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aspirin and gastrointestinal bleeding

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181. To Evaluate the Bioavailability of a Single Oral Dose of the Acetylsalicylic Acid Containing Dry Powder 500 mg in Comparison to the Bioavailability of a Single Oral Dose of Aspirin Tablets and Aspirin Effervescent Tablets in Healthy Adults.

of gastrointestinal bleeding or perforation, including bleeding related to previous NSAID therapy. Active, or history of recurrent peptic ulcer/hemorrhage (two or more distinct episodes of proven ulceration or bleeding). Have taken ASA, ASA-containing products, acetaminophen or any other NSAID (OTC or prescription) seven days prior to dosing or during the Treatment Periods, other than study product Loss of blood in excess of 500 mL within 56 days of the first dose of trial treatment (e.g., donation (...) To Evaluate the Bioavailability of a Single Oral Dose of the Acetylsalicylic Acid Containing Dry Powder 500 mg in Comparison to the Bioavailability of a Single Oral Dose of Aspirin Tablets and Aspirin Effervescent Tablets in Healthy Adults. To Evaluate the Bioavailability of a Single Oral Dose of the Acetylsalicylic Acid Containing Dry Powder 500 mg in Comparison to the Bioavailability of a Single Oral Dose of Aspirin Tablets and Aspirin Effervescent Tablets in Healthy Adults. - Full Text View

2015 Clinical Trials

182. Cilostazol versus aspirin for secondary prevention of vascular events after stroke of arterial origin. Full Text available with Trip Pro

than aspirin in the prevention of vascular events secondary to stroke. Cilostazol has more minor adverse effects, although there is evidence of fewer bleeds. (...) Cilostazol versus aspirin for secondary prevention of vascular events after stroke of arterial origin. Aspirin is widely used for secondary prevention after stroke. Cilostazol has shown promise as an alternative to aspirin in Asian people with stroke.To determine the relative effectiveness and safety of cilostazol compared directly with aspirin in the prevention of stroke and other serious vascular events in patients at high vascular risk for subsequent stroke, those with previous transient

2011 Cochrane

183. Aspirin for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: A Decision Analysis for the U.S. Preventive Services Task Force. Full Text available with Trip Pro

years of use.Results are most sensitive to the relative risk for hemorrhagic stroke and CVD mortality but are affected by all relative risk estimates, baseline GI bleeding incidence and case-fatality rates, and disutilities associated with aspirin use.Aspirin effects by age are uncertain. Stroke benefits are conservatively estimated. Gastrointestinal bleeding incidence and case-fatality rates account only for age and sex.Lifetime aspirin use for primary prevention initiated at younger ages (40 to 69 (...) Aspirin for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: A Decision Analysis for the U.S. Preventive Services Task Force. Evidence indicates that aspirin is effective for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) but also increases the risk for gastrointestinal (GI) and cerebral hemorrhages.To assess the net balance of benefits and harms from routine aspirin use across clinically relevant age, sex, and CVD risk groups.Decision

2016 Annals of Internal Medicine

184. Management of Patients with Ulcer Bleeding

Management of Patients with Ulcer Bleeding nature publishing group 345 © 2012 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY ACG PRACTICE GUIDELINES Ulcers are the most common cause of hospitalization for upper gastrointestinal bleeding (UGIB), and the vast majority of clini- cal trials of therapy for nonvariceal UGIB focus on ulcer disease. Th is guideline provides recommendations for the management of patients with overt UGIB due to gastric or duodenal (...) therapy, post-endoscopic medical therapy and disposition, and preven- tion of recurrent ulcer bleeding. Each section of the document presents the key recommenda- tions related to the section topic, followed by a summary of the supporting evidence. A summary of recommendations is provided in Table 1 . A search of MEDLINE via the OVID interface using the MeSH term “ gastrointestinal hemorrhage ” limited to “ all clinical tr ials ” a n d “ met a-a nal ysis ” f o r y e a r s 1966 – 2010 wi t h o u t la n

2012 American College of Gastroenterology

185. Management of bleeding in patients on antithrombotic agents

anti‐inflammatory drugs; CC, creatinine clearance. Aspirin Aspirin inhibits platelet activation by inactivating platelet cyclooxygenase. Aspirin has a rapid onset of action after oral administration (<1 h but 3–4 h with enteric‐coated preparations) and has a plasma half‐life of c . 20 min. However, laboratory evidence of platelet inhibition may persist for 4 d because the effects of aspirin on individual platelets is irreversible (Li et al , ). Aspirin increases the risk of surgical bleeding 1·5 (...) ‐fold, but does not increase the severity of bleeding for most procedures. Given that 10% of acute cardiovascular events are preceded by aspirin withdrawal and the average time interval from withdrawal to acute stroke and acute coronary syndrome are 14·3 and 8·5 d respectively, aspirin is not usually withdrawn before surgery (Burger et al , ). Several studies have demonstrated a lack of haematoma following neuroaxial anaesthesia while on low dose aspirin (Horlocker et al , ; Burger et al

