scholarly journals Proton Pump Inhibitors Were Associated With Reduced Pseudocysts in Acute Pancreatitis: A Multicenter Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Shengyu Zhang ◽  
Ziying Han ◽  
Yuelun Zhang ◽  
Xiaomao Gao ◽  
Shicheng Zheng ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Control Group ◽  
Total Hospital ◽  
Total Hospital Stay ◽  
Study Results ◽  
Significant Difference

Background: Acute pancreatitis (AP) is a systemic inflammatory disorder with a wide spectrum of clinical symptoms that can range from mild to severe. Previous preclinical study results suggest that proton pump inhibitors (PPIs) can inhibit exocrine pancreatic secretion and exert anti-inflammatory properties, which might in turn improve the outcome of AP.Aim: We conducted this multicenter, retrospective cohort study to investigate the potential effects of PPIs on the mortality, and total duration of hospital stay and local complication occurrence of patients with AP.Methods: A total of 858 patients with AP were included. All patients presented to the hospital within 48 h of symptom onset and were divided into the following two groups: patients who were treated with PPIs (n = 684) and those not treated with PPIs (n = 174). We used propensity score matching (PSM) analysis to reduce confounding bias before comparing the outcomes between the two groups.Results: Before PSM analysis, there were significant differences in a number of parameters between the two groups, including age, sex, hematocrit, blood urea nitrogen, peritonitis signs, Ranson’s score, and Acute Physiology Chronic Health Evaluation II score and organ failure occurrence. Before PSM, the PPIs group had a higher rate of mortality than the control group [RR = 1.065; 95% confidence ratio (CI) 1.045–1.086; p = 0.001]. After PSM, there was no significant difference in mortality (RR = 1.009; 95% CI, 0.999–1.019; p = 0.554) or total hospital stay (p = 0.856), although the PPIs group had a lower occurrence of pancreatic pseudocyst (RR = 0.416; 95% CI 0.221–0.780; p = 0.005).Conclusion: This study showed that PPIs therapy was not associated with reduced mortality or total hospital stay, but was associated with a reduction in the occurrence of pseudocysts in patients with acute pancreatitis.

scholarly journals Analysis of the effect of proton pump inhibitors on the course of common COVID-19

2020 ◽  
Author(s):  
Xiao-Yu Zhang ◽  
Hai-Bing Wu ◽  
Yun Ling ◽  
Zhi-Ping Qian ◽  
Liang Chen
Keyword(s):  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cumulative Incidence ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Clinical Center ◽  
Significant Difference

ABSTRACTBackground/aimsTo evaluate the effect of proton pump inhibitors on the course of common COVID-19.MethodsClinical data of common COVID-19 patients admitted to the Shanghai public health clinical center for treatment from January 20, 2020 to March 16, 2020 were collected. A retrospective study was conducted and the patients were divided into two groups according to whether they used proton pump inhibitors or not. The differences in SARS-CoV-2 clearance and hospital stay between the two groups were compared by univariate and multivariate analyses.ResultsA total of 154 COVID-19 common cases were included in this study, including 80 males (51.9%), 35 patients (22.7%) in the proton pump inhibitors group, and 119 patients (77.3%) in the control group. In the proton pump inhibitors group and the control group, the duration of SARS-CoV-2 clearance were 7(6-9) and 7(6-11) days, and the duration of hospital stay was 21(16-25) and 20(15-26) days, respectively. There was no significant difference between the two groups in the cumulative incidence of SARS-CoV-2 clearance and the cumulative incidence of discharge, and the same after Propensity Score Match, all P > 0.05. Multivariate analysis suggested that chronic gastropathy prolonged the duration of SARS-CoV-2 clearance, the HR was 20.924(3.547-123.447). Hypertension, chronic obstructive pulmonary disease, chronic liver disease and malignant tumor all increased the duration of hospital stay for COVID-19, and the HR were 1.820 (1.073-3.085), 4.370 (1.205-15.844), 9.011 (2.681-30.290) and 5.270 (1.237-22.456), respectively; the duration of hospital stay in COVID-19 patients was shortened by SARS-CoV-2 clearance, and the HR was 0.907 (0.869-0.947); all P < 0.05.ConclusionProton pump inhibitors use have no effect on the prolonging or shortening of the course of adults hospitalized with COVID-19.

scholarly journals Analysis of the Effect of Proton Pump Inhibitors on the Course of Common COVID-19

2020 ◽  
Author(s):  
xiaoyu ZHANG ◽  
Haibing Wu ◽  
Yun Ling ◽  
Liang Chen
Keyword(s):  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Multivariate Analyses ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Clinical Center ◽  
Significant Difference

