Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO.

Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO. Medicina (Kaunas). 2019 Jul 03;55(7): Authors: Goral V, Yılmaz N Abstract Gastric varices are less common than esophageal varices, and their treatment is quite challenging. Gastric varix bleedings (GVB) occur less frequently than esophageal varix (EV) bleedings and represent 10% to 30% of all variceal bleedings. They are; however, more severe and are associated with high mortality. Re-bleeding may occur in 35% to 90% of cases after spontaneous hemostasis. GV bleedings represent a serious clinical problem compared with esophageal varices due to their location. Sclerotherapy and band ligation, in particular, are less effective. Based on the anatomic site and location, treatment differs from EV and is categorized into two groups (i.e., endoscopic or radiologic treatment). Surgical management is used less frequently. Balloon-occluded retrograde transvenous obliteration (BRTO) and cyanoacrylate are safe but there is a high risk of re-bleeding. Portal pressure elevates following BRTO and leads to worsening of esophageal varix pressure. Other significant complications may include hemoglobinuria, abdominal pain, fever, and pleural effusion. Shock and atrial fibrillation are major complications. New and efficient treatment modalities will be possible in the future. PMID: 31277322 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research

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Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Publication date: February 2019Source: The Lancet Haematology, Volume 6, Issue 2Author(s): Loretta J Nastoupil, Matthew A Lunning, Julie M Vose, Marshall T Schreeder, Tanya Siddiqi, Christopher R Flowers, Jonathon B Cohen, Jan A Burger, William G Wierda, Susan O'Brien, Peter Sportelli, Hari P Miskin, Michelle A Purdom, Michael S Weiss, Nathan H FowlerSummaryBackgroundTherapeutic approaches for B-cell malignancies continue to evolve, especially with regard to combination approaches. We assessed the safety and efficacy of the triplet ublituximab, umbralisib, and ibrutinib in patients with advanced B-cell malignancies.Methods...
Source: The Lancet Haematology - Category: Hematology Source Type: research
Individuals share about 99.97 percent of their DNA and only the remaining 0.03 percent is responsible for the differences in skin, hair or eye color, height, shoe size or sunspots. Scientists discovered somewhat recently that our bodies also metabolize drugs differently so it would make sense to prescribe medications based on the knowledge hidden in our DNA. In some cases, physicians already do that. Here’s what you need to know about pharmacogenomics and the future of prescription drugs. It’s all in your genes Why do some people eat creamy French cakes all the time, only do sports when they have to run after t...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Pharma Genomics Medical Professionals Patients Researchers DNA dna testing drugs genetics Health Healthcare Innovation medication pharmacogenetics pharmacogenomics precision health precision medicine technology Source Type: blogs
​BY TRAVIS SMITH, MD, &MATTHEW ZUCKERMAN, MDParamedics were called for a 42-year-old woman found at a motel by her significant other. The patient was alone at the time of EMS arrival. She was pulseless and apneic, so chest compressions were started, and the cardiac monitor showed pulseless electrical activity.Initial ECG showing STE in the anterior leads with ST depression in the inferior leads.The paramedics gave her 1 mg of epinephrine IV and 1 mg of naloxone IV without obvious response. A laryngeal mask airway was placed, and oxygen was delivered by bag valve mask. She received eight rounds of chest compressi...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Authors: Seo JM, Park JS, Jeong SS Abstract A 40-year-old male patient underwent radiofrequency catheter ablation for symptomatic paroxysmal atrial fibrillation (AF). Although pulmonary vein (PV) isolation was successfully completed without acute complications, the patient began complaining of sustained retrosternal pain. Seventeen days after ablation, the patient visited the emergency room with fever and severe chest pain with pericarditis-like features. Chest computed tomography (CT) revealed clustered air bubbles in the pericardial space. Esophagography confirmed leakage of contrast agent into the pericardial sp...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
CONCLUSION:The variables that interplay in cases of severe aortic stenosis are what cause these patients to be so difficult to manage, and specific therapies targeted to fix one issue often worsen the effects of another issue. If someone is in respiratory distress, their airway and breathing needs to be secured, either through non-invasive or invasive means. Next, the patient ’s blood pressure needs to be stabilized. Oftentimes the most appropriate agent will be a positive inotrope, with consideration of a vasoactive agent in persistent hypotension. Once a patient is stabilized, determining the extent of damage to th...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Information This new test series requires ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
This study reported 32 arrhythmic episodes in 24 patients. There was spontaneous recovery with abstinence from alcohol. Reference 1. Ettinger PO, Wu CF, De La Cruz C Jr, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders. Am Heart J. 1978 May;95(5):555-62.Question 14Diagnosis based on the echocardiogram: AEbstein’s anomaly of tricuspid valveBNone of the aboveCEndomyocardial fibrosisDIdiopathic dilatation of right atriumQuestion 14 Explanation:  Endomyocardial Fibrosis (EMF) is a type of restrictive cardiomyopathy. It is characteris...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Welcome to the 210th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Excellent interview by Rob Orman of Weingart discussing the management of extravasation of peripheral vasopressors from Essentials of EM. [AS]   The Best of #FOAMed Emergency Medicine We all know the dangers of hypoxia but how clued up are...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Education LITFL review Source Type: blogs
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