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https://www.readbyqxmd.com/read/29774146/endoscopic-and-angiographic-management-of-lower-gastrointestinal-bleeding-review-of-the-published-literature
#1
REVIEW
David J Werner, Hendrik Manner, Marc Nguyen-Tat, Roman Kloeckner, Ralf Kiesslich, Nael Abusalim, Johannes W Rey
Lower gastrointestinal bleeding is common and occurs often in elderly patients. In rare cases it is associated with hemorrhagic shock. A large number of such bleedings, which are often caused by colon diverticula, subside spontaneously. Alternatively they can be treated by endoscopic procedures successfully. Given the aging population of our society, the rising incidence of lower gastrointestinal tract bleeding and new anticoagulant therapies, some of the bleedings tend to be severe. Colonoscopy is the established standard procedure for the diagnosis and treatment of lower gastrointestinal bleeding...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29766466/concurrent-isolated-igg2-positive-membranous-nephropathy-and-malignant-b-cell-lymphoma
#2
Satoshi Shimada, Takashi Nakamichi, Gen Yamada, Kaori Narumi, Hajime Usubuchi, Tae Yamamoto, Satoshi Ichikawa, Noriko Fukuhara, Mariko Miyazaki, Hideo Harigae, Hiroshi Sato, Sadayoshi Ito
A recent systematic review showed that hematological malignancy is often complicated by membranous nephropathy (MN). Histologically, the deposition of IgG subclasses other than IgG4 may imply secondary MN, such as malignancy-associated MN (M-MN). We describe a very rare case of concurrent isolated IgG2-positive MN and B-cell lymphoma. An 83-year-old woman was hospitalized at our institute for facial and lower extremity edema persisting for 2 months. Laboratory tests showed urinary protein level of 10.8 g/day, serum albumin level of 1...
May 15, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29748353/gastrointestinal-bleeding-with-edoxaban-versus-warfarin-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction
#3
James Aisenberg, Prapti Chatterjee-Murphy, Kathryn Friedman Flack, Jeffrey I Weitz, Christian T Ruff, Francesco Nordio, Michele F Mercuri, Youngsook Choi, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail. METHODS AND RESULTS: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29746945/activation-of-coagulation-and-endothelium-with-concurrent-impairment-of-anticoagulant-mechanisms-in-patients-with-typhoid-fever
#4
Hanna K de Jong, Chris M Parry, Thomas W van der Vaart, Liesbeth M Kager, Stannie J van den Ende, Rapeephan R Maude, Lalith Wijedoru, Aniruddha Ghose, Mohammed U Hasan, Mohammed A Hossain, Arjan M Dondorp, Steve Baker, M Abul Faiz, Joost C M Meijers, W Joost Wiersinga
OBJECTIVES: Typhoid fever caused by Salmonella Typhi remains a major burden worldwide. Gastrointestinal bleeding can be seen in up to 10 percent of patients and may be fatal. The coagulopathy, which may be the driver of this severe complication in patients with typhoid fever, however is ill defined. The aim of this study was to evaluate the activation of coagulation, anticoagulation, and fibrinolysis in patients with acute typhoid fever. METHODS: . Parameters of coagulation and fibrinolysis were measured in 28 hospitalized patients with culture-confirmed or PCR-confirmed typhoid fever and compared to 38 age- and sex-matched healthy volunteers...
May 7, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29742276/hla-b57-01-shields-people-living-with-hiv-for-significantly-better-periodontal-health
#5
Gundolf Schuettfort, Philipp Leuw, Annette Haberl, Eva Herrmann, Kyu-Hyun Park, Timo Wolf, Christoph Stephan
OBJECTIVES: To assess the association between HLA-B57.01 (Human leukocyte antigen) and clinical parameters of chronic periodontitis in people living with HIV (PLWHIV). MATERIALS AND METHODS: All patients were recruited from the HIVCENTER at the Universityhospital Frankfurt during April 2014 and July 2015. Periodontal examination included Periodontal Screening Index (PSI), Gingivalindex (GI), Bleeding on Probing Index (BOP), Periodontal Probing Depth (PD), Clinical Attachment Level (CAL) and DMF-T Score (decayed, missing, filled teeth)...
May 9, 2018: Journal of Periodontology
https://www.readbyqxmd.com/read/29741685/association-between-the-severity-of-acquired-von-willebrand-syndrome-and-gastrointestinal-bleeding-after-continuous-flow-left-ventricular-assist-device-implantation
#6
Ko Sakatsume, Kenki Saito, Masatoshi Akiyama, Konosuke Sasaki, Satoshi Kawatsu, Goro Takahashi, Osamu Adachi, Shunsuke Kawamoto, Hisanori Horiuchi, Yoshikatsu Saiki
OBJECTIVES: Acquired von Willebrand syndrome, characterized by the reduction in von Willebrand factor (vWF) large multimers, has recently been considered as one of the causes of gastrointestinal bleeding (GIB). It remains unclear whether its haematological severity is linked with susceptibility to bleeding because the definition of the haematological severity of acquired von Willebrand syndrome has not been precisely determined. This study sought to establish a quantitative methodology to assess the haematological severity of acquired von Willebrand syndrome and to define the threshold for occurrence of GIB in patients implanted with left ventricular assist devices (LVADs)...
