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low gastrointestinal bleeding

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https://www.readbyqxmd.com/read/29346827/efficacy-and-complications-of-submucosal-tunneling-endoscopic-resection-for-upper-gastrointestinal-submucosal-tumors-and-exploration-for-influencing-factors
#1
Shunzhe Song, Xu Wang, Shen Zhang, Yanxia Li, Xiaonan Zhang, Xufang Chu
BACKGROUND:  Submucosal tunneling endoscopic resection (STER) has emerged as a feasible technique for resecting upper gastrointestinal (GI) tract submucosal tumors (SMTs) through natural orifice transluminal endoscopic surgery. STER reduces the risk of postoperative perforation and abdominal infections and promotes rapid wound healing. The aim of this meta-analysis was to evaluate the safety and efficacy of STER for small (≤ 3.5 cm) upper GI SMTs and explore the potential factors influencing STER's efficacy and complication rate...
January 18, 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29345591/should-antithrombotic-treatment-strategies-in-east-asians-differ-from-caucasians-focused-on-acs-or-pci-treated-patients
#2
Jae Seok Bae, Jong-Hwa Ahn, Udaya Tantry, Paul A Gurbel, Young-Hoon Jeong
With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#3
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29340282/should-vasoconstrictors-be-considered-in-a-cirrhotic-patient-with-acute-non-variceal-upper-gastrointestinal-bleeding
#4
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/29335343/association-between-glucocorticoid-exposure-and-healthcare-expenditures-for-potential-glucocorticoid-related-adverse-events-in-patients-with-rheumatoid-arthritis
#5
Jennie H Best, Amanda M Kong, Gregory M Lenhart, Khaled Sarsour, Marni Stott-Miller, Yong Hwang
OBJECTIVE: Oral glucocorticoid (OGC) use for rheumatoid arthritis (RA) is debated because of the adverse event (AE) profile of OGC. We evaluated the associations between cumulative doses of OGC and potential OGC-related AE, and quantified the associated healthcare expenditures. METHODS: Using the MarketScan databases, patients ≥ 18 years old who have RA with continuous enrollment from January 1 to December 31, 2012 (baseline), and from January 1 to December 31, 2013 (evaluation period), were identified...
January 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29325750/double-balloon-enteroscopy-dbe-in-patients-presenting-with-obscure-gastrointestinal-bleeding-ogib
#6
Esmat Sheba, Ali Farag, Wael Aref, Shaimaa Elkholy, Omar Ashoush
BACKGROUND AND STUDY AIMS: Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of unknown origin that persists or recurs after an initial negative investigation. Identifying the source of OGIB represents a diagnostic challenge that is frequently focused on visualizing the small intestine. Conventional diagnostic methods, such as push enteroscopy, small-bowel follow-through, radionuclide scanning, and angiography, each exhibit inherent limitations. Double balloon enteroscopy (DBE) was designed specifically to evaluate the entire small bowel...
January 8, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/29324514/anticoagulant-bridge-comparison-in-mechanical-circulatory-support-patients
#7
Richard H Cosgrove, Robyn L Basken, Richard G Smith, Chiu-Hsieh Hsu, Toshinobu Kazui, Brandon K Martinez, Richard W Burt, Eric S Crawford, Scott D Lick, Zain Khalpey
Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29317942/carcinoids-and-capsules-a-case-series-highlighting-the-utility-of-capsule-endoscopy-in-patients-with-small-bowel-carcinoids
#8
Michael G Noujaim, Jonathan Green, May Min, Christopher R Schlieve, Krunal Patel, Mitchell Cahan, David Cave
Background: Neuroendocine tumors (NETs) or carcinoids arise at many different sites of the gastrointestinal tract. The small intestine is the most common site for NETs. Diagnosing small bowel carcinoids remains challenging given their non-specific presentations and the overall low incidence of small bowel tumors. Video capsule endoscopy (VCE) has significanly improved our ability to detect small bowel malignancies. We explore the value of VCE in the initial workup and management of a series of small bowel carcinoid patients...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29288707/improving-the-skin-penetration-and-antifebrile-activity-of-ibuprofen-by-preparing-nanoparticles-using-emulsion-solvent-evaporation-method
#9
Yiping Deng, Fengjian Yang, Xiuhua Zhao, Lu Wang, Weiwei Wu, Chang Zu, Mingfang Wu
Ibuprofen (IBU) is an effective analgesic, non-steroidal anti-inflammatory drug. Unfortunately, oral IBU can cause adverse gastrointestinal drug reactions, such as bleeding and ulcerations, and increases the risk for stomach or intestinal perforations. In this study, IBU nanoparticles (IBU-NPs) were prepared through emulsion solvent evaporation and freeze-drying to improve their solubility. IBU nanoemulsion and nanosuspension were optimized through a single-factor experiment. IBU-NPs with a mean particle size of 216...
