scholarly journals ENDOSCOPIC AND HISTOPATHOLOGIC GASTRIC CHANGES IN CHRONIC USERS OF PROTON-PUMP INHIBITORS

2015 ◽  
Vol 52 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Sílvia Maria Perrone CAMILO ◽  
Élia Cláudia de Souza ALMEIDA ◽  
Benito André Silveira MIRANZI ◽  
Juliano Carvalho SILVA ◽  
Rosemary Simões NOMELINI ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Serum Levels ◽  
Control Group ◽  
Upper Gastrointestinal Endoscopy ◽  
Positive Serology ◽  
Cell Hyperplasia ◽  
Sydney System ◽  
A Prospective Study ◽  
Histopathologic Findings

Background Proton-pump inhibitors have been used for at least two decades. They are among the most commonly sold drugs in the world. However, some controversy remains about the indications for their use and the consequences of their prolonged use. Objectives To evaluate and compare the endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors to changes in non-users. Methods A prospective study performed at a tertiary Public Hospital involving 105 patients undergoing upper-gastrointestinal endoscopy. Subjects included 81 proton-pump inhibitor users and 24 non-users (control group). Biopsies of the antral-type mucosa, the antral-fundic transition, and the fundus were evaluated by the Sydney System. The presence of erosion or ulceration, lymphatic follicles, reactive gastropathy, and polypoid or epithelial hyperplasia was also determined. Serum levels of gastrin were measured. Results We found two polyps, one in each group, both of which were negative for Helicobacter pylori. There were two cases of parietal cell hyperplasia in users of proton-pump inhibitors. Gastrin was elevated in 28 users of proton-pump inhibitors and in four members of the control group. We did not find statistically significant differences in the endoscopic or histopathologic findings between the two groups. Conclusions Chronic use of proton-pump inhibitors for the duration examined was not associated with significant gastric changes. An interesting finding was that the 4 chronic users of proton-pump inhibitors who had serum gastrin levels above 500 pg/mL also had positive serology for Chagas disease.

Clinical Impact of Co-medication of Levetiracetam and Clobazam with Proton Pump Inhibitors: A Drug Interaction Study

2020 ◽  
Vol 21 (2) ◽  
pp. 126-131
Author(s):  
Bhuvanachandra Pasupuleti ◽  
Vamshikrishna Gone ◽  
Ravali Baddam ◽  
Raj Kumar Venisetty ◽  
Om Prakash Prasad
Keyword(s):  
Plasma Concentration ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Plasma Concentrations ◽  
Control Group ◽  
Drug Concentrations ◽  
Significant Difference ◽  
Post Hoc ◽  
Hydrolysis Of ◽  
Cytochrome P 450

Background: Clobazam (CLBZ) metabolized primarily by Cytochrome P-450 isoenzyme CYP3A4 than with CYP2C19, Whereas Levetiracetam (LEV) is metabolized by hydrolysis of the acetamide group. Few CYP enzymes are inhibited by Proton Pump Inhibitors (PPIs) Pantoprazole, Esomeprazole, and Rabeprazole in different extents that could affect drug concentrations in blood. The aim of the present study was to evaluate the effect of these PPIs on the plasma concentrations of LEV and CLBZ. Methods: Blood samples from 542 patients were included out of which 343 were male and 199 were female patients and were categorized as control and test. Plasma samples analyzed using an HPLC-UV method. Plasma concentrations were measured and compared to those treated and those not treated with PPIs. One way ANOVA and games Howell post hoc test used by SPSS 20 software. Results: CLBZ concentrations were significantly 10 folds higher in patients treated with Pantoprazole (P=0.000) and 07 folds higher in patients treated with Esmoprazole and Rabeprazole (P=0.00). Whereas plasma concentration of LEV control group has no statistical and significant difference when compared to pantoprazole (P=0.546) and with rabeprazole and esomeprazole was P=0.999. Conclusion: The effect of comedication with PPIs on the plasma concentration of clobazam is more pronounced for pantoprazole to a greater extent when compared to esomeprazole and rabeprazole. When pantoprazole is used in combination with clobazam, dose reduction of clobazam should be considered, or significance of PPIs is seen to avoid adverse effects.

