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Ulcer Bleed

Ismail Hamzaoglu, Bilgi Baca, Eren Esen, Erman Aytac, Volkan Ozben, Afag Aghayeva, Ismail A Bilgin, Tayfun Karahasanoglu
In this study, we aimed to present our initial experience on totally robotic total restorative proctocolectomy in ulcerative colitis (UC) patients. Patients undergoing a totally robotic restorative total proctocolectomy with ileal J-pouch anal anastomosis for UC between January 2015 and November 2017 were included. The da Vinci Xi was used for the operations. Patient demographics, perioperative and short-term operative outcomes were evaluated. Ten patients were included. The median operative time was 380 minutes(range, 300 to 480 min)...
February 12, 2019: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Beatrice Fiorucci, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian William Carpenter, Eike Sebastian Debus, Nikolaos Tsilimparis
OBJECTIVES: Thoracic endovascular aortic repair (TEVAR) has emerged as a safe procedure in the treatment of a wide spectrum of descending thoracic aortic pathologies, with satisfactory results both in elective and urgent settings. We investigated the results of our elective, urgent and emergency TEVAR interventions. METHODS: A single-centre retrospective analysis of all consecutive patients undergoing TEVAR from 2010 to 2016 was performed. Primary end point of the study was early mortality, whereas the secondary end points included major complications according to the urgency of the procedure...
February 14, 2019: European Journal of Cardio-thoracic Surgery
Koki Tamai, Chikara Ebisui, Noriyuki Yamamura, Takayuki Minoji, Hiroyuki Takabatake, Tomohiro Kitahara, Noriyuki Watanabe, Shu Okamura, Nariaki Fukuchi, Hideoki Yokouchi, Masakatsu Kinuta, Kazuhito Ohishi
A 78-year-oldwoman was referredfor exertional dyspnea. Severe anemia(Hb 4.2 g/dL)was detected, and upper endoscopy revealeda giant ulcer at the posterior wall of the gastric body. Computedtomography showeda mass protruding from the gastric wall, suggestive of a submucosal tumor. Although biopsy did not confirm a diagnosis, we performed distal gastrectomy to control the bleeding. The pathological findings and systemic examination confirmed a diagnosis of extramedullary plasmacytoma of the stomach. Plasmacytoma is a tumor of the bone marrow derived from plasma cells that mature from B cells...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Rafiye Çiftçiler, Ahmet Koluman, İbrahim C Haznedaroğlu, Nejat Akar
Background/aim: Ankaferd hemostat (ABS; Ankaferd blood stopper, İstanbul, Turkey) is a folkloric medicinal plant extract. The aim of this study was to determine the effect of Ankaferd hemostat (ABS) on the fate of Helicobacter pylori strains. The study also aims to determine alterations in the antimicrobial resistance of three different H. pylori strains in response to ABS exposure. Materials and methods: H. pylori Strain 1 was obtained from the culture collection ATCC 43504 and passaged three times for viability...
February 11, 2019: Turkish Journal of Medical Sciences
Grace Lai-Hung Wong, Andy Jinhua Ma, Huiqi Deng, Jessica Yuet-Ling Ching, Vincent Wai-Sun Wong, Yee-Kit Tse, Terry Cheuk-Fung Yip, Louis Ho-Shing Lau, Henry Hin-Wai Liu, Chi-Man Leung, Steven Woon-Choy Tsang, Chun-Wing Chan, James Yun-Wong Lau, Pong-Chi Yuen, Francis Ka-Leung Chan
BACKGROUND: Patients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have an increased risk of recurring ulcer complications. AIM: To build a machine learning model to identify patients at high risk for recurrent ulcer bleeding. METHODS: Data from a retrospective cohort of 22 854 patients (training cohort) diagnosed with peptic ulcer disease in 2007-2016 were analysed to build a model (IPU-ML) to predict recurrent ulcer bleeding...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Lucrecia Bandeo, Astrid Rausch, Miguel Saucedo, Anibal Chertcoff, Luciana Leon Cejas, Claudia Uribe Roca, Sol Pacha, Manuel Fernandez Pardal, Ricardo Reisin, Pablo Bonardo
The TNF-α antagonists are the drugs used for the treatment of ulcerative colitis (UC). Nontraumatic convexity subarachnoid hemorrhage is an infrequent nonaneurysmal subtype of subarachnoid bleeding caused mainly by reversible cerebral vasoconstriction syndrome (RCVS), cerebral amyloid angiopathy, and posterior reversible encephalopathy syndrome (PRES). We present a 26-year-old female patient with a diagnosis of UC taking Adalimumab. She received her last doses the same day she was admitted to our hospital for an acute severe UC exacerbation...
