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Immunomodulating Agents in Gastrointestinal Disease
Published in Thomas F. Kresina, Immune Modulating Agents, 2020
Samir A. Shah, Athos Bousvaros, A. Christopher Stevens
The principal adverse effects of MMF are gastrointestinal. Diarrhea, nausea, abdominal distension, gastritis, pancreatitis, and upper gastrointestinal hemorrhage have all been reported. Other reported side effects include headaches, skin rashes, and cramps. As with other agents, opportunistic infections may occur [184–186].
Platelet Disorders Douglas Triplett
Published in Genesio Murano, Rodger L. Bick, Basic Concepts of Hemostasis and Thrombosis, 2019
von Willebrand’s syndrome represents a heterogenous group of patients — genetically, pathophysiologically, and clinically.35 Following von Willebrand’s original description, it quickly became apparent that the frequency of this disorder was greater than that of classic hemophilia A. The clinical picture is dominated by cutaneous and mucosal bleeding, although in the severely affected patients hemarthroses and dissecting intramuscular hematomas may develop.36 Serious hemorrhages due to traumatic injuries or following surgical procedures represent a significant hazard in many patients.37 Early in life, epistaxis is the most common symptom. Bleeding from the gums is also prominent, and shedding of deciduous teeth is often accompanied by troublesome bleeding. Menorrhagia occurs regularly and occasionally patients may have severe post partum hemorrhage, which may be fatal. Gastrointestinal bleeding and hematuria have also been described. Recently, an association between von Willebrand’s syndrome and hereditary hemorrhagic telangiectasia has been emphasized.38 In these patients, gastrointestinal hemorrhage is a prominent clinical feature.
Open hemorrhoidectomy
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
Anemia is an unusual consequence of hemorrhoidal bleeding, but can occur particularly in men in the third and fourth decade. If other causes of gastrointestinal hemorrhage have been excluded, formal hemorrhoidectomy is appropriate.
Efficacy and safety of thrombopoietin receptor agonists in children and adults with persistent and chronic immune thrombocytopenia: a meta-analysis
Published in Expert Opinion on Pharmacotherapy, 2023
Ting Li, Qinqin Liu, Ting Pu, Jing Liu, Aijun Zhang
Regarding the safety of TPO-RAs, the results showed that the incidence of any adverse events and serious adverse events among adult patients who received TPO-RAs was the same as that in the placebo group. This result is consistent with the results of a meta-analysis by Ahmed et al. [37] Trials in adults showed that major adverse events were mild to moderate in severity. The common treatment-related adverse events in the TPO-RAs group were liver function injury (ALT elevation, AST elevation and unconjugated blood bilirubin elevation), nasopharyngitis, nausea and vomiting, fatigue, headache and epistaxis. The reported serious adverse events were severe organ bleeding and thromboembolic events. Severe organ bleeding was mainly hematencephalon and gastrointestinal hemorrhage. A total of 16 drug-related thromboembolic events (1.23%) were reported in all adult patients, including deep venous thrombosis of the lower extremities, pulmonary embolism and renal venous thrombosis.
Comparison of Image-Guided Iodine-125 Seed Interstitial Brachytherapy and Local Chemotherapy Perfusion in Treatment of Advanced Pancreatic Cancer
Published in Journal of Investigative Surgery, 2022
Li Zhou, Hui Yang, Linjun Xie, Jiantong Sun, Jun Qian, Lifei Zhu
In iodine-125 patients, gastrointestinal hemorrhage was found in 1 case and was cured by hemostasis and symptomatic support treatment. Particle displacement was found in 8 (9.53%) cases of patients, however didn’t influence the patients. The levels of amylase in blood and urine were elevated in 27 (32.14%) cases of patients, which was cured by symptomatic treatment. In chemotherapy perfusion patients, nausea and vomiting were found in 59 (72.84%) cases, and WBC reduction and renal dysfunction were found in 14 (17.28%) cases, which was cured by symptomatic treatment. No infection, pancreatic fistula, biliary fistula, intestinal fistula, gastrointestinal obstruction or radiation enteritis was found in both groups. The survival analysis by K-M curve showed the iodine-125 patients (mortality rate 60 (71.43%), median survival time 9.5 months) had longer 1-year overall survival time than the chemotherapy perfusion group (mortality rate 62 (77.50%), median survival time 7.00 months) (p < 0.05, Figure 4).
Long term outcomes of sporadic large fundic gland polyps: a single-center experience
Published in Scandinavian Journal of Gastroenterology, 2021
Abdul Mohammed, Rajat Garg, Sushrut Trakroo, Amandeep Singh, Madhusudhan R. Sanaka
We observed large sporadic FGPs predominantly in women (75.8%) between 50 and 70 years of age, consistent with existing literature [8]. The average BMI of our patient population was 31.6, indicating obesity can be a potential risk factor in the development of large FGPs. Reflux (61.1%) was the most common symptom, followed by abdominal pain and dysphagia. Sporadic FGPs are generally benign without any characteristic symptomatology. There is no direct correlation between reflux symptoms and FGPs. Its relation to PPI use likely explains the high prevalence of reflux-like symptoms. Sporadic FGPs may be single or multiple, usually fewer than ten but occasionally more than 50. They are usually found in the fundus or body of the stomach. The size of the polyp does not appear to influence its location. We observed multiple large polyps predominantly in the body and fundus of the stomach as well. The number of polyps did not affect patient outcomes. Hence, in the absence of dysplasia, the presence of multiple large polyps on endoscopy is not a cause for concern and should not prompt any further evaluation. Further, large polyps were also not associated with any active bleeding or bleeding stigmata. This finding is significant when evaluating patients for sources of upper gastrointestinal hemorrhage. Bleeding should not be attributed to the presence of large FGPs, and other sources of bleeding must be considered.