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Gastric diseases in elderly

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https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#1
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28402960/feasibility-of-laparoscopic-gastrectomy-for-elderly-gastric-cancer-patients-meta-analysis-of-non-randomized-controlled-studies
#2
REVIEW
Liang Zong, Aiwen Wu, Wenyue Wang, Jingyu Deng, Susumu Aikou, Hiroharu Yamashita, Masahiro Maeda, Masanobu Abe, Duonan Yu, Zhiwei Jiang, Yasuyuki Seto, Jiafu Ji
The aim of this meta-analysis was to determine the feasibility of laparoscopic gastrectomy (LG) for elderly gastric cancer patients by comparing laparoscopic and conventional open gastrectomies (OG). Comprehensive search of the PubMed, EMBASE, and Cochrane Library databases revealed nine non-randomized controlled studies that compared LG and OG in elderly gastric cancer patients We then analyzed dichotomous or continuous parameters using odds ratios (ORs) or weighted mean differences (WMDs). Overall survival was estimated using hazard ratios (HRs) with a fixed effects or random effects model...
March 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28378081/laparoscopy-assisted-distal-gastrectomy-is-feasible-also-for-elderly-patients-aged-80-years-and-over-effectiveness-and-long-term-prognosis
#3
Motohira Yoshida, Shigehiro Koga, Kei Ishimaru, Yuji Yamamoto, Yusuke Matsuno, Satoshi Akita, Jun Kuwabara, Kazufumi Tanigawa, Yuji Watanabe
BACKGROUND: Elderly patients usually have concurrent ailments, and the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) for these patients have been controversial. This study aimed to evaluate whether laparoscopy-assisted distal gastrectomy is safe and effective for elderly patients aged 80 years and over, as well as to clarify their long-term prognosis. METHODS: A total of 31 patients aged 80 years and over who underwent LADG in our hospital were retrospectively reviewed...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28361440/acid-suppressive-therapy-and-risk-of-infections-pros-and-cons
#4
REVIEW
Leon Fisher, Alexander Fisher
This narrative review summarises the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors and histamine-2 receptor antagonists, advocating a rationale balanced and individualised approach aimed to minimise any serious adverse consequences. It focuses on current controversies on the potential of ASDs to contribute to infections-bacterial, parasitic, fungal, protozoan and viral, particularly in the elderly, comprehensively and critically discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis, septicaemia and other)...
March 30, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28360040/vitamin-b12-deficiency-from-the-perspective-of-a-practicing-hematologist
#5
Ralph Green
B12 deficiency is the leading cause of megaloblastic anemia and though more common in the elderly, can occur at any age. Clinical disease caused by B12 deficiency usually connotes severe deficiency, resulting from a failure of the gastric or ileal phase of physiological B12 absorption, best exemplified by the autoimmune disease pernicious anemia. There are many other causes of B12 deficiency which range from severe to mild. Mild deficiency usually results from failure to render food B12 bioavailable or from dietary inadequacy...
March 30, 2017: Blood
https://www.readbyqxmd.com/read/28353006/efficacy-and-cost-effectiveness-of-second-line-chemotherapy-in-elderly-patients-with-advanced-gastric-cancer
#6
K Zhou, F Wen, P Zhang, J Zhou, H Chen, H Zheng, Y Yang, Q Li
PURPOSE: Second-line chemotherapy has been shown to benefit patients with advanced gastric cancer (AGC), extending the overall survival (OS) and progression-free survival (PFS). This study aimed to assess the efficacy and cost-effectiveness of second-line treatment for elderly patients with AGC. METHODS: Medical records and follow-up information of elderly patients (≥70 years) with AGC who received second-line chemotherapy were collected. A Markov model comprising three health states PFS, progressive disease and death was developed to simulate the process of AGC...
March 28, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28325163/proton-pump-inhibitors-as-a-risk-factor-for-norovirus-infection
#7
C Prag, M Prag, H Fredlund
Norovirus causes viral gastroenteritis, which is a major problem in health care. The disease causes death in elderly and seriously ill patients, and results in significant health costs each year. Proton pump inhibitors (PPIs) reduce gastric acidity, which is an important protection against microorganisms. We hypothesised that treatment with PPIs increases the risk of contracting norovirus infection. This has not previously been studied. The study was a retrospective case-control study, in which 192 hospitalised patients positive for norovirus in Örebro County, Sweden, were identified as cases...
March 22, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28284210/prognostic-factors-for-gastrectomy-in-elderly-patients-with-gastric-cancer
#8
Daisuke Ueno, Hideo Matsumoto, Hisako Kubota, Masaharu Higashida, Takashi Akiyama, Akiko Shiotani, Toshihiro Hirai
BACKGROUND: The aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer. METHODS: The medical records of 366 patients with gastric cancer who underwent surgical resection at our hospital between January 2007 and December 2014 were retrospectively reviewed. Of the 366 patients, 117 were aged 75 years or older and 249 were aged 74 years or younger. All factors that were identified as significant using univariate analysis were included in the multivariate analysis...