December 27, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29282637/changing-epidemiology-of-upper-gastrointestinal-hemorrhage-in-the-last-decade-a-nationwide-analysis
#10
Brandon A Wuerth, Don C Rockey
BACKGROUND: Upper gastrointestinal hemorrhage (UGIH) is common and carries substantial mortality requiring frequent hospitalizations. AIM: To investigate trends in etiology and outcome of UGIH in hospitalized patients in the USA. METHODS: Retrospective, observational cohort study of the Nationwide Inpatient Sample from 2002 to 2012 was carried out. UGIH was identified in hospitalizations with a principle ICD-9-CM diagnosis of UGIH or secondary diagnosis of UGIH with a principal diagnosis of hematemesis, blood in stool, or gastrointestinal bleeding...
December 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29280119/-efficacy-of-altemeier-procedure-in-the-treatment-of-rectal-prolapse
#11
Yonglei Cao, Yan Zhou, Congqing Jiang, Guiyi Yang, Hui Song, Lvfeng Liu, Xu Ai, Jing Zhong, Zhilin Gong, Jianhua Ding, Wei Fu, Qun Qian
OBJECTIVE: To evaluate the safety and efficacy of the perineal rectosigmoidectomy (Altemeier procedure) in the treatment of full thickness rectal prolapse. METHODS: Clinical and follow-up data of 52 patients with full thickness rectal prolapse undergoing Altemeier procedure in 9 hospitals from September 2010 to July 2016 were analyzed retrospectively. Of which 38 cases were from Zhongnan Hospital of Wuhan University, 1 case from Suizhou Central Hospital of Hubei province, 1 case from Jingzhou Second People's Hospital of Hubei province, 3 cases from Wuxue First People's Hospital of Hubei province, 1 case from Jingmen First People's Hospital of Hubei province, 1 case from Tuanfeng County Hospital of Hubei province, 4 cases from Jingzhou Central Hospital of Hubei province, 2 from PLA Rocket Army General Hospital, 1 case from the Affiliated Hospital of Xuzhou Medical University in Jiangsu province...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29273940/investigation-of-clostridium-difficile-ribotypes-in-symptomatic-patients-of-a-german-pediatric-oncology-center
#12
Arne Simon, Markus Mock, Norbert Graf, Lutz von Müller
In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29...
December 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29245228/use-of-concomitant-variceal-embolization-and-prophylactic-antiplatelet-anticoagulative-in-transjugular-intrahepatic-portosystemic-shunting-a-retrospective-study-of-182-cirrhotic-portal-hypertension-patients
#13
Yingmei Tang, Sheng Zheng, Jinhui Yang, Weimin Bao, Lihong Yang, Yingchun Li, Ying Xu, Jing Yang, Yuyun Tong, Jinhang Gao, Chengwei Tang
Transjugular intrahepatic portosystemic shunting (TIPS) is an effective treatment modality for refractory variceal bleeding and ascites in patients with cirrhotic portal hypertension (CPH). Variceal rebleeding and shunt dysfunction are major post-TIPS morbidities. This study aimed to retrospectively evaluate the effectiveness and safety of use of concomitant variceal embolization and prophylactic antiplatelet/anticoagulative in patients with CPH undergoing TIPS. Between October 2006 and October 2011, 182 patients with CPH were retrospectively and consecutively hospitalized for elective TIPS with Fluency stenting...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29238996/quality-management-of-a-massive-transfusion-protocol
#14
John R Hess, Patrick J Ramos, Nina E Sen, Virginia G Cruz-Cody, Erin E Tuott, Max J Louzon, Eileen M Bulger, Saman Arbabi, Monica B Pagano, Ryan A Metcalf
BACKGROUND: Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis. STUDY DESIGN AND METHODS: A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29238577/lower-gastrointestinal-bleeding-due-to-rectal-dieulafoy-s-lesion
#15
Omar N Nadhem, Omar A Salh, Omar H Bazzaz
Dieulafoy's lesion is a relatively rare but serious cause of gastrointestinal bleeding. It usually involves the upper gastrointestinal tract. However, it has recently been reported in different regions of the gastrointestinal tract, including the rectum. Here, we report the case of a female patient who presented with fresh bleeding per rectum for 1 day with low hemoglobin level. Colonoscopy revealed an actively bleeding rectal Dieulafoy's lesion which was successfully treated with a clip. To our knowledge, there have been few reported cases of lower gastrointestinal bleeding caused by Dieulafoy's lesion in the rectum...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29232212/cost-of-major-complications-after-liver-resection-in-the-united-states-are-high-volume-centers-cost-effective
#16
Jay J Idrees, Fabian M Johnston, Joseph K Canner, Mary Dillhoff, Carl Schmidt, Elliott R Haut, Timothy M Pawlik
OBJECTIVE: The aim of the study was to estimate the cost of major complications after liver resection and determine whether high-volume (HV) centers are cost-effective. METHODS: From 2002 to 2011, 96,107 cases of liver resection performed in the United States were identified using Nationwide Inpatient Sample. Hospitals were categorized as HV (150+ cases/yr), medium-volume (51-149 cases/yr), and low-volume (LV) (1-50 cases/yr) centers. Multivariable regression analysis identified predictors of cost...
