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109 papers 1000+ followers Questioning Medicine previous podcast #FOAMed #MedQuestioning
By Joe Weatherly FM/Hospitalist-CoFounder of QuestioningMedicine and PCRAP contributor.
Giora Weisz, Nathaniel R Smilowitz, Ajay J Kirtane, Michael J Rinaldi, Rupa Parvataneni, Ke Xu, Thomas D Stuckey, Akiko Maehara, Bernhard Witzenbichler, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Bruce R Brodie, Ernest L Mazzaferri, Roxana Mehran, Gregg W Stone
BACKGROUND: Certain proton pump inhibitors (PPIs) interfere with clopidogrel metabolism, potentially attenuating P2Y12 receptor inhibition. Previous observational and randomized trials report conflicting results regarding the clinical significance of this pharmacological interaction. We examined the interaction between concomitant administration of PPI and clopidogrel on platelet reactivity and clinical outcomes in the large-scale, prospective Assessment of Dual AntiPlatelet Therapy With Drug-Eluting Stents study...
October 2015: Circulation. Cardiovascular Interventions
Marko Boban, Viktor Persic, Mate Petricevic, Bojan Biocina, Tomislav Sipic, Vesna Pehar-Pejcnovic, Sanja Balen, Marinko Zulj, Aleksandar Vcev
BACKGROUND: Multiple and yet uncertain connections exist between cardiovascular diseases and the nutritional status of patients, particularly in relation to cardiovascular treatments. Proton pump inhibitors (PPI) are among the most commonly used group of drugs. AIM: To analyse utilisation of PPI in association with nutritional risk of patients scheduled for rehabilitation after treatment for ischaemic and valvular heart disease. METHODS: Retrospective analyses on a consecutive sample of patients, which included drug utilisation of PPI and nutritional risk screening, using a standardised NRS-2002 tool...
2016: Kardiologia Polska
Allison A Lambert, Jennifer O Lam, Julie J Paik, Cesar Ugarte-Gil, M Bradley Drummond, Trevor A Crowell
BACKGROUND: Proton-pump inhibitors (PPIs) are among the most frequently prescribed medications. Community-acquired pneumonia (CAP) is a common cause of morbidity, mortality and healthcare spending. Some studies suggest an increased risk of CAP among PPI users. We conducted a systematic review and meta-analysis to determine the association between outpatient PPI therapy and risk of CAP in adults. METHODS: We conducted systematic searches of MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Scopus and Web of Science on February 3, 2014...
2015: PloS One
Megan E Riehl, Laurie Keefer
Hypnotherapy is an evidence based intervention for the treatment of functional bowel disorders, particularly irritable bowel syndrome. While similar in pathophysiology, less is known about the utility of hypnotherapy in the upper gastrointestinal tract. Esophageal disorders, most of which are functional in nature, cause painful and uncomfortable symptoms that impact patient quality of life and are difficult to treat from a medical perspective. After a thorough medical workup and a failed trial of proton pump inhibitor therapy, options for treatment are significantly limited...
July 2015: American Journal of Clinical Hypnosis
Stacy B Menees, Amanda Guentner, Samuel W Chey, Richard Saad, William D Chey
BACKGROUND: The aim of this study was to assess how US gastroenterologists perceive and utilize over-the-counter (OTC) and prescription medications for gastroesophageal reflux disease (GERD) and chronic constipation (CC). METHODS: A total of 3,600 randomly selected American Gastroenterological Association (AGA) members were mailed a 27-question survey that assessed their perceptions and use of OTC and prescription medications. The χ(2) test and Student's t-test were utilized for bivariate analysis...
November 2015: American Journal of Gastroenterology
Priscila Baptistella Yazbek, Ariane Biolcati Trindade, Chung Man Chin, Jean Leandro Dos Santos
Helicobacter pylori (H. pylori) is one of the leading causes of gastric diseases such as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. The current treatment of H. pylori infection with antibiotics and proton pump inhibitors has several limitations, including poor adherence and intrinsic patient-related factors, drug resistance, and the absence of adequate treatments. This review summarizes the current therapeutic approaches to eradicating H. pylori, the difficulties associated with its treatment, and several new perspectives aimed at improving existing treatment strategies...
October 2015: Digestive Diseases and Sciences
Andrew R Brownlee, Erica Bromberg, Mitchell S Roslin
BACKGROUND: In vertical sleeve gastrectomy (VSG), the majority of the stomach is resected and much of the tissue colonized with Helicobacter pylori and the bulk of acid producing cells are removed. In addition, the effect of H. pylori colonization of the stomach of patients undergoing stapling procedures is unclear. As a result, the need for detection and treatment of H. pylori in patients undergoing VSG is unknown. METHODS: Four hundred and eighty patients undergoing VSG are the subject of this study...
