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aspirin and gastrointestinal bleeding

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41. Low-dose acetylsalicylic acid and gastrointestinal ulcers or bleeding--a cohort study of the effects of proton pump inhibitor use patterns. (Abstract)

Low-dose acetylsalicylic acid and gastrointestinal ulcers or bleeding--a cohort study of the effects of proton pump inhibitor use patterns. The aim of this study was to investigate the associations between proton pump inhibitor (PPI) usage patterns and risk of severe gastrointestinal events in patients treated with low-dose acetylsalicylic acid (LDA).A nationwide cohort study in Sweden.All Swedish residents ≥ 40 years of age, without cancer and receiving LDA treatment (≥ 80% adherence for 365 (...) 1.22 (95% CI 1.07-1.40)]. The risk of LDA treatment interruption was higher with intermittent PPI use [HR 1.16 (95% CI 1.14-1.19)] than continuous PPI use with high adherence.In this large cohort of LDA users, intermittent PPI use was associated with higher risk of gastrointestinal ulcers or bleeding and interrupted LDA treatment, compared with continuous PPI use.© 2013 The Association for the Publication of the Journal of Internal Medicine.

2013 Journal of internal medicine

42. Systematic review with meta analysis: Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding

Systematic review with meta analysis: Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time (...) disease but at a near equivalent risk of increased bleeding Article Text Therapeutics/Prevention Systematic review with meta analysis Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding Michael D Miedema 1 , Salim S Virani 2 Statistics from Altmetric.com Commentary on: Guirguis-Blake JM , Evans CV , Senger CA , et al . Aspirin for the primary prevention of cardiovascular events: a systematic evidence review

2016 Evidence-Based Medicine

43. Management of Bleeding in Patients on Oral Anticoagulants

Bleeds that compromise the organ’sfunctionsuch as intracranial hemorrhage (ICH) and other central nervous system bleeds (e.g., intraocular,spinal)areconsideredto be critical site bleeds. Thoracic, airway, pericardial, intra- abdominal, retroperitoneal, intra-articular, and intra- muscular bleeds are considered critical as they may cause severe disability and necessitate surgical procedures for hemostasis. Intraluminal gastrointestinal (GI) bleeding is not considered a critical site bleed; however (...) Table 7. Components of the Clinician-Patient Discussion 613 5.7.3. Concurrent Medications ... .. 611 5.7.4. GI Bleeding .. 613 5.7.5. Intracranial Hemorrhage ... .. 613 5.7.6. Restarting Anticoagulation After a Surgery/Procedure . .. 613 6.DISCUSSION AND IMPLICATION OF PATHWAY .. 614 PRESIDENT AND STAFF 614 REFERENCES . 614 APPENDIX 1 Author Relationships With Industry and Other Entities (Relevant)— 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral

2020 American College of Cardiology

44. Management of Patients With Acute Lower Gastrointestinal Bleeding

used to cover the lower gastrointestinal tract included (‘Exp Intestine, Large’[Mesh] OR ‘Exp Lower Gas- trointestinal Tract’[Mesh] OR lower gastrointestinal[tiab] OR lower intestinal[tiab]). Th ese terms were combined with terms for gastrointestinal bleeding including ‘Gastrointestinal Hemorrhage’[Mesh:noexp] OR rectal bleeding[tiab] OR colonic hemorrhage[tiab] OR colonic hemorrhages[tiab] OR colonic Table 1 . Continued 20. Epinephrine injection therapy (1:10,000 or 1:20,000 dilution with saline (...) that may suggest a specifi c source such as abdominal pain and diarrhea (colitis), and altered bowel habits and weight loss (malignancy). Likewise, past medical history elements should include any prior GI bleeding events, abdominal and/or vascular surgeries, peptic ulcer disease, infl ammatory bowel disease, or abdominopelvic radiation therapy. It is also important to assess comorbidities including cardiopulmo- nary, renal, or hepatic disease that may put the patient at high risk of poor outcome

