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aspirin and gastrointestinal bleeding

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121. Thoughts On Prolonged Bleeding Whilst Taking Baby Aspirin

their ranks. Doctors mostly worry about major bleeding caused by aspirin; things like bleeding from the gastrointestinal (GI) tract, or into the head. A recent found that baby aspirin doubles the risk of bleeding from the upper GI tract, and increases the risk of intracranial hemorrhage by a factor of 1.4. There is relatively little concern about the type of minor bleeding I experienced. However, beginning in 2010, the Bleeding Academic Research Consortium (BARC) i came up with a more precise way (...) historical “bleeding time” to sophisticated tests of platelet aggregation. The test (not available in the US) of platelet reactivity predicted in one which patients would have BARC type I bleeding like mine. The test did not predict major bleeding complications, things like GI bleeding and intracranial hemorrhage. Those patients who had minor bleeding problems were more likely to be noncompliant, stopping their aspirin therapy. I could easily visualize the following scenario as the blood began pooling

2018 The Skeptical Cardiologist

122. Annual Risk of Major Bleeding Among Persons Without Cardiovascular Disease Not Receiving Antiplatelet Therapy. Full Text available with Trip Pro

individuals in the baseline cohort, 3976 had a major bleeding event during 1 281 896 person-years of follow-up. Most had gastrointestinal (GI) bleeding (n=2910 [73%]). There were 274 fatal bleeding events (7%), of which 153 were intracerebral. The risk of a nonfatal GI bleeding event per 1000 person-years was 2.19 (95% CI, 2.11-2.27), 1.77 (95% CI, 1.69-1.85) and 1.61 (95% CI, 1.52-1.69), in the baseline, non-high-risk, and nonmedication cohorts, respectively. Case fatality associated with GI bleeding (...) Annual Risk of Major Bleeding Among Persons Without Cardiovascular Disease Not Receiving Antiplatelet Therapy. A decision to initiate aspirin therapy for primary prevention of cardiovascular disease (CVD) requires consideration of both treatment benefits and harms. The most significant harm associated with aspirin is major bleeding, yet there is a paucity of data on bleeding risk in suitable community populations.To determine the risk of major bleeding among people without CVD who

2018 JAMA

123. Aspirin and alcohol in gastrointestinal haemorrhage Full Text available with Trip Pro

Aspirin and alcohol in gastrointestinal haemorrhage The intake of aspirin, of alcohol, and of a combination of both, among 817 patients admitted for gastrointestinal haemorrhage is reported. The incidence of ingestion in six diagnostic groups is compared with that in two control groups. Analysis confirms that there is a markedly significant association between overt haemorrhage and the ingestion of aspirin, but this was not shown for alcohol taken alone: the combination of aspirin and alcohol

1971 Gut

124. A review of papers purporting to show a cause-and-effect relationship between aspirin ingestion and massive gastrointestinal haemorrhage. Full Text available with Trip Pro

A review of papers purporting to show a cause-and-effect relationship between aspirin ingestion and massive gastrointestinal haemorrhage. 307769 1978 09 25 2018 11 13 0035-9157 70 Suppl 7 1977 Proceedings of the Royal Society of Medicine Proc. R. Soc. Med. A review of papers purporting to show a cause-and-effect relationship between aspirin ingestion and massive gastrointestinal haemorrhage. 4-10 Shirley E E eng Journal Article England Proc R Soc Med 7505890 0035-9157 R16CO5Y76E Aspirin IM (...) Aspirin administration & dosage adverse effects Gastrointestinal Hemorrhage chemically induced Hematemesis chemically induced Humans Melena chemically induced Time Factors 1977 1 1 1977 1 1 0 1 1977 1 1 0 0 ppublish 307769 PMC1542772 Lancet. 1968 Sep 14;2(7568):603-6 4175160 Med J Aust. 1970 Apr 18;1(16):797-800 5427637 J Pharm Sci. 1970 Oct;59(10):1511-3 5312064 Br Med J. 1969 Aug 9;3(5666):330-2 5306445 Gut. 1967 Jun;8(3):301-7 5298015 Br Med J. 1968 Dec 14;4(5632):661-3 5303550 Gut. 1975 Sep;16(9

