Category Archives: GI

Early TPN in ICU patients

This large trial of patients with a relative contraindication for enteral feeds were randomized to early TPN or usual care. There were no differences in the groups in 60 day mortality or LOS, but those on TPN did have a … Continue reading

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Guidelines for the management of ascites

The American Association for the Study of Liver Disease has released guidelines on the management of ascites. Among the recommendations, some include: use caution when prescribing agents that lower arterial blood pressure (such as ACE/ARBs), avoid the vaptan drugs, and … Continue reading

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Calculator assists with determining risk-benefit of ASA

This online risk calculator can help clinicians weigh the risks and benefits of ASA for individual patients (calculator).

Posted in Cardiology, GI | Comments Off

High dose PPI and mortality in elderly

This cohort of elderly patients discharged from acute care found a higher risk of mortality among those discharged on a PPI versus no PPI. Although only hypothesis generating at this point, this study should give us pause when discharging elderly … Continue reading

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FDA approves 11 pathogen gastroenteritis test

The new xTAG GI pathogen panel has been approved by the FDA, which tests for: Bacteria (Campylobacter, C. difficile toxin A/B, E. coli O157, Enterotoxigenic E.coli, Salmonella, Shigella, and Shiga?like Toxin producing E. coli), Viruses (Norovirus and Rotavirus) and Parasites (Cryptosporidium and Giardia) (FDA site).

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Donor feces for Cdiff

In this trial of patients with recurrent Cdiff, they were treated with vancomycin, then randomized to no further therapy, duodenal lavage, or duodenal infusion of donor feces. Those in the donor feces group had 81% resolution of disease at 10 … Continue reading

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No need to monitor gastric residuals in intubated patients

In this trial of patients intubated and receiving tube feedings, they were randomized to measuring gastric residuals or not measuring gastric residuals. Those that did not have their gastric residuals measured had the same risk of VAP, and higher attainment … Continue reading

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Cdiff detection by swab as good as by stool sample

In this small single center prospective cohort, patients with suspected Cdiff submitted a stool sample and a rectal swab for PCR testing. The rectal swab was found to have a sensitivity and specificity of 96% and 100% respectively. This may … Continue reading

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Risk factors for GI bleeding outside the ICU

This large single center cohort found several factors associated with the risk of non-ICU GI bleeding; researchers developed a scoring system to determine which patients were at highest risk of bleeding (and presumably would benefit from GI prophylaxis). The following … Continue reading

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Restrict transfusions for UGI bleeding

This trial of almost 1,000 patients with acute upper GI bleeding randomized them to a restrictive (Hb<7) or liberal (Hb<9) transfusion strategy. Only 15% of the liberal, and 51% of the restrictive group did not receive a transfusion; 6 week … Continue reading

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