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T-W Chuang, S-C Chen, K-T Chen
AIMS: The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). METHODS: Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review...
July 2017: Acta Gastro-enterologica Belgica
Daryl Ramai, Andrew Ofosu, Madhavi Reddy
Gastric diverticula represent the rarest of gastrointestinal diverticula. While similar to duodenal, jejunal and colonic diverticula, gastric diverticula are found incidentally upon upper endoscopy and are mostly asymptomatic. However, larger diverticula can lead to symptoms such as upper abdominal pain, nausea, emesis, and dyspepsia. Some patients may present with dramatic presentations including ulceration, hemorrhage, or perforation. Clinicians should be aware that diagnostic imaging may not always detect the presence of gastric diverticula...
February 2018: Gastroenterology Research
Cankat Kara, Ceren Gökmenoglu, Onur Sahin, Sezgi Cinel, Nihal Belduz Kara, Elif Sadik
OBJECTIVE: To demonstrate a supportive treatment option based on microorganism's growth characteristics. METHODS: This study was conducted at Ordu University, Faculty of Dentistry, Turkey, between January and April, 2017, comprising patients whose periodontal parameters and saliva pH scores were measured before and after the treatments. The patients were divided into two equal groups. Group I underwent routine periodontal treatment methods for streptococcal gingivitis, while a supportive treatment that involved an antacid chewing tablet two times a day for a week based on the microorganism's growth characteristics was used on patients in Group II...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Aarti Narayan, Arun Subramanian
We report a case of severe generalised muscle weakness in a 66-year-old man who underwent revision of left knee arthroplasty. On postoperative day 1, he developed non-focal muscle weakness and shortness of breath which progressed over a 6-hour period. Serum phosphorus level was severely low at 0.5 mg/dL, along with mild degree of hypokalaemia, hypocalcaemia and hypomagnesaemia. His symptoms completely resolved after emergent phosphorus replacement. The authors believe this case is of educational interest to physicians as generalised muscle weakness is an uncommon presentation of severe hypophosphataemia...
February 23, 2018: BMJ Case Reports
Ovadyah Avraham, Michael Biglow
BACKGROUND: Deprescribing is a recommended intervention to reduce morbidity and mortality caused by polypharmacy in older residents. However, a lack of definite deprescription guidelines and evidence of clinically meaningful outcomes complicates or precludes the practicality of such an approach. OBJECTIVE: The objective of the present pilot study is to establish and implement a stepwise taper protocol that can potentially minimize overuse of proton pump inhibitors in a safe, effective, and feasible manner in the nursing home...
February 1, 2018: Annals of Pharmacotherapy
Rang Wang, Ke Zhou, Qiuping Fan, Haotian Chen, Chengzhong Fan
RATIONALE: Iodine-131 (I-131) is a sensitive marker for the detection of differentiated thyroid cancer (DTC). I-131 whole-body scintigraphy (WBS) has been used widely in evaluation of DTC patient. However, I-131 WBS exists many false-positive uptake of I-131 because radioiodine uptake can also be seen in healthy tissue or in a variety of benign and malignant non-thyroidal tumors. PATIENT CONCERNS: A 44-year-old woman with a papillary thyroid carcinoma for the purpose of ablation therapy after a total thyroidectomy...
February 2018: Medicine (Baltimore)
Dileepa Senajith Ediriweera, Nuwani Dilina, Vipula Saparamadu, Inoka Fernando, Buddhika Kurukulasuriya, Deepika Fernando, Janakie Kurera
OBJECTIVE: Aspirin is a commonly used medicine for primary and secondary prevention of cardiovascular diseases. It is an acidic medicine associated with gastric irritation and acid reflux, which in turn can lead to low oral pH levels. Therefore, it is important to understand the association between aspirin and oral pH levels in order to achieve an optimum oral health condition among patients who take aspirin on prescription. RESULTS: Out of 373 patients, 162 (44%) were males and 245 (66%) were on aspirin...
February 20, 2018: BMC Research Notes
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
April 2018: Expert Review of Gastroenterology & Hepatology
Rebekah A Wahking, Randal L Steele, Rachel E Hanners, Sean M Lockwood, Kelly W Davis
Background: Proton pump inhibitors (PPIs) are effective medications for acid-related disorders; however, they are also overused and may be associated with several adverse effects. A PPI stewardship program was implemented at one institution to combat the overuse of PPIs. Objective: The purpose of this study is to evaluate the effectiveness of an inpatient PPI stewardship program in reducing PPI use, both during hospitalization and upon discharge. Methods: This was a retrospective cohort study of all patients admitted to an internal medicine service at a single institution from March 14, 2016, to August 14, 2016, with an intervention by the PPI stewardship team...
February 2018: Hospital Pharmacy
Marleen M H J van Gelder, Saskia Vorstenbosch, Bernke Te Winkel, Eugène P van Puijenbroek, Nel Roeleveld
Medication use is often underreported in paper-based questionnaires or interviews. Web-based questionnaires may improve recall of medication use, but data on their validity are currently lacking. Participants in the Pregnancy and Infant Development (PRIDE) Study (2014-2016; n = 557) and the Pregnancy Drug Registry (pREGnant) (2015-2016; n = 169) completed a 6-week paper-based medication diary during gestational weeks 19-24 or 26-31. In week 34, they completed a Web-based questionnaire with questions on medication names, time period and frequency of use, and quantity taken...
February 1, 2018: American Journal of Epidemiology
Velu Nair, D N Karan, C S Makhani
Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. Undesirable clinical outcomes are probable if prodromal stage evolves rapidly and is severe. Critical systems like neurovascular, gastrointestinal, haematopoietic and cutaneous are afflicted in Acute Radiation Syndrome. Three main elements which are essential for assessment of prognosis and selection of treatment are vomiting onset time, kinetics of depletion of lymphocyte, and chromosome abnormalities...
