Large intramural hematoma and gastric ulcer after EMR of a small gastric polyp

A 59-year-old man underwent EMR of a 1-cm sessile polyp at the gastric antrum. He had a history of coronary artery disease, chronic kidney disease (creatinine, 460 μmol/L), and compensated liver cirrhosis (platelet count, 144 × 109/L; prothrombin time, 14 s; international normalized ratio, 1.35). He took clopidogrel, which was discontinued 1 week before EMR. We used the inject-and-cut EMR technique and injected the submucosa with 5 mL of saline solution. A small nonexpanding purplish bulge developed after injection (A).
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: At the focal point Source Type: research

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ConclusionsHAPR was infrequently present in a large registry of patients undergoing PCI. There was no clear relationship between HAPR and 2-year clinical outcomes. Investigation of antiplatelet regimens without aspirin after DES implantation are ongoing and should inform future management of patients undergoing PCI.
Source: American Heart Journal - Category: Cardiology Source Type: research
Objective The aim was to perform exploratory research on the application of technetium phytate (99mTc-Phy) portal perfusion index (PPI) imaging in predicting the complications of hepatitis B cirrhosis and their severity. Patients and methods A total of 65 hepatitis B cirrhosis patients were stratified, respectively, into three groups from classes A to C according to Child–Pugh scores and five groups from stages 1 to 5 according to the five-stage prognostic system. PPIs were compared and analyzed, respectively, among the three and five groups. The correlations between PPIs and major biochemical indices of liver f...
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Conclusion IgAVN in elderly patients is characterized by severe renal involvement. Elderly patients are at higher risk than adults for treatment-related adverse events. PMID: 30101942 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Yoshida N, Kanno A, Masamune A, Nabeshima T, Hongo S, Miura S, Takikawa T, Hamada S, Kikuta K, Kume K, Ueno M, Shimosegawa T Abstract A 79-year-old woman was referred for pancreatic tail cancer with multiple liver metastases. The pancreatic tail tumor was diagnosed as acinar cell carcinoma (ACC) histologically by endoscopic ultrasound-guided fine-needle aspiration. Because of multiple liver metastases, S-1 chemotherapy was administered, resulting in a partial response to chemotherapy one year later. After approximately three years, liver atrophy and esophageal varices developed. We suspected S-1 as the cau...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
ConclusionsBoth studied methods produced equal satisfactory outcomes in the treatment of CUTS. Endoscopy has the potential to minimize chronic scar pain and improve scarring esthetics, at the expense of longer operating time.Clinical trial registration numberSupported by Ministry of Health, Czech Republic —conceptual development of research organization (FNOs/2014, project number 20).Graphical abstractMedian postoperative pain from 0 to 10  days by group.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
Conclusions:Patients showing increased airway dimensions at the level of the velum and/or oropharynx with a jaw thrust may benefit the most from OAT. The use of DISE to identify this subset of patients is helpful in optimizing outcomes with OAT.Citation:Huntley C, Cooper J, Stiles M, Grewal R, Boon M. Predicting success of oral appliance therapy in treating obstructive sleep apnea using drug-induced sleep endoscopy.J Clin Sleep Med. 2018;14(8):1333–1337.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Conclusions:The results of this study illustrate that it is feasible to use RCMP during DISE and to determine ETPP within 45 minutes. Comparative research with polysomnography would be useful to further validate the therapy outcome upon use of RCMP during DISE.Citation:Kastoer C, Dieltjens M, Op de Beeck S, Braem MJ, Van de Heyning PH, Vanderveken OM. Remotely controlled mandibular positioning during drug-induced sleep endoscopy toward mandibular advancement device therapy: feasibility and protocol.J Clin Sleep Med. 2018;14(8):1409–1413.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Objective: Non-selective β-blockers (NSBBs) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the inci dence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. Subjects and Methods: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed. Diagnosis of PVT was made by ultrasound. The presence of PVT was evalua...
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
Publication date: Available online 14 August 2018Source: Journal of Arthroscopy and Joint SurgeryAuthor(s): Ramneek Mahajan, Yugal Karkhur, V. Anil, Abhimanyu Kakralia
Source: Journal of Arthroscopy and Joint Surgery - Category: Orthopaedics Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
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