Article
Hematology
Jill M. Johnsen, Hayley J. MacKinnon
Summary: Individuals with inherited bleeding disorders (IBDs) have a higher risk of bleeding during pregnancy, childbirth, and the postpartum period. Clinical management requires a personalized multidisciplinary approach and involving the patient in decision making.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Antoine Rauch, Camille Paris, Yohann Repesse, Julien Branche, Roseline D'Oiron, Annie Harroche, Catherine Ternisien, Sabine-Marie Castet, Aurelien Lebreton, Brigitte Pan-Petesch, Fabienne Volot, Segolene Claeyssens, Pierre Chamouni, Valerie Gay, Claire Berger, Dominique Desprez, Celine Falaise, Christine Biron Andreani, Catherine Marichez, Benedicte Pradines, Christophe Zawadzki, Nathalie Itzhar Baikian, Annie Borel-Derlon, Jenny Goudemand, Romain Gerard, Sophie Susen
Summary: VCE plays a crucial role in diagnosing angiodysplasia and evaluating the prognosis of endoscopic treatment in VWD patients with GI bleeding. It should be more systematically used for patients with unexplained or recurrent GI bleeding to identify angiodysplasia eligible for endoscopic treatment or at high risk of relapse.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Hematology
Julia C. Hews-Girard, Jacqueline Galica, Catherine Goldie, Paula James, Joan Tranmer
Summary: This study aims to investigate the incidence and risk factors of postpartum hemorrhage (PPH) among women with inherited bleeding disorders (IBD). The results suggest that women with IBD have a higher incidence of PPH, potentially due to anemia.
Article
Hematology
Michelle Lavin, Pamela Christopherson, Julie Grabell, Thomas Abshire, Veronica Flood, Sandra L. Haberichter, David Lillicrap, James S. O'Donnell, Robert R. Montgomery, Paula D. James
Summary: This study evaluates the clinical utility of an interim bleeding protocol in VWD patients and provides a new approach to longitudinal bleeding assessment and insights into the evolution of bleeding in VWD.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Paolo Gresele, Emanuela Falcinelli, Loredana Bury, Alessandro Pecci, Marie-Christine Alessi, Munira Borhany, Paula G. Heller, Cristina Santoro, Ana Rosa Cid, Sara Orsini, Pierre Fontana, Erica De Candia, Gianmarco Podda, Meganathan Kannan, Kerstin Jurk, Giancarlo Castaman, Celine Falaise, Giuseppe Guglielmini, Patrizia Noris
Summary: The ISTH Bleeding Assessment Tool has been validated for clinical screening of suspected VWD and for bleeding prediction. This study assessed whether the ISTH-BAT bleeding score can predict subsequent bleeding events requiring treatment in patients with inherited platelet disorders. Patients with high baseline bleeding scores were more likely to suffer from bleeding events requiring treatment, regardless of their specific diagnosis.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Hematology
Amir Samii, Mahshaad Norouzi, Abbas Ahmadi, Akbar Dorgalaleh
Summary: GIB is a serious condition that is difficult to manage due to heterogeneity in CBDs. Evaluating the hematological status and providing urgent interventions for high-risk patients are crucial. The best management strategy for CFD-related bleeding remains controversial.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2022)
Article
Medicine, General & Internal
F. Atiq, J. L. Saes, M. C. Punt, K. P. M. van Galen, R. E. G. Schutgens, K. Meijer, M. H. Cnossen, B. A. P. Laros-Van Gorkom, M. Peters, L. Nieuwenhuizen, M. J. H. A. Kruip, J. de Meris, J. G. van der Bom, F. J. M. van der Meer, K. Fijnvandraat, I. C. Kruis, W. L. van Heerde, H. C. J. Eikenboom, Frank W. G. Leebeek, S. E. M. Schols
Summary: In autosomal inherited bleeding disorders, women are more likely to be referred for bleeding, have a longer diagnostic delay, and often require treatment for sex-specific bleeding.
Review
Hematology
Edwin Ocran, Nicholas L. J. Chornenki, Mackenzie Bowman, Michelle Sholzberg, Paula James
Summary: This paper reviews the literature on GI bleeding in VWD patients and summarizes existing strategies in the management of angiodysplasia-related GI bleeding in patients with VWF abnormalities. Suggestions are made for further research directions.
EXPERT REVIEW OF HEMATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Cosmos L. T. Guo, Sunny H. Wong, Louis H. S. Lau, Rashid N. S. Lui, Joyce W. Y. Mak, Raymond S. Y. Tang, Terry C. F. Yip, William K. K. Wu, Grace L. H. Wong, Francis K. L. Chan, James Y. W. Lau, Joseph J. Y. Sung
Summary: The study found that early endoscopy after admission for acute upper gastrointestinal bleeding was associated with better outcomes compared to urgent or late endoscopy, especially in patients with non-variceal bleeding. This suggests that patients with non-variceal AUGIB should receive endoscopy within 24 hours, while also highlighting the importance of prior resuscitation and pharmacotherapy.
