Long Term Population Study of Prevalence and Risk Factors for Rebleeding in Patients with Peptic Ulcer Disease (PUD)

2005 ◽  
Vol 61 (5) ◽  
pp. AB87
Author(s):  
John Lee ◽  
Sanjay Reddy ◽  
Namgyal Kyulo
1987 ◽  
Vol 21 (5) ◽  
pp. 452-458 ◽  
Author(s):  
Jannet M. Carmichael ◽  
Steven C. Zell

The appropriateness of long-term cimetidine prescribing was evaluated retrospectively in 243 outpatients. Criteria defining appropriate indications for the use of cimetidine for longer than eight weeks were established. Of the 243 patients surveyed, 115 (47 percent) were considered to be inappropriately receiving long-term cimetidine, either because they had never been objectively studied radiographically or endoscopically (23 percent) or had negative results before initiation of therapy (24 percent). Risk factors known to be associated with recurrent peptic ulcer disease were reviewed. Patients fulfilling criteria for appropriate long-term cimetidine usage had a greater prevalence of risk factors compared to the nonjustifiable group. Of particular interest, individuals considered appropriate for long-term therapy were very likely to have had a gastrointestinal bleeding episode prior to beginning therapy (52 percent for gastric ulcer, 8 percent for the nonjustifiable group). This increased prevalence of gastrointestinal hemorrhage may be due to the inherent nature of peptic ulcer disease or a result of physicians selecting affected individuals who may benefit from long-term treatment. Eliminating inappropriate usage of long-term cimetidine in conjunction with a thorough evaluation of risk factors for recurrent ulcer disease can be useful in selecting those individuals most likely to benefit from long-term cimetidine therapy.


2006 ◽  
Vol 74 (7) ◽  
pp. 4064-4074 ◽  
Author(s):  
Mónica Oleastro ◽  
Lurdes Monteiro ◽  
Philippe Lehours ◽  
Francis Mégraud ◽  
Armelle Ménard

ABSTRACT Peptic ulcer disease (PUD) occurs after a long-term Helicobacter pylori infection. However, the disease can develop earlier, and rare cases have been observed in children, suggesting that these H. pylori strains may be more virulent. We used suppressive subtractive hybridization for comparative genomics between H. pylori strains isolated from a 5-year-old child with duodenal ulcer and from a sex- and age-matched child with gastritis only. The prevalence of the 30 tester-specific subtracted sequences was determined on a collection of H. pylori strains from children (15 ulcers and 30 gastritis) and from adults (46 ulcers and 44 gastritis). Two of these sequences, jhp0562 (80.0% versus 33.3%, P = 0.008) and jhp0870 (80.0% versus 36.7%, P = 0.015), were highly associated with PUD in children and a third sequence, jhp0828, was less associated (40.0% versus 10.0%, P = 0.048). Among adult strains, none of the 30 sequences was associated with PUD. However, both jhp0562 and jhp0870 were less prevalent in adenocarcinoma strains than in PUD strains from children and adults, the difference being statistically significant for jhp0870. In conclusion, two H. pylori genes were identified as being strongly associated with PUD in children, and their putative roles as an outer membrane protein for jhp0870 and in lipopolysaccharide biosynthesis for jhp0562, suggest that they may be novel virulence factors of H. pylori.


2019 ◽  
Vol 10 ◽  
pp. 215145931881482 ◽  
Author(s):  
Jordan C. Villa ◽  
Joseph Koressel ◽  
Jelle P. van der List ◽  
Matthew Cohn ◽  
David S. Wellman ◽  
...  

