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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
Adam Chwiesko, Radoslaw Charkiewicz, Jacek Niklinski, Wojciech Luczaj, Elzbieta Skrzydlewska, Robert Milewski, Andrzej Baniukiewicz, Eugeniusz Wroblewski, Mariusz Rosolowski, Andrzej Dabrowski
AIM: We aimed to identify the best method of omeprazole (OME) application with respect to intragastric pH, cytochrome CYP2C19 genotype and phenotype. METHODS: Fifty patients with NVUGIB were prospectively enrolled, after achievement of endoscopic hemostasis, were randomized to 40-mg IV OME bolus injection bid or 80-mg IV bolus injection + 8-mg/h continuous IV infusion for 72 hours. The intragastric pH was recorded for 72 hours. The CYP2C19 variant alleles (*2, *3, *17) were analysed, the serum concentrations of OME and 5-hydroxy-OME were determined...
August 12, 2016: Journal of Digestive Diseases
Karina M Souk, Hani M Tamim, Hussein A Abu Daya, Don C Rockey, Kassem A Barada
AIM: To compare outcomes of patients with non-variceal upper gastrointestinal bleeding (NVUGIB) taking aspirin for primary prophylaxis to those not taking it. METHODS: Patients not known to have any vascular disease (coronary artery or cerebrovascular disease) who were admitted to the American University of Beirut Medical Center between 1993 and 2010 with NVUGIB were included. The frequencies of in-hospital mortality, re-bleeding, severe bleeding, need for surgery or embolization, and of a composite outcome defined as the occurrence of any of the 4 bleeding related adverse outcomes were compared between patients receiving aspirin and those on no antithrombotics...
July 27, 2016: World Journal of Gastrointestinal Surgery
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
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)
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...
April 21, 2016: Gastrointestinal Endoscopy
Sejin Hwang, Seong Woo Jeon, Joong Goo Kwon, Dong Wook Lee, Chang Yoon Ha, Kwang Bum Cho, ByungIk Jang, Jung Bae Park, Youn Sun Park
BACKGROUND: Although the mortality rates for non-variceal upper gastrointestinal bleeding (NVUGIB) have recently decreased, it remains a significant medical problem. AIM: The main aim of this prospective multicenter database study was to construct a clinically useful predictive scoring system by using our predictors and compare its prognostic accuracy with that of the Rockall scoring system. METHODS: Data were collected from consecutive patients with NVUGIB...
July 2016: Digestive Diseases and Sciences
Yoo Jin Lee, Bo Ram Min, Eun Soo Kim, Kyung Sik Park, Kwang Bum Cho, Byoung Kuk Jang, Woo Jin Chung, Jae Seok Hwang, Seong Woo Jeon
BACKGROUND/AIMS: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency that can be life threatening. This study evaluated predictive factors of 30-day mortality in patients with this condition. METHODS: A prospective observational study was conducted at a single hospital between April 2010 and November 2012, and 336 patients with symptoms and signs of gastrointestinal bleeding were consecutively enrolled. Clinical characteristics and endoscopic findings were reviewed to identify potential factors associated with 30-day mortality...
January 2016: Korean Journal of Internal Medicine
Su Hyun Lee, Jin Tae Jung, Dong Wook Lee, Chang Yoon Ha, Kyung Sik Park, Si Hyung Lee, Chang Heon Yang, Youn Sun Park, Seong Woo Jeon
BACKGROUND/AIMS: Endoscopic hemoclip application is an effective and safe method of endoscopic hemostasis. We conducted a multicenter retrospective study on hemoclip and hemoclip combination therapy based on prospective cohort database in terms of hemostatic efficacy not in clinical trial but in real clinical practice. METHODS: Data on endoscopic hemostasis for non-variceal upper gastrointestinal bleeding (NVUGIB) were prospectively collected from February 2011 to December 2013...
August 2015: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Mauro Manno, Santi Mangiafico, Angelo Caruso, Carmelo Barbera, Helga Bertani, Vincenzo G Mirante, Flavia Pigò, Khanna Amardeep, Rita Conigliaro
BACKGROUND AND STUDY AIMS: The over-the-scope clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report a series of patients with high-risk non-variceal upper gastrointestinal bleeding (NVUGIB) lesions in whom OTSCs were used as first-line endoscopic treatment. PATIENTS AND METHODS: We prospectively collected and retrospectively analysed data over a period of 12 months from October 2013 to November 2014 from all consecutive patients who underwent emergency endoscopy for acute severe high-risk NVUGIB and were treated with OTSC as primary first-line therapy...
May 2016: Surgical Endoscopy
Jussi M Kärkkäinen, Sami Miilunpohja, Tuomo Rantanen, Jenni M Koskela, Johanna Jyrkkä, Juha Hartikainen, Hannu Paajanen
BACKGROUND: No current data are available on rebleeding and mortality risk in patients who use alcohol excessively and are admitted for non-variceal upper gastrointestinal bleeding (NVUGIB). This information could help in planning interventions and follow-up protocols for these patients. AIM: This study provides contemporary data on the long-term outcome after first-time NVUGIB in alcohol abusers (AAs) compared to non-abusers (NAs). METHODS: Consecutive patients hospitalized for their first acute gastrointestinal bleeding from 2009 through 2011 were retrospectively recorded and categorized as AA or NA...
December 2015: Digestive Diseases and Sciences
Moe Kyaw, Yee Tse, Daphne Ang, Tiing Leong Ang, James Lau
BACKGROUND AND STUDY AIMS: A meta-analysis was conducted to assess the efficacy of transcatheter arterial embolization (TAE) compared with surgery in the management of patients with recurrent nonvariceal upper gastrointestinal bleeding (NVUGIB) after failure of endoscopic hemostasis. PATIENTS AND METHODS: Publications in English and non-English literatures (OVID, MEDLINE, and EMBASE) and abstracts from major international conferences were searched for studies comparing TAE with surgery for treatment of NVUGIB after endoscopic hemostasis failure...
