7 research outputs found
Routine use of Hemospray for gastrointestinal bleeding: prospective two-center experience in Switzerland
Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a hemostatic agent recently introduced for the management of upper gastrointestinal bleeding (GIB). To date, there is little experience with this fairly new hemostatic tool. The aim of this case series was to reflect the use and effectiveness of Hemospray as a treatment option in GIB in everyday clinical practice at two tertiary referral centers. Consecutive patients (n =â16) with active GIB of various origins were treated with Hemospray. The rate of successful initial hemostasis was 93.75â% (15â/16; salvage therapy 92.85â% [13/14]; monotherapy 100â% [2â/2]). The rebleeding rate within 7 days was 12.5â% (2/16). One patient, in whom interventional radiology also failed, had to undergo surgery as salvage therapy. The effectiveness of Hemospray in the management of GIB in various clinical situations is promising. Future multicenter randomized prospective trials for clearly defined bleeding situations are needed for greater generalizability of case series findings
Routine use of Hemospray for gastrointestinal bleeding: prospective two-center experience in Switzerland
Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a hemostatic agent recently introduced for the management of upper gastrointestinal bleeding (GIB). To date, there is little experience with this fairly new hemostatic tool. The aim of this case series was to reflect the use and effectiveness of Hemospray as a treatment option in GIB in everyday clinical practice at two tertiary referral centers. Consecutive patients (n =â16) with active GIB of various origins were treated with Hemospray. The rate of successful initial hemostasis was 93.75â% (15â/16; salvage therapy 92.85â% [13/14]; monotherapy 100â% [2â/2]). The rebleeding rate within 7 days was 12.5â% (2/16). One patient, in whom interventional radiology also failed, had to undergo surgery as salvage therapy. The effectiveness of Hemospray in the management of GIB in various clinical situations is promising. Future multicenter randomized prospective trials for clearly defined bleeding situations are needed for greater generalizability of case series findings
Multipurpose use of the over-the-scope-clip system (âBear clawâ) in the gastrointestinal tract: Swiss experience in a tertiary center
Differences in Outcomes Reported by Patients With Inflammatory Bowel Diseases vs Their Health Care Professionals
Colectomy Rates in Ulcerative Colitis are Low and Decreasing: 10-year Follow-up Data From the Swiss IBD Cohort Study
Somatic mosaicism and common genetic variation contribute to the risk of very-early-onset inflammatory bowel disease
Very-early-onset inflammatory bowel disease (VEO-IBD) is a heterogeneous phenotype associated with a spectrum of rare Mendelian disorders. Here, we perform whole-exome-sequencing and genome-wide genotyping in 145 patients (median age-at-diagnosis of 3.5 years), in whom no Mendelian disorders were clinically suspected. In five patients we detect a primary immunodeficiency or enteropathy, with clinical consequences (XIAP, CYBA, SH2D1A, PCSK1). We also present a case study of a VEO-IBD patient with a mosaic de novo, pathogenic allele in CYBB. The mutation is present in ~70% of phagocytes and sufficient to result in defective bacterial handling but not life-threatening infections. Finally, we show that VEO-IBD patients have, on average, higher IBD polygenic risk scores than population controls (99 patients and 18,780 controls; Pâ<â4âĂâ10-10), and replicate this finding in an independent cohort of VEO-IBD cases and controls (117 patients and 2,603 controls; Pâ<â5âĂâ10-10). This discovery indicates that a polygenic component operates in VEO-IBD pathogenesis