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https://www.readbyqxmd.com/read/29457492/the-risk-of-community-acquired-enteric-infection-in-proton-pump-inhibitor-therapy-systematic-review-and-meta-analysis
#1
Radwan A Hafiz, Chia Wong, Stuart Paynter, Michael David, Geeske Peeters
BACKGROUND: Previous meta-analyses suggest that users of proton pump inhibitors (PPIs) have a higher risk of developing enteric infections compared with nonusers. These previous meta-analyses have considerable heterogeneity, and it is not clear whether the effect of PPIs is different for different types of microorganisms. OBJECTIVE: The aim of this study is to update previous meta-analyses, concentrating on enteric infection in community settings and exploring potential sources of heterogeneity...
February 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29454848/a-multi-center-derivation-and-validation-of-a-simple-predictive-index-for-healthcare-associated-clostridium-difficile-infection
#2
Meghann L Davis, Harlan G Sparrow, Judy O Ikwuagwu, William L Musick, Kevin W Garey, Katherine K Perez
OBJECTIVES: Clostridium difficile infection (CDI) is the most common cause of healthcare-associated infections in the United States. Despite well-established risk factors, very little research has focused on use of these variables to identify a patient population at high-risk for CDI to target with primary prevention strategies. A predictive index for healthcare-associated CDI could improve clinical care and guide research for primary prevention trials. Our objective was to develop a predictive index to identify patients at high-risk for healthcare-associated CDI...
February 15, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29449419/reversible-cerebellar-oedema-secondary-to-profound-hypomagnesaemia
#3
Amy Louise Ross Russell, Martin Prevett, Paul Cook, Charles Simon Barker, Ashwin Arnold Pinto
Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors...
February 15, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29449127/evaluating-the-effect-of-six-proton-pump-inhibitors-on-the-antiplatelet-effects-of-clopidogrel
#4
Eugene R Przespolewski, Erica S Westphal, Michelle Rainka, Nicholas M Smith, Vernice Bates, Fran M Gengo
BACKGROUND AND GOAL: Cytochrome P450 (CYP) enzymes are responsible for the conversion of clopidogrel into its active metabolite and the metabolism of proton pump inhibitors (PPIs), which may also inhibit CYP enzymes. A current Food and Drug Administration advisory suggests avoiding esomeprazole and omeprazole while taking clopidogrel because of concerns that PPIs may compromise clopidogrel's antiplatelet effects. The objective of the present study was to examine the robustness of this interaction using a well-controlled study design in a population of participants free of confounders...
February 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29448975/analysis-of-patients-with-hypomagnesemia-using-the-japanese-adverse-drug-event-report-database-jader
#5
Hiroyuki Tanaka, Yuka Yoshiba, Tomoko Watanabe, Mitsutoshi Satoh, Toshihiro Ishii
PURPOSE: In order to clarify the occurrence of hypomagnesemia in Japan, we conducted a database search and analysis using the Japanese Adverse Drug Event Report database (JADER). METHODS: Among the cases recorded in JADER between April 2004 and December 2015, we targeted "hypomagnesemia" and analyzed the patients' backgrounds, drug involvement, other adverse events reported with hypomagnesemia, the time of hypomagnesemia onset, outcomes, and year when reported...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29444465/simultaneous-detection-of-human-cyp2c19-polymorphisms-and-antibiotic-resistance-of-helicobacter-pylori-using-a-personalized-diagnosis-kit
#6
Jun Zhang, Jing Zhong, Jian Ding, Jiemin Shi, Tao Tang, Qiqi Liu, Huilian Huang, Licheng Dai, Ningmin Yang
OBJECTIVES: We evaluated a personalized diagnosis kit for Helicobacter pylori that employs visual gene chip technology for the simultaneous detection of CYP2C19 polymorphisms, and clarithromycin/levofloxacin antibiotic resistance. METHODS: H. pylori isolates from the gastric antrum mucosa of 394 patients were tested using the kit. DNA sequencing and antibiotic susceptibility testing were also performed. RESULTS: In total, 267/394 (67.77%) specimens were positive for H...