2012 British Committee for Standards in Haematology

186. Validation of a live animal model for training in endoscopic hemostasis of upper gastrointestinal bleeding ulcers. (Abstract)

Validation of a live animal model for training in endoscopic hemostasis of upper gastrointestinal bleeding ulcers. The management of upper gastrointestinal bleeding requires training of the endoscopist. We aimed to validate a live animal model of bleeding ulcers for training in endoscopic hemostasis.Bleeding ulcers were created by repeated grasp-and-snare gastric mucosectomies in pigs rendered "bleeders" by preadministration of clopidogrel, aspirin, and unfractionated heparin. The feasibility (...) and reproducibility of the model (proportion of bleeding ulcers, number of ulcers per animal, and time needed to produce a bleeding ulcer) were prospectively evaluated in six animals. Ten endoscopic experts assessed the similarity of this pig model to human bleeding ulcers (four-point Likert scale). The training capabilities of the model for hemostatic techniques (needle injection, bipolar electrocoagulation, and hemoclipping) were evaluated in 46 fellows (four-point Likert scale).A total of 53 gastric ulcers

2013 Endoscopy

187. Short-Term Use of Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding. Full Text available with Trip Pro

exposure was seen in male but not female patients.Short-term SSRI use (7-28 days) is significantly associated with upper gastrointestinal bleeding. Gender differences may exist in the relationship between SSRI use and upper gastrointestinal bleeding. Physicians should carefully monitor signs of upper gastrointestinal bleeding even after short-term exposure to SSRIs, as is done with nonsteroidal anti-inflammatory drugs and aspirin. (...) Short-Term Use of Serotonin Reuptake Inhibitors and Risk of Upper Gastrointestinal Bleeding. The association between selective serotonin receptor inhibitors (SSRIs) and risk of upper gastrointestinal bleeding remains controversial. Previous studies have generally evaluated the issue for approximately 3 months, even though the SSRI-mediated inhibition of platelet serotonin concentrations occurs within 7-14 days. The authors explored the risk of upper gastrointestinal bleeding after short-term

2013 American Journal of Psychiatry

188. Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations with Complex Antithrombotic Therapy in Elderly Patients. Full Text available with Trip Pro

Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations with Complex Antithrombotic Therapy in Elderly Patients. Complex antithrombotic therapy (CAT) prescribed to elderly patients increases the risk of gastrointestinal bleeding. We quantified upper (UGIE) and lower gastrointestinal (LGIE) events, transfusions, and hospitalizations in a national cohort of elderly veterans prescribed CAT.Veterans ≥60 years of age prescribed anticoagulant-antiplatelet, aspirin (ASA

2013 Circulation

189. Efficacy of Hemostatic Powder in Preventing Bleeding After Gastric Endoscopic Submucosal Dissection in High-risk Patients: A Prospective Randomized Control Study

surgical material, there is no definite prophylactic treatment to prevent re-bleeding after ESD. To date, coagulation of remnant vessels on the post-resection ulcer surface and administration of a proton pump inhibitor (PPI) after ESD are practical methods to prevent post-ESD bleeding. Polysaccharide hemostatic powder (Endo-Clot™) is a new topical hemostatic method recently used for non-variceal upper gastrointestinal bleeding. This study aimed to identify the efficacy of hemostatic powder (...) Efficacy of Hemostatic Powder in Preventing Bleeding After Gastric Endoscopic Submucosal Dissection in High-risk Patients: A Prospective Randomized Control Study Efficacy of Hemostatic Powder in Preventing Bleeding After Gastric Endoscopic Submucosal Dissection in High-risk Patients: A Prospective Randomized Control Study - 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

2017 Clinical Trials

190. Recent advances in the management of peptic ulcer bleeding Full Text available with Trip Pro

Recent advances in the management of peptic ulcer bleeding Acute upper gastrointestinal haemorrhage due to peptic ulcer bleeding remains an important cause of emergency presentation and hospital admission. Despite advances in many aspects of management, peptic ulcer bleeding is still associated with significant morbidity, mortality, and healthcare costs. Comprehensive international guidelines have been published, but advances as well as controversies continue to evolve. Important recent (...) to provide more accurate determination of both rebleeding risk and the success of endoscopic therapy than purely visual guidance. Non- Helicobacter pylori, non-aspirin/non-steroidal anti-inflammatory drug ulcers contribute an increasing percentage of bleeding peptic ulcers and are associated with a poor prognosis and high rebleeding rate. The optimal management of these ulcers remains to be determined.