October 2017: Medical Journal, Armed Forces India
Nitsan Maharshak, Idan Barzilay, Hasya Zinger, Keren Hod, Iris Dotan
To evaluate the frequency, possible risk factors, and outcome of Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD) patients.There has been an upsurge of CDI in patients with IBD who has been associated with increased morbidity and mortality. Various risk factors have been found to predispose IBD patients to CDI.A retrospective case-control study on IBD patients admitted with exacerbation and tested for CDI at the Tel Aviv Medical Center in 2008 to 2013. Epidemiologic, laboratory, and prognostic data were retrieved from electronic files and compared between patients who tested positive (CDI+) or negative (CDI-) for CDI...
February 2018: Medicine (Baltimore)
Claudio Tana, Mauro Silingardi, Maria Adele Giamberardino, Francesco Cipollone, Tiziana Meschi, Cosima Schiavone
In the "proton pump inhibitors era", a penetrating peptic ulcer (PPU) represents an exceptional cause of abdominal pain, and was more frequently observed in the past where there was not an effective antacid treatment. Ulcer-induced pancreatitis is very rare, too, and manifests with persistent, intense pain radiating to the back. A mild to severe pancreatitis with peripancreatic fluid collection can be observed at imaging. However, only a few cases of association between PPU and emphysematous pancreatitis (EP) have been published in the literature...
December 28, 2017: World Journal of Gastroenterology: WJG
Elisabeth M Robin, Pascaline B Pey, Pauline de Fornel-Thibaud, Pierre H M Moissonnier, Valérie Freiche
CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement. CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing...
February 1, 2018: Journal of the American Veterinary Medical Association
Jürgen Behr, Andreas Günther, Francesco Bonella, Klaus Geißler, Dirk Koschel, Michael Kreuter, Antje Prasse, Nicolas Schönfeld, Helmut Sitter, Joachim Müller-Quernheim, Ulrich Costabel
Idiopathic pulmonary fibrosis (IPF) is a severe and often fatal disease with a median survival of 2 - 4 years after diagnosis. Since the publication of the German IPF guideline in 2013 new treatment trials have been published, necessitating an update of the pharmacological therapy of IPF. Different from the previous guideline, the GRADE system was discarded and replaced by the Oxford evidence classification system which allows a more differentiated judgement. The following pharmacological therapies were rated not suitable for the treatment of IPF patients (recommendation A; evidence 1-b): triple therapy with prednisolone, azathioprine and acetyl-cysteine; imatinib; ambrisentan; bosentan; macitentan...
January 16, 2018: Pneumologie
Shu Yuan, Zhong-Wei Zhang, Zi-Lin Li
Hyperuricemia is the term for an abnormally high serum uric acid level. Many factors contribute to hyperuricemia, however no definite correlation between proton pump inhibitors (PPIs) and hyperuricemia has been reported before. Physical exercise also decreases serum uric acid levels. However, the detailed biochemical-regulatory mechanisms remain unknown. Here we found that adenylate deaminase activities are much higher in hyperuricemia patients than in the healthy people. Therefore, the patients have higher levels of adenosine metabolites hypoxanthine and uric acid...
January 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Bianca Mulder, Maarten J Bijlsma, Catharina Cm Schuiling-Veninga, Leonard P Morssink, Eugene van Puijenbroek, Jan G Aarnoudse, Eelko Hak, Tjalling W de Vries
Background: Understanding perception of risks and benefits is essential for informed patient choices regarding medical care. The primary aim of this study was to evaluate the perception of risks and benefits of 9 drug classes during pregnancy and associations with women's characteristics. Methods: Questionnaires were distributed to pregnant women who attended a Dutch Obstetric Care facility (first- and second-line care). Mean perceived risk and benefit scores were computed for 9 different drug classes (paracetamol, antacids, antibiotics, antifungal medication, drugs against nausea and vomiting, histamine-2 receptor antagonists/proton pump inhibitors, antidepressants, nonsteroidal anti-inflammatory drugs, and sedatives/anxiolytics)...
2018: Patient Preference and Adherence
Chun-Hsien Lee, Fong-Ching Chang, Sheng-Der Hsu, Hsueh-Yun Chi, Li-Jung Huang, Ming-Kung Yeh
BACKGROUND: While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication. METHOD: In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication...
2017: PloS One
Ülkü Dağlı, İsmail Hakkı Kalkan
Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy. In the medical treatment of pregnant women with GERD, alginic acid and sucralfate can be used. Calcium- and magnesium-based antacids can also be used, particularly for patients with preeclampsia. In particular, ranitidine -a histamine-2 receptor blocker- is preferred. In the case of non-responsiveness to the abovementioned treatments, proton pump inhibitors (PPIs), except omeprazole, can be given considering the benefit-harm ratio for the mother and fetus after the first trimester...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Alexandre Seidowsky, Emmanuel Dupuis, Tilman Drueke, Serge Dard, Ziad A Massy, Bernard Canaud
Aluminum intoxication in chronic hemodialysis patients has virtually vanished over the last decade. Therefore, the diagnosis is rarely advocated at present. Aluminum intoxication in dialysis patients associates to different degrees with dialysis encephalopathy, bone disorders and microcytic anemia. We report here the observation of a patient receiving intermittent hemodialysis therapy who presented with acute encephalopathy. It turned out to be caused by aluminum intoxication secondary to a defect in dialysis water treatment...
November 22, 2017: Néphrologie & Thérapeutique
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