Abstract Background/aims: This study is to evaluate the effect of proton pump inhibitors on the course of common COVID-19.Methods: Clinical data of common COVID-19 patients admitted to the Shanghai Public Health Clinical Center for treatment from January 20, 2020 to March 16, 2020 were collected. A retrospective study was conducted and the patients were divided into two groups according to whether they used proton pump inhibitors or not. The differences in SARS-CoV-2 clearance and hospital stay between the two groups were compared by univariate and multivariate analyses.Results: A total of 154 COVID-19 common cases were included in this study, including 80 males (51.9%), 35 patients (22.7%) in the proton pump inhibitors group, and 119 patients (77.3%) in the control group. In the proton pump inhibitors group and the control group, the duration of the SARS-CoV-2 clearance were 7(6-9) and 7(6-11) days, and the duration of the hospital stay was 21(16-25) and 20(15-26) days, respectively. There was no significant difference between the two groups in the cumulative incidence of the SARS-CoV-2 clearance and the discharge, all P > 0.05. Multivariate analysis showed that chronic gastropathy prolonged the duration of SARS-CoV-2 clearance, the HR was 20.924(3.547-123.447). Hypertension, chronic obstructive pulmonary disease, chronic liver disease and malignant tumor all increased the duration of hospital stay for COVID-19, and the HR were 1.820 (1.073-3.085), 4.370 (1.205-15.844), 9.011 (2.681-30.290) and 5.270 (1.237-22.456), respectively; the duration of the hospital stay in COVID-19 patients was shortened by the SARS-CoV-2 clearance, and the HR was 0.907 (0.869-0.947); all P < 0.05.Conclusion: Proton pump inhibitors use has no effect on the prolonging or shortening of the course of adults hospitalized with COVID-19.

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.

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.

A Prospective Randomized Clinical Trial of Combination Therapy with Proton Pump Inhibitors and Mucolytics in Patients with Laryngopharyngeal Reflux

2020 ◽  
Vol 129 (8) ◽  
pp. 781-787
Author(s):  
Minsuk Chae ◽  
Dong Hyuk Jang ◽  
Ho Chan Kim ◽  
Minsu Kwon
Keyword(s):  
Combination Therapy ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Symptomatic Relief ◽  
Control Group ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Significant Difference

Objectives: To identify whether combination therapy with mucolytics and proton pump inhibitors (PPIs) leads to faster and more effective symptomatic relief in patients with laryngopharyngeal reflux (LPR). Methods: Patients diagnosed as LPR with a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7 were enrolled in this prospective study. Patients were randomly allocated to control (PPI only) or experimental (PPI + mucolytics) groups and changes in RSI and RFS values were assessed at 1- and 3-month follow-up. Results: One hundred sixteen patients were randomly allocated into either the control group ( n = 59) or the experimental group ( n = 57). The RSI and RFS scores significantly decreased in both groups (all P < .001) after 1 month of treatment; however, there was no significant difference in RSI change between groups ( P = .223). After 3 months of treatment, there remained no significant difference in RSI change between groups ( P = .592). Conclusions: Combination therapy with mucolytics and PPI compared to PPI alone did not lead to faster or more effective symptomatic relief in LPR patients.

scholarly journals CT-derived sarcopenia should not preclude surgical stabilization of traumatic rib fractures

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Derrick A. Doolittle ◽  
Matthew C. Hernandez ◽  
Francis I. Baffour ◽  
Michael R. Moynagh ◽  
Naoki Takahashi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Frailty Index ◽  
Rib Fractures ◽  
Total Hospital ◽  
Skeletal Muscle Index ◽  
Icu Stay ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Considerable Morbidity

Abstract Background Rib fractures are associated with considerable morbidity and mortality. Surgical stabilization of rib fractures (SSRF) can be performed to mitigate complications. Sarcopenia is in general known to be associated with poor clinical outcomes. We investigated if sarcopenia impacted number of days of mechanical ventilation, intensive care unit (ICU) stay, and total hospital stay in patients who underwent SSRF. Methods A retrospective single institutional review was performed including patients who underwent SSRF (2009–2017). Skeletal muscle index (SMI) was semiautomatically calculated at the L3 spinal level on computed tomography (CT) images and normalized by patient height. Sarcopenia was defined as SMI < 55 cm2/m2 in males and < 39 cm2/m2 in females. Demographics, operative details, and postoperative outcomes were reviewed. Univariate and multivariate analyses were performed. Results Of 238 patients, 88 (36.9%) had sarcopenia. There was no significant difference in number of days of mechanical ventilation (2.8 ± 4.9 versus 3.1 ± 4.3, p = 0.304), ICU stay (5.9 ± 6.5 versus 4.9 ± 5.7 days, p = 0.146), or total hospital stay (13.3 ± 7.2 versus 12.9 ± 8.2 days, p = 0.183) between sarcopenic and nonsarcopenic patients. Sarcopenic patients demonstrated increased modified frailty index scores (1.5 ± 1.1 versus 0.9 ± 0.9, p < 0.001) compared to nonsarcopenic patients. Conclusions For patients who underwent SSRF for rib fractures, sarcopenia did not increase the number of days of mechanical ventilation, ICU stay, or total hospital stay. Sarcopenia should not preclude the utilization of SSRF in these patients.

