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Recurrent bleeding after initial endoscopic control of bleeding peptic ulcers: its prevention and management. / CUHK electronic theses & dissertations collectionJanuary 2002 (has links)
Lau Yun-wong. / "April 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 117-126). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.
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Development and evaluation of a novel endoscopic suturing device in the treatment of massive ulcer haemorrhage. / CUHK electronic theses & dissertations collectionJanuary 2005 (has links)
A live animal model of major haemorrhage using an implanted short gastric artery was devised to test the efficacy and safety of these endo-suture devices in vivo. Pulsatile arterial bleeding was successfully reproduced in eight pigs' stomachs through incision of the pre-buried vessels. Endoscopic suturing controlled the bleeding in all animals without obvious complications. The mean operating time with the Eagle Claw V was statistically shorter than that with the Eagle Claw II machine (3.6 verse 13.8 minutes, p<0.001). / A vessel-perfusion-manometry system was first established incorporating porcine stomach and splenic artery with the Erlangen model. / From these investigations, it is concluded that (1) Both the vessel-perfusion-manometry system and the animal arterial haemorrhage model are reliable, reproducible and realistic methods suitable for endoscopic experiment in the laboratory settings. (2) Either three-throw knot tied endoscopically or intracorporeal endo-loop ligation can secure vessels as large as 2mm in diameter enduring flow pressure greater than 200 mmHg. (3) It is possible to control massive arterial bleeding in stomach with endoscopic suturing using the novel apparatus with a curved needle. (4) The Eagle Claw V represents significant improvement over previous version, and is associated with ease of operation and higher security, which brings the technique closer to clinical applications. (Abstract shortened by UMI.) / Peptic ulcer remains the most common cause of upper gastrointestinal haemorrhage. Existing endoscopic haemostatic modalities cannot securely control massive ulcer bleeding from large eroded vessels. A well-designed endoscopic suturing device has the possibility to plicate large artery. In addition, it may provide enormous potential in other forms of endo-surgery. A novel suturing device using a curved needle, the Eagle Claw, was developed. The aims of this thesis were to evaluate the efficacy and safety of the Eagle Claw II and V in arresting artificial gastric bleeding from large vessel in a laboratory setting. These devices were tested both in vitro on the bench and in vivo in live animal models. / Hu Bing. / "August 2005." / Adviser: Ng Ekw. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3694. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-160). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.
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Preditores de recidiva hemorrágica ou óbito na hemorragia digestiva alta por úlcera péptica ou lesão aguda da mucosa gastroduodenal /Sassaki, Lígia Yukie. January 2009 (has links)
Orientador: Giovanni Faria Silva / Banca: Pedro Achilles / Banca: Luiza Maria Filomena Romanello / Banca: José Luiz Pimenta Modena / Banca: Ciro Garcia Montes / Resumo: A Hemorragia Digestiva Alta (HDA) é uma das desordens digestivas mais comumente diagnosticadas no mundo. As principais causas são a úlcera peptica gastroduodenal (UPGD) e a lesão aguda da mucosa gastroduodenal (LAMGD). Apesar dos avanços tecnológicos ocorridos nas últimas décadas, não se observou um declínio das taxas de mortalidade, que variam entre 11% e 33%. Esforços consideráveis tem sido realizados para a identificação precoce dos preditores de mau prognóstico, possibilitando à equipe médica a identificação dos grupos de alto risco e, com isso, uma intervenção mais agressiva e precoce. Análise comparativa dos preditores de recidiva hemorrágica ou óbito nos pacientes com HDA por UPGD ou LAMGD e análise de sobrevida dos grupos. Análise retrospectiva dos pacientes adultos com HDA por UPGD ou LAMGD submetidos a endoscopia digestiva alta (EDA) no período de jan/01 a dez/04 no HC da Faculdade de Medicina de Botucatu - UNESP. Critérios de inclusao: pacientes com HDA por UPGD ou LAMGD submetidos à EDA. Critérios de exclusão: HDA de outra etiologia. Análise estatística: testes de associação (Qui- Quadrado e teste exato de Fisher), testes de comparação entre os grupos, regressão logística múltipla, teste de Log Rank e regressão de Cox. 255 casas de HDA, sendo 57 por LAMGD e 198 por UPGD. Os grupos foram homogêneos com relação à idade, gênero, uso de anti-inflamatórios não esteroides (AINES), presença de comorbidades, níveis de hematócrito e hemoglobina e índices de recidiva hemorragica e óbito. No grupo com LAMGD,a idade media foi 60,4 anos (±18,7) e 64% dos doentes eram homens. O uso de AINES foi relatado por 46% dos doentes e 58% apresentavam comorbidades. Recidiva hemorrágica ocorreu em 3,5% dos pacientes e óbito em 10%. O preditor de ressangramento foi a necessidade de grande volume de transfusão sanguínea (OR: 2,03; IC:1,07-3,83)... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The upper gastrointestinal bleeding (UGIB) is one of the most commonly diagnosed digestive disorders in the world. The main causes are the peptic ulcer disease (PUD) and erosive disease. Despite technological advances occurring in recent decades there was not a decline in mortality rates, ranging between 11% and 33%. Considerable efforts have been made to identify early predictors of poor prognosis, allowing the medical team to identify high risk patients and, thus, a more aggressive and early intervention. Comparative analysis of predictors of rebleeding or death in patients with UGIB by PUD or erosive disease and analysis of survival of groups. Retrospective analysis of adult patients with UGIB by PUD or erosive disease underwent endoscopy from January 2001 to December 2004 in the Botucatu Medical School - UNESP. Inclusion criteria: patients with UGIB by PUD or erosive disease underwent endoscopy. Exclusion Criteria: UGIB by another etiology. Statistical analysis: chisquare and Fisher exact test, tests for comparison between groups, multivariate logistic regression models, Log Rank test and Cox proportional hazards regression. 255 cases of UGIB, being 57 by erosive disease and 198 by PUD. The groups were homogeneous with respect to age, gender, use of nonsteroidal anti-inflammatory drugs (NSAIDS)... Complete abstract click electronic access below) / Doutor
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Transcatheter arterial embolization in the management of life threatening bleeding applied in upper gastrointestinal and post partum bleedings /Eriksson, Lars-Gunnar, January 2007 (has links)
Diss. (sammanfattning) Uppsala : Uppsala universitet, 2007. / Härtill 4 uppsatser.
