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Medicine (Baltimore) 2019 Feb;98(7):e14471

Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine.

Rationale: Dieulafoy's lesions are characterized by the presence of a dysplastic artery in the submucosa, most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive or fatal hemoptysis PATIENT CONCERNS:: The patient was a 62-year-old male farmer with intermittent hemoptysis of approximately 2 years duration and a definite diagnosis could not be established.

Diagnosis: A thorax-computed tomography at our hospital revealed that the bronchus of left lower lobe was narrowed with associated local atelectasis, and lung cancer was suspected. Read More

Blood Transfus 2019 Feb 4:1-8. Epub 2019 Feb 4.

Division of Haematology and Transfusion Medicine, "Luigi Sacco" University Hospital, Milan, Italy.

Background: There is a lack of prospective clinical trials specifically designed to evaluate the benefits of prophylaxis with vWF/FVIII concentrates in patients with inherited von Willebrand disease (vWD). The aim of the study was to compare efficacy of secondary long-term prophylaxis (PRO) with vWF/FVIII in the prevention of bleeding episodes in severe vWD patients to standard of care (on-demand treatment; ODT).

Materials And Methods: In this 12-month, phase III, open-label study (PRO. Read More

Endosc Int Open 2019 Feb 8;7(2):E298-E301. Epub 2019 Feb 8.

Clinic for Internal Medicine I, Department of Gastroenterology, InExEn, University Hospital Ulm, Ulm, Germany.

En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Read More

Clin Res Hepatol Gastroenterol 2019 Feb 7. Epub 2019 Feb 7.

Department of Medicine, Marienhausklinik St. Josef-Kohlhof, Neunkirchen, Germany; Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany. Electronic address:

Int J Biol Macromol 2019 Feb 6;129:233-245. Epub 2019 Feb 6.

Institut für Chemie/Physikalische Chemie der Polymere, Von-Danckelmann-Platz 4, Martin-Luther-Universität Halle-Wittenberg, 06120 Halle (Saale), Germany.

Oral drug delivery is natural, most acceptable and desirable route for nearly all drugs, but many drugs like NSAIDs when delivered by this route cause gastrointestinal irritation, gastric bleeding, ulcers, and many undesirable effects which limits their usage by oral delivery. Moreover, it is almost impossible to control the release of a drug in a targeted location in body. We developed thermo-responsive chitosan-co-poly(N-isopropyl-acrylamide) injectable hydrogel as an alternative for the gastro-protective and controlled delivery of loxoprofen sodium as a model drug. Read More

Esophagus 2019 Feb 8. Epub 2019 Feb 8.

Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.

Purpose: A prospective trial evaluated the feasibility and safety of "mediastinoscopic esophagectomy with lymph node dissection" (MELD).

Methods: Eligible patients had thoracic esophageal squamous cell carcinoma, excluding T4, a bulky primary lesion or distant metastasis. Ten patients were enrolled and treated between September 2015 and March 2018. Read More

Inflamm Intest Dis 2018 Dec 12;3(2):100-106. Epub 2018 Jul 12.

Department of Internal Medicine, Keiyu Hospital, Yokohama, Japan.

Background/summary: Acute colonic diverticular hemorrhage (CDH) represents a significant challenge for gastroenterologists. There are some clinical problems in the diagnosis, treatment, and prevention of CDH. CDH is the most common cause of overt lower gastrointestinal bleeding in adults in Eastern and Western countries. Read More

World J Emerg Surg 2019 1;14. Epub 2019 Feb 1.

1Emergency Surgery Department, Maggiore Hospital of Parma, University of Parma, Parma, Italy.

Background: Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or referred to transcatheter arterial embolization (TAE)?

Objectives: To carry out a systematic review of the literature and to perform a meta-analysis of studies that directly compare TAE and surgery in patients with refractory NVUGIB.

Materials And Methods: We searched PubMed, Ovid MEDLINE, and Embase. Read More

Vasa 2019 Feb 5:1-4. Epub 2019 Feb 5.