2017 F1000Research

191. Bleeding risk with dabigatran, rivaroxaban, warfarin, and antiplatelet agent in Asians with non-valvular atrial fibrillation Full Text available with Trip Pro

patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013. Propensity-score weighting was used to balance covariates across study groups. Patients were followed until the first occurrence of any bleeding outcome or the end of the study. The CHA2DS2-VASc scores were 4.1±1.6, 4.1±1.6, 3.3±1.8 and 2.4±1.6 for the dabigatran, rivaroxaban, warfarin, and AA groups, respectively. There were 5,822 (88.2 (...) %) and 164 (5.2%) patients taking low dose dabigatran and rivaroxaban, respectively. Hazard ratios (95% confidence intervals) for dabigatran, rivaroxaban, or warfarin versus AA were: intracranial hemorrhage, 0.36 (0.23-0.57;PP=0.0037) and 1.34 (0.89-2.02;P=0.1664); gastrointestinal bleeding, 0.44 (0.32-0.59;PP=0.0189); and all hospitalized major bleeding, 0.41 (0.32-0.53;PP=0.0644) and 0.90 (0.70-1.16;P=0.4130) after adjustment. The risk reduction of all major bleeding for dabigatran versus AA persisted

2017 Oncotarget

192. Warfarin Use and the Risk of Mortality, Stroke, and Bleeding in Hemodialysis Patients with Atrial Fibrillation. (Abstract)

[CI] 0.69-0.84) and lower risk of ischemic stroke (HR 0.68, 95% CI 0.52-0.91). Warfarin use was not associated with a higher risk of hemorrhagic stroke (HR 1.2, 95% CI 0.6-2.2) or gastrointestinal bleeding (HR 0.97, 95% CI 0.77-1.2). The treatment effect was largest in the group with the best international normalized ratio control as measured by time in therapeutic range. Subgroup analyses showed warfarin use was associated with survival benefit in most subgroups. The 2 subgroups that did (...) not benefit were patients with a history of hemorrhagic stroke and patients with concurrent aspirin use.Warfarin use is associated with lower all-cause mortality and ischemic stroke, without significantly increasing the risk of bleeding in hemodialysis patients with atrial fibrillation.Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

2017 Heart Rhythm

193. Effects of antithrombotic therapy on bleeding after endoscopic submucosal dissection: A systematic review and meta-analysis. (Abstract)

multiple antithrombotic drugs, resuming antithrombotics within 1 week, and heparin replacement were significantly associated with post-ESD bleeding; but continuous low-dose aspirin was not. However, much larger prospective studies are required.Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. (...) antiplatelet group (OR, 2.08; 95% CI, 0.93-4.63; P = .07). In the subgroup analysis, resuming antithrombotics within 1 week (OR, 2.46; 95% CI, 1.54-3.93; P = .0002) and using heparin replacement (OR, 4.20; 95% CI, 1.94-9.09; P= .0003) significantly increased post-ESD bleeding risk. Continued use of low-dose aspirin (OR, 1.22; 95% CI, 0.17-8.61; P = .84) did not significantly increase the bleeding risk.Antithrombotic therapy is a risk factor for post-ESD bleeding, especially for delayed bleeding. Using

2017 Gastrointestinal endoscopy

194. The role of aspirin in post-polypectomy bleeding--a retrospective survey. Full Text available with Trip Pro

polypectomy (OR=2.82, 95% C.I, 0.34 to 23.3).Our study confirmed a significantly increased risk of lower gastrointestinal bleeding following polypectomy in patients taking aspirin. We would recommend approaching the patient on aspirin coming forward for a colonoscopy with potential polypectomy with caution. (...) The role of aspirin in post-polypectomy bleeding--a retrospective survey. Bleeding following colonoscopic polypectomy is a common complication and has been reported to occur in up to 6.1% of patients. Several risk factors have been discussed but their overall contribution to post-polypectomy bleeding remains controversial. The aim of the study was to determine the rate of post polypectomy bleeding and to analyse the role of potential risk factors especially the role of aspirin.We conducted

2012 BMC Gastroenterology

195. A Cohort Study of Testing for Helicobacter Pylori and the Long-term Risk of Peptic Ulcer Bleeding With Low-dose Aspirin (2NA3NANC)

A Cohort Study of Testing for Helicobacter Pylori and the Long-term Risk of Peptic Ulcer Bleeding With Low-dose Aspirin (2NA3NANC) Helicobacter Pylori and the Long-term Risk of Peptic Ulcer Bleeding - 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 (...) of Hong Kong Information provided by (Responsible Party): Francis KL Chan, Chinese University of Hong Kong Study Details Study Description Go to Brief Summary: Low-dose aspirin (ASA) has emerged as the most important cause of peptic ulcer bleeding worldwide. In western countries, ASA has overtaken non steroidal antiinflammatory drugs (NSAIDs) as a major cause of peptic ulcer bleeding in the elderly population [1,2]. Management of peptic ulcer bleeding in patients receiving ASA for cardiothrombotic

