This review evaluates the evidence for the use of over-the-scope clips (OTSC), topical haemostatic agents (THA), and prophylactic embolisation (PE) in patients with peptic ulcer bleeding (PUB). The use of OTSC and THA may have the potential to increase the rate of endoscopic haemostasis in PUB not responding to conventional endoscopic treatment. In patients at high risk of recurrent bleeding, the performance of PE after achieving endoscopic haemostasis can reduce the risk of rebleeding and the need for surgery.
View Article and Find Full Text PDFThe randomised clinical trial is the most reliable study design to compare the effects of different interventions, however, the methodological quality of randomised clinical trials varies. In this review, the central considerations for critically appraising a randomised clinical trial are described along with an example, terminological references, description of design variants and reporting guidelines and appraisal tools. This review aims at helping clinicians and other users of randomised clinical trials to assess the trustworthiness and relevance of trial results for their own practice.
View Article and Find Full Text PDFMany scoring systems have been developed to predict various outcomes in patients with upper gastrointestinal bleeding (UGIB) including need-for-intervention, endoscopy, transfusion and/or death. This review summarises the present knowledge of the various scoring systems. It has been impossible to develop one score to predict all outcomes of interest.
View Article and Find Full Text PDFUnlabelled: Upper gastrointestinal bleeding is a feared complication of using non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin. Studies predicting the incidence rate for individuals with a given set of characteristics are lacking. The aim of this study was to develop a risk model to predict the incidence rate of upper gastrointestinal bleeding (UGIB) in users of aspirin/NSAID based on presence of well-defined risk factors for the individual patient.
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