Scurvy‐associated oral mucosal bleeding presenting as suspected haematemesis

2021 ◽  
Vol 51 (3) ◽  
pp. 452-453
Author(s):  
Samuel Hui ◽  
Patricia W. R. Khoo ◽  
Ralph Junckerstorff
Keyword(s):  
Mucosal Bleeding

scholarly journals Long-term safety evaluation of Daxocox® tablets (enflicoxib) in dogs after weekly oral administrations for seven months

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Josep Homedes ◽  
Marta Salichs ◽  
Antonio Guzman
Keyword(s):  
Safety Margin ◽  
Clinical Signs ◽  
Safety Evaluation ◽  
Clinical Pathology ◽  
Occult Blood ◽  
Study Groups ◽  
Placebo Control ◽  
Relevant Dose ◽  
Mucosal Bleeding ◽  
Animal Safety

Abstract Background Daxocox® [Ecuphar/Animalcare Group] contains the selective COX-2 inhibitor enflicoxib, approved in the EU for the treatment of pain and inflammation associated with osteoarthritis in dogs. The safety of Daxocox® was evaluated in a target animal safety study: Groups of 4 dogs per sex each were treated once weekly with placebo or Daxocox tablets at 1-, 3- and 5-times (1X, 3X and 5X) the maximum recommended therapeutic dose of enflicoxib (0, 4, 12 or 20 mg/kg, respectively). After an initial loading dose, dogs in the placebo control, 1X and 3X groups were administered for 32 weeks, and those in the 5X group were administered for 13 weeks. Dogs were subjected to daily food consumption measurements and clinical and dose observations. Body weight measurements, physical examinations, clinical pathology, urinalysis, faecal occult blood (FOB) and electrocardiographic (ECG) and blood pressure measurements, buccal mucosal bleeding time (BMBT), ophthalmology and gastroduodenal endoscopy examinations were conducted throughout the study. At study completion, all dogs were subjected to gross necropsy. Histopathology was performed on selected tissues from all animals in all groups. Results No clinical signs were noted, and no toxicologically relevant dose-associated effects were observed. Conclusions Results show that Daxocox® is well-tolerated and has a broad safety margin when administered as directed in dogs.

scholarly journals Subacute Enteritis Two Months After COVID-19 Pneumonia With Mucosal Bleeding, Perforation, and Internal Fistulas

2021 ◽  
pp. 000313482110234
Author(s):  
Babak Abbassi ◽  
Anasua Deb ◽  
Vanessa Costilla ◽  
Brittany Bankhead-Kendall
Keyword(s):  
Histopathological Examination ◽  
Failure To Thrive ◽  
Small Bowel Resection ◽  
Resected Specimen ◽  
Push Enteroscopy ◽  
Midline Laparotomy ◽  
Internal Fistulas ◽  
Mucosal Bleeding ◽  
Gi Bleed ◽  
Prolonged Hospital

Chronic sequelae of COVID-19 remain undetermined. We report a case of postinfection sequelae in a patient presenting with subacute obstruction 2 months after COVID-19 infection. A 34-year-old man with a prior prolonged hospital stay due to COVID-19 complicated by upper gastrointestinal (GI) bleed presented with subacute obstruction and failure to thrive. Upper GI push enteroscopy revealed residual ulcers and multiple proximal jejuno-jejunal fistulae. Midline laparotomy revealed strictures with dense intra-abdominal adhesions, a large jejuno-jejunal fistula, and evidence of prior jejunal perforation following severe COVID-19 infection. The patient recovered after small bowel resection with anastomoses and was discharged home. Histopathological examination of resected specimen confirmed transmural infarction with evidence of prior hemorrhage, diffuse ulcers, and multifocal inflammation. This is the first report of a chronic GI sequelae resulting from COVID-19. As the pandemic evolves, medical professionals must be vigilant to consider alternative GI diagnoses in the COVID-19 survivors.

Comparison of the buccal mucosal bleeding time in dogs using 3 different-sized lancet devices

2013 ◽  
Vol 42 (4) ◽  
pp. 451-457 ◽  
Author(s):  
Marcel Aumann ◽  
Valentina Rossi ◽  
Kevin Le Boedec ◽  
Armelle Diquélou
Keyword(s):  
Bleeding Time ◽  
Mucosal Bleeding

scholarly journals Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin.

