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Nonvariceal upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28107762/thulium-laser-in-interventional-endoscopy-animal-and-human-studies
#1
Gian E Tontini, Helmut Neumann, Luca Pastorelli, Luisa Spina, Flaminia Cavallaro, Paola Soriani, Alessandro Rimondi, Barbara Bruni, Claudio Clemente, Filippo Fagnani, Pavlos Lagoussis, Luca Carmignani, Maurizio Vecchi
Background and study aims The thulium laser system (TLS) is an emerging surgical tool. The 2-μm wavelength provides a confined coagulation depth (0.2 - 0.4 mm) to reduce the potential for inadvertent injuries. For the first time ever, we assessed TLS feasibility for endoscopic hemostasis ex vivo in pigs. In addition, we performed the first in vivo hemostatic treatments in humans. Patients and methods Tissue damage induced by TLS using different settings and optical fibers was compared to that from argon plasma coagulation (APC) in established ex vivo animal models...
January 20, 2017: Endoscopy
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#2
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
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/27756143/antiplatelet-agents-and-or-anticoagulants-are-not-associated-with-worse-outcome-following-nonvariceal-upper-gastrointestinal-bleeding
#4
Elvira Teles Sampaio, Luís Maia, Paulo Salgueiro, Ricardo Marcos-Pinto, Mário Dinis-Ribeiro, Isabel Pedroto
BACKGROUND: Nonvariceal upper gastrointestinal bleeding emerges as a major complication of using antiplatelet agents and/or anticoagulants and represents a clinical challenge in patients undergoing these therapies. AIM: To characterize patients with nonvariceal upper gastrointestinal bleeding related to antithrombotics and their management, and to determine clinical predictors of adverse outcomes. METHODS: Retrospective cohort of adults who underwent upper gastrointestinal endoscopy after nonvariceal upper gastrointestinal bleeding from 2010 to 2012...
October 19, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27749635/using-hemospray-improves-the-cost-effectiveness-ratio-in-the-management-of-upper-gastrointestinal-nonvariceal-bleeding
#5
Alan N Barkun, Viviane Adam, Yidan Lu, Yen-I Chen, Myriam Martel
GOALS: We compared the cost-effectiveness of traditional recommended endoscopic hemostatic therapies and Hemospray alone or in combination when treating nonvariceal upper gastrointestinal bleeding (NVUGIB). BACKGROUND: Hemospray (TC-325) is a novel endoscopic hemostatic powder, achieving hemostasis through adherence to actively bleeding biological surfaces. STUDY: A decision tree of patients with NVUGIB assessed 4 possible treatment strategies: traditional therapy alone (T), Hemospray alone (H), traditional therapy completed by Hemospray if needed (T+H), or Hemospray completed by traditional therapy if needed (H+T)...
October 4, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27717629/clinical-impact-of-serum-albumin-on-nonvariceal-upper-gastrointestinal-bleeding
#6
EDITORIAL
A Montaño Loza
No abstract text is available yet for this article.
October 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27693643/timing-of-upper-endoscopy-influences-outcomes-in-patients-with-acute-nonvariceal-upper-gi-bleeding
#7
Navin L Kumar, Aaron J Cohen, Jennifer Nayor, Brian L Claggett, John R Saltzman
BACKGROUND AND AIMS: Current guidelines advise that upper endoscopy be performed within 24 hours of presentation in patients with acute nonvariceal upper GI bleeding (UGIB). However, the role of urgent endoscopy (<12 hours) is controversial. Our aim was to assess whether patients admitted with acute nonvariceal UGIB with lower-risk versus high-risk bleeding have different outcomes with urgent compared with nonurgent endoscopy. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital with nonvariceal UGIB...
September 29, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27648468/blatchford-score-is-superior-to-aims65-score-in-predicting-the-need-for-clinical-interventions-in-elderly-patients-with-nonvariceal-upper-gastrointestinal-bleed
#8
Khalid Abusaada, Fnu Asad-Ur-Rahman, Vladimir Pech, Umair Majeed, Shengchuan Dai, Xiang Zhu, Sally A Litherland
Background. Blatchford and AIMS65 scores were developed to risk stratify patients with upper gastrointestinal bleed (UGIB). We sought to assess the performance of Blatchford and AIMS65 scores in predicting outcomes in elderly patients with nonvariceal UGIB. Methods. A retrospective cohort study of elderly patients (over 65 years of age) with nonvariceal UGIB admitted to a tertiary care center. Primary outcome was a combined outcome of in-hospital mortality, need for any therapeutic endoscopic, radiologic, or surgical intervention, rebleeding within 30 days, or blood transfusion...