1 Division of Angiology, Department of Internal Medicine, Medical University of Graz, Austria.

Administration of direct oral anticoagulants (DOACs) for the treatment of venous thrombotic events (VTE) or non-valvular atrial fibrillation (AF) is now standard of care and has demonstrated clinical efficacy and safety in numerous clinical studies. Usually these substances have lower overall mortality and less risk of cerebral hemorrhage, but depending on the substance and study, they are more likely to cause gastrointestinal bleeding than vitamin K antagonists (VKA), the medication that used to be standard for VTE and AF. Since DOACs have very short plasma elimination half-lives compared to VKA, for most bleeding events, expert opinions suggest that withdrawal of DOACs and supportive care will likely suffice to stop a bleeding episode. Read More

Curr Oncol Rep 2019 Feb 4;21(2):18. Epub 2019 Feb 4.

Taussig Cancer Institute, Cleveland Clinic, 10201 Carnegie Ave./CA60, Cleveland, OH, 44195, USA.

Purpose Of Review: Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in cancer patients, and its management is often associated with complications including risk of recurrent VTE and bleeding. Here, we review the current data on pitfalls during anticoagulation in cancer patients and measures necessary to avoid them.

Recent Findings: Although low-molecular-weight heparin monotherapy has been the standard of treatment for several years, emerging data for direct oral anticoagulants (DOACs) are leading to new paradigms in treatment. Read More

BMJ Case Rep 2019 Jan 31;12(1). Epub 2019 Jan 31.

Intensive Care Medicine, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Mendrisio, Switzerland.

A middle-aged woman previously in good health arrived to hospital with severe haemorrhagic shock. An abdominal and pelvic CT scan showed hepatomegaly, fluid in the sigmoid colon, perigastric and right sided pelvic varices without a clear source of bleeding. Urgent esophagogastroduodenoscopy excluded gastric varices and active upper gastrointestinal bleeding and the colonoscopy was inconclusive due to haemodynamic instability and massive bleeding which made it impossible to proceed with a full colonoscopy. Read More

Am J Med 2019 Feb 25;132(2):191-199.e12. Epub 2018 Oct 25.

Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada. Electronic address:

Purpose: Patients with nonvalvular atrial fibrillation commonly have comorbidities requiring concurrent use of oral anticoagulants and antiplatelets. There are no real-world data on the comparative safety of concomitant antithrombotic treatments in the era of direct oral anticoagulant (DOACs). Thus, we compared the incidence of intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding between concomitant DOAC-antiplatelet use and concomitant vitamin K antagonist (VKA)-antiplatelet use in patients with nonvalvular atrial fibrillation. Read More

Korean J Gastroenterol 2019 Jan;73(1):45-49

Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.

A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Read More

Rev Gastroenterol Mex 2019 Jan 18. Epub 2019 Jan 18.

Departamento de Patología, Hospital General de México, Ciudad de México, México.

Am J Cardiol 2019 Jan 7. Epub 2019 Jan 7.

Department of Cardiology, Atlanta VA Medical Center, Decatur, Georgia; Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia. Electronic address:

We studied the trends and outcomes of patients with intestinal angiodysplasia-associated gastrointestinal bleeding (Heyde's syndrome [HS]) with aortic stenosis (AS) who underwent surgical aortic valve replacement (SAVR) versus transcatheter aortic valve implantation (TAVI). The National Inpatient Sample (2007 to 2014) and International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify HS hospitalizations, pertinent co-morbidities, and outcomes of SAVR versus TAVI from 2011 to 2014. The incidence of HS with AS was 3. Read More

Cardiovasc Interv Ther 2019 Jan 17. Epub 2019 Jan 17.

Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan.

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a powerful device for treatment of patients with life-threatening heart failure. Although bleeding is often associated with VA ECMO and sometimes results in a fatal outcome, its precise causes remain unknown. On the other hand, excessive high shear stress in the cardiovascular system causes acquired von Willebrand syndrome (aVWS), characterized by loss of von Willebrand factor (vWF) large multimers. Read More

Exp Ther Med 2019 Jan 20;17(1):874-882. Epub 2018 Nov 20.

Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Key Biomechanical Laboratory of Orthopedics, Shijiazhuang, Hebei 050051, P.R. China.

