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https://www.readbyqxmd.com/read/29908361/incidence-of-upper-and-lower-gastrointestinal-bleeding-in-new-users-of-low-dose-aspirin
#1
Lucía Cea Soriano, Angel Lanas, Montse Soriano-Gabarró, Luis A García Rodríguez
BACKGROUND & AIMS: There are few data on the incidence of upper and lower gastrointestinal bleeding (UGIB and LGIB) from observational studies of low-dose aspirin users. We aimed to estimate incidence rates of UGIB and LGIB in a large cohort of new users of low-dose aspirin in the United Kingdom, with sub-analyses of hospitalization status and fatalities. METHODS: We performed a population-based study of 199,079 new users of low-dose aspirin (median age, 64...
June 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29907656/temporal-trends-in-the-outcomes-of-dialysis-patients-admitted-with-acute-ischemic-stroke
#2
Fahad Alqahtani, Chalak O Berzingi, Sami Aljohani, Mohamed Al Hajji, Anas Diab, Muhammad Alvi, Khaled Boobes, Mohamad Alkhouli
BACKGROUND: There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (AIS) in patients on maintenance dialysis. METHODS AND RESULTS: We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of AIS in dialysis patients. A total of 930 010 patients were admitted with AIS between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of AIS among dialysis patients decreased significantly ( P trend <0...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907655/causes-and-predictors-of-readmission-in-patients-with-atrial-fibrillation-undergoing-catheter-ablation-a-national-population-based-cohort-study
#3
Shilpkumar Arora, Sopan Lahewala, Byomesh Tripathi, Varshil Mehta, Varun Kumar, Divya Chandramohan, Alejandro Lemor, Mihir Dave, Nileshkumar Patel, Nilay V Patel, Ghanshyam Palamaner Subash Shantha, Juan Viles-Gonzalez, Abhishek Deshmukh
BACKGROUND: Reducing readmission after catheter ablation (CA) in atrial fibrillation (AF) is important. METHODS AND RESULTS: We utilized National Readmission Data (NRD) 2010-2014. AF was identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) diagnostic code 427.31 in the primary field, while first CA of AF was identified via ICD-9 -procedure code 37.34. Any admission within 30 or 90 days of index admission was considered a readmission...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29906524/timing-of-gastrointestinal-bleeding-after-implantation-of-left-ventricular-assist-devices-associates-with-anatomic-location-presentation-and-management
#4
James H Tabibian, Daniel P Rhoades, Kimberly A Forde, Rhondalyn C McLean, Vinay Chandrasekhara
BACKGROUND & AIMS: Continuous-flow left ventricular assist devices (LVADs) for advanced heart failure have been associated with gastrointestinal bleeding (GIB). We examined the association between time of GIB after LVAD implantation and bleeding location (determined by endoscopy), etiology, and patient outcomes. METHODS: We performed a retrospective study of consecutive patients who underwent implantation of continuous-flow LVADs from 2008 through 2015. We analyzed data on anatomic location of GIB, etiology, length of hospital stay, transfusion requirement, time to endoscopy, and rate of readmission within 30 days...
June 12, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29904726/sx-ella-danis-stent-in-massive-upper-gastrointestinal-bleeding-in-cirrhosis-a-case-series
#5
Mayank Jain, Mahadevan Balkrishanan, Chenduran Snk, Sridhar Cgs, Ravi Ramakrishnan, Jayanthi Venkataraman
We report our experience of three cases of decompensated cirrhosis with massive upper gastrointestinal bleeding, which required insertion of an SX-Ella Danis stent for hemostasis. The procedure is safe and effective.
June 2018: Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29904492/reduced-iodinated-contrast-media-for-abdominal-imaging-by-dual-layer-spectral-detector-computed-tomography-for-patients-with-kidney-disease
#6
Hirokazu Saito, Kana Noda, Koji Ogasawara, Shutaro Atsuji, Hiroko Takaoka, Hiroo Kajihara, Jiro Nasu, Mitsuhiko Kitaoka, Shoji Morishita, Ikuo Matsushita, Kazuhiro Katahira
Contrast-enhanced computed tomography using iodinated contrast media is useful for diagnosis of gastrointestinal diseases. However, contrast-induced nephropathy remains problematic for kidney diseases patients. Although current guidelines recommended the use of a minimal dose of contrast media necessary to obtain adequate images for diagnosis, obtaining adequate images with sufficient contrast enhancement is difficult with conventional computed tomography using reduced contrast media. Dual-layer spectral detector computed tomography enables the simultaneous acquisition of low- and high-energy data and the reconstruction of virtual monochromatic images ranging from 40 to 200 keV, retrospectively...
