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acute upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/29780141/hemorrhagic-stress-induced-gastric-ulcer-in-a-healthy-toddler
#1
Katsunori Matsueda, Tatsuya Toyokawa, Masahiro Sakata, Isao Fujita, Jouichiro Horii, Yoshiko Abe, Toru Araki
A 1-year-old female toddler who was under a great amount of psychological stress presented with acute hematemesis. She had no significant medical history; she displayed lethargy and was anemic. Although blood transfusion and famotidine were administered for upper gastrointestinal bleeding (UGIB), the anemia did not improve. Thus, early endoscopy was performed under general anesthesia, revealing a gastric ulcer with exposed vessels in the supra-angular region. Cauterization via bipolar hemostatic forceps was performed on the exposed vessels, and the bleeding was controlled successfully...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29721011/a-new-scoring-system-to-predict-poor-clinical-outcomes-in-acute-nonvariceal-upper-gastrointestinal-bleeding-patients-with-high-risk-stigmata
#2
Zhiyu Dong, Junwen Wang, Tingting Zhan, Haiqin Zhang, Lisha Yi, Shuchang Xu
Aims: To explore the risk factors for rebleeding in acute nonvariceal upper gastrointestinal bleeding patients with high-risk stigmata after endoscopic hemostasis and to develop a new scoring system for them. Methods: A retrospective single-center study was conducted from January 2012 to June 2017. The logistic regression model was used to explore risk factors of poor clinical outcomes. Accuracy of new scoring systems was compared with Rockall score (RS) and Glasgow-Blatchford score (GBS) using receiver operating characteristics curve...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29720248/outcome-pre-specification-requires-sufficient-detail-to-guard-against-outcome-switching-in-clinical-trials-a-case-study
#3
Brennan C Kahan, Vipul Jairath
BACKGROUND: Pre-specification of outcomes is an important tool to guard against outcome switching in clinical trials. However, if the outcome is not sufficiently clearly defined, then different definitions could be applied and analysed, with only the most favourable result reported. METHODS: In order to assess the impact that differing outcome definitions could have on treatment effect estimates, we re-analysed data from TRIGGER, a cluster randomised trial comparing two red blood cell transfusion strategies for patients with acute upper gastrointestinal bleeding...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29719748/does-early-endoscopy-improve-mortality-in-patients-with-acute-non-variceal-gastrointestinal-bleeding-a-retrospective-review
#4
Umair Iqbal, Hafsa Anwar, Hunaiz Patel, Ahmad Chaudhary, Pascale Raymond
Introduction Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding the benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy within 24 hours of presentation. Methods From July 2013 to July 2016, 179 patients admitted with a diagnosis of non-variceal UGIB were retrospectively reviewed...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29713571/superior-vena-cava-obstruction-a-rare-cause-of-recurrent-esophageal-variceal-bleeding
#5
Agazi Gebreselassie, Ahmad Awan, Hamid Yaqoob, Adeyinka Laiyemo
"Downhill" esophageal varices are formed in upper two-thirds of the esophagus as a consequence of a superior vena cava obstruction. We present a case of 55-year-old African-American female with a medical history of multiple comorbidities, including end-stage renal disease, who presented with an upper gastrointestinal bleed and was found to have distended neck veins on physical examination. She gave a history of the insertion of an intravenous central line in her neck area for hemodialysis purposes about six years previously...
February 26, 2018: Curēus
https://www.readbyqxmd.com/read/29705263/previous-use-of-anti-thrombotic-agents-reduces-mortality-and-length-of-hospital-stay-in-patients-with-high-risk-upper-gastrointestinal-bleeding
#6
Philip Dj Dunne, Stig B Laursen, Loren Laine, Harry R Dalton, Jing H Ngu, M Schultz, Adam Rahman, Andrea Anderloni, Iain A Murray, Adrian J Stanley
BACKGROUND AND AIMS: Anti-thrombotic agents are risk factors for upper gastrointestinal bleeding (UGIB). However, few studies have evaluated their effects on patient outcomes. We assessed the effects of anti-thrombotic agents on outcomes of patients with high-risk UGIB. METHODS: We performed a prospective study of 619 patients with acute UGIB (defined by hematemesis, coffee-ground vomit or melena) who required intervention and underwent endoscopy at 8 centers in North America, Asia, and Europe, from March 2014 through March 2015...
