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Hemorrhoid Coagulation

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101. Dipyridamole for Immune Activation in HIV

of coagulation: D-dimer Plasma levels of biomarker of coagulation: tissue factor Percent brachial artery flow-mediated dilation (FMD) Proportion of cycling CD4+ T-cells as measured by Ki-67 expression Proportion of cycling CD8+ T-cells as measured by Ki-67 expression Adverse events, discontinuations of study drug [ Time Frame: Entry through week 24 ] Grade 2 or higher adverse events Treatment discontinuations Correlation of plasma Dipyridamole level to markers of immune activation and inflammation [ Time (...) of any unresolved injury, infectious or inflammatory condition of the local mucosa, and presence of symptomatic external hemorrhoids. NOTE: Abnormalities of the colorectal mucosa will be assessed at the time of the enrollment flexible sigmoidoscopy. If no significant colorectal abnormalities or symptoms are present then the participant will undergo the enrollment procedures. If abnormalities are present then no biopsies will be performed and the participant will not be enrolled into the rectal tissue

2014 Clinical Trials

102. Study of PER977 Administered to Subjects With Steady State Edoxaban Dosing and Re-anticoagulation With Edoxaban

and its metabolite when administered with PER977 Safety coagulation measures [ Time Frame: 5 days ] To evaluate changes in point of care prothrombin time, d-dimer, prothrombin factors 1 and 2, tissue factor pathway inhibitor, and possibly other biomarkers following escalating intravenous doses of PER977 administered after edoxaban in healthy volunteers Safety and tolerability [ Time Frame: 5 days ] To determine if adverse events occurred in healthy volunteers who received PER977 after edoxaban Other (...) such as epistaxis, rectal or hemorrhoidal bleeding or gingival bleeding within 1 month prior to screening Personal or family history of clotting disorder or abnormality, excessive bleeding, thrombovascular disease or any hematologic disorder involving platelets or clotting abnormalities or any condition requiring treatment with transfusions, or history of heparin-induced thrombocytopenia Females with a history of dysfunctional uterine bleeding, menorrhagia , metrorrhagia or polymenorrhea Pregnant or breast

2014 Clinical Trials

103. Efficacy, Safety, and Performance Study of a Novel Device Designed to Manage Fecal Incontinence in Hospitalized Bedridden Patients With Liquid to Semi-formed Stool.

Volunteers: No Criteria Inclusion Criteria: Male and female patients, more than 18 years of age incontinent with liquid to semi-formed stool. Non-ambulatory, hospitalized patients. History of passage of at least 1 stool in 24 hours. Exclusion Criteria: Patients with suspected or confirmed rectal mucosal impairment or pathology. Patients with have undergone descending colon or rectal surgery within the preceding six months. Patients with significant hemorrhoids, growth, fissure, stricture, stenosis (...) or local pathology (either benign and malignant) as observed during rectal examination. Patients suspected to have impacted stool or is suffering from constipation. Patients with confirmed pregnancy or suspected to be pregnant. Patients that have planned MRI examination over the duration of the study. Patients who have suffered recent cardiac arrest within the preceding 3 months. Patients enrolled in another clinical study or clinical trial. Patients on oral or IV anti-coagulation (e.g., IV heparin

2014 Clinical Trials

104. Effect Comparison of Electro-acupuncture and Prucalopride for Severe Chronic Constipation: a Randomized Controlled Trial

dysfunction; taking medicine in progress which can induce constipation; severe hemorrhoid or anal fissure; constipation with serious cardiovascular, hepatic or renal diseases, cognitive dysfunction, abdominal aortic aneurysm or hepatosplenomegaly, aphasia, mental disorders, or illness which affects the cooperation for examination and treatment; women in gestation or lactation period; blood coagulation disorders or using anticoagulants regularly such as Warfarin and Heparin; cardiac pacemaker carrier

2014 Clinical Trials

105. TC-325 (HEMOSPRAYâ„¢) VS. CURRENT STANDARD OF CARE IN MANAGING MALIGNANT GASTROINTESTINAL BLEEDING: A PILOT STUDY TO INFORM A RANDOMIZED CONTROLLED TRIAL.

