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https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#1
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27900548/predictors-of-response-to-corticosteroids-for-dyspnea-in-advanced-cancer-patients-a-preliminary-multicenter-prospective-observational-study
#2
Masanori Mori, Akemi Naito Shirado, Tatsuya Morita, Kenichiro Okamoto, Yoshinobu Matsuda, Yoshihisa Matsumoto, Hirohide Yamada, Hiroki Sakurai, Etsuko Aruga, Keisuke Kaneishi, Hiroaki Watanabe, Takashi Yamaguchi, Takuya Odagiri, Shuji Hiramoto, Hiroyuki Kohara, Naoki Matsuo, Hideki Katayama, Tomohiro Nishi, Takashi Matsui, Satoru Iwase
PURPOSE: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients. METHODS: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h)...
November 29, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27884335/pneumonia-prevention-in-intubated-patients-given-sucralfate-versus-proton-pump-inhibitors-and-or-histamine-ii-receptor-blockers
#3
Gene A Grindlinger, Sarah B Cairo, Carole B Duperre
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common cause of infectious morbidity and mortality in the intensive care unit (ICU). The type of stress-ulcer prophylaxis (SUP) given to ventilated patients may, in part, be responsible. We observed an increase in VAP as ventilator bundle compliance increased and a decrease in VAP when bundle compliance decreased. We reasoned that SUP which raises gastric pH such as proton-pump inhibitors (PPIs) and histamine II (H2) receptor antagonists as opposed to SUP which does not raise pH such as sucralfate (S) may be responsible and also may alter the causative bacteria...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27809338/cost-effectiveness-of-histamine2-receptor-antagonists-versus-proton-pump-inhibitors-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#4
Drayton A Hammond, Niranjan Kathe, Anuj Shah, Bradley C Martin
STUDY OBJECTIVE: To determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (H2RA) versus proton pump inhibitors (PPI) in critically ill and mechanically ventilated adults. DESIGN: A decision analytic model estimating the costs and effectiveness of stress ulcer prophylaxis (with H2RAs and PPIs) from a health care institutional perspective. PATIENTS: Adult, mixed intensive care unit (ICU) population who received an H2RA or PPI for up to 9 days...
November 3, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27784575/the-appropriate-use-of-proton-pump-inhibitors-ppis-need-for-a-reappraisal
#5
REVIEW
Vincenzo Savarino, Pietro Dulbecco, Nicola de Bortoli, Andrea Ottonello, Edoardo Savarino
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions...
October 23, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27686121/-design-synthesis-and-evaluation-of-pyrazolo-pyrazole-derivatives-onmethylisocitratelyase-of-pseudomonas-aeruginosa-insilico-and-invitro-study
#6
Madhusudana Pulaganti, Anuradha C M, Chitta Suresh Kumar
Pseudomonas aeruginosa (P.aeruginosa) is an opportunistic microorganism causing diseases both in animals and humans. In case of human pathology, the role of P.aeruginosa is one of the major concerns in intensive care septicemia. Presently the drug resistance strains of P.aeruginosa are arising mainly by developing multiple mechanisms due to its natural and acquired resistance to many of the antimicrobial agents commonly used in clinical practice. As a result, there is a direneed to invent new drugs so that they may restrict the outbreak of multidrug resistant strains...
August 15, 2016: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/27575714/proton-pump-inhibitors-do-not-increase-risk-for-clostridium-difficile-infection-in-the-intensive-care-unit
#7
David M Faleck, Hojjat Salmasian, E Yoko Furuya, Elaine L Larson, Julian A Abrams, Daniel E Freedberg
OBJECTIVES: Patients in the intensive care unit (ICU) frequently receive proton pump inhibitors (PPIs) and have high rates of Clostridium difficile infection (CDI). PPIs have been associated with CDI in hospitalized patients, but ICU patients differ fundamentally from non-ICU patients and few studies have focused on PPI use exclusively in the critical care setting. We performed a retrospective cohort study to determine the associations between PPIs and health-care facility-onset CDI in the ICU...
November 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27563320/comparative-study-on-the-influence-of-three-delivery-positions-on-pain-intensity-during-the-second-stage-of-labor
#8
Mahboubeh Valiani, Mehri Rezaie, Zahra Shahshahan
BACKGROUND: Labor is a physiologic process, and consideration of labor pain and relieving that is among the major components of maternal care. Application of some labor position can lay the fetus better in pelvic canal direction. The present study aimed to investigate the effect of laying the mother in three labor positions on the pain severity in the second, third, and fourth stages of labor. MATERIALS AND METHODS: This is a clinical trial conducted on 96 primiparous pregnant women randomly selected through convenient sampling from those who were hospitalized in the hospitals of Isfahan and Jahrom...
