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https://www.readbyqxmd.com/read/28938310/administration-of-four-factor-prothrombin-complex-concentrate-for-a-life-threatening-bleed-in-a-jehovah-s-witness-patient
#1
Jennifer L Cole, Nathanael D McLeod
: Life-threatening bleeds are medical emergencies that require time-sensitive decision making. Patients of the Jehovah's Witness faith can present a challenging conundrum when their beliefs conflict with modern treatment options for haemorrhage. Providers may not be aware of the grades of acceptance of the newer products outside of packed red blood cells. Researchers present a case of using four-factor prothrombin complex concentrate in a Jehovah's Witness patient in a life-threatening gastrointestinal haemorrhage along with a brief review of the literature...
September 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28936875/hemosuccus-pancreaticus-secondary-to-pseudoaneurysm-of-the-splenic-artery
#2
Mariano José Parada Blázquez, Andrea Núñez Ortiz
A 41-years-old male who presents abdominal pain and rectal bleeding with acute anemization. Both the gastroscopy and the colonoscopy dont identify any potential cause of bleeding. The computed tomography (CT) shows a pseudoaneurysm of the splenic artery. Gastrointestinal bleeding was attributed to a hemosuccus pancreaticus secondary to the pseudoaneurysm of the splenic artery. An arteriography was performed to embolize it. Pseudoaneurysm of the splenic artery is a rare cause of gastrointestinal bleeding. Given the risk of a rupture, the treatment is mandatory irrespective of the size or symptoms...
September 22, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28935474/superselective-embolization-for-arterial-upper-gastrointestinal-bleeding-using-n-butyl-cyanoacrylate-a-single-center-experience-in-152-patients
#3
Saebeom Hur, Hwan Jun Jae, Hyukjoon Lee, Myungsu Lee, Hyo-Cheol Kim, Jin Wook Chung
PURPOSE: To evaluate 30-day safety and efficacy of superselective embolization for arterial upper gastrointestinal bleeding (UGIB) using N-butyl cyanoacrylate (NBCA). MATERIALS AND METHODS: This single-center retrospective 10-year study included 152 consecutive patients with UGIB (gastric, n = 74; duodenal, n = 78) who underwent embolization with NBCA for angiographically positive arterial bleeding. The primary endpoint was clinical success rate defined as achievement of hemostasis without rebleeding or UGIB-related mortality within 30 days after embolization...
September 19, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28935445/-usefulness-of-small-bowel-capsule-endoscopy-in-gastrointestinal-bleeding
#4
Chloé Leandri, Benoit Bordacahar, Sophie Ribiere, Ammar Oudjit, Marie-Anne Guillaumot, Bertrand Brieau, Frédéric Prat, Vered Abitbol, Stanislas Chaussade, Romain Coriat
In France, upper gastrointestinal haemorrhages have an estimated annual incidence of 143 cases per 100,000 inhabitants. Classically, two types of digestive hemorrhage are described: acute and chronic digestive hemorrhages. Upper endoscopy is carried out in case of hematemesis or melena. It requires that the patient has been fasting for at least 6hours for solids and 3hours for liquids. The main etiologies of hemorrhagic hemorrhage of the origin are the vascular abnormalities, inflammatory or drug-induced ulcerations, intestinal tumors, Meckel's diverticulum, and Dieulafoy ulcer...
September 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28932274/the-impact-of-panenteric-capsule-endoscopy-on-the-management-of-crohn-s-disease
#5
REVIEW
Rami Eliakim
Crohn's disease (CD) is a chronic inflammatory disease, in most patients involving the small and large bowel. In recent years, with the use of small bowel video capsule endoscopy (SBCE), it has become clear that in 50% or more of adults with established CD there is not only distal but also proximal small bowel involvement that suggests poor prognosis. A great deal of effort has been put into early diagnosis and stratification of patients into low versus high risk, thus directing treatment from step-up, or accelerated step-up, to top-down therapies...