BMJ ◽  
1989 ◽  
Vol 298 (6672) ◽  
pp. 493-496 ◽  
Author(s):  
P. J. Prichard ◽  
G. K. Kitchingman ◽  
R. P. Walt ◽  
T. K. Daneshmend ◽  
C. J. Hawkey
Keyword(s):  
Low Dose ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Mucosal Bleeding

scholarly journals Thrombocytopenia in the Course of COVID-19 Infection

2020 ◽  
Author(s):  
Noel Lorenzo-Villalba ◽  
Abrar-Ahmad Zulfiqar ◽  
Marc Auburtin ◽  
Marie Helene Schuhmacher ◽  
Alain Meyer ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Biological Response ◽  
Intravenous Immunoglobulins ◽  
Severe Thrombocytopenia ◽  
The Third ◽  
Mucosal Bleeding

We report three cases of severe thrombocytopenia during COVID-19 infection associated with either cutaneous purpura or mucosal bleeding. The initial investigations ruled out other causes of thrombocytopenia. Two of the patients were treated with intravenous immunoglobulins and eltrombopag, while the third recovered spontaneously. A good clinical and biological response was achieved in all patients leading to hospital discharge.

scholarly journals Association of ABO Blood Group with Bleeding Severity in Patients with Bleeding of Unknown Cause

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 16-18
Author(s):  
Dino Mehic ◽  
Stefanie Hofer ◽  
Christof Jungbauer ◽  
Alexandra Kaider ◽  
Helmuth Haslacher ◽  
...  
Keyword(s):  
Blood Group ◽  
Platelet Function ◽  
Multiple Testing ◽  
Light Transmission ◽  
Least Square ◽  
Abo Blood Group ◽  
Plasma Clot ◽  
Travel Costs ◽  
Mucosal Bleeding ◽  
Bleeding Severity

Introduction: Antigens of the ABO blood group system have an impact on the hemostatic balance. The association of blood group non-O and thrombosis risk is well known. In patients with different bleeding manifestations, an overrepresentation of blood group O has been previously reported (Dentali et al, Semin.Thromb. Hemost, 2013). Nevertheless, the independent effect of the ABO blood group on bleeding severity, when considering VWF as a major contributing factor, has not yet been thoroughly investigated. Patients with bleeding of unknown cause (BUC) have a similar bleeding phenotype as patients with a diagnosis of an established bleeding disorder, but the causes underlying their bleeding tendency are currently unclear and might be multifactorial (Gebhart et al, Haemophilia, 2018). Thus, we investigated the prevalence of blood group O and its role as an independent risk factor for increased bleeding severity in a thoroughly characterized cohort of patients with BUC. Methods: For this analysis, we selected all patients with normal results in the assessments of plasmatic coagulation and platelet function consecutively recruited between October 2009 and April 2019 within the Vienna bleeding biobank study (Figure 1; Gebhart et al, Haemophilia, 2018). After informed consent, all patients underwent a structured interview on their previous medical and bleeding history including the assessment of the bleeding severity with the Vicenza bleeding assessment tool (BAT). Biomaterial was processed and stored according to standard operating procedures at the Biobank facility (http://www.biobank.at/). A thorough hemostatic laboratory assessment and measurements of thrombin generation, plasma clot properties, and rotational thromboelastometry (ROTEM), as well as platelet function tests (PFA-100, light transmission aggregometry) were performed. Data on the blood group distribution of 23,145 healthy first-time blood donors were provided by the Austrian Red Cross for comparison. Results: We observed an overrepresentation of blood group O in 199 out of 422 BUC patients (47.2%) compared to 8709 out of 23,145 healthy blood donors (37.6%), odds ratio for blood group O 1.48; 95% CI=1.22-1.79, p<0.001 (Table 1). Blood group O in comparison to non-blood group O was independently associated with an increased bleeding severity (least square mean [95% CI]: 6.2 [5.8-6.6] vs. 5.3 [4.9-5.7], p=0.006) and a higher number of bleeding symptoms (least square (LS) mean [95% CI] 3.5 [3.2-3.7] vs. 3.0 [2.8-3.2], p=0.016), after adjustment for sex, VWF:Ag, VWF:RCo and FVIII activity (Table 2). The prevalence of oral mucosal bleeding was significantly higher in blood group O than in patients with a non-O blood group (26.1% vs. 14.3%), even after adjustment for sex, VWF and FVIII, and multiple testing (p=0.013). When analyzing the influence of blood group O on tests of global hemostatic capacity, results indicated increased clot firmness and reduced lysis in blood group O patients. In ROTEM, the maximum clot firmness was higher (LS mean [95% CI]: 57.4 [56.5-58.3] vs. 55.8 [55.0-56.6] mm, p<0.05) and the maximal lysis lower (LS mean [95% CI]: 13.3 [12.5-14.1] vs. 15.1 [14.4-15.9] %, p<0.05) in patients with blood group O compared to non-O patients, after adjustment for sex, VWF and FVIII, and correction for multiple testing. Also in the analysis of plasma clot properties, the maximum clot absorbance was increased in patients with blood group O after adjustment for sex, VWF and FVIII (LS mean [95% CI]: 0.77 [0.74-0.79] vs 0.71 [0.69-0.74] OD, p<0.05), whereas there was no difference in plasma clot lysis. There was no difference in thrombin generation between BUC patients with blood group O and non-O. We could not identify any differences in platelet function, as assessed by the platelet function analyser-100 and light transmission aggregometry between patients with blood group O in comparison to non-O patients after adjustment for sex, VWF and FVIII, and correction for multiple testing. Conclusion : Blood group O is a risk factor for a more severe bleeding phenotype, especially oral mucosal bleeding, independent of VWF and FVIII levels in patients with BUC. Alterations in global hemostatic capacity in BUC patients with blood group O were identified, whereas platelet function was not different. Our data are important for a better understanding of underlying mechanisms of bleeding in BUC patients, which are most probably multifactorial. Disclosures Jilma: True North Therapeutics: Consultancy, Other: reimbursement for travel costs for scientific presentations; Bioverativ: Consultancy, Other: reimbursement for travel costs for scientific presentations.