July 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27543598/impact-of-a-pharmacist-driven-protocol-to-decrease-proton-pump-inhibitor-use-in-non-intensive-care-hospitalized-adults
#9
Jessica Michal, Thomas Henry, Connie Street
PURPOSE: Results of a pharmacist-driven protocol to decrease proton pump inhibitor (PPI) use in non-intensive care unit (ICU) hospitalized adults are presented. METHODS: This concurrent preintervention and postintervention study included subjects at least 18 years of age receiving PPIs while hospitalized in general medical or surgical beds. Patients were identified for inclusion in the postintervention group using a daily list of hospitalized patients with active PPI orders...
September 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27275859/high-dose-omeprazole-infusion-compared-with-scheduled-second-look-endoscopy-for-prevention-of-peptic-ulcer-rebleeding-a-randomized-controlled-trial
#10
Philip Wai Yan Chiu, Henry Kin Ming Joeng, Catherine Lai Yin Choi, Kelvin Kam Fai Tsoi, Kwok Hung Kwong, Siu Ho Lam, Joseph Jao Yiu Sung
BACKGROUND AND STUDY AIM: Previous studies have shown that both scheduled second-look endoscopy and high-dose continuous omeprazole infusion are effective in preventing peptic ulcer rebleeding. The aim of this noninferiority trial was to compare the efficacy of these two strategies for the prevention of rebleeding following primary endoscopic hemostasis. PATIENTS AND METHODS: Consecutive patients who received endoscopic treatment for bleeding peptic ulcers (actively bleeding, with nonbleeding visible vessels) were randomized to two treatment groups following hemostasis...
August 2016: Endoscopy
https://www.readbyqxmd.com/read/27131401/neonatal-histamine-2-receptor-antagonist-and-proton-pump-inhibitor-treatment-at-united-states-children-s-hospitals
#11
Jonathan L Slaughter, Michael R Stenger, Patricia B Reagan, Sudarshan R Jadcherla
OBJECTIVE: To determine treatment frequency and duration of histamine-2 receptor antagonist (H2RA)/proton pump inhibitor (PPI) use among infants hospitalized within US children's hospital neonatal intensive care units and evaluate diagnoses/demographic factors associated with use. STUDY DESIGN: We retrospectively analyzed a cohort of neonatal intensive care unit infants admitted to 43 US children's hospitals within the Pediatric Health Information System database between January 2006 and March 2013 to determine H2RA/PPI treatment frequency, timing/duration of treatment, factors associated with use, percent of infants remaining on treatment at discharge, and interhospital prescribing variation...
July 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27055405/prophylactic-proton-pump-inhibitors-in-femoral-neck-fracture-patients-a-life-and-cost-saving-intervention
#12
R Singh, R Trickett, Cer Meyer, S Lewthwaite, D Ford
Introduction Acute gastrointestinal stress ulceration is a common and serious complication of trauma. Prophylactic proton pump inhibitors (PPIs) or histamine receptor antagonists have been used in poly-trauma, burns and head and spinal injuries, as well as on intensive care units, for the prevention of acute gastric stress ulcers. Methods We prospectively studied the use of prophylactic PPIs in with femoral neck fracture patients, gathering data on all acute gastric ulcer complications, including coffee-ground vomiting, malena and haematemesis...
July 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27021503/risk-of-clostridium-difficile-infection-with-the-use-of-a-proton-pump-inhibitor-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#13
Youngouk Ro, Chang Soo Eun, Hyun Soo Kim, Ji Yeoun Kim, Young Jae Byun, Kyo-Sang Yoo, Dong Soo Han
BACKGROUND/AIMS: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are commonly prescribed for stress ulcer prophylaxis (SUP) in critically ill patients. Several studies have suggested that the use of PPIs is a potential risk factor for Clostridium difficile infection (CDI). We compared the incidences of CDI in the PPI group and H2RA group for SUP in critically ill patients. METHODS: From August 2005 to July 2012, the incidences of CDI were retrospectively analyzed in patients who were admitted directly to intensive care units and stayed for more than 3 days...
