RESUMEN
OBJECTIVES: Patients on antiplatelet therapy have a gastrointestinal bleeding risk. It is increased by risk factors. The frequency of those risk factors, the prevalence of upper digestive symptoms and their management in patients on antiplatelet agents is unknown. PATIENTS AND METHODS: We performed an observational multi-centred prospective survey among 560 French cardiologists with private practice. Each cardiologist completed a questionnaire for the first four patients treated with antiplatelet agents in primary or secondary prevention. RESULTS: Among the 2182 patients included, (age = 67 ± 11 years; 74% male), 83% had at least one gastrointestinal bleeding risk factor and 38.9% had a history of upper digestive tract symptom. A history of gastrointestinal bleeding was reported in 3.4% and a history of documented gastro-duodenal ulcer in 5.5%. A proton pump inhibitor was already prescribed in 39% of the patients. At the time of the consultation, upper digestive symptoms were described in 21% of the patients. In those patients with symptoms, 85% had no modification in antiplatelet therapy and 62.7% were prescribed gastro-protective drugs (proton pump inhibitors: 51.8%, H(2)-blockers 3.6% other anti-acid medication: 7.3%). CONCLUSION: Among patients on antiplatelet agents, the prevalence of upper digestive symptoms and risk factors for gastrointestinal bleeding is high. Preventative management needs to be clarified in this population.
Asunto(s)
Fármacos Gastrointestinales/uso terapéutico , Pacientes Ambulatorios/estadística & datos numéricos , Úlcera Péptica Hemorrágica/inducido químicamente , Úlcera Péptica Hemorrágica/prevención & control , Médicos/estadística & datos numéricos , Inhibidores de Agregación Plaquetaria/efectos adversos , Úlcera Gástrica/inducido químicamente , Úlcera Gástrica/prevención & control , Anciano , Antiulcerosos/uso terapéutico , Cardiología , Enfermedades Cardiovasculares/prevención & control , Quimioterapia Combinada , Femenino , Francia/epidemiología , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/prevención & control , Encuestas de Atención de la Salud , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica Hemorrágica/epidemiología , Inhibidores de Agregación Plaquetaria/administración & dosificación , Prevalencia , Práctica Privada , Estudios Prospectivos , Inhibidores de la Bomba de Protones/uso terapéutico , Factores de Riesgo , Úlcera Gástrica/epidemiología , Encuestas y Cuestionarios , Resultado del Tratamiento , Tracto Gastrointestinal Superior/efectos de los fármacosRESUMEN
Despite the numerous surgical procedures reported for hypospadias repair, little attention has been given to the precise assessment of penile anatomy in this malformation. In this study of 51 cases of hypospadias, we describe the particular anatomy of the corpus spongiosum encountered, highlighting its relationships with the other features observed in the different forms of this anomaly. It appears that the level where the corpus spongiosum diverges into two limbs particularly induces the degree of penile curvature that influences the severity in this malformation. We report a new technique of anatomic repair of the penis in hypospadias.