February 11, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29441500/the-epidemiology-of-clostridium-difficile-infection-in-japan-a-systematic-review
#7
REVIEW
Thomas V Riley, Tomomi Kimura
To increase understanding of the epidemiology, risks, consequences and resource utilization of Clostridium difficile infection (CDI) in Japan, a systematic literature review was undertaken of relevant publications from January 2006 to November 2017. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and methods, 55 articles met the criteria for full review. The majority (58%) of studies were from a single site, with the most recent data from 2015. The incidence, reported prevalence and recurrence rate of CDI in Japan were 0...
February 13, 2018: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29438118/nsaids-and-the-small-bowel
#8
Foong Way David Tai, Mark E McAlindon
PURPOSE OF REVIEW: The review describes the effects of NSAID gastrointestinal toxicity on the small bowel, wherein injury is as prevalent as in the gastroduodenum. This is well documented by capsule endoscopy, which also provides an endoscopic endpoint for novel treatment strategies. RECENT FINDINGS: Appreciation of the prevalence of NSAID enteropathy has grown with capsule endoscopy and the use of composite end points that include obscure haemoglobin decreases in clinical studies...
February 12, 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29437910/modern-diagnosis-of-gerd-the-lyon-consensus
#9
REVIEW
C Prakash Gyawali, Peter J Kahrilas, Edoardo Savarino, Frank Zerbib, Francois Mion, André J P M Smout, Michael Vaezi, Daniel Sifrim, Mark R Fox, Marcelo F Vela, Radu Tutuian, Jan Tack, Albert J Bredenoord, John Pandolfino, Sabine Roman
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors...
February 3, 2018: Gut
https://www.readbyqxmd.com/read/29436014/comparison-of-dysplastic-fundic-gland-polyps-in-patients-with-and-without-familial-adenomatous-polyposis
#10
Shana F Straub, Michael G Drage, Raul S Gonzalez
AIM: Dysplastic FGPs (d-FGPs) typically arise in patients with familial adenomatous polyposis (FAP) but may occur in nonsyndromic patients. They rarely develop malignancy, but their significance is unclear, especially in nonsyndromic patients. APC/β-catenin alterations have been implicated in their pathogenesis, and β-catenin immunohistochemistry (IHC) may show nuclear positivity. METHODS AND RESULTS: We identified 124 FGPs with low-grade dysplasia (LGD) or high-grade dysplasia (HGD) or indefinite for dysplasia (IFD) from 66 patients (27 with FAP, 39 nonsyndromic)...
February 12, 2018: Histopathology
https://www.readbyqxmd.com/read/29435311/rising-incidence-and-prevalence-of-adult-eosinophilic-esophagitis-in-midwestern-spain-2007-2016
#11
Javier Molina-Infante, Pedro Luis Gonzalez-Cordero, Hal Cliff Ferreira-Nossa, Pilar Mata-Romero, Alfredo J Lucendo, Angel Arias
Objectives: Epidemiologic studies on eosinophilic esophagitis (EoE) are scarce and patient responders to proton pump inhibitor (PPI) therapy have usually been excluded. We aimed to evaluate population-based incidence rates, prevalence and trends in adult EoE over the past decade, including responders to PPI therapy. Methods: We conducted an analysis of a prospectively established case registry in the health area of Cáceres, located in midwestern Spain. From the first EoE case diagnosed in 2007, endoscopy and pathology reports up to December 2016 were manually reviewed...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29435273/efficacy-of-vonoprazan-for-24-week-maintenance-therapy-of-patients-with-healed-reflux-esophagitis-refractory-to-proton-pump-inhibitors
#12
Hideki Mizuno, Kazutoshi Yamada, Keiji Minouchi, Shinji Kamiyamamoto, Yoshinobu Hinoue
The aim of the present study was to evaluate the efficacy of a potassium-competitive acid blocker (P-CAB), vonoprazan, for the maintenance therapy of healed reflux esophagitis (RE). A total of 60 patients were enrolled in this open-label, single-center, prospective study. All patients were diagnosed with RE with a frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 following treatment with standard proton pump inhibitors (PPIs) for a minimum of 8 weeks. Standard PPI treatment was switched to vonoprazan 20 mg once daily for 4 weeks...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29434389/outcomes-from-a-pharmacist-led-proton-pump-inhibitor-stewardship-program-at-a-single-institution
#13
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
https://www.readbyqxmd.com/read/29432214/the-association-of-proton-pump-inhibitors-and-chronic-kidney-disease-cause-or-confounding
#14
Tingting Li, Yan Xie, Ziyad Al-Aly
PURPOSE OF REVIEW: To discuss whether the recently described relationship between proton pump inhibitor (PPI) use and the risk of adverse kidney outcomes represents a causal relationship or is merely the result of confounding. RECENT FINDINGS: A wave of observational studies has described an association between PPI use and the risk of development of chronic kidney disease and its progression to end-stage renal disease. The results are generally robust and remarkably consistent across different studies...
