Intensivists are regularly confronted with the question of gastrointestinal bleeding. To date, the latest international recommendations regarding prevention and treatment for gastrointestinal bleeding lack a specific approach to the critically ill patients. We present recommendations for management by the intensivist of gastrointestinal bleeding in adults and children, developed with the GRADE system by an experts group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF), with the participation of the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP), the French Society of Emergency Medicine (SFMU), the French Society of Gastroenterology (SNFGE), and the French Society of Digestive Endoscopy (SFED). The recommendations cover five fields of application: management of gastrointestinal bleeding before endoscopic diagnosis, treatment of upper gastrointestinal bleeding unrelated to portal hypertension, treatment of upper gastrointestinal bleeding related to portal hypertension, management of presumed lower gastrointestinal bleeding, and prevention of upper gastrointestinal bleeding in intensive care.
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http://dx.doi.org/10.1186/2110-5820-2-46 | DOI Listing |
Diabetes Obes Metab
January 2025
Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
Aims: To examine the cardiovascular safety of combining glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with aspirin in individuals with obesity, both with and without type 2 diabetes (T2D).
Materials And Methods: This propensity score matched cohort study analysed data from 2 946 579 individuals with obesity, with and without T2D, using the TriNetX US and Global dataset. Participants were categorized into four matched groups: those receiving GLP-1 RA plus aspirin versus those receiving GLP-1 RA alone, for both diabetic and non-diabetic individuals.
BMC Gastroenterol
January 2025
Independent Researcher, İzmir, Turkey.
Background: Small-bowel angioectasia is commonly diagnosed and managed using double-balloon enteroscopy; however, rebleeding rates can vary significantly. This study aimed to identify and evaluate the clinical predictors of rebleeding in patients with small-bowel angioectasia.
Methods: This retrospective study focused on adult patients who underwent endoscopic management for small bowel vascular lesions (SBVLs).
Cardiovasc Drugs Ther
January 2025
Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, The Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangzhou, Guangdong Province, China.
Purpose: Coronary endarterectomy combined with coronary artery bypass grafting (CE-CABG) effectively achieves coronary revascularization in patients with diffuse atherosclerotic coronary artery disease (CAD). However, the loss of the subendothelial tissue at the CE-CABG coronary artery accelerates local thrombosis, leading to CE-CABG graft failure. Dual antiplatelet therapy (DAT) and warfarin plus aspirin (WPA) are the two most common anticoagulation strategies post CE-CABG.
View Article and Find Full Text PDFHeart Rhythm
January 2025
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Background: Although drug interactions between clarithromycin/erythromycin/fluconazole and direct oral anticoagulants (DOACs) are mechanistically plausible, it is uncertain whether they are clinically relevant.
Objective: To investigate the association between co-prescribed DOACs and antimicrobials and bleeding, cardiovascular disease and mortality.
Methods: We identified DOAC users in the Clinical Practice Research Datalink Aurum from 1/1/2011-29/3/2021.
Cureus
December 2024
Internal Medicine, Hospital Universitario Dr. José Eleuterio González, Monterrey, MEX.
Heyde's syndrome is a clinical entity that combines aortic stenosis, gastrointestinal angiodysplasia, and an acquired von Willebrand factor disorder. This syndrome is characterized by the association between aortic stenosis and recurrent gastrointestinal bleeding episodes, typically linked to angiodysplasias. Effective treatment requires addressing the underlying condition, specifically aortic stenosis, which leads to the structural destruction of coagulation proteins, resulting in the acquired von Willebrand factor disorder and perpetuating the bleeding.
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