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https://www.readbyqxmd.com/read/28924517/breast-cancer-metastases-to-the-gastrointestinal-tract-presenting-with-anemia-and-intra-abdominal-bleed
#1
Idrees Khan, Rehan Malik, Amina Khan, Salman Assad, Mehr Zahid, Muhammad Saad Sohail, Faizan Yasin, Ahmed H Qavi
Signet ring adenocarcinoma of the breast with synchronous metastasis to the gastrointestinal (GI) tract is a rare occurrence, typically presenting with abdominal pain, dyspepsia, or GI bleed. We report a case of metastatic breast cancer presenting with a complaint of anemia. A further diagnostic evaluation revealed generalized lymphadenopathy, nodular thickening of the urinary bladder wall, bone lesions, and enlarged pancreas. Biopsies from the lymph nodes, pancreatic biopsy, and bladder nodule all revealed a signet cell carcinoma...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/28918295/case-report-primary-aortosigmoid-fistula-a-rare-cause-of-lower-gastrointestinal-bleeding
#2
Chirin Khalaf, Kim C Houlind
INTRODUCTION: A primary aortoenteric fistula (PAEF) is a communication between aorta and the gastrointestinal tract. It is a rare condition that is difficult to diagnose and therefore associated with a high mortality. PRESENTATION OF CASE: We report a rare case of a 66-year old man with an unstable bleeding PAEF. A salvage procedure was performed with a covered stent. Later, a sigmoidectomy was performed with resection of the fistula. Postoperatively, the patient suffered an infection that was treated well with antibiotics and he was discharged two weeks later with complete resolution of the fistula...
September 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28885651/the-practice-pattern-of-anticoagulation-prophylaxis-for-patients-undergoing-total-hip-replacement-in-a-major-orthopaedic-centre-a-retrospective-review
#3
Sura H Hamza, Paul Reynolds
METHODS: In a major centre for orthopaedic surgery, we retrospectively analysed 1,469 patients who underwent elective hip replacement since 2010. All patients but 2 received anticoagulation postoperatively and rivaroxaban was the preferred choice for anticoagulation. RESULTS: The incidence of all adverse events in those who received rivaroxaban was 1.7%. Only 0.3% had a minor upper gastrointestinal bleed and 1.3% developed a minor wound bleeding or haematoma. The occurrence of symptomatic venous thromboembolism (VTE) was 0...
September 5, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28883779/users-knowledge-about-adverse-effects-of-non-steroidal-anti-inflammatory-drugs-in-tirana-albania
#4
Dajana Roshi, Ervin Toçi, Genc Burazeri, Peter Schröder-Bäck, Ledjan Malaj, Helmut Brand
AIM: To assess the level of knowledge of the adult users of non-steroidal anti-inflammatory drugs (NSAIDs) regarding their side effects and the socio-demographic factors associated with the use of these drugs in the adult population of Albania. METHODS: This was a cross-sectional study including a representative sample of 199 individuals aged ≥18 years (77% women; overall mean age: 30.3±10.0 years; overall response rate: 90%) who were users of NSAIDs recruited in ten different pharmacies in Tirana municipality during April-May 2015...
June 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/28882733/-risk-of-fatal-non-fatal-events-in-patients-with-previous-coronary-heart-disease-acute-myocardial-infarction-and-treatment-with-non-steroidal-anti-inflammatory-drugs
#5
REVIEW
L Muñoz Olmo, J Juan Armas, J J Gomariz García
BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk...
