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Cureus Aug 2023Peptic ulcer disease (PUD) refers to the occurrence of an open erosion in the inner lining of the stomach, duodenum, or sometimes lower esophagus. Treatments like proton... (Review)
Review
Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review.
Peptic ulcer disease (PUD) refers to the occurrence of an open erosion in the inner lining of the stomach, duodenum, or sometimes lower esophagus. Treatments like proton pump inhibitors (PPIs) or histamine 2 receptor antagonists (H2RAs) are available on the market to efficiently treat the break in the mucosal lining. However, there is little evidence about the effects of the medication on the type and location of the ulcer and the epigastric pain caused by disintegration and increased acidity in the stomach. Given the above, we conducted a systematic review comparing the safety and efficacy of PPIs and H2RAs in various ulcer locations (gastric, duodenal, and pre-pyloric) and the effect of prolonging the treatment with the same medication or changing into a drug from another class in treatment-resistant ulcers. We employed major research literature databases and search engines such as PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Science Direct, and Google Scholar to find relevant articles. After a thorough screening, a quality check using various tools, and applying filters that suited our eligibility criteria, we identified eight articles, of which five were random clinical trials (RCTs), two review articles, and one meta-analysis. This study compares the different side effects of PPIs and H2RAs. Most studies concluded that omeprazole is superior in healing ulcers and bringing pain relief and that patients resistant to H2RAs can be treated better when switched to a PPI. This study also discusses the adverse effects of chronic use, such as diarrhea, constipation, headaches, and gastrointestinal infections. Patients on long-term PPI therapy are required to take calcium supplements to prevent the risk of fractures in older adults. Regarding long-term outcomes, PPIs remain the mainstay of treatment for peptic ulcer disease, based on the papers we reviewed.
PubMed: 37779765
DOI: 10.7759/cureus.44341 -
3 Biotech Sep 2023Gastroduodenal diseases have prevailed for a long time and more so due to dominance of gut bacteria in most of the cases. But habitation by other gut microbiota in... (Review)
Review
Gastroduodenal diseases have prevailed for a long time and more so due to dominance of gut bacteria in most of the cases. But habitation by other gut microbiota in gastroduodenal diseases and the relationship between and gastrointestinal microbiota in different gastroduodenal diseases is somewhat being unravelled in the current times. For this systematic review, we did a literature search of various gastroduodenal diseases and the effect on gut microbiota pertaining to it. A search of the online bibliographic databases PUBMED and PUBMED CENTRAL was carried out to identify articles published between 1977 and May 2022. The analysis of these selected studies highlighted the inhabitation of other gut microbiota such as , and many others. Interplay between these microbiota and have also been noted which suggested that gastroduodenal diseases and gut microbiota are intertwined by a symbiotic association regardless of the status. The relationship between the gut microbiota and many gastroduodenal diseases, such as gastritis, gastric cancer, lymphomas, and ulcers, demonstrates the dysbiosis of the gut microbiota in both the presence and absence of . The evolving ways for eliminating are provided along with inhibiting qualities of other species on . Most significant member of our gut system is which has been associated with numerous diseases like gastric cancer, gastritis, duodenal ulcer.
PubMed: 37588796
DOI: 10.1007/s13205-023-03734-5 -
GeoHealth Jun 2023Noise is a common harmful factor in our work and the environment. Most studies have investigated the auditory effects of noise exposure; however, few studies have... (Review)
Review
Noise is a common harmful factor in our work and the environment. Most studies have investigated the auditory effects of noise exposure; however, few studies have focused on the extra-auditory effects of exposure to occupational or environmental noise. This study aimed to systematically review published studies on the extra-auditory effects of noise exposure. We reviewed literature from PubMed and Google Scholar databases up to July 2022, using the Patient, Intervention, Comparison, and Outcome criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies that reported extra-auditory effects of occupational or environmental noise exposure. Studies were evaluated utilizing validated reporting tools (CONSORT, STROBE) appropriate to study design. A total of 263 articles were identified, of which 36 were finally selected and reviewed. Upon conducting a review of the articles, exposure to noise can elicit a variety of extra-auditory effects on humans. These effects include circulatory effects linked to higher risk of cardiovascular disease and decreased endothelial function, nervous system effects correlated with sleep disturbance, cognitive impairment, and mental health problems, immunological and endocrinal effects connected to increased physiological stress response and metabolic disorders, oncological and respiratory effects associated with an elevated risk of acoustic neuroma and respiratory disorders, gastrointestinal effects linked to an increased risk of gastric or duodenal ulcer, and obstetric effects connected to the risk of preterm birth. Our review suggests that there are numerous extra-auditory effects of noise exposure on human, and further investigations are needed to fully understand these effects.
