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Asia Pacific Journal of Clinical... 2022Peptic ulcer disease is a common digestive system disease. However, whether peptic ulcer disease and obesity are related is unclear. We assessed the associations of...
BACKGROUND AND OBJECTIVES
Peptic ulcer disease is a common digestive system disease. However, whether peptic ulcer disease and obesity are related is unclear. We assessed the associations of obesity and metabolic status with peptic ulcer disease.
METHODS AND STUDY DESIGN
We conducted a cross-sectional study of 3561 individuals from the Wuwei cohort. We evaluated the associations of general and abdominal adiposity, as defined by different anthropometric indices, with peptic ulcer disease. Odds ratios and 95% confidence intervals were determined through binary logistic regression.
RESULTS
The odds ratio for peptic ulcer disease was 2.37 (1.46-3.84) for women with obesity, compared with the normal group. The association remained significant in Models 2 and 3, with odds ratios of 2.23 (1.35-3.69) and 2.03 (1.19-3.49), respectively. In Model 1, women with obesity had an odds ratio for duodenal ulcer of 2.76 (1.41-5.42) compared with the control group; this result remained significant in Models 2 and 3, with odds ratios of 2.52 (1.24-5.13) and 2.44 (1.13-5.28), respectively. In Model 1, women with metabolically healthy and unhealthy obesity had odds ratios for peptic ulcer disease of 2.26 (1.19-4.28) and 2.15 (1.12-4.15), respectively, compared with the control group. After adjustments for major covariates and H. pylori status, these respective odds ratios became 2.27 (1.20-4.30) and 2.17 (1.12-4.20) in Model 2 and 2.2 (1.15-4.20) and 2.16 (1.11-4.19) in Model 3.
CONCLUSIONS
General adiposity defined by body mass index is associated with peptic ulcer disease in women.
Topics: Cohort Studies; Cross-Sectional Studies; Female; Helicobacter pylori; Humans; Obesity; Peptic Ulcer
PubMed: 35766565
DOI: 10.6133/apjcn.202206_31(2).0015 -
Journal of Healthcare Engineering 2022To improve the safety and reliability of gastric ulcer treatment, the emergence of digestive endoscopy technology in recent years has become a conventional method for...
OBJECTIVE
To improve the safety and reliability of gastric ulcer treatment, the emergence of digestive endoscopy technology in recent years has become a conventional method for the diagnosis of peptic ulcer bleeding. Endoscopic characteristics can judge the severity of patients more accurately and comprehensively, provide a basis for follow-up treatment, and judge the prognosis.
METHODS
298 patients with a suspected gastric ulcer who underwent laryngeal gastroduodenal endoscopy and confirmed gastroduodenal ulcer in our hospital in recent half a year were randomly selected. Olympus cv-170 electronic gastroscope machine was used to carry out gastroscopy for patients with gastric ulcers, analyze, and judge the number of bleeding cases in different stages of treatment, such as lesion type, lesion location, patient age, and gender. The statistics of bleeding cycle and bleeding volume, prognosis recovery, and the correlation of different risk levels were analyzed.
RESULTS
After examination and diagnosis, the patients were followed up for one year. According to the number of bleeding cases, bleeding cycle, and bleeding volume of patients with different ulcer locations in the acute stage, healing stage, and scar stage, the distribution of bleeding cases of different ulcer locations in different stages was roughly the same, and there was no significant difference. The proportion of bleeding cases in the acute stage was the highest, while the proportion in the healing stage was the lowest. The number of bleeding cases, bleeding cycle, bleeding volume, and related symptoms in patients with gastric ulcers during the treatment were significantly correlated with those in the acute stage, healing stage, and scar stage. There was no significant difference in the distribution of bleeding in one year among different stages of ulcer in the same age group, however, the bleeding in one year would be more serious with the increase of age in different age groups. Gender differences have a great impact on the bleeding of the ulcer within one year. It usually shows that the bleeding of ulcers in males is more serious than that in females.
