scholarly journals Determination of the Risk of Recurrent Gastroduodenal Ulcer Bleeding

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
I. I. Dutka ◽  
F. V. Grynchuk
Keyword(s):  
Gastroduodenal Ulcer ◽  
Blood Type ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Recurrent Ulcer ◽  
Type B ◽  
Gastroduodenal Ulcer Bleeding ◽  
Type Ab ◽  
Bleeding Ulcers

Despite the advances in endoscopic haemostasis, the incidence of recurrent ulcer bleeding remains to be high. It necessitates further search for its prognosis and methods of treatment.The objective of the research was to analyse risk factors for recurrent gastroduodenal ulcer bleeding.Materials and methods. The study included 203 patients with gastroduodenal ulcer bleeding. There were 135 (66.5%) males and 68 (33.3%) females. All the patients were examined and received conservative treatment according to treatment protocols.Results. Duodenal ulcer was diagnosed in 127 (62.3%) patients, gastric ulcer was found in 68 (33.3%) patients, gastroduodenal ulcer was seen in 9 (4.4%) patients. The recurrence of bleeding was observed in 24 (11.8%) cases. Most cases of recurrent bleeding (n=11 (45.8%) occurred within 2-3 days after the admission. 9 (37.5%) patients developed the recurrence of bleeding later. The lowest number of recurrent bleeding occurred within the first day - 4 (16.7%) cases. The incidence of recurrent bleeding was higher in men rather than in women - 17 (70.8%). Recurrent bleeding was observed in 9 (64.29%) patients with blood type O; 4 (28.57%) patients with blood type A; 1 (7.14%) patient with blood type B; 1 (7.14%) patient with blood type AB. The majority of recurrences (n=15 (62.5%) occurred in patients without ulcer in anamnesis. There was found no clear connection between ulcer location and the rate of recurrent bleeding.Conclusions.The scales of predicting recurrent bleeding that are known today do not consider a number of important clinical and pathogenetic factors as a basis of recurrence.The improvement of the results of treating bleeding ulcers is possible only on the basis of the complex of factors determining the effectiveness of regeneration.

scholarly journals APPLICATION OF MODERN METHODS OF ENDOSCOPIC HАEMOSTASIS IN THE TREATMENT OF GASTRODUODENAL ULCER BLEEDING

2021 ◽  
pp. 81-84
Author(s):  
N. M. Honcharova ◽  
P. V. Svirepo ◽  
A. S. Honcharov
Keyword(s):  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Modern Methods ◽  
Anesthetic Risk ◽  
Gastroduodenal Ulcer Bleeding ◽  
Endoscopic Clipping ◽  
Submucosal Infiltration

Summary. The aim of the study is to improve the results of treatment of patients with ulcerative gastroduodenal bleeding by using the methods of endoscopic hаemostasis. Materials and research methods. The results of endoscopic hаemostasis of 153 patients who were treated in the surgical department of the “Regional Clinical Hospital” were analyzed. Patients were examined clinically, laboratory and instrumental. Results and its discussion. For Forrest 1a, b bleeding, endoscopic clipping was used in 16 (10.4 %) patients with a visualized vessel in the bottom of the ulcer. In the studied patients of this group, there were no relapses of bleeding. Diathermy coagulation was used in 42 (27.5 %) patients. Recurrent bleeding was observed in 6 patients. Submucosal infiltration was performed in 37 (24.2 %) patients with ulcerative bleeding. Repeated bleeding was recorded in 9 patients within the next 3 hours after the intervention and in 7 patients during the first days after endoscopic hаemostasis. Combinations of endoscopic methods of hаemostasis were used in 58 (37.9 %) patients. Conclusions. The use of modern methods of endoscopic hаemostasis followed by adequate pharmacotherapy in most cases allows achieving a final stop of bleeding. Patients with a high risk of recurrent bleeding and a low surgical and anesthetic risk after successful endoscopic hаemostasis are shown surgical intervention before the development of recurrent bleeding.

scholarly journals New technologies of endoscopic hemostasis in a treatment protocol of patients with gastroduodenal ulcer bleeding

2018 ◽  
Vol 11 (1) ◽  
pp. 16-23
Author(s):  
Mikhail N Romantsov ◽  
Eugene F Cherednikov ◽  
Aleksandr Anatolevich Glukhov ◽  
Constantine O Fursov
Keyword(s):  
New Technologies ◽  
Gastroduodenal Ulcer ◽  
Treatment Protocol ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
Medical Setting ◽  
Recurrent Bleeding ◽  
Emergency Operations ◽  
Hemostatic Agents ◽  
Gastroduodenal Ulcer Bleeding

Relevance of research. Acute gastroduodenal bleeding is remaining a difficult and largely unsolved problem up to day. The fundamental importance in treating this category of patients is an endoscopic hemostasis. The decisive point in this problem is the most stable hemostasis and preventing a recurrence of a hemorrhage. In this regard, the search of new solutions and the development of known methods of treatment of the gastroduodenal ulcer bleeding is an important issue.   Aim of research. To evaluate the effectiveness of the treatment protocol of patients with the gastroduodenal ulcer bleeding by applying combined endoscopic insufflations of hemostatic agents and a diovin as an integral part of a complex therapy.   Materials and methods. The research is based on results of treatment of the patients with the gastroduodenal ulcer bleeding being in a medical setting at the departments of surgery at Voronezh city clinical emergency hospital №1. During the treatment of the main group (59 patients) there was used an integrated approach with the usage of powdered hemostatic agents of gelplastan and lyophilisate NovoSeven in combination with diovin in the endoscopic treatment of gastroduodenal ulcer bleeding. There were used the traditional well-known methods of the endoscopic hemostasis without the usage of hemostatic agents and absorbent grains in treatment of the control group (56 patients).   Results and discussion. The evaluation of results of patients’ treatment with gastroduodenal ulcer bleeding was performed according to the figures of the final hemostasis, the frequency of recurrent bleeding, the prevention of emergency operations, the rates of mortality, the duration of hospitalization. The developed protocol of the patients’ treatment with gastroduodenal ulcer bleeding with the usage of combined the endoscopic insufflation of two hemostatics and diovin makes it possible to achieve the maximum persistent hemostasis at 94.9% of patients, to reduce the risk of recurrent hemorrhages by 2.5 times, to prevent emergency operations and, as a result, to reduce the lethality.   Conclusion. The usage  of new technologies of endoscopic hemostasis by the hemostatic pneumoinsufflation  gelplastan and lyophilisate NovoSeven in combination with diovin in the treatment of patients with gastroduodenal ulcer bleeding allows to reduce the risk of recurrent hemorrhage from 12,5% to 5,01% (by 2,5 times), to prevent emergency operations, to reduce the lethality from 3,65% to 1,7% (by 2,1 times) and to reduce the period of staying in the hospital from 10,2 to 7,4 bed days (p<0.05).

scholarly journals Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Istvan Rácz ◽  
Milan Szalai ◽  
Nora Dancs ◽  
Tibor Kárász ◽  
Andrea Szabó ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastroduodenal Ulcer ◽  
Saline Group ◽  
Saline Infusion ◽  
Active Bleeding ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Acute Ulcer ◽  
Gastroduodenal Ulcer Bleeding ◽  
Bleeding Ulcers

The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD) durations of5.45±12.9hours and6.9±13.2hours, respectively (P=0.29). Actively bleeding ulcers were detected in 46/240 (19.2%) of cases in the pantoprazole group as compared with 23/93 (24.7%) in the saline infusion group (P=0.26). Different durations of pantoprazole infusion (0–4 hours,>4 hours, and>6 hours) had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02andP=0.04). Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

scholarly journals Risk Factor Analysis And Method Development For Predicting The Recurrence Of Gastroduodenal Ulcer Bleeding

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Sergey N. Potakhin ◽  
Yuri G. Shapkin
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Prediction Accuracy ◽  
Method Development ◽  
Clinical Laboratory ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Surgical Department ◽  
Gastroduodenal Ulcer Bleeding

Objective — To clarify clinical, laboratory and endoscopic signs of a high recurrence risk of gastroduodenal ulcer bleeding (GDUB) and to develop a multifactorial method for its prediction. Material and Methods — The research was completed over 2019-2020. The study took place in two stages. At the first stage, 409 patients with GDUB, who were treated at the emergency surgical department of Saratov City Clinical Hospital No. 6 from 1991 to 2000, were included in the study. During that time, endoscopic hemostasis therapy was used in a few cases, while modern antisecretory therapy has not yet been developed and carried out. Two groups of patients were compared: with recurrent bleeding (104 patients) and without recurrent bleeding (305 patients). At the second stage, a retrospective analysis of the outcomes of treating 126 patients with GDUB, cared for at the clinic from 2001 to 2009, was carried out. During this period of time, assistance for this pathology was the most complete and matched all current standards. The analysis included 63 patients with recurrent bleeding and 63 patients without recurrent bleeding. We conducted a comparative analysis of the developed method for predicting bleeding recurrence versus the classifications by J.A. Forrest (1974) and G.P. Giderim (1992) in our original modification. Results — At the first stage of the study, the most significant signs for predicting recurrent bleeding were identified as unstable hemodynamics, severity of blood loss, nature of vomiting, presence of concomitant pathology, state of the ulcer surface sensu J.A. Forrest; and localization, size and depth of the ulcer. We determined their informative value in assessing the risk of recurrent bleeding and developed a novel method of its prediction. Taken alone, each of nine predictive signs has a correlation, comparable in the magnitude with patient allocation into each group (based on the absolute value of gamma, ranging 0.49–0.66); the prediction accuracy is 60–74%, with a positive predictive value of 35-49%. The measure of the gamma relationship for splitting patients among groups by the original method based on nine features in conjunction with each other was -0.79 (p<0.001). Conclusion — Prediction of recurrent bleeding by one or two signs is inferior in informational content (although insignificantly) to the multifactorial method. The developed method for predicting the recurrence of ulcer bleeding from nine signs has an optimal ratio of sensitivity and specificity, which ensures a prediction accuracy of over 70% and a positive predictive value of 68.9%.

Machine learning model to predict recurrent ulcer bleeding in patients with history of idiopathic gastroduodenal ulcer bleeding

2019 ◽  
Vol 49 (7) ◽  
pp. 912-918 ◽  
Author(s):  
Grace Lai-Hung Wong ◽  
Andy Jinhua Ma ◽  
Huiqi Deng ◽  
Jessica Yuet-Ling Ching ◽  
Vincent Wai-Sun Wong ◽  
...  
Keyword(s):  
Machine Learning ◽  
Gastroduodenal Ulcer ◽  
Learning Model ◽  
Ulcer Bleeding ◽  
Recurrent Ulcer ◽  
Machine Learning Model ◽  
History Of ◽  
Gastroduodenal Ulcer Bleeding

scholarly journals 322 – Prevention of Recurrent Idiopathic Gastroduodenal Ulcer Bleeding: A 2-Year Double-Blind Randomized Trial (NRT STUDY)

2019 ◽  
Vol 156 (6) ◽  
pp. S-62-S-63
Author(s):  
Louis Ho Shing Lau ◽  
Jessica Y. Ching ◽  
Yee Kit Tse ◽  
Rachel Ling ◽  
Francis K. Chan ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Double Blind ◽  
Gastroduodenal Ulcer Bleeding

Endoscopic Doppler Sonography in gastroduodenal ulcer bleeding

1992 ◽  
Vol 70 (8) ◽  
Author(s):  
D. Jaspersen ◽  
T. K�rner ◽  
J. Wzatek ◽  
W. Schorr ◽  
C.B. Gaster ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Gastroduodenal Ulcer Bleeding

scholarly journals Signalment and Blood Types in Cats Being Evaluated as Blood Donors at Two Italian University Blood Banks

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Eva Spada ◽  
Arianna Miglio ◽  
Daniela Proverbio ◽  
Maria Teresa Antognoni ◽  
Giada Bagnagatti De Giorgi ◽  
...  
Keyword(s):  
Blood Donors ◽  
Type A ◽  
Blood Type ◽  
Transfusion Reaction ◽  
Type B ◽  
Blood Typing ◽  
Blood Types ◽  
Blood Banks ◽  
Type Ab ◽  
Transfusion Reactions

Data from potential feline blood donors presented at two university blood banks in Italy were recorded. Blood typing was performed using an immunochromatographic method. Over the three years of the study 357 cats representing 15 breeds, 45.3% female and 54.7% male, with a mean age of 3.8 years were evaluated. Of these 90.5% were blood type A, 5.6% type B, and 3.9% type AB. The majority of the cats (54.6%) were European DSH (92.3% were type A, 5.1% type B, and 2.6% type AB), and 21% were Maine Coon (MCO) cats (100% blood type A). The estimated frequencies of transfusion reactions following an unmatched transfusion between DSH (donors and recipients), MCO (donor and recipients), DSH donors and MCO recipients, and MCO donors and DSH recipients were 4.8%, 0%, 0%, and 5.1% for major reactions and 7.2%, 0%, 7.7%, and 0% for minor transfusions reactions, respectively. In a population of blood donors that includes DSH and MCO the risk of transfusion reaction is between 5% and 8% if typing is not performed on donor and recipient blood. Blood typing should therefore be performed before transfusion to remove the risk of transfusion reactions due to blood type incompatibilities.

Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial

Gut ◽  
2019 ◽  
Vol 69 (4) ◽  
pp. 652-657 ◽  
Author(s):  
Grace L H Wong ◽  
Louis H S Lau ◽  
Jessica Y L Ching ◽  
Yee-Kit Tse ◽  
Rachel H Y Ling ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Randomised Trial ◽  
Ulcer Bleeding ◽  
Recurrent Ulcer ◽  
Gi Bleeding ◽  
Double Blind ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
History Of ◽  
Bleeding Ulcers

ObjectivePatients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have a considerable risk of recurrent ulcer complications. We hypothesised that a proton pump inhibitor (lansoprazole) is superior to a histamine 2 receptor antagonist (famotidine) for the prevention of recurrent ulcer bleeding in such patients.DesignIn this industry-independent, double-blind, randomised trial, we 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.ResultsBetween 2010 and 2018, we enrolled 228 patients (114 patients in each study group). Recurrent upper GI bleeding occurred in one patient 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.ConclusionThis 2-year, double-blind randomised trial showed that among patients with a history of H. pylori-negative idiopathic ulcer bleeding, recurrent bleeding rates were comparable between users of lansoprazole and famotidine, although a small difference in efficacy cannot be excluded.Trial registration numberNCT01180179; Results.

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