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Joseph J.y. Sung - One of the best experts on this subject based on the ideXlab platform.

Colin W. Howden - One of the best experts on this subject based on the ideXlab platform.

  • systematic review and meta analysis monopolar hemostatic forceps with soft coagulation in the treatment of Peptic Ulcer Bleeding
    European Journal of Gastroenterology & Hepatology, 2020
    Co-Authors: Faisal Kamal, Muhammad Ali Khan, Raseen Tariq, Mohammad K Ismail, Claudio Tombazzi, Colin W. Howden
    Abstract:

    Monopolar hemostatic forceps with soft coagulation (MHFSC) have been compared with hemoclips, heater probe, and argon plasma coagulation (APC) for the treatment of Peptic Ulcer Bleeding. In this systematic review and meta-analysis, we compared MHFSC with other modalities in the treatment of Peptic Ulcer Bleeding. We reviewed MEDLINE, Embase, Scopus, Cochrane, Web of Science, and Scopus from inception to 7 January 2019 to identify studies comparing MHFSC with other modalities for Peptic Ulcer Bleeding. The primary outcome of interest was achievement of initial hemostasis. Secondary outcomes were reBleeding, adverse events, procedure time, and length of hospital stay. Data were analyzed using a random effects model and summarized as pooled odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was assessed by I statistic. We included five randomized controlled trials and one observational study comprising 693 patients with endoscopically confirmed actively Bleeding Ulcers (spurting or oozing) or nonBleeding visible vessel. MHFSC was superior to other modalities in achieving initial hemostasis (OR 0.25; 95% CI 0.08-0.81; I = 67%) and prevention of reBleeding (OR 0.28; 95% CI 0.09-0.86; I = 46%). Rates of adverse events were similar between MHFSC and other modalities. Procedure times were shorter with MHFSC (mean difference -4.15 min; 95% CI -4.83 to -3.47; I= 59%). Length of hospital stay was also shorter with MHFSC. MHFSC appears to be more effective than other modalities for achievement of initial hemostasis and reduction of reBleeding among patients with Peptic Ulcer Bleeding.

  • Systematic review and meta-analysis: monopolar hemostatic forceps with soft coagulation in the treatment of Peptic Ulcer Bleeding.
    European Journal of Gastroenterology & Hepatology, 2020
    Co-Authors: Faisal Kamal, Muhammad Ali Khan, Raseen Tariq, Mohammad K Ismail, Claudio Tombazzi, Colin W. Howden
    Abstract:

    Monopolar hemostatic forceps with soft coagulation (MHFSC) have been compared with hemoclips, heater probe, and argon plasma coagulation (APC) for the treatment of Peptic Ulcer Bleeding. In this systematic review and meta-analysis, we compared MHFSC with other modalities in the treatment of Peptic Ulcer Bleeding. We reviewed MEDLINE, Embase, Scopus, Cochrane, Web of Science, and Scopus from inception to 7 January 2019 to identify studies comparing MHFSC with other modalities for Peptic Ulcer Bleeding. The primary outcome of interest was achievement of initial hemostasis. Secondary outcomes were reBleeding, adverse events, procedure time, and length of hospital stay. Data were analyzed using a random effects model and summarized as pooled odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was assessed by I statistic. We included five randomized controlled trials and one observational study comprising 693 patients with endoscopically confirmed actively Bleeding Ulcers (spurting or oozing) or nonBleeding visible vessel. MHFSC was superior to other modalities in achieving initial hemostasis (OR 0.25; 95% CI 0.08-0.81; I = 67%) and prevention of reBleeding (OR 0.28; 95% CI 0.09-0.86; I = 46%). Rates of adverse events were similar between MHFSC and other modalities. Procedure times were shorter with MHFSC (mean difference -4.15 min; 95% CI -4.83 to -3.47; I= 59%). Length of hospital stay was also shorter with MHFSC. MHFSC appears to be more effective than other modalities for achievement of initial hemostasis and reduction of reBleeding among patients with Peptic Ulcer Bleeding.

  • Effect of Comorbidity on Mortality in Patients With Peptic Ulcer Bleeding: Systematic Review and Meta-Analysis
    American Journal of Gastroenterology, 2013
    Co-Authors: Grigorios I. Leontiadis, Michael Molloy-bland, Paul Moayyedi, Colin W. Howden
    Abstract:

    Effect of Comorbidity on Mortality in Patients With Peptic Ulcer Bleeding: Systematic Review and Meta-Analysis

  • Pharmacologic treatment of Peptic Ulcer Bleeding
    Current Treatment Options in Gastroenterology, 2007
    Co-Authors: Grigoris I. Leontiadis, Colin W. Howden
    Abstract:

    Over the last 3 decades, there has been extensive clinical research on the pharmacologic treatment of Peptic Ulcer Bleeding. A critical review of randomized controlled trials and meta-analyses reveals insufficient evidence to recommend histamine-2 receptor antagonists (H2RAs), somatostatin, octreotide, or tranexamic acid in the routine management of patients with Peptic Ulcer Bleeding. In contrast, there is good-quality evidence for recommending proton-pump inhibitor (PPI) treatment for patients with Peptic Ulcer Bleeding. PPI treatment, compared with an H2RA or placebo, reduces reBleeding and the need for surgical intervention and, in patients with high-risk endoscopic stigmata, also reduces all-cause mortality. Patients with Ulcers that demonstrate only low-risk endoscopic stigmata (clean base or flat pigmented spot) can be treated with an oral PPI at double the standard clinical dose. Patients with Ulcers that demonstrate high-risk endoscopic stigmata (spurting, oozing, or nonBleeding visible vessel) should receive high-dose intravenous PPI treatment following appropriate endoscopic hemostatic treatment. The currently recommended dose is an initial intravenous bolus equivalent to 80 mg of omeprazole followed by an intravenous infusion equivalent to 8.0 mg/h of omeprazole for up to 72 hours. A switch to high-dose oral PPI treatment may be appropriate before completion of a 72-hour treatment period in some patients whose clinical status stabilizes early. Once the initial Bleeding episode has been dealt with, patients will require standard pharmacologic treatment to heal the Ulcer and prevent recurrence.

Angel Lanas - One of the best experts on this subject based on the ideXlab platform.

Hwai Jeng Lin - One of the best experts on this subject based on the ideXlab platform.

Carlos Sostres - One of the best experts on this subject based on the ideXlab platform.