1977 Proceedings of the Royal Society of Medicine

125. Does an ASA a day really keep the doctor away?

increase in major bleeding. All-cause and cancer mortality was either unchanged or increased with ASA. Routine use of ASA for primary cardiovascular prevention should be discouraged. Evidence: • Three large, high quality, placebo controlled RCTs of ASA 100 mg/day. o ARRIVE: RCT of 12,546 patients at moderate cardiovascular risk [10-year risk 10-20% (mean 17%)]. 1 Predominantly males (70.5%), mean age 64 years. After 5 years: ? No difference in: ? Composite cardiovascular events: 4.3% versus 4.5 (...) % placebo. ? Mortality: 2.6% in each arm. ? Increased major gastrointestinal bleeds with ASA: (hemodynamic compromise or requiring transfusion) 0.3% versus 0.1% placebo; Number needed to harm (NNH)=345. o ASCEND: RCT of 15,480 diabetics (94% type 2), mean age 63 years, 63% males. 2 After 7.4 years follow up, patients on ASA had: ? Decreased composite cardiovascular events: 8.5% versus 9.6% placebo, Number needed to treat (NNT)=91. ? Increased fatal or major (requiring hospitalization, transfusion

2019 Tools for Practice

126. Evaluation of the Efficacy and Safety of Single Dose Tranexamic Acid in Reducing Blood Loss During Colorectal Cancer Surgery

First Posted: July 31, 2018 Last Update Posted: December 28, 2018 Last Verified: December 2018 Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Ahmed H Othman, Assiut University: colorectal,blood, transfusion,haemorrhage,tranexamic acid. Additional relevant MeSH terms: Layout table for MeSH terms Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms (...) Neoplasms by Site Neoplasms Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases Tranexamic Acid Antifibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Hemostatics Coagulants

2018 Clinical Trials

127. A Study of TAK-164 in Participants With Advanced Gastrointestinal (GI) Cancer Expressing Guanylyl Cyclase C (GCC)

. FDA-regulated Drug Product: Yes Studies a U.S. FDA-regulated Device Product: No Keywords provided by Takeda ( Millennium Pharmaceuticals, Inc. ): Drug Therapy Additional relevant MeSH terms: Layout table for MeSH terms Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Colonic Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases Colorectal Neoplasms Intestinal Neoplasms Colonic Diseases Intestinal Diseases (...) Intervention/treatment Phase Gastrointestinal Neoplasms; Esophageal, Stomach, Pancreas, Colon Neoplasms; Malignant Tumors of Digestive Organ; Advanced Gastrointestinal Malignancies Drug: TAK-164 Phase 1 Detailed Description: The drug being tested in this study is a novel antibody-drug conjugate (ADC) called TAK-164. TAK-164 is being evaluated in participants with advanced GCC-positive GI cancer (Part A) or CRC (Part B) to determine safety, tolerability, and pharmacokinetics (PK) and MTD/RP2D of TAK-164

2018 Clinical Trials

128. Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial. Full Text available with Trip Pro

in the aspirin group, and 68 in the aspirin plus placebo group). Six upper-gastrointestinal bleeding events were reported across the treatment groups (two in the EPA group, three in the aspirin group, and one in the placebo group).Neither EPA nor aspirin treatment were associated with a reduction in the proportion of patients with at least one colorectal adenoma. Further research is needed regarding the effect on colorectal adenoma number according to adenoma type and location. Optimal use of EPA and aspirin (...) Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial. The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) and aspirin both have proof of concept for colorectal cancer chemoprevention, aligned with an excellent safety profile. Therefore, we aimed to test the efficacy of EPA and aspirin, alone and in combination

