause-of-acute-upper-gastrointestinal-bleeding-acute-esophageal-necrosis
#17
Nikhil R Kalva, Madhusudhan R Tokala, Sonu Dhillon, Watcoun-Nchinda Pisoh, Saqib Walayat, Vishwas Vanar, Srinivas R Puli
Acute esophageal necrosis (AEN), also called "black esophagus," is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27616071/a-life-threatening-duodenal-ulcer-hemorrhage-due-to-previously-unknown-primary-hyperparathyroidism
#18
Dan Xie, Kunpeng Hu, Ying Xian, Ying Wang, Xiaofeng Yuan, Mingliang Li, Xiaogang Bi, Kouxing Zhang
Peptic ulcer bleeding due to primary hyperparathyroidism is extremely rare. We report a case of a 42-year-old male with life-threatening acute upper gastrointestinal bleeding secondary to a duodenal ulcer and a history of kidney stones. Gastroscopic therapy, Billroth II gastrointestinal anastomosis and angiographic embolization were sequentially conducted to arrest the hemorrhage. A complete investigative work-up revealed that the duodenal ulcer bleeding was due to primary hyperparathyroidism coexisting with a parathyroid adenoma...
September 10, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27608699/gastric-mucormycosis-with-hemolytic-uremic-syndrome
#19
K Sunil Raviraj, P Miglani, A Garg, P K Agarwal
Mucormycosis, is an emerging fungal infection in immunocompromised and diabetic individuals, usually affects rhino-orbito-cerebral, cutaneous and pulmonary regions. But mucormycosis in immunocompetent environment is rare and occurrence of gastric mucormycosis is unusual. We report a case of 19 year old female, with no pre-existing co-morbidities, presented with fever, dysentery, vomiting, and melena for 4 days. On evaluation she was found to have pancytopenia, acute kidney injury, hemolytic anemia, coagulopathy and hepatic derangement and treated with hemodialysis, plasmapheresis along with antibiotics and packed cell RBC transfusion...
October 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27603199/pharmacomechanical-thrombectomy-of-upper-extremity-deep-vein-thrombosis
#20
Evren Ozcinar, Nur Dikmen Yaman, Mehmet Cakici, Cagdas Baran, Mustafa B Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the treatment of upper extremity deep vein thrombosis (UEDVT). METHODS: We conducted a prospective, observational cohort study of consecutive patients with acute UEDVT with low-dose UACDT using the Ekosonic® Endovascular System, EKOS Corporation, Bothell, WA, USA at a single center from September 2012 until October 2014. Overall, sixteen patients(11 males and 6 females, age range 18 to 70 years, mean age, 45...
September 7, 2016: International Angiology: a Journal of the International Union of Angiology
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