scholarly journals Disappearance of Gastric Hyperplastic Polyps after the Discontinuation of Proton Pump Inhibitor in a Patient with Liver Cirrhosis

2021 ◽  
pp. 202-209
Author(s):  
Kengo Yasugi ◽  
Ken Haruma ◽  
Miwa Kawanaka ◽  
Mitsuhiko Suehiro ◽  
Jun Nakamura ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Upper Gastrointestinal Endoscopy ◽  
Complete Disappearance ◽  
Hyperplastic Polyps ◽  
Cell Hyperplasia ◽  
Greater Curvature ◽  
One Year ◽  
Epithelium Cells

Here, we report on a rare case of gastric hyperplastic polyps which disappeared after the discontinuation of proton pump inhibitor (PPI). The patient was an 83-year-old woman with liver cirrhosis and portal hypertension, along with gastroesophageal reflux disease treated by PPI. An initial upper gastrointestinal endoscopy showed unique polypoid lesions in the greater curvature of the stomach. Biopsy specimens of the lesions were diagnosed as hyperplastic polyps and she was followed. One year later, a second endoscopy showed that the lesions had increased in number and size, and an endoscopic mucosal resection (EMR) was performed for the main polyps. The resected specimens indicated a proliferation of foveolar epithelium cells with an increase of capillary ectasia and parietal cell hyperplasia, which was thought to be induced by hypergastrinemia from the PPI. Three months after the EMR, she was admitted because of bleeding from the remaining polyps along with an increase in new polyps. After conservative treatment, PPI was stopped and rebamipide was used. One year and 6 months later, an endoscopy showed the complete disappearance of all gastric polyps.

Proton pump inhibitors and mandibular bone quality: A preliminary study

2021 ◽  
pp. 20200505
Author(s):  
Aykağan Coşgunarslan ◽  
Emin Murat Canger ◽  
Damla Soydan Çabuk
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Fractal Analysis ◽  
Bone Structure ◽  
Study Groups ◽  
Mental Foramen ◽  
Control Group ◽  
Panoramic Radiographs ◽  
Significant Difference ◽  
Bone Changes

Objectives: Proton pump inhibitors (PPI) provide a long-lasting anti-acidic effect by inhibiting the proton pump, and they are one of the most commonly prescribed drugs worldwide. PPIs adversely affect the bone structure via deficiency of vitamins and minerals. The aim of this study was to investigate the possible PPI-induced bone changes in the mandible on panoramic radiographs with the methods of fractal analysis and panoramic morphometric indices. Methods: Panoramic radiographs of 402 patients were used (201 PPI users, 201 control group). Fractal analysis was performed on 4 regions of interests (ROI): 1- upper part of the ramus, 2- angulus, 3- anterior of the mental foramen, 4- distal of the middle ramus. Also, the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) were performed on radiographs. Results: There were significant differences in terms of ROI3, MCW, and KI between the control and study groups (p < 0.05) while there was no significant difference for ROI1, ROI2, ROI4, and PMI (p > 0.05). Males were severely affected than females. Conclusions: Osteoporotic changes were detected in the trabecular and cortical bone in the mental foramen region in PPI users with fractal analysis and morphometric indices, while there were no differences for mandibular ramus and angulus regions according to fractal analysis.

scholarly journals Proton Pump Inhibitor Use May Increase the Risk of Diverticulitis but Not It’s Severity among Patients with Colonic Diverticulosis: A Multicenter Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2966
Author(s):  
Wisam Sbeit ◽  
Tawfik Khoury ◽  
Anas Kadah ◽  
Waseem Asadi ◽  
Amir Shahin ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Developed Countries ◽  
Control Group ◽  
Colonic Diverticulosis ◽  
Hinchey Classification ◽  
Modifiable Factors ◽  
Modifiable Factor ◽  
Colonic Diverticular Disease

