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Gastrointestinal ischemia

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https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#1
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29310345/inferior-mesenteric-arteriovenous-fistula-with-nonpulsatile-abdominal-mass-a-case-report-and-a-mini-review
#2
Ling Cheng, Ruifeng Zhao, Di Guo, Kailin Cai, Kaifang Zou, Jun Yang, Liangru Zhu
RATIONALE: Inferior mesenteric arteriovenous fistula (IMAVF) is a rare condition principally characterized by portal hypertension and ischemic bowel disease. Up to now, only 30 cases have been reported. Presented here is an IMAVF patient with nonpulsatile abdominal mass as the main manifestation. PATIENT CONCERNS: A 62-year-old Chinese male who complained of abdominal discomfort for a month was admitted to our hospital. Physical examination revealed a hard and hardly mobile mass...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306522/visceral-thromboses-in-pancreas-adenocarcinoma-systematic-review
#3
REVIEW
Angel Mier Hicks, Antonio DeRosa, Michael Raj, Richard Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes...
December 12, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29259385/midgut-neuroendocrine-tumor-presenting-with-acute-intestinal-ischemia
#4
Ioannis Mantzoros, Natalia Antigoni Savvala, Orestis Ioannidis, Styliani Parpoudi, Lydia Loutzidou, Despoina Kyriakidou, Angeliki Cheva, Vasileios Intzos, Konstantinos Tsalis
Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors, commonly called carcinoids, account for about 2/3 of all neuroendocrine tumors, they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms, which usually leads to a delayed diagnosis...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29217008/endovascular-versus-surgical%C3%A2-revascularization-for-chronic%C3%A2-mesenteric%C3%A2-ischemia-insights-from-the-national-inpatient-sample-database
#5
Fabio V Lima, Dhaval Kolte, Kevin F Kennedy, David W Louis, J Dawn Abbott, Peter A Soukas, Omar N Hyder, Shafiq T Mamdani, Herbert D Aronow
OBJECTIVES: This study sought to compare in-hospital major adverse cardiac and cerebrovascular events (MACCE) following endovascular therapy with open surgery for chronic mesenteric ischemia (CMI). BACKGROUND: There are limited contemporary data on in-hospital cardiovascular outcomes among patients with CMI undergoing revascularization via endovascular therapy versus open surgery in the United States. METHODS: Patients with CMI undergoing endovascular or surgical (mesenteric bypass or endarterectomy) revascularization between 2007 and 2014 were identified from the National Inpatient Sample...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29198548/embolization-of-arterial-gastrointestinal-hemorrhage-with-fuaile-medical%C3%A2-adhesive
#6
Min Xu, Xiaoli Zhu, Yizhi Liu, Zhi Li, Tianzhi An, Tianpeng Jiang, Jie Song, Lizhou Wang, Shi Zhou, Caifang Ni
BACKGROUND: To investigate the safety and effectiveness of Fuaile medical adhesive (FAL) with superselective catheterization in endovascular embolotherapy for the treatment of gastrointestinal hemorrhage (GIH) that was unresponsive to internal medicine treatment and gastroscopy management. METHODS: A total of 25 patients with GIH, confirmed using angiography but with failed results after internal medicine treatment or gastroscopy were retrospectively analyzed. A mixture of lipiodol and FAL (1:1) was used to embolize the bleeding vessels...
November 30, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#7
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29123859/non-traumatic-bladder-rupture-showing-less-than-10-hounsfield-units-of-ascites
#8
Naoto Mizumura, Satoshi Okumura, Sho Toyoda, Atsuo Imagawa, Masao Ogawa, Masayasu Kawasaki
Aim: Bladder ruptures are commonly misdiagnosed as gastrointestinal perforations or intestinal ischemia. If a diagnosis is made preoperatively, conservative treatment is a safe and effective option. We evaluated the validity of using the attenuation value of ascites, measured by non-contrast computed tomography (CT), to identify patients with bladder ruptures. Methods: A retrospective search of our hospital database identified 7 patients with confirmed bladder ruptures between 2007 and 2013...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29064016/clinical-features-and-outcomes-of-gastric-ischemia
#9
Ayush Sharma, Saurabh Mukewar, Suresh T Chari, Louis M Wong Kee Song
BACKGROUND AND AIMS: Gastric ischemia is a rare condition associated with poor prognosis. Our study aim was to highlight the clinical features and outcomes of patients with gastric ischemia. METHODS: A retrospective review of patients diagnosed with isolated gastric ischemia at our institution from January 1, 2000, to May 5, 2016, was performed. Demographic, clinical, endoscopic, radiologic, and outcome variables were abstracted for analysis. RESULTS: Seventeen patients (65% men) with mean age of 69...
December 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29061584/low-cerebral-exposure-cannot-hinder-the-neuroprotective-effects-of-panax-notoginsenosides
#10
Haofeng Li, Jingcheng Xiao, Xinuo Li, Huimin Chen, Dian Kang, Yuhao Shao, Boyu Shen, Zhangpei Zhu, Xiaoxi Yin, Lin Xie, Guangji Wang, Yan Liang
A bidirectional route of communication between the gastrointestinal tract and the central nervous system, termed the "gut-brain axis", is becoming increasingly relevant to treatment of cerebral damage. Panax Notoginsenoside extract (PNE) is extremely popular for prevention and treatment of cardio-cerebrovascular ischemic diseases although their plasma and cerebral exposure levels were extremely low. To date, the mechanisms underlying the neuroprotective effects of PNE remain largely unknown. In the present study, the neuroprotective effects of PNE are systematically studied via investigating the regulation of PNE on gastrointestinal microbial community and gamma aminobutyric acid (GABA) receptors...