CONCLUSION
The location and pathological development of gastric ulcers can be found in time through gastroscopy, and the status of gastroscopy can be analyzed. Most gastric ulcers are acute bleeding. The amount of bleeding has little correlation with the stage of gastric ulcer, and it is related to the location of bleeding. The older the age, the greater the amount of bleeding, and the amount of bleeding in men is greater than that in women. In the treatment of gastric ulcers, gastroscopy, as a doctor's examination and treatment method, effectively improves the safety and reliability of clinical treatment of gastric ulcer bleeding and reduces the adverse risk.
Topics: Cicatrix; Female; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Male; Reproducibility of Results; Stomach Ulcer; Ulcer
PubMed: 35251562
DOI: 10.1155/2022/2169551 -
Scientific Reports Nov 2020Upper gastrointestinal bleeding (UGIB) is common in liver cirrhosis. Although esophageal and gastric varices (EGV) is the main bleeding source, there were still a...
Upper gastrointestinal bleeding (UGIB) is common in liver cirrhosis. Although esophageal and gastric varices (EGV) is the main bleeding source, there were still a proportion of patients with peptic ulcer bleeding. Thus, this study aimed to analyze the characteristic of variceal bleeding and peptic ulcer bleeding in liver cirrhosis. Cirrhotic patients with confirmed UGIB by urgent endoscopy from July 2012 to June 2018 were enrolled, and classified into peptic ulcer bleeding group (n = 248) and variceal bleeding group (n = 402). Clinical and endoscopic characteristics, therapeutic efficacy and prognosis were evaluated, and independent risk factors for 42-day morality were determined. The mean age and gender ratio of peptic ulcer bleeding group were higher than those in variceal bleeding group (55.58 ± 11.37 vs. 52.87 ± 11.57, P < 0.01; 4.51:1 vs. 2.87:1, P = 0.023). Variceal bleeding group most commonly presented as red blood emesis and coffee grounds (67.16%), while peptic ulcer group primarily manifested as melena (62.10%). Hepatocellular carcinoma was more prevalent in peptic ulcer group (141 vs. 119, P < 0.01). Albumin level in variceal bleeding group was lower higher (P < 0.01), but serum bilirubin, creatinine and prothrombin time were significantly higher (all P < 0.01). Success rate of endoscopic hemostasis for variceal bleeding and peptic ulcer bleeding was 89.05% and 94.35% (P = 0.021). Univariate and multivariate analysis identified prothrombin time (P = 0.041, OR [95% CI] 0.884 [0.786-0.995]), MELD score (P = 0.000, OR [95% CI] 1.153 [1.073-1.240]), emergency intervention (P = 0.002, OR [95% CI] 8.656 [2.219-33.764]), hepatic encephalopathy before bleeding (P = 0.003, OR [95% CI] 8.119 [2.084-31.637]) and hepatic renal syndrome before bleeding (P = 0.029, OR [95% CI] 3.877 [1.152-13.045]) as the independent predictors for 42-day mortality. Peptic ulcer bleeding should be distinguished from variceal bleeding by clinical and endoscopic characteristics.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Esophageal and Gastric Varices; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis; Male; Middle Aged; Peptic Ulcer; Prognosis; Retrospective Studies; Risk Factors; Young Adult
PubMed: 33208832
DOI: 10.1038/s41598-020-76530-3 -
Stem Cell Research & Therapy Sep 2021Peptic ulcer is one of the most common gastrointestinal tract disorders worldwide, associated with challenges such as refractory morbidity, bleeding, interference with... (Review)
Review
Peptic ulcer is one of the most common gastrointestinal tract disorders worldwide, associated with challenges such as refractory morbidity, bleeding, interference with use of anticoagulants, and potential side effects associated with long-term use of proton pump inhibitors. A peptic ulcer is a defect in gastric or duodenal mucosa extending from muscularis mucosa to deeper layers of the stomach wall. In most cases, ulcers respond to standard treatments. However, in some people, peptic ulcer becomes resistant to conventional treatment or recurs after initially successful therapy. Therefore, new and safe treatments, including the use of stem cells, are highly favored for these patients. Adipose-derived mesenchymal stem cells are readily available in large quantities with minimal invasive intervention, and isolation of adipose-derived mesenchymal stromal stem cells (ASC) produces large amounts of stem cells, which are essential for cell-based and restorative therapies. These cells have high flexibility and can differentiate into several types of cells in vitro. This article will investigate the effects and possible mechanisms and signaling pathways of adipose tissue-derived mesenchymal stem cells in patients with refractory peptic ulcers.
