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https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#1
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#2
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28535419/comparison-of-the-efficacy-of-fixed-dose-enoxaparin-and-adjusted-dose-unfractionated-heparin-in-patients-with-cerebral-venous-thrombosis
#3
Pat Korathanakhun, Chusana Petpichetchian, Wongchan Petpichetchian, Pornchai Sathirapanya
OBJECTIVE: Anticoagulants are the standard treatment for cerebral venous thrombosis (CVT). Although low-molecular-weight heparin (LMWH) is recommended in CVT, the specific type and dosage regimen of LMWH have never been specifically suggested. This study compared the clinical outcomes and adverse events in patients who received adjusted-dose unfractionated heparin (AD-UFH) versus fixed-dose enoxaparin (FD-E). METHODS: A retrospective cohort study was conducted at a university hospital in Thailand...
May 10, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28534327/-modified-stapled-transanal-rectal-resection-combined-with-perioperative-pelvic-floor-biofeedback-therapy-in-the-treatment-of-obstructed-defecation-syndrome
#4
Lei Chen, Fanqi Meng, Tongsen Zhang, Yinan Liu, Shuang Sha, Si Chen, Jiandong Tai
OBJECTIVE: To investigate the clinical efficacy and safety of modified stapled transanal rectal resection (STARR) combined with perioperative pelvic floor biofeedback therapy (POPFBFT) in treating obstructed defecation syndrome (ODS). METHODS: Thirty female ODS patients underwent modified STARR (resection and suture was performed in rectocele with one staple) combined with POPFBFT in Department of Colorectal and Anal Surgery, The First Hospital of Jilin university from October 2013 to March 2015...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534326/-comparative-study-of-3d-and-2d-laparoscopic-surgery-for-gastrointestinal-tumors
#5
Fujian Ji, Xuedong Fang, Bingyuan Fei
OBJECTIVE: To evaluate the technical advantages of 3D laparoscopic and 2D laparoscopic surgery for gastrointestinal tumors. METHODS: Clinical data of gastrointestinal cancer patients undergoing 3D laparoscopic or 2D laparoscopic surgery from January 2015 to January 2017 in our department were retrospectively analyzed These patients included 93 gastric cancer cases undergoing laparoscopic radical resection (total gastrectomy, 48 cases in 3D group, 45 cases in 2D group), 45 rectal cancer cases undergoing radical resection combined with lateral lymph node dissection (27 cases in 3D group, 18 cases in 2D group) and 76 right colon cancer cases undergoing radical resection (37 cases in 3D group, 39 cases in 2D group)...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#6
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28530783/a-rare-case-of-obscure-gastrointestinal-bleeding-small-bowel-varices-flowing-into-the-inferior-epigastric-vein
#7
Akira Hoshiai, Junya Tsurukiri, Yasuhiro Sumi
Ectopic varices include all varices except esophageal or gastric varices and comprise large portosystemic venous collaterals that occur anywhere in the abdomen. Ectopic varices are relatively rare; however, approximately 5% are related to gastrointestinal bleeding. Ectopic varices usually occur in the rectum, duodenum, or colon, and portal hypertension is the most common cause. Hemodynamic profiles of ectopic varices remain unknown, and extensive bleeding from these structures occurs because diagnosis and treatment are difficult...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530163/gastrointestinal-histoplasmosis-a-case-series
#8
Rashi Sharma, Lipika Lipi, Smeeta Gajendra, Ishani Mohapatra, Ruchika K Goel, Rajan Duggal, Smruti Ranjan Mishra, Dheeraj Gautam
Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely...
May 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28524623/upper-gastrointestinal-complications-following-ablation-therapy-for-atrial-fibrillation
#9
S-Y Park, M Camilleri, D Packer, K Monahan
BACKGROUND: Following ablation therapy for cardiac arrhythmias, patients may develop upper gastrointestinal (UGI) symptoms. The vagus nerve is close to the atria and may be affected by ablating energy. AIM: To identify structural or functional complications in UGI tract following ablation for atrial fibrillation (AF) and clinical outcomes and association with vagal dysfunction. METHODS: Using natural language processing of electronic medical records and an AF ablation database of 5380 patients treated during 17 years, we identified 40 patients with UGI complications...
May 19, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28523485/report-of-mesocaval-shunt-in-the-management-of-variceal-hemorrhage-following-gastric-bypass-surgery
#10
Anurag Shrimal, Ranjan Sudan, Gaurav Chaubal, Ahmad Zaaroura, Kitza Williams, Kadiyala Ravindra
Gastrointestinal bleeding following Roux-en- Y gastric bypass (RYGB) is rare. We report an unusual cause of upper gastrointestinal bleeding following RYGB that was complicated by porto- splenic vein thrombosis. A 35- year- old woman was successfully treated by mesocaval surgical shunt for recurrent variceal hemorrhage in the excluded stomach following RYGB.