scholarly journals The Association Between Proton Pump Inhibitors and Incident Asthma in Patients with Coronary Artery Disease: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Tsung-Kun Lin ◽  
Jing-Yang Huang ◽  
Chin-Feng Tsai ◽  
Lung-Fa Pan ◽  
Gwo-Ping Jong
Keyword(s):  
Coronary Artery Disease ◽  
Cohort Study ◽  
Coronary Artery ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Low Income ◽  
Control Group ◽  
Research Database ◽  
Incident Asthma ◽  
Artery Disease

Abstract Observational studies have found a significant association between acid-suppressive drug use and incident asthma. However, the association between proton pump inhibitors (PPIs) and incident asthma in patients with coronary artery disease (CAD) is unclear. Thus, this study assessed the association between PPI use and incident asthma in patients with CAD. We conducted a retrospective cohort study using the National Health Insurance Research Database in Taiwan from 2004 to 2013. Each patient who took PPIs was assigned to the PPI group, whereas 1:1 sex-, age-, and drug index date-matched randomly selected patients without PPI prescription were assigned to the non-PPI group. We analyzed the risk of incident asthma using Cox proportional hazard regression models, including sex, age, urbanization, low income, and comorbidities. Sensitivity and subgroup analyses were also conducted. A total of 8499 cases were identified as PPI‐treated patients, and 8,499 subjects were included in the control group of PPI non‐users. After adjusting for sex, age, urbanization, low income, and comorbidities, PPI user was associated with a 1.18-fold (HR: 1.18; 95% CI: 1.05–1.34) increase for incident asthma in patients with CAD. We concluded that PPI use increased the risk of incident asthma in patients with CAD. The risk of incident asthma should be considered when weighing the benefits and risks of PPI and aspirin treatment in patients with CAD in clinical practice.

scholarly journals A comparative study of interval cholecystectomy and early cholecystectomy in acute cholecystitis

2020 ◽  
Vol 7 (5) ◽  
pp. 1419
Author(s):  
Gursimranjit Singh ◽  
Rana Ranjit Singh ◽  
Darpan Bansal
Keyword(s):  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Early Surgery ◽  
Total Hospital ◽  
Total Cost ◽  
Early Cholecystectomy ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Delayed Group ◽  
Day By Day

Background: In the whole world including India, the incidence of acute cholecystitis is increasing day by day. Gall stones are the most common cause of acute cholecystitis in 90-95% of the cases. The management of acute cholecystitis was conservative earlier but now there are studies recommending early surgery as the treatment of choice.Methods: Our study was conducted on 60 patients divided into two groups of 30 each to compare the results of early surgery with the delayed surgery.Results: The overall post-operative complication rate was same in both the groups but there was significant difference in the total hospital stay and total cost of the therapy in both the groups. The average total hospital stay in early group was 6.50±4.44 days and in delayed group was 10.80±5.55 days without including the number of days in non-operating admission.Conclusions: So, early cholecystectomy was found to be more economical with less total hospital stay and less total cost of the therapy than interval cholecystectomy in acute cholecystitis. 

AB0680 SARCOPENIA RATE IN COVID-19 SURVIVORS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1373.1-1373
Author(s):  
D. Levy ◽  
M. Giannini ◽  
W. Oulehri ◽  
M. Riou ◽  
C. Marcot ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Poor Quality ◽  
University Hospital ◽  
Total Hospital ◽  
Total Cohort ◽  
Total Hospital Stay ◽  
Increased Risk ◽  
Significant Difference ◽  
Risk Of Falls ◽  
Hospital Stay Duration