The aim of the current study was to analyze the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar degenerative disc disease for senior patients. The clinical and follow-up data of senior patients were retrospectively reviewed. Patients were divided into a PTED group and an open surgery group. Read More

BMC Geriatr 2019 Jan 16;19(1):14. Epub 2019 Jan 16.

Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, China.

Background: Geriatric nutritional risk index (GNRI) is a simple and useful nutritional marker for predictor of adverse outcomes in patients undergoing a variety of conditions. This study explored the relationship between GNRI and adverse outcomes of Pyogenic Liver Abscess (PLA) patients and assessed GNRI predictive value.

Methods: This was one retrospective study involving 240 PLA patients. Read More

Endosc Int Open 2019 Jan 3;7(1):E26-E35. Epub 2019 Jan 3.

Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Bologna, Italy.

 To assess the rate of adverse events and the technical success rate of biliary stenting with or without EBS.   A literature search up to February 2017 was performed. Studies assessing adverse events (AEs) and technical success rates of stenting with or without EBS were considered. Read More

World J Gastroenterol 2019 Jan;25(1):69-84

Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan.

Acute lower gastrointestinal bleeding (LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic, radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. Read More

Emergencias 2018 Dic;30(6):419-423

Servicio de Aparato Digestivo, Hospital Universitari ParcTaulí. Institut d'Investigació i Innovació ParcTaulí, Barcelona, España. Departamento de Medicina. Universitat Autònoma de Barcelona, España.

Objectives: The American College of Gastroenterology's 2016 clinical guidelines for treating lower gastrointestinal (GI) tract bleeding recommends evaluating of nasogastric tube aspiration and the ratio of blood urea nitrogen (BUN) to creatinine to differentiate upper from lower GI bleeds. However, the evidence base to support recommending these 2 diagnostic variables is low. This study aimed to evaluate the diagnostic utility of nasogastric tube aspiration and the BUN-to-creatinine ratio for distinguishing between upper and lower GI bleeding. Read More

Int J Artif Organs 2019 Jan 10:391398818823769. Epub 2019 Jan 10.

1 School of Energy and Power Engineering, Beihang University, Beijing, China.

Adverse events caused by flow-induced thrombus formation around the bearing/shaft of an axial blood pump remain a serious problem for axial blood pumps. Moreover, excessive anticoagulation with thrombosis around the bearing potentially increases the risk of postoperative gastrointestinal bleeding. The purpose of this study is to analyze the influence of the bearing structure on the thrombosis potential of an axial blood pump. Read More

J Korean Neurosurg Soc 2019 Jan 31;62(1):106-113. Epub 2018 Dec 31.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Objective: The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Read More

Digestion 2019 9;99 Suppl 1:1-26. Epub 2019 Jan 9.

Japanese Gastroenterological Association, Tokyo, Japan.

Colonic diverticular disease has been increasing in prevalence in Japan due to the rapidly aging population. Colonic diverticular bleeding can result in hemorrhagic shock requiring blood transfusion, and it carries a high risk of recurrence within 1 year. Colonic diverticulitis can cause abscess, fistula formation, and perforation of the colon that may require surgery, and it often recurs. Read More

JGH Open 2018 Dec 21;2(6):255-261. Epub 2018 Aug 21.

Department of Gastroenterology Dokkyo Medical University Tochigi Japan.

Background: Gastrointestinal hemorrhage occurs frequently. We reviewed the tendency of occurrence of bleeding gastric and duodenal ulcers and their association with antithrombotic therapy before and after the widespread use of (1st edition), which was published to improve treatment outcomes and prevent peptic ulcers.

Methods: The study enrolled 1105 patients with bleeding gastric and duodenal ulcers treated at our hospital between January 2000 and March 2016. Read More

J Nephrol 2019 Jan 2. Epub 2019 Jan 2.

DaVita Kidney Care, Denver, CO, USA.