2016: Advances in Medicine
https://www.readbyqxmd.com/read/27552329/endoclot-polysaccharide-hemostatic-system-in-nonvariceal-gastrointestinal-bleeding-results-of-a-prospective-multicenter-observational-pilot-study
#9
Jan C Prei, Christian Barmeyer, Nataly Bürgel, Severin Daum, Hans-Jörg Epple, Ute Günther, Jochen Maul, Britta Siegmund, Michael Schumann, Hanno Tröger, Andrea Stroux, Andreas Adler, Winfried Veltzke-Schlieker, Christian Jürgensen, Robert Wentrup, Bertram Wiedenmann, Jana Binkau, Dirk Hartmann, Ellen Nötzel, Dirk Domagk, Wolfram Wacke, Ulrich Wahnschaffe, Christian Bojarski
BACKGROUND AND STUDY AIMS: Hemostatic powders have been introduced to improve the management of gastrointestinal (GI) bleeding and to extend the variety of tools available for emergency endoscopy. The aim of the present pilot study was to evaluate the indication profiles and the short-term outcome of EndoClot. PATIENTS, MATERIALS AND METHODS: In a prospective observational pilot study patients with acute nonvariceal GI bleeding were included. Primary or secondary application of EndoClot was assessed...
November 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27540574/discharge-hemoglobin-and-outcome-in-patients-with-acute-nonvariceal-upper-gastrointestinal-bleeding
#10
Jae Min Lee, Eun Sun Kim, Hoon Jai Chun, Young-Jae Hwang, Jae Hyung Lee, Seung Hun Kang, In Kyung Yoo, Seung Han Kim, Hyuk Soon Choi, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Soon Ho Um, Chang Duck Kim
BACKGROUND AND STUDY AIMS: Many patients with acute gastrointestinal bleeding present with anemia and frequently require red blood cell (RBC) transfusion. A restrictive transfusion strategy and a low hemoglobin (Hb) threshold for transfusion had been shown to produce acceptable outcomes in patients with acute upper gastrointestinal bleeding. However, most patients are discharged with mild anemia owing to the restricted volume of packed RBCs (pRBCs). We investigated whether discharge Hb influences the outcome in patients with acute nonvariceal upper gastrointestinal bleeding...
August 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27518195/effects-of-different-omeprazole-dosing-on-gastric-ph-in-non-variceal-upper-gastrointestinal-bleeding-a-randomized-prospective-study
#11
Adam Chwiesko, Radoslaw Charkiewicz, Jacek Niklinski, Wojciech Luczaj, Elzbieta Skrzydlewska, Robert Milewski, Andrzej Baniukiewicz, Eugeniusz Wroblewski, Mariusz Rosolowski, Andrzej Dabrowski
OBJECTIVE: We aimed to identify the best method of omeprazole (OME) application with respect to intragastric pH, cytochrome P450 2C19 (CYP2C19) genotype and phenotype. METHODS: The patients with non-variceal upper gastrointestinal bleeding (NVUGIB) were prospectively enrolled. After the achievement of endoscopic hemostasis, the patients were randomized to 40-mg intravenous (i.v.) OME bolus injection every 12 h or 8-mg/h continuous i.v. infusion for 72 h after an 80-mg i...
September 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27505402/value-of-oral-proton-pump-inhibitors-in-acute-nonvariceal-upper-gastrointestinal-bleeding-a-network-meta-analysis
#12
Eduardo A Rodriguez, Elie Donath, Akbar K Waljee, Daniel A Sussman
BACKGROUND: Intravenous (IV) proton pump inhibitors (PPI) are the standard medical treatment in acute nonvariceal upper gastrointestinal bleeding (ANVGIB). Optimal route of PPI delivery has been questioned. AIM: The aim was to perform a systematic review and network meta-analysis for the endpoints of risk of rebleeding, length of stay (LOS), surgery (ROS), mortality, and total units of blood transfused (UBT) among trials evaluating acid suppressive medications in ANVGIB...
August 8, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27377742/comparison-of-aims65-score-and-other-scoring-systems-for-predicting-clinical-outcomes-in-koreans-with-nonvariceal-upper-gastrointestinal-bleeding
#13
Sung Min Park, Seok Cheon Yeum, Byung-Wook Kim, Joon Sung Kim, Ji Hee Kim, Eun Hui Sim, Jeong-Seon Ji, Hwang Choi
BACKGROUND/AIMS: The AIMS65 score has not been sufficiently validated in Korea. The objective of this study was to compare the AIMS65 and other scoring systems for the prediction of various clinical outcomes in Korean patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). METHODS: The AIMS65 score, clinical and full Rockall scores (cRS and fRS) and Glasgow-Blatchford (GBS) score were calculated in patients with NVUGIB in a single center retrospectively...
