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aspirin and gastrointestinal bleeding

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101. Tranexamic Acid for Spontaneous Acute Cerebral Hemorrhage Trial

later, at 24 hours and at 1 week. Condition or disease Intervention/treatment Phase Stroke Hemorrhagic Intracerebral Haemorrhage Drug: Tranexamic Acid Phase 3 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 220 participants Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: Randomised placebo-controlled parallel group clinical trial Masking: Double (Participant, Outcomes Assessor (...) Processes Intracranial Hemorrhages Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Tranexamic Acid Antifibrinolytic Agents Tranylcypromine Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Hemostatics Coagulants Antidepressive Agents Psychotropic Drugs Monoamine Oxidase Inhibitors Enzyme Inhibitors Anti-Anxiety Agents Tranquilizing Agents Central Nervous System Depressants Physiological

2017 Clinical Trials

102. Fecal blood loss and plasma salicylate study of salicylsalicylic acid and aspirin. (Abstract)

Fecal blood loss and plasma salicylate study of salicylsalicylic acid and aspirin. Using a placebo-controlled methodology, 20 healthy volunteers housed in a clinical research facility for 23 days were studied for fecal blood loss and plasma salicylate levels after taking salsalate (salicylsalicylic acid) or aspirin. Daily dosages were 3000 mg salsalate or 3900 mg aspirin. Aspirin produced statistically significant gastrointestinal blood loss over control levels and over that produced (...) by salsalate (P less than 0.01). Blood loss with salsalate was not different than that with placebo. Despite the intentional disparity of dosages between the two drugs, plasma salicylate levels were not statistically different. Side effects occurred at about equal frequency with either drug. Most prominent were headache and nausea. However, concomitant upper respiratory infection in 12 subjects rendered interpretation difficult.

1979 Journal of clinical pharmacology

103. Analysis of risk factors for colonic diverticular bleeding and recurrence. Full Text available with Trip Pro

was performed to assess the risk factors for the onset of colonic diverticular bleeding. The distribution of diverticulosis, comorbidity, and medication were evaluated from medical records. We also assigned patients with a first-time bleeding into groups with and without rebleeding during follow-up to determine risk factors for recurrence.Bilateral colonic diverticulosis, nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin (LDA), and anticoagulants were significant risk factors (...) Analysis of risk factors for colonic diverticular bleeding and recurrence. The increase in incidence of colonic diverticular bleeding is relative to an age-related rise in the incidence of colonic diverticulosis and use of antithrombotic medication. However, risk factors related to the onset, recurrence, and prophylaxis have not been established. Therefore, we aimed to determine risk factors for the onset and recurrence of colonic diverticular bleeding.An age- and sex-matched case-control study

2017 Medicine

104. Colonic diverticular hemorrhage associated with the use of nonsteroidal anti-inflammatory drugs, low-dose aspirin, antiplatelet drugs, and dual therapy. (Abstract)

Colonic diverticular hemorrhage associated with the use of nonsteroidal anti-inflammatory drugs, low-dose aspirin, antiplatelet drugs, and dual therapy. The effects of various medications on lower gastrointestinal tract remains unknown. Here, we investigated the effects of nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, and antiplatelet drugs associated with diverticular bleeding.This prospective study involved patients with diverticulosis who underwent colonoscopy. Alcohol (...) and smoking, medications, and Charlson comorbidity index and Gastrointestinal Symptom Rating Scale scores were assessed. The medications evaluated were nine kinds of NSAIDs, two kinds of low-dose aspirin, 10 kinds of nonaspirin antiplatelet drugs, three kinds of anticoagulants, acetaminophen, and corticosteroids. Adjusted odds ratios (aOR) were estimated by a logistic regression model.A total of 911 patients with non-bleeding diverticula (n = 758) and bleeding diverticula (n = 153) were enrolled