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29228736/bleeding-risk-with-dabigatran-rivaroxaban-warfarin-and-antiplatelet-agent-in-asians-with-non-valvular-atrial-fibrillation
#17
Yi-Hsin Chan, Yung-Hsin Yeh, Hui-Tzu Tu, Chi-Tai Kuo, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Lai-Chu See
It is not understood if dabigatran or rivaroxaban are superior to antiplatelet agents (AA) for safety outcomes in Asians with non-valvular atrial fibrillation (NVAF). In this study we evaluated the bleeding risk of dabigatran, rivaroxaban, warfarin and AA in Asians with NVAF. This national retrospective cohort study analyzed 6,600, 3,167, 5,338 and 8,238 consecutive NVAF patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29221664/mechanisms-of-damage-to-the-gastrointestinal-tract-from-non-steroidal-anti-inflammatory-drugs
#18
REVIEW
Ingvar Bjarnason, Carmelo Scarpignato, Erik Holmgren, Michael Olszewski, Kim D Rainsford, Angel Lanas
Non-steroidal anti-inflammatory drugs (NSAIDs) can damage the gastrointestinal tract, causing widespread morbidity and mortality. Although mechanisms of damage involve the activities of prostaglandin-endoperoxide synthase 1 (PTGS1 or COX1) and PTGS1 (COX2), other factors are involved. We review mechanisms of gastrointestinal damage induction by NSAIDs, via COX-mediated and COX-independent processes. NSAIDs interact with phospholipids and uncouple mitochondrial oxidative phosphorylation, which initiates biochemical changes that impair function of the gastrointestinal barrier...
December 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29212103/recurrent-diffuse-gastric-bleeding-as-a-leading-symptom-of%C3%A2-gastrointestinal-al-amyloidosis
#19
Caspar Franck, Marino Venerito, Jochen Weigt, Albert Roessner, Peter Malfertheiner
Amyloidosis is a rare disease (incidence about 0.8/100 000) characterized by extracellular tissue deposition of fibrils composed of low molecular weight subunits of a variety of serum proteins. Clinical manifestations are largely determined by the type of precursor protein, the tissue distribution and the amount of amyloid deposition. Gastrointestinal (GI) manifestations of amyloidosis are even more uncommon (3 % of all amyloidosis patients). Symptoms of GI amyloidosis are nonspecific, heterogeneous, and include weight loss, GI bleeding, heartburn, early satiety, diarrhea and abdominal pain...
December 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29200891/conditioning-on-future-exposure-to-define-study-cohorts-can-induce-bias-the-case-of-low-dose-acetylsalicylic-acid-and-risk-of-major-bleeding
#20
Jennifer L Lund, Erzsébet Horváth-Puhó, Szimonetta Komjáthiné Szépligeti, Henrik Toft Sørensen, Lars Pedersen, Vera Ehrenstein, Til Stürmer
Background: A principle of cohort studies is that cohort membership is defined by current rather than future exposure information. Pharmacoepidemiologic studies using existing databases are vulnerable to violation of this principle. We evaluated the impact of using data on future redemption of prescriptions to determine cohort membership, motivated by a published example seeking to emulate a "per-protocol" association between continuous versus never use of low-dose acetylsalicylic acid (ASA) and major bleeding (e...
2017: Clinical Epidemiology
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