Review
Biochemistry & Molecular Biology
Veronica Palma-Barqueros, Nuria Revilla, Ana Sanchez, Ana Zamora Canovas, Agustin Rodriguez-Alen, Ana Marin-Quilez, Jose Ramon Gonzalez-Porras, Vicente Vicente, Maria Luisa Lozano, Jose Maria Bastida, Jose Rivera
Summary: Platelets are essential for hemostasis, and inherited platelet disorders (IPDs) are rare genetic diseases with variable clinical manifestations, where early diagnosis and close patient follow-up are crucial. Genetic diagnosis is important for proper clinical management, and although advances have been made in diagnosis, there are still ethical concerns regarding genetic investigations.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Hematology
Ferdows Atiq, Esmee Wuijster, Moniek P. M. de Maat, Marieke J. H. A. Kruip, Marjon H. Cnossen, Frank W. G. Leebeek
Summary: The study investigated the incidence of bleeding after low VWF diagnosis and developed a risk score to predict future bleeding. The cutoff value for low VWF diagnosis should be set at 0.60 IU/ml, and a risk score has been developed to identify individuals with a high risk for bleeding after low VWF diagnosis.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Review
Hematology
Wolfgang Miesbach, Erik Berntorp
Summary: The limited awareness and challenges in diagnosing and treating patients with von Willebrand disease highlight the need for greater understanding and implementation of long-term prophylactic treatment similar to that used in patients with severe haemophilia.
THROMBOSIS RESEARCH
(2021)
Article
Hematology
Lisa Clarke, Peta M. Dennington, Jennifer Curnow
Summary: This study aimed to evaluate the outcomes of adult patients with inherited bleeding disorders undergoing elective surgery in NSW/ACT, Australia, and assess their adherence to guidelines. The results showed low complication rates in surgeries, but also indicated non-compliance with published guidelines in certain areas.
Article
Obstetrics & Gynecology
Luis D. Pacheco, George R. Saade, Andra H. James
Summary: The maternal and fetal implications of inherited bleeding disorders include von Willebrand disease (VWD), hemophilia, other congenital clotting factor deficiencies, inherited platelet disorders, defects of fibrinolysis, and connective tissue disorders. The most common diagnosed bleeding disorder among women is VWD, while other bleeding disorders, such as hemophilia carriership, are less common. Management for maternal includes obtaining clotting factor levels, planning for delivery at a center with hemostasis expertise, and using hemostatic agents. Fetal management includes prepregnancy counseling, preimplantation genetic testing, and consideration of cesarean delivery for potentially affected male neonates with hemophilia.
OBSTETRICS AND GYNECOLOGY
(2023)
Article
Hematology
Christine J. Guelcher, Jaime Chase, Debra Pollard
Summary: Over the last few decades, there has been an increasing focus on women with inherited bleeding disorders (WBD), leading to more patients being treated at Haemophilia Treatment Centres (HTC) worldwide. These women face unique challenges, including a significant risk of heavy menstrual bleeding (HMB). Nurses, who play a central role in patient and family education within the HTC, are well positioned to provide clinical care and education specifically for WBD. However, there is a lack of literature highlighting the role of HTC nurses and their potential impact on this growing but understudied patient population.
Review
Gastroenterology & Hepatology
Nicolas Chapelle, Myriam Martel, Marc Bardou, Majid Almadi, Alan N. Barkun
Summary: This study systematically reviewed the effectiveness of Doppler endoscopic probe (DEP) in nonvariceal upper gastrointestinal bleeding (NVUGIB) and found that DEP-related information improves prediction of rebleeding and DEP-guided management reduces overall rebleeding, bleeding-related mortality, and need for surgery in NVUGIB patients.
DIGESTIVE ENDOSCOPY
(2023)
Article
Gastroenterology & Hepatology
Daniel von Renteln, Roupen Djinbachian, Florence Benard, Alan N. Barkun, Mickael Bouin, Simon Bouchard, Erik Deslandres, Benoit Panzini, Sacha Sidani, Raymond Leduc, Bruce C. Jobse, Heiko Pohl
Summary: This study aimed to evaluate the incomplete resection rates (IRRs) when using the cold snare polypectomy (CSP) for colorectal polyps of 4-20 mm. The study found that CSP is safe and feasible for polyps smaller than 10 mm, but CSP failure occurs frequently for polyps larger than or equal to 10 mm, and the IRR remains high.
Article
Medicine, General & Internal
Omar Kherad, Antonio Vaz Carneiro
Summary: In high-income countries, regular general health check-ups are commonly practiced, but their actual benefits are not well supported by evidence. The Choosing Wisely campaigns provide an opportunity to shift away from this non-evidence based practice. As members of the European Federation of Internal Medicine's CW working group, we aim to contribute our evidence-based perspective to this discussion.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Vincent Palmieri, Alan Barkun, Nauzer Forbes, Myriam Martel, Eric Lam, Jennifer Telford, Gurpal Sandha, Sarto Paquin, Anand Sahai, Yen- Chen
Summary: This study evaluated the practice of EUS-BD and identified barriers to its widespread adoption. The uptake of EUS-BD as a first-line treatment for MDBO was low, mainly due to lack of high-quality data, fear of adverse events, and limited access to EUS-BD dedicated devices. In salvage situations following failed ERCP, most favored EUS-BD, but in potentially resectable disease, the percutaneous approach was preferred due to concerns about complicating future surgery.