December 2015: Obesity Surgery
Craig S Brown, Brittany Lapin, Chi Wang, Jay L Goldstein, John G Linn, Woody Denham, Stephen P Haggerty, Mark S Talamonti, John A Howington, Joann Carbray, Michael B Ujiki
INTRODUCTION: Barrett's esophagus (BE) is the most predictive risk factor for development of esophageal adenocarcinoma (EAC), a malignancy with the fastest increasing incidence in the US. The aim of this study was to investigate differences in exposures, demographics, and comorbidities between regressing and non-regressing patients. METHODS AND PROCEDURES: We retrospectively collected and analyzed data from a cohort of BE patients participating in a single-center study comprised of all patients diagnosed with BE over a 10-year period...
October 2014: Surgical Endoscopy
G Sachs, J M Shin, C W Howden
Proton pump inhibitors inhibit the gastric H+/K+-ATPase via covalent binding to cysteine residues of the proton pump. All proton pump inhibitors must undergo acid accumulation in the parietal cell through protonation, followed by activation mediated by a second protonation at the active secretory canaliculus of the parietal cell. The relative ease with which these steps occur with different proton pump inhibitors underlies differences in their rates of activation, which in turn influence the location of covalent binding and the stability of inhibition...
June 2006: Alimentary Pharmacology & Therapeutics
Joseph J Y Sung, Bing-Yee Suen, Justin C Y Wu, James Y W Lau, Jessica Y L Ching, Vivian W Y Lee, Philip W Y Chiu, Kelvin K F Tsoi, Francis K L Chan
OBJECTIVES: The use of intravenous proton-pump inhibitors (PPIs) has shown to reduce recurrent bleeding and improve patient outcome after endoscopic hemostasis on patients with peptic ulcer. However, the efficacy of oral PPI is uncertain. Studies from Asia indicated that even oral PPI can achieve the same therapeutic effect. This study is designed to compare the efficacy of high-dose intravenous PPI to oral PPI in preventing recurrent bleeding after endoscopic hemostasis. METHODS: This is a single-center, randomized-controlled, double-blind, and double-dummy study...
July 2014: American Journal of Gastroenterology
Emad Hamdy, Ayman El Nakeeb, Hosam Hamed, Mohamed El Hemaly, Nabil Gad ElHak
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common public health problem. Medical treatment remains the first line of treatment of GERD. Failure of medical treatment may occur in up to 45% of GERD patients. This study aims to evaluate the outcome of laparoscopic Nissen fundoplication (LNF) as a means of antireflux surgery in patients with poor response to anti-reflux medication. PATIENTS AND METHODS: This is a prospective study of patients who underwent LNF in the period between January 2000 and December 2010 in the Gastrointestinal Surgical Center, Mansoura University, Egypt...
September 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
W T Liang, J N Wu, F Wang, Z W Hu, Z G Wang, T Ji, X L Zhan, C Zhang
AIM: Laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) are used as main alternative strategies to manage medication-refractory GERD. This study was therefore prospectively evaluated outcomes of patients with refractory GERD 5 years after LNF or Stretta RF. METHODS: A total of 215 consecutive patients with refractory GERD underwent LNF (N.=102) and Stretta RF (N.=113) in our department between 2007 and 2008. They were followed-up for 5 years, during which the outcome measures including symptom scores of regurgitation, heartburn, chest pain, belching, hiccup, cough and asthma as well as the proton pump inhibitor (PPI) use and complications...
August 2014: Minerva Chirurgica
Jason Y Park, Xi Zhang, Nathalie Nguyen, Rhonda F Souza, Stuart J Spechler, Edaire Cheng
OBJECTIVE: Besides reducing gastric acid secretion, proton pump inhibitors (PPIs) suppress Th2-cytokine-stimulated expression of an eosinophil chemoattractant (eotaxin-3) by esophageal epithelial cells through acid-independent, anti-inflammatory mechanisms. To explore acid-inhibitory and acid-independent, anti-inflammatory PPI effects in reducing esophageal eosinophilia, we studied eotaxin-3 expression by the proximal and distal esophagus of children with esophageal eosinophilia before and after PPI therapy...
2014: PloS One
Yasuhisa Sakata, Kazunari Tominaga, Mototsugu Kato, Hiroshi Takeda, Yasuyuki Shimoyama, Toshihisa Takeuchi, Ryuichi Iwakiri, Kenji Furuta, Kouichi Sakurai, Takeo Odaka, Hiroaki Kusunoki, Akihito Nagahara, Katsuhiko Iwakiri, Takahisa Furuta, Kazunari Murakami, Hiroto Miwa, Yoshikazu Kinoshita, Ken Haruma, Shin'ichi Takahashi, Sumio Watanabe, Kazuhide Higuchi, Kazuma Fujimoto, Motoyasu Kusano, Tetsuo Arakawa
BACKGROUND: The incidence and severity of gastroesophageal reflux disease (GERD) in Japan tends to increase in elderly women. Rikkunshito (RKT), a traditional Japanese medicine, acts as a prokinetic agent and improves gastric emptying and gastric accommodation. Our previous prospective randomized placebo-controlled study showed that RKT combined with a standard-dose of rabeprazole (RPZ) significantly improved the acid-related dysmotility symptoms (ARD) in elderly patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD)...
