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https://www.readbyqxmd.com/read/28449186/the-risk-of-lower-gastrointestinal-bleeding-in-low-dose-aspirin-users
#1
W-C Chen, K-H Lin, Y-T Huang, T-J Tsai, W-C Sun, S-K Chuah, D-C Wu, P-I Hsu
BACKGROUND: Aspirin increases the risk of gastrointestinal bleeding. AIM: To investigate the risk of lower gastrointestinal bleeding (LGIB) in aspirin users. METHODS: Low-dose (75-325 mg daily) aspirin users and controls matched by age, gender and enrollment time in a 1:5 ratio were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. Cox proportional hazard regression models were developed to evaluate the predictors of LGIB with adjustments for age, gender, comorbidities including coronary artery disease, ischaemic stroke, diabetes, hypertension, chronic kidney disease, liver cirrhosis, chronic obstructive pulmonary disease, dyslipidemia, uncomplicated peptic ulcer disease, history of peptic ulcer bleeding, and concomitant use of clopidogrel, ticlopidine, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, steroids, proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), nitrates, alendronate, selective serotonin reuptake inhibitors (SSRIs) and calcium channel blockers...
April 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28445167/spatial-features-of-dose-surface-maps-from-deformably-registered-plans-correlate-with-late-gastrointestinal-complications
#2
Calyn R Moulton, Michael J House, Victoria Lye, Colin I Tang, Michele Krawiec, David J Joseph, James W Denham, Martin A Ebert
This study investigates the associations between spatial distribution of dose to the rectal surface and observed gastrointestinal toxicities after deformably registering each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate brachytherapy (HDRBT) prostate cancer treatment. The study contains data for 118 patients where the HDRBT CT was deformably-registered to the EBRT CT. The EBRT and registered HDRBT TG43 dose distributions in a reference 2 Gy/fraction were 3D-summed. Rectum dose-surface maps (DSMs) were obtained by virtually unfolding the rectum surface slice-by-slice...
April 26, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#3
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#4
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28403994/risk-of-gastrointestinal-bleeding-with-direct-oral-anticoagulants-a-systematic-review-and-network-meta-analysis
#5
Nick Burr, Katie Lummis, Ruchit Sood, John Samuel Kane, Aaron Corp, Venkataraman Subramanian
BACKGROUND: Direct oral anticoagulants are increasingly used for a wide range of indications. However, data are conflicting about the risk of major gastrointestinal bleeding with these drugs. We compared the risk of gastrointestinal bleeding with direct oral anticoagulants, warfarin, and low-molecular-weight heparin. METHODS: For this systematic review and meta-analysis, we searched MEDLINE and Embase from database inception to April 1, 2016, for prospective and retrospective studies that reported the risk of gastrointestinal bleeding with use of a direct oral anticoagulant compared with warfarin or low-molecular-weight heparin for all indications...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396990/incidence-and-outcomes-of-early-left-ventricular-thrombus-following-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#6
Shafik Khoury, Sarit Carmon, Gilad Margolis, Gad Keren, Yacov Shacham
BACKGROUND: Since the advent of primary percutaneous coronary intervention (PCI), studies have reported a declining incidence of left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). We investigated the incidence and outcomes of early (pre-discharge) LVT in the contemporary era of PCI practice in a large cohort of STEMI patients. METHODS: We retrospectively studied 2071 consecutive STEMI patients who underwent successful primary PCI...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28396275/relationship-of-time-to-presentation-after-onset-of-upper-gi-bleeding-with-patient-characteristics-and-outcomes-a-prospective-study
#7
Loren Laine, Stig B Laursen, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
BACKGROUND & AIMS: We performed a prospective multi-national study of patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) and assessed the relationship of time to presentation after onset of UGIB symptoms with patient characteristics and outcomes. METHODS: Consecutive patients presenting with overt UGIB (red-blood emesis, coffee-ground emesis and/or melena) from March 2014 to March 2015 at 6 hospitals were included. Multiple pre-defined patient characteristics and outcomes were collected...