July 15, 2016: Gut and Liver
https://www.readbyqxmd.com/read/26911559/stress-ulcer-prophylaxis-in-critical-illness-a-canadian-survey
#14
Melissa Shears, Waleed Alhazzani, John C Marshall, John Muscedere, Richard Hall, Shane W English, Peter M Dodek, François Lauzier, Salmaan Kanji, Mark Duffett, Jeffrey Barletta, Mohammed Alshahrani, Yaseen Arabi, Adam Deane, Deborah J Cook
PURPOSE: Stress ulcer prophylaxis (SUP) using histamine-2-receptor antagonists has been a standard of care in intensive care units (ICUs) for four decades. Proton pump inhibitors (PPIs) are increasingly used despite apparently lower background rates of gastrointestinal bleeding and growing concerns about PPI-associated complications. Our objective was to understand the views and prescribing habits amongst Canadian physicians regarding SUP in the ICU and to gauge interest in a future randomized-controlled trial (RCT)...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26855894/prevention-of-stress-related-ulcer-bleeding-at-the-intensive-care-unit-risks-and-benefits-of-stress-ulcer-prophylaxis
#15
REVIEW
Lukas Buendgens, Alexander Koch, Frank Tacke
Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26553337/defining-appropriate-use-of-proton-pump-inhibitors-among-medical-inpatients
#16
Matt Pappas, Sanjay Jolly, Sandeep Vijan
BACKGROUND: Proton-pump inhibitors (PPIs) are commonly used among medical inpatients, both for prophylaxis against upper gastrointestinal bleeding (UGIB) and continuation of outpatient use. While PPIs reduce the risk of UGIB, they also appear to increase the risk of hospital-acquired pneumonia (HAP) and Clostridium difficile infection (CDI). Depending upon the underlying risks of these conditions and the changes in those risks with PPIs, use of proton-pump inhibitors may lead to a net benefit or net harm among medical inpatients...
April 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/26092300/emergence-of-community-acquired-clostridium-difficile-infection-the-experience-of-a-french-hospital-and-review-of-the-literature
#17
REVIEW
Maja Ogielska, Philippe Lanotte, Cécile Le Brun, Anne Sophie Valentin, Denis Garot, Anne-Charlotte Tellier, Jean Michel Halimi, Philippe Colombat, Laurent Guilleminault, Bertrand Lioger, Hélène Vegas, Bertrand De Toffol, Thierry Constans, Louis Bernard
BACKGROUND: Clostridium difficile infection (CDI) is a common cause of nosocomial diarrhoea. People in the general community are not usually considered to be at risk of CDI. CDI is associated with a high risk of morbidity and mortality. The risk of severity is defined by the Clostridium Severity Index (CSI). METHODS: The cases of 136 adult patients with CDI treated at the University Hospital of Tours, France between 2008 and 2012 are described. This was a retrospective study...
August 2015: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/26069973/the-use-of-wet-cupping-for-persistent-nonspecific-low-back-pain-randomized-controlled-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Abdullah AlBedah, Mohamed Khalil, Ahmed Elolemy, Asim A Hussein, Meshari AlQaed, Abdullah Al Mudaiheem, Raid A Abutalib, Faisal Mohamed Bazaid, Ahmad Saeed Bafail, AboBakr Essa, Mohammed Yahia Bakrain
OBJECTIVES: To evaluate the effectiveness and safety of wet cupping therapy as a single treatment for persistent nonspecific low back pain (PNSLBP). DESIGN: Randomized controlled trial comparing wet cupping versus no treatment in PNSLBP. SETTING: Outpatient clinic in three secondary care hospitals in Saudi Arabia. PATIENTS: Eighty eligible participants with PNSLBP for at least 3 months were randomly allocated to an intervention group (n=40) or to a control group (n=40)...
August 2015: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/26005351/evaluation-of-costs-accrued-through-inadvertent-continuation-of-hospital-initiated-proton-pump-inhibitor-therapy-for-stress-ulcer-prophylaxis-beyond-hospital-discharge-a-retrospective-chart-review
#19
Sooyoung Shin
BACKGROUND: Stress ulcers and related upper gastrointestinal bleeding are well-known complications in intensive care unit (ICU) patients. Proton pump inhibitor (PPI)-based stress ulcer prophylaxis (SUP) has been widely prescribed in noncritically ill patients who are at low risk for clinically significant bleeding, which is then injudiciously continued after hospital discharge. This study aimed to evaluate the incidence of inappropriate prescribing of PPI-based preventative therapy in ICU versus non-ICU patients that subsequently continued postdischarge, and to estimate the costs incurred by the unwarranted outpatient continuation of PPI therapy...
2015: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/25959032/factors-associated-with-negative-histamine-control-for-penicillin-allergy-skin-testing-in-the-inpatient-setting
#20
Bob Geng, Ami Thakor, Elisabeth Clayton, Lindsay Finkas, Marc A Riedl
BACKGROUND: Identification of factors adversely affecting the utility of allergy skin testing is important in optimizing patient care. Inpatient penicillin skin test data from 1997 through 2007 demonstrate that up to 20% of attempted penicillin skin tests are indeterminate owing to a negative histamine test response, despite exclusion of H1 antagonists. Critical illness, vasopressors, steroid use, and psychotropic medications have been postulated to influence outcomes, but large studies are lacking...
July 2015: Annals of Allergy, Asthma & Immunology
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