April 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29904461/pancreatic-arteriovenous-malformation-mimicking-pancreatic-neoplasm-a-systematic-multimodality-diagnostic-approach-and-treatment
#7
Olga Nikolaidou, Ekaterini Xinou, Pavlos Papakotoulas, Andis Philippides, Dimitra Panagiotopoulou-Boukla
Pancreatic arteriovenous malformation (pAVM) is a very rare entity, as less than 100 cases are reported in the international literature. Patients with pAVM may be asymptomatic or may present a wide range of symptoms, such as vague pain, feeling of fullness, gastrointestinal bleeding, or even portal hypertension. We present the multimodality approach in the diagnosis of a patient with pAVM and treatment via transcatheter arterial embolization of the lesion using steel coils. The patient was free of symptoms 12 months later...
April 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29904312/secondary-involvement-of-the-gastrointestinal-tract-by-renal-cell-carcinoma
#8
Daniel S Grosser, He Huang
Secondary involvement of the gastrointestinal (GI) tract by renal cell carcinoma is rare. We undertook a retrospective review of our institution's pathology records from January 2006 to July 2017 and identified eight cases of GI tract involvement by renal cell carcinoma. Sites of involvement included stomach, duodenum, jejunum, ileum, and cecum. Pertinent clinical information was obtained from electronic medical records. The interval from primary resection to identification of GI involvement was often prolonged, averaging 6 years, and mimicked primary GI tract malignancies, with presentations including GI bleeding, abdominal pain, and obstruction...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29903893/living-without-a-pulse-the-vascular-implications-of-continuous-flow-left-ventricular-assist-devices
#9
Suneet N Purohit, William K Cornwell, Jay D Pal, JoAnn Lindenfeld, Amrut V Ambardekar
Pulsatility seems to have a teleological role because evolutionary hierarchy favors higher ordered animals with more complex, multichamber circulatory systems that generate higher pulse pressure compared with lower ordered animals. Yet despite years of such natural selection, the modern generation of continuous-flow left ventricular assist devices (CF-LVADs) that have been increasingly used for the last decade have created a unique physiology characterized by a nonpulsatile, nonlaminar blood flow profile with the absence of the usual large elastic artery Windkessel effect during diastole...
June 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29901639/reversible-splenial-lesion-syndrome-after-blood-transfusion-presents-callosal-disconnection-syndrome-a-case-report
#10
Xinxin Ma, Wen Su, Haibo Chen
RATIONALE: Reversible splenial lesion syndrome (RESLES) is a reversible condition with an excellent prognosis in most patients. The clinical features include altered states of consciousness, delirium, headache, and seizures, but no callosal disconnection syndromes have been described in RESLES. PATIENT CONCERNS: We presented a 57-year-old patient with alien hand syndrome, autotopagnosia, gait disorders, and left ideomotor apraxia after blood transfusion. The brain magnetic resonance imaging (MRI) showed a few regions with high signal intensity in the genu, body, and splenium of the right corpus callosum on diffusion weighted images...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901606/a-case-report-of-successful-treatment-of-secondary-aortoenteric-fistula-complicated-with-gastrointestinal-bleeding-and-retroperitoneal-abscess-in-an-elderly-patient
#11
Chunyan Jiang, Xueming Chen, Jianshe Li, Hongwei Li
RATIONALE: The treatment of secondary aortoenteric fistula (SAEF) involves maintaining hemodynamic stability, infection control, revascularization, and surgical repair. Conventional open repair is associated with high mortality, whereas endovascular stent-graft repair is associated with recurrent infection or bleeding. PATIENT CONCERNS: We report the case of an 85-year-old man with SAEF who presented with gastrointestinal bleeding and retroperitoneal abscess. DIAGNOSES: He was misdiagnosed for 5 months...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29900874/dabigatran-in-patients-with-myocardial-injury-after-non-cardiac-surgery-manage-an-international-randomised-placebo-controlled-trial
#12
P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. METHODS: In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries...
June 9, 2018: Lancet
https://www.readbyqxmd.com/read/29900748/ileal-tubular-adenoma-as-a-cause-of-lower-gastrointestinal-bleeding-in-infants
#13
Robin Germán Prieto, Manuel Alejandro Mahler, Gustavo Vidales
Lower gastrointestinal bleeding is a common pathology with diverse causes depending on the patients´ age. The most common causes in adults are polyps, neoplasias, diverticular disease and angiodysplasia. In neonates, necrotizing enterocolitis and volvulus, and anal fissures and bowel intussusception in infants. Polyps are reported as a cause of bleeding only in children of preschool age.