2016 American College of Gastroenterology

45. Massive esophageal bleeding in long-standing achalasia complicated by esophageal carcinoma and aspirin-induced stasis ulcer: Case report. Full Text available with Trip Pro

Massive esophageal bleeding in long-standing achalasia complicated by esophageal carcinoma and aspirin-induced stasis ulcer: Case report. Esophageal hemorrhage may occasionally develop subsequent to esophagitis and stasis ulcer, but potentially fatal esophageal bleeding is very uncommon in primary achalasia.We describe a case of a 64-year-old man with long-standing achalasia and megaesophagus who presented acute episodes of life-threatening upper gastrointestinal bleeding.Five (...) and adherent blood clots suggestive of bleeding stigma. The biopsy specimen demonstrated esophageal cancer. Accordingly, a diagnosis of massive esophageal hemorrhage in long-standing achalasia complicated by squamous cell carcinoma, possibly triggered by acute mucosal irritation and ulcer caused by aspirin stasis, was made. The patient then successfully underwent the Ivor-Lewis operation. Resultantly, the tumor was diagnosed as moderately differentiated squamous cell carcinoma stage IIA (T2N0M0

2019 Medicine

46. Efficacy and Safety of Etrasimod (APD334) in Inflammatory Bowel Disease Patients With Active Skin Extra-intestinal Manifestations

Pharmaceuticals ClinicalTrials.gov Identifier: Other Study ID Numbers: APD334-006 First Posted: May 3, 2017 Last Update Posted: March 27, 2018 Last Verified: March 2018 Layout table for additional information Studies a U.S. FDA-regulated Drug Product: Yes Studies a U.S. FDA-regulated Device Product: No Product Manufactured in and Exported from the U.S.: Yes Additional relevant MeSH terms: Layout table for MeSH terms Intestinal Diseases Inflammatory Bowel Diseases Gastrointestinal Diseases Digestive System (...) Efficacy and Safety of Etrasimod (APD334) in Inflammatory Bowel Disease Patients With Active Skin Extra-intestinal Manifestations Efficacy and Safety of Etrasimod (APD334) in Inflammatory Bowel Disease Patients With Active Skin Extra-intestinal Manifestations - 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

2017 Clinical Trials

47. The role of endoscopy in the patient with lower GI bleeding

usually results from surface ulcerations of an advanced tumor. 11 Patients with tumors in the right side of the colon are more likely to present with occult blood loss and iron de?ciency anemia, whereas those with left- sidedtumorsmorecommonlypresentwithhematochezia. 71 Endoscopic treatment for hemostasis is rarely required because bleeding from colorectal neoplasia is slow in the majority of patients. 24 Postpolypectomy bleeding Postpolypectomy bleeding has been reported to account for 2% to 8 (...) . www.giejournal.org Volume 79, No. 6 : 2014 GASTROINTESTINAL ENDOSCOPY 879 Endoscopy in patients with lower GI bleedingscreening patients (odds ratio 2.87; P! .0001). 107 Persis- tent melena after negative results with bidirectional endos- copy may warrant small-bowel endoscopy for evaluation of OGIB. 106 Intermittent scant hematochezia Chronic intermittent passage of small amounts of blood per rectum is the most common pattern of LGIB 108,109 and usually is caused by an anorectal or distal colon source

2014 American Society for Gastrointestinal Endoscopy

48. How soon to start: aspirin resumption after upper gastrointestinal bleed? Full Text available with Trip Pro

low-dose aspirin recipients who had peptic ulcer bleeding, continuous aspirin therapy may increase the risk for recurrent bleeding but potentially reduces mortality rates. Larger trials are needed to confirm these findings. Fifty million Americans use low-dose aspirin, 325 mg/day or less, regularly for cardioprophylaxis[ ]. The estimated average excess risk of upper gastrointestinal bleeding (UGIB) related to cardioprophylactic doses of ASA is 5 cases per 1000 ASA users per year [ ]. Currently (...) 30 days of the initial event. Secondary outcomes included all cause mortality, and death attributed to cardiovascular, cerebrovascular or gastrointestinal complications. Secondary endpoints included blood transfusion requirement, duration of hospital stay, requirement of surgery, and recurrence of acute ischemic events (ACS/CVA). There was no significant difference in the primary outcome measure, incidence of recurrent ulcer bleeding at 30 days (10.3% in the low-dose aspirin group and 5.4

