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Naloxone plus enteral nutrition for gastrointestinal dysfunction in elderly cerebral infarction and peptic ulcer patients 认领 引用
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作者 Xin-Xin Chen Xue-Fei Han Yan Chu 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期288-295,共8页
BACKGROUND Cerebral infarction(CI)is a major subtype of ischemic stroke,with high incidence,recurrence rate,disability rate,and mortality rate in the elderly.Elderly CI patients are prone to peptic ulcer due to long-t... BACKGROUND Cerebral infarction(CI)is a major subtype of ischemic stroke,with high incidence,recurrence rate,disability rate,and mortality rate in the elderly.Elderly CI patients are prone to peptic ulcer due to long-term use of antiplatelet drugs and stress factors,which further leads to gastrointestinal dysfunction,seriously affecting nutritional intake and rehabilitation.Naloxone,an opioid receptor antagonist,has neuroprotective potential,and enteral nutrition(EN)can improve gastrointestinal function.This study aims to explore the intervention effect of their combination.AIM To investigate the efficacy of naloxone combined with EN on gastrointestinal dysfunction in elderly patients with CI and peptic ulcer.METHODS In this randomized controlled trial,110 elderly patients with CI and peptic ulcer were equally assigned to a control group(receiving standard therapy combined with EN)or a combination group(receiving standard therapy,EN,and naloxone).The National Institute of Health Stroke Scale(NIHSS)scores,Barthel Index(BI),Chinese version of the MOS 36-Item Short Form Health Survey(SF-36)scores,gastrointestinal function scores,and serum levels of motilin(MTL),gastrin(GAS),and somatostatin(SS)were compared.Adverse reactions were also recorded.RESULTS Compared with the control group,the combination group had lower NIHSS scores(5.88±1.07 vs 8.73±1.14,P<0.001)and gastrointestinal dysfunction scores(5.14±1.27 vs 8.62±1.31,P<0.001),higher BI(87.36±4.42 vs 72.29±3.23,P<0.001)and SF-36 scores(76.26±3.85 vs 70.21±3.66,P<0.001),increased serum MTL(201.31±12.35 ng/L vs 186.81±11.18 ng/L,P<0.001)and GAS levels(94.46±9.64 pg/mL vs 103.15±10.52 pg/mL,P<0.001),and decreased SS levels(5.69±1.25 pg/mL vs 8.31±1.19 pg/mL,P<0.001).No significant difference in the incidence of adverse reactions was found between the two groups.CONCLUSION The combination of naloxone and EN is a safe and efficacious therapeutic approach for ameliorating gastrointestinal dysfunction and promoting overall recovery in elderly individuals with CI and peptic ulcer. 展开更多
关键词 Naloxone Enteral nutrition support Cerebral infarction Peptic ulcer Gastrointestinal dysfunction
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Acid peptic disorder compass:An Indian expert consensus on comprehensive management 认领 引用
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作者 Saroj Kant Sinha Rakesh Kochhar +12 位作者 KS Somasekhar Rao Dawesh Yadav Sujay Ray Aniruddha Pratap Singh Pradeepta Kumar Sethy Ramit Mahajan D Viswanath Reddy Vivek Mohan Sharma Antriksh Kumar Amit Mishra Shubham Jain Onkar C Swami Dinesh Patil 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 2026年第1期16-33,共18页
Overlapping pathophysiological mechanisms of gastroesophageal reflux disease,peptic ulcer disease,and functional dyspepsia often limit the symptom-based diagnosis precision.Additionally,the easy availability of overth... Overlapping pathophysiological mechanisms of gastroesophageal reflux disease,peptic ulcer disease,and functional dyspepsia often limit the symptom-based diagnosis precision.Additionally,the easy availability of overthe-counter proton pump inhibitors has increased the instances of self-diagnosis and self-treatment in the Indian population.Prolonged,unsupervised use of acid suppressants may reduce the treatment efficacy and increase the risk of adverse effects,such as infections and nutrient deficiencies.Therefore,a task force of 13 leading gastroenterologists under the Society for Clinical Gastroenterology reviewed the existing evidence to develop expert consensus statements for differentiating the overlapping symptoms of acid peptic disorders(APD)and guiding the rational use of acid-suppressive therapies.The available literature was searched and summarized in order to identify the relevant data.The pieces of evidence were discussed,validated,and revised in a face-to-face interaction of the task force members that led to a final set of 20 consensus statements.A comprehensive algorithm of the APD 360°compass was prepared for diagnosis and effective management of APDs based on the recommendations.This algorithm may guide physicians in India for timely diagnosis and appropriate medical interventions,thereby improving the patients’quality of life. 展开更多
关键词 Acid peptic disorders Consensus Dyspepsia Gastroesophageal reflux disease Peptic ulcer Potassiumcompetitive acid blockers Proton pump inhibitors India
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Helicobacter pylori eradication and the prevention of peptic ulcer bleeding and cardiovascular disease progression in chronic aspirin users 认领 引用
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作者 Atteyat A Semeya Wael Ahmed Makled +2 位作者 Mohamed A Elnagdy Rasha Elgamal Amira A A Othman 《World Journal of Gastroenterology》 SCIE CAS 2026年第17期90-115,共26页
