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Abdominal Pain in Older Adults

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1. Teduglutide (Revestive) - for the treatment of patients aged 1 year and above with short bowel syndrome

for Pharmacoeconomics March 20182 Summary In July 2017, Shire submitted a pharmacoeconomic assessment to the National Centre for Pharmacoeconomics (NCPE) to support the use of teduglutide for the treatment of patients aged one year and above with Short Bowel Syndrome. Short Bowel Syndrome (SBS) is a chronic and potentially life-threatening condition characterised by reduced absorption of nutrients, water and electrolytes in the intestine. People with SBS can develop chronic intestinal failure, also known as Type (...) was only slightly higher in the teduglutide treated patients compared to the placebo treated patients. Severity was also comparable in the two groups. However, serious adverse drug reactions (TESAEs considered possibly related to treatment) occurred more often in the teduglutide group than in the placebo group. The same was the case for TEAEs leading to discontinuation. 4 The most frequently reported adverse events (AEs) were reported from the GI system, e.g. abdominal pain; nausea; vomiting; abdominal

2018 Pediatric Endocrine Society

2. CRACKCast E095 – Large Intestine

? What are the risk factors for developing each type? In general you can get a volvulus anywhere. Patients can present with a bowel obstruction pattern. Can get: Electrolyte disturbances secondary to third spacing / respiratory compromise from massive abdominal distention If left untreated bowel can get ischemic, gangrenous and perforate. Pearl: Sigmoid volvulus account for 60% of all intestinal volvulus. So if you’re a betting person that’s the most common. Gastric – Not large intestine…we know 2 (...) between large pseudopolypoid projections extending into the colonic lumen. Copied from: 11) What the potential causes of toxic megacolon? Toxic megacolon (pathologic dilatation due to inflammation, paralysis of the smooth muscle layers) may occur as a complication of IBD, infectious colitides of diverse etiology, ischemic colitis, volvulus, diverticulitis, and obstructive colon cancer. Most people present with multiple days of loose bloody stools (>10 /day), fever, abdominal pain, dehydration

2017 CandiEM

3. Gastrointestinal motility should be emphasized after laparotomy treatment for complete small intestinal volvulus in older adults: A case report. Full Text available with Trip Pro

Gastrointestinal motility should be emphasized after laparotomy treatment for complete small intestinal volvulus in older adults: A case report. Complete small intestinal volvulus is a rare entity in adults, unlike partial intestinal volvulus. Although prompt surgical intervention is the mainstay of treatment, attention should also be paid to recovery of intestinal function postoperatively. Ignoring this issue during the postoperative recovery process can have serious consequences. We report (...) the case of an 82-year-old woman with complete small intestinal volvulus at the root of the superior mesenteric vessel.The patient was admitted for acute onset (22 hours) of abdominal pain and distention. Nausea and vomiting also developed during this period.Abdominal physical examination was suspicious for peritoneal irritation. Computed tomography scan showed anticlockwise swirl of the mesenteric vessels at the lower margin of the pancreas with distension of the entire small intestine. A complete

2019 Medicine

4. Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older)

Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) | Innovation Observatory toggle menu Menu Search View All Filter by Speciality Filter by Year Filter by Category This search function provides links to outputs produced by NIHR Innovation Observatory. These are briefing notes or reports on new or repurposed technologies (...) . This search will not return all technologies currently in development as these outputs are produced as required for our stakeholders. > > > Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) August 2017 Acute myeloid leukaemia (AML) is a type of cancer that causes the bone marrow to produce lots of immature white blood cells

2017 NIHR Innovation Observatory

5. BSG consensus guidelines on the management of inflammatory bowel disease in adults

and symptomatic burden between patients, and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing (...) BSG consensus guidelines on the management of inflammatory bowel disease in adults 1 Version accepted by Gut 10 th June 2019 British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults Authors Christopher A. Lamb 1,2 *, Nicholas A. Kennedy 3,4 , Tim Raine 5 , Philip Hendy 6,7 , Philip J. Smith 8 , Jimmy K. Limdi 9,10 , Bu’Hussain Hayee 11,12 , Miranda Lomer 12,13 , Gareth C. Parkes 14,15 , Christian P. Selinger 16,17 , Kevin J. Barrett 18

2019 British Society of Gastroenterology

6. The bowel function and quality of life of Hirschsprung disease patients who have reached 18 years of age or older - the long-term outcomes after undergoing the transabdominal soave procedure. (Abstract)