2011 Critical Care - EBM Journal Club

49. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

resonance imaging; SBP, systolic blood pressure; and VKA, vitamin K antagonist. Downloaded from http://ahajournals.org by on March 27, 20192036 Stroke July 2015 Neuroimaging The abrupt onset of focal neurological symptoms is presumed to be vascular in origin until proven otherwise; however, it is impossible to know whether symptoms are caused by ischemia or hemorrhage on the basis of clinical characteristics alone. Vomiting, systolic BP (SBP) >220 mm Hg, severe headache, coma or decreased level (...) Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Results—Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention

2015 Congress of Neurological Surgeons

50. Guidelines for the management of spontaneous intracerebral hemorrhage Full Text available with Trip Pro

were given FFP alone received a higher volume of FFP and developed more adverse events, primarily attributable to fluid overload. PCCs may increase the risk of thrombotic complications, although this risk appears low. In 2013, the first large phase 3 randomized controlled trial demonstrated noninferiority of 4-factor PCC to FFP for urgent reversal of warfarin in a cohort of 202 patients with acute bleeding (24 of whom had intracranial hemorrhage). In this study, the rate of achieving an INR <1.3 (...) and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Results— Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention and control of secondary brain injury and intracranial pressure, the role of surgery, outcome prediction, rehabilitation, secondary prevention, and future considerations. Results of new phase 3 trials were

2015 American Academy of Neurology

51. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage Full Text available with Trip Pro

resonance imaging; SBP, systolic blood pressure; and VKA, vitamin K antagonist. Downloaded from http://ahajournals.org by on March 27, 20192036 Stroke July 2015 Neuroimaging The abrupt onset of focal neurological symptoms is presumed to be vascular in origin until proven otherwise; however, it is impossible to know whether symptoms are caused by ischemia or hemorrhage on the basis of clinical characteristics alone. Vomiting, systolic BP (SBP) >220 mm Hg, severe headache, coma or decreased level (...) Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Results—Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention

2015 American Heart Association

52. Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants?

to anticoagulation in patients with atrial ?brillation and low risk of stroke or for those with contraindications to anticoagulants. However, the latest guidelines no longer recommend the use of aspirin for atrial ?brillation regardless of age. 4 Although it is well known that age increases the risk of bleeding, this systematic review aimed to evaluate whether bleeding risk is equivalent among allantithromboticdrugs. This meta-analysis of 43,199 pa- tientsrevealedthattheriskofmajor hemorrhage in older adults (...) no difference in the risk of major hemorrhage in olderpatients. 6,7 The data from this systematic re- view do not support the wide- spread notion that antiplatelet agents have a lower risk of major bleeding in comparison with anti- coagulants. The belief that anti- platelet agents are safer than anticoagulants disagrees mecha- nistically with the early steps in hemostasis, involving platelet acti- vation and aggregation. Vascular injury results in platelet activation and the simultaneous release

2018 Annals of Emergency Medicine Systematic Review Snapshots

53. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer

daily. • There is no recommendation for or against aspirin therapy in adults aged < 50 or = 60 years. • 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 NSAIDS daily, or other medicine to prevent blood clots. The recommendations above reflect a change from initiate to consider in adults aged 50-59 years with 10-year (...) cardiovascular risk patients who were over 55 years of age (males) or 60 years of age (females) to 100 mg aspirin or placebo. The primary efficacy endpoint was a composite outcome consisting of time to first occurrence of confirmed myocardial infarction, stroke, cardiovascular death, unstable angina, or transient ischemic attack. There was no difference in CV events between groups. There were significantly higher rates of gastrointestinal bleeding among patients taking aspirin (0.97%) compared to the placebo