BACKGROUND Long-term low-dose aspirin(LDA)use is associated with an increased risk of peptic ulcer bleeding(PUB).Helicobacter pylori(H.pylori)infection is a well-known risk factor for peptic ulcer disease(PUD).AIM To ... BACKGROUND Long-term low-dose aspirin(LDA)use is associated with an increased risk of peptic ulcer bleeding(PUB).Helicobacter pylori(H.pylori)infection is a well-known risk factor for peptic ulcer disease(PUD).AIM To evaluate the prevalence of H.pylori infection in long-term LDA users,assess the impact of eradication on PUB risk,and explore its association with cardiovascular(CV)disease status and progression.METHODS A prospective observational study was conducted at Benha Teaching Hospital from January 2023 to January 2024.Four hundred adults(≥18 years)on daily LDA for at least one year were enrolled.All participants underwent a comprehensive evaluation,including assessment of CV comorbidities.H.pylori was diagnosed via a stool antigen test,urea breath test,and histopathology.Infected patients received levofloxacin-based triple therapy for 14 days.Eradication was assessed at six weeks,and participants were followed for six months to evaluate PUB incidence and CV outcomes,including disease progression.RESULTS The prevalence of H.pylori infection was 65.5%(262/400).H.pylori-positive patients exhibited significantly lower albumin levels(3.5±0.4 g/dL vs 3.9±0.6 g/dL,P<0.001)and higher levels of urea(29.3±6.4 mg/dL vs 23.5±4.6 mg/dL,P<0.001),sodium(137.8±2.9 mmol/L vs 135.3±3.5 mmol/L,P<0.001),potassium(4.1±0.9 mmol/L vs 3.8±0.6 mmol/L,P=0.014),and cholesterol(191.0±29.7 mg/dL vs 177.0±35.9 mg/dL,P=0.004).PUB was significantly more prevalent in H.pylori-positive patients with gastric erosions(12.2%vs 0.0%,P<0.001),peptic ulcers(23.7%vs 0.0%,P<0.001),and gastric ulcers(10.7%vs 0.0%,P<0.001).After eradication therapy,51.9%(136/262)of patients tested negative for H.pylori,while 48.1%(126/262)remained positive.PUB was significantly more frequent in patients with persistent H.pylori infection(8.7%at 6 weeks,11.9%at 6 months)compared to those with successful eradication(1.5%at 6 weeks,3.7%at 6 months,P<0.001),highlighting the importance of successful eradication in reducing PUB risk.Additionally,H.pylori-positive patients had a higher prevalence of ischemic heart disease(54.3%vs 33.3%,P<0.001)and a higher burden of CV disease progression during follow-up(hazard ratio=3.5,P<0.001),suggesting a potential interaction between H.pylori infection and CV risk.CONCLUSION Successful screening and eradicating H.pylori in high-risk LDA users was associated with significantly reduced PUB risk and was linked to less CV disease progression in patients with persistent infection. 展开更多
关键词 Helicobacter pylori Peptic ulcer bleeding Low-dose aspirin Eradication therapy Gastroprotection
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Impact of a nursing-led peri-endoscopic management protocol on outcomes in patients with peptic ulcer bleeding undergoing therapeutic endoscopy 认领 引用
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作者 Hai-Yan Zhang Jia-Rong Zhang +3 位作者 Yun-Ying Zhuang Qing-Cheng Wu Heng Zhang Yong-De Huang 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第6期293-300,共8页
BACKGROUND Nursing-led peri-endoscopic management protocols play an important role in reducing the risk of short-term rebleeding in patients with peptic ulcer bleeding and may also contribute to shorter hospital stays... BACKGROUND Nursing-led peri-endoscopic management protocols play an important role in reducing the risk of short-term rebleeding in patients with peptic ulcer bleeding and may also contribute to shorter hospital stays.AIM To evaluate the impact of a nursing-led peri-endoscopic management protocol on outcomes in peptic ulcer bleeding treated with therapeutic endoscopy.METHODS This prospective randomized controlled trial included 130 patients with peptic ulcer bleeding who underwent therapeutic endoscopy at our hospital,between March 2023 and March 2025.Patients were randomly assigned to an observation group(n=65)or a control group(n=65).The observation group received a nursing-led peri-endoscopic management protocol,whereas the control group received routine endoscopic nursing care.Outcomes included rebleeding,hospital stay,blood transfusion volume,complications,and patient satisfaction.RESULTS Baseline characteristics were comparable between groups(P>0.05).Rebleeding rates in the observation group were lower than in the control group at both time points:6.15%(4/65)vs 18.46%(12/65)on day 7 and 9.23%(6/65)vs 24.62%(16/65)on day 30(all P<0.05).Mean hospital stay was shorter in the observation group (6.8 ± 2.1 days vs 8.1 ± 2.6 days;P = 0.002). Mean blood transfusion volume was also lower (1.3 ± 0.9 U vs 1.9± 1.1 U;P < 0.05). The incidence of endoscopic complications was lower in the observation group (P < 0.05). Patientsatisfaction rate was higher in the observation group, 92.31% (60/65) vs 78.46% (51/65) in the control group (P <0.05).CONCLUSIONNursing-led peri-endoscopic management reduces short-term rebleeding in patients with peptic ulcer bleedingafter therapeutic endoscopy, shortens hospital stay, decreases blood transfusion requirements, and improves patientexperience, indicating substantial clinical value. 展开更多
关键词 Nursing-led peri-endoscopic management protocol Peptic ulcer bleeding Therapeutic endoscopy Rebleeding Clinical outcomes
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Perforated peptic ulcer in pregnancy and puerperium: A systematic review 认领 引用