April 26, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29691384/blood-transfusion-strategies-for-acute-upper-gastrointestinal-bleeding-are-we-back-where-we-started
#7
EDITORIAL
Andrew W Yen
Blood transfusion practices for acute upper gastrointestinal hemorrhage have changed over time. Restrictive strategies, which gave way to more liberal approaches for the greater part of the 20th century, have again gained traction as emerging research suggests restricting transfusion is associated with similar, or possibly better outcomes in UGI bleeding. In a large, retrospective cohort study from an integrated health care system in Taiwan, Chen, et al., report the association between early blood transfusion and clinical outcomes in patients presenting to the emergency department with UGI bleeding, and these findings are discussed in the context of current knowledge and practice...
April 25, 2018: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29684971/-clinical-outcomes-of-angiography-and-transcatheter-arterial-embolization-for-acute-gastrointestinal-bleeding-analyses-according-to-bleeding-sites-and-embolization-types
#8
Soo Min Noh, Ji Hoon Shin, Ha Il Kim, Sun Ho Lee, Kiju Chang, Eun Mi Song, Sung Wook Hwang, Dong Hoon Yang, Byong Duk Ye, Seung Jae Myung, Suk Kyun Yang, Jeong Sik Byeon
Background/Aims: The clinical outcomes of angiography and transcatheter arterial embolization (TAE) for acute gastrointestinal bleeding (GIB) have not been completely assessed, especially according to bleeding sites. This study aimed to assess the efficacy of angiography and safety of TAE in acute GIB. Methods: This was a retrospective study evaluating the records of 321 patients with acute GIB who underwent angiography with or without TAE. Targeted TAE was conducted in 134 patients, in whom angiography showed bleeding sources...
April 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29671058/transcatheter-arterial-embolization-for-bleeding-peptic-ulcers-a-multicenter-study
#9
Stavros Spiliopoulos, Riccardo Inchingolo, Pierleone Lucatelli, Roberto Iezzi, Athanasios Diamantopoulos, Alessandro Posa, Bryan Barry, Carmelo Ricci, Marco Cini, Chrysostomos Konstantos, Konstantinos Palialexis, Lazaros Reppas, Artemis Trikola, Michele Nardella, Andreas Adam, Elias Brountzos
PURPOSE: To investigate the outcomes of transcatheter arterial embolization (TAE) for the treatment of peptic ulcer bleeding (PUB). MATERIALS AND METHODS: This is a retrospective, multicenter study, which investigated all patients who underwent TAE for the treatment of severe upper gastrointestinal hemorrhage from peptic ulcers in five European centers, between January 1, 2012 and May 1, 2017. All patients had undergone failed endoscopic hemostasis. Forty-four patients (male; mean age 74...
April 18, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29668596/predictors-of-in-hospital-mortality-in-a-cohort-of-elderly-egyptian-patients-with-acute-upper-gastrointestinal-bleeding
#10
Mohamed A Elsebaey, Heba Elashry, Tamer A Elbedewy, Ahmed A Elhadidy, Noha E Esheba, Sherif Ezat, Manal Saad Negm, Yousry Esam-Eldin Abo-Amer, Mohamed El Abgeegy, Heba Fadl Elsergany, Loai Mansour, Sherief Abd-Elsalam
Acute upper gastrointestinal bleeding (UGIB) affects large number of elderly with high rates of morbidity and mortality. Early identification and management of the factors predicting in-hospital mortality might decrease mortality. This study was conducted to identify the causes of acute UGIB and the predictors of in-hospital mortality in elderly Egyptian patients.286 elderly patients with acute UGIB were divided into: bleeding variceal group (161 patients) and bleeding nonvariceal group (125 patients). Patients' monitoring was done during hospitalization to identify the risk factors that might predict in-hospital mortality in elderly...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29652028/risk-factors-of-in-hospital-mortality-among-patients-with-upper-gastrointestinal-bleeding-and-acute-myocardial-infarction
#11
Lingjie He, Jianwei Zhang, Shutian Zhang
Background/Aims: Patients with simultaneous upper gastrointestinal bleeding (UGIB) and acute myocardial infarction (AMI) have higher mortality than patients with either GIB or AMI. We aimed to assess the incidence and risk factors of in-hospital mortality in patients with UGIB and AMI. Patients and Methods: A total of 243 patients with UGIB and AMI were enrolled during 2012-2017. Clinical and laboratory data were collected and analyzed for clinical characteristics and potential risk factors of in-hospital mortality...
