Impact of an evaluation of the professional practices on the relevance of proton pump inhibitors prescriptions pertinence at the hospital.

The objective of this work was to optimize the relevance of the prescriptions of the IPP in two services of internal medicine and geriatrics through an evaluation of the professional practices. All PPI prescriptions introduced in outpatient visits or during hospitalization were analyzed. PATIENTS AND METHODS: Data collection was prospective, over two periods of 2 months and included 163 (first phase), then 139 patients (second phase). An assessment grid of PPI prescriptions was completed by physicians regarding the active substance, the dose, the duration and the indication of the prescription. The relevance of the prescription corresponded to PPI with a conformed indication and duration and to the prescriptions no recommended stopped. Following the first period of data collection, information was given to medical students and physicians on the relevance of their prescriptions with regard to the current recommendations and informative flyers were offered with the aim of improving the practices before the second period of evaluation (second phase). RESULTS: During the first phase, only 25% of the pre-hospital prescriptions and 33% of the hospital prescriptions respected the HAS recommendations. The main indication of the PPI was the prevention of peptic ulcers in a context of associated drug estimated at risk. An improvement of the global relevance of prescription was observed after awareness of the physicians: 26% relevance during the first phase and 60% in the second...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research

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​BY FAHAD SHAH &AHMED RAZIUDDIN, MDA 68-year-old woman presented with acute abdominal pain that had started three hours earlier. She said she had constant upper abdominal pain that was sharp and stabbing, and she rated her pain as 8/10.The patient said the pain did not radiate, and she was clearly in acute distress. She reported that her last meal had been four hours before and that she was nauseated and had had three to four episodes of dry heaves.She had no other concerning symptoms, and her pain was unaffected by eating, drinking, or position. She had a paraesophageal rolling hiatal hernia and was aware of her chr...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
ConclusionIt ’s obviously different in ultrastructure of DHPW and PQD patients under TEM, which may give a helpful hint for the microcosmic syndrome differentiation of HPCG.
Source: Chinese Journal of Integrative Medicine - Category: Internal Medicine Source Type: research
AbstractPurposePerforated peptic ulcer (PPU) complicates 2 to 10% of patients with peptic ulcer disease and has mortality risk of up to 20%. Omental patch repair is the mainstay of surgical management and gastric resectional procedures are advocated for a large/giant ulcer or suspected malignancy. Emergency gastrectomy is associated with increased morbidity and mortality. The aim of this study is to compare the outcomes of omental patch repair with gastrectomy in patients with large PPU ( ≥ 20 mm).MethodsA retrospective review of all PPU patients who underwent surgery from January 2008 to December 2014 was d...
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
This article take attention to treatment approaches using nanoparticles as an alternative to H.Pylori treatment to cope with increased antibiotic resistance. The purpose of this review is to provide an overview of the current limitations and new promising altenatives in treatment of H.Pylori, to highlight the location of nanotechnology to overcome treatment failures, and to emphasize the advantages of using membrane-coated nanoparticles for the first time. Expert opinion: Because of the current problems in the treatment of H.Pylori, there is increasing interest in alternative approaches including nanotechnology. The strong...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Abstract Helicobacter pylori (H. pylori) is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide. However, its prevalence varies among different geographic areas, and is influenced by several factors. The infection can be acquired by means of oral-oral or fecal-oral transmission, and the pathogen possesses various mechanisms that improve its capacity of mobility, adherence and manipulation of the gastric microenvironment, making possible the colonization of an organ with a highly acidic lumen. In addition, H. pylori presents a large variety of virulence factors that improve its pa...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
This study evaluated the impact of cumulative corticosteroid exposure on the risk of developing specific adverse events in men with CRPC.MethodsData were obtained from administrative claims databases. Adult chemotherapy-na ïve men who initiated CRPC treatment following surgical or medical castration were selected. Patients were grouped into four cohorts based on cumulative corticosteroid dose: no exposure, low exposure (  2.0 g). Time to each adverse event was assessed using Kaplan–Meier analyses and time-dependent Cox proportional hazard models, adjusting for baseline characteristics.ResultsOverall,...
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
A 19-year-old woman attended to the emergency room with a 5-day history of epigastric pain. Physical examination revealed abdominal tenderness. Laboratory data found a high level of weight blood cells (WBC  = 16250 C/ml) and C-reactive protein (CRP =180 mg/l). The Chest X-ray was normal. Abdominal CT-san showed a concentric wall thickening of the pyloric and duodenal regions and intra-peritoneal effusion. Perforated duodenal peptic ulcer was suspected and an emergent surgery was performed. Intra -operatively, we found multiple nodules on the small bowel’s serosa and peritoneum with dense adhesions (Fig.
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Medical Imagery Source Type: research
CONCLUSION: The use of esomeprazole for psoriasis resulted in excellent clinical results with a significant reduction of PASI score.RESUMO CONTEXTO: A psor íase é uma doença inflamatória da pele que afeta 1%-3% das populações caucasianas e pode ser persistente, desfigurante e estigmatizante. Inibidores da bomba de prótons (IBP) são potentes bloqueadores da secreção de ácido no estômago. Eles são considerados como os agentes de escolha para o tratamento de doenças ácido-pépticas. No entanto, além dos efeitos...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
Conclusion: The endoscopic diagnosis of persistent dyspepsia in our setting showed a predominance of functional disease. Every 4th person (26.7%) with persistent dyspepsia had organic lesions whereas UGI malignancy was an uncommon finding. The most frequent significant pathologies included erosive gastroduodenitis, esophagitis and peptic ulcer disease. Patients with recent onset of dyspepsia who are in the age group at risk of gastric malignancy should undergo early endoscopy. UGI endoscopy is simple procedure that can be undertaken for early diagnosis of benign as well as malignant lesions in patient presenting with dyspe...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Updated Date: Mon, 30 Sep 2019 00:00:00 EDT
Source: DailyMed Drug Label Updates - Category: Drugs & Pharmacology Source Type: alerts
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