Active Gastric Bleeding Research Articles

Primary Pancreatic Lymphoma with Active Gastric Bleeding. A Clinical Case and Review Literature.

Primary Pancreatic Lymphoma with Active Gastric Bleeding. A Clinical Case and Review Literature.

Prophylactic use of the Angel® Catheter in a patient with paraneoplastic syndrome scheduled for surgical tumor resection: A case report and literature review

Introductio. The Angel? catheter (BiO2 Medical Inc, San Antonio, Texas, USA) is a novel device that combines a triple lumen central venous catheter with an inferior vena cava filter for prevention of pulmonary embolism (IVC filtercatheter). Case report. We present the case of a 53- yearold male patient with renal carcinoma and a history of recent deep venous thrombosis (DVT) on oral anticoagulation who was scheduled to undergo open radical nephrectomy. Because of concerns about the risks from documented pre-existing DVT, we decided to insert the Angel? catheter preoperatively in order to have central venous access during surgery and also to reduce the risk of perioperative pulmonary embolism. On the first postoperative day, active gastric bleeding was detected and nadroparine was stopped. Before removal of the Angel? catheter, a pre-removal cavagram revealed large thrombus mass in the catheter filter. Because of the presence of the thrombus mass, the catheter was removed surgically, after a permanent vena cava filter was inserted. Conclusion. This case suggests that the use of the Angel? IVC filter/3-lumen central catheter combination could be a reasonable option for pulmonary embolism prophylaxis in the patients at a high risk for DVT, such as the patients with malignant disease, paraneoplastic syndrome and chemotherapy who need to undergo surgery.

Effect of proton pump inhibitors in hospitalization on mortality of patients with hepatic encephalopathy and cirrhosis but no active gastrointestinal bleeding

Hepatic encephalopathy (HE) is a neuropsychiatric complication of decompensated cirrhosis. Proton pump inhibitors (PPIs), used as potent acid suppressants, are associated with HE occurrence in cirrhotic patients. However, it is still unknown if PPIs contribute to mortality in cirrhotic patients with HE and no active gastrointestinal bleeding. We used the Taiwan National Health Insurance Database to identify 1004 cirrhotic patients with HE and no active gastric bleeding, who received oral PPIs between January 1, 2010 and December 31, 2013. On the basis of comorbid disorder data, we used propensity score matching at a 1:4 ratio to select 4016 cirrhotic patients with HE and no active gastric bleeding who did not receive PPIs as a comparison group. All patients were followed up for one year from the index time. The overall 30-day, 90-day, and 1-year mortalities were 36.1%, 52.6%, and 70.1% in PPI group, and 27.5%, 41.7%, and 62.4% in non-PPI group. Using Cox regression model analysis with adjustment for age, gender, and other comorbid disorders, we obtained hazard ratios of 1.360 (95% CI: 1.208-1.532, P<0.001), 1.563 (95% CI: 1.314-1.859; P<0.001), and 1.187 (95% CI: 1.008-1.398; P=0.040) for, respectively, 30-day, 30-day to 90-day, and 90-day to 1-year mortality in patients taking PPIs. PPIs increase short-term and long-term mortality of cirrhotic patients with HE and no active gastrointestinal bleeding.

Withdrawal of Clopidogrel in Active Gastric Bleeding

Letters18 May 2010Withdrawal of Clopidogrel in Active Gastric BleedingJean-Jacques Mourad, MD, PhDJean-Jacques Mourad, MD, PhDFrom Avicenne University Hospital, AP-HP, 93000 Bobigny, France.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-10-201005180-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Sung and colleagues (1) provided important results on a very frequent clinical situation: withdrawal of aspirin in active gastric bleeding. We were surprised by the unusually high incidence of mortality at 1 month (9%). Could this be explained by any other factor related to study design, namely, the withdrawal of clopidogrel? The authors stated that they “did not exclude patients who received clopidogrel in conjunction with aspirin, but [they] discontinued clopidogrel therapy after randomization … ” The indications for dual antiplatelet blockade are few and include percutaneous coronary interventions. Discontinuation of therapy with clopidogrel in patients treated ...Reference1. Sung JJ, Lau JY, Ching JY, Wu JC, Lee YT, Chiu PW, et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2010;152:1-9. [PMID: 19949136] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Avicenne University Hospital, AP-HP, 93000 Bobigny, France.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoContinuation of Low-Dose Aspirin Therapy in Peptic Ulcer Bleeding Joseph J.Y. Sung , James Y.W. Lau , Jessica Y.L. Ching , Justin C.Y. Wu , Yuk T. Lee , Philip W.Y. Chiu , Vincent K.S. Leung , Vincent W.S. Wong , and Francis K.L. Chan Withdrawal of Clopidogrel in Active Gastric Bleeding Joseph J.Y. Sung Metrics 18 May 2010Volume 152, Issue 10Page: 685KeywordsConflicts of interestDrug therapyHeart rateHemorrhageMorbidityPercutaneous coronary interventionStent implantationThrombosis ePublished: 18 May 2010 Issue Published: 18 May 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Withdrawal of Clopidogrel in Active Gastric Bleeding