Colonic diverticular disease, especially diverticulitis constitutes a major cause of hospitalization and an economic burden in developed countries. Proton pump inhibitors (PPIs) are among the commonest drugs used to treat several diseases affecting the upper gastrointestinal tract. A few studies have reported that the use of Proton Pump Inhibitors PPIs caused dysbiosis. In this study, we searched for a relationship between PPI use and the onset and severity of diverticulitis in patients with colonic diverticulosis. In a retrospective study, patients who were hospitalized for documented diverticulitis were enrolled as cases and compared with a control group of patients with uncomplicated diverticulosis. Overall, 613 patients who had a diagnosis of diverticulosis were included in the study, 217 of whom had diverticulitis. After multivariate analysis, the non-modifiable risk factors associated with diverticulitis included: age (p < 0.0001), hypertension (p < 0.0001), chronic renal failure (p = 0.007), diabetes mellitus (p < 0.0001), and left colon location (p = 0.02). However, among the modifiable factors, only PPI use (p < 0.0001) showed a significant association. Advanced disease severity (according to Hinchey classification of diverticulitis stages II–IV) was associated with aspirin use (p = 0.0004) and pan-colonic location (p = 0.02). PPI use was the only modifiable factor significantly associated with diverticulitis, but not with its severity, among patients with diverticulosis. This observation should be confirmed in future multicenter prospective studies.

scholarly journals Postthyroidectomy Throat Pain and Swallowing: Do Proton Pump Inhibitors Make a Difference?

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Faisal Zawawi ◽  
Keith Richardson ◽  
Rickul Varshney ◽  
Jonathan Young ◽  
Alex M. Mlynarek ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Thyroid Surgery ◽  
Laryngopharyngeal Reflux ◽  
Clinic Visit ◽  
Control Group ◽  
Study Group ◽  
Pain Level ◽  
Throat Pain ◽  
Average Pain

Objectives. Following thyroid surgery patients complain from swallowing disability and throat pain resembling symptoms of laryngopharyngeal reflux (LPR). The purpose of this study is to assess whether proton pump inhibitors (PPIs) given to patients in the first postoperative week relieve the swallowing disability and throat pain complaints. Materials and Methods. A questionnaire was given to 523 patients who had thyroid surgery between October 2010 and August 2011. In the first postoperative clinic visit each patient was approached to fill out a questionnaire. 208 patients met criteria, 100 of which were on PPIs (study group) and 108 were not on PPIs (control group). Results. When comparing the study group to the control group, the average pain level was 2.57 compared to 3.9 during the first postoperative week, and 1.27 compared to 2.41 at day 7 ( value = 0.001). Swallowing disability was also lower in the study group when compared to the control group, 1.87 and 3.12, respectively, during the first postoperative week and 0.87 and 1.76, respectively, at day 7 ( value = 0.007). Conclusion. Patients treated with PPIs had less pain and swallowing disability in the first week following thyroid surgery, when compared to patients not treated with PPIs.

scholarly journals Study The Overprescription Of Proton Pump Inhibitors And Their Relation With Recurrent Community Aquired Infections In Outpatient Refilled Prescriptions Of Chronic Diseases Patients

2016 ◽  
Vol 12 (6) ◽  
pp. 116
Author(s):  
Aysha Abedalhameed Alkhalaylah ◽  
Maisan Mahmoud Hayajneh ◽  
Shireen Imad Hijazeen ◽  
Tahanie Ali Alqhewii ◽  
Eva Raji Haddad ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Neutrophil Count ◽  
Inflammatory Biomarkers ◽  
Control Group ◽  
Study Group ◽  
Study Participants ◽  
And Control ◽  
The Relationship