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作者 Goran Augustin Jure Krstulović +1 位作者 Ante Tavra Zrinka Hrgović 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第4期360-368,共9页
BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the d... BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the diagnosis of preoperative PPU during pregnancy and puerperium challenging.AIM To identify predictive factors for early diagnosis and treatment,and the association between the diagnosis and maternaleonatal outcomes.METHODS We searched PubMed,PubMed Central,and Google Scholar.Articles were analyzed following preferred reporting items for systematic reviews and metaanalysis.The search items included:‘ulcer’,‘PUD’,‘pregnancy’,‘puerperium’,‘postpartum’,‘gravid’,‘labor’,‘perforated ulcer’,‘stomach ulcer’,‘duodenal ulcer’,‘peptic ulcer’.Additional studies were extracted by reviewing reference lists of retrieved studies.We included all available full-text cases and case series.Demographic,clinical,obstetric,diagnostic and treatment parameters,and outcomes were collected.RESULTS Forty-three cases were collected.The mean maternal age was 30.9 years;36.6%were multiparous,and 63.4%were nulliparous or primiparous,with multiparas being older than primiparas.Peptic ulcer perforated in 44.2%of postpartum and 55.8%of antepartum patients.Antepartum PPU incidence increased with advancing gestation 2.3%in the first,7%in the second,and 46.5%in the third trimester.The most common clinical findings were abdominal tenderness(72.1%),rigidity(34.9%),and distension(48.8%).Duodenal ulcer predominated(76.7%).In 79.5%,the time from delivery to surgery or vice versa was>24 hours.The maternal mortality during the third trimester and postpartum was 10%and 31.6%,respectively.The trimester of presentation did not influence maternal mortality.The fetal mortality was 34.8%,with all deaths in gestational weeks 24-32.CONCLUSION Almost all patients with PPU in pregnancy or puerperium presented during the third trimester or the first 8 days postpartum.Early intervention reduced fetal mortality but without influence on maternal mortality.Maternal mortality did not depend on the use of X-ray imaging,perforation location,delivery type,trimester of presentation,and maternal age.Explorative laparoscopy was never performed during pregnancy,only postpartum. 展开更多
关键词 Peptic ulcer disease Perforated peptic ulcer Pregnancy Puerperium Outcomes Systematic review
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Clinical efficacy and mechanism of Bletilla striata and Chinese herbal compounds in treatment of peptic ulcer 认领 引用 被引量：3
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作者 Yi-Tong Sun Fang Zhou +1 位作者 Hong-Xin Zheng Jing-Dong Xiao 《World Journal of Gastroenterology》 SCIE CAS 2025年第30期23-32,共10页
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec... Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use. 展开更多
关键词 Bletilla striata Related traditional Chinese medicine compound formulations Peptic ulcer Mechanism of action Clinical efficacy
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Intravenous proton pump inhibitors vs oral potassium competitive acid blockers before endoscopic treatment of bleeding peptic ulcers 认领 引用 被引量：1
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作者 Na Rae Lim Woo Chul Chung 《World Journal of Gastrointestinal Endoscopy》 2025年第6期64-73,共10页
BACKGROUND The use of proton pump inhibitors(PPIs)with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.AIM To compare intravenou... BACKGROUND The use of proton pump inhibitors(PPIs)with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.AIM To compare intravenous PPIs and oral potassium competitive acid blockers(PCABs)administered prior to endoscopic treatment of bleeding peptic ulcers.METHODS This retrospective study involved 105 consecutive patients with non-variceal upper gastrointestinal bleeding(treated August 2023 to February 2024).Prior to emergency endoscopy,patients received either intravenous PPI(pantoprazole 80 mg bolus)or oral PCAB(tegoprazan 50 mg single-dose).Severity of bleeding was assessed using the Glasgow-Blatchford,Rockall,and AIMS65 scoring systems.Patients with severe comorbidities were excluded.Primary outcomes included need for therapeutic endoscopic intervention and occurrence of re-bleeding.Multivariate logistic regression was performed to adjust for potential confounding factors.RESULTS Total of the 105 patients,61 received intravenous PPI injection and 44 received oral PCAB prior to emergency endoscopy.To minimize selection bias,bleeding severity was assessed using the Glasgow-Blatchford,Rockall and AIMS65 scores,with no statistically significant differences observed between the two groups.During emergency endoscopy performed within 48 hours,ulcer bed status was classified according to the Forrest classification.The proportion of lesions graded IIa or higher was significantly lower in the PCAB group(P<0.001),as was the frequency of therapeutic endoscopy intervention(odds ratio=0.272,95%confidence interval:0.111-0.665,P=0.004).The frequency of re-bleeding events was statistically significantly higher in the PPI group(odds ratio=0.141,95%confidence interval:0.024-0.844,P=0.032).CONCLUSION Pre-endoscopic PCAB administration is more effective than PPI injection for upper gastrointestinal bleeding and may reduce ulcer bleeding mortality. 展开更多
