AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohor...AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohort study of all patients diag-nosed with benign perforated peptic ulcer.Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010.Ulcers with a malignant neoplasia diagnosis,verified by histology after biopsy or resection,were excluded.Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes(K25.1,K25.2,K25.5, K25.6,K26.1,K26.2,K26.5,K26.6).Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures(e.g.,JDA 60,JDA 61,JDH 70 and JDH 71)were performed to enable a complete identification of all patients.Patient demographics,presentation patterns and clinical data were retrieved from hospital records and surgical notes.Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS:In the study period,a total of 172 patients with PPU were identified.The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year(95%CI:5.6-7.6)and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year(95%CI:0.7-1.6).A non-significant decline in ad-justed incidence rate from 9.7 to 5.6 occurred during the decade.The standardized mortality ratio for the whole study period was 5.7(95%CI:3.9-8.2),while the total 30-d mortality was 16.3%.No difference in in-cidence or mortality was found between genders.However,for patients≥60 years,the incidence increased over 10-fold,and mortality more than 50-fold,compared to younger ages.The admission rates outside office hours were high with almost two out of three(63%) admissions seen at evening/night time shifts and/or during weekends.The observed seasonal variations in admissions were not statistically significant. CONCLUSION:The adjusted incidence rate,seasonal distribution and mortality rate was stable.PPU fre-quently presents outside regular work-hours.Increase in incidence and mortality occurs with older age.展开更多
BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of th...BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of the disease.AIM To assess trends in the incidence,presentation,and outcome of PPU over a period of 40 years.METHODS This was a single-centre,retrospective,cohort study of all patients admitted to Levanger Hospital,Norway,with PPU from 1978 to 2017.The patients were identified in the Patient Administrative System of the hospital using International Classification of Diseases(ICD),revision 8,ICD-9,and ICD-10 codes for perforated gastric and duodenal ulcers.We reviewed the medical records of the patients to retrieve data.Vital statistics were available for all patients.The incidence of PPU was analysed using Poisson regression with perforated ulcer as the dependent variable,and sex,age,and calendar year from 1978 to 2017 as covariates.Relative survival analysis was performed to compare long-term survival over the four decades.RESULTS Two hundred and nine patients were evaluated,including 113(54%)men.Fortysix(22%)patients were older than 80 years.Median age increased from the first to the last decade(from 63 to 72 years).The incidence rate increased with increasing age,but we measured a decline in recent decades for both sexes.A significant increase in the use of acetylsalicylic acid,from 5%(2/38)to 18%(8/45),was observed during the study period.Comorbidity increased significantly over the 40 years of the study,with 22%(10/45)of the patients having an American Society of Anaesthesiologists(ASA)score 4-5 in the last decade,compared to 5%(2/38)in the first decade.Thirty-nine percent(81/209)of the patients had one or more postoperative complications.Both 100-day mortality and long-term survival were associated with ASA score,without significant variations between the decades.CONCLUSION Declining incidence rates occurred in recent years,but the patients were older and had more comorbidity.The ASA score was associated with both short-term mortality and long-term survival.展开更多
Background: Although migrant workers make up nearly one-third of the Saudi population, there is no data on peptic ulcer diseases (PUD) among them. We aimed to assess the prevalence and risk factors of PUD in a sample ...Background: Although migrant workers make up nearly one-third of the Saudi population, there is no data on peptic ulcer diseases (PUD) among them. We aimed to assess the prevalence and risk factors of PUD in a sample of migrant workers in Saudi Arabia. Methods: Migrant workers (n = 2123) from seven different occupations (i.e., auto repair, construction, hairdressers, hospital cleaners, poultry factory, restaurants, and city cleaners) from Al Qassim province in Saudi Arabia participated in this cross-sectional study. They were interviewed using a standardized questionnaire on demography, lifestyle, job factors, and chronic health conditions. A worker had PUD if he reported having this condition diagnosed by a physician and was taking medication for it. Binary logistic regression was employed to explore risk factors of PUD. Results: The mean age (standard deviation) was 35 ± 9 years. The prevalence of PUD was 4% and varied by occupation, with the highest among auto-repair workers (8.3%) and the lowest among construction workers (1.8%). Lifestyle characteristics such as diet, self-rated health status, smoking, and stress, were significantly associated with peptic ulcers. Conclusion: The prevalence of peptic ulcers among migrant workers in Saudi Arabia (4%) was not significantly different from the general population or the global prevalence of 5% - 10%. Further studies are needed to validate these findings.展开更多
AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retro...AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December 2008.The differences were compared.RESULTS:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers respectively.Patients with gastric ulcers were younger than those with duodenal ulcers.Although more men existed,there was a female predominance in middle-aged cases.Patients with duodenal ulcers had a higher rate of Helicobacter pylori(H.pylori) infection(62.4% vs 43.3%,P = 0.001),and those with gastric ulcers owned a significantly higher amount of aspirin and nonsteroidal anti-inflammatory drug(NSAID) use(7.5% vs 1.5%,6.7% vs 2.1%,P = 0.001).Tobacco smoking and alcohol drinking had no different impact between these two groups.Proton-pump inhibitors and H2-receptor antagonists(H2RA) were effective,but significantly less so in cases with duodenal ulcers receiving H2RAs,or in those with H.pylori infection and a history of NSAID use.CONCLUSION:Patients with gastric ulcers had lower H.pylori infection but more aspirin or NSAID use.Antisecretory therapy was ineffective in gastric ulcers underwent H2RA treatment,and cases combined H.pylori infection and NSAID use.展开更多
AIM:To investigate variations in the incidence of peptic ulcers(PUs) in Taiwan by day of the week within age subgroups.METHODS:Ambulatory care data were retrieved from the Longitudinal Health Insurance Database 2000.T...AIM:To investigate variations in the incidence of peptic ulcers(PUs) in Taiwan by day of the week within age subgroups.METHODS:Ambulatory care data were retrieved from the Longitudinal Health Insurance Database 2000.There were 7204 subjects≥18 years-old with an emergency room admission claim for the treatment of PUs,resulting in a total of 9234 emergency room visits for PUs between 2009 and 2011.Data was divided into the seven days of the week and an additional variable for holidays.One-way analysis of variance was used to examine associations among the daily mean number of PU emergency room admissions and holidays/weekends/weekdays.RESULTS:One-way analysis of variance showed that there was a significant difference in emergency room admissions for PUs by the day of the week(P<0.001),with admission more likely to occur on Sundays or holidays than weekdays within the total and working populations.The weekday patterns of admission were similar for the patients aged 18-64 years and≥65years of age.Holidays,followed by Sundays,had higher PU admissions than the mean daily PU emergency room admissions.Furthermore,inclusion of only those treated for PUs with hemorrhage or perforation,Sundays and holidays had higher mean emergency room admissions than other days.Inclusion of patients who diagnosed with Helicobacter pylori infection,only holidays had higher mean emergency room admissions than other days.Inclusion of patients who had been prescribed non-steroidal anti-inflammatory drugs(NSAIDs)for over30 d,Sundays and holidays had higher mean PU ER admissions than other non-holiday weekdays.CONCLUSION:There is a higher incidence of emergency room admission for PUs on weekends than on weekdays for the total and working populations.展开更多
目的探讨 Hp 感染性胃部疾病患者 T_H1/T_H2型细胞因子的含量变化.方法对患不同胃部疾病的 Hp 阳性患者109例及 Hp 阴性患者30例的外周血单个核细胞(PBMC)进行离心、培养,取上清液后,对其 T_H1型细胞因子 IFN-γ,IL-2及 T_H2型细胞因子I...目的探讨 Hp 感染性胃部疾病患者 T_H1/T_H2型细胞因子的含量变化.方法对患不同胃部疾病的 Hp 阳性患者109例及 Hp 阴性患者30例的外周血单个核细胞(PBMC)进行离心、培养,取上清液后,对其 T_H1型细胞因子 IFN-γ,IL-2及 T_H2型细胞因子IL-4,IL-10的含量采取双抗体夹心 ELISA 法进行检测.结果在不同胃部疾病伴 Hp 感染者 IFN-γ,IL-2的含量分别较对照组明显增高,(CSG,PU,CAG,GC:IFN-γ:ng·L^(-1):55±21,64±15,99±32,195±39 vs 42±18;IL-2;ng·L^(-1):37±15,40±17,47±7,69±20 vs 29±16,t 检验,P<0.05).而 IL-4,IL-10的含量大部分无显著差异(CAG,GC:IL-4:ng·L^(-1):21±6,32±12 vs 35±22;CSG,PU,CAG:IL-10:ng·L^(-1):40±24,28±19,27±5 vs 29±21,t 检验,P>0.05),PU 患者 IL-10的含量明显低于 CSG 患者(ng·L^(-1):28±19 vs40±24,t 检验,P<0.05);CAG IFN-γ的含量明显高于 CSG和 PU(ng·L^(-1):99±32 vs 55±21,64±15,t 检验,P<0.001);GC 患者 IFN-γ,IL-2,IL-4,IL-10含量明显高于CAG 患者(ng·L^(-1):195±39,69±20,32±12,58±17 vs 99±32,47±7,21±6,27±5,t 检验,P<0.05～0.001).结论 Hp 感染性胃部疾病患者均存在细胞免疫功能亢进,表现为 T_H1优势应答.在不同的胃部疾病之间某些细胞因子含量存在差异.展开更多
