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[PMID]:28082800
[Au] Autor:Lué A; Lanas A
[Ad] Endereço:Alberto Lué, Angel Lanas, Digestive Diseases Service, University Clinic Hospital Lozano Blesa, Avenida San Juan Bosco, 50009 Zaragoza, Spain.
[Ti] Título:Protons pump inhibitor treatment and lower gastrointestinal bleeding: Balancing risks and benefits.
[So] Source:World J Gastroenterol;22(48):10477-10481, 2016 Dec 28.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Proton pump inhibitors (PPIs) represent a milestone in the treatment of acid-related diseases, and are the mainstay in preventing upper gastrointestinal bleeding in high-risk patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin. However, this beneficial effect does not extend to the lower gastrointestinal tract. PPIs do not prevent NSAID or aspirin-associated lower gastrointestinal bleeding (LGB). PPIs may increase both small bowel injury related to NSAIDs and low-dose aspirin treatment and the risk of LGB. Recent studies suggested that altering intestinal microbiota by PPIs may be involved in the pathogenesis of NSAID-enteropathy. An increase in LGB hospitalization rates may occur more frequently in older patients with more comorbidities and are associated with high hospital resource utilization, longer hospitalization, and increased mortality. Preventive strategies for NSAID and aspirin-associated gastrointestinal bleeding should be directed toward preventing both upper and lower gastrointestinal damage. Future research should be directed toward identifying patients at low-risk for gastrointestinal events associated with the use of NSAIDs or aspirin to avoid inappropriate PPI prescribing. Alternatively, the efficacy of new pharmacologic strategies should be evaluated in high-risk groups, with the aim of reducing the risk of both upper and lower gastrointestinal bleeding in these patients.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/efeitos adversos
Hemorragia Gastrointestinal/prevenção & controle
Probióticos/uso terapêutico
Inibidores da Bomba de Prótons/efeitos adversos
Inibidores da Bomba de Prótons/uso terapêutico
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Anti-Inflamatórios não Esteroides/uso terapêutico
Anticoagulantes/efeitos adversos
Anticoagulantes/uso terapêutico
Aspirina/administração & dosagem
Aspirina/efeitos adversos
Aspirina/uso terapêutico
Hemorragia Gastrointestinal/induzido quimicamente
Microbioma Gastrointestinal/efeitos dos fármacos
Seres Humanos
Prescrição Inadequada/prevenção & controle
Trato Gastrointestinal Inferior/efeitos dos fármacos
Medição de Risco
Fatores de Risco
Trato Gastrointestinal Superior/efeitos dos fármacos
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Anticoagulants); 0 (Proton Pump Inhibitors); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170114
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v22.i48.10477


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[PMID]:28019112
[Au] Autor:Gönczi L; Kürti Z; Golovics P; Végh Z; Lovász B; Dorkó A; Seres A; Sümegi L; Menyhárt O; Kiss L; Papp J; Gecse K; Lakatos PL
[Ad] Endereço:I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Korányi Sándor u. 2/A, 1083.
[Ti] Título:[Indications, diagnoses and quality markers in upper and lower endoscopies in 2010 and 2011 at the 1st Department of Medicine, Semmelweis University, Budapest].
[Ti] Título:A felso és alsó endoszkópiák indikációja, a diagnózisok megoszlása és minoségi mutatók 2010­2011-ben a Semmelweis Egyetem I. Belgyógyászati Klinikáján..
[So] Source:Orv Hetil;157(52):2074-2081, 2016 Dec.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Ab] Resumo:INTRODUCTION AND AIM: The aim was to assess the incidence of endoscopic findings based on the indication of the procedures in upper/lower endoscopies, and measuring quality indicators of colonoscopies at the 1st Department of Medicine, Semmelweis University, Budapest. METHOD: Data of 2987 patients (male/female:1361/1626, mean age: 60.7 years(y), SD: 16.7y) between 01.01.2010 and 31.12.2011 were analyzed. Both inpatient and outpatient records were collected. RESULTS: Incidence of peptic ulcer disease, esophageal varices, gastric polyps and gastric cancer were 10.8%, 4.5%, 6.1%, 2.9% in upper endoscopies, respectively. In colonoscopies colorectal polyps, diverticulosis, colorectal cancer and IBD were found in 29.9%, 22.4%, 6.9%, 9.7%, respectively. In patients having upper endoscopy with GI bleeding indication, older age (p<0.001), male gender (p<0.001, OR: 1.64), acenocoumarol/heparin use (p<0,001, peptic ulcers and esophageal varices were more frequent (p<0.001, OR: 2.83 and p<0.001, OR: 2.79), while in colonoscopies colorectal cancer had higher incidence (p<0.001, OR:3.27). 81% of colonoscopies were complete. Causes of incomplete procedures were ineffective bowel preparation (38.2%), technical difficulties (25.1%) and strictures (20.5%). CONCLUSION: The endoscopic findings and quality indicators (adenoma detection rate, coecal intubation rate) were in line with that reported in published series. Orv. Hetil., 2016, 157(52), 2074-2081.
[Mh] Termos MeSH primário: Endoscopia Gastrointestinal/métodos
Gastroenteropatias/diagnóstico
Trato Gastrointestinal Inferior/diagnóstico por imagem
Trato Gastrointestinal Superior/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Endoscopia Gastrointestinal/estatística & dados numéricos
Feminino
Hemorragia Gastrointestinal/diagnóstico
Neoplasias Gastrointestinais/diagnóstico
Seres Humanos
Hungria
Pólipos Intestinais/diagnóstico
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161227
[St] Status:MEDLINE
[do] DOI:10.1556/650.2016.30602