关键词 Peptic ulcer Bleeding Proton pump inhibitor Potassium competitive acid blocker Ulcer bleeding
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Evaluation of the Efficacy Rate of Rebamipide Combined with Triple Therapy in the Treatment of Senile Peptic Gastric Ulcers 认领 引用
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作者 Rong Li 《Journal of Clinical and Nursing Research》 2025年第11期270-275,共6页
Objective:To evaluate the efficacy rate of rebamipide combined with triple therapy in the treatment of senile peptic gastric ulcers.Methods:A cohort of 68 elderly patients diagnosed with peptic gastric ulcers was enro... Objective:To evaluate the efficacy rate of rebamipide combined with triple therapy in the treatment of senile peptic gastric ulcers.Methods:A cohort of 68 elderly patients diagnosed with peptic gastric ulcers was enrolled in this study between January 2022 and December 2024.Using the envelope method for randomization,the patients were divided into two equal groups:a control group administered standard triple therapy and an observation group that received the same triple therapy supplemented with rebamipide.The clinical efficacy,gastric mucosal morphology(mucosal thickness,gland density,active inflammatory cell infiltration,chronic inflammatory cell infiltration),and pepsinogen I/II were compared between the two groups.Results:The total effective rate in the observation group was significantly higher than that in the control group,with a statistically significant difference(p<0.05).After treatment,the scores of all items in both groups were significantly lower than those before treatment,and the scores in the observation group were significantly lower than those in the control group,with statistically significant differences(p<0.05).After treatment,the ratios in both groups were significantly higher than those before treatment,and the ratio in the observation group was significantly higher than that in the control group,with statistically significant differences(p<0.05).Conclusion:Rebamipide combined with triple therapy can significantly improve the treatment efficacy of senile peptic gastric ulcers,effectively improve the histological status of the gastric mucosa,and promote the recovery of gastric mucosal function,with superior efficacy compared to triple therapy alone. 展开更多
关键词 Rebamipide Triple therapy Elderly Peptic gastric ulcer Gastric mucosal morphology Pepsinogen
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Low serum albumin may predict poor efficacy in patients with perforated peptic ulcer treated nonoperatively 认领 引用 被引量：2
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作者 Tang-Shuai Liang Bao-Lei Zhang +1 位作者 Bing-Bo Zhao Dao-Gui Yang 《World Journal of Gastrointestinal Surgery》 SCIE 2021年第10期1226-1234,共9页
BACKGROUND Nonoperative management(NOM)is a promising therapeutic modality for patients with perforated peptic ulcer(PPU).However,the risk factors for poor efficacy and adverse events of NOM are a concern.AIM To inves... BACKGROUND Nonoperative management(NOM)is a promising therapeutic modality for patients with perforated peptic ulcer(PPU).However,the risk factors for poor efficacy and adverse events of NOM are a concern.AIM To investigate the factors predictive of poor efficacy and adverse events in patients with PPU treated by NOM.METHODS This retrospective case-control study enrolled 272 patients who were diagnosed with PPU and initially managed nonoperatively from January 2014 to December 2018.Of these 272 patients,50 converted to emergency surgery due to a lack of improvement(surgical group)and 222 patients were included in the NOM group.The clinical data of these patients were collected.Baseline patient characteristics and adverse outcomes were compared between the two groups.Logistic regression analysis and receiver operating characteristic curve analyses were conducted to investigate the factors predictive of poor efficacy of NOM and adverse outcomes in patients with PPU.RESULTS Adverse outcomes were observed in 71 patients(32.0%).Multivariate analyses revealed that low serum albumin level was an independent predictor for poor efficacy of NOM and adverse outcomes in patients with PPU.CONCLUSION Low serum albumin level may be used as an indicator to help predict the poor efficacy of NOM and adverse outcomes,and can be used for risk stratification in patients with PPU. 展开更多
关键词 Perforated peptic ulcer Peptic ulcer disease Nonoperative treatment Risk factor
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Influence of interleukin polymorphisms on development of gastric cancer and peptic ulcer 认领 引用 被引量：67
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作者 Mitsushige Sugimoto Yoshio Yamaoka Takahisa Furuta 《World Journal of Gastroenterology》 SCIE CAS 2010年第10期1188-1200,共13页
Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual ... Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous studies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous stud- ies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2.02, 1.31-3.10). In peptic ulcer development, IL-2-330 G and IL-4-590 T allele carriers had a significantly decreased risk (0.37, 0.27-0.50 and 0.58, 0.34-0.99, respectively). Moreover, IL-2, IL-4, IL-6 and IL-8 gene genotypes prevalence differs among popula- tions. The inflammatory cytokine gene polymorphisms (e.g. IL-4 -590 and IL-6 -572 for gastric cancer, and IL-4-590, IL-6-572 and IL-8-251 for peptic ulcer) have a more potent influence on development of gastroduo- denal diseases in Western than East Asian populations. These cytokine gene polymorphisms, as well as those of IL-1B, IL-1RN and TNF-A, may be used to identify groups at higher risk of gastric cancer and peptic ulcer, and those suitable for their prevention by H. pylori eradication therapy in Western populations..02, 1.31-3.10). In peptic ulcer development, IL-2-330 G and IL-4-590 T allele carriers had a significantly decreased risk (0.37, 0.27-0.50 and 0.58, 0.34-0.99, respectively). Moreover, IL-2, IL-4, IL-6 and IL-8 gene genotypes prevalence differs among populations. The inflammatory cytokine gene polymorphisms (e.g. IL-4 -590 and IL-6 -572 for gastric cancer, and IL-4-590, IL-6-572 and IL-8-251 for peptic ulcer) have a more potent influence on development of gastroduo-denal diseases in Western than East Asian populations. These cytokine gene polymorphisms, as well as those of IL-1B, IL-1RN and TNF-A, may be used to identify groups at higher risk of gastric cancer and peptic ulcer, and those suitable for their prevention by H. pylori eradication therapy in Western populations. 展开更多
关键词 Helicobacter pylori Cytokines Genetic polymorphism Stomach neoplasms Peptic ulcer
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Epidemiology of perforated peptic ulcer:Age-and gender-adjusted analysis of incidence and mortality 认领 引用 被引量：21
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作者 Kenneth Thorsen Jon Arne Sreide +2 位作者 Jan Terje Kvaly Tom Glomsaker Kjetil Sreide 《World Journal of Gastroenterology》 SCIE CAS 2013年第3期347-354,共8页
AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohor... AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohort study of all patients diag-nosed with benign perforated peptic ulcer.Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010.Ulcers with a malignant neoplasia diagnosis,verified by histology after biopsy or resection,were excluded.Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes(K25.1,K25.2,K25.5, K25.6,K26.1,K26.2,K26.5,K26.6).Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures(e.g.,JDA 60,JDA 61,JDH 70 and JDH 71)were performed to enable a complete identification of all patients.Patient demographics,presentation patterns and clinical data were retrieved from hospital records and surgical notes.Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS:In the study period,a total of 172 patients with PPU were identified.The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year(95%CI:5.6-7.6)and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year(95%CI:0.7-1.6).A non-significant decline in ad-justed incidence rate from 9.7 to 5.6 occurred during the decade.The standardized mortality ratio for the whole study period was 5.7(95%CI:3.9-8.2),while the total 30-d mortality was 16.3%.No difference in in-cidence or mortality was found between genders.However,for patients≥60 years,the incidence increased over 10-fold,and mortality more than 50-fold,compared to younger ages.The admission rates outside office hours were high with almost two out of three(63%) admissions seen at eveningight time shifts and/or during weekends.The observed seasonal variations in admissions were not statistically significant. CONCLUSION:The adjusted incidence rate,seasonal distribution and mortality rate was stable.PPU fre-quently presents outside regular work-hours.Increase in incidence and mortality occurs with older age. 展开更多
关键词 Perforated peptic ulcer Epidemiology Incidence Mortality Seasonal variation
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Clinical effects of psychological intervention and drug therapy against peptic ulcer 认领 引用 被引量：17
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作者 Duo-Yu Wu Min Guo +6 位作者 Yun-Suo Gao Yan-Hai Kang Jun-Cheng Guo Xiang-Ling Jiang Feng Chen Tao Liu Min Li 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2012年第10期831-833,共3页
Objective:To evaluate the clinical effects of psychological interventions and drug therapy against peptic ulcer.Methods:96 patients with peptic ulcer were divided into control group with Tagamet 800 mg per evening p.o... Objective:To evaluate the clinical effects of psychological interventions and drug therapy against peptic ulcer.Methods:96 patients with peptic ulcer were divided into control group with Tagamet 800 mg per evening p.o.and trial group with psychological intervention on the basis of drug treatment.Results:There were significant differences between the two groups(P【0.05), the trial group showed that the anxiety and depression cases declined obviously and effective rate of ulcer therapy was much higlier than control group.Conclusions:In sum,psychological intervention combined with drug therapy provides an effective method for ulcer treatment. 展开更多
关键词 Psychological intervention Drug therapy Peptic ulcer
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Upper-gastrointestinal bleeding secondary to peptic ulcer disease:Incidence and outcomes 认领 引用 被引量：25
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作者 Samuel Quan Alexandra Frolkis +9 位作者 Kaylee Milne Natalie Molodecky Hong Yang Elijah Dixon Chad G Ball Robert P Myers Subrata Ghosh Robert Hilsden Sander Veldhuyzen van Zanten Gilaad G Kaplan 《World Journal of Gastroenterology》 SCIE CAS 2014年第46期17568-17577,共10页
AIM: To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).