2014 Journal of gastroenterology and hepatology

105. Clinical outcomes of various continued antiplatelet therapies in patients who were administered DAPT following the implantation of drug-eluting stents and developed gastrointestinal hemorrhage Full Text available with Trip Pro

to be significantly different among the three groups (P<0.05), and continued aspirin or clopidogrel use was superior to continued DAPT. In conclusion, the results of the present study indicated that there were no significant differences in the clinical effectiveness and safety of continuing antiplatelet monotherapy or DAPT in patients who are administered DAPT and experience gastrointestinal hemorrhage following DES implantation. As for the prevention of recurrent bleeding, antiplatelet monotherapy (...) outcomes from DES, it is important to formulate a novel continued antiplatelet therapy for patients who were administered DAPT and subsequently develop gastrointestinal hemorrhage following DES implantation. The present study aimed to evaluate the effects of continued aspirin, clopidogrel or DAPT use on the incidence of clinical adverse events and gastrointestinal rebleeding in patients who received DAPT and subsequently developed gastrointestinal hemorrhage following implantation of DES for CHD

2016 Experimental and therapeutic medicine

106. Defining patients at high risk for gastrointestinal hemorrhage after drug-eluting stent placement: a cost utility analysis Full Text available with Trip Pro

-analysis was used for the risk of gastrointestinal bleeding while on aspirin and Plavix (dual anti-platelet therapy), which was the key model input. Monetary benefit and utility valuations: The utility values were from a published study. Measure of benefit: Quality-adjusted life-years (QALYs) were the summary benefit measure. Cost data: The economic analysis included the costs of initial stent placement, aspirin, Plavix, coronary artery bypass graft, and gastrointestinal haemorrhage. Procedure-related (...) costs were from the literature and weighted averages were calculated where multiple sources were available. The costs of drugs were from average wholesale prices. All costs were in US dollars ($) and the price year was 2009. Analysis of uncertainty: A one-way sensitivity analysis was undertaken varying the risk of gastrointestinal bleeding from dual anti-platelet therapy. A two-way analysis was carried out varying the risk of gastrointestinal bleeding while on aspirin alone and the risk

2010 NHS Economic Evaluation Database.

107. Misoprostol for Small Bowel Ulcers and Obscure Bleeding Due to Aspirin or Nonsteroidal Antiinflammatory Drugs

the digestive system. The source of this bleeding can be obvious (overt), or obscure and thought to come from the small intestine. Obscure bleeding can show as anemia due to lack of iron in the blood. Small intestine ulcers are now easily diagnosed using an endoscope the size of a big pill (video capsule endoscopy). Small bowel ulcers are not related to stomach acid and therefore do not heal using remedies usually taken to stop acid formation. A different drug, misoprostol, consists of a chemical (...) Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Misoprostol for the Healing of Small Bowel Ulceration in Patients With Obscure Blood Loss While Taking Low-dose Aspirin or Nonsteroidal Antiinflammatory Drugs [MASTERS Trial] Actual Study Start Date : January 7, 2016 Actual Primary Completion Date : October 11, 2017 Actual Study Completion Date : October 11, 2017 Resource links provided by the National Library of Medicine related

2014 Clinical Trials

108. Individualised prediction of alternate-day aspirin treatment effects on the combined risk of cancer, cardiovascular disease and gastrointestinal bleeding in healthy women. Full Text available with Trip Pro

women with baseline plasma samples in the Women's Health Study, a randomised trial of 100 mg alternate-day aspirin versus placebo, were used to develop competing risks models for individualised prediction of absolute risk reduction of the combination of CVD, cancer and major gastrointestinal bleeding by aspirin.Although aspirin was associated with a modestly decreased 15-year risk of colorectal cancer, CVD, and in some women non-colorectal cancer, aspirin treatment resulted in a negative treatment (...) effect in the majority of women if gastrointestinal bleeding was also taken into account. The excess risk of major gastrointestinal bleeding by aspirin increased with age, but the benefits for colorectal cancer and CVD risk were also greater at higher age. Decision curves indicated that selective treatment of women ≥65 years may improve net benefit compared to treating all, none and prediction-based treatment. The observed 15-year number needed to treat to prevent one event among women ≥65 years

2015 Heart Controlled trial quality: uncertain

109. Effect of proton-pump inhibitors on the risk of lower gastrointestinal bleeding associated with NSAIDs, aspirin, clopidogrel, and warfarin. (Abstract)