Heparin is widely used to prevent coagulation during hemodialysis. Although systemic anticoagulants and antiplatelet agents are commonly prescribed in the hemodialysis population, the safety and efficacy of heparin in the presence of these medications is unclear. This retrospective cohort study considered adult hemodialysis patients treated in the United States (August 2015-July 2017). Read More

Pediatr Transplant 2018 Dec 30:e13339. Epub 2018 Dec 30.

Paediatric Liver, Gastroenterology and Nutrition Centre, King's College Hospital, London, UK.

Objectives: Acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis complicated by other organ failure and is associated with increased mortality and morbidity. ACLF has not been studied in children with biliary atresia (BA), which is the commonest indication for pediatric liver transplantation (LT) worldwide. This study aims to evaluate ACLF and outcomes in children with BA while awaiting deceased donor LT. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Dec;30(12):1196-1199

Department of Burns and Plastic Surgery, the Affiliated Nanshi Hospital of Henan University, Nanyang 473065, Henan, China. Corresponding author: Wang Shuo, Email:

Objective: To retrospectively analyze the injury characteristics of victims and treatment strategies in the explosion accident on the 17th May 2018 in Xixia county (Xixia "May 17th" explosion accident).

Methods: Completion the Level Three treatment on time, which was depended on the leading role played by the regional trauma centers was the main rescuing mode of the work in Xixia county, where the primary and secondary treatments were the key parts. The three-level treatment model includes: the local hospital acts as a level-one emergency medical institution, county hospitals function as secondary emergency medical institutions, and other higher medical institutions are the tertiary first aid medical institutions. Read More

Anticancer Res 2019 Jan;39(1):25-31

Department of Respiratory Medicine, Omuta Tenryo Hospital, Omuta, Japan.

Many studies about anticoagulant therapy for disseminated intravascular coagulation (DIC) confused gastrointestinal surgery-related DIC with DIC unrelated to a prior operation. Furthermore, the potentially increased risk of bleeding by anticoagulants complicates their use. We carried out a systematic review to describe the efficacy and safety of anticoagulant agents for DIC after gastrointestinal surgery. Read More

Int J Clin Pract 2018 Dec 27:e13308. Epub 2018 Dec 27.

Department of Cardiology, First Center of Chinese, PLA General Hospital, Beijing, China.

Background: Novel oral anticoagulants are the cornerstone of therapy for non-valvular atrial fibrillation patients to lower the risk of ischaemic stroke. Given the lack of head-to-head comparisons among oral anticoagulants, a Bayesian analysis was used to evaluate their safety and efficacy based on studies from real-world practice.

Methods: The PubMed, Embase, Cochrane and Web of Science databases were searched for relevant studies. Read More

Ann Ital Chir 2018 ;89:212-216

The authors present a series of 15 patients with lower gastrointestinal bleeding. 11 (73%) out of 15 patients, were directly subjected to surgery, and 4 (37%) attempted to stop hemorrhage with angiography. In the group of patients undergoing surgery we had a mortality of 1 out of 12 (8%). Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1408-1413

Department of Gastrointestinal Surgery, Tai Zhou People's HospitaL, Jiangsu Taizhou225300, China.

Objective: To explore the feasibility, safety and the economical efficiency of double-pouch anastomosis in laparoscopic radical rectal cancer assisted by small incisions.

Methods: Clinical data of 224 patients undergoing gastrointestinal surgery at Taizhou People's Hospital of Jiangsu Province from January 2011 to December 2017 were retrospectively analyzed. Indusion criteria: patients were diagnosed as primary rectal adenocarcinoma by preoperative enteroscopy pathology, the distance of the tumor to anal margin was from 4 to 15 cm, and patients were treated with laparoscopic total mesorectal excision(TME) through small incision. Read More

J Pain Res 2018 14;11:3211-3219. Epub 2018 Dec 14.

Department of clinical Pharmacy, College of Pharmacy, Ajou University, Yeongtong-gu, Suwon, Republic of Korea,

Background: A 2011 systematic review found an increased cardiovascular (CV) risk at both ≤200 mg/day and >200 mg/day doses of celecoxib. This study aimed to evaluate adverse drug events with celecoxib relative to traditional nonsteroidal anti-inflammatory drugs (NSAIDs) in real-world practice settings, focusing on gastrointestinal (GI), CV, and renal toxicity, in older patients with osteoarthritis or rheumatoid arthritis.