Background: proton pump inhibitors are widely used worldwide and studies have demonstrated that the use of PPIs to be associated with various diseases such as several types of infection. Study objectives: to explore the effect of using PPIs on patients through studying some inflammatory biomarkers including WBC, neutrophil count, ESR, CRP, and IL-6. Methods and subjects: a retrospective study design was followed to collect data from study participants. The study included 62 patients receiving PPIs and 60 persons without being prescribed for PPIs. A working sheet was created for each patient and included the following information: age, WBC, neutrophil count, ESR, CRP, and IL-6. Data analysis was carried out using SPSS version 20. The relationship between variables was tested using independent T test. Significance was considered at alpha level < 0.05. Study findings: age was not varied significantly between study group and control group. All inflammatory biomarkers under study were significantly elevated in study group compared with control group. Conclusions: the findings of the present study showed that the use of PPIs was associated significantly with increased inflammatory biomarkers. We think that health settings should pay much attention to the role of pharmacists and pharmacy doctors to increase the awareness about the use of PPIs.

scholarly journals Effect of COVID-19 on Lipid Profile and its Correlation with Acute Phase Reactants

2021 ◽  
Author(s):  
Jahanzeb Malik ◽  
Uzma Ishaq ◽  
Talha Laique ◽  
Amna Ashraf ◽  
Asmara Malik ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Acute Phase ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Control Group ◽  
Acute Phase Reactants ◽  
And Gender ◽  
Thyroid Profile ◽  
A Prospective Study

Background and Objective Coronavirus disease 2019 (COVID-19) manifests as multiple clinical and pathological organ dysfunctions. It also disrupts metabolic profile due to the release of pro-inflammatory cytokines causing a systemic inflammation reaction. However, the development and correlation of dyslipidemia with acute phase reactants is unknown. This investigation was performed to assess the pathological alterations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL), triglycerides, and total cholesterol levels in COVID-19 patients. Methods This was a prospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 patients (mild: 319; moderate: 391; critical: 357) hospitalized at our center between April 2020 through January 2021. Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 patients when compared with the control group (P < 0.001, 0.047, 0.045, < 0.001, respectively). All parameters decreased gradually with COVID-19 disease severity (LDL-C: median (IQR), mild: 98 (91,134); moderate: 97 (81,113); critical: 68 (68,83); HDL: mild: 45 (37,50); moderate: 46 (41,50); critical: 40 (37,46); TG: mild: 186 (150,245); moderate: 156 (109,198); critical: 111 (98,154); TC: mild: 224 (212,238); moderate: 212 (203,213); critical: 154 (125,187)). LDL-C, TC, and TG were inversely correlated with acute phase reactants (interleukin-6 (IL-6), Procalcitonin, C-reactive protein (CRP), and D-dimers). Logistic regression demonstrated lipid profile, thyroid profile, and acute phase reactants as predictors of severity of COVID-19 disease. Conclusion Hypolipidemia develops in increasing frequency with severe COVID-19 disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.

scholarly journals A Novel Paradigm Based on ST2 and Its Contribution towards a Multimarker Approach in the Diagnosis and Prognosis of Heart Failure: A Prospective Study during the Pandemic Storm

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1080
Author(s):  
Radu-Stefan Miftode ◽  
Daniela Constantinescu ◽  
Corina Maria Cianga ◽  
Antoniu Octavian Petris ◽  
Amalia-Stefana Timpau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnosis And Prognosis ◽  
Test Kit ◽  
Positive Correlations ◽  
Lactate Levels ◽  
A Prospective Study