2018 Lancet Controlled trial quality: predicted high

129. A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. Full Text available with Trip Pro

A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. Data regarding smoking and alcohol consumption and risk of gastrointestinal bleeding (GIB) are sparse and conflicting. We assessed the risk of major GIB associated with smoking and alcohol consumption in a large, prospective cohort.We prospectively studied 48,000 men in the Health Professional follow-up Study (HPFS) who were aged 40-75 years at baseline in 1986. We identified men (...) with major GIB requiring hospitalization and/or blood transfusion via biennial questionnaires and chart review.We documented 305 episodes of major GIB during 26 years of follow-up. Men who consumed >30 g/day of alcohol had a multivariable relative risk (RR) of 1.43 (95% confidence interval (CI), 0.88-2.35; P for trend 0.006) for major GIB when compared with nondrinkers. Alcohol consumption appeared to be primarily related to upper GIB (multivariable RR for >30 g/day vs. nondrinkers was 1.35; 95% CI, 0.66

2016 PLoS ONE

130. Effects of aspirin on mortality and re-bleeding in patients with non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis

Effects of aspirin on mortality and re-bleeding in patients with non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith (...) to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may be recalculated from mg/dL); Renal histological damage as assessed by Jablonski scale; continuous; Jablonski score. ">Data to be extracted: secondary

2016 PROSPERO

131. Gastrointestinal microbleeding in normal subjects receiving acetylsalicylic acid, placebo, and R-803, a new antiinflammatory agent, in a design balanced for residual effects. (Abstract)

Gastrointestinal microbleeding in normal subjects receiving acetylsalicylic acid, placebo, and R-803, a new antiinflammatory agent, in a design balanced for residual effects. This study was undertaken to compare the relative gastrointestinal toxicity of equipotent doses of acetylsalicylic acid (ASA), 900 MG q.i.d., and a new anti-inflammatory agent, R-803, 300 mg q.i.d., against placebo. Gastrointestinal micro-bleeding was quantitated with the 61Cr-labeled erythrocyte assay. The experimental (...) design was balanced for residual effects in the first week following any treatment. An interesting relationship between stool weight and blood loss was found to influence the microbleeding independently of the treatments themselves. All observed blood loss values were corrected by regression to a reference stool weight of 100 Gm. Final analysis of corrected values was done on arithmetic and logarithmic scales. On both scales, R-803 induced much less blood loss than ASA. A difference of 1.3 ml/day

1976 Journal of clinical pharmacology

132. Salicylates and Gastro-intestinal Bleeding Full Text available with Trip Pro

Salicylates and Gastro-intestinal Bleeding 14008184 1998 11 01 2018 12 01 0007-1447 1 5279 1962 Mar 10 British medical journal Br Med J Salicylates and gastrointestinal bleeding. Acetylsalicylic acid and aspirin derivatives. 669-75 WOOD P H PH HARVEY-SMITH E A EA DIXON A S AS eng Journal Article England Br Med J 0372673 0007-1447 0 Salicylates R16CO5Y76E Aspirin OM Aspirin analogs & derivatives Gastrointestinal Hemorrhage etiology Hemorrhage Humans Salicylates ACETYLSALICYLIC ACID/related (...) compounds HEMORRHAGE, GASTROINTESTINAL/etiology 1962 3 10 1962 3 10 0 1 1962 3 10 0 0 ppublish 14008184 PMC1958179 Am J Med. 1961 Aug;31:259-65 13735596 Gastroenterology. 1961 Mar;40:383-8 13709097 Lancet. 1958 Nov 1;2(7053):920-5 13589048 Q J Med. 1961 Apr;30:167-88 13749371 Gastroenterology. 1957 Nov;33(5):770-7 13480417 J Pharmacol Exp Ther. 1957 Aug;120(4):540-5 13476378 Am J Med. 1961 Aug;31:266-78 13784037 N Engl J Med. 1958 Jan 30;258(5):213-9 13504447 Br Med J. 1955 Jul 2;2(4930):7-12 14378624

