Pathophysiology and causes of upper gastrointestinal haemorrhage

2016 ◽  
Author(s):  
Tasneem Pirani ◽  
Tony Rahman
Keyword(s):  
Risk Factors ◽  
Specific Treatment ◽  
Gastrointestinal Haemorrhage ◽  
Treatment Modalities ◽  
Accurate Assessment ◽  
Common Cause ◽  
Ulcer Disease ◽  
Factors Associated ◽  
Risk Patients ◽  
Upper Gastrointestinal

Specific causes for upper gastrointestinal haemorrhage (UGIH) can often be ascertained through accurate history and examination. Causes can be thought of anatomically, as certain pathophysiological processes have a predilection for specific areas of the upper gastrointestinal tract, while other processes are diffuse. Specific treatment modalities exist for certain causes and therefore accurate assessment aids the tailoring of therapy. Peptic ulcer disease (PUD) is the most common cause of UGIH and Helicobacter pylori testing is recommended for all patients diagnosed with PUD. Understanding the risk factors associated with UGIH enables the physician to adopt preventative strategies such as gastric protection for high-risk patients on non-steroidal anti-inflammatory agents.

scholarly journals Role of Helicobacter pylori infection and use of NSAIDs in the etiopathogenesis of upper gastrointestinal bleeding

2007 ◽  
Vol 54 (1) ◽  
pp. 51-62 ◽  
Author(s):  
A. Sokic-Milutinovic ◽  
M.N. Krstic ◽  
D. Popovic ◽  
N.S. Mijalkovic ◽  
S. Djuranovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Aspirin Therapy ◽  
Ulcer Disease ◽  
Bleeding Lesion ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Risk Patients ◽  
Upper Gastrointestinal

Introduction: Non-steroid antiinflammatory drugs (NSAIDs) and Helicobacter pylori (Hp) infection are two most important independent risk factors involved in the etiopathogenesis of gastroduodenal mucosal injury with a clear and critical role in both uncomplicated and complicated peptic ulcer disease. It is estimated that up to 90% of all peptic ulcers result from the effect of one or both of these factors. AIM: To determine the frequency of NSAIDs use and Hp infection in patients with acute upper gastrointestinal bleeding. Patients and methods: Study evaluated data from 500 patients in whom esophagogastroduodenoscopy was performed following presentation in emergency unit with acute upper gastrointestinal bleeding. Anamnestic data was collected together with detailed information on previous salicilates and/or NSAIDs use. Hp status was determined and anatomic localization of bleeding lesion was also registered. Results: Acute upper GIT bleading was caused solely by NSAIDs in 55 (11%), by aspirin in 66 (13.2%), while combined NSAID/aspirin therapy was identified in 19 (3.8%) of patients. In total NSAID and/or aspirin use were diagnosed in 139 (27.8%). while in 122 (24.4%) only Hp infection was diagnosed. Both risk factors were identified in 144 (28.8%) patients (Hp+NSAIDs in 12.2%, Hp+aspirin in 10.8% and Hp+aspirin+NSAIDs in 5.8%) . In 19.8% of the cases (14% of males and 27% of females) neither NSAID/aspirin use nor presence of Hp infection was noted. Out of 500 patients enrolled, 63% were mails. In females, bleeding lesion was most frequently localized in gastric mucosa, while males had equal chance of bleeding from either gastric or duodenal mucosa. Fortunately, only 5 to 7% of patients were bleeding from both gastric and duodenal lesion. Conclusion : Prevention of acute upper gastrointestinal bleeding can be achieved trough strict and limited use of aspirin and NSAIDs, eradication of Hp infection and use of gastroprotective therapy in well-defined risk patients that need chronic NSAIDs and/or aspirin therapy. In all patients starting long-term NSAID and/or aspirin therapy and all patients already on long-term aspirin therapy test and treat strategy for Hp infection should be used. On the other hand, only in high risk patients (more than 65 years, history of peptic ulcer disease, concomitant corticosteroid, aspirin, clopidogrel or warfarin therapy) already on chronic NSAID therapy long-term PPI therapy should be prescribed after testing and treating of Hp infection.

Use of a Multitheoretic Model to Understand and Classify Juvenile Computer Hacking Behavior

2020 ◽  
pp. 009385482096975
Author(s):  
Bryanna Fox ◽  
Thomas J. Holt
Keyword(s):  
Risk Factors ◽  
Latent Class ◽  
National Sample ◽  
Treatment Modalities ◽  
Structural Level ◽  
Factors Associated ◽  
Computer Hacking ◽  
Criminological Inquiry ◽  
Insight Into ◽  
Cross National

Criminological inquiry has identified a range of risk factors associated with juvenile delinquency. However, little research has assessed juvenile computer hacking, despite the substantial harm and opportunities for delinquent behavior online. Therefore, understanding the applicability of criminological risk factors among a cross-national sample of juvenile hackers is important from a theoretical and applied standpoint. This study aimed to address this gap using a logistic regression and latent class analysis (LCA) of risk factors associated with self-reported hacking behavior in a sample of more than 60,000 juveniles from around the globe. Results demonstrated support for individual- and structural-level predictors of delinquency, although distinct risk factors for hacking among three subtypes are identified in the LCA. This study examines criminological risk factors for juvenile hacking in a cross-national sample and provides insight into the distinct risk factors of hacking, so more tailored prevention and treatment modalities can be developed.

scholarly journals Does Preendoscopy Rockall Score Safely Identify Low Risk Patients following Upper Gastrointestinal Haemorrhage?