Effect of proton-pump inhibitors on the risk of lower gastrointestinal bleeding associated with NSAIDs, aspirin, clopidogrel, and warfarin. We investigated the effects of proton-pump inhibitors (PPIs) on lower gastrointestinal bleeding (LGIB) and of their interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, clopidogrel, and warfarin on LGIB risk.We prospectively studied 355 patients emergently hospitalized for LGIB and 8,221 nonbleeding patients. All patients (...) ), clopidogrel (AOR 0.99, p = 0.985), or warfarin (AOR 1.52; p = 0.398).This large case-control study demonstrated that PPI use did not lead to an increased risk of LGIB, regardless of the type of PPI used. Further, LGIB risk was not affected by PPI use, irrespective of concomitant therapy with NSAIDs, low-dose aspirin, clopidogrel, or warfarin.

2015 Journal of gastroenterology

110. Effect of low-dose proton pump inhibitor on preventing upper gastrointestinal bleeding in chronic kidney disease patients receiving aspirin. (Abstract)

Effect of low-dose proton pump inhibitor on preventing upper gastrointestinal bleeding in chronic kidney disease patients receiving aspirin. Upper gastrointestinal bleeding (UGIB) leads to significant morbidity and mortality in chronic kidney disease (CKD) patients. This study determined the efficacy of using a low-dose proton pump inhibitor (PPI) to reduce the risk of non-variceal UGIB in CKD patients receiving aspirin.We retrospectively reviewed the medical records of 500 CKD patients who (...) received aspirin between January 2008 and March 2013. Cumulative incidence analysis using the Kaplan-Meier method was performed to analyze the rate of non-variceal UGIB and association with the administration of low-dose PPI.Of the 500 patients, 191 received low-dose PPI. Over the follow-up period, which lasted 1067 person-years, three patients in the low-dose PPI group (8.9 per 1000 person-years) and 19 patients in the non-PPI group (25.9 per 1000 person-years) developed non-variceal UGIB

2015 Journal of gastroenterology and hepatology

111. Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial (Abstract)

receiving lansoprazole (duodenal ulcer) and three receiving famotidine (two gastric ulcers and one duodenal ulcer). The cumulative incidence of recurrent upper GI bleeding in 24 months was 0.88% (95% CI 0.08% to 4.37%) in the lansoprazole arm and 2.63% (95% CI 0.71% to 6.91%) in the famotidine arm (p=0.313; crude HR 0.33, 95% CI 0.03 to 3.16, p=0.336). None of the patients who rebled used aspirin, non-steroidal anti-inflammatory drugs or other antithrombotic drugs.This 2-year, double-blind randomised (...) recruited patients with a history of idiopathic bleeding ulcers. After ulcer healing, we randomly assigned (1:1) patients to receive oral lansoprazole 30 mg or famotidine 40 mg daily for 24 months. The primary endpoint was recurrent upper GI bleeding within 24 months, analysed in the intention-to-treat population as determined by an independent adjudication committee.Between 2010 and 2018, we enrolled 228 patients (114 patients in each study group). Recurrent upper GI bleeding occurred in one patient

2019 EvidenceUpdates

112. The Association of Coloproctology of Great Britain and Ireland Consensus Guidelines in Surgery for Inflammatory Bowel Disease Full Text available with Trip Pro

disease is a severe inflammatory condition of the intestine affecting 322 per 100 000 people in Europe and 319 per 100 000 people in North America . It is associated with periods of debilitating symptoms including tiredness, severe abdominal discomfort, weight loss and chronic diarrhoea, often leading to the need for hospitalization and time off work. The disease can affect any part of the gastrointestinal track from the mouth to the anus, but in one‐third of patients it is localized to the ileocaecal (...) The Association of Coloproctology of Great Britain and Ireland Consensus Guidelines in Surgery for Inflammatory Bowel Disease The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease - Brown - 2018 - Colorectal Disease - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term The full text of this article hosted at iucr.org

