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https://www.readbyqxmd.com/read/27930875/comparison-of-three-scoring-systems-in-predicting-clinical-outcomes-in-patients-with-acute-upper-gastrointestinal-bleeding-a-prospective-observational-study
#1
Min Zhong, Wan Jun Chen, Xiao Ye Lu, Jie Qian, Chang Qing Zhu
OBJECTIVE: To compare the performance of the Glasgow-Blatchford score (GBS), modified GBS (mGBS), and AIMS65 in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding (AUGIB). METHODS: This study enrolled 320 consecutive patients with AUGIB. High-risk and low-risk patients were categorized according to the GBS, mGBS and AIMS65 scoring systems. The primary outcome was the occurrence of adverse events. Secondary outcomes were occurrences of rebleeding, in-hospital mortality, and need for clinical intervention...
December 8, 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27928803/-efficacy-analysis-of-laparoscopic-curve-resection-for-gastric-gastrointestinal-stromal-tumor
#2
Minzhe Li, Jian Shen, Yanfu Du, Dehong Xie, Hao Qu, Yudong Zhang
OBJECTIVE: To evaluate the feasibility and safety of curved cutter stapler in laparoscopic curve resection for gastric gastrointestinal stromal tumor(GIST). METHODS: A retrospective clinical study was carried out with the clinical data of 19 cases of gastric GIST, who received laparoscopic curve resection with the curved cutter stapler during the period between January 2015 and December 2015 in Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27928663/volume-of-hospital-is-important-for-the-prognosis-of-high-risk-patients-with-nonvariceal-upper-gastrointestinal-bleeding-nvugib
#3
Jin Woo Choi, Seong Woo Jeon, Jung Gu Kwon, Dong Wook Lee, Chang Yoon Ha, Kwang Bum Cho, Byung Ik Jang, Jung Bae Park, Youn Sun Park
BACKGROUND AND AIM: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a potentially life-threatening hospital emergency requiring hemodynamic stabilization and resuscitation. This study is carried out to determine whether hospital volume can influence outcome in patients with NVUGIB. METHOD: This is a retrospective study with a prospective cohort database (KCT 0000514. cris.nih.go.kr). Eight teaching hospitals were divided into two different groups: high-volume centers (HVC, ≥60 NVUGIB patients/year, four clinics) and low-volume centers (LVC, <60 NVUGIB patients/year, four clinics)...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27925464/risk-factors-for-severity-and-recurrence-of-colonic-diverticular-bleeding
#4
Natércia Joaquim, Paulo Caldeira, Artur G Antunes, Marta Eusébio, Horácio Guerreiro
BACKGROUND: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined. OBJECTIVE: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding. METHODS: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution...
December 7, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27922890/tolerability-and-biological-effects-of-long-acting-octreotide-in-patients-with-continuous-flow-left-ventricular-assist-devices
#5
Rajiv Malhotra, Keyur B Shah, Raveen Chawla, Sammy Pedram, Melissa C Smallfield, Anna G Priday, Christine T DeWilde, Donald F Brophy
Patients with implanted continuous, non-pulsatile, left ventricular assist devices (LVADs) have increased occurrence of gastrointestinal bleeding (GIB). While the pathophysiology is multifactorial, there are few treatments beyond supportive care. Octreotide acetate is a somatostatin analog that reduces GIB in various patient populations. However, there are sparse case-series that suggest octreotide acetate may reduce GIB in LVAD patients. This 10 patient, 28-week Phase I study evaluated the safety and tolerability of octreotide acetate long-acting release (LAR) 20 mg depot injection every four weeks until week 16 following LVAD placement...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922855/liver-stiffness-predicts-variceal-bleeding-in-hiv-hcv-coinfected-patients-with-compensated-cirrhosis
#6
Nicolás Merchante, Antonio Rivero-Juárez, Francisco Téllez, Dolores Merino, Maria José Ríos-Villegas, Guillermo Ojeda-Burgos, Mohamed Omar, Juan Macías, Antonio Rivero, Monserrat Pérez-Pérez, Miguel Raffo, Inmaculada López-Montesinos, Manuel Márquez-Solero, Maria Amparo Gómez-Vidal, Juan A Pineda
BACKGROUND: A liver stiffness (LS) < 21 kPa has a high negative predictive value (NPV) to exclude the presence of esophageal varices (EV) at risk of bleeding in HIV/HCV-coinfected patients. Consequently, upper gastrointestinal endoscopy (UGE) for the screening of EV could be avoided in these patients. However, this strategy has not been widely accepted due to concerns about its safety. OBJECTIVE: To assess the ability of LS to predict the risk of portal hypertensive gastrointestinal bleeding (PHGB) in HIV/HCV-coinfected patients with compensated cirrhosis...