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[PMID]:27783401
[Au] Autor:Andy UU; Vaughan CP; Burgio KL; Alli FM; Goode PS; Markland AD
[Ad] Endereço:Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults.
[So] Source:J Am Geriatr Soc;64(11):e183-e188, 2016 Nov.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To estimate the prevalence of constipation, fecal incontinence (FI), and combined symptoms and to identify shared factors associated with bowel symptoms in older U.S. men and women DESIGN: Population-based cross-sectional study. SETTING: National Health and Nutrition Examination Survey (2005-2010). PARTICIPANTS: Women and men aged 50 and older. MEASUREMENTS: Constipation was defined as hard stool consistency on the validated Bristol Stool Form Scale or stool frequency of fewer than three bowel movements per week. FI was defined as at least monthly loss of solid, liquid, or mucus stool. Combined symptoms was defined as constipation and FI. Multinomial multivarible models adjusted for age, race, socioeconomic status, education, self-rated health, depression, impairments in activities of daily living, and number of comorbidities. RESULTS: Women (n = 3,078) reported higher prevalence of bowel symptoms than men (constipation 11.8% vs 4.7%%, FI 11.2% vs 8.6%, combined symptoms 1.4% vs 0.4%). In adjusted models, women had greater odds of having constipation (odds ratio (OR) = 3.0, 95% confidence interval (CI) = 2.3-3.8), FI (OR = 1.4, 95% CI = 1.1-1.8), and combined symptoms (OR = 4.6, 95% CI = 2.0-10.2) than men. Shared risk factors included poor self-rated health and depression symptoms (constipation: OR = 1.8, 95% CI = 1.4-2.4 and OR = 1.8, 95% CI = 1.0-3.2; FI: OR = 1.6, 95% CI = 1.2-2.2 and OR = 2.3 95% CI = 1.4-3.6; combined symptoms: OR = 2.6 95% CI = 1.5-4.8 and OR = 4.6, 95% CI = 1.3-16.4). CONCLUSION: When defining constipation and FI using validated instruments, women had a much higher prevalence of constipation than men, whereas men had a higher prevalence of FI than constipation. Shared risk factors reflect the negative effect that bowel symptoms have on quality of life.
[Mh] Termos MeSH primário: Constipação Intestinal
Incontinência Fecal
Trato Gastrointestinal Inferior/fisiopatologia
Qualidade de Vida
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Comorbidade
Constipação Intestinal/diagnóstico
Constipação Intestinal/epidemiologia
Constipação Intestinal/fisiopatologia
Constipação Intestinal/psicologia
Incontinência Fecal/diagnóstico
Incontinência Fecal/epidemiologia
Incontinência Fecal/fisiopatologia
Incontinência Fecal/psicologia
Fezes
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos Nutricionais/métodos
Prevalência
Fatores de Risco
Fatores Sexuais
Fatores Socioeconômicos
Avaliação de Sintomas/métodos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161027
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14521


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[PMID]:27601696
[Au] Autor:Balliet A
[Ti] Título:Contrast Osmolality in Neonatal Lower Gastrointestinal Studies: Risk Assessment and Prevention of Acute Kidney Injury.
[So] Source:Radiol Technol;88(1):76-9, 2016 Sep.
[Is] ISSN:1943-5657
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente
Lesão Renal Aguda/prevenção & controle
Compostos de Bário/administração & dosagem
Compostos de Bário/efeitos adversos
Fluoroscopia/efeitos adversos
Iodo/efeitos adversos
Trato Gastrointestinal Inferior/diagnóstico por imagem
[Mh] Termos MeSH secundário: Meios de Contraste/administração & dosagem
Meios de Contraste/efeitos adversos
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Recém-Nascido
Iodo/administração & dosagem
Masculino
Concentração Osmolar
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Barium Compounds); 0 (Contrast Media); 9679TC07X4 (Iodine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160908
[St] Status:MEDLINE


