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World Journal of Gastroenterology Jun 2019Small bowel vascular lesions, including angioectasia (AE), Dieulafoy's lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure... (Review)
Review
Small bowel vascular lesions, including angioectasia (AE), Dieulafoy's lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be venous lesions, they usually manifest as a chronic, well-compensated condition. Subsequent to video capsule endoscopy, deep enteroscopy can be applied to control active bleeding or to improve anemia necessitating blood transfusion. Despite the initial treatment efficacy of argon plasma coagulation (APC), many patients experience re-bleeding, probably because of recurrent or missed AEs. Pharmacological treatments can be considered for patients who have not responded well to other types of treatment or in whom endoscopy is contraindicated. Meanwhile, a conservative approach with iron supplementation remains an option for patients with mild anemia. DL and AVM are considered to be arterial lesions; therefore, these lesions frequently cause acute life-threatening hemorrhage. Mechanical hemostasis using endoclips is recommended to treat DLs, considering the high re-bleeding rate after primary APC cauterization. Meanwhile, most small bowel AVMs are large and susceptible to re-bleeding therefore, they usually require surgical resection. To achieve optimal diagnostic and therapeutic approaches for each type of small bowel lesion, the differences in their epidemiology, pathology and clinical presentation must be understood.
Topics: Anemia; Angiodysplasia; Argon Plasma Coagulation; Capsule Endoscopy; Gastrointestinal Hemorrhage; Hemostatic Techniques; Humans; Intestine, Small; Iron; Treatment Outcome
PubMed: 31235995
DOI: 10.3748/wjg.v25.i22.2720 -
Ugeskrift For Laeger Dec 2022Gastric antral vascular ectasia is characterized endoscopically by stripes of dilated blood vessels in the antrum. It is a well-known cause of gastrointestinal blood... (Review)
Review
Gastric antral vascular ectasia is characterized endoscopically by stripes of dilated blood vessels in the antrum. It is a well-known cause of gastrointestinal blood loss, anaemia, and recurrent need for blood transfusion. The treatment may be challenging, and an overview is given in this review. Pharmacological treatment has not been effective, endoscopic treatment is more tolerable than abdominal surgery. The endoscopic modalities, including argon plasma coagulation, endoscopic band ligation, and radiofrequency ablation are safe and relative efficient. Comparative studies are sparse but indicate the modalities as equally effective.
Topics: Humans; Gastric Antral Vascular Ectasia; Treatment Outcome; Gastroscopy; Argon Plasma Coagulation; Anemia; Gastrointestinal Hemorrhage
PubMed: 36621874
DOI: No ID Found -
Biomedicines Nov 2022The plasma scalpel is an application of gas discharges in electrosurgery. This paper introduces the device structure and physicochemical parameters of the two types of... (Review)
Review
The plasma scalpel is an application of gas discharges in electrosurgery. This paper introduces the device structure and physicochemical parameters of the two types of plasma scalpels, namely, a single-electrode Ar discharge device (argon plasma coagulation) and a two-electrode discharge device in normal saline. The diagnostic methods, including the voltage and current characteristics, optical emission spectroscopy, electron spin resonance, and high-speed imaging, are introduced to determine the critical process parameters, such as the plasma power, the gas temperature, the electron density, and the density of active species, and study the ignition dynamics of the plasma discharges in water. The efficacy of the plasma scalpel is mainly based on the physical effects of the electric current and electric field, in addition to the chemical effects of high-density energetic electrons and reactive species. These two effects can be adjusted separately to increase the treatment efficacy of the plasma scalpel. Specific guidance on further improvements of the plasma scalpel devices is also provided.
PubMed: 36428535
DOI: 10.3390/biomedicines10112967 -
Annals of Gastroenterology 2019Bleeding due to primary or metastatic gastrointestinal (GI) tumors remains clinically challenging. Bleeding is further complicated in the setting of underlying friable... (Review)
Review
Bleeding due to primary or metastatic gastrointestinal (GI) tumors remains clinically challenging. Bleeding is further complicated in the setting of underlying friable neovascularization of tumors and coagulopathy. Endoscopic hemostatic therapeutic options have traditionally involved the use of thermal/mechanical therapy in conjunction with injection therapy. This review looks at the role of endoscopy in managing tumor-related GI bleeding, specifically contact and non-contact thermal therapy, radiofrequency ablation, endoloops, epinephrine and ethanol injection, and, most recently, Hemospray. Overall, current data show that endoscopic therapy is limited, with high rebleeding rates and a failure to improve overall outcomes. Larger clinical trials are needed to determine the efficacy of current techniques and establish therapeutic algorithms, with the goal of achieving primary hemostasis and reducing rebleeding rates.
PubMed: 31263356
DOI: 10.20524/aog.2019.0391 -
Oman Journal of Ophthalmology 2023
PubMed: 38059093
DOI: 10.4103/ojo.ojo_240_23 -
Heliyon May 2023Xenon and argon inhalation were included on the WADA Prohibited List in 2014 due to the reported positive effects on erythropoiesis and steroidogenesis that occur as a... (Review)
Review
BACKGROUND
Xenon and argon inhalation were included on the WADA Prohibited List in 2014 due to the reported positive effects on erythropoiesis and steroidogenesis that occur as a result of their application. Thus, the systematic review of studies supporting these notions is of interest.
METHODS
A thorough search on the effects of xenon and argon inhalation on erythropoiesis and steroidogenesis, as well as their negative effects on human health and method detection was conducted. Pubmed and Google Scholar databases and the Cochrane Library were researched, as well as the WADA research section. The search was conducted in accordance with the PRISMA guidelines. All articles written in English and published between 2000 and 2021 were analyzed, as well as reference studies meeting the search criteria.
RESULTS
At present, there are only two publications in healthy human subjects evaluating the effects of xenon inhalation on erythropoiesis that found no conclusive evidence of a positive effect on erythropoiesis. This research was published following the inclusion of this gas on the WADA Prohibited List in 2014 and had a high risk of bias. There were no studies available on the effect of argon inhalation on erythropoiesis. Furthermore, no studies were found on the effect of xenon or argon inhalation on steroidogenesis in healthy subjects and no studies relating to the effects of xenon or argon inhalation on erythropoiesis and steroidogenesis were found on the WADA website.
CONCLUSION
There is still inconclusive evidence to support the administration of xenon and argon inhalations on erythropoiesis and steroidogenesis and their positive effects on health. Further research is warranted to establish the effects of these gases. Additionally, improved communication between anti-doping authorities and all key stakeholders is required to support the inclusion of various substances on recognized prohibited lists.
PubMed: 37215856
DOI: 10.1016/j.heliyon.2023.e15837