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aspirin and gastrointestinal bleeding

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181. Risk of gastrointestinal bleeding and cardiovascular events due to NSAIDs in the diabetic elderly population Full Text available with Trip Pro

Risk of gastrointestinal bleeding and cardiovascular events due to NSAIDs in the diabetic elderly population We assessed gastrointestinal bleeding (GIB) and cardiovascular (CV) risks such as myocardial infarction or stroke associated with non-steroidal anti-inflammatory drug (NSAID) use among elderly patients with diabetes.Using a nationwide claims database covering 2008-2012, we conducted a cohort study of patients with diabetes aged ≥65 years. Among the 117 610 patients, NSAID users and non (...) with an aHR of 1.20 (95% CI 1.15 to 1.25). The risk of GIB was higher in patients with liver disease and renal failure, while that of CV events was higher in patients who received anticoagulants, antiplatelet agents, aspirin and selective serotonin reuptake inhibitors. The number needed to harm was 111 for GIB and 77 for CV events. Among different NSAIDs, nimesulide increased the risk of GIB and ketorolac increased the risk of CV events compared to celecoxib (aHR 2.60 and 3.13, respectively).Elderly

2015 BMJ open diabetes research & care

182. Antithrombotic drugs, patient characteristics, and gastrointestinal bleeding: Clinical translation and areas of research. (Abstract)

Antithrombotic drugs, patient characteristics, and gastrointestinal bleeding: Clinical translation and areas of research. Gastrointestinal bleeding (GIB) is a potentially fatal and avoidable medical condition that poses a burden on global health care costs. Current understanding of the roles of platelet activation and thrombin generation/activity in vascular medicine has led to the development of effective antithrombotic treatments. However, in parallel with a sustained coronary and cerebral (...) of illness, comorbidities) in whom it is used exert a greater impact on the risk of GIB than the type of antithrombotic agent employed. The latter concept argues for the occurrence of GIB as reflecting the presence of patients at the highest risk for adverse outcomes. The HAS-BLED score identifies subjects at risk of bleeding among those untreated and those treated with warfarin, DOACs and/or low-dose aspirin. Its use within the frame of a severity score (e.g., the CHA2DS2-VASc score in patients

2015 Blood reviews

183. Risk of Upper and Lower Gastrointestinal Bleeding in Patients Taking Nonsteroidal Anti-inflammatory Drugs, Antiplatelet Agents, or Anticoagulants. (Abstract)

Risk of Upper and Lower Gastrointestinal Bleeding in Patients Taking Nonsteroidal Anti-inflammatory Drugs, Antiplatelet Agents, or Anticoagulants. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin is associated with increased risk of upper gastrointestinal bleeding. There is little evidence on the risk of lower gastrointestinal bleeding with NSAIDs, antiplatelet agents (APAs), or anticoagulants. We aimed to quantify the relative risk (RR) of upper and lower (...) days or less before hospitalization. RRs and 95% confidence intervals (CIs) were estimated by unconditional logistic regression analysis.Use of anticoagulants, low-dose aspirin, and other drugs (non-aspirin-APA, 82.3% thienopiridines) was associated with upper and lower gastrointestinal bleeding; the risk was 2-fold higher for anticoagulants (RR, 4.2; 95% CI, 2.9-6.2) than for low-dose aspirin (RR, 2.1; 95% CI, 1.4-3.3) or other non-aspirin-APA drugs (RR, 2.0; 95% CI, 1.6-2.6). NSAID use was also

2015 Clinical Gastroenterology and Hepatology

184. Recurrence and mortality among patients hospitalized for acute lower gastrointestinal bleeding. (Abstract)

Recurrence and mortality among patients hospitalized for acute lower gastrointestinal bleeding. The long-term recurrence of lower gastrointestinal bleeding (LGIB) and associated mortality have not been studied extensively. We investigated rates of recurrence of LGIB, mortality, and associated risk factors.In a retrospective study, we analyzed data from 342 patients hospitalized for overt LGIB at the National Center for Global Health and Medicine in Japan from December 2004 through June 2013 (...) . All patients underwent colonoscopy. We assessed Charlson comorbidity index scores and the use of nonsteroidal anti-inflammatory drugs, low-dose aspirin, other antiplatelet drugs, or warfarin. Rebleeding, the total number of rebleeding episodes, and mortality were measured. The Cox proportional hazards model was used to estimate hazard ratios (HRs).Rebleeding occurred in 84 patients, at a mean follow-up time of 19 months. The cumulative percentages of patients with rebleeding at 1 and 5 years were

