Academic literature on the topic 'Ren Gi Hospital'
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Journal articles on the topic "Ren Gi Hospital"
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McCahill, Laurence E., Sunil Konduri, Alan T. Davis, Mary May, Coralyn Martinez, Wendy K. Taylor, and Gerald P. Wright. "Quality of gastrointestinal cancer care at a community hospital under the paradigm of multidisciplinary care." Journal of Clinical Oncology 30, no. 4_suppl (February 1, 2012): 133. http://dx.doi.org/10.1200/jco.2012.30.4_suppl.133.
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133 Background: Benefits of MDC have been established for other cancers but not GI malignancies. Benefits of GI NDC cancer care for underserved populations is yet to be quantified. Our GI-MDC was established to provide efficient, evidenced-based, high quality cancer care to patients of all ethnic and socioeconomic backgrounds. Methods: We prospectively identified underserved patients in seven categories. A GI nurse navigator (NN) contacted patients, coordinated appointments /diagnostic studies and prepared for prospective case evaluation and weekly multidisciplinary GI clinic. Health care efficiency/quality data was abstracted by an R.N. quality analyst. Outcomes were compared between underserved and non-underserved populations. Percentages were compared using Chi square and medians by Mann-Whitney U test. Results: From Jan 2010-July 2011, 208 patients were evaluated, with 137 confirmed new cancers, clinically estimated as Stage I=31, II=30, III=26, and IV=47. Among underserved patients, categories included age >80(n=26), public aid (n=28), uninsured (n=12), mental disability/impairment (n=15), incarcerated/institutionalized (n=4), and language barrier (n=2), more then one category could be selected. Outcomes are listed in the Table. Conclusions: A model of GI cancer care including a GI NN, treatment planning conference, and MDC clinic is feasible in a community cancer center. Preliminary data demonstrates small differences between underserved and non underserved patient populations. This model of health care may help to reduce disparities in cancer care. [Table: see text]
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BAWANY, MUHAMMAD ADNAN, JAHANGIR LIAQUAT, MUHMMAD AKBER, Falak Naz, Shereen Rahat Khanzada, Adnan Ali Khahro, and Saeed Arain. "CIRRHOTIC PATIENTS;." Professional Medical Journal 20, no. 06 (December 15, 2013): 876–81. http://dx.doi.org/10.29309/tpmj/2013.20.06.1732.
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Objective: To determine the frequency of upper GI bleeding and its predicting factors and esophageal varices in the patientswith liver cirrhosis disease admitted at medicine ward of Isra university hospital. Design: Prospective and observational study. Setting:Isra university hospital. Period: March 2012 to August 2012 (six months). Methods: Containing 100 patients, mean age was 45.8, and allthe patients with cirrhosis disease were included in this study with liver cirrhosis disease. All patients were under went endoscopy andFrequency of upper GI bleeding and varices presentation and classification according to grade were noted. Results: All the 100 patientswere selected on the basis of presenting liver cirrhosis disease. Male were more found than the female with the mean age 45.8. Mostlycirrhotic patients were found with HCV positive and upper GI bleeding were noted in (40%) of the cases. With the endoscopic findingmostly patients were noted in ll - lll grad of esophageal varices and according to child pug classification majority of patients was noted inclass “C” In addition, thrombocytopenia and red wale markings along with the presence of large sized varices were associated with thepresence of esophageal varices. Conclusions: In the conclusion of this study we found majority of the cirrhotic patients with HCV,Esophageal varices and thrombocytopenia are the important factors of upper GI bleeding. Knowledge and etiology of this manuscript mayhelpful in the prevention of oesophageal varices and upper GI bleeding.
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Snelling, S., R. Ghaffar, and ST Ward. "CT angiograms for lower GI bleeding: the experience of a large UK teaching hospital." Annals of The Royal College of Surgeons of England 104, no. 2 (February 2022): 100–105. http://dx.doi.org/10.1308/rcsann.2021.0127.