2019 Kaiser Permanente National Guideline Program

54. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

389Introduction Colorectal cancer is one of the most common cancers world- wide, particularly in the economically developed world [1]. Large-bowel obstruction caused by advanced colonic cancer occurs in 8%–13% of colonic cancer patients [2–4]. The man- agementof thissevereclinicalconditionhasbeencontroversial [5].Over thelastdecade,manyarticleshavebeenpublishedon the subject of colonic stenting for malignant colonic obstruc- tion, including randomized controlled trials (RCTs) and sys- tematic reviews. Thereby (...) different definitions (e.g. basedon symptoms, radiologic, orendoscopic findings) and reported inconsistent outcomes. Increasing age and American Society of Anesthesiologists (ASA) classification =III do not affect stenting outcome (i.e., clinical success and complications) in several observational studies [17–22], although these are well-known risk factors for postoperative mortality after surgical treatment of large-bowel obstruction [23–25]. When malignant colonic obstruction is suspected, contrast

2020 European Society of Gastrointestinal Endoscopy

55. Comparative outcomes in patients with ulcer- vs non-ulcer-related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4478 patients. (Abstract)

to have been taking aspirin (40% vs 27%, P < 0.001) and present with shock (43% vs 32%, P < 0.001). Furthermore, those with ulcer-related bleeding were more likely to receive blood transfusion (66% vs 39%, P < 0.001), PPI infusion (27% vs 5%, P < 0.001) and endoscopic therapy (37% vs 8%, P < 0.001). Overall, ulcer-related bleeding had higher odds of in-hospital mortality (OR: 1.54; 95% CI: 1.21-1.96, P < 0.0001), rebleeding (OR: 2.08; 95% CI: 1.73-2.51, P < 0.0001) and need for surgical/radiologic (...) Comparative outcomes in patients with ulcer- vs non-ulcer-related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4478 patients. Outcomes after Nonvariceal upper gastrointestinal bleeding (NVUGIB) have historically focused on ulcer-related causes. Little is known regarding non-ulcer bleeding, the most common cause of NVUGIB.To compare outcomes between ulcer- and non-ulcer-related NVUGIB and explore whether these could be explained by differences in baseline

2019 Alimentary Pharmacology & Therapeutics

56. Is there Evidence to Support the use of Enteric Coated (EC) Aspirin to Reduce Gastrointestinal Side Effects in Patients with Cardiovascular Disease?

) formulation of aspirin was developed and marketed in an effort to reduce GI adverse effects associated with aspirin therapy. There are reports however, that EC does not significantly reduce the risk of GI bleeding when compared to standard formulations of aspirin. There is also speculation that enteric coating may reduce the anti-platelet effect of aspirin due to a reduction in bioavailability, thereby reducing its clinical efficacy in prevention of cardiovascular events. This Q&A reviews the evidence (...) Is there Evidence to Support the use of Enteric Coated (EC) Aspirin to Reduce Gastrointestinal Side Effects in Patients with Cardiovascular Disease? Is there Evidence to Support the use of Enteric Coated (EC) Aspirin to Reduce Gastrointestinal Side Effects in Patients with Cardiovascular Disease? – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Menu · · 10th January 2020 · London and South East Regional Medicines Information The enteric coated (EC

2020 Specialist Pharmacy Services

57. the Efficiency of Endoscopic Treatment for Recurrent Small Intestinal Bleeding Due to Gastrointestinal Vascular Malformation