PubMed: 37303697
DOI: 10.1029/2023GH000805 -
ANZ Journal of Surgery May 2023Duodenal diverticulum occurs in approximately 20% of the population and can lead to life-threatening complications such as perforation. Most perforations are secondary...
BACKGROUND
Duodenal diverticulum occurs in approximately 20% of the population and can lead to life-threatening complications such as perforation. Most perforations are secondary to diverticulitis, with iatrogenic causes being exceptionally rare. This systematic review explores the aetiology, prevention and outcomes of iatrogenic perforation of duodenal diverticulum.
METHODS
A systematic review was performed according to the PRISMA guidelines. Four databases were searched, including Pubmed, Medline, Scopus and Embase. The primary data extracted were clinical findings, type of procedure, prevention and management of perforation and outcomes.
RESULTS
Forty-six studies were identified, of which 14 articles met inclusion criteria and comprised 19 cases of iatrogenic duodenal diverticulum perforation. Four cases identified duodenal diverticulum pre-intervention, nine were identified peri-intervention, and the remainder were identified post-intervention. Perforation secondary to endoscopic retrograde cholangiopancreatography (n = 8) was most common, followed by open and laparoscopic surgery (n = 5), gastroduodenoscopy (n = 4) and other (n = 2). Operative management with diverticulectomy was the most frequent treatment (63%). Iatrogenic perforation was associated with 50% morbidity and 10% mortality.
CONCLUSION
Iatrogenic perforation of duodenal diverticulum is exceptionally rare and associated with high morbidity and mortality. There are limited guidelines surrounding standard perioperative steps to prevent iatrogenic perforations. A review of preoperative imaging helps identify potential aberrant anatomy, such as a duodenal diverticulum, to allow for recognition and prompt management initiation in the event of perforation. Intraoperative recognition and immediate surgical repair are safe options for this complication.
Topics: Humans; Duodenal Ulcer; Cholangiopancreatography, Endoscopic Retrograde; Gastroscopy; Diverticulum; Iatrogenic Disease; Intestinal Perforation
PubMed: 36881513
DOI: 10.1111/ans.18376 -
Journal of Ethnopharmacology Nov 2022Ilex rotunda Thunb. (I. rotunda) is an Ilex species of Aquifoliaceae, widely distributed in East Asia. Its dried bark is commonly used as a medicinal part in the field... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Ilex rotunda Thunb. (I. rotunda) is an Ilex species of Aquifoliaceae, widely distributed in East Asia. Its dried bark is commonly used as a medicinal part in the field of traditional Chinese medicine (TCM), named Ilicis Rotundae Cortex. This medicinal plant is commonly used for clearing heat and removing toxin, draining dampness and relieving pain in TCM to treat tonsillitis, acute gastroenteritis, gastric and duodenal ulcer, rheumatism, traumatic injury, and so on. It also has significant development value on lipid-lowering, hepatoprotection and anti-inflammation, but the potential mechanism needs to be further explored.
AIM OF THE REVIEW
More and more medicinal substances are being discovered in I. rotunda with multiple biological activities, which help to advance the ethno-pharmacological research in I. rotunda. However, to date there is a lack of a systematic summary of research progress on I. rotunda. This review aims to provide a critical summary of the current studies on I. rotunda. The progress in research on botany, phytochemistry, traditional uses, pharmacology, toxicology, quality control and pharmacokinetics of the plant is discussed. It hopes to provide useful references and guidance for the future directions of research on I. rotunda.
MATERIALS AND METHODS
Studies of I. rotunda were collected via Google Scholar and Baidu Scholar, PubMed, ScienceDirect, SciFinder, Web of Science, China National Knowledge Infrastructure (CNKI), WANFANG DATA and libraries. Some local books, official websites, PhD or MS's dissertations were also included. The literature cited in this review covered the period from 1956 to January 2022.
RESULTS
Analysis of the literature indicates that I. rotunda is a potentially valuable herbal medicine for the therapeutic of various diseases. To date, 120 compounds were found and identified in I. rotunda, mainly including triterpenoids, phenylpropanoids, etc. Modern pharmacological studies also found that the plant has the activities of protecting the cardiovascular system, lowering lipids and protecting the liver, as well as being an anti-inflammatory, anti-tumor and antibacterial.