2015 Clinical Gastroenterology and Hepatology

185. Mucosal Innate Immune Activation in Chronic Intestinal Disorders

of Arkansas Information provided by (Responsible Party): University of Arkansas Study Details Study Description Go to Brief Summary: Crohn's disease and ulcerative colitis are types of chronic intestinal disorder called inflammatory bowel diseases (IBD) that can affect the small and large bowel causing symptoms of abdominal pain, diarrhea, blood in the stool, and weight loss. Irritable bowel syndrome (IBS) is a milder form of IBD, with symptoms of abdominal pain, bloating, diarrhea or constipation (...) Verified: October 2018 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Irritable Bowel Syndrome Inflammatory Bowel Diseases Intestinal Diseases Colonic Diseases, Functional Colonic Diseases Gastrointestinal Diseases Digestive System Diseases Gastroenteritis

2018 Clinical Trials

186. The Effect of Probiotic Intake on Intestinal Permeability in Healthy Adults

on each intervention ] difference in the changes (week 2 of intervention with aspirin minus week 1 of intervention without aspirin) in sucralose/erythritol ratio in the 0 to 24-hour urine collection with the probiotic versus the placebo interventions Other Outcome Measures: Digestive Health [ Time Frame: Weekly through the completion of the 14 week study ] Weekly GI symptoms assessed using the Gastrointestinal Symptom Rating Scale (GSRS). The GSRS consists of 15 questions related to 5 syndromes (...) or chronic respiratory diseases including asthma, gastrointestinal disorders including heartburn, or any other disease, that by the investigators discretion could interfere with the intestinal barrier function of the subject. Daily use of NSAIDs in the last 3 months or incidental use in the last 2 weeks prior to screening. Use of medications in the last 2 weeks prior to the pre-baseline period. This does not include birth control pills or standard multi-vitamin/mineral supplements. Allergy to aspirin

2018 Clinical Trials

187. A Study to Evaluate Disease Control and Treatment Pattern in Participants With Moderate to Severe Inflammatory Bowel Disease (IBD) in Real Life Practice

information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Takeda: Drug therapy Additional relevant MeSH terms: Layout table for MeSH terms Crohn Disease Intestinal Diseases Inflammatory Bowel Diseases Colitis, Ulcerative Gastroenteritis Gastrointestinal Diseases Digestive System Diseases Colitis Colonic Diseases (...) and diarrhea/altered bowel habit, and endoscopic remission as Mayo endoscopic sub-score of 0 to 1. T2T approach for CD includes clinical remission as resolution of abdominal pain and diarrhea/altered bowel habit, and endoscopic remission for CD as resolution of ulceration at ileocolonoscopy or resolution of findings of inflammation on cross-sectional imaging in participants who cannot be adequately assessed with ileocolonoscopy. Mayo score is an instrument used to measure disease activity. Mayo score

2018 Clinical Trials

188. A Small Bowel Ulcer due to Clopidogrel with Cytomegalovirus Enteritis Diagnosed by Capsule and Double-Balloon Endoscopy Full Text available with Trip Pro

A Small Bowel Ulcer due to Clopidogrel with Cytomegalovirus Enteritis Diagnosed by Capsule and Double-Balloon Endoscopy We report the first case of small bowel ulcers due to clopidogrel in a 74-year-old man. He presented with diarrhea and melena after having been taking low-dose aspirin (LDA) and clopidogrel. There was no evidence of bleeding in the stomach, duodenum, or colon. Capsule endoscopy showed multiple ulcers and erosions in the small intestine. Double-balloon endoscopy revealed (...) multiple ulcers throughout the ileum. Examination of the biopsy specimen showed cytomegalovirus infection. His LDA was discontinued and he was prescribed ganciclovir. However, the small bowel ulcers were aggravated. Therefore, clopidogrel was discontinued. The small bowel ulcers subsequently healed completely, forming scars.