, consequently is in dire of effective treatment. The investigators' previous study first confirmed thalidomide treatment of GIVM bleeding was safe and effective. This trial intends to investigate the efficiency of endoscopic intervention to the hemorrhage due to GIVM. What more, the research tends to suggest standardizing clinical paths for small bowel bleeding due to GIVM. Condition or disease Intervention/treatment Phase Gastrointestinal Vascular Malformation Device: balloon assisted enteroscopy (...) the Efficiency of Endoscopic Treatment for Recurrent Small Intestinal Bleeding Due to Gastrointestinal Vascular Malformation the Efficiency of Endoscopic Treatment for Recurrent Small Intestinal Bleeding Due to Gastrointestinal Vascular Malformation - 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

2016 Clinical Trials

58. Anticoagulants is a risk factor for spontaneous rupture and hemorrhage of gallbladder: a case report and literature review. Full Text available with Trip Pro

Anticoagulants is a risk factor for spontaneous rupture and hemorrhage of gallbladder: a case report and literature review. The spontaneous rupture of the gallbladder is extremely rare, majority of ruptures occur secondary to traumatic injuries. Here, we report a case of spontaneous rupture of the gallbladder with probably cause of oral anticoagulants.A 51-year-old woman presented to the emergency room with sudden-onset severe abdominal pain, as well as hypotension and low level of hemoglobin (...) . Abdominal computed tomography (CT) scan showed a 2.5 cm filling defect and discontinuity in the wall of the gallbladder body, and a massive hematocele in the abdominal cavity. Past medical history was significant for hypertension and had been taking daily aspirin for the past three years because of interventional surgery for cerebral aneurysms, but no history of recent abdominal trauma or past episodes of biliary colic. The patient underwent an urgent laparoscopic abdominal exploration

2019 BMC Surgery

59. Dual antiplatelet therapy may increase the risk of non-intracranial haemorrhage in patients with minor strokes: a subgroup analysis of the CHANCE trial Full Text available with Trip Pro

). Of 36 (0.7%) cases of intracranial haemorrhages, 20 (0.4%) were in the clopidogrel-aspirin group and 16 (0.3%) in the aspirin group. Each group had 8 (0.3%) cases of symptomatic haemorrhagic strokes. Other common haemorrhagic events included 24 (0.5%) cases of skin bruises, 13 (0.3%) gastrointestinal haemorrhages, 9 (0.2%) gum haemorrhages and 8 (0.2%) intraocular haemorrhages.There was no overall significant difference in haemorrhagic events (p=0.29), especially in the rate of intracranial (...) Dual antiplatelet therapy may increase the risk of non-intracranial haemorrhage in patients with minor strokes: a subgroup analysis of the CHANCE trial The aim of this study was to explore the difference between haemorrhagic events among those patients on either aspirin or aspirin plus clopidogrel who were enrolled in the Clopidogrel in High-Risk Patients with Acute Non-disabling Ischemic Cerebrovascular Events (CHANCE) trial.This was an ad hoc analysis of the CHANCE trial; data on all patients

2016 Stroke and vascular neurology Controlled trial quality: uncertain

60. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part I: Review of Anticoagulation Agents and Clinical Considerations Full Text available with Trip Pro

, history of ministrokes or stroke, or those requiring an urgent need for surgery, including coronary artery bypass graft surgery. VerifyNow P2Y12 and VerifyNow ASA are point-of-care devices that can detect a patient’s resistance to thienopyridines or acetylsalicylic acid (ASA). If a patient is resistant to these medications, the normal recommended withholding times may not apply. Cyclooxygenase Inhibitors Aspirin is one of the most commonly prescribed antiplatelet agents for the prevention (...) physiology is beyond the scope of this paper, a brief overview can be helpful in discussing commonly used antiplatelet and anticoagulation medications and how they affect bleeding risk. The ultimate goal of the coagulation cascade is to form a platelet-rich cross-linked fibrin clot, which creates a scaffolding across areas of endothelial damage to prevent blood loss from the vessel lumen ( x 9 Beshay, J.E., Morgan, H., Madden, C., Yu, W., and Sarode, R. Emergency reversal of anticoagulation

2019 Society of Interventional Radiology

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