April 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28395384/laparoscopic-and-luminal-endoscopic-cooperative-surgery-can-be-a-standard-treatment-for-submucosal-tumors-of-the-stomach-a-retrospective-multicenter-study
#8
Tatsuo Matsuda, Souya Nunobe, Toshiyuki Kosuga, Hiroshi Kawahira, Noriyuki Inaki, Shuji Kitashiro, Nobutsugu Abe, Isao Miyashiro, Sayaka Nagao, Masahiko Nishizaki, Naoki Hiki
Background and study aims We have developed a combined laparoscopic and luminal endoscopic surgery technique for resection of gastric submucosal tumors (SMTs) that can be performed without excessive resection of the stomach. In a multicenter retrospective study we aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for gastric SMT resection. Patients and methods Between October 2007 and December 2011, 126 patients with gastric SMTs underwent LECS at 8 institutions...
May 2017: Endoscopy
https://www.readbyqxmd.com/read/28381079/complications-of-colorectal-resection-for-endometriosis-review
#9
Jerome Bouaziz, David Soriano
Based on a review of the current literature, we will discuss early and late (more than 3 months postoperative) complications associated with surgery for colorectal endometriosis resection. The most common surgical complications are: rectovaginal fistulae, anastomotic leakages and abscesses. Post-operative bleeding occurs rarely but has also been reported; and usually requires blood transfusion without surgical interventions. The selection of patients for surgery requires a multidisciplinary approach and complete preoperative imaging work-up by an experienced physician...
April 4, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28374257/endoscopic-submucosal-dissection-for-gastric-gastrointestinal-stromal-tumors-a-retrospective-cohort-study
#10
Wei An, Ping-Bo Sun, Jie Gao, Fei Jiang, Feng Liu, Jie Chen, Dong Wang, Zhao-Shen Li, Xin-Gang Shi
BACKGROUND AND AIM: Endoscopic submucosal dissection (ESD) has been used to remove submucosal tumors. However, with regard to the potential malignant behavior of gastrointestinal stromal tumors (GISTs), whether ESD can be recommended for treatment is still controversial. Therefore, we evaluated the efficacy and safety of ESD for removal of GISTs in the muscularis propria (MP) layer and to assess the possible risk factors for a gastric-wall defect (GWD). METHODS: For 168 GISTs located in the MP layer from 168 consecutive patients, the baseline information, complications, and therapeutic outcomes were recorded...
April 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28363584/upper-gastrointestinal-toxicity-associated-with-long-term-aspirin-therapy-consequences-and-prevention
#11
Carl J Lavie, Colin W Howden, James Scheiman, James Tursi
Antiplatelet therapy represents a fundamental part of preventive management for patients who are at risk of a secondary cardiovascular disease (CVD) event. In most cases, the antiplatelet regimen is based on low-dose aspirin, a drug that is highly effective in reducing the incidence of CVD events, but is associated with a substantial risk of gastrointestinal (GI) toxicity. The dyspeptic symptoms, which can result from aspirin administration, and which may occur with or without associated ulceration and bleeding, may lead patients to discontinue therapy, thus increasing their CVD risk...
May 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28361278/cost-effectiveness-of-gastroprotection-with-proton-pump-inhibitors-in-older-low-dose-acetylsalicylic-acid-users-in-the-netherlands
#12
Sek Hung Chau, Reinier L Sluiter, Wietske Kievit, Michel Wensing, Martina Teichert, Jacqueline G Hugtenburg
PURPOSE: The present study aimed to assess the cost effectiveness of concomitant proton pump inhibitor (PPI) treatment in low-dose acetylsalicylic acid (LDASA) users at risk of upper gastrointestinal (UGI) adverse effects as compared with no PPI co-medication with attention to the age-dependent influence of PPI-induced adverse effects. METHODS: We used a Markov model to compare the strategy of PPI co-medication with no PPI co-medication in older LDASA users at risk of UGI adverse effects...