2014: BMC Gastroenterology
Kentaro Isoda, Tohru Takeuchi, Takuya Kotani, Suzue Hirano-Kuwata, Takeshi Shoda, Kenichiro Hata, Shuzo Yoshida, Shigeki Makino, Toshiaki Hanafusa
OBJECTIVE: Proton pump inhibitors (PPIs) are frequently coadministered with calcineurin inhibitors (CNIs) such as tacrolimus (TAC) and cyclosporin A (CSA), to treat or prevent upper gastrointestinal complications in Japanese patients with connective tissue diseases (CTDs). The coadministration of PPIs increases the blood concentration of TAC due to drug interaction. We retrospectively investigated the influence of the coadministration of PPIs and CNIs, as well as the influence of the cytochrome P450 (CYP) 2C19 gene polymorphism status, on the blood concentrations of TAC and CSA in patients with CTDs...
2014: Internal Medicine
Evan S Dellon, Olga Speck, Kimberly Woodward, Shannon Covey, Spencer Rusin, Jessica H Gebhart, Xiaoxin Chen, John T Woosley, Nicholas J Shaheen
BACKGROUND & AIMS: Distinguishing between eosinophilic esophagitis (EoE), gastroesophageal reflux disease, and proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) is challenging. We assessed whether immunohistochemical analysis of esophageal tissues for major basic protein (MBP), eotaxin-3, and tryptase can be used for diagnosis of EoE and to differentiate EoE from PPI-REE. METHODS: We conducted a prospective study of 196 consecutive adults who underwent outpatient endoscopy at the University of North Carolina from 2009 through 2012...
December 2014: Clinical Gastroenterology and Hepatology
Mitsushige Sugimoto, Naohito Shirai, Masafumi Nishino, Chise Kodaira, Takahiro Uotani, Shu Sahara, Hitomi Ichikawa, Takuma Kagami, Ken Sugimoto, Takahisa Furuta
INTRODUCTION: The aim of therapeutic regimens using proton pump inhibitors (PPIs) in patients with acid-related diseases is to potently inhibit acid secretion for the full 24 h. However, optimum treatment is still unclear because the pharmacodynamics of PPIs differ among CYP2C19 genotypes and most of the previous studies have had loss of sample power. METHODS: Using pH monitoring, we compared acid inhibition at standard dosage of omeprazole (20 mg, 50 times), lansoprazole (30 mg, 68 times), and rabeprazole (10 mg, 65 times) in Helicobacter pylori-negative healthy young Japanese volunteers...
September 2014: European Journal of Clinical Pharmacology
Kurt J Griffin, Paul A Thompson, Michael Gottschalk, Jennifer H Kyllo, Alex Rabinovitch
BACKGROUND: Type 1 diabetes results from autoimmune destruction of pancreatic β cells. Findings from preclinical studies suggest that dipeptidyl peptidase-4 inhibitors and proton-pump inhibitors might enhance β-cell survival and regeneration. We postulated that sitagliptin and lansoprazole would preserve β-cell function in patients with recent-onset type 1 diabetes. METHODS: We did a double-blind, placebo-controlled, phase 2 trial (REPAIR-T1D). Participants aged 11-36 years, diagnosed with type 1 diabetes within the past 6 months were recruited from Sanford Health Systems (Sioux Falls, SD, USA; Fargo, ND, USA), Children's Hospitals and Clinics of Minnesota (St Paul, MN, USA), and Rady Children's Hospital (San Diego, CA, USA)...
September 2014: Lancet Diabetes & Endocrinology
J P Depta, P A Lenzini, D E Lanfear, T Y Wang, J A Spertus, R G Bach, S Cresci
We examined clinical outcomes with proton pump inhibitors (PPI) use within CYP2C19 genotype groups during clopidogrel treatment following acute myocardial infarction (AMI). 2062 patients were genotyped for CYP2C19*2 and *17 variants in TRIUMPH. 12 month clinical outcomes were analyzed among patients discharged on clopidogrel within CYP2C19*2 carrier, CYP2C19*17 carrier, and CYP2C19*1 homozygote genotype groups. PPI use was not associated with a difference in mortality. Among clopidogrel-treated Caucasians following AMI, PPI use was associated with a significantly higher rate of cardiac rehospitalization (HR 1...
February 2015: Pharmacogenomics Journal
Hakan Güzel, Sahin Kahramanca, Duray Şeker, Gülay Özgehan, Gündüz Tunç, Tevfik Küçükpınar, Hülagü Kargıcı
BACKGROUND/AIMS: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. MATERIALS AND METHODS: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years...
April 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
2014-07-14 08:22:37
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