CONCLUSIONS
This review summarizes the results from current studies of I. rotunda. However, the current explanation seems insufficient and unsatisfactory, in terms of the relationships between the traditional uses and the modern pharmacological activities, the mechanisms and the material basis. Thus, a critical and comprehensive evaluation is necessary to explore its future research prospects and development direction.
Topics: Botany; Drugs, Chinese Herbal; Ethnopharmacology; Ilex; Medicine, Chinese Traditional; Phytochemicals; Phytotherapy; Plants, Medicinal; Quality Control
PubMed: 35781006
DOI: 10.1016/j.jep.2022.115419 -
Dermatologic Therapy Apr 2022Sucralfate is an aluminum salt of sucrose octasulfate, generally considered safe in terms of adverse effects. Systemic sucralfate is FDA-approved for the treatment of... (Review)
Review
Sucralfate is an aluminum salt of sucrose octasulfate, generally considered safe in terms of adverse effects. Systemic sucralfate is FDA-approved for the treatment of duodenal ulcers. Since 1991, topical sucralfate has been used in various mucocutaneous conditions, but it is not approved by the FDA yet. In this systematic review, the online databases were searched with appropriate keywords, and the papers were screened by the authors. After screening steps, the relevant articles were selected according to the inclusions and exclusions criteria. Finally, the full texts of 18 articles were included for final evaluations. In conclusion, topical sucralfate has some clinical benefit in several mucocutaneous conditions, including mucocutaneous inflammatory conditions (e.g., post-radiotherapy reaction, diaper dermatitis, keratoconjunctivitis sicca, etc.), mucocutaneous infectious disorders (e.g., peristomal wound reaction/infection); ulcers; burns, and also pain relief.
Topics: Burns; Humans; Sucralfate; Ulcer
PubMed: 35080090
DOI: 10.1111/dth.15334 -
Journal of Clinical and Translational... 2021Liver penetration by a confined perforation of peptic ulcer is a rare but severe event. Its clinical and pathological features are unclear.
BACKGROUND AND OBJECTIVE
Liver penetration by a confined perforation of peptic ulcer is a rare but severe event. Its clinical and pathological features are unclear.
METHODS
In total, 41 qualified English publications were identified using the PubMed database and one in-house case.
RESULTS
Among the 42 patients, 20 patients had liver involvement by a perforated duodenal ulcer and 22 by a gastric ulcer. Among the 23 cases of known ulcer histology, 2 ulcers were malignant and were adenocarcinomas in the gastric remnant and the remaining 21 ulcers were confirmed as histologically benign (for frequency of malignancy in duodenal versus gastric ulcers, = 0.48). The presence of hepatocytes was the clue of diagnosis for 19 cases. The median ages of the patients were 64.5 years (95% Confidence Intervals [CI] 53.40-71.90) for duodenal ulcer and 65.5 years (95% CI: 59.23-70.95) for gastric ulcer, respectively. The male to female ratio was 1.5:1 for duodenal ulcers and 2:1 for gastric ulcers. Patients with liver involvement of a perforated gastric ulcer were more likely to have a larger ulcer (median largest dimension, 4.75 cm versus 2.5 cm, = 0.014). Female patients with liver involvement of a gastric ulcer were older than male patients (median age 72 versus 60 years, = 0.045). There were no differences in gender, region (Asia, Europe, America versus others), use of non-steroidal anti-inflammatory drugs (n = 15), positivity (n = 10), possible history of peptic ulcer disease (n = 19) or mortality (n = 32) between duodenal and gastric ulcers.
CONCLUSIONS
Careful histologic examination, clinicopathological correlation, and immunohistochemistry are critical to establish the diagnosis and avoid misdiagnosing liver involvement as malignancy.
PubMed: 34927172
DOI: 10.14218/jctp.2021.00007 -
The Journal of Trauma and Acute Care... Oct 2021There is no consensus on optimal surgical treatment of large duodenal defects arising from perforated ulcers, even though such defects are challenging to repair and...
BACKGROUND
There is no consensus on optimal surgical treatment of large duodenal defects arising from perforated ulcers, even though such defects are challenging to repair and inadequate repair is associated with high morbidity and mortality. The aim of this study was to carry out a systematic literature review of different surgical techniques used to treat large duodenal perforations, provide a narrative description of these techniques, and propose a framework for approaching this pathology.
METHODS
PubMed/MEDLINE database was searched for articles published in English between January 1, 1970, and December 1, 2020. Studies describing surgical techniques used to treat giant duodenal ulcer perforation and their outcomes in adult patients were included. No quantitative analysis was planned because of the heterogeneity across studies.