May 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28523328/duodenal-gastrointestinal-stromal-tumor-presenting-as-pancreatic-head-mass-a-case-report
#11
DănuŢ Vasile, George Iancu, Raluca Claudia Iancu, George Simion, Radu Constantin Ciuluvică
Duodenal gastrointestinal stromal tumors (GISTs) are uncommon. Tumors arising from the first and the second part of the duodenum (DI and DII, respectively) can be wrongly diagnosed as pancreatic mass. We present a case of a 59-year-old woman who came with abdominal pain and severe upper gastrointestinal bleeding (hemoglobin 3.5 g÷dL). A solid, heterogeneously enhancing neoplasm in the head of the pancreas was revealed preoperatively by an abdominal computed tomography scan. A diagnosis of GIST was suggested...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#12
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523325/synchronous-gastric-tumors-case-presentation
#13
Carmen NeamŢu, Bogdan Dan Totolici, Octavian Marius CreŢu, Casiana Stănescu, Andrei Ardelean, Oana Badea, George Ciprian Pribac, Mircea Ovidiu Ciobanu, GarofiŢa Olivia Mateescu, Stelian ŞtefăniŢă Mogoantă
Synchronous gastric tumors, and, especially the presence of an adenocarcinoma and gastrointestinal stromal tumors, are less frequent. We present the case of a 75-year-old patient, with no gastrointestinal pathology in the medical history, who was admitted for marked asthenia, nausea, coffee grounds vomiting, inappetence, dizziness, weight loss and periodical epigastralgias. The clinical and imagistic examinations highlighted an ulcerative, infiltrative, bleeding tumor formation, present on the anterior side and subcardially on the small curvature...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522785/infeasibility-of-endoscopic-transmural-drainage-due-to-pancreatic-pseudocyst-wall-calcifications-case-report
#14
Andrzej Krajewski, Gustaw Lech, Marcin Makiewicz, Andrzej Kluciński, Monika Wojtasik, Sławomir Kozieł, Maciej Słodkowski
Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28520574/orthotopic-liver-transplantation-changes-the-course-of-gastric-antral-vascular-ectasia-a-case-series-from-a-transplant-center
#15
Chaitanya Allamneni, Basem Alkurdi, Rehan Naseemuddin, Brendan M McGuire, Mohamed G Shoreibah, Devin E Eckhoff, Shajan Peter
BACKGROUND AND AIM: Gastric antral vascular ectasia (GAVE) is an important cause of upper gastrointestinal bleeding and anemia in patients with cirrhosis. The aim of our study was to evaluate the effect of orthotopic liver transplantation (OLT) on GAVE and associated anemia. PATIENTS AND METHODS: We performed a chart review and identified all cirrhotic patients with GAVE who underwent OLT at the University Of Alabama at Birmingham between 2005 and 2013. Population's demographics, etiology of cirrhosis, comorbidities, presentation and treatment modalities of GAVE, endoscopic and histopathologic reports, hemoglobin values before and after transplant, and immunosuppressive regimens were collected...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28515767/cost-effectiveness-evaluation-of-aspirin-in-primary-prevention-of-myocardial-infarction-amongst-males-with-average-cardiovascular-risk-in-iran
#16
Mohammadreza Amirsadri, Mohammad Javad Sedighi
Aspirin is one of the certified medicines commonly used for the secondary prevention of myocardial infarction (MI). Aspirin side effects and gastrointestinal bleeding, in particular, have arisen debates on its use for the primary prevention of MI. The present research evaluates the cost-effectiveness of the use of aspirin in the primary prevention of MI among Iranian men with average cardiovascular disease (CVD) risk, using Markov modeling technique. The incremental cost-effectiveness ratios (ICERs) estimated to be 864 USA dollars (USD) per quality-adjusted life years (QALY) gained and 782 USD per life years gained (LYG) for each patient in the base-case scenario (public tariffs and no discounting)...
April 2017: Research in Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28514389/-acute-bleeding-from-upper-gastrointestinal-tract-due-to-splenic-artery-pseudoaneurysm-in-a-cavity-of-pancreatic-pseudocyst
#17
I G Repin, K A Savostiyanov, S P Mizin, A A Stolyarov, D I Repin
No abstract text is available yet for this article.
2017: Khirurgiia
https://www.readbyqxmd.com/read/28514384/-innovative-endoscopic-technologies-in-multi-field-medical-facility
#18
O E Karpov, P S Vetshev, A S Maady, K I Alekseev, A S Osipov, I V Vasiliev
The modern clinical practice is characterized by intensive introduction of innovative technologies for improving treatment and diagnostic procedures, minimizing their impact on the patient, complications rate and economic reasons. One of the priorities in this area is both diagnostic and therapeutic endoscopy. The degree of practical use of innovative endoscopic technologies depends on not only the quality of care, but also their economic reasons. Endoscopic treatment has become the method of choice for gastrointestional bleeding, extraction of foreign bodies, obstructive jaundice, polyps of the gastrointestinal tract, achalasia, esophageal strictures, etc...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#19
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28512647/early-esophagogastroduodenoscopy-is-associated-with-better-outcomes-in-upper-gastrointestinal-bleeding-a-nationwide-study
#20
Sushil K Garg, Chimaobi Anugwom, James Campbell, Vaibhav Wadhwa, Nancy Gupta, Rocio Lopez, Sukhman Shergill, Madhusudhan R Sanaka
Background and study aims We analyzed NIS (National Inpatient Sample) database from 2007 - 2013 to determine if early esophagogastroduodenoscopy (EGD) (24 hours) for upper gastrointestinal bleeding improved the outcomes in terms of mortality, length of stay and costs. Patients and methods Patients were classified as having upper gastrointestinal hemorrhage by querying all diagnostic codes for the ICD-9-CM codes corresponding to upper gastrointestinal bleeding. For these patients, performance of EGD during admission was determined by querying all procedural codes for the ICD-9-CM codes corresponding to EGD; early EGD was defined as having EGD performed within 24 hours of admission and late EGD was defined as having EGD performed after 24 hours of admission...
May 2017: Endoscopy International Open
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