Stress Ulcer Prophylaxis in Critically Ill Children: A Multicenter Observational Study

Conclusions: Stress ulcer prophylaxis is common in Canadian PICUs. Clinically important gastrointestinal bleeding and C. difficile–associated diarrhea are rare, and the utility of routine prophylaxis should be examined.
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

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Conclusion The English version of the difficulty of life scale is a reliable and valid disease-specific scale for ulcerative colitis. It can be used to communicate the challenge of daily living between patients with this long-term condition and health care providers.
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research
AbstractNewly diagnosed immune thrombocytopenia (ITP) is a relatively common disorder of childhood that does not require an exhaustive laboratory workup for diagnosis. A history and physical exam with a review of the peripheral smear are crucial for excluding secondary causes of thrombocytopenia. Several guidelines have been published to guide physicians in the management of ITP. However, the decision for treatment can be arduous. The management strategy should not be focussed on the platelet count but the severity of bleeding symptoms. Agents for treating acute ITP, including corticosteroids, immunoglobulin and anti-D imm...
Source: Indian Journal of Pediatrics - Category: Pediatrics Source Type: research
CONCLUSIONS: Thrombomodulin alfa did not improve the 90-day survival proportion. The present results suggest that the use of thrombomodulin alfa for the treatment of acute exacerbation of idiopathic pulmonary fibrosis not be recommended. Clinical trial registration available at www.clinicaltrials.gov, ID: NCT02739165. PMID: 31917621 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
We report a case of juvenile dermatomyositis (JDM) resembling late-stage Degos disease with gastrointestinal perforations successfully treated with combination rituximab and cyclophosphamide therapy. We systematically reviewed the literature detailing the medical and surgical treatments for gastrointestinal perforation in dermatomyositis, Degos-like dermatomyositis, and Degos disease. In addition to our case, as of October 2019, we identified 36 cases describing gastrointestinal perforation in patients with underlying dermatomyositis, 5 cases of Degos-like dermatomyositis and 17 cases of idiopathic Degos disease. Corticost...
Source: Rheumatology International - Category: Rheumatology Source Type: research
Abstract Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagnosis. History and examination, including anoscopy, are usually sufficient for diagnosing these conditions, although additional testing is needed in some situations. The primary treatment for hemorrhoids is fiber supplementation. Patients who do not improve and those with large high-grade hemo...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
The patient GMFA, 52 years old and African-white, sought an oral diagnostic service because of a spontaneous bleeding complaint in the region of the tongue. She reported that episodes of profuse bleeding used to happen after feeding or brushing. The clinical examination revealed the presence of a reddish traumatized papule of approximately 1 mm at the dorsum lingual surface. A topical corticosteroid was prescribed, inducing an interruption of the bleeding episodes, and a reduction of the lesion was observed in the following appointments.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0039-1700512Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder affecting approximately 1 in 20,000 people. Patients typically present with clinically benign mucocutaneous bleeding, but morbid internal bleeding can occur. Diagnosis remains clinical, possible only after ruling out other causes of thrombocytopenia through history and laboratory testing. Many adult patients do not require treatment. For those requiring intervention, initial treatment of adult ITP is with corticosteroids, intravenous immunoglobulin, or intravenous anti-RhD immune globulin. These agents are rapid-...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
ConclusionA concurrent lymphoma can lead to emergency surgery and should be considered when sarcoidosis treatment does not improve symptoms, lymphadenopathy occurs, or hematologic changes persist under therapy.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
The authors reviewed the evidence on the effect on death of using corticosteroids in children and adults with sepsis.Sepsis is present when an infection is complicated by organ failure. People develop rapid breathing, hypotension (low blood pressure), and mental confusion. Sepsis can interfere with the effectiveness of the body ’s corticosteroids, which serve as a key defence against infection. Corticosteroids have been given for decades to people with infection resulting from various causes.The review included 61 trials (12,192 participants). Fifty-eight trials compared corticosteroids to no corticosteroids  (p...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
CONCLUSION: Oesophageal bullous detachment is rare in AIBD but, as seen here, it may be responsible for massive haemorrhage, especially in the event of associated AHA. This feature underscores the need for evaluation of haemostasis in the early stages and during relapses for all patients with AIBD. PMID: 31831217 [PubMed - as supplied by publisher]
Source: Annales de Dermatologie et de Cenereologie - Category: Dermatology Authors: Tags: Ann Dermatol Venereol Source Type: research
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