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https://www.readbyqxmd.com/read/29473522/an-evidence-based-review-of-off-label-uses-of-polidocanol
#1
Hossein Babaei, Elgar Enamzadeh
BACKGROUND: Polidocanol is approved for its competence in treatment of varicose veins and spider veins; however, unfortunately, many of its off-label uses are still underappreciated. OBJECTIVE: Lack of an appropriate comprehensive review for off-label uses of this medication troubles physicians about making evidence-based decisions on prescribing it for its various outstanding off-label uses. This article attempts to provide physicians with the latest information concerning successful and unsuccessful use of polidocanol as an alternative treatment for esophageal and gastric varices, tendinopathy and epicondylitis, vascular malformations, varicocele, hydrocele and spermatocele, aneurysmal bone cysts, itching, management of gastrointestinal bleeding, simple renal cysts, reducing the incidence and severity of radio-induced dermatitis, and hemorrhoids...
February 23, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29469530/-percutaneous-transsplenic-varices-embolization-in-treatment-of-upper-gastrointestinal-hemorrhage-of-schistosomiasis-cirrhosis
#2
Ji Chang-Xue, Li Ying, Ju Shuai, Qiang Jin-Wei
OBJECTIVE: To evaluate the application value of percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. METHODS: Sixteen schistosomiasis cirrhosis patients (12 males and 4 females) with portal hypertension complicated with esophageal and upper gastrointestinal hemorrhage were selected as the investigation subjects, all the patients had been treated by esophageal vein ligation and sclerotherapy, but with bleeding again post-operation...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29469515/-application-of-degree-of-portal-systemic-shunting-in-assessing-upper-gastrointestinal-bleeding-in-patients-with-schistosomiasis-cirrhosis
#3
Ju Shuai, Li Ying, Ji Chang-Xue, Zhang Biao
OBJECTIVE: To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointestinal bleeding in patients with hepatic schistosomiasis. METHODS: Thirty-three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis (a bleeding group) and 29 schistosomiasis cirrhosis patients without bleeding (a non-bleeding group) were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29467124/gastric-and-duodenal-ischaemia-after-transarterial-chemoembolisation-for-hepatocellular-carcinoma-an-unexpected-but-significant-complication
#4
Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29465096/management-of-acute-upper-gastrointestinal-bleeding-an-update-for-the-general-physician
#5
K Siau, W Chapman, N Sharma, D Tripathi, T Iqbal, N Bhala
Acute upper gastrointestinal bleed (AUGIB) is one of the most common medical emergencies in the UK, with roughly one presentation every 6 min. Despite advances in therapeutics and endoscopy provision, mortality following AUGIB over the last two decades has remained high, with over 9,000 deaths annually in the UK; consequently, several national bodies have published UK-relevant guidelines. Despite this, the 2015 UK National Confidential Enquiry into Patient Outcome and Death in AUGIB highlighted variations in practice, raised concerns regarding suboptimal patient care and released a series of recommendations...
September 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29450749/an-analysis-of-the-clinical-laboratory-and-histological-features-of-striped-punctate-and-nodular-gastric-antral-vascular-ectasia
#6
Arul Thomas, David Koch, William Marsteller, David Lewin, Adrian Reuben
BACKGROUND: Gastric antral vascular ectasia (GAVE) commonly presents as linear striped ("watermelon stomach") or punctate phenotypes, to which a newly discovered nodular form was recently added. AIMS: We performed a retrospective cohort study to detail and compare the clinical and histological characteristics of major GAVE phenotypes. METHODS: In 136 GAVE patients (tertiary care ambulatory and inpatient, median age 61.3 years, 73 men, and 63 women), clinical and laboratory results were recorded, with comorbidities, endoscopy indications, and complications of cirrhosis...
February 15, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29428942/outcomes-of-patients-undergoing-endoscopic-hemostasis-for-the-upper-gastrointestinal-bleeding-were-not-influenced-by-the-timing-of-hospital-emergency-visits-a-situation-prevailing-in-japan
#7
Satoko Matsuura, Yasuhisa Sakata, Nanae Tsuruoka, Koichi Miyahara, Megumi Hara, Yoichiro Ito, Kenichiro Nakayama, Takuya Shimamura, Takahiro Noda, Takahiro Yukimoto, Ryo Shimoda, Ryuichi Iwakiri, Kazuma Fujimoto
BACKGROUND: The aim of the present study was to determine differences in the prognosis of patients in Japan who underwent emergency endoscopic hemostasis (i) during regular hours versus off hours and (ii) as outpatients versus hospitalized patients. METHODS: The present retrospective study included 443 patients who underwent emergency endoscopic hemostasis for non-variceal upper gastrointestinal bleeding from January 2008 to December 2014. These patients were classified into 2 groups: hospitalized patients and outpatients...