November 2018: Journal of Vascular and Interventional Neurology
Umair Ahmad, Muhammad Sohail, Mahmood Ahmad, Muhammad Usman Minhas, Shahzeb Khan, Zahid Hussain, Mubeen Kousar, Sabeeh Mohsin, Mudassir Abbasi, Syed Ahmed Shah, Haroon Rashid
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...
February 6, 2019: International Journal of Biological Macromolecules
Nastaran Rezaei, Amir Avan, Mehran Pashirzad, Farzad Rahmani, Reyhaneh Moradi Marjaneh, Reihane Behnam-Rassouli, Mojtaba Shafiee, Mikhail Ryzhikov, Milad Hashemzehi, Fatemeh Ariakia, Amirhossein Bahreyni, Seyed Mahdi Hassanian, Majid Khazaei
Ulcerative colitis is a chronic inflammatory bowel disease with high incidence and prevalence worldwide. To investigate the therapeutic potency of crocin, as a pharmacologically active component of saffron, in dextran sodium sulfate (DSS)-induced colitis mice model. Experimental colitis was induced by 7-day administration of DSS dissolved in water at a concentration of 1.5% (w/v). The animals were randomly divided into four groups (n¼6 for each group). (1) Control group received regular drinking water for four weeks, (2) the second group of mice received regular drinking water for three weeks and then received DSS for one week, (3) and (4) the other two groups received 50-ppm or 200-ppm crocin for three weeks, respectively, and then treated with DSS for one week...
February 3, 2019: Drug and Chemical Toxicology
Min Xiao, Chenyu Qian, Xi Luo, Mengbi Yang, Yufeng Zhang, Cheyuen Wu, Chungtong Mok, Puiwai Lee, Zhong Zuo
ETHNOPHARMACOLOGICAL RELEVANCE: Dual antiplatelet therapy (DAPT) with aspirin (ASA) and clopidogrel (CLP) has been consistently shown clinical effectiveness in patients with coronary artery disease. According to the literature, four traditional Chinese medicine (TCM) herbs effective for prevention cardiovascular diseases, namely Radix Salvia Miltiorrhiza (Red sage root, Danshen), Radix Pueraria Lobata (Kudzu root, Gegen), Radix Angelica Sinensis (Angelica root, Danggui), and Rhizoma Ligusticum chuanxiong (Szehuan lovage rhizome, Chuanxiong), are of high potential to be co-administered during DAPT...
January 30, 2019: Journal of Ethnopharmacology
Taha Anwar, Elizabeth Malm-Buatsi
Infantile haemangiomas are one of the most common tumours in infancy, but typically present as cutaneous lesions; haemangiomas of the urinary bladder are incredibly rare. Although benign, these can sometimes ulcerate and bleed, causing haematuria in the case of bladder lesions. Propranolol is a well-documented medical therapy for cutaneous lesions, but surgical treatment dominates the literature on bladder haemangiomas. We present the case of a child with infantile haemangiomas of the urinary bladder, as well as internal and cutaneous lesions, treated with propranolol...
February 1, 2019: BMJ Case Reports
S Poornakala, N S Prema
Context: Globally, colorectal cancer (CRC) is one of the leading causes of cancer death. Many Asian countries experience an increasing incidence of CRC due to changes in diet and lifestyle. Many pathological prognostic factors other than the tumor-node-metastasis (TNM) staging reflect the biological behavior of tumor tissue and influence the treatment and survival. Aims: The aim is to evaluate: (1) Various morphological prognostic factors of colorectal cancer, (2) the correlation of the prognostic factors with survival, and (3) the prognostic factors with independent prognostic significance...
January 2019: Indian Journal of Pathology & Microbiology
Jeremy D Cumberledge, Ikenna Anaka, Justin T Kupec
We present a case of a healthy 59-year-old woman who presented for a capsule endoscopy to evaluate melaena and iron deficiency anaemia. She had previously underwent an oesophagogastroduodenoscopy and colonoscopy at an outside institution which were unremarkable. Capsule endoscopy showed an ulcerated, bleeding lesion likely in the duodenum. Differential diagnosis included adenocarcinoma, carcinoid tumour, lymphoma, gastrointestinal stromal tumour and metastatic disease. A push enteroscopy was performed after which showed an ulcerated mass in the third portion of the duodenum...
January 29, 2019: BMJ Case Reports
Joao Serigado, Eugene Lewis, Grace Kim
A 47-year-old man presented with fatigue, decrease appetite, abdominal pain and rectal bleeding. His colonoscopy revealed a single, firm, raised, centrally ulcerated mass at the anorectal junction. During this same admission, he was diagnosed with HIV and syphilis, found to have multiple hepatic lesions and positive cerebrospinal fluidvenereal disease research laboratory test (VDRL). Biopsies from both the hepatic lesions and rectal ulcer showed spirochaetes by immunostaining. The initial presentation was felt to be secondary to a rectal inflammatory mass caused by syphilis...