关键词 Epidemiology Peptic ulcer hemorrhage Digestive system surgical procedures Mortality Endoscopy Validation studies Incidence
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Endoscopic hemoclip treatment for bleeding peptic ulcer 认领 引用 被引量：8
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作者 Lai YC Yang SS +1 位作者 Wu CH Chen TK 《World Journal of Gastroenterology》 SCIE CAS 2000年第1期53-56,共4页
AIM To evaluate the efficacy of endoscopichemoclip in the treatment of bleeding pepticulcer.METHODS Totally,40 patients with F1a andFib hemorrhagic activity of peptic ulcers wereenrolled in this uncontrolled prospecti... AIM To evaluate the efficacy of endoscopichemoclip in the treatment of bleeding pepticulcer.METHODS Totally,40 patients with F1a andFib hemorrhagic activity of peptic ulcers wereenrolled in this uncontrolled prospective studyfor endoscopic hemoclip treatment.We used anewly developed rotatable clip-device for theapplication of hemoclip(MD850)to stopbleeding.Endoscopy was repeated if there wasany sign or suspicion of rebleeding,and re-clipping was performed if necessary andfeasible.RESULTS Initial hemostatic rate by clippingwas 95%,and rebleeding rate was only 8%.Ultimate hemostatic rates were 87%,96%,and93% in the Fla and Flb subgroups,and totalcases,respectively.In patients with shock onadmission,hemoclipping achieved ultimatehemostasis of 71% and 83% in F1a and F1bsubgroups,respectively.Hemostasis reached100% in patients without shock regardless ofhemorrhagic activity being F1a or F1b.Theaverage number of clips used per case was 3.0(range 2-5).Spurting bleeders required moreclips on average than did oozing bleeders(3.4versus 2.8).We observed no obviouscomplications,no tissue injury,or impairmentof ulcer healing related to hemoclipping.CONCLUSION Endoscopic hemoclip placementis an effective and safe method.With theimprovement of the clip and application device,the procedure has become easier and much moreefficient.Endoscopic hemoclipping deservesfurther study in the treatment of bleeding pepticulcers. 展开更多
关键词 Subject headings endoscopic hemoclipping gastrointestinal hemorrhageherapy peptic ulcer hemostasis
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Risk factors and therapeutic response in Chinese patients with peptic ulcer disease 认领 引用 被引量：23
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作者 Shou-Wu Lee Chi-Sen Chang +3 位作者 Teng-Yu Lee Hong-Zen Yeh Chun-Fang Tung Yen-Chun Peng 《World Journal of Gastroenterology》 SCIE CAS 2010年第16期2017-2022,共6页
AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retro... AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December 2008.The differences were compared.RESULTS:Among all 448 cases,254(56.6%)and 194(43.4%)patients had gastric ulcers and duodenal ulcers respectively.Patients with gastric ulcers were younger than those with duodenal ulcers.Although more men existed,there was a female predominance in middle-aged cases.Patients with duodenal ulcers had a higher rate of Helicobacter pylori(H.pylori)infection(62.4%vs 43.3%,P=0.001),and those with gastric ulcers owned a significantly higher amount of aspirin and nonsteroidal anti-inflammatory drug(NSAID)use(7.5%vs 1.5%,6.7%vs 2.1%,P=0.001).Tobacco smoking and alcohol drinking had no different impact between these two groups.Proton-pump inhibitors and H2-receptor antagonists(H2RA)were effective,but significantly less so in cases with duodenal ulcers receiving H2RAs,or in those with H.pylori infection and a history of NSAID use.CONCLUSION:Patients with gastric ulcers had lower H.pylori infection but more aspirin or NSAID use.Antisecretory therapy was ineffective in gastric ulcers underwent H2RA treatment,and cases combined H.pylori infection and NSAID use. 展开更多
关键词 Epidemiology Peptic ulcer disease Therapy
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Protective effect of essential oil of Pistacia atlantica Desf. on peptic ulcer: role of α-pinene 认领 引用 被引量：12
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作者 Zahra Memariani Mohammad Sharifzadeh +5 位作者 Mahbubeh Bozorgi Mannan Hajimahmoodi Mohammad Hosein Farzaei Mahdi Gholami Farideh Siavoshi Parastoo Saniee 《Journal of Traditional Chinese Medicine》 SCIE CSCD 2017年第1期57-63,共7页