Letters18 May 2010Withdrawal of Clopidogrel in Active Gastric BleedingJoseph J.Y. Sung, MD, PhDJoseph J.Y. Sung, MD, PhDFrom Prince of Wales Hospital, New Territories, Hong Kong.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-10-201005180-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:In our study, 1 patient in the placebo group, who had triple-vessel disease and percutaneous coronary intervention, took dual antiplatelet agents: aspirin and clopidogrel. This patient stopped receiving aspirin and clopidogrel for the study period and did well. None of our participants who died received concomitant clopidogrel and aspirin before randomization. All patients were taking aspirin, either 80 mg/d or 160 mg/d. Therefore, the increased mortality in the placebo group cannot be explained by the withdrawal of clopidogrel.Joseph J.Y. Sung, MD, PhDPrince of Wales HospitalNew Territories, Hong Kong Author, Article, and Disclosure InformationAffiliations: From Prince of Wales Hospital, New Territories, Hong Kong.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoContinuation of Low-Dose Aspirin Therapy in Peptic Ulcer Bleeding Joseph J.Y. Sung , James Y.W. Lau , Jessica Y.L. Ching , Justin C.Y. Wu , Yuk T. Lee , Philip W.Y. Chiu , Vincent K.S. Leung , Vincent W.S. Wong , and Francis K.L. Chan Withdrawal of Clopidogrel in Active Gastric Bleeding Jean-Jacques Mourad Metrics Cited byCurrent awareness: Pharmacoepidemiology and drug safety 18 May 2010Volume 152, Issue 10Page: 685KeywordsAspirinConflicts of interestHemorrhageMortalityPercutaneous coronary intervention ePublished: 18 May 2010 Issue Published: 18 May 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Oral and Intravenous Eradication of Helicobacter pylori

The aim of this study was to determine the efficacy of oral regimens in patients without active gastric bleeding and those of intravenous regimens in a group with active gastric bleeding. This study was performed as an interventional investigation in Tehran between April 2004 and March 2008. The patients who had active peptic ulcer were included and divided into two groups. One group included 26 subjects with active gastric bleeding and the other included 29 patients without active gastric bleeding. The intravenous treatment included metronidazole, ampicillin, ranitidine and orally administered bismuth for five days. The oral regimen included metronidazole, amoxicillin, ranitidine and bismuth sub-citrate for 14 days. In intravenous group 24 patients (92.3%) and in oral group 24 subjects (82.8%) had no drug adverse events. The successful treatment was seen in 61.5% (16/26) and 55.2% (16/29) in intravenous and oral methods, respectively. Finally, it may be concluded that both five-day intravenous therapeutic regimen in patients with active gastric bleeding and 14-day oral regimen in patients without active gastric bleeding would have good efficacy and low rate of drug adverse events.

Survey on transfusion practices of pediatric intensivists.

To describe the red blood cell transfusion practices of pediatric intensivists. Cross-sectional self-administered survey. Pediatric intensive care units. Academic pediatric intensivists. None. Scenario-based survey among English- or French-speaking intensivists from Canada, France, Belgium, or Switzerland, working in tertiary-care pediatric intensive care units. Respondents were asked to report their decisions regarding transfusion practice with respect to four scenarios: cases of bronchiolitis, septic shock, trauma, and the postoperative care of a patient with Fallot's tetrad. The response rate was 71% (163 of 230). The overall baseline hemoglobin transfusion threshold that would have prompted intensivists to transfuse a patient ranged from 7 to 13 g/dL (70-130 g/L) within almost all scenarios. There was a significant difference between scenarios of the average baseline hemoglobin transfusion thresholds (p < .0001). A low Pao2, a high blood lactate concentration, a high Pediatric Risk of Mortality score, active gastric bleeding, emergency surgery, and age (2 wks) were important determinants of red blood cell transfusion, whereas none of the respondents' personal characteristics were. The average volume of packed red blood cells transfused in the four scenarios did not differ significantly. This survey documented a significant variation in transfusion practice patterns among pediatric critical care practitioners with respect to the threshold hemoglobin concentration for red blood cell transfusion. The volume of packed red blood cells given was not adjusted to the hemoglobin concentration.