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Matthew R. Johnston ◽  
Iain A. Murray ◽  
Michael Schultz ◽  
Peter McLeod ◽  
Nathan O’Donnell ◽  
...  
Keyword(s):  
Endoscopic Therapy ◽  
Gastrointestinal Haemorrhage ◽  
Low Risk ◽  
Outpatient Management ◽  
Endoscopic Intervention ◽  
Point Increase ◽  
Risk Patients ◽  
Rebleeding Rate ◽  
Rockall Score ◽  
Upper Gastrointestinal

Objective.To determine if preendoscopy Rockall score (PERS) enables safe outpatient management of New Zealanders with upper gastrointestinal haemorrhage (UGIH).Methods.Retrospective analysis of adults with UGIH over 59 consecutive months. PERS, diagnosis, demographics, need for endoscopic therapy, transfusion or surgery and 30-day mortality and 14-day rebleeding rate, and sensitivity and specificity of PERS for enabling safe discharge preendoscopy were calculated.Results.424 admissions with UGIH. Median age was 74.3 years (range 19–93 years), with 55.1% being males. 30-day mortality was 4.6% and 14-day rebleeding rate was 6.0%. Intervention was required in 181 (46.6%): blood transfusion (147 : 37.9%), endoscopic intervention (75 : 19.3%), and surgery (8 : 2.1%). 42 (10.8%) had PERS = 0 with intervention required in 15 (35.7%). Females more frequently required intervention, OR 1.73 (CI: 1.12–2.69). PERS did not predict intervention but did predict 30-day mortality: each point increase equated to an increase in mortality of OR 1.46 (CI: 1.11–1.92). Taking NSAIDs/aspirin reduced 30-day mortality, OR 0.22 (CI: 0.08–0.60).Conclusion.PERS identifies 10.8% of those with UGIH as low risk but 35.7% required intervention or died. It has a limited role in assessing these patients and should not be used to identify those suitable for outpatient endoscopy.

scholarly journals Incidence and risk factors associated with human albumin administration following total joint arthroplasty: a multicenter retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shaoyun Zhang ◽  
Haibo Si ◽  
Jinwei Xie ◽  
Yuangang Wu ◽  
Qinsheng Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enhanced Recovery ◽  
Human Albumin ◽  
Albumin Level ◽  
Factors Associated ◽  
Patient Demographics ◽  
Colloidal Fluids ◽  
Risk Patients ◽  
Goal Directed Fluid Therapy ◽  
Independent Risk Factors

Abstract Background Enhanced recovery after surgery (ERAS) program advocates implementation of perioperative goal-directed fluid therapy and reduced application of colloidal fluids. It should be used reasonably selectively in high-risk patients despite the clear efficacy of human albumin (HA). Therefore, it is vital to identify the risk factors for the use of HA. This study aims to determine the incidence and risk factors of HA administration in patients undergoing total hip or knee arthroplasty (THA, TKA). Methods We identified patients undergoing THA or TKA in multiple institutions from 2014 to 2016 and collected patient demographics and perioperative variables. The criterion of HA administration was defined as a postoperative albumin level < 32 g/L or 32 to 35 g/L for at-risk patients. We compared 14 variables between patients who received HA administration and those who did not after stratification by the preoperative albumin (pre-ALB) level. Multivariable regressions identified the independent risk factors associated with HA administration. Results In total, 958 (20.3%) of 4713 patients undergoing THA and 410 (9.7%) of 4248 patients undergoing TKA received HA administration. In addition to pre-ALB < 35 g/L, preoperative anemia (odds ratio [OR] 2.12, P = 0.001; OR 1.39, P < 0.001) and drain use (OR 3.33, P = 0.001; OR 4.25, P < 0.001) were also independent risk factors for HA administration after THA regardless pre-ALB < 35 g/L or not, and patients undergoing TKA diagnosed of rheumatoid arthritis or ankylosing spondylitis tended to receive HA administration regardless pre-ALB < 35 g/L or not (OR 3.67, P = 0.002; OR 2.06, P < 0.001). Conclusions The incidence of HA administration was high in patients undergoing THA or TKA, and several variables were risk factors for HA administration. This finding may aid surgeons in preoperatively identifying patients requiring HA administration and optimizing perioperative managements.

scholarly journals Plantar Fasciitis:

2012 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
Suzan M. Attar
Keyword(s):  
Risk Factors ◽  
Effective Treatment ◽  
Clinical Diagnosis ◽  
Plantar Fasciitis ◽  
Treatment Options ◽  
Heel Pain ◽  
Treatment Modalities ◽  
Medical Attention ◽  
Common Cause ◽  
Multiple Treatment

Plantar fasciitis is a common cause of heel pain in adults. It is a clinical diagnosis, as patients classically presents with pain that is particularly severe with the first few steps in the morning. Although it is a self-limited condition; however, due to the severity of the pain, medical attention is sought. Symptoms will ease quicker if risk factors are adjusted and multiple treatment modalities are started as early as possible. This article reviews plantar fasciitis; presents the most effective treatment options currently available.

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