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Introduction The clinical presentation of lower gastrointestinal bleeding (LGIB) is variable in severity, cause and potential investigations. The British Society of Gastroenterology recently published LGIB guidelines, recommending CT angiography (CT-A) for haemodynamically unstable patients, defined by shock index (SI) greater than 1. The aim of this study was to assess the use and role of CT-A in diagnosing LGIB, by assessing the pickup rate of active LGIB defined by contrast extravasation or ‘blush’ and to determine any association between positive CT-A with various patient and clinical characteristics. Methods A retrospective analysis was carried out of 4 years of LGIB admissions. Demographics, inpatient observations and use of blood products were acquired. Vital signs nearest the time of CT-A plus abnormal vital signs preceding imaging were used to calculate SI, Age SI, National Early Warning Score 2 (NEWS2) and Standardised Early Warning Score (SEWS). A consultant gastrointestinal radiologist further reviewed all consultant-reported scans. Results In total, 930 patients were admitted with LGIB. Median age was 71 years and 51% were male; 179 (19.2%) patients received red blood cell transfusion and 93 patients (10%) underwent CT-A, who were older and were likely to be hypotensive and receive red cell transfusions. Following exclusions, 92 CT-As were included in the analysis. Nine (9.8%) were positive. Univariate analysis showed no association between positive CT-A and any scoring system. A multivariate analysis, including age and gender, showed association between both NEWS2 and SEWS scores with positive CT-A. Conclusion In our analysis of the typical LGIB population, CT-A has shown relatively low pick up rate of active bleeding. CT-A clearly has a role in the investigation of LGIB, but selection remains challenging.
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Khoury, Leen, David Hill, Miroslav Kopp, Melissa Panzo, Tushar Bajaj, Carson Schell, Andrew Corrigan, Ryan Rodriguez, and Stephen M. Cohn. "The Natural History of Gastrointestinal Bleeding in Patients without an Obvious Source." American Surgeon 84, no. 8 (August 2018): 1345–49. http://dx.doi.org/10.1177/000313481808400850.
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With the advent of proton pump inhibitors and H. Pylori treatment, the old dogma “the most common cause of lower GI bleeding is upper GI bleeding” may no longer be valid. We sought to determine the most common causes of GI bleeding in patients without an obvious source and their clinical outcomes. We queried our hospital database for GI hemorrhage during 2015, excluding patients with obvious sources such as hematemesis or anal pathology. We collected data from patients with GI bleeding defined as bright red blood per rectum, melena, or a positive fecal occult blood test. The primary endpoints were etiology of GI bleed, amount of transfusions required, and types of interventions performed. Ninety-three patients were admitted with GI bleeding as defined previously: mean age was 74 years and mean hemoglobin was 8.2. Seventy-four per cent received blood transfusions with an average of 2 units transfused per patient; 22 per cent received 3 or more units of blood. The etiology of bleeding was 17 per cent upper GI source, 15 per cent lower GI source, and in 68 per cent, the source remained unknown. Bleeding stopped spontaneously in 86 per cent of patients and 9 per cent died. Endoscopy was performed in 71 per cent, but only 6 per cent underwent therapeutic endoscopic intervention. No patient had surgical or interventional radiologic procedures related to their GI bleed. Gastrointestinal bleeding, without an obvious source on presentation, rarely requires operative intervention or interventional radiologic procedure. Blood transfusions were not predictive of the need for therapeutic endoscopic intervention which was required in only 6 per cent of patients.
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Badiger, Raju H., Santosh Hajare, Ravindra Kantamaneni, Ashray Kole, and Deebanshu. "Etiological profile of patients presenting with lower gastrointestinal bleeding at tertiary care hospital at Belagavi: a cross sectional study." International Journal of Advances in Medicine 4, no. 5 (September 22, 2017): 1429. http://dx.doi.org/10.18203/2349-3933.ijam20174297.
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Background: Lower gastrointestinal bleeding (LGIB) is bleeding arising below the ligament of Treitz. Hemorrhage from the lower gastrointestinal (GI) tract accounts for about 20% of all cases of acute GI bleeding. Lower GI bleeding is that which occurs from the colon, rectum, or anus, and presenting as either hematochezia (bright red blood or red wine color stools) or malena, blood streaking of the stool. The objective of this study was to evaluate the etiological profile of patients presenting with lower gastrointestinal bleeding.Methods: This one-year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2015 to December 2015. The study design was a cross-sectional study. This study was carried out from January 2015 to December 2015. Patients with lower gastro-intestinal bleeding presenting at Department of Medicine and Department of Gastro-enterology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi were studied.Results: In the present study majority of the patients were males with the mean age was 43.82±17.96 years and majority of the patients were married with moderate built and nourishment. As per the occupation majority were housewives followed by students. In the present study diabetes mellitus was the most common medical history reported. Internal haemorrhoids was significantly associated with male sex, student’s profession followed by housewife with mixed diet consumption, the clinical presentations significantly associated with internal haemorrhoids were haematochezia, loss of appetite, tenesmus, passage of mucus in stools, constipation, abdominal pain and vomiting.Conclusions: Internal hemorrhoids is the most common cause followed by ulcerative colitis. Though not common, carcinoma colon, solitary rectal ulcer syndrome, polyp, colonic diverticulosis, ischaemic colitis, non-specific proctitis, and radiation proctitis are the other causes of LGIB.