February 9, 2018: Digestion
https://www.readbyqxmd.com/read/29415371/effectiveness-of-the-polysaccharide-hemostatic-powder-in-non-variceal-upper-gastrointestinal-bleeding-using-propensity-score-matching
#8
Jun Chul Park, Yeong Jin Kim, Eun Hye Kim, Jinae Lee, Hyun Su Yang, Eun Hwa Kim, Kyu Yeon Hahn, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
BACKGROUND AND AIM: Recently, the application of hemostatic powder to the bleeding site has been used to treat active upper gastrointestinal bleeding (UGIB). We aimed to assess the effectiveness of the polysaccharide hemostatic powder (PHP) in patients with non-variceal UGIB. METHODS: We reviewed prospectively collected 40 patients with UGIB treated with PHP therapy between April 2016 and January 2017 (PHP group) and 303 patients with UGIB treated with conventional therapy between April 2012 and October 2014 (conventional therapy group)...
February 7, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29413215/management-of-acute-gastrointestinal-bleed
#9
REVIEW
Francisca Cisneros Farrar
Acute gastrointestinal bleeding is a common problem found in critically ill patients that can range from self-limited bleeding to a hemorrhaging emergency. Patients can quickly develop shock and altered mental status when they develop hemodynamic instability. Therefore, it is essential that the frontline critical care nurse develop self-efficacy for management of these disorders. This article overviews standards of practice for the management of upper and lower acute gastrointestinal bleeding. Common bleeding disorders are reviewed with expanded focus on peptic ulcer, acute variceal hemorrhage, colonic diverticular bleeding, and angiodysplasias, which are commonly found in the critical care setting...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29390375/hepatic-artery-embolization-cures-the-acute-pancreatitis-associated-with-a-tiny-arteriobiliary-fistula-after-tips-a-case-report
#10
Xiuli Yin, Xiaofei Lei, Changqing Xu, Jing Yang, Yingying Zhao, Kun Li
RATIONALE: Esophageal variceal bleeding caused by portal hypertension is massive and life-threatening to those patients with decompensated liver cirrhosis. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively stop bleeding. But the process of puncture may lead to bile duct injury and even form fistulas between the hepatic artery and bile duct. PATIENT CONCERNS: The case report illustrated a 52-year-old Chinese female patient who underwent TIPS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29380820/severity-and-outcomes-of-upper-gastrointestinal-bleeding-with-bloody-vs-coffee-grounds-hematemesis
#11
Loren Laine, Stig B Laursen, Liam Zakko, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
OBJECTIVES: Numerous reviews indicate bloody hematemesis signifies more severe bleeding than coffee-grounds hematemesis. We assessed severity and outcomes related to bleeding symptoms in a prospective study. METHODS: Consecutive patients presenting with hematemesis or melena were categorized as bloody emesis (N=1209), coffee-grounds emesis without bloody emesis (N=701), or melena without hematemesis (N=1069). We assessed bleeding severity (pulse, blood pressure) and predictors of outcome (hemoglobin, risk stratification scores) at presentation, and outcomes of bleeding episodes...
January 30, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29372608/gastrointestinal-duodenal-variceal-bleeding-secondary-to-thrombophilia-related-portal-vein-thrombosis
#12
B H Mullish, S Mathew, A Dhar
No abstract text is available yet for this article.
February 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29369239/rising-events-and-improved-outcomes-of-gastrointestinal-bleed-with-shock-in-usa-a-12-year-national-analysis
#13
Nauman S Siddiqui, Suman Paul, Zubair Khan, Toseef Javaid, Syed S Hasan, Zarmina Khan, Jamal Saleh, Douglas J Federman, Sadik Khuder, Ali Nawras
OBJECTIVE: Limited information is available based on single-center studies on trends of incidence and outcomes in gastrointestinal (GI) bleed with shock. METHODS: We analyzed data from 2002 to 2013 National Inpatient Sample. Using ICD-9 codes we identified 6.4 million hospital discharges of GI bleed from National Inpatient Sample database. Events were analyzed based on type of GI bleed, in-hospital mortality, hemodynamic status, and use of blood products. RESULTS: GI bleed with shock results in higher hospital mortality (20...
January 23, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29359035/ectopic-gastrointestinal-variceal-bleeding-with-portal-hypertension
#14
Keita Minowa, Shuhei Komatsu, Kenichiro Takashina, Sachie Tanaka, Tatsuya Kumano, Kenichiro Imura, Katsumi Shimomura, Jun Ikeda, Fumihiro Taniguchi, Yasuo Ueshima, Tecchuu Lee, Eito Ikeda, Eigo Otsuji, Yasuhiro Shioaki
Massive gastrointestinal bleeding from gastrointestinal varices is one of the most serious complications in patients with portal hypertension. However, if no bleeding point can be detected by endoscopy in the predilection sites of gastrointestinal varices, such as the esophagus and stomach, ectopic gastrointestinal variceal bleeding should be considered as a differential diagnosis. Herein, we report a case of ectopic ileal variceal bleeding in a 57-year-old woman, which was successfully diagnosed by multi-detector row CT (MDCT) and angiography and treated by segmental ileum resection...