ENDOSCOPIC ULTRASOUND
(2023)
Article
Gastroenterology & Hepatology
Ali A. Alali, Sarvee Moosavi, Myriam Martel, Majid Almadi, Alan N. Barkun
Summary: This study comprehensively reviewed the effectiveness of topical hemostatic agents in the management of upper gastrointestinal bleeding (UGIB) in different clinical settings. The results showed that topical hemostatic agents achieved immediate hemostasis effectively and had similar overall rebleeding rates compared to conventional endoscopic modalities. However, due to methodological limitations of available data, additional studies are needed to confirm their effectiveness in the management of patients with UGIB.
ENDOSCOPY INTERNATIONAL OPEN
(2023)
Review
Gastroenterology & Hepatology
Corey Miller, Joshua A. Benchaya, Myriam Martel, Alan Barkun, Jonathan M. Wyse, Lorenzo Ferri, Yen- Chen
Summary: Background and study aims: Malignant gastric outlet obstruction (MGOO) is traditionally treated with surgical gastrojejunostomy (SGJ) or endoscopic stenting (ES). This study compared the effectiveness and safety of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) to SGJ and ES for MGOO. Results showed that EUS-GE had higher clinical success rates and lower adverse event rates compared to ES or SGJ, making it the most successful approach.
ENDOSCOPY INTERNATIONAL OPEN
(2023)
Review
Gastroenterology & Hepatology
Ali A. Alali, Antoine Boustany, Myriam Martel, Alan N. Barkun
Summary: Despite advances in managing upper gastrointestinal bleeding (UGIB), morbidity and mortality are still significant. Risk assessment scores can help with early risk stratification, optimizing identification of low-risk patients and reducing the need for early endoscopy and hospital admissions.
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
(2023)
Review
Medicine, General & Internal
Antoine Boustany, Ali A. Alali, Majid Almadi, Myriam Martel, Alan N. Barkun
Summary: This systematic review and meta-analysis compared the predictive abilities of different pre-endoscopic scores in prognosticating adverse events in patients with upper gastrointestinal bleeding (UGIB). The Glasgow-Blatchford score (GBS) showed good discriminative ability and clinical utility in predicting the need for hospital-based interventions. Setting the GBS cutoff at 1 or lower effectively identified low-risk patients and allowed for outpatient management.
JOURNAL OF CLINICAL MEDICINE
(2023)
Correction
Medicine, General & Internal
Evans J. Callum, A. Barkun
CANADIAN MEDICAL ASSOCIATION JOURNAL
(2023)
Article
Pharmacology & Pharmacy
Fatema Fawzi Younis Al-Habeeb, Ali Abd Alateef Abd Alhassan Al Ali
Summary: Due to the high effectiveness and lack of adverse effects, research has focused on using biological agents and natural products as an alternative method for treating incurable diseases like cancer. This study tested NDV and lavender oil on cancer and normal cell lines, and found that both substances showed cytotoxic effects on cancer cells. Pathological abnormalities were observed in the treated cells, indicating the harmful impacts of the substances on cell appearance. Additionally, programmed cell death was examined using acridine orange and ethidium bromide staining.
JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY
(2023)
Article
Gastroenterology & Hepatology
Omar Kherad, Sophie Restellini, Majid Almadi, Myriam Martel, Alan N. Barkun
Summary: The ABC risk score is effective in identifying high-risk patients with acute lower and upper gastrointestinal bleeding (UGIB). It outperforms other prognostication scales in predicting 30-day mortality, but shows limited clinical usefulness in predicting secondary outcomes, limiting its adoption in early management of high-risk UGIB patients.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2023)
Review
Gastroenterology & Hepatology
Ali A. Alali, Alan N. Barkun
Summary: Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal emergency that has significant morbidity and mortality. The epidemiology of UGIB has been changing with a decrease in peptic ulcer disease and an increase in other etiologies. Risk assessment and patient stratification are important for optimal care, with some tools able to identify a low-risk group for outpatient management. Primary care providers play a crucial role in resuscitation, stabilizing patients, providing blood transfusions, and arranging urgent endoscopic assessment and intervention. Managing antithrombotic agents in the acute setting remains challenging.
GASTROENTEROLOGY REPORT
(2023)
Meeting Abstract
Gastroenterology & Hepatology
Edgard Medawar, Roupen Djinbachian, Ioana Popescu Crainic, Peter L. Lakatos, Ali Vedadi, Alan N. Barkun, Daniel Von Renteln
Meeting Abstract
Gastroenterology & Hepatology
Faisal S. Ali, Maryam Rafaqat Hussain, Abdulaziz Altowaijri, Majid A. Almadi, Alan N. Barkun
Meeting Abstract
Gastroenterology & Hepatology
Alan N. Barkun, Michel Boivin, Gaetano Morelli, Line Nederby, Francisco Trelles, Roberto Rodriguez-Suarez, Andrea Herrera-Gayol, Katia Betito, Gilles Jobin