March 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28275301/surgery-for-gastric-cancer-patients-of-age-85-and-older-multicenter-survey
#9
Hirotaka Konishi, Daisuke Ichikawa, Hiroshi Itoh, Kenichiro Fukuda, Naoki Kakihara, Manabu Takemura, Kaori Okugawa, Kiyoshi Uchiyama, Masashi Nakata, Hiroshi Nishi, Toshiyuki Kosuga, Shuhei Komatsu, Kazuma Okamoto, Eigo Otsuji
AIM: To investigate the surgical therapies for gastric cancer (GC) patients of age 85 or older in a multicenter survey. METHODS: Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28248891/concurrent-apatinib-and-local-radiation-therapy-for-advanced-gastric-cancer-a-case-report-and-review-of-the-literature
#10
REVIEW
Ming Zhang, Weiye Deng, Xiaoci Cao, Xiaoming Shi, Huanfen Zhao, Zheping Duan, Bonan Lv, Bin Liu
RATIONALE: Apatinib is a novel anti-angiogenic agent targeting vascular endothelial growth factor receptor-2, which is effective in patients with chemotherapy-refractory gastric cancer. There are no reports of concurrent apatinib with local radiation therapy in elderly patients with advanced gastric cancer. PATIENT CONCERNS AND DIAGNOSES:: we present the first published report of a 70-year-old male patient with advanced gastric cancer who received concurrent apatinib and local radiation therapy after failure of oxaliplatin and S-1 chemotherapy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28217755/lymphadenectomy-in-elderly-high-risk-patients-should-it-be-different
#11
REVIEW
Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Davide Inversini, Francesco Martignoni, Luigi Boni, Gianlorenzo Dionigi, Stefano Rausei
The global aging of population will lead a greater number of elderly patients to undergo surgical procedure in a near future. Concerning gastric cancer, the impact of lymphadenectomy on survival has been demonstrated in RCTs, and extended lymphadenectomy is now considered as gold standard of treatment in non-early tumors. However, the role of age as a prognostic factor and the benefit of extended surgery in elderly/high-risk patients are not clearly defined yet. From our revision of literature, it seems that surgery for gastric cancer may have a further tailorization, considering not only the stage of disease, but also patients' age and comorbidities...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28191493/endoscopic-submucosal-dissection-for-early-gastric-cancer-in-very-elderly-patients-age-85-or-older
#12
Ko Watanabe, Takuto Hikichi, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Hitomi Kikuchi, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Katsutoshi Obara, Hiromasa Ohira
Background and study aims The safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in very elderly patients remains unclear. The aim of this study was to evaluate the safety and efficacy of ESD for EGC in patients age 85 years and older. Patients and methods Patients who underwent ESD for EGC between September 2003 and April 2015 were divided into 3 groups: the very elderly (≥ 85 years; 43 patients), the elderly (65 - 84 years; 511 patients), and the non-elderly ( ≤ 64 years; 161 patients)...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28174386/-a-case-of-an-elderly-patient-who-experienced-long-term-survival-after-receiving-s-1-for-synchronous-advanced-gallbladder-and-stomach-cancer
#13
Rina Tsutsui, Naoto Kurihara, Yoshifumi Matsuura, Syuhei Iida
The reported patient was a 90-year-old woman with anorexia. She was diagnosed with advanced gallbladder cancer that occurred concurrently with stomach cancer. Subsequent to intestinal bypass surgery, S-1(80mg/day)was administered for 14 days, followed by 7 days of rest for one course. Tumor marker levels returned to normal after 4 months. Computed tomography results indicated that, in regard to the gallbladder cancer, the patient had stable disease after 8 months. In addition, gastroscopy revealed a complete response of the gastric cancer after a year...
January 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28148891/feasibility-and-efficacy-of-simultaneous-off-pump-coronary-artery-bypass-grafting-and-esophagectomy-in-elderly-patients
#14
Ban Liu, Chang Gu, Yuliang Wang, Xiaowei Wang, Wen Ge, Lingtong Shan, Yujian Wei, Xiaohan Xu, Yangyang Zhang
INTRODUCTION: To analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer. METHODS: Twenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated...
