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Pearl Toh, 31 Dec 2019
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Haemostatic sprays effective for upper gastrointestinal bleeding

13 Dec 2019

Novel haemostatic powders are easy to use and appear to be effective for the management of upper gastrointestinal bleeding, reports a recent meta-analysis.

Accessing the databases of Pubmed, Embase, Google Scholar and the Cochrane Library, researchers retrieved 24 studies eligible for analysis. For inclusion, studies had to have reported on haemostatic success or rebleeding rate; case reports, animal studies and nonendoscopic investigations were excluded.

Overall, 1,063 patients with gastrointestinal bleeding were assessed, 913 of whom received haemostatic powders. Almost all participants (95.3 percent) achieved immediate haemostasis, with only moderate evidence of heterogeneity.

Disaggregation according to treatment strategy did not meaningfully change the results. Monotherapy had an immediate haemostasis rate of 94.4 percent. This improved slightly to 96 percent when combined with endoscopic procedures. Rates were also comparable between the two haemostatic agents analysed (Hemospray vs EndoClot: 95.8 percent vs 91.2 percent).

The aetiology and type of upper gastrointestinal bleeding likewise had no significant effect on the immediate haemostasis rate.

All-cause mortality rate was 7.6 percent, mostly occurring within 1 month of the treatment; bleeding-related mortality was 1.4 percent. Heterogeneity of evidence for all-cause mortality was large, though this was mostly driven by the variety of causes of death considered.

“To the best of our knowledge, the current manuscript represents the first meta-analysis in the field and the first attempt to systematically compare haemostatic powders with conventional endoscopic treatments,” said researchers.

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.
11 Jan 2020
Prevention of glucocorticoid-induced osteoporosis (GIOP) and postmenopausal osteoporosis (PMOP) remains inadequate in patients with rheumatoid arthritis (RA), as shown in a study that evaluated the implementation of the 2003 and 2014 French guidelines on the prevention and treatment of GIOP and the 2012 update of the French guidelines for the treatment of PMOP.