July 15, 2016: Gut and Liver
https://www.readbyqxmd.com/read/27367977/simple-risk-factors-to-predict-urgent-endoscopy-in-nonvariceal-upper-gastrointestinal-bleeding-pre-endoscopically
#14
Jianzong Wang, Duanming Hu, Wen Tang, Chuanyin Hu, Qin Lu, Juan Li, Jianhong Zhu, Liming Xu, Zhenyu Sui, Mingjie Qian, Shaofeng Wang, Guojian Yin
The goal of this study is to evaluate how to predict high-risk nonvariceal upper gastrointestinal bleeding (NVUGIB) pre-endoscopically. A total of 569 NVUGIB patients between Match 2011 and January 2015 were retrospectively studied. The clinical characteristics and laboratory data were statistically analyzed. The severity of NVUGIB was based on high-risk NVUGIB (Forrest I-IIb), and low-risk NVUGIB (Forrest IIc and III). By logistic regression and receiver-operating characteristic curve, simple risk score systems were derived which predicted patients' risks of potentially needing endoscopic intervention to control bleeding...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27213011/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-uncontrollable-nonvariceal-upper-gastrointestinal-bleeding
#15
Hidefumi Sano, Junya Tsurukiri, Akira Hoshiai, Taishi Oomura, Yosuke Tanaka, Shoichi Ohta
BACKGROUND: Although resuscitative endovascular balloon occlusion of the aorta (REBOA) in various clinical settings was found to successfully elevate central blood pressure in hemorrhagic shock, this intervention is associated with high mortality and may represent a last-ditch option for trauma patients. We conducted a retrospective study of patients with nonvariceal upper gastrointestinal bleeding (UGIB) who underwent REBOA to identify the effectiveness of REBOA and reviewed published literatures...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27108061/the-use-of-hemostatic-spray-as-an-adjunct-to-conventional-hemostatic-measures-in-high-risk-nonvariceal-upper-gi-bleeding-with-video
#16
Rohit Sinha, Khalida A Lockman, Nicholas I Church, John N Plevris, Peter C Hayes
BACKGROUND: Endoscopic management of nonvariceal upper GI bleed (NVUGIB) can be challenging. Hemospray is a novel endoscopic hemostatic agent for NVUGIB. Its efficacy in attaining hemostasis in NVUGIB is promising, particularly with respect to technically difficult lesions. However, most of the currently available data are focused on its application as monotherapy. The aim of this study was to evaluate its efficacy as a second agent to adrenaline, or as an addition to the combination of adrenaline with either clips or a thermal device in NVUGIB...
December 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27048253/clinical-outcome-of-acute-nonvariceal-upper-gastrointestinal-bleeding-after-hours-the-role-of-urgent-endoscopy
#17
Dong-Won Ahn, Young Soo Park, Sang Hyub Lee, Cheol Min Shin, Jin-Hyeok Hwang, Jin-Wook Kim, Sook-Hyang Jeong, Nayoung Kim, Dong Ho Lee
BACKGROUND/AIMS: This study was performed to investigate the clinical role of urgent esophagogastroduodenoscopy (EGD) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) performed by experienced endoscopists after hours. METHODS: A retrospective analysis was performed for consecutively collected data of patients with ANVUGIB between January 2009 and December 2010. RESULTS: A total of 158 patients visited the emergency unit for ANVUGIB after hours...
May 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27016164/nonvariceal-upper-gastrointestinal-bleeding
#18
REVIEW
Syed Irfan-Ur Rahman, Kia Saeian
In the intensive care unit, vigilance is needed to manage nonvariceal upper gastrointestinal bleeding. A focused history and physical examination must be completed to identify inciting factors and the need for hemodynamic stabilization. Although not universally used, risk stratification tools such as the Blatchford and Rockall scores can facilitate triage and management. Urgent evaluation for nonvariceal upper gastrointestinal bleeds requires prompt respiratory assessment, and identification of hemodynamic instability with fluid resuscitation and blood transfusions if necessary...
April 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/26962402/endoscopic-hemostasis-state-of-the-art-nonvariceal-bleeding
#19
REVIEW
Stefan Karl Goelder, Juliane Brueckner, Helmut Messmann
New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity...
February 25, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/26923946/successful-endoscopic-hemostasis-is-a-protective-factor-for-rebleeding-and-mortality-in-patients-with-nonvariceal-upper-gastrointestinal-bleeding
#20
Yong Jae Han, Jae Myung Cha, Jae Hyun Park, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee
BACKGROUND: Rebleeding and mortality rates remain high in patients with nonvariceal upper gastrointestinal bleeding. AIM: To identify clinical and endoscopic risk factors for rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding. METHODS: This study was performed in patients with nonvariceal upper gastrointestinal bleeding who underwent upper endoscopic procedures between July 2006 and February 2013. Clinical and endoscopic characteristics were compared among patients with and without rebleeding and mortality...
July 2016: Digestive Diseases and Sciences
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