1962 British medical journal

133. Evaluation of the Efficacy of Low-dose Acetylsalicylic Acid on Diarrhea Induced by Anti-cancer Targeted Therapies.

% versus 77.8%. The frequency of diarrhea was 18.5% (or 5 patients) in the standard group versus 0% in the group with acetylsalicylic acid. Similarly, it was found a reduction in the occurrence of skin rash, 33.3% or 4 patients in the acetylsalicylic acid group versus 74.1% s, 20 patients in the standard group. Finally, in this study, it was not revealed significant differences in terms of response to treatment with gefitinib (37% in the standard group versus 33% in the group treated with aspirin (...) the processing line monotherapy, administered over a period of at least 15 days with continued dosing, with usual care recommendations; Diarrhea grade 1-3 according to NCI criteria CTCAE.4, in the absence of complications signs with at least 2 doses of loperamide per day. Exclusion Criteria: Processing acetylsalicylic acid; Allergy or against-indications to acetylsalicylic acid (including concomitant antiplatelet or anticoagulant considered as increasing the risk of bleeding by the investigator) acid

2014 Clinical Trials

134. Clinical, clinicopathologic, and gastrointestinal changes from aspirin, prednisone, or combination treatment in healthy research dogs: A double-blind randomized trial. Full Text available with Trip Pro

trial of dogs administered placebo, aspirin (2 mg/kg q24h), prednisone (2 mg/kg q24h), or combination treatment PO for 28 days. Clinical signs were recorded daily, with laboratory work performed at baseline and day 28. Gastrointestinal mucosal hemorrhages, erosions, and ulcers were numerated for endoscopic studies performed on days 0, 14, and 28; endoscopic mucosal lesion scores were calculated. Results were compared using mixed model repeated-measures analyses of variance and generalized estimating (...) -73.6) and 31.5 times (95% CI, 3.5-288.0) higher odds, respectively, of having endoscopic mucosal lesion scores ≥4 than dogs receiving placebo (P ≤ .01).Gastrointestinal bleeding occurs commonly in dogs administered aspirin, prednisone, or prednisone/aspirin treatment, with higher lesion scores for dogs receiving combination treatment. Even severe lesions are not accompanied by clinical signs.© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf

2019 Journal of Veterinary Internal Medicine Controlled trial quality: predicted high

135. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

Lymphadenopathy 29 Pelvic floor disorders associated with urinary or bowel incontinence 29 Prostate cancer 29 Retroperitoneal conditions 30 Splenic hematoma 30 Splenomegaly 30 Sports hernia (athletic pubalgia) 30 Undescended testicle (cryptorchidism) 31 Imaging of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 4 Nonspecific Signs and Symptoms 31 Abdominal pain 31 Azotemia 32 Lower extremity edema 32 Fever of unknown origin 32 Pelvic pain 32 Weight loss 33 Exclusions 33 (...) Tumor or neoplasm – not otherwise referenced 12 Female Reproductive System and Obstetrics 12 Adenomyosis 12 Adnexal mass 12 Endometriosis 13 Obstetric indications 13 Uterine artery embolization procedures 13 Gastrointestinal Conditions 14 Appendicitis 14 Bowel obstruction 14 Constipation (Pediatric only) 15 Diverticulitis 15 Enteritis and colitis 15 Foreign body (Pediatric only) 16 Gastrointestinal bleeding (Pediatric only) 16 Henoch-Schonlein purpura (Pediatric only) 16 Inflammatory bowel disease

2019 AIM Specialty Health

136. Gastrointestinal blood loss. Effect of aspirin, fenoprofen, and acetaminophen in rheumatoid arthritis as determined by sequential gastroscopy and radioactive fecal markers. (Abstract)

Gastrointestinal blood loss. Effect of aspirin, fenoprofen, and acetaminophen in rheumatoid arthritis as determined by sequential gastroscopy and radioactive fecal markers. The feasibility of determining the exact site and amount of drug-induced gastric bleeding was tested. Fourteen patients with rheumatoid arthritis received equivalent therapeutic doses of the antinflammatory drugs aspirin, 4 gm/day, and fenoprofen calcium, 2.4 gm/day, in randomized order for seven days. Acetaminophen (...) was given for 14 days just prior to each of these periods. By fiberoptic gastroscopy, antral ulceration and acute mucosal lesions were found in seven patients following aspirin ingestion, in one taking fenoprofen, and in none taking acetaminophen. Fecal blood loss in four-day stool collections, quantitated by autologous chromium 51-labeled erythrocytes shed into the stool averaged 5.0 ml/day while taking aspirin, 2.2 ml/day while taking fenoprofen calcium, and 0.8 ml/day while taking acetaminophen