The bowel function and quality of life of Hirschsprung disease patients who have reached 18 years of age or older - the long-term outcomes after undergoing the transabdominal soave procedure. Hirschsprung disease (HD) is considered curable, but the postoperative bowel function is not always satisfactory. In this study, we evaluated the general condition, bowel function, and social performance in adults who were older than 17years of age who had undergone definitive operations in childhood.From (...) 1984 to 2016, 110 patients with HD underwent definitive surgery at our institute. Sixty-three patients who had undergone the transabdominal Soave procedure reached 18years of age. Their present status and symptoms, anorectal function, genitourinary function, and social performance were evaluated during the clinical follow-up via a questionnaire survey.The mean age of the questionnaire respondents was 25.0 (19-37) years. The bowel function was mostly good. However, 56% of patients had abdominal pain

2017 Journal of Pediatric Surgery

7. Epidural analgesia versus patient-controlled intravenous analgesia for pain following intra-abdominal surgery in adults. Full Text available with Trip Pro

, colorectal and upper gastrointestinal procedures), a wide range of adult ages, and were performed in several different countries.Our pooled analyses suggested a benefit with regard to pain scores (using a visual analogue scale between 0 and 100) in favour of EA techniques at rest. The mean pain reduction at rest from waking to six hours after operation was 5.7 points (95% confidence interval (CI) 1.9 to 9.5; 7 trials, 384 participants; moderate-quality evidence). From seven to 24 hours, the mean pain (...) Epidural analgesia versus patient-controlled intravenous analgesia for pain following intra-abdominal surgery in adults. Intravenous patient-controlled analgesia (IVPCA) with opioids and epidural analgesia (EA) using either continuous epidural administration (CEA) or patient-controlled (PCEA) techniques are popular approaches for analgesia following intra-abdominal surgery. Despite several attempts to compare the risks and benefits, the optimal form of analgesia for these procedures remains

2018 Cochrane

8. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

associated with increased risk of CVD incidence and angina, myocardial infarction (MI), HF, stroke, peripheral artery disease (PAD), and abdominal aortic aneurysm, each evaluated separately. An increased risk of CVD associated with higher SBP and DBP has been reported across a broad age spectrum, from 30 years to >80 years of age. Although the relative risk of incident CVD associated with higher SBP and DBP is smaller at older ages, the corresponding high BP–related increase in absolute risk is larger (...) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines | Hypertension Search Hello Guest! Login to your account Email Password

2017 American Heart Association

9. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary Full Text available with Trip Pro

with a doubling in the risk of death from stroke, heart disease, or other vascular disease. In a separate observational study including >1 million adult patients ≥30 years of age, higher SBP and DBP were associated with increased risk of CVD incidence and angina, myocardial infarction (MI), HF, stroke, peripheral artery disease (PAD), and abdominal aortic aneurysm, each evaluated separately. An increased risk of CVD associated with higher SBP and DBP has been reported across a broad age spectrum, from 30 (...) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines | Hypertension Search Hello Guest

2017 American Heart Association

10. Abdominal Pain in Children Develops With Age and Increases With Psychosocial Factors. (Abstract)

Abdominal Pain in Children Develops With Age and Increases With Psychosocial Factors. Functional gastrointestinal disorders are highly prevalent, cause significant suffering, and are costly to society. Pain is a central feature of 2 of the most common functional gastrointestinal disorders-irritable bowel syndrome and functional dyspepsia. Although these disorders have been well studied in adults, their etiology is poorly understood. We sought to identify early-life factors associated (...) with development of abdominal pain in children (2-12 years old).We collected data from the All Babies in Southeast Sweden study on 1781 children, born from October 1, 1997 through October 31, 1999, whose families answered questions about abdominal pain and risk factors at birth, 1 year, 2.5 years, 5 years, 8 years, and 10-12 years. We used latent growth curve models to evaluate risk factors for development of abdominal pain. The primary outcomes were prevalence of abdominal pain and associated factors.The

2019 Clinical Gastroenterology and Hepatology

11. Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey Full Text available with Trip Pro

Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey Irritable bowel syndrome with constipation (IBS-C) is a representative psychosomatic disorder. Several pathophysiological factors have been linked to IBS symptoms such as the modulation of gastrointestinal motility, visceral hypersensitivity, dysregulation of the gut-brain axis, genetic and environmental factors, sequelae of infection (...) a questionnaire on the degree of anxiety, thoughts about bowel habits, and their dominant gastrointestinal symptoms together with exacerbation factors. The correlation between gender and age and IBS-C symptoms was analyzed.When analyzed by gender, the expression rate of abdominal discomfort, abdominal distention, and abdominal fullness was significantly higher in female than male IBS-C subjects (66.5% vs. 58.7%, p < 0.05; 54.7% vs. 43.6%, p < 0.01; 18.9% vs. 9.6%, p < 0.01, respectively). When analyzed by age