OBJECTIVE: To evaluate the efficacy of Pistacia atlantica Desf. oleoresin essential oil on peptic ulcer(PU) and its antibacterial effect on metronidazole-resistant Helicobacter pylori, as well as chemi-cal composition... OBJECTIVE: To evaluate the efficacy of Pistacia atlantica Desf. oleoresin essential oil on peptic ulcer(PU) and its antibacterial effect on metronidazole-resistant Helicobacter pylori, as well as chemi-cal composition of the essential oil.METHODS: The essential oil was standardized using gas chromatography mass spectrometry(GC/MS) analysis. Acute toxicity of the essential oil was assessed in animal model. In vitro anti-Helicobacter pylori activity was performed through disc diffusion and minimum inhibitory concentration method. For gastroprotective assay, rats received Pistacia atlantica Desf. essential oil(25, 50 and 100 mg/kg orally) 1 h before induction of ulcer by ethanol.Macroscopic(ulcer index and protection rate) and microscopic examination were performed.RESULTS: The GC/MS analysis of the essential oil led to the identification of twenty constituents andα-pinene is predominant constituent. The essential oil was safe up to 2000 mg/kg. All Helicobacter pylori strains were susceptible to the essential oil and the MIC ranged from 275 to 1100 μg/m L. The ulcer index for treated groups was significantly reduced compared to control(P < 0.001) with EC50 value of 12.32 mg/kg. In microscopic examination, Pistacia atlantica attenuated destruction and necrosis of gastric tissue.CONCLUSION: Current study exhibited protective effect of standardized Pistacia atlantica essential oil against ethanol-induced gastric ulcer and its antibacterial activity on Helicobacter pylori. α-pinene might be the responsible agent. 展开更多
关键词 Peptic ulcer Pistacia Oils volatile Oleoresins Gastroprotective Helicobacter pylori Medicine traditional
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Clinical characteristics of Helicobacter pylori-negative drugnegative peptic ulcer bleeding 认领 引用 被引量：10
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作者 Woo Chul Chung Eun Jung Jeon +5 位作者 Dae Bum Kim Hea Jung Sung Yeon-Ji Kim Eun Sun Lim Min-ah Kim Jung Hwan Oh 《World Journal of Gastroenterology》 SCIE CAS 2015年第28期8636-8643,共8页
AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(H.pylori)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced P... AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(H.pylori)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced PUB between 2006 and 2012 was retrospectively analyzed.A total of 232 patients were enrolled in this study.The patients were divided into four groups according to the etiologies of PUB:idiopathic,H.pylori-associated,drug-induced and combined(H.pylori-associated and drug-induced)types.We compared the clinical characteristics and outcomes between the groups.When the silver stain or rapid urease tests were H.pylori-negative,we obtained an additional biopsy specimen by endoscopic re-examination and performed an H.pylori antibody test 6-8 wk after the initial endoscopic examination.For a diagnosis of idiopathic PUB,a negative result of an H.pylori antibody test was confirmed.In all cases,re-bleeding was confirmed by endoscopic examination.For the risk assessment,the Blatchford and the Rockall scores were calculated for all patients.RESULTS:For PUB,the frequency of H.pylori infection was 59.5%(138/232),whereas the frequency of idiopathic cases was 8.6%(20/232).When idiopathic PUB was compared to H.pylori-associated PUB,the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis during the hospital stay(30%vs 7.4%,P = 0.02).When idiopathic PUB was compared to drug-induced PUB,the patients in the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis upon admission(30%vs 2.7%,P < 0.01).When drug-induced PUB was compared to H.pylori-associated PUB,the patients in the drug-induced PUB were older(68.49 ± 14.76 years vs 47.83 ± 15.15 years,P< 0.01) and showed a higher proportion of gastric ulcer(77%vs 49%,P < 0.01).However,the Blatchford and the Rockall scores were not significantly different between the two groups.Among the patients who experienced drug-induced PUB,no significant differences were found with respect to clinical characteristics,irrespective of H.pylori infection.CONCLUSION:Idiopathic PUB has unique clinical characteristics such as re-bleeding after initial hemostasis upon admission.Therefore,these patients need to undergo close surveillance upon admission. 展开更多
关键词 Peptic ulcer Gastrointestinal bleeding Helicobacter pylori Non-steroidal anti-inflammatorydrug
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Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleedinq 认领 引用 被引量：17
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作者 Tai-Cherng Liou Shee-Chan Lin +1 位作者 Horng-Yuan Wang Wen-Hsiung Chang 《World Journal of Gastroenterology》 SCIE CAS 2006年第19期3108-3113,共6页
