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Variceal hemorrhage

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https://www.readbyqxmd.com/read/29154015/albumin-bilirubin-grade-versus-meld-score-for-predicting-survival-after-transjugular-intrahepatic-portosystemic-shunt-tips-creation
#1
J Ronald, Q Wang, S S Choi, P V Suhocki, M D Hall, T P Smith, C Y Kim
OBJECTIVES: The purpose of this study was to compare the albumin-bilirubin (ALBI) grade and model for end-stage liver disease (MELD) scores for predicting survival after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: A retrospective study of pre-procedure ALBI and MELD scores was performed in 197 patients who underwent TIPS from 2005 to 2012. There were 140 men and 57 women, with a mean age of 56±11 (SD) (range: 19-90years)...
November 16, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29134968/-weekend-effect-in-patients-with-upper-gastrointestinal-hemorrhage-a-systematic-review-and-meta-analysis
#2
REVIEW
Ashutosh Gupta, Rajender Agarwal, Ashwin N Ananthakrishnan
OBJECTIVES: "Weekend effect" refers to worse outcomes among patients presenting to the hospital on weekends or holidays. We performed a systematic review and meta-analysis of observational studies assessing the impact of the "weekend effect" in patients with upper gastrointestinal hemorrhage (UGIH). METHODS: We searched key bibliographic databases using keywords and MeSH terms related to gastrointestinal hemorrhage and "weekend effect". Our primary analysis evaluated mortality in patients with UGIH who were hospitalized on the weekend or after-hours compared with a weekday...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29117668/outcomes-of-patients-treated-with-sengstaken-blakemore-tube-for-uncontrolled-variceal-hemorrhage
#3
Ja Yun Choi, Yun Won Jo, Sang Soo Lee, Wan Soo Kim, Hye Won Oh, Cha Young Kim, Eun Young Yun, Jin Joo Kim, Jae Min Lee, Hong Jun Kim, Hyun Jin Kim, Tae Hyo Kim, Woon Tae Jung, Ok Jae Lee, Rock Bum Kim
Background/Aims: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. Methods: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed...
November 10, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29110128/endoscopic-treatments-for-portal-hypertension
#4
REVIEW
Gin-Ho Lo
Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy is superior to vasoconstrictor or endoscopic therapy alone for control of acute esophageal variceal hemorrhage. After control of acute variceal bleeding, combination of banding ligation and beta-blockers is generally recommended to prevent variceal rebleeding...
November 7, 2017: Hepatology International
https://www.readbyqxmd.com/read/29075990/biology-of-portal-hypertension
#5
REVIEW
Matthew McConnell, Yasuko Iwakiri
Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized...
October 26, 2017: Hepatology International
https://www.readbyqxmd.com/read/29058164/hand-assisted-laparoscopic-hassab-s-procedure-for-esophagogastric-varices-with-portal-hypertension
#6
Takashi Kobayashi, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Zhengkun Zhang, Takuya Ando, Kizuki Yuza, Yuki Hirose, Tomohiro Katada, Kazuyasu Takizawa, Masayuki Nagahashi, Jun Sakata, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension...
October 23, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29052175/african-americans-with-cirrhosis-are-less-likely-to-receive-endoscopic-variceal-screening-within-one-year-of-cirrhosis-diagnosis
#7
Ann Robinson, Hesam Tavakoli, Benny Liu, Taft Bhuket, Ramsey Cheung, Robert J Wong
BACKGROUND: Esophageal variceal hemorrhage is a complication of cirrhosis that carries high mortality, and can be reduced with timely endoscopic variceal screening and treatment. AIM: We aim to evaluate overall rates of and disparities in receipt of endoscopic variceal screening among an ethnically diverse urban safety-net hospital. METHODS: All consecutive adults with cirrhosis (7/1/2014 to 12/31/2015) were retrospectively evaluated to determine the rates of receiving esophageal variceal screening within 6 months and within 1 year after cirrhosis diagnosis...