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[PMID]:27472233
[Au] Autor:Marginean EC
[Ad] Endereço:From the Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Título:The Ever-Changing Landscape of Drug-Induced Injury of the Lower Gastrointestinal Tract.
[So] Source:Arch Pathol Lab Med;140(8):748-58, 2016 Aug.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: -There is an ever-growing armamentarium of pharmacologic agents that can cause gastrointestinal (GI) mucosal injury, the most common symptoms being diarrhea, constipation, nausea, and vomiting. These are often self-limiting and without serious sequelae, but some symptoms are of greater concern, like drug-induced mucosal ulceration that can manifest as GI hemorrhage, stricture formation, and even perforation. Histologically, there is significant overlap between drug-induced injuries and various disease entities. A single type of medication may cause multiple patterns of injury, which can involve the entire GI tract or just some parts of it. OBJECTIVE: -To review the most common drug-induced injury patterns affecting the colon, which may be recognized by the surgical pathologist on colonic mucosal biopsies. This review does not address the injuries occurring in the upper GI tract. DATA SOURCES: -A PubMed review of English-language literature, up to December 2015, on drug-induced injury of GI tract was performed. CONCLUSIONS: -There are numerous drugs that damage the colonic mucosa. The most common drugs are included in this review according to their histologic pattern of injury. It is important for the pathologist to keep in mind that a single drug type can induce many histologic patterns of mucosal injury that can mimic many disease entities. Although there are some histologic clues helpful in the diagnosis of drug-induced colonic injury, correlation with clinical history and especially medication history is essential to improve diagnostic accuracy.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/efeitos adversos
Colo/efeitos dos fármacos
Gastroenteropatias/induzido quimicamente
Mucosa Intestinal/efeitos dos fármacos
Trato Gastrointestinal Inferior/efeitos dos fármacos
[Mh] Termos MeSH secundário: Colo/patologia
Constipação Intestinal/induzido quimicamente
Diarreia/induzido quimicamente
Seres Humanos
Mucosa Intestinal/patologia
Trato Gastrointestinal Inferior/patologia
Náusea/induzido quimicamente
Vômito/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160730
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2015-0451-RA


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[PMID]:27469369
[Au] Autor:Hughes PA; Costello SP; Bryant RV; Andrews JM
[Ad] Endereço:Centre for Nutrition and Gastrointestinal Disease, Department of Medicine, University of Adelaide and South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Austr
[Ti] Título:Opioidergic effects on enteric and sensory nerves in the lower GI tract: basic mechanisms and clinical implications.
[So] Source:Am J Physiol Gastrointest Liver Physiol;311(3):G501-13, 2016 Sep 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Opioids are one of the most prescribed drug classes for treating acute pain. However, chronic use is often associated with tolerance as well as debilitating side effects, including nausea and dependence, which are mediated by the central nervous system, as well as constipation emerging from effects on the enteric nervous system. These gastrointestinal (GI) side effects limit the usefulness of opioids in treating pain in many patients. Understanding the mechanism(s) of action of opioids on the nervous system that shows clinical benefit as well as those that have unwanted effects is critical for the improvement of opioid drugs. The opioidergic system comprises three classical receptors (µ, δ, κ) and a nonclassical receptor (nociceptin), and each of these receptors is expressed to varying extents by the enteric and intestinal extrinsic sensory afferent nerves. The purpose of this review is to discuss the role that the opioidergic system has on enteric and extrinsic afferent nerves in the lower GI tract in health and diseases of the lower GI tract, particularly inflammatory bowel disease and irritable bowel syndrome, and the implications of opioid treatment on clinical outcomes. Consideration is also given to emerging developments in our understanding of the immune system as a novel source of endogenous opioids and the mechanisms underlying opioid tolerance, including the potential influence of opioid receptor splice variants and heteromeric complexes.
[Mh] Termos MeSH primário: Analgésicos Opioides/farmacologia
Gastroenteropatias/tratamento farmacológico
Trato Gastrointestinal Inferior/inervação
Receptores Opioides/metabolismo
[Mh] Termos MeSH secundário: Analgesia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Receptors, Opioid)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160730
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00442.2015