2012 Clinical Trials

196. The Risk of Bleeding After Removal of Large Colorectal Polyps in Patients Taking Aspirin

information Responsible Party: Jaroslaw Regula, Professor in Gastroenterology, MD, PhD, Maria Sklodowska-Curie Institute - Oncology Center ClinicalTrials.gov Identifier: Other Study ID Numbers: ASAPOL First Posted: March 9, 2012 Last Update Posted: March 9, 2012 Last Verified: March 2012 Keywords provided by Jaroslaw Regula, Maria Sklodowska-Curie Institute - Oncology Center: Gastrointestinal bleeding Lower gastrointestinal bleeding (LGIB) Polypectomy Large colorectal polyps ASA Aspirin Acetylsalicylic (...) The Risk of Bleeding After Removal of Large Colorectal Polyps in Patients Taking Aspirin The Risk of Bleeding After Removal of Large Colorectal Polyps in Patients Taking Aspirin - 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

2012 Clinical Trials

197. Does Early Re-administration of Aspirin/Clopidogrel Increase the Risk of Bleeding From Artificial Ulcer After EMR or ESD?

Does Early Re-administration of Aspirin/Clopidogrel Increase the Risk of Bleeding From Artificial Ulcer After EMR or ESD? Does Early Re-administration of Aspirin/Clopidogrel Increase the Risk of Bleeding From Artificial Ulcer After EMR or ESD? - 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. Does Early Re-administration of Aspirin/Clopidogrel Increase the Risk of Bleeding From Artificial Ulcer After EMR or ESD? 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 Government. Read our for details. ClinicalTrials.gov Identifier: NCT01621451 Recruitment Status : Unknown Verified

2012 Clinical Trials

198. Aspirin

Antiinflammatory effect Inhibits prostaglandin biosynthesis effect Relieves pain of mild to moderate intensity Antipyretic (Lowers ) VI. Mechanism: Platelet Effects Inhibits Thromboxane synthesis Inhibits platelet aggregation Aspirin poisons the platelets for its remaining life (using an example patient with 250,000 ) New platelets are generated at a rate of 10% per day (25,000/day for a patient with a 250,000 ) By 2 days off Aspirin, a patient will have 50,000 normal platelets (enough to counter bleeding (...) mg Tertiary prevention (post-MI) Prior recommendations: 325 mg orally daily New (2012) recommendations: 81 mg orally daily Similar efficacy in coronary disease prevention as the 325 mg dose Half the risk of gastrointestinal as the 325 mg dose References Prevention in known vascular disease: 160-325 mg daily Antipyretic or Dose Adult: 600 mg PO q4 hours Adult: 650-1000 mg PO q4-6 hours Antiinflammatory dose Adult: 4 grams maximum per day VIII. Preparations: Extended Release Aspirin Durlaza

2018 FP Notebook

199. UI-EWD for Endoscopic Hemostasis of Bleeding Peptic Ulcers and Bleeding After EMR/ESD

: Clinical diagnosis of bleeding peptic ulcer and active bleeding after ESD/EMR Exclusion Criteria: Coagulation disorder (PLT < 50*10^9/L, INR > 2) Connot stop taking the antiplatelet drug, NSAID, Anticoagulant drug, and Aspirin during endoscopic treatment and after 72h endoscopy 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 (...) UI-EWD for Endoscopic Hemostasis of Bleeding Peptic Ulcers and Bleeding After EMR/ESD UI-EWD for Endoscopic Hemostasis of Bleeding Peptic Ulcers and Bleeding After EMR/ESD - 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

2016 Clinical Trials

200. Activation of the bile acid receptor GPBAR1 protects against gastrointestinal injury caused by nonsteroidal anti-inflammatory drugs and aspirin in mice Full Text available with Trip Pro

Activation of the bile acid receptor GPBAR1 protects against gastrointestinal injury caused by nonsteroidal anti-inflammatory drugs and aspirin in mice Low doses of aspirin (acetylsalicylic acid; ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of gastrointestinal bleeding. GPBAR1 is a bile acid receptor expressed in the gastrointestinal tract. Here, we have investigated whether GPBAR1 was required for mucosal protection in models of gastrointestinal injury caused (...) of GPBAR1 altered the morphology of the small intestine and increased sensitivity to injury caused by naproxen.GPBAR1 is essential to maintain gastric and intestinal mucosal integrity. GPBAR1 agonists protect against gastrointestinal injury caused by ASA and NSAIDs by a COX-independent mechanism.© 2012 The Authors. British Journal of Pharmacology © 2012 The British Pharmacological Society.

2012 British journal of pharmacology

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