-7). Other recognized single or multimodality treatment approaches include radiation therapy, interventional angiography, and surgery. All exhibit disappointing rebleeding rates, and in the case of emergency surgery, high mortality(4, 8-11). Challenges associated with bleeding tumors include hematological derangements such as thrombocytopenia, disseminated intravascular coagulation, and neutropenia, as well as the endoscopic manipulation of friable, diffusely bleeding surfaces when attempting (...) , varices, vascular malformations, radiation proctitis, polyps, hemorrhoids, and diverticulosis Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02135627 Locations Layout table for location information Canada, Quebec McGill University Health Center

2014 Clinical Trials

106. Normal and Abnormal Puerperium (Overview)

ice applied to the perineum to reduce the swelling and to help with pain relief. Conventional treatment is to use ice for the first 24 hours after delivery and then switch to warm sitz baths. However, little evidence supports this method over other methods of postpartum perineum treatment. Pain medications are helpful both systemically as nonsteroidal anti-inflammatory drugs (NSAIDs) or narcotics and as local anesthetic spray to the perineum. Hemorrhoids are another postpartum issue likely (...) to affect women who have vaginal deliveries. Symptomatic relief is the best treatment during this immediate postpartum period because hemorrhoids often resolve as the perineum recovers. This can be achieved by the use of corticosteroid creams, witch hazel compresses, and local anesthetics in addition to a bowel regimen that avoids constipation. Tampon use can be resumed when the patient is comfortable inserting the tampon and can maintain it without discomfort. This often takes longer for the woman who

2014 eMedicine.com

107. Esophageal Varices (Overview)

examination): Suggests upper gastrointestinal (GI) bleeding Hemorrhoids See for more detail. Diagnosis Laboratory testing Complete blood count Liver disease–associated blood tests (eg, aspartate aminotransferase [AST], alanine aminotransferase [ALT], bilirubin, alkaline phosphatase [ALP]) Type and cross-match Coagulation studies (prothrombin time [PT], partial thromboplastin time [PTT], international normalized ratio [INR]): Prolonged INR is suggestive of impaired hepatic synthetic function Albumin (...) from portal gastropathy Mental status changes: May indicate the presence of portosystemic encephalopathy Increasing abdominal girth: May indicate ascites formation Abdominal pain and fever: May indicate spontaneous bacterial peritonitis, although this disease also presents without symptoms Hematochezia: May indicate bleeding from portal colopathy or enlarged hemorrhoids Signs of portosystemic collateral formation include the following: Anterior abdominal wall dilated veins: May indicate umbilical

2014 eMedicine.com

108. Deep Venous Thrombosis (Diagnosis)

laboratory studies to be considered include the following: D-dimer testing Coagulation studies (eg, prothrombin time and activated partial thromboplastin time) to evaluate for a hypercoagulable state See for more detail. Management Treatment options for DVT include the following: Anticoagulation (mainstay of therapy) - Heparins, warfarin, factor Xa inhibitors, and various emerging anticoagulants Pharmacologic thrombolysis Endovascular and surgical interventions Physical measures (eg, elastic compression (...) in the legs and PE. DVT is the presence of coagulated blood, a thrombus, in one of the deep venous conduits that return blood to the heart. The clinical conundrum is that symptoms (pain and swelling) are often nonspecific or absent. However, if left untreated, the thrombus may become fragmented or dislodged and migrate to obstruct the arterial supply to the lung, causing potentially life-threatening PE See the images below. Venous thrombus. Pulmonary embolus. DVT most commonly involves the deep veins

2014 eMedicine Surgery

109. Lower Gastrointestinal Bleeding: Surgical Perspective (Diagnosis)

: Complete blood cell (CBC) count Serum electrolytes levels (eg, sequential multiple analysis 7 [SMA7]) Coagulation profile, including activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and/or bleeding time (bleeding time is only recommended in patients with bleeding disorders and in those using antiplatelet agents) Helical computed tomography (CT) scanning of the abdomen and pelvis can be used when a routine workup fails to determine the cause of active GI bleeding (...) bleeding, the patient may require invasive hemodynamic monitoring to direct therapy. Hemostasis Once the bleeding site is localized, nonsurgical therapeutic options that may be considered include the following: Diverticular bleeding: Colonoscopy with bipolar probe coagulation, epinephrine injection, or metallic clips Recurrent bleeding: Resection of the affected bowel segment Angiodysplasia: Thermal therapy (eg, electrocoagulation, argon plasma coagulation) Conservative management, including nothing