September 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28929324/stress-ulcer-prophylaxis-in-neurocritical-care
#6
Jeffrey F Barletta, Alicia J Mangram, Joseph F Sucher, Victor Zach
Stress ulcer prophylaxis (SUP) with acid-suppressive drug therapy is widely utilized in critically ill patients following neurologic injury for the prevention of clinically important stress-related gastrointestinal bleeding (CIB). Data supporting SUP, however, largely originates from studies conducted during an era where practices were vastly different than what is considered routine by today's standard. This is particularly true in neurocritical care patients. In fact, the routine provision of SUP has been challenged due to an increasing prevalence of adverse drug events with acid-suppressive therapy and the perception that CIB rates are sparse...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28929218/percutaneous-gastric-remnant-gastrostomy-following-roux-en-y-gastric-bypass-surgery-a-single-tertiary-center-s-13-year-experience
#7
Shehbaz Hasam Shaikh, Justin Jay Stenz, David W McVinnie, James J Morrison, Todd Getzen, Arthur M Carlin, Farhaan R Mir
PURPOSE: The purpose of the study is to evaluate the indications, techniques, and outcomes for percutaneous gastrostomy placement in the gastric remnant following Roux-en-Y gastric bypass (RYGB) in bariatric patients. MATERIALS AND METHODS: Retrospective chart review and summary statistical analysis was performed on all RYGB patients that underwent attempted percutaneous remnant gastrostomy placement at our institution between April 2003 and November 2016. RESULTS: A total of 38 patients post-RYGB who underwent gastric remnant gastrostomy placement were identified, 32 women and 6 men, in which a total of 41 procedures were attempted...
September 19, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28925290/differences-in-the-clinical-course-of-516-japanese-patients-with-upper-gastrointestinal-bleeding-between-weekday-and-weekend-admissions
#8
Minoru Fujita, Noriaki Manabe, Takahisa Murao, Motoyasu Osawa, Shinsuke Hirai, Shinya Fukushima, Yo Shogen, Rui Nakato, Manabu Ishii, Hiroshi Matsumoto, Jiro Hata, Akiko Shiotani
BACKGROUND AND AIMS: Patients suspected of having upper gastrointestinal bleeding (UGIB) admitted during the weekend tend to have a poor outcome in western countries. However, no Japanese studies have been reported on this matter. We aimed to evaluate differences in the clinical course of patients with UGIB between weekday and weekend admissions in Japan. METHODS: Medical records of patients who had undergone emergency endoscopy for UGIB were retrospectively reviewed...
September 19, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28925169/-systematic-review-on-safety-of-salvianolate-injection
#9
Zhi-Wei Chen, Yan-Ming Xie, Xing Liao, Gui-Qian Wang
To systematically evaluate the safety of salvianolate injection in clinical medication. A systematic literature search was performed in the databases of Cochrane Library, Medline, Embase, the Web of Science, Clinical Trials, CNKI, VIP, WanFang Data and CBM. Literature screening was done according to inclusion and exclusion criteria, and quality was assessed according to internationally recognized quality evaluation criteria. Then the data were reviewed for analysis. 148 papers were included, consisting of 122 randomized controlled trials(RCTs), 10 non-randomized controlled trials(NRCTs), 4 case series studies, and 12 case reports...
October 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28924603/dieulafoy-s-lesion-of-the-rectum-a-case-report-and-review-of-the-literature
#10
Mo Wang, Xiang Bu, Jing Zhang, Shanshan Zhu, Ying Zheng, Xinxing Tantai, Shiyang Ma
One patient with Dieulafoy's lesion (DL) of the rectum who had a history of anal receptive intercourse is described and the relevant literature reviewed. DL is rare in clinical practice and is extremely rare in the rectum. It often affects patients with no history of cirrhosis or gastrointestinal disease and occurs with abrupt or recurrent gastrointestinal bleeding. Visible vessels can usually be found by endoscopy and coinstantaneous treatments are essential while surgical interventions can occur when necessary...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924594/can-we-now-recommend-otsc-as-first-line-therapy-in-case-of-non-variceal-upper-gastrointestinal-bleeding
#11
EDITORIAL
Shannon Melissa Chan, James Yw Lau
No abstract text is available yet for this article.
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#12
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#13
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28924517/breast-cancer-metastases-to-the-gastrointestinal-tract-presenting-with-anemia-and-intra-abdominal-bleed
#14
Idrees Khan, Rehan Malik, Amina Khan, Salman Assad, Mehr Zahid, Muhammad Saad Sohail, Faizan Yasin, Ahmed H Qavi
Signet ring adenocarcinoma of the breast with synchronous metastasis to the gastrointestinal (GI) tract is a rare occurrence, typically presenting with abdominal pain, dyspepsia, or GI bleed. We report a case of metastatic breast cancer presenting with a complaint of anemia. A further diagnostic evaluation revealed generalized lymphadenopathy, nodular thickening of the urinary bladder wall, bone lesions, and enlarged pancreas. Biopsies from the lymph nodes, pancreatic biopsy, and bladder nodule all revealed a signet cell carcinoma...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/28923638/treatment-of-refractory-gastrointestinal-bleeding-in-patients-with-portal-hypertension-a-case-series-and-treatment-algorithm
#15
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/28922451/low-medical-morbidity-and-mortality-after-acute-courses-of-electroconvulsive-therapy-in-a-population-based-sample
#16
D M Blumberger, D P Seitz, N Herrmann, J G Kirkham, R Ng, C Reimer, P Kurdyak, A Gruneir, M J Rapoport, Z J Daskalakis, B H Mulsant, S N Vigod
BACKGROUND: To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). METHOD: Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality...
