PubMed Health⌕ Search

Biomedical subjects

A Godil

Publications and source records attributed to A Godil.

10 recordsLinked to original sources
PubMed2000

Recent nonsteroidal anti-inflammatory drug use increases the risk of early recurrence of bleeding in patients presenting with bleeding ulcer.

BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) use is a well-known risk factor for ulcer formation and ulcer complications. The purpose of this study was to determine whether recent NSAID use increases the risk of early recurrence of bleeding in patients who present with bleeding ulcer. METHODS: Clinical and endoscopic data were collected prospectively. Dose, frequency, and duration of recent NSAID use were quantified. Recent NSAID use was defined as consumption of over-the-counter or prescription NSAIDs or aspirin for at least 5 days of the 2-week period preceding the index episode of bleeding. Endoscopy was performed within 24 hours of admission to confirm the source of bleeding and endoscopic intervention was applied for stigmata of bleeding. Early recurrence of bleeding was defined as melena, hematochezia or blood per nasogastric tube with a 2 gm or greater decrease in hemoglobin during a period of 48 hours, occurring less than 2 weeks from index episode of bleeding. RESULTS: One hundred twenty patients (52 NSAID users and 68 nonusers) were enrolled in the study; mean age was 56 years. NSAID users were older than nonusers (p = 0.003); nonusers were more likely to have a history of ulcer disease (p < 0.0005) and higher prevalence of Helicobacter pylori infection (p = 0.05). Recent NSAID use was associated with a significantly higher frequency of early recurrence of bleeding and in-hospital recurrent bleeding compared with nonusers: 19% vs. 6%, p = 0.02, and 17% vs. 6%, p = 0.04, respectively. In multivariate logistic regression analysis, the significant association between recent NSAID use and early recurrence of bleeding persisted (p = 0.0048) while controlling for age and other covariates. CONCLUSIONS: Recent NSAID use predisposes bleeding ulcer patients to early and in-hospital recurrent bleeding, probably via its effects on platelet function, mucosal prostaglandins, and ulcer healing.

Adult↗
PubMed1998

Comparison of two rapid urease tests for detection of Helicobacter pylori infection.

Rapid urease tests are widely used at endoscopy to determine the presence of Helicobacter pylori infection. In this prospective study, we compared the accuracy of two rapid urease tests, CLOtest and PyloriTek, using histology as the gold standard. Histologic staining was performed using both H&E and Giemsa, and all slides were reviewed by a single pathologist who was blinded to the results of the rapid urease tests and endoscopic findings. One hundred two patients were enrolled; their mean age was 59 years (range 16 to 95 years), and there were 45 males and 57 females. Histology confirmed the presence of H. pylori infection in 39% of patients. The proportions of false positives for CLOtest (8.0%) and PyloriTek measured at 1 hr (29.0%) were significantly different (Z = 2.90, P = 0.0038). No significant difference was seen between the proportions of false negatives. We conclude that the clinical usefulness of PyloriTek urease test is limited by its lack of specificity.

Adolescent↗
PubMed1997

Rectal variceal bleeding treated by transjugular intrahepatic portosystemic shunt. Potentials and pitfalls.

Bleeding from anorectal varices can be massive and life threatening. Prompt differentiation between hemorrhoids and anorectal varices is crucial in treating these patients. Many different treatments are available for bleeding anorectal varices, but none has proved efficacy. We report a case of successful transjugular intrahepatic portosystemic shunt (TIPS) in controlling massive rectal variceal bleeding in an elderly patient with primary biliary cirrhosis and portal hypertension. After TIPS, rapid decompensation of liver function and encephalopathy developed and led to her death. Although TIPS may be effective in controlling acute life-threatening bleeding from anorectal varices, it can be associated with life-threatening complications.

Aged↗
PubMed1993

A multicenter case-controlled study of percutaneous endoscopic gastrostomy in HIV-seropositive patients.

OBJECTIVES: Malnutrition is an important cause of morbidity and mortality in AIDS patients. Percutaneous endoscopic gastrostomy (PEG) is a safe and effective method of providing nutrition in HIV-seronegative patients who are unable to swallow food, but have an otherwise functional alimentary tract. This study analyzes the risks and benefits of PEG in HIV-seropositive patients. METHODS: The risks of PEG were analyzed in 14 consecutive HIV-seropositive patients admitted to two university hospitals, and were compared with the risks in a sex- and age-matched control group of 21 patients. Thirteen HIV patients had AIDS. RESULTS: PEG indications included mechanical esophageal obstruction in six, wasting in six, and central nervous system disorders in two. The mean weight of the HIV patients increased by 7.4% +/- 3.0% (SE) 3-8 wk after PEG. Despite advanced HIV infection, serum biochemical parameters of nutritional status remained stable at 3-8 wk after PEG. Nine HIV patients suffered 10 complications during a mean follow-up of 111 +/- 147 (SD) days. The HIV patients had six (43%) minor complications, whereas the controls had four (19%) minor complications (not significantly different, Fisher's exact test). Minor complications in the HIV patients included transient tenderness and erythema at the PEG site in four, transient pyrexia without a source in one, and transient ileus in one. The HIV patients had four (29%) significant complications, compared to none in the controls (p < 0.02, Fisher's exact test). Significant complications in the HIV-seropositive patients included stomal cellulitis treated with intravenous antibiotics in three, and gastric bleeding requiring transfusion of one unit of packed erythrocytes in one. None of these complications were severe; all complications rapidly resolved with therapy. The high rate of wound infection following PEG in AIDS patients, like the previously reported high rate of postoperative wound infection in AIDS patients, is attributable to immunosuppression. During the study period, four HIV patients underwent surgical gastrostomy, with one complication of severe gastrointestinal bleeding. CONCLUSIONS: This work suggests that PEG is a useful and relatively safe method of providing long-term nutritional support in selected AIDS patients with a functional gastrointestinal tract.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Percutaneous endoscopic gastrostomy for nutrition support in pregnancy associated with hyperemesis gravidarum and anorexia nervosa.

BACKGROUND: Pregnant women with hyperemesis gravidarum (HEG) or anorexia nervosa are at high risk of developing malnutrition and adverse fetal outcome. Providing adequate nutrition support is the mainstay of therapy in these patients. Because of potential complications associated with total parenteral nutrition (TPN), enteral nutrition support is the preferred route. METHODS: We describe the first two reported cases of percutaneous endoscopic gastrostomy (PEG) placement in two conscious pregnant women who could not tolerate oral feedings because of severe anorexia nervosa and HEG, respectively. RESULTS: PEG was placed safely and provided adequate enteral nutrition in both patients, resulting in favorable maternal and fetal outcomes. CONCLUSIONS: Our observation is the first demonstration that PEG may be a safe and effective alternative to TPN in selected pregnant women with HEG or anorexia nervosa who have failed conventional treatment.

Adolescent↗