2014 eMedicine Surgery

110. Lower Gastrointestinal Bleeding: Surgical Perspective (Follow-up)

of active bleeding. Transfuse packed red blood cells (PRBCs) to maintain the hemoglobin level above 7 g/dL. Initial resuscitation involves establishing large-bore IV access and administration of normal saline. Besides ordering routine laboratory studies (eg, complete blood cell (CBC) count, electrolyte levels, and coagulation studies), blood should be typed and cross-matched. The patient's blood loss and hemodynamic status should be ascertained, and in cases of severe bleeding, the patient may require (...) be performed initially. [ , ] Once the bleeding site is localized, therapeutic options include coagulation and injection with vasoconstrictors or sclerosing agents. In cases of diverticular bleeding, bipolar probe coagulation, epinephrine injection, and metallic clips may be used. [ ] If recurrent bleeding is present, the affected bowel segment can be resected. In cases of angiodysplasia, thermal therapy, such as electrocoagulation or argon plasma coagulation, is generally successful. Angiodysplastic

2014 eMedicine Surgery

111. Lower Gastrointestinal Bleeding (Diagnosis)

electrolytes levels (eg, sequential multiple analysis 7 [SMA7]) Coagulation profile, including activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and/or bleeding time (bleeding time is only recommended in patients with bleeding disorders and in those using antiplatelet agents) Helical computed tomography (CT) scanning of the abdomen and pelvis can be used when a routine workup fails to determine the cause of active GI bleeding. Multiple criteria are used for establishing (...) monitoring to direct therapy. Hemostasis Once the bleeding site is localized, nonsurgical therapeutic options that may be considered include the following: Diverticular bleeding: Colonoscopy with bipolar probe coagulation, epinephrine injection, or metallic clips Recurrent bleeding: Resection of the affected bowel segment Angiodysplasia: Thermal therapy (eg, electrocoagulation, argon plasma coagulation) Conservative management, including nothing by mouth (NPO) and IV hydration in patients with ischemic

2014 eMedicine.com

112. Esophageal Varices (Diagnosis)

examination): Suggests upper gastrointestinal (GI) bleeding Hemorrhoids See for more detail. Diagnosis Laboratory testing Complete blood count Liver disease–associated blood tests (eg, aspartate aminotransferase [AST], alanine aminotransferase [ALT], bilirubin, alkaline phosphatase [ALP]) Type and cross-match Coagulation studies (prothrombin time [PT], partial thromboplastin time [PTT], international normalized ratio [INR]): Prolonged INR is suggestive of impaired hepatic synthetic function Albumin (...) from portal gastropathy Mental status changes: May indicate the presence of portosystemic encephalopathy Increasing abdominal girth: May indicate ascites formation Abdominal pain and fever: May indicate spontaneous bacterial peritonitis, although this disease also presents without symptoms Hematochezia: May indicate bleeding from portal colopathy or enlarged hemorrhoids Signs of portosystemic collateral formation include the following: Anterior abdominal wall dilated veins: May indicate umbilical

2014 eMedicine.com

113. Therapeutic Injections for Pain Management (Treatment)

can be identified by median branch nerve blocks and then ameliorated with radio-frequency neurotomy or chemical neurolysis. New technologies have evolved, such as the use of spinal cord stimulators and a host of intradiskal procedures, including electrothermal coagulation, percutaneous mechanical disk decompression, laser disc decompression and radiofrequency intradiskal/annular neurolysis. Other new treatment methods include vertebroplasty and kyphoplasty for vertebral fractures. Fluoroscopy

2014 eMedicine.com

114. Surgical Management of Abortion (Treatment)

reduction includes the following: Intracardiac injection (potassium chloride or digoxin) Cord occlusion techniques, such as embolization with alcohol or enbucrilate gel; Nd:YAG laser photocoagulation; fetoscope cord ligation; bipolar cord coagulation; and monopolar cord coagulation Selective reduction procedures are not included in the statistics for second-trimester abortions. For the rare condition of monochorionic twins, selective reduction cord occlusion techniques are reported by Challis et al

