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Biomedical subjects

R P Fogel

Publications and source records attributed to R P Fogel.

5 recordsLinked to original sources
PubMed1998

Stress ulcer prophylaxis in medical ICU patients: annual utilization in relation to the incidence of endoscopically proven stress ulceration.

OBJECTIVE: To measure changes in the proportion of medical intensive care unit (MICU) patients prescribed pharmacologic stress ulcer prophylaxis therapy over a 4-year period in relation to the incidence of stress-related ulceration detected by endoscopy at our institution. DESIGN: Retrospective 4-year review of pharmacy and endoscopy databases. SETTING: A 35-bed MICU. PATIENTS: Patients (n = 2941) admitted to the MICU for longer than 24 hours, between January 1, 1993, and December 31, 1996, without acute gastrointestinal hemorrhage on admission. METHODS: Records were reviewed to identify patients prescribed pharmacologic stress ulcer prophylaxis (> 24 h of sucralfate or a histamine2-receptor antagonist [H2RA]), and patients with evidence of stress ulceration during endoscopy. RESULTS: The number of patients per year receiving stress ulcer prophylaxis significantly (p < 0.001) decreased between 1993 and 1996: 1993, 492/693 (71%); 1994, 478/798 (60%); 1995, 295/670 (44%); 1996, 164/780 (21%). There was no difference between years in the median duration of stress ulcer prophylaxis therapy or the proportion of patients receiving sucralfate versus H2RA therapy. There was no difference (p = 0.91) between years in the annual incidence of definite or possible stress-related ulceration: 1993, 6/693 (0.87%); 1994, 5/798 (0.63%); 1995, 6/670 (0.90%); 1996, 5/780 (0.64%). CONCLUSIONS: The incidence of endoscopically proven stress-related ulceration has remained unchanged over the past 4 years in our MICU despite significantly fewer patients receiving pharmacologic stress ulcer prophylaxis therapy.

Anti-Ulcer Agents↗
PubMed1995

Gastroparesis: current management.

Gastroparesis is delayed gastric emptying of either solids or liquids, which occurs in the absence of mechanical obstruction. Although associated with many diseases, the most frequent cause of gastroparesis is diabetes mellitus. It is estimated that up to 50% of diabetic patients may have this problem. Symptoms of gastroparesis include postprandial nausea, epigastric pain/burning, bloating, early satiety, excessive eructation, anorexia and vomiting. The vomiting associated with gastroparesis often has the following two features: (1) emesis of undigested foods ingested more than four hours previous; and (2) emesis of undigested foods in the middle of the night or in the morning prior to eating breakfast. It is important to recognize and treat gastroparesis not only to decrease symptoms but also to prevent bezoar formation and nutritional deficiencies as well as to improve glycemic control in brittle diabetics. The purpose of this article is to review the physiology of gastric emptying and to use this information to understand the pharmacological therapies for this debilitating problem.

Gastroparesis↗
PubMed1989

Common gastrointestinal problems in the elderly.

Despite advances in our knowledge about the pathogenesis of gastrointestinal disease, very little is known about the effects of aging on the gastrointestinal tract. We believe that the spectrum of gastrointestinal problems of the elderly and possible therapies for these problems will be the subjects of many future investigations.

Aged↗
PubMed1980

Liquid caustic ingestion. Spectrum of injury.

Seventeen patients who ingested liquid caustics were reviewed for location, extent, severity, and outcome of the mucosal injury. Although many complained of glossopharyngeal pains and dysphagia (12 patients), and most had some oral mucosal burns (15 patients), the absence of severe oral burns or pharyngoesophageal symptoms did not exclude esophageal or gastric injury as determined by endoscopy. The location of the most severe mucosal injury was unpredictable by symptoms alone; seven of the 17 patients demonstrated gastric mucosal injury greater than esophageal. One patient died of extensive esophageal, gastric, and duodenal injury; esophageal strictures developed in three patients. Caustic ingestion is a serious medical condition whose severity can best be gauged by endoscopic findings and not by patient symptoms alone. Outcome is variable, ranging from an asymptomatic state to stricture formation or even death.

Adolescent↗