AIM： To define the optimal injection volume of epinephrine with high efficacy for hemostasis and low complication rate in patients with actively bleeding ulcers. METHODS： This prospective, randomized, comparative tr... AIM： To define the optimal injection volume of epinephrine with high efficacy for hemostasis and low complication rate in patients with actively bleeding ulcers. METHODS： This prospective, randomized, comparative trial was conducted in a medical center. A total of 228 patients with actively bleeding ulcers （spurting or oozing） were randomly assigned to three groups with 20, 30 and 40 mL endoscopic injections of an 1：10000 solution of epinephrine. The hemostatic effects and clinical outcomes were compared between the three groups. RESULTS： There were no significant differences in all background variables between the three groups. Initial hemostasis was achieved in 97.4%, 98.7% and 100% of patients respectively in the 20, 30 and 40 mL epinephrine groups. There were no significant differences in the rate of initial hemostasis between the three groups. The rate of peptic ulcer perforation was significantly higher in the 40 mL epinephrine group than in the 20 and 30 mL epinephrine groups （P 〈 0.05）. The rate of recurrent bleeding was significantly higher in the 20 mL epinephrine group （20.3%） than in the 30 （5.3%） and 40 mL （2.8 %） epinephrine groups （P 〈 0.01）. There were no significant differences in the rates of surgical intervention, the amount of transfusion requirements, the days of hospitalization, the deaths from bleeding and 30 d mortality between the three groups. The number of patients who developed epigastric pain due to endoscopic injection, was significantly higher in the 40 mL epinephrine group （51/76） than in the 20 （2/76） and 30 mL （5/76） epinephrine groups （P 〈 0.001）. Significant elevation of systolic blood pressure after endoscopic injection was observed in the 40 mL epinephrine group （P 〈 0.01）. Significant decreasing and normalization of pulse rates after endoscopic injections were observed in the 20 mL and 30 mL epinephrine groups （P 〈 0.01）.CONCLUSION： Injection of 30 mL diluted epinephrine （1：10000） can effectively prevent recurrent bleeding with a low rate of complications. The optimal injection volume of epinephrine for endoscopic treatment of an actively bleeding ulcer （spurting or oozing） is 30 mL. 展开更多
关键词 Endoscopic injection Epinephrine Volume Peptic ulcer bleeding
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Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer? 认领 引用 被引量：14
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作者 Katsuhiro Mabe Mikako Takahashi +6 位作者 Haruhumi Oizumi Hideaki Tsukuma Akiko Shibata Kazutoshi Fukase Toru Matsuda Hiroaki Takeda Sumio Kawata 《World Journal of Gastroenterology》 SCIE CAS 2009年第34期4290-4297,共8页
AIM:To investigate the effects of Helicobacter pylori (H pylori)eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS:A multicenter prospective cohort study was conducted betwee... AIM:To investigate the effects of Helicobacter pylori (H pylori)eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS:A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture,Japan.The study included patients with H pylori-positive peptic ulcer who decided themselves whether to receive H pylori eradication(eradication group)or conventional antacid therapy(non-eradication group).Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys,as well as Yamagata Prefectural Cancer Registry data,and was compared between the two groups and by results of H pylori therapy.RESULTS:A total of 4133 patients aged between 13 and 91 years(mean 52.9 years)were registered,and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years.The sex-and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group,was 0.58 (95%CI:0.28-1.19)and ratios by follow-up period(3 years)were 1.16(0.27-5.00),0.50 (0.17-1.49),and 0.34(0.09-1.28),respectively.Longer follow-up tended to be associated with better prevention of gastric cancer,although not to a significant extent.No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy(32/2451 patients,1.31%)and those with treatment failure(11/639 patients,1.72%).Among patients with duodenal ulcer,which is known to be more prevalent in younger individuals,the incidence of gastric cancer was significantly less in those with successful eradication therapy(2/845 patients,0.24%)than in those with treatment failure(3/216 patients,1.39%). CONCLUSION:H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the incidence of gastric cancer. 展开更多
关键词 Helicobacter pylori Peptic ulcer Gastric cancer Eradication therapy Cancer prevention
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Polymorphism of -765G > C COX-2 is a risk factor for gastric adenocarcinoma and peptic ulcer disease in addition to H pylori infection:A study from northern India 认领 引用 被引量：18
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作者 Ashish Saxena Kashi Nath Prasad +3 位作者 Uday Chand Ghoshal Monty Roshan Bhagat Narendra Krishnani Nuzhat Husain 《World Journal of Gastroenterology》 SCIE CAS 2008年第10期1498-1503,共6页
AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (6... AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis. RESULTS: Frequency of C carrier had significantassociation with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD. 展开更多
关键词 COX-2 polymorphism Gastric adenocarcinoma Peptic ulcer disease Helicobacter pylori infection
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