January 28, 2019: BMJ Case Reports
Daisuke Uchida, Yoshinari Kawai, Hironari Kato, Hiroyuki Okada
A 74-year-old man presented to the emergency department with acute abdominal pain in addition to anemia and melena, which were suspected to be due to gastrointestinal bleeding. Computed tomography (CT) revealed a blood-filled duodenum and acute pancreatitis. We prioritized treatments for pancreatitis, as the vital signs were stable, and temporary hemostasis was achieved. Two days later, esophagogastroduodenoscopy revealed a duodenal ulcer with an exposed vessel, and endoscopic hemostasis was performed. We urge clinicians to consider the possibility of pancreatitis associated with massive bleeding due to a duodenal ulcer...
January 29, 2019: Clinical Journal of Gastroenterology
Aya Matsuoka, Hiroaki Inoue, Kaoru Ogura, Akinori Hattori, Hiroko Yukawa, Shiho Sakaguchi, Natsuko Tanaka, Asaka Kodera, Mari Kamimura, Yoshihiko Naritaka, Akira Hirano
A 64-year-old woman detected a tumor in her left breast in July 2015, and the tumor became exposed and ulcerated in January 2016. Subsequently, the tumor began to bleed, and the patient was admitted to our hospital on an emergency basis in March 2016. A CT scan revealed the presence of a giant tumor in the left breast, accompanied by chest wall infiltration, left axillary lymph node metastasis, and multiple liver and bone metastases. Following needle biopsy, the specimen was diagnosed as Luminal-HER2-type invasive ductal carcinoma, and pertuzumab plus trastuzumab plus docetaxel was administered...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hak Su Kim, Hee Kyoung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho
Intramural hematoma of the duodenum is a relatively unusual complication associated with the endoscopic treatment of bleeding peptic ulcers. Intramural hematomas are typically resolved spontaneously with conservative treatment alone. We report a case of an intramural duodenal hematoma following endoscopic hemostasis with epinephrine injection therapy, which was associated with transient obstructive jaundice in a patient undergoing hemodialysis. The patient developed biliary sepsis due to obstruction of the common bile duct secondary to the huge hematoma...
January 25, 2019: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Jong Yoon Lee, Jin Seok Jang, Dong Kyun Kim, Jae Hwang Cha, Won Jong Choi
Aortoesophageal fistula (AEF) is an extremely rare but lethal cause of massive gastrointestinal hemorrhage. Characteristic symptoms are mid-thoracic pain, sentinel minor hemorrhage, and massive hemorrhage after a symptom-free interval. Prompt diagnosis and immediate treatments are necessary to reduce mortality. However, AEF is difficult to diagnose because it is uncommon and often leads to death with massive bleeding before proper evaluation. We report a case of endoscopic diagnosis of AEF that did not present with hematemesis; it was treated with thoracic endovascular aortic repair (TEVAR) and surgery...
January 25, 2019: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Marija Barbateskovic, Søren Marker, Anders Granholm, Carl Thomas Anthon, Mette Krag, Janus Christian Jakobsen, Anders Perner, Jørn Wetterslev, Morten Hylander Møller
PURPOSE: Most intensive care unit (ICU) patients receive stress ulcer prophylaxis. We present updated evidence on the effects of prophylactic proton pump inhibitors (PPIs) or histamine 2 receptor antagonists (H2RAs) versus placebo/no prophylaxis on patient-important outcomes in adult ICU patients. METHODS: We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) of randomised clinical trials assessing the effects of PPI/H2RA versus placebo/no prophylaxis on mortality, gastrointestinal (GI) bleeding, serious adverse events (SAEs), health-related quality of life (HRQoL), myocardial ischemia, pneumonia, and Clostridium (Cl...
January 24, 2019: Intensive Care Medicine
Yssra S Soliman, Amor Khachemoune
Infantile hemangioma (IH) is the most common vascular tumor of infancy, affecting up to 10% of all infants. Our understanding of IH and its management has greatly evolved. The etiology of IH is unclear but hypoxia is thought to play a key role. Furthermore, GLUT1, IGF2, and HIF-1-? are thought to be important mediators. Current management options include active observation, medical treatment, and surgical intervention. The goals of treatment are preventing cosmetic disfiguration, psychosocial distress, and life-threatening complications...
September 15, 2018: Dermatology Online Journal
Hyun Sik Kang, Jeong Sub Lee, Chang Rim Hyun, In-Ho Jung, Ki Soo Kang
We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans...
January 2019: Pediatric Gastroenterology, Hepatology & Nutrition
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