October 23, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29046747/ventricular-fibrillation-due-to-overdose-of-loperamide-the-poor-man-s-methadone
#11
Amr Salama, Yana Levin, Pramod Jha, Richard Alweis
Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29031944/comparison-of-lactic-acid-levels-in-children-with-suspected-and-confirmed-intussusception
#12
Vanessa Tamas, Paul Ishimine
BACKGROUND: Currently, no laboratory test can identify children with intussusception. Lactic acid is a marker of ischemia in gastrointestinal emergencies. OBJECTIVES: We present a case series comparing lactic acid levels in children with suspected and confirmed intussusception. METHODS: This is a prospective single case series of 39 patients who had suspected intussusception. Patients were eligible if they underwent abdominal ultrasound screening for suspected intussusception...
October 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29017807/unplanned-30-day-readmission-in-patients-with-diabetic-foot-wounds-treated-in-a-multidisciplinary-setting
#13
Courtenay M Holscher, Caitlin W Hicks, Joseph K Canner, Ronald L Sherman, Mahmoud B Malas, James H Black, Nestoras Mathioudakis, Christopher J Abularrage
OBJECTIVE: Readmission rates are known to be high for vascular surgery patients in general, but there are limited data describing the risk of surgical and nonsurgical readmission among patients with diabetic foot ulcers (DFUs). Our aim was to identify factors associated with unplanned readmission in DFU patients treated in a multidisciplinary setting. METHODS: We studied a single-center cohort of patients enrolled in a multidisciplinary diabetic foot service (July 2012-June 2017)...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28933137/rectal-perforation-in-a-42-year-old-woman-due-to-henoch-sch%C3%A3-nlein-purpura-a-case-report
#14
F Almassinokiani, A Mehdizadeh Kashi, A Musavi, S Khodaverdi, K Tahermanesh, S Ariana
Henoch-Schönlein purpura (HSP) is caused by deposition of IgA-containing immune complexes within the blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. These can be caused by gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, and bowel perforation. In adults, intussusception is less frequent than in children. We report a 42-year-old woman referred to our hospital with acute abdominal pain...
September 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#15
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28900398/role-of-hydrogen-sulfide-in-retinal-diseases
#16
REVIEW
Jiantong Du, Hongfang Jin, Liu Yang
As the third gasotransmitter, hydrogen sulfide (H2S) plays a crucial role in the physiology and pathophysiology of many systems in the body, such as the nervous, cardiovascular, respiratory, and gastrointestinal systems. The mechanisms for its effects, including inhibiting ischemic injury, reducing oxidative stress damage, regulating apoptosis, and reducing the inflammation reaction in different systems, have not been fully understood. Recently, H2S and its endogenous synthesis pathway were found in the mammalian retina...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28892784/ileal-angiodysplasia-presentation-as-a-bowel-obstruction-a-case-report
#17
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
INTRODUCTION: Angiodysplasia is a common vascular abnormality of the gastrointestinal tract, found in the elderly and most frequently revealed by gastrointestinal bleeding. We report an original case of ileal angiodysplasia in an 83-year-old woman presenting as a bowel obstruction. CASE PRESENTATION: An 83-year-old woman with a medical history of chronic untreated anemia, presented with cardinal symptoms of bowel obstruction. Computed tomography revealed diffuse ileal wall thickening with multiple zones of stenosis, which were aggravated by an ileal perforation and associated with vascular abnormalities compatible with angiodysplasia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28879575/in-hospital-mortality-for-hepatic-portal-venous-gas-analysis-of-1590-patients-using-a-japanese-national-inpatient-database
#18
Chie Koizumi, Nobuaki Michihata, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Hepatic portal venous gas (HPVG) is rare but potentially serious condition. Main cause of HPVG is bowel ischemia, while detection of HPVG without bowel ischemia may have been increasing possibly due to widespread use of computed tomography. However, little is known about variation in etiologies of HPVG and mortality of HPVG with each etiology. We examined patient backgrounds, underlying diseases, and in-hospital mortality of HPVG patients using a national inpatient database...
September 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28849898/catheter-directed-thrombolysis-is-not-limited-to-acute-limb-ischemia-treatment-the-experience-from-vascular-surgery-division
#19
Aleksander Lukasiewicz, Piotr Flisinski, Wojciech Lichota
BACKGROUND: Thrombolytic treatment has many potential indications in the era of modern vascular surgery. We aimed to analyze the contemporary experience in the catheter-directed, intraarterial thrombolysis in different clinical scenarios. METHODS: The available data of 121 patients with different types (acute, subacute, complications of vascular procedures) of lower limb ischemia treated by means of the intraarterial, catheter- directed thrombolysis between 11.2011 and 12...
August 29, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#20
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
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