March 30, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28338108/vkorc1-1639-g-a-polymorphism-and-the-risk-of-non-variceal-upper-gastrointestinal-bleeding
#13
Ioana Groza, Dana Matei, Marcel Tantau, Adrian P Trifa, Sorin Crisan, Stefan C Vesa, Corina Bocsan, Anca D Buzoianu, Monica Acalovschi
BACKGROUND AND AIMS: The mutations in the gene that encodes vitamin K epoxide reductase (VKOR) enzyme are responsible for low levels of vitamin K. The purpose of this study was to evaluate whether the presence of the VKORC1 -1639 G> A polymorphism is a risk factor for non-variceal upper gastrointestinal bleeding (UGIB) in patients without concomitant therapy with vitamin K antagonists. METHODS: This case-control study comprised 163 consecutive patients diagnosed with UGIB and 178 controls, in whom the diagnosis of UGIB was excluded...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#14
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28320118/prothrombin-complex-concentrate-administration-for-bleeding-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-the-samurai-nvaf-study
#15
Sohei Yoshimura, Shoichiro Sato, Kenichi Todo, Yasushi Okada, Eisuke Furui, Takayuki Matsuki, Hiroshi Yamagami, Masatoshi Koga, Jun C Takahashi, Kazuyuki Nagatsuka, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: Antidotes appropriate for non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are not yet in widespread clinical use. Efficacy of prothrombin complex concentrate (PCC) in NOAC-associated bleeding remains unclarified. METHODS: Ten NOAC users (4 women, median 74years old) who developed major bleeding and received PCC were prospectively enrolled. Eight single-center NOAC users (0 women, median 74years old) with intracerebral hemorrhage, who over the same period did not receive PCC, were studied for comparison...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#16
Xiaoyan Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28284460/the-impact-of-prolonged-waiting-time-for-coronary-care-unit-admission-on-patients-with-non-st-elevation-acute-coronary-syndrome
#17
Chien-Chih Chen, I-Min Chiu, Fu-Jen Cheng, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). METHODS: Patients were divided into 2 groups according to the CCU waiting time (<12h and >12h)...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28272736/reintroduction-of-anti-thrombotic-therapy-after-a-gastrointestinal-haemorrhage-if-and-when
#18
REVIEW
Martin J Scott, Andrew Veitch, Jecko Thachil
Gastrointestinal haemorrhage is a common clinical scenario and, in those using antithrombotic agents, the risk is significantly increased. Management of these patients, in terms of initial resuscitation is well established and numerous guidelines exist in this area. However, few studies have addressed the subsequent dilemma of if and when antithrombotic agents should be reintroduced. Consequently, practice is variable and not necessarily evidenced-based. Overall, for patients that are either anticoagulated or using antiplatelet drugs for secondary prophylaxis, there is a clear benefit to restarting these agents...
March 8, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28268536/segmentation-of-angiodysplasia-lesions-in-wce-images-using-a-map-approach-with-markov-random-fields
#19
Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima
This paper deals with the segmentation of angiodysplasias in wireless capsule endoscopy images. These lesions are the cause of almost 10% of all gastrointestinal bleeding episodes, and its detection using the available software presents low sensitivity. This work proposes an automatic selection of a ROI using an image segmentation module based on the MAP approach where an accelerated version of the EM algorithm is used to iteratively estimate the model parameters. Spatial context is modeled in the prior probability density function using Markov Random Fields...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226712/segmentation-of-angiodysplasia-lesions-in-wce-images-using-a-map-approach-with-markov-random-fields
#20
Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima, Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima, Pedro M Vieira, Carla R Goncalves, Bruno Goncalves, Carlos S Lima
This paper deals with the segmentation of angiodysplasias in wireless capsule endoscopy images. These lesions are the cause of almost 10% of all gastrointestinal bleeding episodes, and its detection using the available software presents low sensitivity. This work proposes an automatic selection of a ROI using an image segmentation module based on the MAP approach where an accelerated version of the EM algorithm is used to iteratively estimate the model parameters. Spatial context is modeled in the prior probability density function using Markov Random Fields...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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