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Gastrointestinal and non-gastrointestinal complication rates associated with diagnostic esophagogastroduodenoscopy under sedation
Esophagogastroduodenoscopy (EGD) under sedation may result in gastrointestinal (GI) and non-GI complications. However, no previous studies have reported 30-day GI and non-GI complications after diagnostic EGD under sedation. We conducted a retrospective, observational study of 30-day GI and non-GI complication rates after outpatient diagnostic EGD under sedation in subjects ≥18 years between January 2012 and December 2017 based on a common data model database. Thirty-day complication rates were compared with EGD under sedation or not, type of sedation drugs (midazolam only vs midazolam/propofol) and age groups (18-6...
Source: Medicine - May 13, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Dysphagia: Evaluation and Collaborative Management.
Abstract Dysphagia is common but may be underreported. Specific symptoms, rather than their perceived location, should guide the initial evaluation and imaging. Obstructive symptoms that seem to originate in the throat or neck may actually be caused by distal esophageal lesions. Oropharyngeal dysphagia manifests as difficulty initiating swallowing, coughing, choking, or aspiration, and it is most commonly caused by chronic neurologic conditions such as stroke, Parkinson disease, or dementia. Symptoms should be thoroughly evaluated because of the risk of aspiration. Patients with esophageal dysphagia may report a s...
Source: American Family Physician - January 15, 2021 Category: Primary Care Authors: Wilkinson JM, Codipilly DC, Wilfahrt RP Tags: Am Fam Physician Source Type: research

Cerebral Air Embolism after Esophagogastroduodenoscopy: Insight on Pathophysiology, Epidemiology, Prevention and Treatment
Air embolism is an extremely rare complication that can follow gastrointestinal endoscopy. The most accepted treatment of cerebral air embolism (CAE) is hyperbaric oxygen (HBO). Limited evidence suggests that lidocaine may have a neuroprotective effect. The exact mechanism does not appear to be well elucidated.
Source: Journal of Stroke and Cerebrovascular Diseases - September 25, 2019 Category: Neurology Authors: Malik Ghannam, Azizullah Beran, Dana Ghazaleh, Tanner Ferderer, Brent Berry, Mona Al Banna, Leighton Mohl, Christopher Streib, Tapan Thacker, Ivan Matos Source Type: research

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news

Duodenal Glomus Tumor: A Rare Cause of Upper GI Bleeding
An 88-year-old woman with a past medical history of hypertension and stroke presented with 1 week of progressive weakness, lethargy, and orthostasis. She denied abdominal pain, melena, or hematochezia. Initial vitals signs were unremarkable, and physical examination was notable only for small external hemorrhoids. Stool was positive for occult blood. Her hemoglobin was 7 g/dL; it had been 12.1 g/dL 7 months before the time of her presentation. The following day, an esophagogastroduodenoscopy was performed, which showed a probable 1.5 cm  × 1 cm submucosal mass in the duodenal bulb with oozing at the edges (Figure A).
Source: Clinical Gastroenterology and Hepatology - March 22, 2016 Category: Gastroenterology Authors: Nicholas P. Tarangelo, Kai Ha, Kevin S. Skole Tags: Electronic Image of the Month Source Type: research

Measurement of cardiac index and stroke volume using electrical cardiometry before and after administration of adenosine in a 6-year-old patient with supraventricular tachycardia
We report the case of a 6-year-old boy who developed a supraventricular tachycardia during an upper endoscopy while under general anesthesia. A noninvasive electrical cardiometry device was applied to the patient, and cardiac index and stroke volume were measured before and after the administration of adenosine. Cardiac index fell 41% (P
Source: Journal of Clinical Anesthesia - September 29, 2015 Category: Anesthesiology Authors: Samuel M. Vanderhoek, Charles J. Coté Tags: Case report Source Type: research

