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https://www.readbyqxmd.com/read/27925464/risk-factors-for-severity-and-recurrence-of-colonic-diverticular-bleeding
#1
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/27924367/risk-factors-and-outcomes-of-acute-lower-gastrointestinal-bleeding-in-intestinal-beh%C3%A3-et-s-disease
#2
Jihye Park, Jae Hee Cheon, Yong Eun Park, Yoon Jee Lee, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim
BACKGROUND: Intestinal Behçet's disease (BD) can cause acute lower gastrointestinal bleeding, which is sometimes fatal. AIM: We aimed to identify the risk factors and outcomes of acute lower gastrointestinal bleeding and factors associated with rebleeding in intestinal BD patients. METHODS: Of the total of 588 intestinal BD patients, we retrospectively reviewed the medical records of 66 (11.2%) patients with acute lower gastrointestinal bleeding and compared them with those of 132 matched patients without bleeding...
December 6, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27921360/mortality-in-patients-who-discontinue-low-dose-acetylsalicylic-acid-therapy-after-upper-gastrointestinal-bleeding
#3
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/27900231/efficacy-and-safety-of-direct-oral-anticoagulants-compared-to-warfarin-in-prevention-of-thromboembolic-events-among-elderly-patients-with-atrial-fibrillation
#4
REVIEW
Shilpa D Kailas, Sirisha Reddy Thambuluru
Direct oral anticoagulants (DOACs), previously also known as novel oral anticoagulants (NOACs), have increased the therapeutic options for stroke prevention in atrial fibrillation (AF). Previous studies comparing their relative efficacy and safety do not address age-related differences, such as comorbidities and physical and social boundaries. This review aimed to summarize and compare the clinical and safety outcomes of DOACs and warfarin for stroke prevention in AF in the elderly population (≥ 65 years)...
October 18, 2016: Curēus
https://www.readbyqxmd.com/read/27895403/first-line-endoscopic-treatment-with-over-the-scope-clips-significantly-improves-the-primary-failure-and-rebleeding-rates-in-high-risk-gastrointestinal-bleeding-a-single-center-experience-with-100-cases
#5
Hans-Jürgen Richter-Schrag, Torben Glatz, Christine Walker, Andreas Fischer, Robert Thimme
AIM: To evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB). METHODS: A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 (n = 93) who underwent FLET and SLET with OTSCs...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894604/evaluation-of-the-efficacy-of-therapeutic-endoscopy-in-gastrointestinal-bleeding-secondary-to-angiodysplasias
#6
J Arribas Anta, C Zaera de la Fuente, R Martín Mateos, J A González Martín, A Cañete Ruiz, D Boixeda de Miquel, A Albillos Martínez
INTRODUCTION: Gastrointestinal angiodysplasias are defined as vascular dilations that communicate capillaries and veins in the walls of the digestive tract. The clinical presentation of these lesions varies from chronic occult bleeding to severe gastrointestinal hemorrhage. AIM: The primary aim of our study was to analyze lesion location, the efficacy of therapeutic endoscopy with argon plasma coagulation, and the factors associated with rebleeding in patients with gastrointestinal angiodysplasias...
November 25, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27894426/lower-gastrointestinal-bleeding-intussusception
#7
REVIEW
Benjamin E Padilla, Willieford Moses
Relatively uncommon compared with the adult population, lower gastrointestinal bleeding in children requires expeditious evaluation and management because of the variety of causes ranging from benign to life-threatening conditions. The causes of lower gastrointestinal bleeding (LGIB) vary with patient age. This review focuses on the differential diagnosis and management of LGIB in children. Because intussusception is one of the most common sources of LGIB, particular attention will be given to its diagnosis and management...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27889951/performance-of-the-high-dimensional-propensity-score-in-a-nordic-health-care-model
#8
Jesper Hallas, Anton Pottegård
The high-dimensional propensity score (hdPS) is increasingly used as a tool to adjust for confounding in observational studies of drug effects. It was developed within very rich data sources, e.g., the American claims databases. Thus, it is unknown whether it can be applied in settings that provide little more than prescriptions and diagnoses from hospital contacts, as in the Nordic data sources. Our objective was to evaluate the performance of hdPS under such circumstances. As our model, we chose the association between use of selective cyclooxygenase-2 inhibitors (coxibs) and traditional NSAIDs (tNSAIDs) and the risk of upper GI bleeding...