2018 BioPsychoSocial medicine

12. A Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by PNEUMOVAXâ„¢23 in Healthy Adults 50 Years of Age or Older (V114-016/PNEU-PATH)

A Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by PNEUMOVAXâ„¢23 in Healthy Adults 50 Years of Age or Older (V114-016/PNEU-PATH) A Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by PNEUMOVAX™23 in Healthy Adults 50 Years of Age or Older (V114-016/PNEU-PATH) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x (...) × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by PNEUMOVAX™23 in Healthy Adults 50 Years of Age or Older (V114-016/PNEU-PATH) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated

2018 Clinical Trials

13. Immunogenicity and Safety Study of GSK Biologicals' Herpes Zoster Vaccine GSK1437173A When Co-administered With Prevenar13 in Adults Aged 50 Years and Older

Immunogenicity and Safety Study of GSK Biologicals' Herpes Zoster Vaccine GSK1437173A When Co-administered With Prevenar13 in Adults Aged 50 Years and Older Immunogenicity and Safety Study of GSK Biologicals' Herpes Zoster Vaccine GSK1437173A When Co-administered With Prevenar13 in Adults Aged 50 Years and Older - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record (...) Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Immunogenicity and Safety Study of GSK Biologicals' Herpes Zoster Vaccine GSK1437173A When Co-administered With Prevenar13 in Adults Aged 50 Years and Older The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal

2018 Clinical Trials

14. Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors: Two case reports. Full Text available with Trip Pro

Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors: Two case reports. Adult intussusception is rarely observed, and the clinical manifestations are very atypical. The most common symptom is abdominal pain, while the incidence of hematochezia is relatively low. We report two cases of adult intussusception secondary to small intestinal tumors with gastrointestinal hemorrhage as the main symptom.Two men aged 19 and 54 years were successively referred (...) with gastrointestinal hemorrhage as the main symptom. Isolated hamartoma polyp is a rare cause of intussusception in adults. The clinical manifestations of adult intussusception are very atypical, and thus, making a preoperative diagnosis is difficult. Abdominal CT or CTA is an effective diagnostic method for adult intussusception. For adult patients with gastrointestinal hemorrhage caused by intussusceptions, active surgery should be performed when conservative treatment is not effective. Laparoscopic surgery

2018 Medicine

15. Gastric volvulus through Morgagni hernia and intestinal diverticulosis in an adult patient: a case report. Full Text available with Trip Pro

Gastric volvulus through Morgagni hernia and intestinal diverticulosis in an adult patient: a case report. Morgagni's hernia (MH) is a rare type of congenital diaphragmatic hernia with limited available literature. Late presentations are infrequent and the ones complicated due to gastric volvulus are even rarer. Another uncommon association of MH is with small bowel diverticulosis. We herein discussed a case of gastric volvulus as the content of MH, and small bowel diverticulosis present (...) in a patient concomitantly.A 30 year old woman, who presented with a one year history of epigastric burning and indigestion, occasionally associated with pain and vomiting. On clinical examination, no clue to the diagnosis could be ascertained. Her chest and abdominal x-ray indicated an abnormal air-fluid level at right hemithorax, which prompted a Computed Tomography (CT) scan, showing organo-axial gastric volvulus. MH with gastric volvulus was observed during laparotomy and trans-thoracic reduction

2018 BMC Surgery

16. Hepatic Issues and Complications Associated With Inflammatory Bowel Disease: A Clinical Report From the NASPGHAN Inflammatory Bowel Disease and Hepatology Committees

vein thrombosis was reported in 1.3% of IBD cases, with mortality of 50% (54). Recent abdominal surgery, younger age, and female sex are associated with a higher incidence of PVT (55). The factors involved in this pathogenesis are diverse. Acquired prothrombotic factors can be identified, such as inflammation, immobilization, extent of colon disease, surgery, central catheters, corticosteroids, and smoking (56,57). Inflammation is the most common risk factor. Presentation and Diagnosis of Portal (...) Vein Thrombosis PVT may present in many ways from an acute abdomen to a more chronic and insidious presentation (58). Symptoms will vary based on the acuity and degree of vessel involvement. Acute PVT is rare, but should be considered in those presenting with acute abdominal or lumbar pain, nonspiking fevers, and moderate abdominal distension (due to an ileus). If the superior mesenteric vein is also occluded then they may have nonbloody diarrhea and intermittent abdominal pain that can progress