April 13, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29644032/severe-acute-gallstone-pancreatitis-with-diffuse-hemorrhagic-gastritis
#12
Timothy J Harris, William C Beck, Avi Bhavaraju, Benjamin Davis, Mary K Kimbrough, Joseph C Jensen, Anna Privratsky, John R Taylor, Kevin W Sexton
A 67-year-old male presented with acute pancreatitis secondary to gallstones, also known as acute biliary pancreatitis, and subsequently developed gastric outlet obstruction and was transferred to our hospital. A gastro-jejunal feeding tube was placed and an open cholecystectomy was performed. The patient had a pancreatic drain placed for interval increase in pancreatic necrosis and then nearly exsanguinated from gastroduodenal artery pseudoaneurysm bleed. This was managed by coiling the gastroduodenal artery...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29626014/glasgow-blatchford-score-and-risk-stratifications-in-acute-upper-gastrointestinal-bleed-can-we-extend-this-to-2-for-urgent-outpatient-management
#13
Kelly Chatten, Huw Purssell, Ashwini Kumar Banerjee, Stephanie Soteriadou, Yeng Ang
Upper gastrointestinal (GI) bleeds are a common presentation to emergency departments in the UK. The Glasgow Blatchford score (GBS) predicts the outcome of patients at presentation. Current UK and European guidelines recommend outpatient management for a GBS of 0. In the current study, our aim was to assess whether extending the GBS allows for early discharge while maintaining patient safety. We also analysed whether pathologies could be missed by discharging patients too early. Data were retrospectively collected on patients admitted with symptoms of an upper GI bleed between 1 October 2013 and 10 June 2016...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29607402/massive-ileal-bleeding-secondary-to-a-dieulafoy-s-lesion
#14
Aymeric Becq, Xavier Dray, Giulia Boarini
Dieulafoy's lesions are a rare cause of gastrointestinal bleeding. This article presents the case of a young woman presenting with a massive ileal bleeding, secondary to a Dieulafoy's lesion. A computed-tomography angiography scan showed an arterial bleeding in the ileum and the diagnosis was confirmed by an emergency peroperative enteroscopy. Surgical treatment was performed. Dieulafoy's lesions account for 1 % to 2 % of acute gastrointestinal bleeding and lesions are mostly located in the upper gastrointestinal tract...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29601652/comparison-of-clinical-outcomes-between-variceal-and-non-variceal-gastrointestinal-bleeding-in-patients-with-cirrhosis
#15
Parul Tandon, Kirles Bishay, Stacey Fisher, Dominique Yelle, Ian Carrigan, Krista Wooller, Erin Kelly
BACKGROUND AND AIM: Acute upper gastrointestinal bleeding (UGIB) in cirrhosis is associated with significant morbidity and mortality and can be classified as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). Differences in mortality, hospital length of stay (LOS) and 30-day readmission have yet to be determined. As such, we aimed to evaluate differences in these clinical outcomes in cirrhotic patients admitted with UGIB. METHODS: This retrospective study included all cirrhotic patients hospitalized for UGIB who underwent upper endoscopy from July 2014 to July 2016...
March 30, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29599508/the-association-between-red-blood-cell-transfusion-and-outcomes-in-patients-with-upper-gastrointestinal-bleeding
#16
Yi-Chuan Chen, Cheng-Ting Hsiao, Leng-Chieh Lin, Kuang-Yu Hsiao, Ming-Szu Hung
BACKGROUND: The benefits of transfusion for acute upper gastrointestinal bleeding (UGIB) have not been well established; however, previous studies suggest that transfusion is associated with adverse outcomes. We performed an observational study using a 10-year database to analyze the association between red blood cell (RBC) transfusion and outcomes in patients with UGIB in the emergency department (ED). METHOD AND FINDINGS: All adult patients with UGIB were identified through diagnostic codes...