September 18, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28918809/endoscopic-ultrasonography-guided-hemostasis-techniques
#17
REVIEW
Everson Luiz de Almeida Artifon, Fernando Pavinato Marson, Muhammad Ali Khan
Endoscopic ultrasonography (EUS)-guided hemostasis is an evolving technique that has the potential to improve the care of patients with refractory variceal and nonvariceal gastrointestinal bleeding. EUS-guided treatment of fundal varices with coil and/or cyanoacrylate seems to be highly effective in active bleeding, as well as for primary and secondary bleeding prophylaxis. Reports of EUS-guided treatment of refractory nonvariceal sources of bleeding are more scarce, but show high success rates. The procedures involve a medium to high technical difficulty level, and this has been replicated worldwide...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918295/case-report-primary-aortosigmoid-fistula-a-rare-cause-of-lower-gastrointestinal-bleeding
#18
Chirin Khalaf, Kim C Houlind
INTRODUCTION: A primary aortoenteric fistula (PAEF) is a communication between aorta and the gastrointestinal tract. It is a rare condition that is difficult to diagnose and therefore associated with a high mortality. PRESENTATION OF CASE: We report a rare case of a 66-year old man with an unstable bleeding PAEF. A salvage procedure was performed with a covered stent. Later, a sigmoidectomy was performed with resection of the fistula. Postoperatively, the patient suffered an infection that was treated well with antibiotics and he was discharged two weeks later with complete resolution of the fistula...
September 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28918131/cirrhotic-patients-with-portal-hypertension-related-bleeding-and-an-indication-for-early-tips-a-large-multicentre-audit-with-real-life-results
#19
Dominique Thabut, Arnaud Pauwels, Nicolas Carbonell, Andre Jean Remy, Pierre Nahon, Xavier Causse, Jean-Paul Cervoni, Jean-François Cadranel, Isabelle Archambeaud, Slim Bramli, Florent Ehrhard, Philippe Ah-Soune, Florian Rostain, Alexandre Pariente, Julien Vergniol, Jean-Pierre Dupuychaffray, Anne-Laure Pelletier, Florence Skinazi, Anne Guillygomarc'h, René-Louis Vitte, Jean Henrion, Stéphanie Combet, Marika Rudler, Christophe Bureau
BACKGROUND: The Baveno VI consensus meeting concluded that an early TIPS must be considered in high-risk cirrhotic patients presenting with variceal bleeding (VB) (Child B + active bleeding at endoscopy or Child C10-13 patients). Whether this therapeutic approach is feasible in a real-life setting remains unclear. AIMS: To determine (1) the proportion of patients eligible for early-TIPS among cirrhotic patients with VB, (2) the proportion of these patients who underwent early-TIPS placement and the main reasons for discarding TIPS, and (3) the outcomes of patients who experienced early-TIPS placement in a large, national, prospective, multicentre audit including academic and non-academic centres...
September 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28916678/gucy2c-signaling-opposes-the-acute-radiation-induced-gi-syndrome
#20
Peng Li, Evan Wuthrick, Jeff A Rappaport, Crystal Kraft, Jieru E Lin, Glen Marszalowicz, Adam E Snook, Tingting Zhan, Terry M Hyslop, Scott A Waldman
High doses of ionizing radiation induce acute damage to epithelial cells of the gastrointestinal (GI) tract, mediating toxicities restricting the therapeutic efficacy of radiation in cancer and morbidity and mortality in nuclear disasters. No approved prophylaxis or therapy exists for these toxicities, in part reflecting an incomplete understanding of mechanisms contributing to the acute radiation-induced GI syndrome (RIGS). Guanylate cyclase C (GUCY2C) and its hormones guanylin and uroguanylin have recently emerged as one paracrine axis defending intestinal mucosal integrity against mutational, chemical, and inflammatory injury...
September 15, 2017: Cancer Research
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