September 4, 2017: Semergen
https://www.readbyqxmd.com/read/28882336/comparison-of-in-hospital-outcomes-and-readmission-rates-in-acute-pulmonary-embolism-between-systemic-and-catheter-directed-thrombolysis-from-the-national-readmission-database
#6
Shilpkumar Arora, Sidakpal S Panaich, Nitesh Ainani, Varun Kumar, Nileshkumar J Patel, Byomesh Tripathi, Purav Shah, Nirali Patel, Sopan Lahewala, Abhishek Deshmukh, Apurva Badheka, Cindy Grines
There are sparse comparative data on in-hospital outcomes and readmission rates in patients with acute pulmonary embolism (PE) who receive systemic thrombolytics versus catheter-directed thrombolysis (CDT). The study cohort was derived from the National Readmission Database 2013 to 2014, subset of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. Systemic and CDT were identified using appropriate International Classification of Diseases, 9th Revision, Clinical Modification codes...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28878651/ischemic-colitis-associated-with-paclitaxel-and-carboplatin-combination
#7
Ahmed Gamal Elsayed, Roma Srivastava, Toni Pacioles, Teresa Limjoco, Maria Tria Tirona
A 62-year-old white female with a history of early-stage triple-negative breast cancer on a combination of carboplatin and paclitaxel in the adjuvant setting presented with lower gastrointestinal bleeding. She tolerated 4 cycles of dose-dense adriamycin/cyclophosphamide with no major symptoms. After 6 cycles of weekly paclitaxel in combination with carboplatin every 3 weeks, she presented with diarrhea and lower gastrointestinal bleeding. Colonosopic examination showed erythema and inflammation in the splenic flexure, descending colon, and sigmoid colon consistent with ischemic colitis...
May 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28874418/therapeutic-endoscopy-related-gi-bleeding-and-thromboembolic-events-in-patients-using-warfarin-or-direct-oral-anticoagulants-results-from-a-large-nationwide-database-analysis
#8
Naoyoshi Nagata, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Kazuhiro Watanabe, Junichi Akiyama, Naomi Uemura, Ryota Niikura
OBJECTIVE: To compare the risks of postendoscopy outcomes associated with warfarin with direct oral anticoagulants (DOACs), taking into account heparin bridging and various types of endoscopic procedures. DESIGN: Using the Japanese Diagnosis Procedure Combination database, we identified 16 977 patients who underwent 13 types of high-risk endoscopic procedures and took preoperative warfarin or DOACs from 2014 to 2015. One-to-one propensity score matching was performed to compare postendoscopy GI bleeding and thromboembolism between the warfarin and DOAC groups...
September 5, 2017: Gut
https://www.readbyqxmd.com/read/28874129/comparative-effectiveness-of-rivaroxaban-versus-warfarin-or-dabigatran-for-the-treatment-of-patients-with-non-valvular-atrial-fibrillation
#9
Faye L Norby, Lindsay G S Bengtson, Pamela L Lutsey, Lin Y Chen, Richard F MacLehose, Alanna M Chamberlain, Ian Rapson, Alvaro Alonso
BACKGROUND: Rivaroxaban is an oral anticoagulant approved in the US for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). We determined the effectiveness and associated risks of rivaroxaban versus other oral anticoagulants in a large real-world population. METHODS: We selected NVAF patients initiating oral anticoagulant use in 2010-2014 enrolled in MarketScan databases. Rivaroxaban users were matched with warfarin and dabigatran users by age, sex, enrolment date, anticoagulant initiation date, and high-dimensional propensity score...
September 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28871989/long-term-outcomes-of-phase-1-and-2-studies-of-sbrt-for-hepatic-colorectal-metastases
#10
Andrew McPartlin, Anand Swaminath, Ri Wang, Melania Pintilie, James Brierley, John Kim, Jolie Ringash, Rebecca Wong, Rob Dinniwell, Tim Craig, Laura A Dawson
PURPOSE: To report mature outcomes of prospective phase 1 and 2 studies of stereotactic body radiation therapy (SBRT) for the treatment of colorectal liver metastases (CLMs). METHODS AND MATERIALS: Patients with histologically confirmed CLMs unsuitable for resection or standard therapies were eligible for sequential phase 1 and 2 studies conducted from 2003 to 2012. RESULTS: Of 60 patients treated, 82% had received previous chemotherapy, 23% had undergone previous focal liver treatment, and 38% had extrahepatic disease at the time of SBRT...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28871658/minimal-factor-xiii-activity-level-to-prevent-major-spontaneous-bleeds-comment
#11
Akbar Dorgalaleh, Shadi Tabibian, Majid Safa, Mahmood Shams, Majid Naderi
In a recent publication by Menegatti et al. on patients with congenital factor XIII (FXIII) deficiency, an effort was made to suggest a cut-off to start prophylaxis in order to prevent spontaneous major bleeds, including central nervous system (CNS) bleeding, gastrointestinal (GI) bleeding, hematoma and hemarthrosis (grade III bleeding according to EN-RBD classification) (1). Fifteen IU/dL FXIII coagulant activity (FXIII:C) was proposed as a cut-off for this purpose. Surprisingly, in this study, ~50% of patients with FXIII:C between the lower detection limit and 29 IU/dL, experienced these bleeds and 36% of those with FXIII:C ≥ 30% had minor spontaneous bleeding (1)...