December 5, 2016: AIDS
https://www.readbyqxmd.com/read/27921360/mortality-in-patients-who-discontinue-low-dose-acetylsalicylic-acid-therapy-after-upper-gastrointestinal-bleeding
#7
Antonio González-Pérez, María Eugenia Sáez, Saga Johansson, Péter Nagy, Luis A García Rodríguez
PURPOSE: Discontinuing low-dose acetylsalicylic acid (ASA) therapy after upper gastrointestinal bleeding (UGIB) may increase the risk of cardiovascular-related death. Our aim was to compare mortality in UK primary care patients who discontinue ASA after UGIB with that in patients who continue therapy. METHODS: ASA users at the time of UGIB and who were alive 30 days after were selected using The Health Improvement Network. Predictors of survival were assessed using adjusted Cox proportional hazards regression models...
December 6, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27920640/intussuscepting-ampullary-adenoma-an-unusual-cause-of-gastric-outlet-obstruction-leading-to-cavitating-lung-lesions
#8
Simon J McCluney, Vickna Balarajah, Alex Giakoustidis, Joanne Chin-Aleong, Bryony Lovett, Hemant M Kocher
Ampullary adenomas are a rare clinical entity, occurring at a rate of 0.04-0.12% in the general population. They are premalignant lesions which have the capability to progress to malignancy, and they should be excised if they are causing immediate symptoms and/or are likely to degenerate to carcinoma. Intestinal intussusception in adults is rare and, unlike in children, is often due to a structural pathology. Intussuscepting duodenal/ampullary adenomas have been reported in the literature on 13 previous occasions, however never before with this presentation...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#9
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27917124/the-benefit-and-safety-of-aspirin-for-primary-prevention-of-ischemic-stroke-a-meta-analysis-of-randomized-trials
#10
REVIEW
Hong Lei, Qian Gao, Shan-Rong Liu, Jian Xu
Background: Although aspirin is effective in the secondary prevention of stroke among men and women, its use in primary prevention remains controversial. We conducted a meta-analysis of randomized trials to evaluate the benefit and safety of aspirin for the primary prevention of ischemic stroke. Methods: We searched three electronic databases (Medline, the Cochrane Central Register of Controlled Trials, and Embase) for articles published before August 1st, 2016. Randomized trials reporting the effect of aspirin on the primary prevention of ischemic stroke and its side effects (hemorrhagic stroke and severe gastrointestinal bleeding) were included...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#11
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27906917/efficacy-and-safety-of-tc-325-hemospraytm-for-non-variceal-upper-gastrointestinal-bleeding-at-middlemore-hospital-the-early-new-zealand-experience
#12
Hannah Giles, Dinesh Lal, Stephen Gerred, Paul Casey, Alasdair Patrick, Derek Luo, Ravinder Ogra
AIMS: A case series to review early experiences with HemosprayTM for a variety of non-variceal upper gastrointestinal bleeding (UGIB) at Middlemore Hospital. METHODS: HemosprayTM was administered therapeutically as first line or rescue at the discretion of the endoscopist. All cases of UGIB requiring HemosprayTM at Middlemore Hospital were identified to the investigator who undertook analysis of electronic and hard copy notes. RESULTS: Between October 2013 and July 2016, 36 patients were treated endoscopically with HemosprayTM...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27904252/hemobilia
#13
REVIEW
Rakesh Navuluri
Hemobilia is a rare source of upper gastrointestinal bleeding, though the incidence is increasing along with the rise in minimally invasive biliary interventions. Prompt diagnosis and treatment rests on having appropriate clinical suspicion which should be based on the patient's presenting signs and symptoms, as well as history including recent instrumentation. Endoscopy should be reserved for cases of upper gastrointestinal bleeding with low suspicion for hemobilia. Interventional radiology may be the first-line diagnostic and therapeutic option for patients with a high suspicion of hemobilia...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27903032/-interventional-left-atrial-appendage-closure-in-a-patient-with-gave-syndrome