文摘AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohort study of all patients diag-nosed with benign perforated peptic ulcer.Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010.Ulcers with a malignant neoplasia diagnosis,verified by histology after biopsy or resection,were excluded.Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes(K25.1,K25.2,K25.5, K25.6,K26.1,K26.2,K26.5,K26.6).Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures(e.g.,JDA 60,JDA 61,JDH 70 and JDH 71)were performed to enable a complete identification of all patients.Patient demographics,presentation patterns and clinical data were retrieved from hospital records and surgical notes.Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS:In the study period,a total of 172 patients with PPU were identified.The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year(95%CI:5.6-7.6)and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year(95%CI:0.7-1.6).A non-significant decline in ad-justed incidence rate from 9.7 to 5.6 occurred during the decade.The standardized mortality ratio for the whole study period was 5.7(95%CI:3.9-8.2),while the total 30-d mortality was 16.3%.No difference in in-cidence or mortality was found between genders.However,for patients≥60 years,the incidence increased over 10-fold,and mortality more than 50-fold,compared to younger ages.The admission rates outside office hours were high with almost two out of three(63%) admissions seen at evening/night time shifts and/or during weekends.The observed seasonal variations in admissions were not statistically significant. CONCLUSION:The adjusted incidence rate,seasonal distribution and mortality rate was stable.PPU fre-quently presents outside regular work-hours.Increase in incidence and mortality occurs with older age.
文摘BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of the disease.AIM To assess trends in the incidence,presentation,and outcome of PPU over a period of 40 years.METHODS This was a single-centre,retrospective,cohort study of all patients admitted to Levanger Hospital,Norway,with PPU from 1978 to 2017.The patients were identified in the Patient Administrative System of the hospital using International Classification of Diseases(ICD),revision 8,ICD-9,and ICD-10 codes for perforated gastric and duodenal ulcers.We reviewed the medical records of the patients to retrieve data.Vital statistics were available for all patients.The incidence of PPU was analysed using Poisson regression with perforated ulcer as the dependent variable,and sex,age,and calendar year from 1978 to 2017 as covariates.Relative survival analysis was performed to compare long-term survival over the four decades.RESULTS Two hundred and nine patients were evaluated,including 113(54%)men.Fortysix(22%)patients were older than 80 years.Median age increased from the first to the last decade(from 63 to 72 years).The incidence rate increased with increasing age,but we measured a decline in recent decades for both sexes.A significant increase in the use of acetylsalicylic acid,from 5%(2/38)to 18%(8/45),was observed during the study period.Comorbidity increased significantly over the 40 years of the study,with 22%(10/45)of the patients having an American Society of Anaesthesiologists(ASA)score 4-5 in the last decade,compared to 5%(2/38)in the first decade.Thirty-nine percent(81/209)of the patients had one or more postoperative complications.Both 100-day mortality and long-term survival were associated with ASA score,without significant variations between the decades.CONCLUSION Declining incidence rates occurred in recent years,but the patients were older and had more comorbidity.The ASA score was associated with both short-term mortality and long-term survival.
文摘Background: Although migrant workers make up nearly one-third of the Saudi population, there is no data on peptic ulcer diseases (PUD) among them. We aimed to assess the prevalence and risk factors of PUD in a sample of migrant workers in Saudi Arabia. Methods: Migrant workers (n = 2123) from seven different occupations (i.e., auto repair, construction, hairdressers, hospital cleaners, poultry factory, restaurants, and city cleaners) from Al Qassim province in Saudi Arabia participated in this cross-sectional study. They were interviewed using a standardized questionnaire on demography, lifestyle, job factors, and chronic health conditions. A worker had PUD if he reported having this condition diagnosed by a physician and was taking medication for it. Binary logistic regression was employed to explore risk factors of PUD. Results: The mean age (standard deviation) was 35 ± 9 years. The prevalence of PUD was 4% and varied by occupation, with the highest among auto-repair workers (8.3%) and the lowest among construction workers (1.8%). Lifestyle characteristics such as diet, self-rated health status, smoking, and stress, were significantly associated with peptic ulcers. Conclusion: The prevalence of peptic ulcers among migrant workers in Saudi Arabia (4%) was not significantly different from the general population or the global prevalence of 5% - 10%. Further studies are needed to validate these findings.
