engraftment by donor lymphocytes in an immunologically compromised host can result in donor t-cell activation against host major histocompatibility complex antigens, with resultant gvhd. the acute form of gvhd (agvhd) is characterized by erythroderma, cholestatic hepatitis, and enteritis. the intestinal symptoms of agvhd include crampy abdominal pain and watery diarrhea, often with blood. the c...

INTRODUCTION AND OBJECTIVES The incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting. The available bleeding risk scores have not been validated specifically in the elderly. Our aim was to assess predictive ability of the most important bleeding risk scores in patients with acute coronary syndrome aged ≥...

This article discussed the diagnosis and management of acute GI bleeding, prophylaxis against GI bleeding, acute pancreatitis, and acalculous cholecystitis. These diseases are commonly encountered in the ICU setting. Acute GI bleeding is usually obvious and with GI and with available interventional radiologic techniques, patients rarely need surgery. Conversely, acalculous cholecystitis is diff...

Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, ...

crohn’s disease (cd) is rarely presented with lower gi bleeding (lgib) which eludes the clinician. a 25-year-old lady with severe rectorrhagia was presented with no history of constipation, diarrhea or abdominal pain. colonoscopy revealed ulcers in the rectum, sigmoid colon, and terminal ileum. crohn’s pathologic features were detected in the terminal ileum. the bleeding was controlled via supp...

Acute bleeding after bone marrow transplantation (BMT) was investigated in 1,402 patients receiving transplants at Johns Hopkins Hospital between January 1, 1986 and June 30, 1995. Bleeding categorization was based on daily scores of intensity used by the blood transfusion service. Moderate and severe episodes were analyzed for bleeding sites. Analysis of the cause of death and the interval of ...

Glanzmann's thromboasthenia (GT) is a rare platelet disorder, due to membrane defects involving glycoprotein GP IIb/IIIa complex. Symptoms appear in infancy with episodes of bruising, gingival bleeding, epistaxis, or at the time of menarche acute episode of uterine bleeding. Hormonal therapy and antifibrinolytic agents are first-line treatment. Platelet transfusion is given to control hemorrhag...

Gastroesophageal varices bleeding is a major complication in patients with cirrhosis. Gastric varices (GVs) occur in approximately 20% of patients with portal hypertension. However, GV bleeding develops in only 25% of patients with GV and requires more transfusion and has higher mortality than esophageal variceal (EV) bleeding. The best strategy for managing acute GV bleeding is similar to that...