Delayed-onset sinus node dysfunction in a child victim of Russell’s viper bite

2020 ◽  
Vol 28 (4) ◽  
pp. 213-215
Author(s):  
Arjuna Salinda Athapathu ◽  
Visvalingam Arunath ◽  
Aruppala AHS Aruppala ◽  
Thabitha Jebaseeli Hoole ◽  
Kanagapathasuntharam Suntharesan ◽  
...  
Keyword(s):  
Sinus Node ◽  
International Normalized Ratio ◽  
Sinus Node Dysfunction ◽  
Cardiac Complications ◽  
Child Victim ◽  
Delayed Onset ◽  
Escape Rhythm ◽  
Systemic Manifestations ◽  
Russell’S Viper ◽  
Mucosal Bleeding

Cardiac complications following envenomation by Russell’s viper venom are uncommon. We describe a 14-year-old girl who developed delayed-onset sinus node dysfunction. She presented with mucosal bleeding, ptosis, and muscle weakness. Her 20-min whole blood clotting time and international normalized ratio were prolonged. The initial electrocardiogram showed sinus tachycardia. Her systemic manifestations responded to antivenom serum. After 24 h, she developed bradycardia and electrocardiography showed sinus node dysfunction with sinus arrest and an atrial escape rhythm. This case shows that arrhythmias can have a delayed onset even after resolution of other systemic manifestations, and even after treatment with antivenom serum.

scholarly journals Comparison between use of single lightwand and video laryngoscope-guided lightwand for tracheal intubation in simulated cervical spine-immobilized patients: a single-blind randomized study

2019 ◽  
Vol 47 (11) ◽  
pp. 5632-5642
Author(s):  
Ha Yeon Kim ◽  
Eun Jung Kim ◽  
Hei Jin Yoon ◽  
Byungwoong Ko ◽  
Seung Yeon Choi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Postoperative Complications ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Randomized Study ◽  
Video Laryngoscope ◽  
Second Grade ◽  
Airway Complications ◽  
Mucosal Bleeding ◽  
Single Blind

Objective This study was performed to compare the use of a video laryngoscope-guided lightwand versus a single lightwand for tracheal intubation performed by non-experts in cervical spine-immobilized patients. Methods In total, 318 patients under general anesthesia were assigned either to the single lightwand group (Group L) or the video laryngoscope-guided lightwand group (Group VL) at a 1:1 ratio. First- or second-grade residents performed tracheal intubation with the assigned device after applying semi-hard fitted cervical collars to the patients. Outcomes, including the success rate and airway complications, were compared between the two groups. Results There were no significant differences in demographics or airway-related characteristics between the two groups. The success rate of intubation on the first attempt was significantly higher in Group VL than in Group L (90% vs. 64%, respectively). Postoperative complications, including oral mucosal bleeding, hoarseness, and sore throat scores at 1 and 24 hours after surgery, were significantly lower in Group VL than in Group L. Conclusions The use of a video laryngoscope-guided lightwand for tracheal intubation can be useful for non-experts who encounter difficult airway situations.

scholarly journals Parahaemophilia: A Rare Case Report

2020 ◽  
Vol 38 (4) ◽  
pp. 205-208
Author(s):  
Mohammed Nuruzzaman Bhuiyan ◽  
Susane Giti ◽  
Arif Ahmed Khan ◽  
Md Moshiur Rahman ◽  
Md Anwarul Karim
Keyword(s):  
Rare Case ◽  
Bleeding Time ◽  
Armed Forces ◽  
Coagulation Factors ◽  
Activated Partial Thromboplastin Time ◽  
Factor V ◽  
Thrombin Time ◽  
Normal Range ◽  
Rare Case Report ◽  
Mucosal Bleeding

Parahaemophilia or Owren’s diseaseis a rare haemorrhagic disorder occurs due to congenital and frequently familial deficiency of Factor V.It is characterized by epistaxis, bruising, mucosal bleeding, soft tissue bleeding and haemarthrosis. We report a case of 6 year old female patient with overlapping features with other haemorrhagic disorder. With the complaints of recurrent episodic per rectal bleeding, patient was evaluated at different hospitals in Chattagram and was diagnosed as a case of Haemophilia B and treated accordingly. As her condition was not improved expectedly, she was referred to Armed Forces Institute of Pathology (AFIP) for further evaluation. The lab tests showed prolongation of prothrombin time (PT) and activated partial thromboplastin time (APTT), with normal bleeding time (BT) and thrombin time (TT). Coagulation factors assay revealed a significant decrease of factor V, 1% of normal range. Other coagulation factors are normal. She was treated with FFP and recovered four weeks after treatment. J Bangladesh Coll Phys Surg 2020; 38(4): 205-208

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