September 4, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28864318/comparison-of-the-effectiveness-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-newly-diagnosed-atrial-fibrillation
#12
Inmaculada Hernandez, Yuting Zhang, Samir Saba
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28858942/colonoscopy-in-patients-with-postmyocardial-infarction-gastrointestinal-bleeding-a-nationwide-analysis
#13
Rohan M Modi, Feng Li, Khalid Mumtaz, Alice Hinton, Scott M Lilly, Hisham Hussan, Edward Levine, Cheng Zhang, Darwin L Conwell, Somashekar G Krishna, Peter P Stanich
GOALS: The goal of this study was to evaluate outcomes of colonoscopy in the setting of post myocardial infarction (MI) gastrointestinal bleeding (GIB) in a large population-based data set. BACKGROUND: The literature to substantiate the proposed safety of colonoscopy following an acute MI is limited. STUDY: The Nationwide Inpatient Sample (2007 to 2013) was utilized to identify all adult patients (age, 18 y or above) hospitalized with a primary diagnosis of ST-elevation MI and receiving left heart catheterization (STEMI-C)...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28858078/comparative-analysis-of-diagnostic-colonoscopy-in-symptomatic-young-adults-from-south-korea-and-the-united-states
#14
MULTICENTER STUDY
Min Seob Kwak, Jae Myung Cha, Jeong-Sik Byeon, Otto S Lin, Richard A Kozarek
To date, not much is known about ethnic differences in the prevalence of colorectal neoplasia in symptomatic young patients with lower gastrointestinal symptoms. This study sought to compare diagnostic colonoscopic findings in symptomatic young patients from South Korea and the United States. Results from the first diagnostic colonoscopies in symptomatic 18- to 49-year-old patients were compared between the United States and Korean cohorts. The US cohort data were collected at Virginia Mason Medical Center in Seattle, Washington between January 2007 and January 2010, and the Korean cohort data were collected at 14 university hospitals in Korea between June 2006 and June 2015...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28857707/comparison-of-clinical-findings-between-dogs-with-suspected-anaphylaxis-and-dogs-with-confirmed-sepsis
#15
Andrea M Walters, Mauria A O'Brien, Laura E Selmic, Maureen A McMichael
OBJECTIVE To compare clinical signs, laboratory test results, and imaging findings between dogs with suspected anaphylaxis and dogs with sepsis. DESIGN Retrospective case-case study. ANIMALS 10 dogs with suspected anaphylaxis and 22 dogs with confirmed sepsis that met the criteria for systemic inflammatory response syndrome. PROCEDURES Medical records for dogs in each group were reviewed and data extracted regarding signalment; reason for hospital admission; physical examination findings; results of CBC, serum biochemical analysis, coagulation testing, cytologic examination, and microbial culture; and imaging reports...