Introduction: Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. Purposes: To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery. Methods: This is a retrospective analysis of 463 geriatric patients who required HF surgery at a metropolitan level-1 trauma center. The outcomes were time to transfer (out of bed to chair) and time to walk. Results: Three hundred ninety-two (84.7%) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range: 24.7-53.69 hours), while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range: 40.72-74.56 hours). Preinjury ambulators with aids (hazard ratio [HR]: 0.70, confidence interval [CI]: 0.50-0.99), age >80 years (HR: 0.66, CI: 0.52-0.84), peptic ulcer disease (HR: 0.57, CI: 0.57-0.82), depression (HR: 0.66, CI: 0.49- 0.89), time to surgery >24 hours (HR: 0.77, CI: 0.61-0.98), and surgery on Friday (HR: 0.73, CI: 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR: 0.74, CI: 0.56-0.98), females (HR: 0.67, CI: 0.48-0.94), peptic ulcer disease (HR: 0.23, CI: 0.84-0.66), and depression (HR: 0.51, CI: 0.33-0.77). Conclusions: Operative predictors of delayed time to transfer were surgery on Friday and time to surgery >24 hours after admission. Depression is associated with delayed time to transfer and time to walk. These data suggest that is important to perform surgeries within 24 hours of admission identify deficiencies in care during the weekends, and create rehabilitation programs specific for patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient care costs, and better long-term functional outcomes.


2020 ◽  
Vol 7 (1) ◽  
pp. e000350
Author(s):  
Sarah Peiffer ◽  
Matthew Pelton ◽  
Laura Keeney ◽  
Eustina G Kwon ◽  
Richard Ofosu-Okromah ◽  
...  

IntroductionIn 2013, peptic ulcer disease (PUD) caused over 300 000 deaths globally. Low-income and middle-income countries are disproportionately affected. However, there is limited information regarding risk factors of perioperative mortality rates in these countries.ObjectiveTo assess perioperative mortality rates from complicated PUD in Africa and associated risk factors.DesignWe performed a systematic review and a random-effect meta-analysis of literature describing surgical management of complicated PUD in Africa. We used subgroup analysis and meta-regression analyses to investigate sources of variations in the mortality rates and to assess the risk factors contributing to mortality.ResultsFrom 95 published reports, 10 037 patients underwent surgery for complicated PUD. The majority of the ulcers (78%) were duodenal, followed by gastric (14%). Forty-one per cent of operations were for perforation, 22% for obstruction and 9% for bleeding. The operations consisted of vagotomy (38%), primary repair (34%), resection and reconstruction (12%), and drainage procedures (6%). The overall PUD mortality rate was 6.6% (95% CI 5.4% to 8.1%). It increased to 9.7% (95% CI 7.1 to 13.0) when we limited the analysis to studies published after the year 2000. The correlation was higher between perforated PUD and mortality rates (r=0.41, p<0.0001) than for bleeding PUD and mortality rates (r=0.32, p=0.001). Non-significant differences in mortality rates existed between sub-Saharan Africa (SSA) and North Africa and within SSA.ConclusionPerioperative mortality rates from complicated PUD in Africa are substantially high and could be increasing over time, and there are possible regional differences.


2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.


1993 ◽  
Vol 104 (5) ◽  
pp. 1356-1370 ◽  
Author(s):  
Regina Lamberts ◽  
Werner Creutzfeldt ◽  
Hans G. Strüber ◽  
Gorik Brunner ◽  
Enrico Solcia

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Amber Amin ◽  
Qaisar Farooq ◽  
Rizwan Jameel

BACKGROUND & OBJECTIVE: Peptic ulcer disease (PUD) is one of the common presentations in the medical as well as Gastroenterology clinics and it can end up in various short- and long-term complications among which osteoporosis is highly under rated. Therefore, the present study was designed to determine the frequency of osteoporosis in cases having PUD. METHODOLOGY: A cross-sectional study was conducted at the Department of Medicine during 1st January 2020 to 30th June 2020 in Sheikh Zayed Hospital, Lahore. The diagnosed cases of PUD on the basis of history and endoscopic findings with the age range of 20 to 60 years were included. Osteoporosis was labelled as yes, where a T-score of ≤ -2.5 on DEXA scan was noted. RESULTS: In this study, there were a total of 139 cases, out of which 75 (53.95%) were males and 64 (46.05%) females. The mean age of the participants was 48.11±9.43 years. Osteoporosis was observed in 14 (10.07%) out of 139 cases. Osteoporosis was seen in 05 (6.67%) males vs 09 (14.06%) females in their respective groups with p= 0.148. Osteoporosis was observed in 4 (5.80%) cases with a duration of PUD up to 2 years and 10 (14.28%) cases with duration more than this with p= 0.096 CONCLUSION: Osteoporosis is not uncommon in cases with Peptic ulcer disease, and there is no significant association with any of the confounders of this study.


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