October 19, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29043000/effect-of-entecavir-in-the-treatment-of-patients-with-hepatitis-b-virus-related-compensated-and-decompensated-cirrhosis
#8
Xiao-Dong Gai, Wei-Feng Wu
Chronic hepatitis B virus (CHB) infection is a burden on global healthcare and is associated with a higher risk of serious sequelae, including cirrhosis and hepatocellular carcinoma. The clinical application of entecavir as a treatment for CHB has produced positive outcomes, and so is an attractive form of pharmacological therapy. However, little data exists comparing the safety and efficacy of entecavir for the treatment of hepatitis B virus (HBV)-related compensated, and decompensated cirrhosis, respectively...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28994870/predictive-scores-of-early-mortality-from-variceal-gastrointestinal-bleeding-in-cirrhotic-patients
#9
Leila Mouelhi, Hend Ayadi, Yosra Zaimi, Oussama Daboussi, Mohamed Salem, Radhouane Debbech, Fatma Houissa, Taoufik Najjar
INTRODUCTION: The variceal bleeding, main complication of portal hypertension during cirrhosis, is associated with high early mortality riskestimated between 15 and 20%. This highlights the necessity of predictive models that allow identifying high-risk patients raising the issue of amore aggressive therapeutic care. OBJECTIVE: To assess the performance of four scores for the prediction of cirrhotic patients' high early mortality risk due to digestive hemorrhageand to compare them to the Child-Pugh reference score...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28983709/late-complications-of-biliary-atresia-hepatopulmonary-syndrome-and-portopulmonary-hypertension
#10
Frederick M Karrer, Bradley J Wallace, Arturo E Estrada
Children with biliary atresia (BA) following Kasai portoenterostomy have a high risk for portal hypertension, however, while variceal and hemorrhagic complications have been more commonly studied, less frequent but no less possibly devastating complications of hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPH) remain less well understood. HPS and PPH both occur in a setting of portal hypertension, however, paradoxically patients with HPS develop pulmonic vasculature dilation leading to shunting and hypoxia, while those with PPH develop an opposite progression of pulmonary vasoconstriction eventually leading to cor pulmonale and decompensation...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28983161/etiological-and-endoscopic-profile-of-middle-aged-and-elderly-patients-with-upper-gastrointestinal-bleeding-in-a-tertiary-care-hospital-in-north-india-a-retrospective-analysis
#11
Pranav Mahajan, Vijant Singh Chandail
BACKGROUND: Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease...
July 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28962152/study-of-the-association-between-hemorrhage-and-the-position-of-hemorrhagic-stigmata-in-patients-with-esophageal-varices
#12
Shao-Hua Shen, Ying-Di Liu, Xiao Sun, Meng Li, Guo-Hui Sun, Juan Wang, Jiang-Tao Liu, Jun Tie, Jing Yang
The aim of the present study was to investigate the predilection position of hemorrhagic stigmata (HS) in patients with esophageal variceal hemorrhage and provide guidance on endoscopic therapy for esophageal varices. The clinical characteristics, particularly the endoscopic manifestations of HS, in the patients who presented with gastroesophageal variceal hemorrhage and cirrhosis between January 2003 and December 2013 at our hospital were summarized and patients were grouped according to the distance of the lesion site to incisors at 35-40 and ~30 cm...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28953556/uncontrolled-bleeding-of-the-gastrointestinal-tract
#13
Alain D'Hondt, Lionel Haentjens, Nicolas Brassart, Frédéric Flamme, Jean-Charles Preiser
PURPOSE OF REVIEW: Acute gastrointestinal bleeding is a frequent emergency situation, whose incidence will likely rise as a result of the increasing use of direct anticoagulants and of the medical progresses resulting in longer life expectancy with underlying comorbidities. Updated guidelines and improvements in the diagnostic and therapeutic tools are now available and will likely improve the management of massive gastrointestinal bleeding in the near future. RECENT FINDINGS: The assessment of severity has been improved by validated scores useable upon admission...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28923638/treatment-of-refractory-gastrointestinal-bleeding-in-patients-with-portal-hypertension-a-case-series-and-treatment-algorithm
#14
J Balogh, S Gordon-Burroughs, P Schwarz, J Galati, R A McFadden, M Cusick, M J Snyder, H R Bailey, M Weiner, A Wong, R A Ochoa, A Saharia, A O Gaber, R M Ghobrial