Background:COVID-19 survivors may have high risks of developing sarcopenia, which is associated to handicap, poor quality of life, higher healthcare costs, increased risk of falls, increased mortality (1).Objectives:To assess sarcopenia rate (which has not been described yet) following COVID-19 hospitalization and to highlights features associated with sarcopenic vs. non-sarcopenic patients.Methods:Major confirmed COVID-19 patients undergoing intensive care unit (ICU) or Pneumology Department admission in Strasbourg University Hospital between March and June 2020 were prospectively included. Muscle and cardio-respiratory evaluations were performed 3 months after discharge. Sarcopenic patients were compared to non-sarcopenic ones. A second muscle assessment 6 months after discharge was performed in patients with pathologic muscle tests.Results:127 patients were included, 39 (30.7%) not requiring ICU care, 88 (69.3%) requiring ICU care. The cohort consisted of 71% male patients, with a median age of 63 years [28-82]. Forty-one-percent were obese (BMI>30 kg/m2). Most individuals had preexisting comorbidities (82 patients, 70%), mainly hypertension and diabetes mellitus. The median total hospital stay duration was 22 days and up to 89 days. At the 3 months assessment, 17/127 (13%) patients were diagnosed with sarcopenia which comprised 6/17 (35%) severe sarcopenia (4.7% of the total cohort). At the 6 months assessment, only 4/15 (27%) of the initial sarcopenic patients remained sarcopenic (3% of the total cohort) and 3 of these 4 patients had severe sarcopenia. BMI (26,3 vs. 29,3, p=0.03), COPD (20% vs. 3%, p=0.03), comorbidities (93% vs. 67%, p=0.04), total hospital stay duration (33 vs. 20 days, p=0.03) and ICU stay duration (33 vs. 13 days, p=0.01) were significantly associated with sarcopenic vs. no sarcopenic patients. However, there was no significant difference concerning cardio-pulmonary evaluations between these two groups.Conclusion:We here highlighted a sarcopenia prevalence at 3 and 6 months following a hospitalization for COVID-19 of 13% and 3% respectively, occurring mainly in patients with comorbidities. Sarcopenia was not associated to worse cardio-pulmonary results in comparison with non-sarcopenic patients.References:[1]Di Filippo L, De Lorenzo R, D’Amico M, Sofia V, Roveri L, Mele R, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clinical Nutrition [Internet]. oct 2020. https://linkinghub.elsevier.com/retrieve/pii/S0261561420305896Disclosure of Interests:None declared

Application of operation room optimization process with multidisciplinary collaborative management in hysteromyoma surgery

2021 ◽  
Vol 7 (6) ◽  
pp. 6477-6483
Author(s):  
Lihua Zheng ◽  
Shufen Yang ◽  
Huajuan Wang ◽  
Yunping Lan
Keyword(s):  
Hospital Stay ◽  
Optimization Process ◽  
Collaborative Management ◽  
Control Group ◽  
Observation Group ◽  
Operation Room ◽  
Total Hospital Stay ◽  
Sf 36 ◽  
Significant Difference

Objective: To explore the application of operation room optimization process with multidisciplinary collaborative management in hysteromyoma surgery. Methods: 500 patients who underwent hysteromyoma surgery from March to December 2018 were selected as the control group. 500 patients who underwent hysteromyoma surgery using operation room optimization process with multidisciplinary collaborative management from March to December 2019 were selected as the observation group. The scores of self-care ability (ESCA), psychological status (HAMA, HAMD score), time of postoperative early ambulation activity, comfort of ambulation activity, postoperative hospital stay and total hospital stay, postoperative complications, quality of life score (SF-36), satisfaction with care were compared between the two groups. Results: There was no significant difference in the scores of ESCA, HAMA and HAMD between the two groups before operation (P>0.05). On the 7th day after operation, the score of ESCA of tne two groups was increased (P <0.05), and that of the observation group was higher than that of the control group (P<0.05). The scores of HAMA and HAMD of the two groups were lower than that before operation (P<0.05) and that of the observation group was lower than that of the control group (P <0.05). The earliest time of postoperative ambulation activity of the observation group was earlier than that of the control group (P<0.05). Ambulation activity comfort was superior to the control group (P<0.05). The postoperative hospital stay and total hospital stay of patients in the observation group were shorter than that in the control group (P <0.05). There was no significant difference in preoperative SF-36 scores between the two groups (P>0.05). There was significant difference in SF-36 scores between the two groups after operation and after follow up for 3 months (P<0.05). The occurrence of adverse events in the observation group was lower than that in the control group (P<0.05). The satisfaction of nursing in the observation group was higher than that in the control group (P<0.05). Conclusion: The application of multidisciplinary collaborative management in hysteromyoma surgery can optimize the operation process, alleviate the patient's operation anxiety, promote the patient's postoperative rehabilitation, improve the patient's quality of lite and improve tne patients satisfaction, and therefore, it is worth popularizing.

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