November 27, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27889397/comparative-effectiveness-of-dabigatran-and-rivaroxaban-versus-warfarin-for-the-treatment-of-non-valvular-atrial-fibrillation
#9
Lindsay G S Bengtson, Pamela L Lutsey, Lin Y Chen, Richard F MacLehose, Alvaro Alonso
BACKGROUND: Effectiveness data on novel oral anticoagulants (NOACs) versus warfarin for stroke prevention in non-valvular atrial fibrillation (NVAF) by prior warfarin use are limited. METHODS: We used data from the US MarketScan databases from 2009 to 2012. NVAF patients initiating dabigatran or rivaroxaban were matched with up to 5 warfarin users. Propensity score-adjusted Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for relevant endpoints in NOACs versus warfarin users...
November 23, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#10
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/27888219/long-term-intestinal-bleeding-in-a-child-a-rare-case-of-heterotopic-gastric-mucosa-in-the-jejunum
#11
Stella Leng, Marco Ghionzoli, Chiara Caporalini, Anna Maria Buccoliero
We report a rare case of heterotopic gastric mucosa presenting in a jejunal polyp of a 9-year-old girl, diagnosed with capsule endoscopy and laparoscopic exploration, after a 15-month history of lower gastrointestinal bleeding and anaemia. During surgery, the jejunal segment containing the polyp was resected and pathological examination revealed a polyp with gastric heterotopia. Heterotopic gastric mucosa is a rare pathology characterised by the presence of gastric mucosa outside of the stomach. Heterotopic gastric mucosa usually occurs in the oesophagus, duodenum, Meckel's diverticulum and enteric duplication cysts...
November 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27874917/traitement-analg%C3%A3-sique-apr%C3%A3-s-des-interventions-en-m%C3%A3-decine-dentaire
#12
Claudio Rostetter, Heinz-Theo Lübbers, Philipp Metzler
This script gives a pragmatic advice for dentists on pain control and anti-inflammation treatment considering current literature and state of the art of analgesic treatment. Naproxen seems to be the feasible anti-inflammatory painkiller as it has a lower cardio-vascular risk profile compared to other NSAID. The higher gastrointestinal bleeding risk can be mitigated using proton-pump inhibitors. Additionally, the duration of the drug effect of about 12–15 hours allows excellent patient compliance and comfort in comparison to other NSAID...
2016: Swiss Dental Journal
https://www.readbyqxmd.com/read/27872767/diffuse-alveolar-hemorrhage-associated-with-edoxaban-therapy
#13
Kenichi Nitta, Hiroshi Imamura, Akihiro Yashio, Satoko Kashima, Katsunori Mochizuki
Introduction. The main adverse effect of anticoagulant therapy is bleeding, and major bleeding, including intracranial, gastrointestinal, and retroperitoneal bleeding, has been reported as an adverse effect of edoxaban, a direct oral anticoagulant (DOAC). Bleeding during systemic anticoagulation with edoxaban presents a therapeutic conundrum, because there is currently no safe or efficacious reversal agent to stop major bleeding. Case Report. A 51-year-old woman had multiple traumatic injuries, including lower limb fractures...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27862856/liver-stiffness-and-platelet-count-for-identifying-patients-with-compensated-liver-disease-at-low-risk-of-variceal-bleeding
#14
Astrid Marot, Eric Trépo, Christopher Doerig, Alain Schoepfer, Christophe Moreno, Pierre Deltenre
BACKGROUND & AIMS: The 2015 Baveno VI guidelines recommend against performing upper gastrointestinal endoscopy in patients with compensated cirrhosis who have a liver stiffness <20 kPa and a platelet count >150 000/mm³ because of a low prevalence of varices at risk of bleeding in this population. The aim was to synthesize the available evidence on the usefulness of the combined use of liver stiffness and platelet count to identify patients without oesophageal varices. METHODS: Meta-analysis of trials evaluating the usefulness of a given cut-off for liver stiffness and platelet count to rule out the presence of oesophageal varices...