RESULTS
Out of 960 identified records, 25 studies were eligible for inclusion. Two randomized controlled trials, one case-control trial, three cohort studies, 14 case series, and 5 case reports were included. Eight main surgical approaches are described, ranging from simple damage-control operations, such as the omental plug and triple-tube techniques, all the way to complex resections, such as gastrectomy.
CONCLUSION
Evidence on surgical treatment of large duodenal defects is of poor quality, with the majority of studies corresponding to Oxford levels 3b-4. Current evidence does not support any single surgical technique as superior in terms of morbidity or mortality, but choice of technique should be guided by several factors including location of the perforation, degree of duodenal tissue loss, hemodynamic stability of the patient, as well as expertise of the operating surgeon.
LEVEL OF EVIDENCE
SR with more than two negative criteria, Level IV.
Topics: Duodenal Ulcer; Duodenum; Humans; Peptic Ulcer Perforation; Risk Factors
PubMed: 34254960
DOI: 10.1097/TA.0000000000003357 -
Journal of Ethnopharmacology Nov 2021Different orchids are important in traditional medicine, and species belonging to the genus Bletilla are important. Bletilla species have been used for thousands of...
ETHNOPHARMACOLOGICAL RELEVANCE
Different orchids are important in traditional medicine, and species belonging to the genus Bletilla are important. Bletilla species have been used for thousands of years in Traditional Chinese Medicine (TCM) for the treatment of several health disorders, such as gastrointestinal disorders, peptic ulcer, lung disorders, and traumatic bleeding etc. AIM OF THIS REVIEW: This review aims to provide a systematic overview and objective analysis of Bletilla species and to find the probable relationship between their traditional use, chemical constituents, and pharmacological activities, while assessing their therapeutic potential in treatment of different human diseases.
MATERIALS AND METHODS
Relevant literatures on Bletilla species have been collected using the keywords "Bletilla", "phytochemistry", and "pharmacology" in scientific databases, such as "PubMed", "Scifinder", "The Plant List", "Elsevier", "China Knowledge Resource Integrated databases (CNKI)", "Google Scholar", "Baidu Scholar", and other literature sources, etc. RESULTS: This review indicates the isolation and identification of over 261 compounds from this genus, till December 2020. These chemical isolates belong to the stilbenes (bibenzyls and phenanthrenes), flavonoids, triterpenoids, steroids, simple phenolics, and glucosyloxybenzyl 2-isobutylmalates classes of compounds. These compounds have been reported to be characteristically distributed in Bletilla striata (Thunb.) Rchb. f. (BS), Bletilla ochracea Schltr. (BO), and Bletilla formosana (Hayata) Schltr. (BF). The crude extracts and pure compounds derived from the three Bletilla species have reportedly exhibited a wide spectrum of in vitro and in vivo pharmacological effects, such as hemostatic, anti-inflammatory, anti-tumor, and anti-microbial activities. As a Traditional Chinese Medicine (TCM), Bletilla species or preparations containing Bletilla species have been used for the treatment of epistaxis, gastrointestinal bleeding, cough and hemoptysis, gastric and duodenal ulcer, and traumatic injuries. Thus, Bletilla species have proven potential both in traditional uses and scientific studies.
CONCLUSIONS
Pharmacological studies have validated the use of Bletilla species in the traditional medicine, especially hemorrhagic diseases. Polysaccharides and stilbenes are the major bioactive chemical constituents of Bletilla genus according to the literatures. However, the mechanism of action of these molecules is yet to be studied. In addition, a detailed comparative analysis of the phytochemistry and biological activities of the three Bletilla species (BS, BO and BF) is highly recommended for understanding their ethnopharmacological uses and applications in clinics. Clinical toxicity tests on BS have been found to be negative, but it can't be used with Aconitum carmichaeli in traditional uses. Furthermore, not many reports are present in the literature regarding the conservation of Bletilla species.
Topics: Animals; Drugs, Chinese Herbal; Ethnopharmacology; Humans; Medicine, Chinese Traditional; Orchidaceae; Phytochemicals; Polysaccharides; Stilbenes
PubMed: 34144194
DOI: 10.1016/j.jep.2021.114263 -
Journal of Gastroenterology Apr 2021The Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an...
The Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.
Topics: Humans; Anti-Bacterial Agents; Evidence-Based Practice; Japan; Peptic Ulcer; Proton Pump Inhibitors
PubMed: 33620586
DOI: 10.1007/s00535-021-01769-0