Topics: Humans; Mesenchymal Stem Cells; Peptic Ulcer; Proton Pump Inhibitors; Stomach Ulcer
PubMed: 34565461
DOI: 10.1186/s13287-021-02584-3 -
Journal of Critical Care Apr 2021To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019. (Review)
Review
PURPOSE
To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019.
MATERIALS AND METHODS
The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 36 journals monthly for impactful articles and reviewed 113 articles during 2019 according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.
RESULTS
Articles with a 1A grade, including three clinical practice guidelines, six meta-analyses, and five original research trials are reviewed here from those included in the monthly CCPLU. Clinical practice guidelines on the use of polymyxins and antiarrhythmic drugs in cardiac arrest as well as meta-analyses on antipsychotic use in delirium, stress ulcer prophylaxis (SUP), and vasoactive medications in septic shock and cardiac arrest were summarized. Original research trials evaluated delirium, sedation, neuromuscular blockade, SUP, anticoagulation reversal, and hemostasis.
CONCLUSION
This clinical review and expert opinion provides summary and perspectives of clinical practice impact on influential critical care pharmacotherapy publications in 2019.
Topics: Critical Care; Humans; Peptic Ulcer; Shock, Septic
PubMed: 33422810
DOI: 10.1016/j.jcrc.2020.12.018 -
Chinese Medical Journal Dec 2022The pharmacokinetic and clinical behaviors of many proton pump inhibitors (PPIs) in peptic ulcer treatment are altered by CYP2C19 genetic polymorphisms. This... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The pharmacokinetic and clinical behaviors of many proton pump inhibitors (PPIs) in peptic ulcer treatment are altered by CYP2C19 genetic polymorphisms. This non-inferiority study evaluated the efficacy and safety of the novel PPI anaprazole compared with rabeprazole. We also explored the influence of Helicobacter pylori ( H. pylori ) infection status and CYP2C19 polymorphism on anaprazole.
METHODS
In this multicenter, randomized, double-blind, double-dummy, positive-drug parallel-controlled, phase III study, Chinese patients with duodenal ulcers were randomized 1:1 to receive rabeprazole 10 mg + anaprazole placebo or rabeprazole placebo + anaprazole 20 mg once daily for 4 weeks. The primary efficacy endpoint was the 4-week ulcer healing rate assessed by blinded independent review. Secondary endpoints were the proportion of patients with improved overall and individual duodenal ulcer symptoms at 4 weeks. Furthermore, exploratory subgroup analysis of the primary endpoint by H. pylori status and CYP2C19 polymorphism was conducted. Adverse events were monitored for safety. Non-inferiority analysis was conducted for the primary endpoint.
RESULTS
The study enrolled 448 patients (anaprazole, n = 225; rabeprazole, n = 223). The 4-week healing rates were 90.9% and 93.7% for anaprazole and rabeprazole, respectively (difference, -2.8% [95% confidence interval, -7.7%, 2.2%]), demonstrating non-inferiority of anaprazole to rabeprazole. Overall duodenal ulcer symptoms improved in 90.9% and 92.5% of patients, respectively. Improvement rates of individual symptoms were similar between the groups. Healing rates did not significantly differ by H. pylori status or CYP2C19 genotype for either treatment group. The incidence of treatment-emergent adverse events was similar for anaprazole (72/220, 32.7%) and rabeprazole (84/219, 38.4%).
CONCLUSIONS
The efficacy of anaprazole is non-inferior to that of rabeprazole in Chinese patients with duodenal ulcers.
REGISTRATION
ClinicalTrials.gov, NCT04215653.
