• Title/Summary/Keyword: bleeding

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Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding

  • Wei, Kun-Yan;Yan, Qiong;Tang, Bo;Yang, Shi-Ming;Zhang, Peng-Bing;Deng, Ming-Ming;Lu, Mu-Han
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.391-398
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    • 2017
  • Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

A Literature Study on Stercoremia(Fecal blood) (변혈(便血)에 대한 문헌적(文獻的) 고찰(考察))

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Kim, Hee-Eun
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.105-129
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    • 2004
  • Methods: It was studied on the 47 kinds of oriental medical literature for fecal blood. Results: Fecal blood means bleeding with faces from anus and indicates all the three cases such as blooding before and after evacuation, evacuation of feces mixed with blood, and simple melena. The main causes are fire(火) and deficiency of spleen qi (脾氣虛). According to the color of fecal blood and the region of the bleeding, first, if the blood color is dark-red and blood discharges after emptying the bowels, it is called deposited poison into Jang(臟毒) or distant bleeding(遠血), and if the color of blood is clear and bowel emptying occurs after bleeding, it is bloody stool due to intestinal wind(腸風) or nearby bleeding(近血). For treating methods(治法). removing heat from the blood and stopping bleeding(淸熱凉血止血), removing dampness and stopping bleeding(淸熱除濕止血), invigorating Ki for promoting Hul-controJ(益氣攝血), warming the spleen and stomach to dispel cold and stopping bleeding(溫中散寒止血) etc are applied. As for the treating prescriptionl(治法), a Hwangtotang(黃土湯). Jeoksodudanggwitang(赤小豆當歸散). Gwihwasan(槐花散). Wipungtang(胃風湯). Hwangnyeonhwan modifying(黃連丸加減). Samultang modifying(四物湯加減). Paedoksan modifying(敗毒散加減) etc are used. As for acupuncture and moxibustion(鍼灸療法). if etiology(病因) is damp-heat(濕熱), acupuncture(刺鍼) at Janggang(長强); Charyo(BL 32); Sangeoheo(ST 37)(上巨虛); Seungsan(BL 57)(承山穴), and in case of deficiency of spleen Gi(脾氣虛), acupunture(刺鍼) with tonification(補法) at I Baek(EX-UE 2)(二白); Gwanwon(CC 4)(關元); Joksamni(ST 36)(足三里) Taebaek(SP 3)(太白); Hoeeum(CC 1)(會陰穴), or mxibuston(灸) at Baekoe(GC 2O)(百會); Myeongmun9GC (命門) or the point of opposite to umbilicus among spinal vertebrae(脊中對臍穴) are used. The external treatment(外治療法) was consisted of plastering umbilicus therapy(敷臍法) and enema therapy(灌腸法).

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Influence of Cement and Mixing time Factor on the Bleeding of Concrete (콘크리트의 블리딩에 미치는 시멘트 및 믹싱시간의 영향)

  • Lee, Won-Am;Um, Tai-Sun;Lee, Jong-Ryul
    • Proceedings of the Korea Concrete Institute Conference
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    • 2008.11a
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    • pp.593-596
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    • 2008
  • The bleeding of concrete is defined as a kind of separation of materials. The durability of concrete, as well as the quality caused by the bleeding. Therefore, This study is intended to find influence of cement and mixing time factor on the bleeding of concrete. We want to know two factors that determine the change, to provide it to our customers. According to the results, The bleeding ratio increase by the increase of mixing time factor. At the 90 second of mixing time, the amount of bleeding differ greatly from cement properties. This paper presents an experimental study on bleeding ratio, slump and compressive strength properties with three days. In addition, the mixing time is inversely related slump loss ratio, the initial value of the compressive strength is only affected by the mixing time. As a result, the bleeding of concrete was obtained that their characteristics depends on the cement and mixing time factor, also in the future, to derive optimum mixing time for a variety of review is necessary.