2014 eMedicine.com

116. Oral Manifestations of Systemic Diseases (Treatment)

for GERD in adults is proton pump inhibitors (PPIs), although H2-receptor antagonists are also beneficial. [ ] Patients may also benefit from decreased consumption of acidic foods and beverages. [ ] Patients with xerostomia should consider discontinuing medications that may exacerbate hyposalivation or use a salivary supplement. [ ] Also see . Chronic liver disease The liver has numerous synthetic, storage, and excretory functions. The liver synthesizes many of the coagulation factors necessary (...) , alcoholic liver disease, and nonalcoholic fatty liver disease, although countless other conditions can cause CLD. [ ] CLD is a leading cause of mortality and morbidity both in the United States and around the world. [ ] The systemic manifestations of CLD are numerous and beyond the scope of this article. They can be classified as those due to synthetic dysfunction (eg, coagulopathies, hypoalbuminemia), portal hypertension (eg, ascites, esophageal varices, hemorrhoids), bilirubin secretion (eg, jaundice

2014 eMedicine.com

117. Normal and Abnormal Puerperium (Treatment)

ice applied to the perineum to reduce the swelling and to help with pain relief. Conventional treatment is to use ice for the first 24 hours after delivery and then switch to warm sitz baths. However, little evidence supports this method over other methods of postpartum perineum treatment. Pain medications are helpful both systemically as nonsteroidal anti-inflammatory drugs (NSAIDs) or narcotics and as local anesthetic spray to the perineum. Hemorrhoids are another postpartum issue likely (...) to affect women who have vaginal deliveries. Symptomatic relief is the best treatment during this immediate postpartum period because hemorrhoids often resolve as the perineum recovers. This can be achieved by the use of corticosteroid creams, witch hazel compresses, and local anesthetics in addition to a bowel regimen that avoids constipation. Tampon use can be resumed when the patient is comfortable inserting the tampon and can maintain it without discomfort. This often takes longer for the woman who

2014 eMedicine.com

118. Portal Hypertension (Overview)

examination): Suggests upper gastrointestinal (GI) bleeding Hemorrhoids See for more detail. Diagnosis Laboratory testing Complete blood count Liver disease–associated blood tests (eg, aspartate aminotransferase [AST], alanine aminotransferase [ALT], bilirubin, alkaline phosphatase [ALP]) Type and cross-match Coagulation studies (prothrombin time [PT], partial thromboplastin time [PTT], international normalized ratio [INR]): Prolonged INR is suggestive of impaired hepatic synthetic function Albumin (...) from portal gastropathy Mental status changes: May indicate the presence of portosystemic encephalopathy Increasing abdominal girth: May indicate ascites formation Abdominal pain and fever: May indicate spontaneous bacterial peritonitis, although this disease also presents without symptoms Hematochezia: May indicate bleeding from portal colopathy or enlarged hemorrhoids Signs of portosystemic collateral formation include the following: Anterior abdominal wall dilated veins: May indicate umbilical

2014 eMedicine.com

119. Threatened Abortion (Treatment)

reduction includes the following: Intracardiac injection (potassium chloride or digoxin) Cord occlusion techniques, such as embolization with alcohol or enbucrilate gel; Nd:YAG laser photocoagulation; fetoscope cord ligation; bipolar cord coagulation; and monopolar cord coagulation Selective reduction procedures are not included in the statistics for second-trimester abortions. For the rare condition of monochorionic twins, selective reduction cord occlusion techniques are reported by Challis et al

2014 eMedicine.com

120. Therapeutic Abortion (Treatment)

reduction includes the following: Intracardiac injection (potassium chloride or digoxin) Cord occlusion techniques, such as embolization with alcohol or enbucrilate gel; Nd:YAG laser photocoagulation; fetoscope cord ligation; bipolar cord coagulation; and monopolar cord coagulation Selective reduction procedures are not included in the statistics for second-trimester abortions. For the rare condition of monochorionic twins, selective reduction cord occlusion techniques are reported by Challis et al

2014 eMedicine.com

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