February 9, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29431404/hoarseness-in-adults
#15
Steven A House, Eric L Fisher
Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered. The initial evaluation begins with a targeted history and physical examination, while also looking for signs of potential systemic etiologies...
December 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29428498/the-role-of-gut-microbiota-in-clostridium-difficile-infection
#16
REVIEW
Michael Samarkos, Elpida Mastrogianni, Olga Kampouropoulou
Clostridium difficile infection has emerged as a major health problem. Because it is a spore-forming microorganism, C. difficile is difficult to eradicate and recurrences of the infection are frequent. The strong association of CDI with prior use of antibiotics led to the recognition that disturbances in the gut microbiota apparently plays a central role in CDI. Except for antibiotics, several other risk factors for CDI have been recognised, such as advanced age and use of proton pump inhibitors. The common characteristic of these factors is that they are associated with changes in the composition of gut microbiota...
February 7, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29427733/extraesophageal-symptoms-and-diseases-attributed-to-gerd-where-is-the-pendulum-swinging-now
#17
Michael F Vaezi, David Katzka, Frank Zerbib
BACKGROUND AND AIMS: The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations. METHODS: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1. The role of a gastroenterologist in patients referred for evaluation of suspected extra esophageal symptom is to assess for gastroesophageal etiologies that could contribute to the presenting symptoms...
February 7, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29427406/risk-factors-for-clostridium-difficile-infection-in-intestinal-transplant-recipients-during-the-first-year-post-transplant
#18
Luis Guzman, Fang Qiu, Andre C Kalil, David F Mercer, Alan Langnas, Diana F Florescu
BACKGROUND: C. difficile is the most common cause of healthcare-associated infectious diarrhea. Risk factors for C. difficile infections (CDI) in intestinal transplant recipients (ITR) are not well defined. The aim of our study was to assess specific risk factors for CDI in ITR. METHODS: This is a 1:3 case-control study that included 29 ITR who developed CDI (cases) and 87 ITR without CDI (controls) observed during the first year post transplantation. Wilcoxon rank sum and Fisher's exact tests were used to compare variables...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29416369/rationale-and-design-of-the-vision-study-a-randomized-open-label-study-to-evaluate-the-long-term-safety-of-vonoprazan-as-maintenance-treatment-in-patients-with-erosive-esophagitis
#19
Naomi Uemura, Yoshikazu Kinoshita, Ken Haruma, Takashi Yao, Ryoji Kushima, Tatsuhiro Kanoo
Erosive esophagitis (EE) occurs when the epithelial mucosa is damaged due to gastric acid reflux, and the incidence of this disease is increasing in Japan due to changes in diet and lifestyle. The condition can be treated using proton pump inhibitors (PPIs) that act by irreversibly blocking the H+,K+-ATPase responsible for acid secretion. Vonoprazan is a K+ competitive channel inhibitor, which reversibly and potently inhibits gastric acid secretion. However, long-term data on vonoprazan use are limited. The aim of the VISION trial is to investigate the long-term efficacy and safety of vonoprazan in comparison with the PPI lansoprazole...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29413218/evidence-based-practice-in-the-treatment-for-antibiotic-associated-diarrhea-in-the-intensive-care-unit
#20
REVIEW
Robin Squellati
Unit nurses provide care to patients with serious health conditions. Often antibiotics are recommended to fight infections. Sometimes patients are on proton pump inhibitors (PPI). Antibiotics and PPIs may lead to diarrhea, causing the patient more discomfort, and possibly leading to a more serious infection. One serious infection is caused by Clostridium difficile, which causes death in some cases. About 75% of patients on antibiotics may not need antibiotics. Several studies showed less diarrhea in patients on probiotics...
March 2018: Critical Care Nursing Clinics of North America
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