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Preditores de recidiva hemorrágica ou óbito na hemorragia digestiva alta por úlcera péptica ou lesão aguda da mucosa gastroduodenalSassaki, Ligia Yukie [UNESP] 04 September 2009 (has links) (PDF)
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sassaki_ly_dr_botfm.pdf: 618033 bytes, checksum: 8e8fdeb2dc06c1ecf211853224855ccb (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A Hemorragia Digestiva Alta (HDA) é uma das desordens digestivas mais comumente diagnosticadas no mundo. As principais causas são a úlcera peptica gastroduodenal (UPGD) e a lesão aguda da mucosa gastroduodenal (LAMGD). Apesar dos avanços tecnológicos ocorridos nas últimas décadas, não se observou um declínio das taxas de mortalidade, que variam entre 11% e 33%. Esforços consideráveis tem sido realizados para a identificação precoce dos preditores de mau prognóstico, possibilitando à equipe médica a identificação dos grupos de alto risco e, com isso, uma intervenção mais agressiva e precoce. Análise comparativa dos preditores de recidiva hemorrágica ou óbito nos pacientes com HDA por UPGD ou LAMGD e análise de sobrevida dos grupos. Análise retrospectiva dos pacientes adultos com HDA por UPGD ou LAMGD submetidos a endoscopia digestiva alta (EDA) no período de jan/01 a dez/04 no HC da Faculdade de Medicina de Botucatu - UNESP. Critérios de inclusao: pacientes com HDA por UPGD ou LAMGD submetidos à EDA. Critérios de exclusão: HDA de outra etiologia. Análise estatística: testes de associação (Qui- Quadrado e teste exato de Fisher), testes de comparação entre os grupos, regressão logística múltipla, teste de Log Rank e regressão de Cox. 255 casas de HDA, sendo 57 por LAMGD e 198 por UPGD. Os grupos foram homogêneos com relação à idade, gênero, uso de anti-inflamatórios não esteroides (AINES), presença de comorbidades, níveis de hematócrito e hemoglobina e índices de recidiva hemorragica e óbito. No grupo com LAMGD,a idade media foi 60,4 anos (±18,7) e 64% dos doentes eram homens. O uso de AINES foi relatado por 46% dos doentes e 58% apresentavam comorbidades. Recidiva hemorrágica ocorreu em 3,5% dos pacientes e óbito em 10%. O preditor de ressangramento foi a necessidade de grande volume de transfusão sanguínea (OR: 2,03; IC:1,07-3,83)... / The upper gastrointestinal bleeding (UGIB) is one of the most commonly diagnosed digestive disorders in the world. The main causes are the peptic ulcer disease (PUD) and erosive disease. Despite technological advances occurring in recent decades there was not a decline in mortality rates, ranging between 11% and 33%. Considerable efforts have been made to identify early predictors of poor prognosis, allowing the medical team to identify high risk patients and, thus, a more aggressive and early intervention. Comparative analysis of predictors of rebleeding or death in patients with UGIB by PUD or erosive disease and analysis of survival of groups. Retrospective analysis of adult patients with UGIB by PUD or erosive disease underwent endoscopy from January 2001 to December 2004 in the Botucatu Medical School - UNESP. Inclusion criteria: patients with UGIB by PUD or erosive disease underwent endoscopy. Exclusion Criteria: UGIB by another etiology. Statistical analysis: chisquare and Fisher exact test, tests for comparison between groups, multivariate logistic regression models, Log Rank test and Cox proportional hazards regression. 255 cases of UGIB, being 57 by erosive disease and 198 by PUD. The groups were homogeneous with respect to age, gender, use of nonsteroidal anti-inflammatory drugs (NSAIDS)... Complete abstract click electronic access below)
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