Methods: In this population-based retrospective cohort study using national health insurance claims data in Korea, patients aged 65 years and older with arthritis who were treated with celecoxib or traditional NSAIDs for ≥30 days in 2016, were included for study analyses. Read More

Circulation 2019 Feb;139(6):748-756

Department of Thrombosis and Hemostasis, Leiden University Medical Center, the Netherlands (S.J.V.d.W., F.A.K., M.V.H.).

Background: Although dabigatran has a favorable risk-benefit profile compared with vitamin K antagonist therapy for venous thromboembolism and nonvalvular atrial fibrillation, major bleeding events, including gastrointestinal (GI) bleeding, may occur. Therefore, our aim was to provide insights into the efficacy and safety of idarucizumab for urgent dabigatran reversal in patients with major GI bleeding.

Methods: Patients with uncontrollable GI bleeding requiring reversal were enrolled from June 2014 through July 2016 in the RE-VERSE AD study (Reversal of Dabigatran Anticoagulant Effect With Idarucizumab), a prospective, multicenter, open-label study of idarucizumab, and were followed up for 90 days for primary and secondary outcomes. Read More

J Gastrointestin Liver Dis 2018 Dec;27(4):459-463

Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC., USA.

Gaucher Disease arises due to a deficiency in the enzyme glucocerebrosidase and is the most common lysosomal storage disease. This enzyme deficiency leads to the accumulation of glucocerebroside within macrophages (Gaucher cells) and the resulting infiltration of these cells into organs can cause clinical symptoms. There are three types of Gaucher Disease that differ based on the clinical course and the presence or absence of neurological involvement, but classically, Gaucher cell infiltrates impact a patient's spleen, liver, bone marrow and cortex. Read More

Dig Liver Dis 2018 Dec 3. Epub 2018 Dec 3.

Gastrointestinal Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Electronic address:

Eur Urol 2019 Mar 17;75(3):464-476. Epub 2018 Dec 17.

Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Context: Radiotherapy used for treating localized prostate cancer is effective at prolonging cancer-specific and overall survival. Still, acute and late pelvic toxicities are a concern, with gastrointestinal (GI) and genitourinary (GU) sequelae being most common as well as other pelvic complications.

Objective: To present a critical review of the literature regarding the incidence and risk factors of pelvic toxicity following primary radiotherapy for prostate cancer and to provide a narrative review regarding its management. Read More

Platelets 2018 Dec 20:1-5. Epub 2018 Dec 20.

b Department of Hematology , Oslo University Hospital , Oslo , Norway.

Factor Xa inhibitors are safe and effective alternatives to warfarin, but several studies indicate that rivaroxaban may cause a different risk profile for bleeding. For instance, while the risk of major bleeding in general may be lower with rivaroxaban than for warfarin, the risk of gastrointestinal bleeding or abnormal uterine bleeding may be higher. The underlying mechanisms for these differences are not known, and the effect of rivaroxaban on primary hemostasis is poorly understood. Read More

Pak J Med Sci 2018 Nov-Dec;34(6):1320-1325

Mingqing Peng, Department of Anesthesiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.

Objective: Goal-directed fluid therapy (GDFT) was associated with improved outcomes after surgery. Noninvasive Cardiac Output Monitoring (NICOM) has proved to be a good choice for guiding GDFT. This study evaluated the effect of GDFT based on NICOM on prognosis in elderly patients undergoing resection of gastrointestinal tumor. Read More

P T 2018 Dec;43(12):748-749

Idarucizumab is approved for patients treated with dabigatran when reversal of the anticoagulant effects is needed. Like dabigatran, idarucizumab is excreted in the urine. The effect of renal dysfunction on drug elimination is uncertain, as patients in the RE-VERSE AD trial had a median creatinine clearance of 58 mL/min. Read More

BMC Anesthesiol 2018 Dec 13;18(1):190. Epub 2018 Dec 13.