September 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28855770/dual-antiplatelet-therapy-and-the-severity-risk-of-lower-intestinal-bleeding
#16
Neal Carlin, Fady Asslo, Raymund Sison, Hamid Shaaban, Walid Baddoura, Faiza Manji, Joseph Depasquale
BACKGROUND: Dual antiplatelet (Plt) therapy with aspirin and clopidogrel is recommended for up to 1 year following acute coronary syndrome. Many of these cardiac patients are also on anithrombotic therapy like warfarin. Lower gastrointestinal bleeding (LGIB) is the main adverse event of this treatment. AIMS: The main purpose of this study was to analyze the relationship of dual anti-Plt therapy and the risk of LGIB. METHODS: Patients' electronic charts were reviewed to include a total of 19 variables, which included age, sex, ethnicity, daily use aspirin of any dose, daily use of clopidogrel, use of nonsteroidal anti-inflammatory drugs (NSAIDs) at least twice in the last week prior to admission and the daily use of anticoagulants (warfarin, heparin), and were obtained from history and physical examination reports, lab transcripts and procedural reports...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28854073/major-bleeding-risk-during-anticoagulation-with-warfarin-dabigatran-apixaban-or-rivaroxaban-in-patients-with-nonvalvular-atrial-fibrillation
#17
Gboyega Adeboyeje, Gosia Sylwestrzak, John J Barron, Jeff White, Alan Rosenberg, Jacob Abarca, Geoffrey Crawford, Rita Redberg
BACKGROUND: The use of non-vitamin K oral anticoagulants (NOACs) has increased steadily following marketing approval; however, their relative safety in nonvalvular atrial fibrillation (NVAF) patients in real-world clinical practice remains unclear. OBJECTIVE: To compare the risk of major bleeding during anticoagulation therapy between warfarin and NOACs. METHODS: This retrospective cohort study analyzed administrative claims data on new NVAF users of warfarin, dabigatran, apixaban, or rivaroxaban in routine clinical care from November 2010 to February 2015 in a commercially insured population in the United States...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28852493/gastrointestinal-complications-induced-by-sevelamer-crystals
#18
Claudia Yuste, Evangelina Mérida, Eduardo Hernández, Ana García-Santiago, Yolanda Rodríguez, Teresa Muñoz, Gonzalo Jesús Gómez, Ángel Sevillano, Manuel Praga
BACKGROUND: Sevelamer is a phosphate binder widely used in chronic kidney disease (CKD) patients. Sevelamer, as well as other resin-based binders, can crystallize leading to the formation of concretions. Sevelamer crystals (SC) have been associated with gastrointestinal (GI) mucosal injury. We describe three new cases of GI lesions associated with SC and review previously reported cases. METHODS: We describe three new cases of GI lesions associated with SC and review previously reported cases...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28851694/dose-optimisation-of-intravenous-tranexamic-acid-for-elective-hip-and-knee-arthroplasty-the-effectiveness-of-a-single-pre-operative-dose
#19
R J M Morrison, B Tsang, W Fishley, I Harper, J C Joseph, M R Reed
OBJECTIVES: We have increased the dose of tranexamic acid (TXA) in our enhanced total joint recovery protocol at our institution from 15 mg/kg to 30 mg/kg (maximum 2.5 g) as a single, intravenous (IV) dose. We report the clinical effect of this dosage change. METHODS: We retrospectively compared two cohorts of consecutive patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery in our unit between 2008 and 2013. One group received IV TXA 15 mg/kg, maximum 1...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28845890/long-term-aspirin-does-not-lower-risk-of-stroke-and-increases-bleeding-risk-in-low-risk-atrial-fibrillation-ablation-patients
#20
Victoria Jacobs, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler DO, John D Day, Charles Mallender, Jeffrey S Osborn, J Peter Weiss, T Jared Bunch
BACKGROUND: Stroke risk is a significant concern in patients with atrial fibrillation (AF). Low stroke risk patients (CHADS2 VASc 0-2) are often treated long-term with aspirin after catheter ablation. Defining the long-term risks versus benefits of aspirin therapy, after an ablation, is essential to validate this common clinical approach. METHODS: A total of 4,124 AF ablation patients undergoing their index ablation were included in this retrospective observational study...
August 28, 2017: Journal of Cardiovascular Electrophysiology
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