Topics: Humans; Rabeprazole; Duodenal Ulcer; Cytochrome P-450 CYP2C19; Omeprazole; Anti-Ulcer Agents; Amoxicillin; Proton Pump Inhibitors; Helicobacter Infections; Helicobacter pylori; Drug Therapy, Combination
PubMed: 36580650
DOI: 10.1097/CM9.0000000000002508 -
The Journal of Trauma and Acute Care... Jul 2022Peptic ulcer disease (PUD), once primary a surgical problem, is now medically managed in the majority of patients. The surgical treatment of PUD is now strictly reserved...
BACKGROUND
Peptic ulcer disease (PUD), once primary a surgical problem, is now medically managed in the majority of patients. The surgical treatment of PUD is now strictly reserved for life-threatening complications. Free perforation, refractory bleeding and gastric outlet obstruction, although rare in the age of medical management of PUD, are several of the indications for surgical intervention. The acute care surgeon caring for patients with PUD should be facile in techniques required for bleeding control, bypass of peptic strictures, and vagotomy with resection and reconstruction. This video procedures and techniques article demonstrates these infrequently encountered, but critical operations.
CONTENT VIDEO DESCRIPTION
A combination of anatomic representations and videos of step-by-step instructions on perfused cadavers will demonstrate the key steps in the following critical operations. Graham patch repair of perforated peptic ulcer is demonstrated in both open and laparoscopic fashion. The choice to perform open versus laparoscopic repair is based on individual surgeon comfort. Oversewing of a bleeding duodenal ulcer via duodenotomy and ligation of the gastroduodenal artery is infrequent in the age of advanced endoscopy and interventional radiology techniques, yet this once familiar procedure can be lifesaving. Repair of giant duodenal or gastric ulcers can present a challenging operative dilemma on how to best repair or exclude the defect. Vagotomy and antrectomy, perhaps the least common of all the aforementioned surgical interventions, may require more complex reconstruction than other techniques making it challenging for inexperienced surgeons. A brief demonstration on reconstruction options will be shown, and it includes Roux-en-Y gastrojejunostomy.
CONCLUSION
Surgical management of PUD is reserved today for life-threatening complications for which the acute care surgeon must be prepared. This presentation provides demonstration of key surgical principles in management of bleeding and free perforation, as well as gastric resection, vagotomy and reconstruction.
LEVEL OF EVIDENCE
Video procedure and technique, not applicable.
Topics: Duodenal Ulcer; Gastrectomy; Humans; Peptic Ulcer; Peptic Ulcer Perforation; Vagotomy
PubMed: 35358158
DOI: 10.1097/TA.0000000000003636 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Apr 2020To compare the features of patients with peptic ulcer between Han and Uyghur ethnicity from 2013 to 2018 in Xinjiang and to provide the evidence of prevention and...
OBJECTIVES
To compare the features of patients with peptic ulcer between Han and Uyghur ethnicity from 2013 to 2018 in Xinjiang and to provide the evidence of prevention and treatment for the different ethnicity.
METHODS
Data of 3 586 patients with peptic ulcer (3 293 Han and 293 Uyghur) in the Karamay Central Hospital of Xinjiang, including the detection rate of peptic ulcer, () detection rate of population, season, gender, lesion location and complication, were collected from January 2013 to December 2018 and compared between 2 nationalities.
RESULTS
There were significant difference in the detection rate of peptic ulcer and population's between Han and Uyghur (<0.01). The detection rates for peptic ulcer of Han were sustainable declined from 15.20% to 10.23%, while Uyghur's detective rates for peptic ulcer were raised again from 17.49% to 8.38%. The detection rate of Uyghur's population was higher than that of Han (<0.01). There were significant difference in the season's detection rate for peptic ulcer between Han and Uyghur (<0.01). The detection rate for peptic ulcer of Han was the highest in the winter, while that of Uyghur was the highest in the spring. The detective rate of Uyghur's peptic ulcer was significant higher than that of Han in the spring (<0.01). The detection rates for peptic ulcer of 2 nationality were the highest at ≤25 age groups, the detection rate for Uyghur's peptic ulcer was higher than that of Han at ≤35 age groups (<0.05). There were more men than women in peptic ulcer in the 2 nationalities. The approximate proportion was 2꞉1. The rates of multiple gastric ulcer and compound duodenal ulcer of Han were more than those of Uyghur (<0.05), but the rate for pyloric obstruction of Uyghur patient was higher than that of Han (<0.05).