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A prospective randomized trial of xylometazoline drops and epinephrine merocele nasal pack for reducing epistaxis during nasotracheal intubation

  • Patel, Sonam;Hazarika, Amarjyoti;Agrawal, Prachi;Jain, Divya;Panda, Naresh Kumar
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.223-231
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    • 2020
  • Background: The most frequent complication of nasotracheal intubation (NTI) is epistaxis. Epinephrine nasal gauze packing has been used conventionally as a pre-treatment for reducing epistaxis, but it carries a disadvantage of pain and anxiety in patients. However, xylometazoline drops are easier to administer and more convenient for patients. We aimed at comparing the effectiveness of xylometazoline drops and epinephrine merocele packing in reducing bleeding and postoperative complications in our population. Methods: Our study enrolled 120 patients in a double-blind randomized controlled trial. We randomly allocated ASA1 or 2 adult patients into 2 groups: Group X and Group E. Group X received 0.1% xylometazoline nasal drops, and epinephrine (1:10,000) merocele nasal packing was used in Group E. The primary outcome was the incidence of bleeding during NTI; the severity of bleeding, navigability, bleeding during extubation, and postoperative complications were secondary outcomes. We used IBM SPSS and Minitab software for statistical analysis, and P < 0.05 was considered statistically significant. Results: We analyzed the data of 110 patients: 55 in Group X and 55 in Group E. The two groups did not have different bleeding incidence (56.4% vs 60.0%; P = 0.70); however, the incidence of severe bleeding was less with xylometazoline than with epinephrine (3.63% vs 14.54%; P < 0.05). We also observed less bleeding during extubation (38.2% vs 68.5%; P < 0.05) with xylometazoline. Other secondary outcomes were akin to both groups. Conclusion: The incidence of severe and post-extubation bleeding was significantly less with xylometazoline. Hence, it may be an effective alternative for reducing the incidence and severity of epistaxis during NTI.

Factors associated with gingival bleeding by tooth brushing in college students (일부 대학생들의 칫솔질 시 치은출혈 관련요인)

  • Cho, Myung-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.6
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    • pp.921-926
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    • 2014
  • Objectives: The purpose of the study is to investigate the factors associated with gingival bleeding(GB) by tooth brushing in college students. Methods: A self-reported questionnaire was filled out by 232 college students in Daegu Health College from March to June, 2014. Data were analyzed for frequency, chi square test, and logistic regression analysis using SPSS 12.0 program. The study was a cross sectional study. The questionnaire consisted of general characteristics of the subjects(gender, age, marital status, and smoking), frequency and duration of tooth brushing, scaling experience, and physical health status. Self-reporting hemorrhage was reported by yes or no. Frequency of tooth brushing was documented as the number of behavior. Above 4 times of tooth brushing was defined as 4. Duration of tooth brushing was documented as minute. Above 4 minutes, it was recorded as 4. In physical health status, 1 is feeling weak and 4 is feeling very healthy. Cronbach alpha was 0.82 in the study. Results: There were significant relationships between gingival bleeding and age(p<0.05), subjective health(p<0.01), tooth brushing frequency(p<0.05) and duration(p<0.05) by chi square test. Logistic regression analysis showed that the age(p<0.05), subjective health(p<0.01), tooth brushing frequency(p<0.05) and duration(p<0.05) were associated with gingival bleeding. Prevalence of gingival bleeding in 20 years was 0.62(odds ratio 1.85, 95% CI 1.00~3.43) and it was higher than that in 10 years. Prevalence of gingival bleeding in good health group was -1.38 and it was lower than that in poor health group. Conclusions: The factors associated with gingival bleeding were age, subjective health, and tooth brushing frequency and time.

Analysis of the Effects of CO Poisoning and Air Bleeding on the Performance of a PEM Fuel Cell Stack using First-Order System Model (일차계 모델을 이용한 고분자전해질 연료전지 스택의 CO Poisoning 및 Air Bleeding 효과 분석)

  • Han, In-Su;Shin, Hyun Khil
    • Korean Chemical Engineering Research
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    • v.51 no.3
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    • pp.370-375
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    • 2013
  • We analyze the effects of CO poisoning and air bleeding on the performance of a PEM (polymer electrolyte membrane) fuel cell stack fabricated using commercial MEA (membrane electrode assembly). Dynamic response data from the experiments on the performance of a stack are identified by obtaining steady-state gains and time-constants of the first-order system model expressed as a first-order differential equation. It is found that the cell voltage of the stack decreases by 1.3-1.6 mV as the CO concentration rises by 1 ppm. The time elapsed to reach a new steady state after a change in the CO concentration is shortened as the magnitude of the change in the CO concentration increases. In general, the steady-state gain becomes bigger and the time-constant gets smaller with increasing the air concentration (air-bleeding level) in the reformate gas to restore the cell voltage. However, it is possible to recover 87%-96% of the original cell voltages, which are measured with free of CO, within 1-30 min by introducing the bleed air as much as 1% of the reformate gas into the stack.