2018 Case reports in gastroenterology

189. Von Willebrand Antigen and Activity as Novel Biomarkers of Hemostasis in Inflammatory Bowel Disease

Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Intestinal Diseases Inflammatory Bowel Diseases Von Willebrand Diseases Gastrointestinal Diseases Digestive System Diseases Gastroenteritis Blood Coagulation Disorders, Inherited Blood Coagulation Disorders Hematologic Diseases Coagulation Protein Disorders Blood Platelet Disorders Hemorrhagic Disorders Genetic Diseases, Inborn Hemostatics Coagulants (...) the thrombotic risk in IBD detection of acquired von willebrand syndrome [ Time Frame: follow up for one year ] All patients who have bleeding not explained by the IBD status will be investigated for detection of any cases of acquired von willebrand syndrome. Secondary Outcome Measures : Estimation of the prevalence of IBD patients attending our clinic (Assiut University Experience). [ Time Frame: one year ] prevalence of inflammatory bowel disease in assiut university hospital. Eligibility Criteria Go

2018 Clinical Trials

190. Bowel cancer screening for women at midlife. (Abstract)

Bowel cancer screening for women at midlife. In Australia one in 15 women will be diagnosed with colorectal cancer in their lifetime because of the high incidences of lifestyle risk factors. The risk could be reduced by taking aspirin. Evidence-based Clinical Practice Guidelines for the prevention, early detection and management of colorectal cancer produced by Cancer Council Australia and approved by the National Health and Medical Research Council recommended that 'population screening (...) in Australia, directed at those at average risk of colorectal cancer and without relevant symptoms, is immunochemical fecal occult blood testing every 2 years, starting at age 50 years and continuing to age 74 years.' Women at high risk because of family history will need more intense screening. At the current 40% participation rate, it is estimated that biennial screening with fecal immunohistochemical tests (FIT) reduces colorectal cancer incidence by 23% and mortality by 36%. The major adverse effects

2018 Climacteric

191. The CReST Trial: Stenting vs Surgery for Malignant Large Bowel Obstruction

The CReST Trial: Stenting vs Surgery for Malignant Large Bowel Obstruction The CREST Trial A randomised phase III study of stenting as a bridge to surgery in obstructing colorectal cancer. Results of the UK ColoRectal Endoscopic Stenting Trial (CREST). Funded by Cancer Research UK and developed by the National Cancer Research InstituteCurrent acute oncological problem NBOCA audit report 2015 • Emergency admission with colorectal cancer remains at a stubborn 21 % of all cases. • Over 5,000 cases (...) to a specialist colorectal surgeon § Major surgery may be avoided for patients with: § Rapidly progressive cancer § Unstable comorbid disease Presented by:Presented by: Stenting needs to be properly evaluated in a randomised controlled trial addressing two key questions: * Is there a worthwhile net benefit (in reduced operative mortality and morbidity, reduced stoma formation and better quality of life adjusted survival) from endoluminal stenting for patients presenting with an obstructing colonic cancer

2016 Association of Coloproctology of Great Britain and Ireland

192. Kaiser Permanente National Aspirin Clinician Guide

artery disease or peripheral artery disease, e.g., aortic atherosclerosis, or abnormal ankle brachial index (ABI) detected on screening. Exclusions for Aspirin Therapy ? Exclude adults with increased risk of bleeding. This includes those with a history of gastrointestinal (GI) bleeding, GI ulcers, intracranial bleed, bleeding disorders, renal failure, severe liver disease, thrombocytopenia, or using other medicine to prevent blood clots. Kaiser Permanente National CLINICAL PRACTICE GUIDELINES (...) National Clinical Practice Guidelines This Clinician Guide expires within two years of the posted month. 2 See National Clinical Library for current version (https://cl.kp.org). © 2018 Kaiser Permanente Care Management Institute Table 1: Lifetime Events in 10,000 taking aspirin. Green = start aspirin, Blue = consider aspirin ASCVD Risk Gender MIs Prevented Ischemic Strokes Prevented Colorectal Cancer Cases Prevented Serious GI Bleeding Caused Hemorrhagic Strokes Caused Net Life- Years Gained Quality