Background: Acute heart failure (HF) represents an increasingly common and challenging presentation in the emergency room, also inducing a great socio-economic burden. Extensive research was conducted toward finding an ideal biomarker of acute HF, both in terms of sensitivity and specificity, but today practicians’ interest has shifted towards a more realistic multimarker approach. Natriuretic peptides (NPs) currently represent the gold standard for diagnosing HF in routine clinical practice, but novel molecules, such as sST2, emerge as potentially useful biomarkers, providing additional diagnostic and prognostic value. Methods: We conducted a prospective, single-center study that included 120 patients with acute HF and 53 controls with chronic HF. Of these, 13 patients (eight with acute HF, five from the control group) associated the coronavirus-19 disease (COVID-19). The diagnosis of HF was confirmed by a complete clinical, biological and echocardiographic approach. Results: The serum levels of all studied biomarkers (sST2, NT-proBNP, cardiac troponin) were significantly higher in the group with acute HF. By area under the curve (AUC) analysis, we noticed that NT-proBNP (AUC: 0.976) still had the best diagnostic performance, closely followed by sST2 (AUC: 0.889). However, sST2 was a significantly better predictor of fatal events, showing positive correlations for both in-hospital and at 1-month mortality rates. Moreover, sST2 was also associated with other markers of poor prognosis, such as the use of inotropes or high lactate levels, but not with left ventricle ejection fraction, age, body mass index or mean arterial pressure. sST2 levels were higher in patients with a positive history of COVID-19 as compared with non-COVID-19 patients, but the differences were statistically significant only within the control group. Bivariate regression showed a positive and linear relationship between NT-proBNP and sST2 (r(120) = 0.20, p < 0.002). Conclusions: we consider that sST2 has certain qualities worth integrating in a future multimarker test kit alongside traditional biomarkers, as it provides similar diagnostic value as NT-proBNP, but is emerging as a more valuable prognostic factor, with a better predictive value of fatal events in patients with acute HF.

A Prospective Study of Clinical Outcomes in Laryngopharyngeal Reflux Diseases Following Treatment with Proton Pump Inhibitors in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (28) ◽  
pp. 2538-2543
Author(s):  
Binu Raju George ◽  
Ajayan P.V ◽  
Saify Samad
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Cost Effective ◽  
Reflux Symptom ◽  
P Value ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
A Prospective Study

BACKGROUND Laryngopharyngeal reflux (LPR) is found to be a common disease encountered in Otolaryngology practice. LPR presents clinically with symptoms of laryngeal irritation, frequent throat clearing, cough, and hoarseness of voice. The main diagnostic methods currently used are Fiber-optic laryngoscopy and in some centers pH monitoring. Proton pump inhibitors (PPIs) are used and found to be cost-effective and useful for the treatment of LPR. The main objective of this study was to study the effectiveness of PPIs in alleviating the symptoms assessed using Reflux Symptom Index (RSI) score and Reflux Finding Scores (RFS). METHODS A prospective study was carried out on 100 patients attending the ENT OPD of Government Medical College and Hospital, Thrissur, Kerala. Patients were evaluated for improvement in symptoms of Laryngopharyngeal reflux disease following use of proton pump inhibitors, using Reflux symptom index and Reflux finding scores using 70 degree / flexible nasopharyngolaryngoscopy. Patients with clinical findings of LPRD with RSI score > 13 and RFS score > 7 were given a standard treatment protocol followed in our ENT department using Tab. Pantoprazole 40 mg twice daily before food and the treatment response was assessed by proper follow up at 6 weeks and 12 weeks. On each follow up visit, improvement in RSI and RFS scores with Proton pump inhibitor therapy was assessed. Data collected was then tabulated and analysed. RESULTS The study was conducted in 100 patients, 59 % of whom were females and 41 % males. Mean RSI score changed from 18.9 at the beginning to 14.5 at 6 weeks of treatment and 9.0 at 12 weeks of treatment with Proton pump inhibitor. Mean RFS score changed from 10.7 at the beginning to 8.7 at 6 weeks of treatment and to 5.9 at 12 weeks of treatment. Comparison of mean Reflux Symptom Index and mean Reflux Finding Scores before and after treatment revealed improvement and the result was statistically significant (p value < 0.001). CONCLUSIONS The use of RSI and RFS scores in the assessment of PPIs at fixed intervals is cost effective and avoids time consuming and cost intensive examinations. These scores also help in early diagnosis and long term follow up of LPR patient. Fixed time interval PPI treatment significantly improved RSI and RFS scores in LPR patients. The mean RSI score changed from 18.9 at the beginning of treatment to 14.5 at 6 weeks after treatment (p value < 0.001) and 9.0 after 12 weeks of treatment; (p value < 0.001) The mean RFS score changed from 10.7 at the beginning of treatment to 8.7 at 6 weeks after treatment (p value < 0.001) and 5.9 after 12 weeks of treatment; (p value < 0.001). KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score

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