#14
Christian Fastner, Sebastian Belle, Ibrahim Akin
History and findings | A 56-year-old female with a gastric antral vascular ectasia (GAVE) suffered from recurrent episodes of upper gastrointestinal bleeding. Because of a history of a permanent atrial fibrillation (CHA2DS2-VASc score 3 points) an oral anticoagulation therapy with phenprocoumon was carried out which even worsened the bleeding frequency and intensity. A change of medication to low-molecular weight heparin did not lead to success. The frequent periods in hospital limited the patient's quality of life...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27902749/risk-factors-associated-with-renal-involvement-in-childhood-henoch-sch%C3%A3-nlein-purpura-a-meta-analysis
#15
Han Chan, Yan-Ling Tang, Xiao-Hang Lv, Gao-Fu Zhang, Mo Wang, Hai-Ping Yang, Qiu Li
BACKGROUND AND OBJECTIVE: Henoch-Schönlein purpura (HSP) is an important cause of chronic kidney disease in children. This meta-analysis identified risk factors associated with renal involvement in childhood HSP. METHODS: PubMed, Embase, and Web of Science were searched. The quality of all eligible studies was assessed using the Newcastle-Ottawa scale criteria. An analysis of possible risk factors was conducted to report the odds ratio (OR) and weighted mean difference (WMD)...
2016: PloS One
https://www.readbyqxmd.com/read/27895392/determination-of-the-adequate-dosage-of-rebamipide-a-gastric-mucoprotective-drug-to-prevent-low-dose-aspirin-induced-gastrointestinal-mucosal-injury
#16
Kazuhiro Ota, Toshihisa Takeuchi, Sadaharu Nouda, Haruhiko Ozaki, Shinpei Kawaguchi, Yoshiaki Takahashi, Satoshi Harada, Shoko Edogawa, Yuichi Kojima, Takanori Kuramoto, Kazuhide Higuchi
Small intestinal mucosal injury caused by low-dose aspirin is a common cause of obscure gastrointestinal bleeding. We aimed to investigate the protective effects and optimal dose of rebamipide for low-dose aspirin-induced gastrointestinal mucosal injury. In this prospective randomized trial, 45 healthy volunteers (aged 20-65 years) were included and divided into three groups. The groups received enteric-coated aspirin 100 mg (low-dose aspirin) plus omeprazole 10 mg (Group A: proton pump inhibitor group), low-dose aspirin plus rebamipide 300 mg (Group B: standard-dose group), or low-dose aspirin plus rebamipide 900 mg (Group C: high-dose group)...
November 2016: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/27891047/endoscopic-submucosal-dissection-outcomes-for-gastroesophageal-tumors-in-low-volume-units-a-multicenter-survey
#17
Ahmad Najib Azmi, Christopher J L Khor, Khek-Yu Ho, Rapat Pittayanon, Rungsun Rerknimitr, Thawee Ratanachu-Ek, Doreen S C Koay, Jianyi Calvin Koh, Shiaw-Hooi Ho, Khean-Lee Goh, Sanjiv Mahadeva
Background and Aims. Endoscopic submucosal dissection (ESD) outcomes have traditionally been reported from high volume centers in East Asia. Data from low volume centers in other parts of Asia remain sparse. Methods. A retrospective survey with a structured questionnaire of 5 tertiary centers in 3 countries in South East Asia was conducted. Details of training and clinical outcomes of ESD cases, with follow-up data from these centers, were analyzed. Results. Seven endoscopists from the 5 centers performed a total of 35 cases of ESD in the upper gastrointestinal tract (UGIT) over a 6-year duration...
2016: Diagnostic and Therapeutic Endoscopy
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#18
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27888303/dual-energy-ct-workflow-multi-institutional-consensus-on-standardization-of-abdominopelvic-mdct-protocols
#19
Bhavik N Patel, Lauren Alexander, Brian Allen, Lincoln Berland, Amir Borhani, Achille Mileto, Courtney Moreno, Desiree Morgan, Dushyant Sahani, William Shuman, Eric Tamm, Mitchell Tublin, Benjamin Yeh, Daniele Marin
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used...
November 25, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#20
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
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