November 18, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27846246/systematic-review-and-meta-analysis-of-randomised-trials-to-ascertain-fatal-gastrointestinal-bleeding-events-attributable-to-preventive-low-dose-aspirin-no-evidence-of-increased-risk
#15
Peter C Elwood, Gareth Morgan, Julieta Galante, John W K Chia, Sunil Dolwani, J Michael Graziano, Mark Kelson, Angel Lanas, Marcus Longley, Ceri J Phillips, Janet Pickering, Stephen E Roberts, Swee S Soon, Will Steward, Delyth Morris, Alison L Weightman
BACKGROUND: Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin...
2016: PloS One
https://www.readbyqxmd.com/read/27844452/urgency-surgical-treatment-for-duodenal-gists-analysis-of-aged-patients-and-review-of-the-literature
#16
Carlo Boselli, Roberto Cirocchi, Alessandro Gemini, Francesco Barberini, Veronica Grassi, Stefano Avenia, Andrea Polistena, Alessandro Sanguinetti, Daniele Pironi, Alberto Santoro, Renata Tabola, Nicola Avenia
INTRODUCTION: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms (85%) of the gastrointestinal (GI) tract; duodenal GISTs constitute 3-5% of all GISTs and represent 10-30% of all malignant tumours of the duodenum. Rarely, patients present severe bowel obstruction, perforation or severe bleeding. The radical resection with complete removal of the tumour remains the main therapeutic approach. We performed a local resection in patients with suspected GIST admitted for emergency treatment for GI bleeding...
November 14, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27843050/major-bleeding-with-vitamin-k-antagonists-or-direct-oral-anticoagulants-in-real-life
#17
Cecilia Becattini, Laura Franco, Jan Beyer-Westendorf, Luca Masotti, Cinzia Nitti, Simone Vanni, Giorgia Manina, Sergio Cattinelli, Roberto Cappelli, Rodolfo Sbrojavacca, Fulvio Pomero, Sandra Marten, Giancarlo Agnelli
BACKGROUND: Limited data are available on major bleeding (MB) occurring during treatment with vitamin K (VKAs) or direct oral anticoagulants (DOACs) outside clinical trials. METHODS: Patients hospitalized for MB while on treatment with VKAs or DOACs were included in a multicenter study to compare clinical presentation, management and outcome of bleeding. The primary study outcome was death at 30days. RESULTS: Between September 2013 and September 2015, 806 patients were included in the study, 76% on VKAs and 24% on DOACs...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27817766/-clinical-effect-and-safety-of-somatostatin-in-treatment-of-postoperative-gastrointestinal-bleeding-in-neonates
#18
Bo-Xiang Qi, Lei Zhu, Lei Shang, Li-Ping Sheng, Bao-Li Hu, Kun Gao
OBJECTIVE: To investigate the clinical effect and safety of somatostatin in the treatment of postoperative gastrointestinal bleeding in neonates. METHODS: A prospective randomized study was performed, and 126 neonates who underwent surgery for congenital gastrointestinal anomalies were randomly divided into control group, treatment group A, and treatment group B. The neonates in the control group were given routine postoperative hemostasis, and those in the treatment groups were given somatostatin in addition to the treatment for the control group...
November 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#19
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
November 3, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27815920/intestinal-hemorrhage-caused-by-meckel-s-diverticulum-with-ectopic-gastric-mucosa-on-polypoid-lesion-a-case-report
#20
Toshiyuki Irie, Seiichi Shinji, Hiroki Arai, Hayato Kan, Takeshi Yamada, Michihiro Koizumi, Yasuyuki Yokoyama, Goro Takahashi, Takuma Iwai, Mikihiro Okusa, Keiichiro Ohta, Eiji Uchida
Meckel's diverticulum may sometimes present as an intraluminal polypoid mass causing small bowel obstruction; however, gastrointestinal bleeding due to Meckel's diverticulum with a polypoid lesion is rare. A 14-year-old girl presented with tarry stool and syncope in our hospital. Laboratory examination showed iron-deficiency anemia with a low hemoglobin level of 5.8 g/dl. The bleeding site was detected by neither upper gastrointestinal endoscopy nor colonoscopy. Transanal double-balloon enteroscopy showed a diverticulum with an ulceration at a site approximately 50 cm from the ileocecal valve and a polypoid lesion inside of the diverticulum...
December 2016: Surgical Case Reports
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