March 2014: Endoscopy International Open
Antonios Wehbeh, Hani M Tamim, Hussein Abu Daya, Rachel Abou Mrad, Rami J Badreddine, Mohamad A Eloubeidi, Don C Rockey, Kassem Barada
OBJECTIVE: To determine the effect of aspirin and anticoagulants on clinical outcomes and cause of in-hospital death in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB). METHODS: Patients were identified from a tertiary center database that included all patients with UGIB. Clinical outcomes including (1) in-hospital mortality, (2) severe bleeding, (3) rebleeding, (4) in-hospital complications, and (5) length of hospital stay were examined in patients taking (a) aspirin only, (b) anticoagulants only, and (c) no antithrombotics...
July 2015: Digestive Diseases and Sciences
Khairy H Morsy, Mohamed A A Ghaliony, Hamdy S Mohammed
BACKGROUND/AIMS: Variceal bleeding is one of the most frequent causes of morbidity and mortality among cirrhotic patients. Clinical endoscopic features and outcomes of cirrhotic patients with non-variceal upper gastrointestinal bleeding (NVUGIB) have been rarely reported. Our aim is to identify treatment outcomes and predictors of in-hospital mortality among cirrhotic patients with non-variceal bleeding in Upper Egypt. MATERIALS AND METHODS: A prospective study of 93 cirrhotic patients with NVUGIB who were admitted to the Tropical Medicine and Gastroenterology Department, Assiut University Hospital (Assiut, Egypt) over a one-year period (November 2011 to October 2012)...
December 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Yidan Lu, Alan N Barkun, Myriam Martel
OBJECTIVES: To assess process of care in nonvariceal upper gastrointestinal bleeding (NVUGIB) using a national cohort, and to identify predictors of adherence to 'best practice' standards. METHODS: Consecutive charts of patients hospitalized for acute upper gastrointestinal bleeding across 21 Canadian hospitals were reviewed. Data regarding initial presentation, endoscopic management and outcomes were collected. Results were compared with 'best practice' using established guidelines on NVUGIB...
October 2014: Canadian Journal of Gastroenterology & Hepatology
(no author information available yet)
The Indonesian Society of Gastroenterology has compiled a national consensus guideline for the management of non-variceal upper gastrointestinal bleeding (NVUGIB). It is an endeavor to raise the quality of service for NVUGIB patients associated with peptic ulcer. The references for developing this consensus include three recent consensus guidelilnes on the management of NVUGIB and a modification of Delphi process was done to develop clinical guidelines. The three references are: The International Consensus Recommendations on the Management of Patients with Non-variceal Upper Gastrointestinal Bleeding (ICON-UGIB), 2010; Asia-Pacific Working Group consensus on non-variceal upper gastrointestinal bleeding, 2011; and Management of Patients with Ulcer Bleeding, ACG guidelines, 2012...
April 2014: Acta Medica Indonesiana
Yen-I Chen, Alastair P Dorreen, Paul J Warshawsky, Jonathan M Wyse
Non-variceal upper-gastrointestinal bleeding (NVUGIB) refractory to therapeutic endoscopy is a challenging situation. The following details a novel use for the Sengstaken-Blakemore tube in a case of severe ulcerative esophagitis after failure of conventional medical and endoscopic treatment. A 77-year-old man with a history of peptic ulcer disease developed massive hematemesis during a hospital admission. Initial gastroscopy revealed an adherent blood clot occupying the distal esophagus, extending to the gastric cardia and proximal fundus...
November 2014: Gastroenterology Report
George Papatheodoridis, Evangelos Akriviadis, Nikolaos Evgenidis, Anargyros Kapetanakis, Demetrios Karamanolis, Jannis Kountouras, Gerassimos Mantzaris, Spyros Potamianos, Konstantinos Triantafyllou, Charalambos Tzathas
BACKGROUND: Non-variceal upper gastro-intestinal bleeding (NVUGIB) is a common and challenging emergency situation. We aimed to describe the characteristics and clinical outcomes of patients with NVUGIB in Greece. METHODS: ENERGIB (NCT00797641) was an epidemiological survey conducted in 7 European countries including Greece. It included adult patients with overt NVUGIB from 10 tertiary hospitals across Greece. Data for each patient were collected on admission and up to 30 days thereafter...
2012: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Michael O'Byrne, Erin L Smith-Windsor, Chris R Kenyon, Sanchit Bhasin, Jennifer L Jones
BACKGROUND: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is associated with significant mortality. OBJECTIVE: To examine several factors that may impact the mortality and 30-day rebleed rates of patients presenting with NVUGIB. METHODS: A retrospective study of the charts of patients admitted to hospital in either the Saskatoon Health Region (SHR) or Regina Qu'Appelle Health Region (RQHR) (Saskatchewan) in 2008 and 2009 was performed...
March 2014: Canadian Journal of Gastroenterology & Hepatology
Arunkumar Krishnan, Vimalraj Velayutham, Jeswanth Satyanesan, Selvakumar Eswaran, Surendran Rajagopal
BACKGROUND: Acute non-variceal upper GI bleeding (NVUGIB) is a challenging emergency condition. Early endoscopic therapy has been recommended as the first-line of treatment for upper GI bleeding (UGIB) as it has been shown to reduce recurrent bleeding. We aimed to determine the various causes of NVUGIB and discuss the role of band ligation. PATIENTS AND METHODS: A total of 74 patients with NVUGIB who had been treated with endoscopic band ligation (EBL), between November 2006 and December 2011, were included in the study...
April 2013: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
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