2019 Kaiser Permanente National Guideline Program

193. Aneurysmal Subarachnoid Hemorrhage Trial RandOmizing Heparin

intraventricular hemorrhage is acceptable. The Modified Fisher CT rating scale: Grade 1 (minimal or diffuse thing SAH without IVH); Grade 2 (minimal or thin SAH with IVH), Grade 3 (thick cisternal clot without IVH), Grade 4 (thick cisternal clot with IVH) [From: Claassen J et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke 2001;32:2012-2020.] Location and pattern of the SAH must have the majority of the SAH (...) may be used in some situations to determine that the associated aneurysms did not rupture based on lack of blood seen adjacent to the additional aneurysms. Femoral arteriotomy stick above the inferior epigastric artery OR angiographic, CT, or clinical evidence of an arteriotomy related retroperitoneal hematoma or large flank hematoma. A stable groin hematoma is not an exclusion. Patient received heparin in any form within the last 100 days prior to admission (not including coiling procedure

2015 Clinical Trials

194. A Scoring System to Determine Risk of Delayed Bleeding after Endoscopic Mucosal Resection of Large Colorectal Lesions. Full Text available with Trip Pro

A Scoring System to Determine Risk of Delayed Bleeding after Endoscopic Mucosal Resection of Large Colorectal Lesions. After endoscopic mucosal resection (EMR) of colorectal lesions, delayed bleeding is the most common serious complication, but there are no guidelines for its prevention. We aimed to identify risk factors associated with delayed bleeding that required medical attention after discharge until day 15 and develop a scoring system to identify patients at risk.We performed (...) (OR, 3.63; P ≤ .01). We developed a risk scoring system based on these 6 variables that assigned patients to the low-risk (score, 0-3), average-risk (score, 4-7), or high-risk (score, 8-10) categories with a receiver operating characteristic curve of 0.77 (95% confidence interval, 0.70-0.83). In these groups, the probabilities of delayed bleeding were 0.6%, 5.5%, and 40%, respectively.The risk of delayed bleeding after EMR of large colorectal lesions is 3.7%. We developed a risk scoring system based

2016 Clinical Gastroenterology and Hepatology

195. Small bowel injury in low-dose aspirin users. Full Text available with Trip Pro

Small bowel injury in low-dose aspirin users. The use of low-dose aspirin (LDA) is well known to be associated with an increased risk of serious upper gastrointestinal complications, such as peptic ulceration and bleeding. Until recently, attention was mainly focused on aspirin-induced damage of the stomach and duodenum. However, recently, there has been growing interest among gastroenterologists on the adverse effects of aspirin on the small bowel, especially as new endoscopic techniques (...) ulcers with stricture. In addition, to reduce the incidence of gastrointestinal lesions in LDA users, it is important for clinicians to confirm the differences in the gastrointestinal toxicity between different types of aspirin formulations in clinical use. Some studies suggest that enteric-coated aspirin may be more injurious to the small bowel mucosa than buffered aspirin. The ideal treatment for small bowel injury in patients taking LDA would be withdrawal of aspirin, however, LDA is used

2015 Journal of gastroenterology

196. A Study to Evaluate LB1148 for Return of Gastrointestinal Function and Adhesions in Subjects Undergoing Bowel Resection

: No Keywords provided by Leading BioSciences, Inc: Post-operative Ileus Post-Operative Abdominal Adhesions Return of Gastrointestinal Function Anastomosis Enterotomy Enterostomy Colorectal Surgery Intestines Surgery Additional relevant MeSH terms: Layout table for MeSH terms Tissue Adhesions Ileus Cicatrix Fibrosis Pathologic Processes Intestinal Obstruction Intestinal Diseases Gastrointestinal Diseases Digestive System Diseases (...) adhesions in subjects undergoing elective bowel resection. Condition or disease Intervention/treatment Phase Ileus Post-Operative Adhesions Drug: LB1148 Drug: Placebo Phase 2 Detailed Description: This will be a multicenter, randomized, double-blind, parallel, placebo-controlled, proof-of-concept, adaptive design, Phase 2 study to evaluate LB1148 for return of gastrointestinal function and reduction of post-operative ileus and intra-abdominal adhesions in subjects undergoing elective bowel resection

2016 Clinical Trials

197. Gastric mucosal damage caused by plain and microencapsulated acetylsalicylic acid tablets in healthy subjects: a gastrocamera study. (Abstract)