1977 JAMA Controlled trial quality: uncertain

137. Effects (MACE and bleeding events) of ticagrelor combined with omeprazole on patients with acute myocardial infarction undergoing primary PCI. Full Text available with Trip Pro

and control group by the draw, with 43 patients in each group. All patients were routinely treated with dual antiplatelet therapy with aspirin plus ticagrelor. Omeprazole was used in the observation group and placebo was used in the control group. Baseline data of patients, platelet response index (PRI) ADP-induced platelet aggregation (ADP-Ag), major adverse cardiac events (MACE), and incidence of bleeding events were recorded and compared.PRI and ADP-Ag at 7 days, 1 month, and 6 months after operation (...) patients undergoing primary PCI, omeprazole can reduce the incidence of gastrointestinal bleeding without reducing the antiplatelet aggregation effect of ticagrelor or increasing the risk of MACE, which is worthy of clinical promotion.Copyright © 2019 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

2019 Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese Controlled trial quality: uncertain

138. Delayed bleeding of the Transplant Duodenum After Simultaneous Kidney Pancreas Transplantation: Case Series. Full Text available with Trip Pro

, and the resection specimen showed enlarged and congestive submucosal veins in both patients. There was no recurrence of bleeding after re intervention. In the third patient, enteric derivation was not possible because of the extremely fragile intestinal tissue perioperatively and a conservative approach was taken. As possible precipitating factors are concerned, all three of our patients were taking low dose aspirin and/or clopidogrel as secondary cardiovascular prevention.Bleeding of the transplanted donor (...) Delayed bleeding of the Transplant Duodenum After Simultaneous Kidney Pancreas Transplantation: Case Series. In simultaneous pancreas kidney (SPK) transplant recipients, the majority of complications described in the literature, are early postoperative complications. However, there is growing attention for late complications associated with SPK transplantation.In this case series, we present three cases, two enteric and one bladder derived SPK transplant patients, with anastomotic hemorrhage

2019 Transplantation

139. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication

aspirin use is an individual one. Grade: C No recommendation. Grade: I (insufficient evidence) No recommendation. Grade: I (insufficient evidence) Risk Assessment Primary risk factors for CVD are older age, male sex, race/ethnicity, abnormal lipid levels, high blood pressure, diabetes, and smoking. Risk factors for GI bleeding with aspirin use include higher aspirin dose and longer duration of use, history of GI ulcers or upper GI pain, bleeding disorders, renal failure, severe liver disease (...) artery stenosis, coronary heart disease, high blood pressure, lipid disorders, obesity, diabetes, peripheral artery disease, and colorectal cancer. These recommendations are available on the USPSTF Web site ( ) Abbreviations: ACC/AHA=American College of Cardiology/American Heart Association; CVD=cardiovascular disease; GI=gastrointestinal. For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go

2016 U.S. Preventive Services Task Force

140. The Effect of a Probiotic Strain on Aspirin-induced GI Damage.

within endurance sports) Willing to abstain from any other probiotic products and/or medication known to alter gastrointestinal function throughout the participation of the trial Exclusion Criteria: Abdominal surgery which, as judged by the investigator, might affect the GI function (except appendectomy and cholecystectomy) History of peptic ulcer disease Any known bleeding disorder Allergy to Aspirin History of H. pylori disease Resting diastolic blood pressure ≥ 90 mmHg Resting systolic blood (...) or disease Intervention/treatment Phase Side Effects of Acetylsalicylic Acid Use Dietary Supplement: probiotic strain Dietary Supplement: Placebo Phase 2 Detailed Description: The trial includes a run-in period of two weeks duration followed by a six weeks intervention period where a probiotic strain/placebo and Aspirin is co-administered. After the 6 weeks, probiotic strain/placebo is given for two additional weeks to investigate the potential effects of the probiotic strain on intestinal healing after

2017 Clinical Trials

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