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Nadeem, Shoket, Kumar Dinesh, Zargar Tasneef, Sahni Bhavna, Sharma Rahul, and Bala Kiran. "Dietary risk factors in gastrointestinal cancers: A case–control study in North India." Journal of Cancer Research and Therapeutics 19, no. 5 (2023): 1385–91. http://dx.doi.org/10.4103/jcrt.jcrt_1830_21.
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ABSTRACT Background: One-third of all cancer deaths are preventable by alterations in diet. Methods: A case control study was conducted in a Regional Cancer Center in North India to evaluate the relationship of diet with selected gastrointestinal cancers. A total of 171 cases, 151 hospital controls, and 167 healthy controls were interviewed using food frequency questionnaire. Data was analyzed using odds ratio with 95% confidence interval and Chi-square test. Results: Two to three times increased risk of GI cancers was observed with hot and salted tea. Alcohol [OR 2.30 (1.32-4)] and smoking [OR (2.77 (1.77-4.33)] emerged as risk factors in healthy controls among whom freshly prepared food had significant protective effect [OR 0.57 (0.37-0.88)]. Sweet tea showed protective effect in hospital and healthy controls (OR 0.33 and 0.26, respectively). NSAIDS was associated with significantly higher risk of GI cancers. Consumption of dietary fibers decreased risk, which was significant for wheat and pulses but insignificant for rice. Vegetables and fruits showed significant protective effect ranging from 20 to 80% while intake of non-vegetarian foods showed significantly higher odds among controls (OR 2.37–13.4). Odds of GI cancer cases having consumed chutneys and pickles were significantly higher in comparison to healthy controls while consumption of dairy products showed protection. Low and medium intake of mixed spices inclusive of curcumin showed protection (OR 0.13 and 0.39, respectively) while intake of red chillies was associated with 2–30 times significantly higher odds. Conclusions: We have been able to generate baseline evidence of association between diet and selected GI cancers to encourage prevention and further research.
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Alam, Md F., AKM S. Kabir, and Md N. Islam. "Endoscopic Findings of Upper Gastrointestinal Diseases at a Tertiary Care Hospital in Dhaka." Journal of Medical Science & Research 24, Number 1 (January 1, 2015): 22–26. http://dx.doi.org/10.47648/jmsr.2015.v2401.04.
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Endoscopic findings help the clinical to give the treatment properly The purpose of the present study was to find out common findings of UGI endoscopy at a tertiary care hospital in Dhaka. This retrospective study was conducted in the Department of Gastroenterology at Holy Family Red Crescent Hospital, Dhaka from 14th October 2009 to 25th June 2013 among all the patients presented with GI symptoms. Endoscopies were documented on a computer-based datasheet. Under topical lidocaine, a Fujinon EG fiber optic Upper GI scope was passed through the mouth of a patient in left lateral position through the upper esophageal sphincter into the esophagus stomach and duodenum. Biopsies were collected and histopathology reports were recorded A total number of 2632 patients were recruited for this study and endoscopy was done of which 1406(53.4%) cases were reported as abnormal findings. Male (52.1%) was predominant than female (47.9%). Maximum patients were diagnosed as peptic ulcer disease (54.2%) followed by varices with or without gastropathy (20.04, gastric cancer (11.5%), esophageal cancer (9.6%) and gastritis with or without duodenitis which were 267cases, 154cases, 128cases and 63(4.7%) cases respectively. The most common cause of UGI bleeding was due to PUD (43.1%) followed by varices (34.7%), Gastric cancer (12.5%). The most common endoscopic findings are the PUD, varices with or without gastropathy, gastric cancer, esophageal cancer and gastritis with or without duodenitis.
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Khoury, Leen, Patrick Tobin-Schnittger, Nicholas Champion, Vasiliy Sim, Asaf Gave, Samuel Hawkins, Melissa Panzo, and Stephen Cohn. "Natural History of Patients Undergoing Therapeutic Endoscopies for Acute Gastrointestinal Bleeding." American Surgeon 85, no. 11 (November 2019): 1246–52. http://dx.doi.org/10.1177/000313481908501131.