June 14, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29900001/transfusion-management-of-incident-dialysis-patients-in-canada-a-prospective-observational-study
#14
Aminu K Bello, Christine M Ribic, Serge H Cournoyer, Mercedeh Kiaii, Martine LeBlanc, Melanie Poulin-Costello, David N Churchill, Norman Muirhead
Background: Several studies have demonstrated harm associated with using erythropoiesis-stimulating agents (ESA) to achieve higher hemoglobin (Hb) levels. Subsequently, more conservative use of ESAs has changed anemia therapy in patients with chronic renal failure. Objective: The objectives were to identify transfusion rates in hemodialysis (HD) patients during the first year of therapy, to identify factors associated with the probability of transfusion, describe reasons for the transfusions, and identify the Hb values associated with each transfusion...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29898476/-cases-of-suspected-poisoning-in-small-animal-practice-a-retrospective-and-prospective-survey
#15
Svenja Allkämper, Sarah Kösters, Amely Campe, Manfred Kietzmann, Lothar Kreienbrock
OBJECTIVE: Systematic survey of data from cases of suspected poisoning in small animal practices. MATERIAL AND METHODS: In 11 exemplary selected small animal practices, patient files from cases of suspected poisoning over 2006/2007, data entry forms of poisonings 2009-2010 and the contact group, which are all patients with at least one visit in 2007, were analysed. RESULTS: In 2007, approximately 1 in 200 dog and 1 in 500 cat patients were presented with poisoning...
June 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/29898280/upper-gastrointestinal-bleeding-in-neck-of-femur-fracture-patients-a-single-tertiary-centre-experience
#16
Jessamine Liu, Rohit Gupta, Karen Hay, Chrys Pulle, Tony Rahman, Shaun Pandy
This study aimed to identify the incidence of perioperative acute upper gastrointestinal bleeding (UGIB) in our hip fracture patients; to evaluate the characteristics, management and clinical outcomes of these patients; and to explore risk factors and protective factors. Of the 1691 consecutive patients admitted for surgical management of hip fractures, 11 (0.65%) had UGIB and a further four patients for each case were selected as controls for evaluation of risk factors and protective factors. Pre-existing peptic ulcer disease was identified as a risk factor for acute UGIB (odds ratio 7...
June 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29895412/benefit-of-an-electronic-medical-record-based-alarm-in-the-optimization-of-stress-ulcer-prophylaxis
#17
Emanuel José Saad, Marianela Bedini, Ana Florencia Becerra, Gustavo Daniel Martini, Jacqueline Griselda Gonzalez, Andrea Bolomo, Luciana Castellani, Silvana Quiroga, Cristian Morales, James Leathers, Domingo Balderramo, Ricardo Arturo Albertini
BACKGROUND: The use of stress ulcer prophylaxis (SUP) has risen in recent years, even in patients without a clear indication for therapy. AIM: To evaluate the efficacy of an electronic medical record (EMR)-based alarm to improve appropriate SUP use in hospitalized patients. METHODS: We conducted an uncontrolled before-after study comparing SUP prescription in intensive care unit (ICU) patients and non-ICU patients, before and after the implementation of an EMR-based alarm that provided the correct indications for SUP...
June 9, 2018: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/29891522/clinical-impact-of-local-progression-in-pancreatic-cancer
#18
Nicholas Cardillo, Daniel M Seible, Katherine E Fero, Andrew R Bruggeman, Reith R Sarkar, Alexa Azuara, Daniel R Simpson, James D Murphy
Background: The high prevalence of distant metastatic disease among patients with pancreatic cancer often draws attention away from the local pancreatic tumor. This study aimed to define the complications and hospitalizations from local versus distant disease progression among a retrospective cohort of patients with pancreatic cancer. Methods: Records of 298 cases of pancreatic cancer treated at a single institution from 2004 through 2015 were retrospectively reviewed, and cancer-related symptoms and complications requiring hospitalization were recorded...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29888274/difference-between-the-upper-and-the-lower-gastrointestinal-bleeding-in-patients-taking-nonvitamin-k-oral-anticoagulants
#19
Kyohei Maruyama, Takatsugu Yamamoto, Hitoshi Aoyagi, Akari Isono, Koichiro Abe, Shinya Kodashima, Hiroto Kita, Yuji Watari, Ken Kozuma
Nonvitamin K oral anticoagulants (NOACs) sometimes cause hemorrhage, and the gastrointestinal tract is a common site of involvement. However, clinical characteristics of gastrointestinal bleeding (GIB) during NOAC therapy have not been fully elucidated. We studied 658 patients who were prescribed dabigatran, rivaroxaban, or apixaban between April 2011 and November 2015. Medical charts were reviewed to examine whether clinically relevant bleeding (Bleeding Academic Research Consortium criteria type 2 or greater) developed...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29886667/-postoperative-complications-and-survival-analysis-of-1-118-cases-of-open-splenectomy-and-azygoportal-disconnection-in-the-treatment-of-portal-hypertension
#20
R Z Qi, X Zhao, S Z Wang, K Zhang, Z Y Chang, X L Hu, M L Wu, P R Zhang, L X Yu, C H Xiao, X J Shi, Z W Li
Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People's Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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