Apixaban versus Warfarin in Patients with Chronic Kidney Disease; A Systematic Review and Meta-analysis (만성신장병환자에서 apixaban과 warfarin의 안전성 비교: 체계적 문헌고찰 및 메타분석)

  • Nam, Jae Hyun;Kim, Chae Young;Lee, Yoo Kyung;Jung, Da Woom;Gwak, Hye Young;Chung, Jee Eun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.87-95
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    • 2021
  • Background: Patients with chronic kidney disease (CKD) are at a high risk of stroke-related morbidity, mortality, and bleeding. However, the overall risk/benefit of anticoagulant therapy among patients with CKD remains unclear. Methods: The MEDLINE, EMBASE, and CENTRAL databases were comprehensively searched until July 31, 2020, to investigate the safety and efficacy of apixaban in patients with stage 4 or 5 CKD, as compared with warfarin. The primary outcome was an incidence of major bleeding. Secondary outcomes included composite bleeding (major, clinically relevant, and minor bleeding), venous thromboembolism (VTE), stroke, and death. Results: In total, seven studies consisting of 10,816 patients were included. Compared with warfarin, apixaban was associated with a reduced risk of major bleeding (OR 0.49, 95% CI 0.41-0.58). In terms of composite bleeding, apixaban tended to pose a significantly lower risk than warfarin (OR 0.51, 95% CI 0.37-0.71). There was no difference between apixaban and warfarin with respect to the risk of stroke or death (stroke: OR 1.23, 95% CI 0.49-3.12; death: OR 0.73, 95% CI 0.45-1.18). Conclusion: Among patients with stage 4 or 5 CKD, the use of apixaban was associated with a lower risk of bleeding compared to warfarin and was also found to pose no excess risk of thromboembolic events.

Systematic review of self-assembling peptides as topical agents for treatment and prevention of gastrointestinal bleeding

  • Andrei Voiosu;Monica State;Victor Dragan;Sergiu Vaduva;Paul Balanescu;Radu Bogdan Mateescu;Theodor Voiosu
    • Clinical Endoscopy
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    • v.57 no.4
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    • pp.454-465
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    • 2024
  • Background/Aims: Gastrointestinal bleeding is a significant and potentially lethal event. We aimed to review the efficiency and safety of self-assembling peptides for the treatment and prevention of gastrointestinal tract bleeding. Methods: We conducted a systematic search for studies describing the endoscopic use of self-assembling peptides for treatment or prevention of bleeding in the gastrointestinal tract in a parallel, independent fashion. The primary outcomes were rates of successful initial hemostasis, delayed bleeding, and rebleeding. The secondary outcomes were adverse events and ease and volume of gel used. Results: Seventeen studies were analyzed. Overall success rate of self-assembling peptides in gastrointestinal bleeding was 87.7% (38%-100%), regardless of etiology or associated treatments. Rebleeding rate ranged from 0% to 16.2%, with a mean of 4.7%, and overall delayed bleeding rate was 5% (range, 0%-15.9%). Only three adverse events were reported in a pooled number of 815 patients. The volume of gel used varied (0.43 to 3.7 mL) according to indication and type of bleeding. Conclusions: The limited available data on the use of self-assembling peptides in gastrointestinal endoscopy suggest a high efficiency and good safety profile.

Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?

  • Hwang, Jin-Bok;Hong, Jeana
    • Clinical and Experimental Pediatrics
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    • v.56 no.12
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    • pp.514-518
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    • 2013
  • The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.

Cervical Spinal Epidural Hematoma Following Cervical Posterior Laminoforaminotomy

  • Choi, Jeong Hoon;Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.125-128
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    • 2013
  • A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible.