scholarly journals The Impact of Novel Anticoagulants on the Upper Gastrointestinal Tract Mucosa

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 363
Author(s):  
Lubomir Mihalkanin ◽  
Branislav Stancak
Keyword(s):  
Gastrointestinal Tract ◽  
Protective Factor ◽  
Bleeding Risk ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Tract ◽  
Bleeding Detection ◽  
Increased Risk ◽  
Clinically Significant ◽  
The Impact ◽  
Upper Gastrointestinal

Background and objectives: Although treatment with novel oral non-vitamin K antagonist 3anticoagulants (NOACs) is associated with an overall decrease in hemorrhagic complications compared to warfarin, the incidence of gastrointestinal bleeding remains contradictory. Materials and Methods: After the exclusion of patients with pre-existing pathological lesions in the upper gastrointestinal tract (GIT) on esophageal-gastroduodenoscopy (EGD) at entry, a cohort of 80 patients (mean age of 74.8 ± 2.0 years) was randomly divided into four equivalent groups, treated with dabigatran, rivaroxaban, apixaban, or warfarin. Patients were prospectively followed up for three months of treatment, with a focus on anamnestic and endoscopic signs of bleeding. In addition, bleeding risk factors were evaluated. Results: In none of the patients treated with warfarin or NOACs was any serious or clinically significant bleeding recorded within the follow-up period. The incidence of clinical bleeding and endoscopically detected bleeding in the upper GT after three months of treatment was not statistically different among groups (χ2 = 2.8458; p = 0.41608). The presence of Helicobacter pylori (HP) was a risk factor for upper GIT bleeding (p < 0.05), while the use of proton pump inhibitors (PPIs) was a protective factor (p = 0.206; Spearman’s correlation coefficient = 0.205). We did not record any post-biopsy continued bleeding. Conclusions: No significant GIT bleeding was found in any of the treatment groups, so we consider it beneficial to perform routine EGD before the initiation of any anticoagulant therapy in patients with an increased risk of upper GIT bleeding. Detection and eradication of HP as well as preventive PPI treatment may mitigate the occurrence of endoscopic bleeding. Endoscopic biopsy during the NOAC treatment is safe.

W2053 The Impact of Using Different Standardized Meals in the Assessment of Motility of Upper Gastrointestinal Tract

2009 ◽  
Vol 136 (5) ◽  
pp. A-781 ◽  
Author(s):  
Maria C. Bucur ◽  
Whitney Michalek ◽  
Richard McCallum ◽  
Kenneth L. Koch ◽  
Michael D. Sitrin ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
The Impact ◽  
Upper Gastrointestinal

scholarly journals Adenocarcinoma of the Upper Gastrointestinal Tract After Bariatric Surgery. A Review of the Literature.

2020 ◽  
Vol 3 (2) ◽  
pp. 01-03
Author(s):  
Vladimirov M
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Gastrointestinal Tract ◽  
Gastric Carcinoma ◽  
Upper Gastrointestinal Tract ◽  
Review Of The Literature ◽  
Early Diagnostics ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
Upper Gastrointestinal

Obesity is associated with an increased risk of cancer development in the upper gastrointestinal tract. One own case of a female patient with gastric carcinoma after sleeve gastrectomy was the reason to review the literature about the frequency and the genesis of gastric carcinoma after bariatric surgery. Additional to our case 3 further patients with gastric carcinoma after sleeve gastrectomy and 33 patients with carcinomas of the upper gastrointestinal tract after other bariatric operations are reported in the literature. Due to a lack of registry studies the incidence of gastric cancer after bariatric surgery cannot be calculated. Early diagnostics should be performed in symptomatic patients and in patients with unspecific symptoms after bariatric surgery to avoid a delay of the diagnosis of potential carcinomas of the upper gastrointestinal tract.

Malignancies in Giant Cell Arteritis: A Population-based Cohort Study

2019 ◽  
Vol 47 (3) ◽  
pp. 400-406 ◽  
Author(s):  
Pavlos Stamatis ◽  
Carl Turesson ◽  
Minna Willim ◽  
Jan-Åke Nilsson ◽  
Martin Englund ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Population Based ◽  
Upper Gastrointestinal Tract ◽  
Tract Cancer ◽  
Gastrointestinal Tract Cancer ◽  
Background Population ◽  
Increased Risk ◽  
Upper Gastrointestinal

ObjectiveTo investigate the risk of cancer in patients with biopsy-proven giant cell arteritis (GCA) from a defined population in southern Sweden.Methods.The study cohort consisted of 830 patients (mean age at GCA diagnosis was 75.3 yrs, 74% women) diagnosed with biopsy-proven GCA between 1997 and 2010. Temporal artery biopsy results were retrieved from a regional database and reviewed to ascertain GCA diagnosis. The cohort was linked to the Swedish Cancer Registry. The patients were followed from GCA diagnosis until death or December 31, 2013. Incident malignancies registered after GCA diagnosis were studied. Based on data on the first malignancy in each organ system, age- and sex-standardized incidence ratios (SIR) with 95% CI were calculated compared to the background population.Results.One hundred seven patients (13%) were diagnosed with a total of 118 new malignancies after the onset of GCA. The overall risk for cancer after the GCA diagnosis was not increased (SIR 0.98, 95% CI 0.81–1.17). However, there was an increased risk for myeloid leukemia (2.31, 95% CI 1.06–4.39) and a reduced risk for breast cancer (0.33, 95% CI 0.12–0.72) and upper gastrointestinal tract cancer (0.16, 95% 0.004–0.91). Rates of other site-specific cancers were not different from expected.Conclusion.In this Swedish population-based cohort of GCA, the overall risk for cancer was not increased compared to the background population. However, there was an increased risk for leukemia and a decreased risk for breast and upper gastrointestinal tract cancer.

scholarly journals Clinical characteristics and related factors of fungal empyema thoracis

2020 ◽  
Author(s):  
EnJian Zhong ◽  
HuiWen Qian ◽  
ChunQi Hou ◽  
Juan Li ◽  
XueFeng Qian ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gastrointestinal Tract ◽  
Clinical Characteristics ◽  
Positive Culture ◽  
Upper Gastrointestinal Tract ◽  
Empyema Thoracis ◽  
Related Factors ◽  
Tract Perforation ◽  
Increased Risk ◽  
Upper Gastrointestinal

Abstract ObjectData on the characteristics and related factors of fungal empyema thoracis (FET) are limited. Our aim is to investigate the clinical characteristics and related factors of FET.MethodsWe conducted a retrospective study of patients with positive culture from pleural effusion who were admitted to the First Affiliated Hospital of Soochow University between January 2007 and January 2018. The clinical and laboratory characteristics of all study participants were collected. Logistic regression models were used to assess the related factors of FET.ResultsThere were 30 patients diagnosed with FET. The median age of patients with FET was 62.7 years old and 24 (80.0%) were male. The most frequent pathogens of FET were Candida albicans (55.9%). Diabetes mellitus (23.3% vs. 7.9%, P = 0.019) and upper gastrointestinal tract perforation or rupture (20.0% vs. 2.1%, P < 0.001) were associated with increased risk of FET. The adjusted odds ratios (95% confident interval) were 3.11 (1.02–9.56) for diabetes mellitus and 12.71 (3.47–46.55) for upper gastrointestinal tract perforation or rupture. There were 10 deaths (33.3%) among FET patients after one-year of follow-up.ConclusionsDiabetes mellitus and upper gastrointestinal tract perforation or rupture were associated with increased risk of FET.

Sign in / Sign up

Export Citation Format

Share Document