CONCLUSIONS
There are statistical difference in detection rate of PU, detection rate of population, morbidity season, age, complication and the rate of complex ulcer between Han and Uyghur, However, there aren't statistical difference in detection rate of peptic ulcer patient, the gender, lesion location between the 2 nationalities during last 6 years.
Topics: Child, Preschool; Duodenal Ulcer; Ethnicity; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Stomach Ulcer
PubMed: 32879061
DOI: 10.11817/j.issn.1672-7347.2020.190013 -
Scientific Reports Nov 2023Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with...
Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with fasting in patients with a history of metabolic/bariatric surgery (MBS). There is little published evidence on the possible complications during fasting and needs stronger recommendations and guidance to minimize them. An international survey was sent to surgeons to study the types of complications occurring during religious fasting in patients with history of MBS to evaluate the risk factors to manage and prepare more evidence-based recommendations. In total, 21 centers from 11 countries participated in this survey and reported a total of 132 patients with complications occurring during religious fasting after MBS. The mean age of patients with complications was 36.65 ± 3.48 years and mean BMI was 43.12 ± 6.86 kg/m. Mean timing of complication occurring during fasting after MBS was 14.18 months. The most common complications were upper GI (gastrointestinal) symptoms including [gastroesophageal reflux disease (GERD), abdominal pain, and dyspepsia], marginal ulcers and dumping syndrome in 24% (32/132), 8.3% (11/132) and 23% (31/132) patients respectively. Surgical management was necessary in 4.5% of patients presenting with complications (6/132) patients due to perforated marginal or peptic ulcer in Single Anastomosis Duodenoileostomy with Sleeve gastrectomy (SADI-S), one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG), obstruction at Jejunojenostomy after Roux-en-Y gastric bypass (RYGB) (1/6) and acute cholecystitis (1/6). Patients after MBS should be advised about the risks while fasting including abdominal pain, dehydration, and peptic ulcer disease exacerbation, and a thorough review of their medications is warranted to minimize complications.
Topics: Humans; Adult; Retrospective Studies; Bariatric Surgery; Gastric Bypass; Gastrectomy; Peptic Ulcer; Abdominal Pain; Fasting; Obesity, Morbid; Treatment Outcome
PubMed: 37980363
DOI: 10.1038/s41598-023-47673-w -
The Korean Journal of Gastroenterology... Nov 2020Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin are the most frequently prescribed drugs worldwide, and their long-term use often leads to peptic ulcers (PUs)... (Review)
Review
Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin are the most frequently prescribed drugs worldwide, and their long-term use often leads to peptic ulcers (PUs) along with serious complications, such as bleeding and perforation. () infection is a significant risk factor for developing NSAID-related PU and ulcer bleeding during long-term aspirin use. In a revised version of the Clinical Guidelines for Drug-induced Peptic Ulcer, two statements regarding eradication are recommended. 1) Patients scheduled for long-term NSAID therapy should be tested and treated for infection to prevent PU and its complications. 2) Patients with a history of PU receiving long-term low-dose aspirin (LDA) therapy should undergo treatment for infection to prevent PU and its complications. On the other hand, unlike NSAID-naïve patients, the preventive effects of eradication in chronic NSAID users are unclear. In addition, anti-ulcer drugs, such as proton pump inhibitors, may be necessary for maintenance therapy after eradication in a subset of long-term LDA users, particularly if the patients are taking concomitant antiplatelet agents or anticoagulants.
Topics: Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer; Peptic Ulcer Hemorrhage; Pharmaceutical Preparations
PubMed: 33234768
DOI: 10.4166/kjg.2020.141