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[PMID]:27401609
[Au] Autor:Payen T; Palermo CF; Sastra SA; Chen H; Han Y; Olive KP; Konofagou EE
[Ad] Endereço:Biomedical Engineering, Columbia University, USA.
[Ti] Título:Elasticity mapping of murine abdominal organs in vivo using harmonic motion imaging (HMI).
[So] Source:Phys Med Biol;61(15):5741-54, 2016 Aug 07.
[Is] ISSN:1361-6560
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Recently, ultrasonic imaging of soft tissue mechanics has been increasingly studied to image otherwise undetectable pathologies. However, many underlying mechanisms of tissue stiffening remain unknown, requiring small animal studies and adapted elasticity mapping techniques. Harmonic motion imaging (HMI) assesses tissue viscoelasticity by inducing localized oscillation from a periodic acoustic radiation force. The objective of this study was to evaluate the feasibility of HMI for in vivo elasticity mapping of abdominal organs in small animals. Pathological cases, i.e. chronic pancreatitis and pancreatic cancer, were also studied in vivo to assess the capability of HMI for detection of the change in mechanical properties. A 4.5 MHz focused ultrasound transducer (FUS) generated an amplitude-modulated beam resulting in 50 Hz harmonic tissue oscillations at its focus. Axial tissue displacement was estimated using 1D-cross-correlation of RF signals acquired with a 7.8 MHz diagnostic transducer confocally aligned with the FUS. In vitro results in canine liver and kidney showed the correlation between HMI displacement and Young's moduli measured by rheometry compression testing. HMI was capable of providing reproducible elasticity maps of the mouse abdominal region in vivo allowing the identification of, from stiffest to softest, the murine kidney, pancreas, liver, and spleen. Finally, pancreata affected by pancreatitis and pancreatic cancer showed HMI displacements 1.7 and 2.2 times lower than in the control case, respectively, indicating higher stiffness. The HMI displacement amplitude was correlated with the extent of fibrosis as well as detecting the very onset of stiffening even before fibrosis could be detected on H&E. This work shows that HMI can produce reliable elasticity maps of mouse abdominal region in vivo, thus providing a potentially critical tool to assess pathologies affecting organ elasticity.
[Mh] Termos MeSH primário: Abdome/diagnóstico por imagem
Técnicas de Imagem por Elasticidade/métodos
[Mh] Termos MeSH secundário: Animais
Cães
Módulo de Elasticidade
Técnicas de Imagem por Elasticidade/instrumentação
Rim/diagnóstico por imagem
Fígado/diagnóstico por imagem
Trato Gastrointestinal Inferior/diagnóstico por imagem
Camundongos
Movimento (Física)
Transdutores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160713
[St] Status:MEDLINE
[do] DOI:10.1088/0031-9155/61/15/5741


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[PMID]:27340195
[Au] Autor:Hidding JT; Viehoff PB; Beurskens CH; van Laarhoven HW; Nijhuis-van der Sanden MW; van der Wees PJ
[Ad] Endereço:J.T. Hidding, PT, MSc, Department of Orthopedics, Section of Physical Therapy, Radboud University Medical Center, Geert Groteplein Noord 21, Nijmegen 6525 EZ, the Netherlands, and Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (I
[Ti] Título:Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review.
[So] Source:Phys Ther;96(12):1965-1981, 2016 Dec.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. PURPOSE: The purpose of this study was to provide best evidence regarding which measurement instruments are most appropriate in measuring lymphedema in its different stages. DATA SOURCES: The PubMed and Web of Science databases were used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. STUDY SELECTION: Clinical studies on measurement instruments assessing lymphedema were reviewed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) scoring instrument for quality assessment. DATA EXTRACTION: Data on reliability, concurrent validity, convergent validity, sensitivity, specificity, applicability, and costs were extracted. DATA SYNTHESIS: Pooled data showed good intrarater intraclass correlation coefficients (ICCs) (.89) for bioimpedance spectroscopy (BIS) in the lower extremities and high intrarater and interrater ICCs for water volumetry, tape measurement, and perometry (.98-.99) in the upper extremities. In the upper extremities, the standard error of measurement was 3.6% (σ=0.7%) for water volumetry, 5.6% (σ=2.1%) for perometry, and 6.6% (σ=2.6%) for tape measurement. Sensitivity of tape measurement in the upper extremities, using different cutoff points, varied from 0.73 to 0.90, and specificity values varied from 0.72 to 0.78. LIMITATIONS: No uniform definition of lymphedema was available, and a gold standard as a reference test was lacking. Items concerning risk of bias were study design, patient selection, description of lymphedema, blinding of test outcomes, and number of included participants. CONCLUSIONS: Measurement instruments with evidence for good reliability and validity were BIS, water volumetry, tape measurement, and perometry, where BIS can detect alterations in extracellular fluid in stage 1 lymphedema and the other measurement instruments can detect alterations in volume starting from stage 2. In research, water volumetry is indicated as a reference test for measuring lymphedema in the upper extremities.
[Mh] Termos MeSH primário: Antropometria/métodos
Linfedema/diagnóstico
[Mh] Termos MeSH secundário: Antropometria/instrumentação
Água Corporal
Impedância Elétrica
Seres Humanos
Trato Gastrointestinal Inferior
Variações Dependentes do Observador
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Extremidade Superior
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170503
[Lr] Data última revisão:
170503
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160625
[St] Status:MEDLINE


