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  • 1
    Online Resource
    Online Resource
    Lack of incremental effect of histamine receptor antagonists over proton pump inhibitors on the risk of neoplastic progression in patients with B arrett's esophagus: a cohort study
    Wiley ; 2017
    In:  Journal of Digestive Diseases Vol. 18, No. 3 ( 2017-03), p. 143-150
    Details
    In: Journal of Digestive Diseases, Wiley, Vol. 18, No. 3 ( 2017-03), p. 143-150
    Abstract: Long‐term acid suppression reduces the risk of progression to esophageal adenocarcinoma ( EAC ) in patients with B arrett's esophagus ( BE ). Given recent reports about the harmful effects of using chronic proton pump inhibitors ( PPI ) there is renewed interest in alternative methods of acid suppression. Hence, we studied the effect of H 2 receptor antagonists ( H 2 RA ) on the risk of progression to neoplasia in our BE cohort. METHODS This is a retrospective analysis of prospectively collected data of patients in our BE r egistry from 2002 to 2015. Patients' characteristics, endoscopic findings, such as the length of BE , hiatal hernia size and histological findings and patients' use of medications such as PPI , aspirin, H 2 RA , metformin and antihyperlipidemic agents were studied. RESULTS The cohort consisted of 1466 patients with a mean age of 61 ± 13 years. The patients had a predominance of male sex (76.7% [1118/1457]) and Caucasian race (96.6% [1209/1252] ). After excluding prevalent high‐grade dysplasia ( HGD ) or EAC , 1025 patients had a median follow up of 43.6 months during which 57 patients progressed to HGD or EAC . PPI use (56% in progressors vs 69% in non‐progressors; P = 0.007) but not H 2 RA use (12% progressors vs 19% in non‐progressors P = 0.162) was associated with lower risk of neoplastic progression. On multivariate analysis, there was no synergistic effect of addition of H 2 RA to PPI on risk of neoplastic progression to HGD or EAC (relative risk 0.33; confidence intervals 0.05–2.29, P = 0.262). CONCLUSION H 2 RA do not seem to have a chemopreventive role in patients with BE .
    Type of Medium: Online Resource
    ISSN: 1751-2972 , 1751-2980
    URL: Issue
    URL: Article
    DOI: 10.1111/cdd.2017.18.issue-3
    DOI: 10.1111/1751-2980.12457
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2317117-0
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  • 2
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    Online Resource
    Lactulose may reduce Clostridium difficile ‐related diarrhea among patients receiving antibiotics
    Wiley ; 2020
    In:  JGH Open Vol. 4, No. 6 ( 2020-12), p. 1088-1090
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    In: JGH Open, Wiley, Vol. 4, No. 6 ( 2020-12), p. 1088-1090
    Abstract: Prebiotics are nondigestible oligosaccharides that are metabolized by colonic bacteria, resulting in a change in the pH of the colonic milieu as well as modifying the microbiome of the colon. The purpose of this retrospective study was to determine whether concomitant lactulose administration affected the Clostridium difficile infection rate among hospitalized adult patients receiving antibiotics. Methods We retrospectively reviewed inpatient medical records of patients in a large teaching hospital admitted during a one‐year period. Individuals treated with antibiotic therapy during the course of their hospitalization were considered for inclusion in the study. Patients were evaluated for development of C. difficile infection, as well as concomitant lactulose therapy for hepatic encephalopathy. The incidence of C. difficile infection among patients who received lactulose and antibiotic therapy was compared with that among those who received antibiotic therapy alone. Results Patients who received lactulose and antibiotic therapy were slightly older ( n = 87, mean age 67) than patients who received antibiotic therapy alone ( n = 103, mean age 60). Similar numbers of patients were males in both groups (male/female: 50/53 and male/female: 46/41). Two (2.3%) patients who received lactulose and antibiotic therapy developed C. difficile infection during the course of hospitalization, compared with 10 (9.7%) patients who received antibiotic therapy alone ( P = 0.04, Fisher exact test). Conclusion Administration of lactulose may reduce the incidence of C. difficile ‐related diarrhea among hospitalized adult patients receiving antibiotics.
    Type of Medium: Online Resource
    ISSN: 2397-9070 , 2397-9070
    URL: Issue
    URL: Article
    DOI: 10.1002/jgh3.v4.6
    DOI: 10.1002/jgh3.12390
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2919809-4
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  • 3
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    Online Resource
    Obesity is Associated with Worse Outcomes in COVID‐19: Analysis of Early Data from New York City
    Wiley ; 2020
    In:  Obesity Vol. 28, No. 9 ( 2020-09), p. 1606-1612
    Details
    In: Obesity, Wiley, Vol. 28, No. 9 ( 2020-09), p. 1606-1612
    Abstract: The 2019 novel coronavirus disease (COVID‐19) has triggered a rapidly expanding global pandemic in which patients exhibit a wide spectrum of disease severity. Given the high prevalence of obesity in the United States, we hypothesized that the presence of obesity may play a role in the clinical course of patients with COVID‐19. Methods This is a retrospective review of adult patients admitted with confirmed severe acute respiratory syndrome coronavirus 2. Demographics, clinical characteristics, laboratory data, and clinical outcomes were abstracted. BMI (kilograms per meter squared) was analyzed with regard to a composite outcome of intensive care unit (ICU) admission or death and intubation rate. Results About 770 patients were included (61% male, mean age 63.5 years). Patients with obesity were more likely to present with fever, cough, and shortness of breath. Obesity was also associated with a significantly higher rate of ICU admission or death (RR = 1.58, P  = 0.002) even after adjusting for age, race, and troponin level. Conclusions Patients with obesity had an increased risk for critical illness leading to ICU admission or death compared with normal weight individuals. This study confirms that obesity is a major risk factor for COVID‐19 disease severity, significantly impacting disease presentation and critical care requirements.
    Type of Medium: Online Resource
    ISSN: 1930-7381 , 1930-739X
    URL: Article
    DOI: 10.1002/oby.22923
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2027211-X
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