Acute Lower Gastrointestinal Bleeding: Evaluation and Management.
Acute Lower Gastrointestinal Bleeding: Evaluation and Management. Am Fam Physician. 2020 Feb 15;101(4):206-212 Authors: Hawks MK, Svarverud JE Abstract Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel disease are other common sources. Initial evaluation should focus on obtaining the patient's history and performing a physical examination, including evaluation of hemodynamic status. Subsequent evaluation should be based on the suspected etiology. Most patients should undergo colonoscopy for diagnostic and therapeutic purposes once they are hemodynamically stable and have completed adequate bowel preparation. Early colonoscopy has not demonstrated improved patient-oriented outcomes. Hemodynamic stabilization using normal saline or balanced crystalloids improves mortality in critically ill patients. For persistently unstable patients or those who cannot tolerate bowel preparation, abdominal computed tomographic angiography should be considered for localization of a bleeding source. Technetium Tc 99m-labeled red blood cell scintigraphy should not be routinely used in the evaluation of lower gastrointestinal bleeding. Surgical intervention should be considered only for patients with uncontrolled severe bleeding or multiple ineff...
Conclusion: The most important finding of one-month ticagrelor consumption were dyspnea, bleeding, and hypersensitivity reaction. No case of bradycardia and stent thrombosis was detected. In our study , iranian population has more susceptibility to dyspnea than PLATO result. The rate of drug discontinuation in this series of cases was 6.4 %. PMID: 32259131 [PubMed - as supplied by publisher]
In this report, we presented a case of POT due to knife injury in which the knife blade was removed and bleeding was controlled, the patient's general condition after surgery was good, but the vision of the right eye was lost. PMID: 32259125 [PubMed - as supplied by publisher]
Conclusion: The knowledge, attitude, and practice of EMS staff regarding bleeding control were moderate, positive and appropriate, and incomplete, respectively. Since bleeding is a life threatening status and EMS staff skills are critical in this issue, it seems that we need to provide continuous education in this regard. PMID: 32259111 [PubMed - as supplied by publisher]
Conclusion: Our data showed that adjuvant CAPOX induced severe enterocolitis in 13.1% of patients. In addition, we found that advanced age, right colectomy and concurrent use of ARB were statistically associated with these events. Awareness of these factors could be easily incorporated into the treatment decision and patient orientation. PMID: 32256697 [PubMed - as supplied by publisher]
Conclusions Spiral-TOFs may deliver high-quality intracranial vessel imaging thus matching the performance of conventional parallel imaging–accelerated TOFs (such as the SENSE). Specifically, imaging can be performed at unprecedented scan times as short as 1:32 minutes per sequence (70.12% scan time reduction compared with SENSE). Optionally, spiral imaging may also be used to increase spatial resolution while maintaining the scan time of a Cartesian-based acquisition schema. The CNR was decreased in spiral-TOF images.
Authors: Brancadoro M, Dimitri M, Boushaki MN, Staderini F, Sinibaldi E, Capineri L, Cianchi F, Biffi Gentili G, Menciassi A Abstract Introduction: During the last two decades, many surgical procedures have evolved from open surgery to minimally invasive surgery (MIS). This limited invasiveness has motivated the development of robotic assistance platforms to obtain better surgical outcomes. Nowadays, the da Vinci robot is a commercial tele-robotic platform widely used for different surgical applications.Material and methods: In this work, the da Vinci Research Kit (dVRK), namely the research version of the da Vinci...
Condition: Ulcerative Colitis Intervention: Drug: tofacitinib Sponsor: Pfizer Not yet recruiting
ConclusionAcute lower gastrointestinal bleeding is common among elderly patients and the commonest cause is diverticular disease. Colonoscopy plays an important role in the diagnosis. Most patients respond to conservative therapy.
We report a case of lower gastrointestinal bleeding due to angiodysplasia of the appendix. A 72-year-old man presented with hematochezia. Colonoscopy showed active bleeding from the orifice of the appendix. We performed a laparoscopic appendectomy. Microscopically, dilated veins were found at the submucosal layer of the appendix. The patient was discharged uneventfully. Although lower gastrointestinal bleeding of appendiceal origin is very rare, clinicians should consider it during differential diagnosis. PMID: 27437394 [PubMed]