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[PMID]:27016165
[Au] Autor:Qayed E; Dagar G; Nanchal RS
[Ad] Endereço:Grady Memorial Hospital, Emory University School of Medicine, 49 Jesse Hill Junior Drive, Atlanta, GA 30303, USA.
[Ti] Título:Lower Gastrointestinal Hemorrhage.
[So] Source:Crit Care Clin;32(2):241-54, 2016 Apr.
[Is] ISSN:1557-8232
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Lower gastrointestinal bleeding (LGIB) is a frequent reason for hospitalization especially in the elderly. Patients with LGIB are frequently admitted to the intensive care unit and may require transfusion of packed red blood cells and other blood products especially in the setting of coagulopathy. Colonoscopy is often performed to localize the source of bleeding and to provide therapeutic measures. LGIB may present as an acute life-threatening event or as a chronic insidious condition manifesting as iron deficiency anemia and positivity for fecal occult blood. This article discusses the presentation, diagnosis, and management of LGIB with a focus on conditions that present with acute blood loss.
[Mh] Termos MeSH primário: Transfusão de Sangue
Hemorragia Gastrointestinal/diagnóstico
Hemorragia Gastrointestinal/terapia
Trato Gastrointestinal Inferior/diagnóstico por imagem
[Mh] Termos MeSH secundário: Colonoscopia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170110
[Lr] Data última revisão:
170110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160327
[St] Status:MEDLINE


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[PMID]:26960997
[Au] Autor:Bosmans JW; Moossdorff M; Al-Taher M; van Beek L; Derikx JP; Bouvy ND
[Ad] Endereço:Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands. ac.bosmans@maastrichtuniversity.nl.
[Ti] Título:International consensus statement regarding the use of animal models for research on anastomoses in the lower gastrointestinal tract.
[So] Source:Int J Colorectal Dis;31(5):1021-30, 2016 May.
[Is] ISSN:1432-1262
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This project aimed to reach consensus on the most appropriate animal models and outcome measures in research on anastomoses in the lower gastrointestinal tract (GIT). The physiology of anastomotic healing remains an important research topic in gastrointestinal surgery. Recent results from experimental studies are limited with regard to comparability and clinical translation. METHODS: PubMed and EMBASE were searched for experimental studies investigating anastomotic healing in the lower GIT published between January 1, 2000 and December 31, 2014 to assess currently used models. All corresponding authors were invited for a Delphi-based analysis that consisted of two online survey rounds followed by a final online recommendation survey to reach consensus on the discussed topics. RESULTS: Two hundred seventy-seven original articles were retrieved and 167 articles were included in the systematic review. Mice, rats, rabbits, pigs, and dogs are currently being used as animal models, with a large variety in surgical techniques and outcome measures. Forty-four corresponding authors participated in the Delphi analysis. In the first two rounds, 39/44 and 35/39 participants completed the survey. In the final meeting, 35 experts reached consensus on 76/122 items in six categories. Mouse, rat, and pig are considered appropriate animal models; rabbit and dog should be abandoned in research regarding bowel anastomoses. ARRIVE guidelines should be followed more strictly. CONCLUSIONS: Consensus was reached on several recommendations for the use of animal models and outcome measurements in research on anastomoses of the lower GIT. Future research should take these suggestions into account to facilitate comparison and clinical translation of results.
[Mh] Termos MeSH primário: Pesquisa Biomédica
Consenso
Internacionalidade
Trato Gastrointestinal Inferior/cirurgia
[Mh] Termos MeSH secundário: Anastomose Cirúrgica/efeitos adversos
Animais
Modelos Animais de Doenças
Complicações Pós-Operatórias/etiologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170104
[Lr] Data última revisão:
170104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160311
[St] Status:MEDLINE
[do] DOI:10.1007/s00384-016-2550-5



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