In patients with portal hypertension, ectopic varices can develop at any site along the gastrointestinal tract outside the classically described gastroesophageal location. Like esophageal variceal hemorrhage, bleeding from ectopic varices can be life-threatening. Diagnosis and treatment of ectopic varices can be challenging; to date, no effective treatment algorithm has been described. A systematic teamwork approach to diagnosing and treatment of ectopic varices is required to successfully manage hemorrhage from ectopic varices...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28919600/modified-blatchford-score-for-risk-stratification-in-adult-patient-with-nonvariceal-upper-gastrointestinal-haemorrhage-and-their-short-term-hospital-outcome
#15
M S Islam, M Z Uddin, M S Ali, M N Islam, M H Rahman, I H Robi, M M Haque, M W Rahman, M A Uddin, F Ahamed, M S Malek, M A Kabir, M S Rahman, A U Khan, F A Doel
Upper gastrointestinal hemorrhage (UGIH) is one of the most common and life-threatening gastrointestinal emergency. There are several risk scores for risk stratification in UGIB patients. The Modified Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting The Modified Blatchford scoring system also known as Glasgow Blatchford Scoring (GBS) have been developed to stratify risk of non variceal upper gastrointestinal hemorrhage or need of medical or surgical intervention, endoscopic therapy...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28915680/combination-therapy-versus-pharmacotherapy-endoscopic-variceal-ligation-or-the-transjugular-intrahepatic-portosystemic-shunt-alone-in-the-secondary-prevention-of-esophageal-variceal-bleeding-a-meta-analysis-of-randomized-controlled-trials
#16
Lu-Lu Lin, Shi-Ming Du, Yan Fu, Hui-Yun Gu, Lei Wang, Zhi-Yuan Jian, Xian-Feng Shen, Jie Luo, Chao Zhang
Patients with liver cirrhosis and variceal hemorrhage are at increased risk of rebleeding. We performed a meta-analysis toassess the clinical efficacy of combination therapy (pharmacotherapy and endoscopic variceal ligation (EVL)) compared with pharmacotherapy, EVL, or transjugular intrahepatic portosystemic shunt (TIPS) alone in the prevention of rebleeding and mortality. A literature search of MEDLINE, EMBASE, and the Cochrane Controlled Trials Register, up until November 2016, identified relevant randomized controlled trials...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28906321/variceal-hemorrhage-and-adverse-liver-outcomes-in-patients-with-cystic-fibrosis-cirrhosis
#17
Wen Ye, Michael R Narkewicz, Daniel H Leung, Wikrom Karnsakul, Karen F Murray, Estella M Alonso, John C Magee, Sarah Jane Schwarzenberg, Alexander Weymann, Jean P Molleston
OBJECTIVES: Cirrhosis occurs in 5-10% of CF (cystic fibrosis) patients, often accompanied by portal hypertension. We analyzed three adverse liver outcomes, variceal bleeding (VB), liver transplant (LT), and liver death (LD), and risk factors for these in CF Foundation Patient Registry (CFFPR) subjects with reported cirrhosis. METHODS: We determined 10-year incidence rates for VB, LT, LD, and all-cause mortality (ACM), and examined risk factors using competing risk models and Cox-proportional hazard regression...
September 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28865767/management-of-acute-variceal-hemorrhage-as-a-model-of-individualized-care-for-patients-with%C3%A2-cirrhosis
#18
EDITORIAL
Guadalupe Garcia-Tsao
No abstract text is available yet for this article.
September 1, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28855391/higher-flow-is-present-in-unruptured-arteriovenous-malformations-with-silent-intralesional-microhemorrhages
#19
Xiaolin Chen, Daniel L Cooke, David Saloner, Jeffrey Nelson, Hua Su, Michael T Lawton, Christopher Hess, Tarik Tihan, Yuanli Zhao, Helen Kim
BACKGROUND AND PURPOSE: Silent microhemorrhage (hemosiderin) has been observed in resected brain arteriovenous malformations (bAVM) tissue and may represent a subgroup at increased risk for clinical hemorrhage. Previous studies suggest that ruptured bAVMs have faster flow and shorter mean transit time of contrast in blood vessels than unruptured bAVMs. We hypothesized that flow would be faster in unruptured AVMs with hemosiderin compared with those without hemosiderin. METHODS: We selected unruptured, supratentorial bAVMs >3...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28843589/hemorrhage-risk-with-transjugular-intrahepatic-portosystemic-shunt-tips-insertion-at-the-main-portal-vein-bifurcation-with-stent-grafts
#20
A S Griffin, S R Preece, J Ronald, T P Smith, P V Suhocki, C Y Kim
PURPOSE: The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS: TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic...
August 23, 2017: Diagnostic and Interventional Imaging
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