May 8, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29739056/development-of-a-combined-human-transferrin-hemoglobin-lateral-immunochromatographic-assay-for-accurate-and-rapid-fecal-occult-blood-test
#7
Yuanyuan Ye, Yin Deng, Jinju Mao, Qin Yan, Yidan Huang, Jun Zhang, Jian Zheng, Yue Li, Weixian Chen
BACKGROUND: Fecal occult bloodtest (FOBT) plays an important role in the diagnosis of gastrointestinal diseases. The sensitivities of current FOBT methods are still not satisfactory. The aim of this study is to develop a combined human transferrin (HTf)-hemoglobin (HHb) lateral flow assay (LFA) for accurate and rapid FOBT. METHODS: Monoclonal antibodies (MAbs) targeting HTf were developed by conventional methods and paired using LFA strips. The best HTf MAb pair was chosen according to the overall performance on testing limit and specificity...
May 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29734211/early-versus-standard-colonoscopy-a-randomized-controlled-trial-in-patients-with-acute-lower-gastrointestinal-bleeding-results-of-the-bleed-study
#8
Inge van Rongen, Bregje J W Thomassen, Lars E Perk
GOALS: The aim of our study was to examine differences in length of hospital stay (LOHS) between patients with lower gastrointestinal bleeding who received either an early colonoscopy (within 24 h of presentation) or a standard colonoscopy (within 1 to 3 d). BACKGROUND: Diagnostic management of lower gastrointestinal bleeding has been extensively debated in recent literature, especially whether colonoscopy within 24 hours of presentation is feasible and safe...
May 4, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29722073/complications-related-to-chronic-supratherapeutic-use-of-codeine-containing-compound-analgesics-in-a-cohort-of-patients-presenting-for-codeine-withdrawal
#9
Victoria Cock, Carolyn Edmonds, Charles Cock
INTRODUCTION AND AIMS: This study aimed to compare complications arising due to the supratherapeutic use of paracetamol/codeine or ibuprofen/codeine containing compound analgesics in primary codeine-dependent patients presenting to a drug and alcohol withdrawal service. Data was compared to determine if there was any difference in the number of complications observed between the two groups. DESIGN AND METHODS: A retrospective case review of patients presenting for primary codeine dependence from 2009 to 2014...
May 2, 2018: Drug and Alcohol Review
https://www.readbyqxmd.com/read/29721111/risk-factors-and-prevention-of-dabigatran-related-gastrointestinal-bleeding-in-patients-with-atrial-fibrillation
#10
Teerapat Nantsupawat, Suthipong Soontrapa, Nopakoon Nantsupawat, David Sotello, Saranapoom Klomjit, Selcuk Adabag, Alejandro Perez-Verdia
Introduction: Dabigatran, as compared with warfarin, was associated with lower rates of stroke and systemic embolism with similar rates of major hemorrhage. But it has a significantly higher risk of gastrointestinal bleeding (GIB). There are limited data on how to prevent GIB from dabigatran and what are the risk factors. Methods: We performed a retrospective cohort study of patients with atrial fibrillation who have ever taken dabigatran for thromboprophylaxis from October 2010 to February 2013...
February 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29718567/usefulness-of-dual-phase-cone-beam-computed-tomography-during-arteriography-and-automated-tumour-feeder-detection-software-in-transarterial-embolization-for-obscure-arterial-bleeding-in-the-abdomen
#11
Shiro Miyayama, Masashi Yamashiro, Keiichi Nagai, Natsuki Sugimori, Koji Iwata, Naoko Sakuragawa
We report the usefulness of dual-phase cone-beam computed tomography during angiography (CBCTA) and automated tumour-feeder detection software (AFD) in transarterial embolization (TAE) for three consecutive cases of obscure arterial bleeding in the abdomen. Two patients presented with lower gastrointestinal bleeding and one showed bleeding into the pancreatic pseudocyst. Superior mesenteric or common hepatic angiography did not demonstrate extravasation, but dual-phase CBCTA and AFD could identify extravasation and an access route to the bleeding point...
May 2, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29705263/previous-use-of-anti-thrombotic-agents-reduces-mortality-and-length-of-hospital-stay-in-patients-with-high-risk-upper-gastrointestinal-bleeding
#12
Philip Dj Dunne, Stig B Laursen, Loren Laine, Harry R Dalton, Jing H Ngu, M Schultz, Adam Rahman, Andrea Anderloni, Iain A Murray, Adrian J Stanley
BACKGROUND AND AIMS: Anti-thrombotic agents are risk factors for upper gastrointestinal bleeding (UGIB). However, few studies have evaluated their effects on patient outcomes. We assessed the effects of anti-thrombotic agents on outcomes of patients with high-risk UGIB. METHODS: We performed a prospective study of 619 patients with acute UGIB (defined by hematemesis, coffee-ground vomit or melena) who required intervention and underwent endoscopy at 8 centers in North America, Asia, and Europe, from March 2014 through March 2015...