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When endoscopy is performed for acute GI bleeding, therapeutic endoscopic procedures are infrequently required (only 6% of cases). We sought to determine the natural history of GI hemorrhage in patients who have undergone therapeutic endoscopy. We queried our hospital database for inpatients with acute GI bleeding who underwent therapeutic endoscopy between 2015 and 2017. The primary endpoints were recurrence of bleeding and the subsequent need for repeated endoscopic interventions, angioembolization, or surgery. Demographic information was collected. We reviewed 205 hospitalized patients: mean age was 70 years, 58 per cent were male, and mean hemoglobin was 9 g/dL. Patients had medical conditions predisposing them to bleeding in 59 per cent and history of previous GI bleeding in 37 per cent of cases. Sixty per cent were on antiplatelet/ anticoagulation medications, and 10 per cent were receiving nonsteroidal anti-inflammatory medications. Blood transfusions were given to 78 per cent of patients, with an average of 2.3 units of packed red blood cells transfused per patient before intervention. Recurrence of hemorrhage after therapeutic endoscopy was seen in 9 per cent of patients. Only 2 per cent underwent a second therapeutic endoscopic procedure, and 5 per cent had surgery or angioembolization (half of these patients then had a further recurrence of bleeding). In total, seven patients died (3%). Recurrence of GI bleeding after therapeutic endoscopies is uncommon (9%). Surgery and angioembolization are not commonly necessary, but when used are only successful in 50 per cent of cases.
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Hawken, James, Amy Knott, Wesam Alsakkaf, Amanda Clark, and Faisal Fayyaz. "Rituximab to the rescue: novel therapy for chronic gastrointestinal bleeding due to angiodysplasia and acquired von Willebrand syndrome." Frontline Gastroenterology 10, no. 4 (January 9, 2019): 434–37. http://dx.doi.org/10.1136/flgastro-2018-101116.
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Identification of acquired von Willebrand syndrome (AVWS) was key to treating a patient with chronic gastrointestinal (GI) bleeding due to angiodysplasia. After exhausting endoscopic and pharmacological options, the patient was successfully treated with rituximab. A 78-year-old man developed chronic GI bleeding from caecal and jejunal angiodysplasia. Red cell transfusion was required weekly despite argon plasma coagulation. A diagnosis of AVWS was made from analysis of clotting factors. Therapies including von Willebrand factor concentrate, thalidomide and tranexamic acid were unsuccessful. With failed endoscopic therapy and no viable surgical option, the patient was given intravenous immunoglobulins (IVIGs). Haemoglobin remained stable from this point. The impact on the patient and hospital of attending for IVIG every 3 weeks necessitated consideration to longer-term therapy. After a single course of rituximab, no further blood products, IVIG or rituximab were required. This case is the first to describe the use of rituximab in AVWS-associated angiodysplasia.
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Jajeh, Ahmad. "Management of Major Bleeding Caused By Rivaroxaban and the Use of Desmopressin." Blood 124, no. 21 (December 6, 2014): 5099. http://dx.doi.org/10.1182/blood.v124.21.5099.5099.
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Abstract Rivaroxaban is a new anticoagulant that is substituted for Coumadin on a large scale in the treatment and prevention of Deep Vein Thrombosis DVT and Pulmonary Embolism PE. It is an oral agent that inhibits Factor Xa. The most attractive attribute of this new anticogulant is the lack of monitoring PT/INR. However, out of many cases put on Rivaroxaban a few reports of major and threatening bleed that could be fatal. Particularly, the the GI bleeding. Unfortunately, no set standard antidote or management is available when such catastrophic bleeds happen. This abstract present our experience with three major bleeding cases that presented with massive GI bleeding. Two are associated with peptic ulcer upon Upper GI endoscopy. Two males and one female age 60, 71 (males) and 71 (female). The first two patients were treated with Prothrombin complex product. The female patient presented with sever anemia of 4 grams of Hb with hematemesis and bright red blood per rectum. The Prothrombin complex product was not readly available . She was given multipe doses of Fresh Frozen Plasma FFP and multiple units of packed red blood cells. She was also given a product Profilnine which contains Factor II, IX and VII. Patient's coagulation profile of PTT, PT and Thrombin time were corrected. However, she continue to have bright blood per NG suction. Upon receiving D-DAVP Desmopressin 0.3 micrograms per Kg she stopped bleeding and EGD was done later with sclerosing treatment of gastric ulcer and ligation. Patient was given later a small dose of Prothrombine complex when was available since the last dose of Rivaroxaban was given less than 13 hours from her presentation to the hospital. All of the mentioned patients had prolongation of PT/INR/PTT at presentation. Thrombin time was monitored in all of them. All patients had survived the magor GI bleeding. D-DAVP were given to all of them. In conclusion D-DAVP Desmopressin should be considered as an adjuvant drug in patient presentong with major GI bleeding secondary to Rivaroxaban. Disclosures No relevant conflicts of interest to declare.