基金Supported by Summer studentships(2010,2011,and 2012)by Alberta Innovates-Health Solutions.Alexandra Frolkis is funded by an Alberta Innovates-Health Solutions studentship to Samuel QuanA New Investigator Award from the Canadian Institute of Health Research and a Clinical Investigator Award from Alberta Innovates-Health Solutions to Dr.MyersA New Investigator Award from the Canadian Institute of Health Research and a Population Health Investigator Award from Alberta Innovates-Health Solutions to Dr.Kaplan
文摘AIM: To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).
文摘AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December 2008.The differences were compared.RESULTS:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers respectively.Patients with gastric ulcers were younger than those with duodenal ulcers.Although more men existed,there was a female predominance in middle-aged cases.Patients with duodenal ulcers had a higher rate of Helicobacter pylori(H.pylori) infection(62.4% vs 43.3%,P = 0.001),and those with gastric ulcers owned a significantly higher amount of aspirin and nonsteroidal anti-inflammatory drug(NSAID) use(7.5% vs 1.5%,6.7% vs 2.1%,P = 0.001).Tobacco smoking and alcohol drinking had no different impact between these two groups.Proton-pump inhibitors and H2-receptor antagonists(H2RA) were effective,but significantly less so in cases with duodenal ulcers receiving H2RAs,or in those with H.pylori infection and a history of NSAID use.CONCLUSION:Patients with gastric ulcers had lower H.pylori infection but more aspirin or NSAID use.Antisecretory therapy was ineffective in gastric ulcers underwent H2RA treatment,and cases combined H.pylori infection and NSAID use.
文摘AIM:To investigate variations in the incidence of peptic ulcers(PUs) in Taiwan by day of the week within age subgroups.METHODS:Ambulatory care data were retrieved from the Longitudinal Health Insurance Database 2000.There were 7204 subjects≥18 years-old with an emergency room admission claim for the treatment of PUs,resulting in a total of 9234 emergency room visits for PUs between 2009 and 2011.Data was divided into the seven days of the week and an additional variable for holidays.One-way analysis of variance was used to examine associations among the daily mean number of PU emergency room admissions and holidays/weekends/weekdays.RESULTS:One-way analysis of variance showed that there was a significant difference in emergency room admissions for PUs by the day of the week(P<0.001),with admission more likely to occur on Sundays or holidays than weekdays within the total and working populations.The weekday patterns of admission were similar for the patients aged 18-64 years and≥65years of age.Holidays,followed by Sundays,had higher PU admissions than the mean daily PU emergency room admissions.Furthermore,inclusion of only those treated for PUs with hemorrhage or perforation,Sundays and holidays had higher mean emergency room admissions than other days.Inclusion of patients who diagnosed with Helicobacter pylori infection,only holidays had higher mean emergency room admissions than other days.Inclusion of patients who had been prescribed non-steroidal anti-inflammatory drugs(NSAIDs)for over30 d,Sundays and holidays had higher mean PU ER admissions than other non-holiday weekdays.CONCLUSION:There is a higher incidence of emergency room admission for PUs on weekends than on weekdays for the total and working populations.
文摘目的探讨 Hp 感染性胃部疾病患者 T_H1/T_H2型细胞因子的含量变化.方法对患不同胃部疾病的 Hp 阳性患者109例及 Hp 阴性患者30例的外周血单个核细胞(PBMC)进行离心、培养,取上清液后,对其 T_H1型细胞因子 IFN-γ,IL-2及 T_H2型细胞因子IL-4,IL-10的含量采取双抗体夹心 ELISA 法进行检测.结果在不同胃部疾病伴 Hp 感染者 IFN-γ,IL-2的含量分别较对照组明显增高,(CSG,PU,CAG,GC:IFN-γ:ng·L^(-1):55±21,64±15,99±32,195±39 vs 42±18;IL-2;ng·L^(-1):37±15,40±17,47±7,69±20 vs 29±16,t 检验,P<0.05).而 IL-4,IL-10的含量大部分无显著差异(CAG,GC:IL-4:ng·L^(-1):21±6,32±12 vs 35±22;CSG,PU,CAG:IL-10:ng·L^(-1):40±24,28±19,27±5 vs 29±21,t 检验,P>0.05),PU 患者 IL-10的含量明显低于 CSG 患者(ng·L^(-1):28±19 vs40±24,t 检验,P<0.05);CAG IFN-γ的含量明显高于 CSG和 PU(ng·L^(-1):99±32 vs 55±21,64±15,t 检验,P<0.001);GC 患者 IFN-γ,IL-2,IL-4,IL-10含量明显高于CAG 患者(ng·L^(-1):195±39,69±20,32±12,58±17 vs 99±32,47±7,21±6,27±5,t 检验,P<0.05～0.001).结论 Hp 感染性胃部疾病患者均存在细胞免疫功能亢进,表现为 T_H1优势应答.在不同的胃部疾病之间某些细胞因子含量存在差异.