2018 Association of Coloproctology of Great Britain and Ireland

113. Neural network prediction of severe lower intestinal bleeding and the need for surgical intervention Full Text available with Trip Pro

factors for each patient correlated significantly with the outcome of severe bleeding (r = 0.29, P < 0.001). However, the Strate model was less accurate than an ANN (AUROC 0.66 [0.57-0.75] versus 0.98 [0.95-1.00], respectively) which incorporated six variables present on admission: hemoglobin, systolic blood pressure, outpatient prescription for Aspirin 325 mg daily, Charlson comorbidity index, base deficit ≥5 mEq/L, and international normalized ratio ≥1.5. A similar ANN including hemoglobin nadir (...) and the occurrence of a 20% decrease in hematocrit was effective in predicting the need for surgery (AUROC 0.95 [0.90-1.00]).The Strate prediction rule effectively stratified risk for severe ALIB, but was less accurate than an ANN. A separate ANN accurately predicted the need for surgery by combining risk factors for severe bleeding with parameters quantifying blood loss. Optimal prognostication may be achieved by integrating pragmatic regression-based calculators for quick decisions at the bedside and highly

2016 The Journal of surgical research

114. Further Haemorrhage after Admission to Hospital for Gastrointestinal Haemorrhage Full Text available with Trip Pro

Further Haemorrhage after Admission to Hospital for Gastrointestinal Haemorrhage During 1967 and 1968 817 episodes of acute alimentary tract haemorrhage were treated in Aberdeen hospitals. In 229 cases further haemorrhage occurred in hospital, with a mortality of 28.8%; the mortality among patients who did not have this complication was 7.8%. This was true of any kind of further haemorrhage. As judged by transfusion requirements and mortality the severity of the further haemorrhage (...) was unaffected by its occurrence as haematemesis and melaena or as melaena only or by whether it took place before or after 48 hours from the time of admission. The occurrence of further haemorrhage did not appear to be affected by the sex or blood group of patients, by aspirin ingestion, or by a history of a previous haemorrhage.The effects of the occurrence of further haemorrhage, of the age being over 60 years, or of coincidental disease being present were of descending importance in regard

1973 British medical journal

115. New/Novel Oral Anticoagulants (NOACs): Management of Bleeding

Table 1). ? Transfusion therapy should be given as per standard supportive measures: ? RBC transfusion if symptomatic anemia ? Platelet transfusion if platelets less than 50 x 10 9 /L or if patient is taking antiplatelet therapy © 2016 Thrombosis Canada Page 2 of 2 ? Consultation for further investigations and definitive management, if indicated (e.g. endoscopy) Severe/Life-threatening bleeding e.g. intracranial hemorrhage, severe GI bleed Initial management ? Interrupt anticoagulant therapy (...) reversal is expected within minutes. ? Ongoing bleeding is due to anatomical cause PCC (Octaplex®) rivaroxaban apixaban dabigatran* ? 50 units/kg, max 3000 units ? Mix diluent and PCC following manufacturer instructions ? infuse at 1 mL/min followed by maximum 3 mL/min (180 mL/hr) per institution/Blood Bank instructions ? Contraindicated in heparin-induced thrombocytopenia ? For life-threatening bleeding (e.g. intracranial hemorrhage) give 2000 units IV STAT if weight not available and cannot delay

2016 Thrombosis Interest Group of Canada

116. Primary Care Corner with Geoffrey Modest MD: Continue Aspirin After Lower GI Bleeds?

, smoking, severity of comorbidities, history of GI bleeding (upper and lower), blood transfusion, meds (anticoagulants, steroids, non-aspirin antiplatelet drugs) within the 30 days prior to index bleed. Outcomes assessed: recurrent lower GI bleed, serious cardiovascular events (nonfatal MI, nonfatal stroke, death from vascular cause), and deaths from other causes Results, comparing non-users to users: Lower GI bleeding recurred in 18.9% of those on aspirin vs 6.9% of non-users (SHR 2.76; p=0.011) [SHR (...) : This article highlights the very likely conclusion that those with a lower GI bleed but at high cardiovascular risk are more likely to get benefit over harm by continuing aspirin use . The issue with the more common adverse event of aspirin-associated upper GI bleeding is a bit easier given the potential of adding acid suppression therapy to minimize recurrent risk I think it is also important to stress that aspirin may have real benefits in preventing cancer (see below). The data on this has been

2016 Evidence-Based Medicine blog

117. Prevention of Upper Gastrointestinal Hemorrhage Using Albis® in the Patients of Locally Advanced Pancreatic Cancer Who Underwent Concurrent Chemoradiotherapy