An Unusual Cause Of Recurrent Ischemic Stroke: Trousseau's Syndrome From Gastric Cancer (P4.231)
CONCLUSIONS: Trousseau’s Syndrome must be considered in those presenting with recurrent strokes with an otherwise negative embolic work up especially in the elderly and those with cancer risk factors. It must prompt the clinician to look for an associated malignancy.Disclosure: Dr. JADEJA has nothing to disclose. Dr. Johnson has nothing to disclose. Dr. Soetanto has nothing to disclose. Dr. Nalleballe has nothing to disclose. Dr. DeNiro has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Graber has received personal compensation for activities with Stemedica Inc., Novocure Inc., and Biogen Idec.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jadeja, N., Johnson, J., Soetanto, A., Nalleballe, K., DeNiro, L., Qureshi, I., Graber, J. Tags: Neuro-oncology: Paraneoplastic Disorders Source Type: research

Use of Apixaban and Warfarin in Patients Undergoing Procedures: Insights from ARISTOTLE (P5.002)
CONCLUSIONS: Procedures are common in patients with atrial fibrillation. The majority of procedures are non-major and non-emergent, and anticoagulation therapy is likely to be stopped peri-procedure. Overall and among emergent procedures, rates of clinical events in the first 30 days post-procedure were low and comparable between treatment groups.Study Supported by: Bristol-Myers Squibb Company and Pfizer Inc. Editorial assistance (i.e., formatting the abstract to ensure compliance with AAN guidelines) was provided by Claire Hall of Caudex Medical and was funded by Bristol-Myers Squibb Company and Pfizer Inc.Disclosure: Dr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lopes, R., Garcia, D., Wojdyla, D., Dorian, P., Alexander, J., Wallentin, L., Lanas, F., Hanna, M., Held, C., Granger, C. Tags: Cerebrovascular Disease and Interventional Neurology II Source Type: research

Use of Apixaban and Warfarin in Patients Undergoing Procedures: Insights from ARISTOTLE (I2-2.003)
CONCLUSIONS: Procedures are common in patients with atrial fibrillation. The majority of procedures are non-major and non-emergent, and anticoagulation therapy is likely to be stopped peri-procedure. Overall and among emergent procedures, rates of clinical events in the first 30 days post-procedure were low and comparable between treatment groups.Study Supported by: Bristol-Myers Squibb Company and Pfizer Inc. Editorial assistance (i.e., formatting the abstract to ensure compliance with AAN guidelines) was provided by Claire Hall of Caudex Medical and was funded by Bristol-Myers Squibb Company and Pfizer Inc.Disclosure: Dr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lopes, R., Garcia, D., Wojdyla, D., Dorian, P., Alexander, J., Wallentin, L., Lanas, F., Hanna, M., Held, C., Granger, C. Tags: New Antithrombotic Agents for Stroke Prevention Data Blitz Presentations Source Type: research

Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To assess evidence regarding periprocedural management of antithrombotic drugs in patients with ischemic cerebrovascular disease. The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review with practice recommendations. Results and recommendations: Clinicians managing antithrombotic medications periprocedurally must weigh bleeding risks from drug continuation against thromboembolic risks from discontinuation. Stroke patients undergoing dental procedures should routinely continue aspirin (Level A). Stroke patients underg...
Source: Neurology - May 27, 2013 Category: Neurology Authors: Armstrong, M. J., Gronseth, G., Anderson, D. C., Biller, J., Cucchiara, B., Dafer, R., Goldstein, L. B., Schneck, M., Messe, S. R. Tags: Ultrasound, All Medical/Systemic disease, All Neuro-ophthalmology, All Cerebrovascular disease/Stroke, All Trauma SPECIAL ARTICLE Source Type: research

Fatal dabigatran toxicity secondary to acute renal failure
We describe the case of a 74-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation who presented to the emergency department after 20 mL of hematemesis at home. Laboratory evaluation revealed a partial thromboplastin time of 99 seconds, international normalized ratio of 11.7, and creatine of 3.1 mg/dL (baseline creatine, 0.9 mg/dL). Upper endoscopy revealed diffuse gastritis and bleeding. Despite treatment with packed red blood cells and fresh frozen plasma, the patient's hematemesis persisted resulting in significant aspiration requiring endotracheal intubation. Per poison control center recommendation...
Source: The American Journal of Emergency Medicine - November 19, 2012 Category: Emergency Medicine Authors: Joseph K. Maddry, Mana Kouros Amir, Daniel Sessions, Kennon Heard Tags: Case Reports Source Type: research