April 26, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#13
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698506/external-validation-of-the-noblads-score-a-risk-scoring-system-for-severe-acute-lower-gastrointestinal-bleeding
#14
Tomonori Aoki, Atsuo Yamada, Naoyoshi Nagata, Ryota Niikura, Yoshihiro Hirata, Kazuhiko Koike
BACKGROUND: We aimed to evaluate the generalizability of NOBLADS, a severe lower gastrointestinal bleeding (LGIB) prediction model which we had previously derived when working at a different institution, using an external validation cohort. NOBLADS comprises the following factors: non-steroidal anti-inflammatory drug use, no diarrhea, no abdominal tenderness, blood pressure ≤ 100 mmHg, antiplatelet drug use, albumin < 3.0 g/dL, disease score ≥ 2, and syncope. METHODS: We retrospectively analyzed 511 patients emergently hospitalized for acute LGIB at the University of Tokyo Hospital, from January 2009 to August 2016...
2018: PloS One
https://www.readbyqxmd.com/read/29696108/comparing-the-effectiveness-of-patient-control-analgesia-pump-and-bolus-morphine-in-controlling-pain-after-cardiopulmonary-bypass-graft-surgery
#15
Vali Imantalab, Ali Mirmansouri, Ali Mohammadzadeh Jouryabi, Bahram Naderi Nabi, Gholamreza Kanani, Nassir Nassiri Sheikhani, Zahra Atrkarroushan, Samaneh Ghazanfar Tehran, Nastaran Samadpour
Background: Postoperative pain is a complex process commonly caused by surgical trauma. It is one of the major concerns of patients undergoing heart surgery. Despite new techniques and modern analgesic treatments, postoperative pain is still one of the most important controversial issues. Methods: 68 patients scheduled for elective CABG with CPB were included in a prospective, double-blind clinical trial. They were randomly divided into two groups. One group received PCA pump including morphine (group P) with underlying infusion of 0...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29691259/transdermal-estradiol-for-the-management-of-refractory-uremic-bleeding
#16
Jimmy Gonzalez, Samantha Bryant, Evelyn R Hermes-DeSantis
PURPOSE: The efficacy and thrombogenicity of transdermal estradiol in the management of refractory uremic bleeding in adults are examined. SUMMARY: Platelet dysfunction from chronic kidney disease may induce uremic bleeding. This type of bleeding may involve the skin, oral and nasal mucosa, gingivae, respiratory system, and gastrointestinal or urinary tract. While the mainstay of treatment for uremic bleeding primarily involves dialysis and use of prohemostatic agents such as desmopressin and erythropoiesis-stimulating agents, certain patients may experience bleeding refractory to these interventions...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29684971/-clinical-outcomes-of-angiography-and-transcatheter-arterial-embolization-for-acute-gastrointestinal-bleeding-analyses-according-to-bleeding-sites-and-embolization-types
#17
Soo Min Noh, Ji Hoon Shin, Ha Il Kim, Sun Ho Lee, Kiju Chang, Eun Mi Song, Sung Wook Hwang, Dong Hoon Yang, Byong Duk Ye, Seung Jae Myung, Suk Kyun Yang, Jeong Sik Byeon
Background/Aims: The clinical outcomes of angiography and transcatheter arterial embolization (TAE) for acute gastrointestinal bleeding (GIB) have not been completely assessed, especially according to bleeding sites. This study aimed to assess the efficacy of angiography and safety of TAE in acute GIB. Methods: This was a retrospective study evaluating the records of 321 patients with acute GIB who underwent angiography with or without TAE. Targeted TAE was conducted in 134 patients, in whom angiography showed bleeding sources...
April 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#18
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29673583/novel-artificial-stool-material-for-external-quality-assurance-eqa-on-a-fecal-immunochemical-test-for-hemoglobin-fit-the-confirmed-utility-of-stable-hemoglobin-and-an-internal-standard-material
#19
Ryota Yasui, Miyu Yamada, Shizuka Takehara, Ikunosuke Sakurabayashi, Katsunori Watanabe
The fecal immunochemical test for hemoglobin (FIT), which detects lower gastrointestinal bleeding, is widely accepted for population-based colorectal cancer (CRC) screening programs. However, the FIT screening process has not been standardized yet, and standardizing the pre-analytical phase and establishing an external quality assurance (EQA) program compliant with ISO requirements is urgently needed. Although there have been various attempts to establish EQA materials suitable for FIT, no materials have yet been reported to have sufficient uniformity and acceptable immunochemical stability of hemoglobin (Hb)...
April 16, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#20
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
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