Gastric mucosal damage caused by plain and microencapsulated acetylsalicylic acid tablets in healthy subjects: a gastrocamera study. In a randomized, cross-over study plain acetylsalicylic acid (ASA) tablet and microencapsulated ASA tablets were given in doses of 1 gram 3 times a day for 3 days to 8 healthy subjects with no previous gastrointestinal disturbances. Gastrocamera examinations were performed before the ASA treatment and 1--2 hours after the last dose of ASA. The gastric mucosa (...) appeared macroscopically normal at all the control examinations; whereas musocal bleeding was evident in all the subjects after the ASA treatment. There was no statistically significant difference between the plain ASA and the microencapsulated ASA preparations. No correlation could be found between the ASA concentration in plasma and the gastric mucosal damage.

1977 Scandinavian journal of gastroenterology Controlled trial quality: uncertain

198. Clinical practice guidelines for surveillance colonoscopy - in adenoma follow-up; following curative resection of colorectal cancer; and for cancer surveillance in inflammatory bowel disease (December 2011)

for detection of colorectal cancer and adenomas. This needs to be taken into consideration when decisions are made about the choice and timing of surveillance procedures. While the overall sensitivity for colorectal cancer is 95%, 2 the available literature suggests that cancer miss rates are higher in the proximal colon than elsewhere in the large bowel. 3 In a systematic review of polyp miss rates as determined by tandem colonoscopy, Van Rijn et al (2006) 4 identified studies in which patients had (...) of Colorectal Cancer (2005), 1 colonoscopy is the first-line investigation for assessing the colon and rectum, having a sensitivity of 95% for detection of colorectal (bowel) cancer 2 . Colonoscopy allows biopsy and histologic confirmation of the diagnosis of cancer as well as identification and immediate removal of synchronous polyps. The purpose of this chapter is to detail technical advances and improvements in colonoscopy relevant to surveillance. It also addresses the issue (and importance) of high

2011 Clinical Practice Guidelines Portal

199. Primary fascial closure after damage control laparotomy: sepsis vs haemorrhage. (Abstract)

Primary fascial closure after damage control laparotomy: sepsis vs haemorrhage. To compare the outcomes of patients undergoing damage control laparotomy (DCL) for intra-abdominal sepsis vs intra abdominal haemorrhage. We hypothesize that patients undergoing DCL for sepsis will have a higher rate of septic complications and a lower rate of primary fascial closure.Retrospective study of patients undergoing DCL from December 2006 to November 2009. Data are presented as medians and percentages (...) where appropriate.111 patients were identified (55 men), 79 with sepsis and 32 with haemorrhage. There was no difference in age (63 vs 62 years), body mass index (BMI, 27 vs 28), diabetes mellitus (13% vs 9%), or duration of initial operation (125 vs 117 min). Patients with sepsis presented with a lower serum lactate (2.2 vs 4.7 mmol/L, p<0.01), base deficit (4.0 vs 8.0, p ≤ 0.01) and ASA score (3.0 vs 4.0, p<0.01). There was no statistical difference in overall morbidity (81% vs 66), mortality (19

2014 Injury

200. The effect of reducing the incidence of gastrointestinal complications in patients treated with aspirin, referred to Imam Hospital, of Ahvaz, Iran Full Text available with Trip Pro

with Helicobacter pylori infection is associated with a decreasing risk of gastrointestinal bleeding (O'connor et al., 2013) [1]. In this study, 165 patients with positive helicobacter pylori infection test were chosen among those who were referred to Imam H. In this paper, the effects of sex, smoking, renal failer, diabetes, age, blood pressure and aspirin consumption have been studied (Fletcher et al., 2010) [2]. After completion of the observations and records of patient's medical records, the obtained coded (...) The effect of reducing the incidence of gastrointestinal complications in patients treated with aspirin, referred to Imam Hospital, of Ahvaz, Iran This research contains data which were obtained during the analysis of treated patients with aspirin who were referred to Imam Hospital (Imam H) of Ahvaz, Iran; and the effect of this type of treatment (Helicobacter pylori eradicate (HPE)) on reducing the incidence of gastrointestinal complications. Studies have shown that taking aspirin in patients

2017 Data in brief

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