% of pancreatic cancer patients were diagnosed as locally advanced unresectable status without distant metastasis. Concurrent chemoradiotherapy (CCRT) was a reasonable treatment modality for locally advanced pancreatic cancer. However, several adverse events of chemoradiation could lead unfavorable treatment results, which included unique gastrointestinal (GI) toxicities, such as ulcer and hemorrhage in the stomach and duodenum that are included in the radiation field. According to the study (...) incidence [ Time Frame: within 4 weeks from end of chemoradiation ] After 1 month after the chemoradiation, all the patients receive the esophagogastroduodenoscopy to detect the development of gastrointestinal ulcers. The proportion of patients with radiation-induced GI ulcers in each group will be investigated Secondary Outcome Measures : Adverse event of gastrointestinal hemorrhage [ Time Frame: within 4 weeks ] Eligibility Criteria Go to Information from the National Library of Medicine Choosing

2015 Clinical Trials

118. Risk of bleeding after endoscopic submucosal dissection for colorectal tumors in patients with continued use of low-dose aspirin. (Abstract)

Risk of bleeding after endoscopic submucosal dissection for colorectal tumors in patients with continued use of low-dose aspirin. Although Japanese guidelines proposed by the Japan Gastroenterological Endoscopy Society for endoscopic submucosal dissection (ESD) for colorectal tumors recommend continued use of low-dose aspirin (LDA), this strategy is controversial. It was our practice to interrupt LDA therapy 5-7 days before ESD until December 2010, when we instituted the new guidelines (...) ), and no anticoagulant/antiplatelet group (541 patients with 565 colorectal tumors).The en bloc resection rate was 100% (13/13) in the LDA-interrupted group and 90.3% (28/31) in the LDA-continued group. Incidences of poor bleeding control during the procedure and bleeding after the procedure were 7.7% (1/13) and 15.4% (2/13) of patients, respectively, in the LDA-interrupted group, and 3.2% (1/31) and 16.1% (5/31) of patients, respectively, in the LDA-continued group. No patients experienced ischemic events

2015 Journal of gastroenterology

119. Pomalidomide in Hereditary Hemorrhagic Telangiectasia and Transfusion-Dependent Vascular Ectasia: a Phase I Study

telangiectasia (HHT). This study will focus on documented bleeding sites in the small bowel, including the duodenum, jejunum and ileum. Eligible patients will have endoscopically-documented sites of vascular ectasia and will have required at least 4 units of blood transfusion or episodes of intravenous iron administration over the preceding four months. Condition or disease Intervention/treatment Phase Hereditary Hemorrhagic Telangiectasia Idiopathic Vascular Ectasia Drug: Pomalidomide Phase 1 Detailed (...) Identifier: NCT02287558 Recruitment Status : Recruiting First Posted : November 10, 2014 Last Update Posted : July 20, 2018 See Sponsor: The Cleveland Clinic Information provided by (Responsible Party): Keith McCrae, The Cleveland Clinic Study Details Study Description Go to Brief Summary: This study will evaluate patients > 18 years of age with transfusion-dependent gastrointestinal bleeding due to documented gastrointestinal vascular ectasia with or without concurrent hereditary hemorrhagic

2014 Clinical Trials

120. Bleeding

by specialists. Consider tranexamic acid (as in section on 'Bleeding from skin and mucous membranes') although there is a risk of clot retention until the complete cessation of bleeding. Bladder irrigation ± instillations with 0 . 9% Sodium Chloride or tranexamic acid (5g in 50ml water) can be tried once or twice daily if oral treatment is unsuccessful. Bleeding from gastrointestinal (GI) tract (for oral or rectal bleeding see under mucous membranes) H2 antagonist or proton pump inhibitor. Tranexamic acid (...) . Also assess whether bleeding is due to local effects (such as blood vessel invasion) or to systemic effects of disease (such as disseminated intravascular coagulopathy [DIC]). Review the need for drugs that increase risk of bleeding e.g. low molecular weight heparin, aspirin, warfarin, dexamethasone, NSAIDS. Management Anticipatory planning If significant bleeding can be anticipated, it is usually best to discuss the possibility with the patient and their family. Ensure carers at home have

2015 Scottish Palliative Care Guidelines

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