Institute of Anaesthesiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

Background: Conservative obesity treatment often leads to limited results. Bariatric surgery is highly efficient, but the candidates are at risk of developing perioperative complications. Bariatric outcomes have been well described in the past, but there are only few reports of perioperative outcomes. Read More

J Thromb Thrombolysis 2018 Dec 6. Epub 2018 Dec 6.

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Gastrointestinal bleeding (GIB) occurs in up to 40% of patients with continuous-flow (CF) left ventricular assist devices (LVADs). We sought to identify targets to improve hospital resource utilization and decrease readmissions after GIB. We performed a single-center, retrospective analysis of LVAD-associated GIB resulting in hospital admission between July 2011 and April 2014. Read More

Arab J Gastroenterol 2018 Dec 3;19(4):143-147. Epub 2018 Dec 3.

Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan. Electronic address:

Background And Study Aims: Azotaemia is commonly identified among patients with upper gastrointestinal bleeding (UGIB) due to absorption of blood products in the small bowel. Previous studies have found blood urea nitrogen-to-creatinine (BUN/Cr) ratio to be significantly elevated among patients UGIB bleeding compared to patients with lower GI bleeding. However, no studies have explored the relationship between BUN/Cr ratio and mortality. Read More

Eur J Intern Med 2018 Dec 4. Epub 2018 Dec 4.

First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.

Background: Gastrointestinal bleeding (GIB) is burdened by high mortality rate that increases with aging. Elderly patients may be exposed to multiple risk factors for GIB. We aimed at defining the impact of GIB in elderly patients. Read More

Surg Laparosc Endosc Percutan Tech 2018 Dec 11. Epub 2018 Dec 11.

Department of Anorectal Surgery, First Affiliated Hospital of Nanjing University of Traditional Chinese Medicine (TCM), Qinhuai District, Nanjing, Jiangsu Province.

This meta-analysis aimed to compare the clinical outcomes of stapled hemorrhoidectomy (SH) and transanal hemorrhoidal dearterialization (THD) for treating hemorrhoidal disease. Randomized control trials (RCTs) comparing SH with THD were searched in databases, including MEDLINE, PubMed, Web of Science, EMBASE, and the Cochrane Library database. Nine RCTs, with 1077 patients, were included in this meta-analysis. Read More

Front Neurol 2018 27;9:1003. Epub 2018 Nov 27.

Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

No previous study has compared the impact of dipyridamole-based triple antiplatelet therapy on secondary stroke prevention and long-term outcomes to that of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI) and previous stroke. This study aimed to evaluate the impact of dipyridamole added to DAPT on stroke prevention and long-term outcomes in patients with cerebral infarction after first AMI. This nationwide, case-control study included 75,789 patients with cerebral infarction after first AMI. Read More

Colorectal Dis 2018 Dec 7. Epub 2018 Dec 7.

Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal.

Aim: Acute lower gastrointestinal bleeding (ALGIB) is a common gastroenterological emergency. Despite this, outcomes are difficult to predict. Only STRATE and BLEED scores are readily available. Read More

J Comput Assist Tomogr 2018 Dec 10. Epub 2018 Dec 10.

Department of Radiology, Suzhou Hospital, Nanjing Medical University, Suzhou.

Objective: The aim of this study was to evaluate the computed tomography enterography (CTE) characteristics of bleeding Meckel diverticulum.

Methods: The CTE images of 35 patients with Meckel diverticulum and gastrointestinal bleeding were retrospectively evaluated.

Results: Meckel diverticulum was visualized in 33 of 35 patients and located in the right lower abdomen (20/33), midline lower abdomen (8/33), left lower abdomen (3/33), or paramedially near the umbilicus (2/33). Read More

Dig Dis Sci 2018 Dec 5. Epub 2018 Dec 5.

Department of Gastroenterology, New York Medical College, Valhalla, NY, 10595, USA.

Background: Gastrointestinal hemorrhage (GIH) is reported to occur in 1-8% of patients admitted with acute ischemic stroke (AIS). AIS is considered to be a relative contraindication to GIE.

Aims: Evaluate the outcomes of gastrointestinal endoscopy (GIE) in patients hospitalized with AIS and GIH. Read More