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Stress Ulcers (stress + ulcer)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Effect of thyroid hormones on stress ulcer formation

ANZ JOURNAL OF SURGERY, Issue 9 2002
Ayhan Koyuncu
Background: Stress ulcers are gastric mucosal lesions that may cause life-threatening upper gastrointestinal bleeding. Although it is known that hyperthyroid status prevents stress ulcer formation, the effect of thyroid hormones given just as the stress is beginning has not been studied. The aim of this study was to assess the effect of thyroid hormone supplementation on gastric stress ulcers at the beginning of the restraint stress. Methods: Thyroid hormones were administered to rats 2 days before or at the beginning of the restraint stress. The linear length of the gastric mucosal lesions, mucosal pH and thyroid hormone levels were measured and histopathological examinations were carried out. Results: It was found that both triiodothyronin and thyroxin reduce the length and depth of the stress ulcers (P < 0.001). Conclusion: Although the mechanisms by which the thyroid hormones act on stress ulcers are uncertain, current experimental studies suggest that thyroid hormones reduce the formation of stress ulcers in rats when given before or at the beginning of the stress. [source]

Patient and physician predictors of inappropriate acid-suppressive therapy (AST) use in hospitalized patients,

JOURNAL OF HOSPITAL MEDICINE, Issue 8 2009
Jagdish S. Nachnani MD
Abstract BACKGROUND: The use of acid suppressive therapy (AST) in prevention of stress ulcers has been well defined in critical care patients, though its use has become increasingly common in general medicine patients, with little to no supportive evidence. None of the previous studies has examined the patient and physician characteristics of inappropriate AST initiation and use in hospitalized patients. The aim of our study was to identify: (1) the appropriateness of AST in hospitalized patients and the cost associated with inappropriate use; and (2) patient and physician characteristics predicting inappropriate initiation and use of AST. METHODS: All discharges over a period of 8 consecutive days were selected. RESULTS: There were 207 patients discharged over a period of 8 days. AST was inappropriately initiated in 92 of 133 (69.2%) patients included in our study. On univariate analysis, higher hemoglobin value, postgraduate year 1 (PGY-1) residents, physicians with an MD degree, international medical graduates (IMGs), and internal medicine physicians were more likely to prescribe AST inappropriately. On multivariate analysis, a higher hemoglobin value, PGY-1 residents, and MD physicians were factors associated with inappropriate AST use. The total direct patient cost for this inappropriate use was $8026, with an estimated annual cost of approximately $366,000. CONCLUSIONS: AST was inappropriately initiated in 69.2% of patients with increased direct costs of $8026. Residents in their first year of training as well physicians with a MD degree are more likely to initiate AST inappropriately. Curtailing the inappropriate use of AST therapy may reduce overall costs for the patient and institution. Journal of Hospital Medicine 2009;4:E10,E14. © 2009 Society of Hospital Medicine. [source]