December 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29342468/the-role-of-history-of-gastro-duodenal-ulcer-in-patients-with-upper-gastrointestinal-bleeding
#15
Yusaku Takatori, Motohiko Kato, Yukie Sunata, Yuichiro Hirai, Yoko Kubosawa, Keichiro Abe, Yoshiaki Takada, Tetsu Hirata, Shigeo Banno, Michiko Wada, Satoshi Kinoshita, Hideki Mori, Kaoru Takabayashi, Miho Kikuchi, Masahiro Kikuchi, Masayuki Suzuki, Toshio Uraoka
BACKGROUND: Some scoring systems have been introduced to predict the need for performing urgent endoscopy in patients with upper gastrointestinal bleeding (UGIB). However, in an emergency situation, this intervention is insufficient and cannot easily provide the required treatment. AIM: To identify new risk factors that can predict the need for endoscopic intervention (EI) in UGIB patients. METHODS: This is a retrospective cross-sectional study...
January 17, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29340282/should-vasoconstrictors-be-considered-in-a-cirrhotic-patient-with-acute-non-variceal-upper-gastrointestinal-bleeding
#16
Xingshun Qi, Hongyu Li, Xiaodong Shao, Zhendong Liang, Xia Zhang, Ji Feng, Hao Lin, Xiaozhong Guo
Varices manifest as a major etiology of upper gastrointestinal bleeding in patients with chronic liver diseases, such as liver cirrhosis and hepatocellular carcinoma. By contrast, non-variceal upper gastrointestinal bleeding is rare. Pharmacological treatment differs between patients with variceal and non-variceal bleeding. Vasoconstrictors are recommended for the treatment of variceal bleeding, rather than non-variceal bleeding. In contrast, pump proton inhibitors are recommended for the treatment of non-variceal bleeding, rather than variceal bleeding...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29340247/weekend-effect-in-upper-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis
#17
Pei-Ching Shih, Shu-Jung Liu, Sung-Tse Li, Ai-Chen Chiu, Po-Chuan Wang, Lawrence Yu-Min Liu
Aim: To perform a systematic review and meta-analysis of the weekend effect on the mortality of patients with upper gastrointestinal bleeding(UGIB). Methods: The review protocol has been registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42017073313) and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a search of the PUBMED, COCHRANE, EMBASE and CINAHL databases from inception to August 2017...
2018: PeerJ
https://www.readbyqxmd.com/read/29317941/rockall-score-larger-than-7-as-a-reliable-criterion-for-the-selection-of-indications-for-preventive-transarterial-embolization-in-a-subgroup-of-high-risk-elderly-patients-after-primary-endoscopic-hemostasis-for-non-variceal-upper-gastrointestinal-bleeding
#18
Aleksejs Kaminskis, Patricija Ivanova, Sanita Ponomarjova, Maksims Mukans, Viesturs Boka, Guntars Pupelis
Background: Transarterial embolization (TAE) is an alternative procedure to repeat endoscopy or surgical intervention in the case of re-bleeding after primary endoscopic treatment. The aim of the study was to assess the Rockall score as a criterion for TAE in the case of re-bleeding after endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). Methods: Out of the 673 patients who underwent emergent endoscopic hemostasis due to NVUGIB, 111 had a high risk of re-bleeding having a Forrest I-IIb ulcer and the Rockall score ≥ 5...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#19
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29315156/bleeding-risk-of-variceal-band-ligation-in-extrahepatic-portal-vein-obstruction-is-not-increased-by-oral-anticoagulation
#20
Maeva Guillaume, Camille Christol, Aurélie Plessier, Michèle Corbic, Jean-Marie Péron, Agnès Sommet, Pierre-Emmanuel Rautou, Yann Consigny, Jean-Pierre Vinel, Charles-Dominique Valla, Christophe Bureau
BACKGROUND AND OBJECTIVES: Noncirrhotic nontumoral extrahepatic portal vein obstruction (EHPVO) is the second leading cause of portal hypertension (PHT) and is mainly related to prothrombotic disorders. Patients with EHPVO often require prolonged oral anticoagulation therapy (OAT) together with variceal band ligation (VBL) to prevent thrombosis recurrence and PHT-related bleeding, respectively. The benefit-risk balance of VBL in this context remains unknown. We aimed to assess upper gastrointestinal bleeding (UGB) risk and variceal eradication efficacy in EHPVO patients undergoing a VBL program without stopping OAT...
January 8, 2018: European Journal of Gastroenterology & Hepatology
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