ABSTRACT
Background/Aims@#Proton pump inhibitors (PPIs) are widely used to treat several acid-related gastrointestinal disorders. This study aimed to investigate the risk of dementia in patients taking PPIs. @*Materials and Methods@#A systematic review was conducted to evaluate the correlation between PPIs and dementia. The methodological quality of the included studies was evaluated using the Risk of Bias Assessment tool for non-randomized studies. Publication bias was assessed. @*Results@#A total of 12 nested, case-control, and cohort studies were identified and analyzed. We obtained hazard ratios (HRs) from five studies and performed a meta-analysis. The meta-analysis of four cohort studies and one nested case-control study showed no association between PPIs and dementia (HR, 1.165; 95% CI, 0.912~1.488; P=0.222). Sensitivity analysis revealed consistent results. No publication bias was detected. @*Conclusions@#This systematic review and meta-analysis revealed no statistically significant association between the use of PPIs and dementia.
ABSTRACT
Background/Aims@#Proton pump inhibitors (PPIs) are widely used to treat several acid-related gastrointestinal disorders. This study aimed to investigate the risk of dementia in patients taking PPIs. @*Materials and Methods@#A systematic review was conducted to evaluate the correlation between PPIs and dementia. The methodological quality of the included studies was evaluated using the Risk of Bias Assessment tool for non-randomized studies. Publication bias was assessed. @*Results@#A total of 12 nested, case-control, and cohort studies were identified and analyzed. We obtained hazard ratios (HRs) from five studies and performed a meta-analysis. The meta-analysis of four cohort studies and one nested case-control study showed no association between PPIs and dementia (HR, 1.165; 95% CI, 0.912~1.488; P=0.222). Sensitivity analysis revealed consistent results. No publication bias was detected. @*Conclusions@#This systematic review and meta-analysis revealed no statistically significant association between the use of PPIs and dementia.
ABSTRACT
Background/Aims@#Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals. @*Methods@#We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included. @*Results@#The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN. @*Conclusions@#CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.
ABSTRACT
Background/Aims@#Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals. @*Methods@#We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included. @*Results@#The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN. @*Conclusions@#CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.
ABSTRACT
Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main causes of peptic ulcers and the increased risk of upper gastrointestinal tract complications, such as perforation and bleeding. Thus, the prevention of NSAID-induced peptic ulcers is an important clinical issue. Previous studies have evaluated various strategies for preventing ulcers in patients requiring prolonged NSAID use. The Korean clinical practice guidelines have been published recently based on the evidence of the currently available data. This review describes the strategies for the prevention of peptic ulcers due to NSAID. An assessment of the risk factors for peptic ulcers from NSAID is recommended to identify patients who should be considered for primary prophylaxis. The risk of NSAID-induced peptic ulcers can be reduced by the concomitant use of proton pump inhibitors (PPI), misoprostol, and histamine-2 receptor antagonists. Selective cyclooxygenase-2 inhibitors can be used with caution due to concerns regarding cardiovascular toxicity. Attempts should be made to use the lowest dose and shortest duration of the NSAID.
ABSTRACT
Fabry disease is an X-linked lysosomal storage disorder caused by alpha-galactosidase A deficiency, which results in the intracellular accumulation of globotriaosylceramide and leads to severe painful neuropathy with progressive renal, cardiovascular, and cerebrovascular dysfunction and early death. We report 52- and 55-year-old women with proteinuria and hematuria that were proven to be due to Fabry disease. A gene analysis using PCR direct sequencing confirmed a missense mutation of the GLA (alpha-galactosidase A) gene. Electron microscopy of a kidney biopsy showed lamella inclusion bodies, which are typical findings of Fabry disease. The patients were treated with enzyme replacement therapy as outpatients. They had a reduction in proteinuria and normal renal function.
Subject(s)
Female , Humans , Middle Aged , alpha-Galactosidase , Biopsy , Enzyme Replacement Therapy , Fabry Disease , Genes, vif , Hematuria , Inclusion Bodies , Kidney , Microscopy, Electron , Mutation, Missense , Outpatients , Polymerase Chain Reaction , ProteinuriaABSTRACT
Coccidioidomycosis is a fungal infection caused by Coccidioides immitis. The endemic area is mostly south-western United States. As increasing in overseas travel to endemic areas, the incidence rate has been recently increased in non-endemic areas. The diagnosis may be delayed in non-endemic area. It is important to elicit traveling histories and to differentiate lung consolidation with eosinophilia, for timely diagnosis of coccidioidomycosis. Recently, we experienced a case with pulmonary coccidioidomycosis in a Korean American who visited Korea showed consolidation in right lower lobe on chest X-ray and prolonged eosinophilia. In the case, a confirmatory diagnostic method was percutaneous transthoracic needle biopsy of lung. We report acute pulomonary coccidioidomycosis case and review previous published reports with pulmonary manifestation in Korea.