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BMC Musculoskeletal Disorders Jun 2021To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery. (Review)
Review
BACKGROUND
To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery.
METHODS
Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed.
RESULTS
Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer.
CONCLUSION
Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.
Topics: Acute Disease; Early Diagnosis; Female; Humans; Length of Stay; Male; Peptic Ulcer; Peptic Ulcer Perforation
PubMed: 34134676
DOI: 10.1186/s12891-021-04443-x -
BioMed Research International 2014
Topics: Humans; Peptic Ulcer
PubMed: 25610875
DOI: 10.1155/2014/898349 -
Epidemiology and Infection Jan 2016Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and... (Review)
Review
Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and adenocarcinoma of the stomach. Guidelines have been developed in the United States and Europe (areas with low prevalence) for the diagnosis and management of this infection, including the recommendation to 'test and treat' those with dyspepsia. A group of international experts performed a targeted literature review and formulated an expert opinion for evidenced-based benefits and harms for screening and treatment of H. pylori in high-prevalence countries. They concluded that in Arctic countries where H. pylori prevalence exceeds 60%, treatment of persons with H. pylori infection should be limited only to instances where there is strong evidence of direct benefit in reduction of morbidity and mortality, associated peptic ulcer disease and MALT lymphoma and that the test-and-treat strategy may not be beneficial for those with dyspepsia.
Topics: Arctic Regions; Dyspepsia; Guidelines as Topic; Helicobacter Infections; Helicobacter pylori; Humans; Lymphoma, B-Cell, Marginal Zone; Peptic Ulcer; Prevalence
PubMed: 26094936
DOI: 10.1017/S0950268815001181 -
The Korean Journal of Gastroenterology... Nov 2020Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main... (Review)
Review
Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main causes of peptic ulcers and the increased risk of upper gastrointestinal tract complications, such as perforation and bleeding. Thus, the prevention of NSAID-induced peptic ulcers is an important clinical issue. Previous studies have evaluated various strategies for preventing ulcers in patients requiring prolonged NSAID use. The Korean clinical practice guidelines have been published recently based on the evidence of the currently available data. This review describes the strategies for the prevention of peptic ulcers due to NSAID. An assessment of the risk factors for peptic ulcers from NSAID is recommended to identify patients who should be considered for primary prophylaxis. The risk of NSAID-induced peptic ulcers can be reduced by the concomitant use of proton pump inhibitors (PPI), misoprostol, and histamine-2 receptor antagonists. Selective cyclooxygenase-2 inhibitors can be used with caution due to concerns regarding cardiovascular toxicity. Attempts should be made to use the lowest dose and shortest duration of the NSAID.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Histamine H2 Antagonists; Humans; Peptic Ulcer; Pharmaceutical Preparations; Proton Pump Inhibitors; Risk Factors
PubMed: 33234769
DOI: 10.4166/kjg.2020.139 -
Arquivos de Gastroenterologia 2014To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori). (Review)
Review
OBJECTIVES
To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori).
METHODS
A search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries.
RESULTS
It was observed that the prevalence of H. pylori infection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylori shows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries.
DISCUSSION
The observations might be suggestive of H. pylori being only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.
Topics: Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer
PubMed: 25003270
DOI: 10.1590/s0004-28032014000200016 -
FEMS Immunology and Medical Microbiology May 2005Helicobacter pylori infection is the major cause of gastroduodenal pathologies, but only a minority of infected patients develop chronic and life threatening diseases,... (Review)
Review
Helicobacter pylori infection is the major cause of gastroduodenal pathologies, but only a minority of infected patients develop chronic and life threatening diseases, as peptic ulcer, gastric cancer, B-cell lymphoma, or autoimmune gastritis. The type of host immune response against H. pylori is crucial for the outcome of the infection. A predominant H. pylori-specific Th1 response, characterized by high IFN-gamma, TNF-alpha, and IL-12 production associates with peptic ulcer, whereas combined secretion of both Th1 and Th2 cytokines are present in uncomplicated gastritis. Gastric T cells from MALT lymphoma exhibit abnormal help for autologous B-cell proliferation and reduced perforin- and Fas-Fas ligand-mediated killing of B cells. In H. pylori-infected patients with autoimmune gastritis cytolytic T cells infiltrating the gastric mucosa cross-recognize different epitopes of H. pylori proteins and H+K+ ATPase autoantigen. These data suggest that peptic ulcer can be regarded as a Th1-driven immunopathological response to some H. pylori antigens, whereas deregulated and exhaustive H. pylori-induced T cell-dependent B-cell activation can support the onset of low-grade B-cell lymphoma. Alternatively, H. pylori infection may lead in some individuals to gastric autoimmunity via molecular mimicry.