2017 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

17. Pain self-management plus nurse-led support in young adults with irritable bowel syndrome: Study protocol for a pilot randomized control trial. Full Text available with Trip Pro

and related health outcomes. A sample of 80 young adults (age 18-29 years old) will be recruited and randomly assigned to the experimental or control group. Both groups will receive 10 electronic video modules focused on IBS-pain SM knowledge and skills. The experimental group also will receive nurse-led one-on-one phone consultations to facilitate monitoring and problem-solving. All participants will be followed over 12 weeks. Primary outcomes will be measured at baseline, 6 weeks, and 12 weeks (...) Pain self-management plus nurse-led support in young adults with irritable bowel syndrome: Study protocol for a pilot randomized control trial. Irritable bowel syndrome (IBS) is a functional gut disorder that typically manifests in early adult years. IBS patients report that pain is the most distressing symptom with the greatest impact on quality of life. Pain-sensitivity genes and the gut microbiome may influence severity of symptoms as well as response to self-management (SM) interventions

2018 Research in nursing & health Controlled trial quality: uncertain

18. PredictSure-IBD for inflammatory bowel disease prognosis

is an option for adults, children and young people aged 6 and over, but adalimumab is an option for adults only. Both drugs can be used with an immunosuppressive drug. NICE guidance also recommends vedolizumab after TNF inhibitors have not responded. Severe ulcerative colitis is defined as 6 or more bowel movements a day with visible blood, high temperature and heart rate and anaemia. It is treated first with intravenous corticosteroids or intravenous ciclosporin for people who cannot tolerate, or decline (...) Crohn's disease or ulcerative colitis. Innovations PredictSure-IBD is an assay designed to predict the prognosis for people recently diagnosed with Crohn's disease or ulcerative colitis. By identifying those whose disease is more likely to progress to severe and relapsing, PredictSure-IBD can allow more personalised and effective anti-TNF treatment to start sooner. Current care pathway After initial diagnostic investigations and tests for inflammatory bowel disease (IBD), drug treatment is prescribed

2019 National Institute for Health and Clinical Excellence - Advice

19. Truberzi (eluxadoline) - for the treatment of adults who have irritable bowel syndrome with diarrhoea

discussion within the Committee, issued a positive opinion for granting a Marketing Authorisation to Truberzi. Assessment report EMA/549473/2016 Page 8/108 2. Scientific discussion 2.1. Introduction Problem statement Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal problem characterised primarily by intestinal pain and/or discomfort and associated alterations of defecation and/or bowel habit. Associations with other symptoms are regularly present, such as abdominal distension (...) dose in the older population while showing similar or somewhat increased efficacy, has a smaller increase in adverse events (as compared to the younger age groups). The composite response rate difference for the older patients was higher than 20% for both doses, and even the abdominal pain response rate difference was >10% in the older population. Contrary to the population aged 3xULN of ALT and 65 years). About at least one third of the events occurred in a close time-relation to the first intake

2016 European Medicines Agency - EPARs

20. Electrospun P(LLA-CL) Nanoscale Fibrinogen Patch vs Porcine Small Intestine Submucosa Graft Repair of Inguinal Hernia in Adults: A Randomized, Single-Blind, Controlled, Multicenter, Noninferiority Trial Full Text available with Trip Pro

. Eligible patients (20 to 75 years old) with primary unilateral, reducible groin hernias were randomly assigned (1:1) to electrospun nanoscale P(LLA-CL)/fibrinogen patch (experimental group) or porcine small intestine submucosa (control group) patch groups. Patients were treated with the Lichtenstein technique, and the primary endpoint was hernia recurrence at 33 months after surgery. The secondary endpoints were postoperative complications including groin pain and operative site infections.Between July (...) Electrospun P(LLA-CL) Nanoscale Fibrinogen Patch vs Porcine Small Intestine Submucosa Graft Repair of Inguinal Hernia in Adults: A Randomized, Single-Blind, Controlled, Multicenter, Noninferiority Trial The aim of this study was to compare primary efficacy indicators of a low-cost, electrospun, nanoscale P(LLA-CL)/fibrinogen patch with a porcine small intestine submucosa patch for hernia repair.A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai

2019 EvidenceUpdates

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