RESUMO
Background: We aimed to determine the effects of anti-platelet drugs use on adverse outcomes in patients with non-variceal upper gastrointestinal bleeding [UGIB]
Materials and Methods: A historical cohort study was performed on patients with non-variceal UGIB admitted to a tertiary care hospital. Clinical outcomes were compared among users of aspirin and patients who did not receive aspirin. Adverse outcome variables consisted of re-bleeding, need for surgery, and death
Results: Out of 271 patients [77.5% men, mean age 59.5+/-19.0 years] with non-variceal UGIB, 157 [57.9%] did not receive any anti-platelet drugs, 87 [32.1%] received only aspirin, and 27 [10.0%] received dual anti-platelet therapy. The frequency of adverse outcomes was significantly higher in patients who bled while not receiving anti-platelets [31.2% no anti-platelets, 12.6% single anti-platelet agent, and 14.8% on dual anti-platelets, p=0.002]. A significant difference in the duration of admission was not found between the three groups [5.5+/-4.3 in patients with no anti-platelet drugs, 5.6+/-4.6 in patients received single anti-platelet agent, and 5.0+/-4.3 in patients received dual anti-platelets, p =0.84]
Conclusion: Patients with non-variceal UGIB while taking anti-platelet drugs had a lower rate of adverse outcomes compared with non-users of anti-platelets
RESUMO
There are some controversial studies on effects of anti-epileptic drugs [AEDs] on serum IgG subclasses; however, the role of these medications is still unclear. The aim of this study was evaluation the effects of anti-epileptic drugs on serum concentration of IgG and its subclasses. Serum IgG and IgG subclasses of 61 newly diagnosed epileptic patients were measured at the beginning of monotherapy with carbamazepine, sodium valproate, and phenobarbital, and 6 months later. Measurement of IgG and its subclasses was performed using nephlometry and ELISA techniques, respectively. Reduction of at least one IgG subclass was found in 6 patients 6 months after treatment with AEDs. Among 27 patients receiving carbamazepine, decrease in at least one serum IgG subclass level was found in 5 patients. Among 20 patients using sodium valproate, only one patient showed decrease in IgG2 subclass. None of the 14 patients using phenobarbital revealed significant decrease in IgG subclasses. No infection was seen in the patients with reduction of subclasses. Although in our study, children with selective IgG subclass deficiency were asymptomatic, assessment of serum immunoglobulin levels could be recommended at starting the administration of AEDs and in serial intervals afterward in epileptic patients