Topics: Autoimmune Diseases; Cytokines; Helicobacter Infections; Helicobacter pylori; Humans; Lymphoma, B-Cell, Marginal Zone; Peptic Ulcer; Stomach Neoplasms; T-Lymphocytes
PubMed: 15866204
DOI: 10.1016/j.femsim.2004.10.013 -
World Journal of Gastroenterology May 2006For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the... (Review)
Review
For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery, patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understanding of the impact of H pylori has led to a trend towards minimalism in surgical therapy for complicated peptic ulcer disease. In addition to the changes in patient care, these developments have had an impact on the training of surgeons. This article outlines these trends and developments.
Topics: Digestive System Surgical Procedures; Gastritis; Helicobacter Infections; Humans; Peptic Ulcer; Proton Pump Inhibitors
PubMed: 16718847
DOI: 10.3748/wjg.v12.i20.3248 -
Langenbeck's Archives of Surgery Nov 2023The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y... (Meta-Analysis)
Meta-Analysis Review
One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies.
INTRODUCTION
The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after laparoscopic sleeve gastrectomy (LSG).
METHODS
In PubMed, Embase, and Cochrane Library, a search was performed using the terms "Roux-en-Y gastric bypass versus one anastomosis gastric bypass," "revisional surgery," and "sleeve gastrectomy." Only original articles in English language comparing OAGB and RYGB were included. No temporal interval was set. The primary outcome measure was weight loss (%TWL). The secondary endpoints were leak, bleeding, marginal ulcer, and GERD. PRISMA flowchart was used. Differences in continuous and dichotomous outcome variables were expressed as mean difference (MD) and risk difference (RD) with 95% CI, respectively. Heterogeneity was assessed by using I statistic.
RESULTS
Six retrospective comparative articles were included in the present meta-analysis. Weight loss analysis showed a MD = 5.70 (95% CI 4.84-6.57) in favor of the OAGB procedure with a statistical significance (p = 0.00001) and no significant statistical heterogeneity (I = 0.00%). There was no significant RD for leak, bleeding, or marginal ulcer after the two revisional procedures. After conversion to OAGB, remission from GERD was 68.6% (81/118), and it was 80.6% (150/186) after conversion to RYGB with a RD = 0.10 (95% CI -0.04, 0.24), no statistical significance (p = 0.19), and high heterogeneity (I = 96%). De novo GERD was 6.3% (16/255) after conversional OAGB, and it was 0.5% (1/180) after conversion to RYGB with a RD = -0.23 (95% CI -0.57, 0.11), no statistical significance (p = 0.16), and high heterogeneity (I = 92%).
Topics: Humans; Gastric Bypass; Obesity, Morbid; Retrospective Studies; Reoperation; Gastroesophageal Reflux; Gastrectomy; Peptic Ulcer; Weight Loss; Laparoscopy
PubMed: 37980292
DOI: 10.1007/s00423-023-03175-x -
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 -
Chirurgia (Bucharest, Romania : 1990) Dec 2023Helicobacter pylori, a gram-negative bacterium, has been identified as a major contributor to gastrointestinal diseases, ranging from gastritis and peptic ulcers to more... (Review)
Review
Helicobacter pylori, a gram-negative bacterium, has been identified as a major contributor to gastrointestinal diseases, ranging from gastritis and peptic ulcers to more severe complications such as gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. While pharmacological eradication therapies have been successful in managing H. pylori-associated diseases, the implications of this bacterium on surgical interventions remain a topic of ongoing research and clinical consideration. This comprehensive review aims to elucidate the intricate surgical implications of H. pylori infection. Recent data on the well-known relationship between and the development of gastroduodenal diseases, including peptic ulcers and gastric cancer, is analyzed. Concurrently, Helicobacter pylori infection may have a role in promoting colonic carcinogenesis and, more interestingly, it has also been linked to biliary tract cancers. The review highlights the evolving landscape of H. pylori management in the context of surgical interventions, accentuating the need for further research to delineate optimal strategies for preoperative screening, eradication therapies, and their impact on surgical outcomes and long-term patient prognosis. Comprehending the surgical ramifications of H. pylori infection remains crucial, emphasizing the significance of interdisciplinary approaches and ongoing research effort aimed at enhancing patient care.
Topics: Humans; Helicobacter Infections; Helicobacter pylori; Treatment Outcome; Peptic Ulcer; Gastritis; Stomach Neoplasms; Lymphoma, B-Cell, Marginal Zone
PubMed: 38228590
DOI: 10.21614/chirurgia.2023.v.118.i.6.p.568