January 26, 2017: Oncotarget
https://www.readbyqxmd.com/read/28133040/-efficacy-of-partial-resection-for-stomach-cancer-in-the-elderly
#15
So Katayanagi, Yousuke Makuuchi, Hiroaki Osakabe, Masatoshi Shigoka, Tetsuo Sumi, Akihiko Tsuchida, Shigeyuki Kawachi
We examined the effectiveness of partial gastrectomy in the elderly. Twelve patients who underwent partial gastrectomy for gastric cancer in our hospital had an average of 2.75 comorbidities before surgery. Two patients relapsed, and 2 patients died from other diseases. The depth of the gastric tumor was T2 in patients with recurrence. Partial gastrectomy should be considered carefully for advanced stage cancer. There were only small changes in weight, PS, and nutrition before and after surgery, suggesting that partial gastrectomy is effective...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28119270/distribution-of-gastric-carcinoma-in-an-area-with-a-high-prevalence-of-helicobacter-pylori
#16
Javed Yakoob, Syeda Sadia Fatima, Zaigham Abbas, Syed Farrukh Mustafa, Hamza Abdur Rahim Khan, Muhammad Faraz Raghib, Safia Awan, Zubair Ahmad
BACKGROUND/AIMS: South Asia is an enigma for gastric cancer (GC) because it is a low risk region with a high prevalence of Helicobacter pylori (H. pylori) infections. We evaluated the trend of GC clinical presentation and risk factors in patients with dyspeptic symptoms. MATERIALS AND METHODS: The medical records of patients, coded by the international classification of diseases (ICD-10-CM, 2015, Diagnosis Code C16.9) for malignancies of stomach diagnosed by esophagogastroduodenoscopy (EGD) and histopathology, were studied...
March 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28119041/a-multi-center-open-label-randomized-phase-iii-trial-of-first-line-chemotherapy-with-capecitabine-monotherapy-versus-capecitabine-plus-oxaliplatin-in-elderly-patients-with-advanced-gastric-cancer
#17
In Gyu Hwang, Jun Ho Ji, Jung Hun Kang, Hyo Rak Lee, Hui-Young Lee, Kyong-Choun Chi, Suk Won Park, Su Jin Lee, Seung Tae Kim, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang
OBJECTIVES: More than half of cases of gastric cancer (GC) are diagnosed in elderly patients (≥70years). While doublet combination with fluoropyrimidines and platinum is currently considered standard first-line chemotherapy in advanced GC, the main goal of chemotherapy remains palliation. MATERIALS AND METHODS: In a multi-center phase III trial, patients with chemotherapy-naïve, metastatic GC, aged 70years or older were randomized 1:1 to receive X monotherapy (capecitabine 1000mg/m(2) bid po on days one to fourteen) or XELOX (X plus oxaliplatin 110mg/m(2) iv on D1)...
January 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28053812/outcome-of-gastric-cancer-surgery-in-elderly-patients
#18
Min Sung Kim, Sungsoo Kim
PURPOSE: Owing to increased life expectancy, the number of elderly patients with gastric cancer has increased. This study aimed to identify the outcomes of gastric cancer patients aged 80 years or older through comparison of their clinicopathological characteristics, surgical outcomes, and oncologic outcomes. MATERIALS AND METHODS: Between January 2006 and December 2013, the records of 478 patients who underwent surgery for gastric cancer were retrospectively evaluated...
December 2016: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/28045555/clinicopathologic-characteristics-of-elderly-with-gastric-cancer-and-the-risk-factors-of-postoperative-complications
#19
Yong Li, Bibo Tan, Liqiao Fan, Qun Zhao, Ming Tan, Dong Wang, Nan Jia, Qingwei Liu
PURPOSE: In China, gastric cancer (GC), which is one of the most common malignant tumors, has an increasing incidence in elderly population due to aging process. Since a considerable number of elderly patients with GC accepting surgical treatments developed postoperative complications, it is necessary to evaluate risk factors for postoperative complications. MATERIALS AND METHODS: In the present study, the clinicopathologic characteristics of 3,024 elderly patients (aged ≥65 years) with GC, who underwent surgery between 1996 and 2006, were examined and contributing factors for postoperative complications were analyzed...
January 3, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27999655/clinical-implications-of-repeated-drug-monitoring-of-imatinib-in-patients-with-metastatic-gastrointestinal-stromal-tumour
#20
Ivar Hompland, Øyvind Sverre Bruland, Kumari Ubhayasekhera, Jonas Bergquist, Kjetil Boye
BACKGROUND: Imatinib mesylate (IM) is the preferred treatment for the majority of patients with metastatic gastrointestinal stromal tumour (GIST). Low trough IM concentration (Cmin) values have been associated with poor clinical outcomes in GIST patients. However, there are few studies of repeated measurements of IM levels, and therapeutic drug monitoring is not yet a part of routine clinical practice. This study was conducted to reveal clinical scenarios where plasma concentration measurement of IM trough level (Cmin) is advantageous...
2016: Clinical Sarcoma Research
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