March 29, 2018: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29590726/bleeding-peptic-ulcer-tertiary-center-experience-epidemiology-treatment-and-prognosis
#17
Ivan Budimir, Sanja Stojsavljević, Davor Hrabar, Dominik Kralj, Alen Bišćanin, Lora Stanka Kirigin, Mario Zovak, Žarko Babić, Sven Bohnec, Ivan Budimir
The aim of this study was to demonstrate epidemiological, clinical and endoscopic characteristics of acute upper gastrointestinal bleeding (UGIB) with special reference to peptic ulcer bleeding (PUB). The study included 2198 consecutive patients referred to our emergency department due to acute UGIB from January 2008 to December 2012. All patients underwent urgent upper GI endoscopy within 24 hours of admission, and 842 patients diagnosed with PUB were enrolled and prospectively followed-up. The cumulative incidence of UGIB was 126/100,000 in the 5-year period...
December 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29573830/gastric-mucormycosis-in-a-liver-and-kidney-transplant-recipient-case-report-and-concise-review-of-literature
#18
G Alfano, F Fontana, D Francesca, G Assirati, P Magistri, G Tarantino, R Ballarin, G Rossi, E Franceschini, M Codeluppi, G Guaraldi, C Mussini, F Di Benedetto, G Cappelli
Mucormycosis is an uncommonly encountered fungal infection in solid organ transplantation. The infection is severe and often results in a fatal outcome. The most common presentations are rhino-sino-orbital and pulmonary disease. We describe a rare case of gastric mucormycosis in a patient with a combined liver-kidney transplant affected by glycogen storage disease type Ia. A 42-year-old female patient presented with gastric pain and melena 26 days after transplantation. Evaluation with upper endoscopy showed two bleeding gastric ulcers...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29570557/the-use-and-safety-of-a-novel-haemostatic-spray-in-the-endoscopic-management-of-acute-non-variceal-upper-gastrointestinal-bleeding-in-children
#19
Mike Thomson, Arun Urs, Priya Narula, Prithviraj Rao, Dalia Belsha
AIMS AND BACKGROUND: Advanced endo-haemostatic technique performance and experience is extremely variable in distribution amongst pediatric endoscopists. Haemostatic spray (Hemospray®), a novel endo-haemostatic topically applied powder has the advantage of extreme ease of use and; hence may lower the threshold of competency required by the endoscopist thereby potentially reducing mortality. The aim of the study is to prospectively evaluate the efficacy and the safety of haemostatic spray in paediatric patients with AUGIB...
March 22, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29548729/hyperbaric-oxygen-therapy-improves-survival-and-functional-outcome-of-acute-severe-intracerebral-hemorrhage
#20
Xiaowei Li, Jingze Li, Xuehui Yang, Zhaosheng Sun, Jinrong Zhang, Wangmiao Zhao, Shuzhi Dong, Cong Li, Yanqiao Ye, Jianchao Chen, Yongqian Li, Yi Xiang, Jianhui Mao, Guangjie Li, Hong Guo, Wenchao Zhang, Hao Guo, Yazhao Zhang, Mingzhe Zhang, Wanzeng Zhang, Zhanyi Xu, Baoshuai Zhao, Jianhui Wei, Gengshui Zhao, Ronghua Ma, Xiuzhi Shen, Chunyan Ge, Cunling Zheng, Shang Li, Yan Wang
BACKGROUND: Prognosis of spontaneous intracerebral hemorrhage (ICH) remains poor worldwide. AIMS OF THE STUDY: To investigate the effect and optimal protocol for hyperbaric-oxygen therapy (HBOT), and reduce incidence of upper gastrointestinal bleeding (UGIB) in ICH. METHODS: This prospective, randomized, controlled trial included 565 patients with acute severe ICH. Participants were randomly assigned to a sham-control group (Group A) and four intervention groups: Groups B and C with 2...
October 2017: Archives of Medical Research
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