The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Hideo Yasunaga - One of the best experts on this subject based on the ideXlab platform.
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histamine 2 receptor antagonists versus proton pump inhibitors for septic shock after Lower Gastrointestinal Tract perforation a retrospective cohort study using a national inpatient database
Journal of intensive care, 2020Co-Authors: Jun Suzuki, Yusuke Sasabuchi, Shuji Hatakeyama, Hiroki Matsui, Teppei Sasahara, Yuji Morisawa, Toshiyuki Yamada, Hideo YasunagaAbstract:Studies have shown the potential benefit of stress ulcer prophylaxis including histamine-2 receptor antagonists (H2RA) and proton pump inhibitors (PPI) in critically ill patients. However, the adverse effects of stress ulcer prophylaxis such as Clostridioides difficile infection (CDI) and hospital-acquired pneumonia have been reported. Abdominal septic shock is associated with increased risk of bleeding, CDI, and pneumonia; however, which ulcer prophylaxis might be associated with better outcomes in patients with septic shock after Lower Gastrointestinal Tract perforation is unknown. In this retrospective cohort study using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2015, we identified patients aged 18 years or older who received open abdominal surgery for Lower Gastrointestinal Tract perforation and who used vasopressors and antibiotics within 2 days of admission. We performed propensity score matching and inverse probability of treatment weighting (IPTW) to compare the outcomes between patients who received H2RA and those who received PPI within 2 days of admission. The outcomes included Gastrointestinal bleeding requiring endoscopic hemostasis within 28 days of admission, 28-day mortality, CDI, and hospital-acquired pneumonia. The propensity score matching created 1088 pairs of patients who received H2RA or PPI within 2 days of admission. There were no significant differences between the H2RA and PPI groups regarding Gastrointestinal bleeding requiring endoscopic hemostasis within 28 days of admission (0.74% vs 1.3%, risk ratio 0.57 (0.24–1.4), and P = 0.284), 28-day mortality (11.3% vs 12.9%, risk ratio 0.88 (0.68–1.1), and P = 0.386), CDI (0.64% vs 0.46%, risk ratio 1.4 (0.45–4.4), and P = 0.774), and hospital-acquired pneumonia (3.0% vs 4.3%, risk ratio 0.70 (0.45–1.1), and P = 0.138). IPTW analysis showed similar results. There were no significant differences in Gastrointestinal bleeding requiring endoscopic hemostasis within 28 days of admission, 28-day mortality, CDI, and hospital-acquired pneumonia between H2RA and PPI in patients with septic shock after Lower Gastrointestinal Tract perforation.
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factors affecting in hospital mortality in patients with Lower Gastrointestinal Tract bleeding a retrospective study using a national database in japan
Journal of Gastroenterology, 2015Co-Authors: Ryota Niikura, Hideo Yasunaga, Yutaka Yamaji, Hiromasa Horiguchi, Kiyohide Fushimi, Atsuo Yamada, Yoshihiro Hirata, Kazuhiko KoikeAbstract:Background Bleeding of the Lower Gastrointestinal Tract requires hospitalization and can cause in-hospital death in the most serious cases; however, only a few studies have evaluated in-hospital death from bleeding of the Lower Gastrointestinal Tract. The aim of this study was to investigate the in-hospital mortality of patients with bleeding of the Lower Gastrointestinal Tract and elucidate the factors associated with it using a large-scale database.
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factors affecting in hospital mortality in patients with Lower Gastrointestinal Tract bleeding a retrospective study using a national database in japan
Journal of Gastroenterology, 2015Co-Authors: Ryota Niikura, Hideo Yasunaga, Yutaka Yamaji, Hiromasa Horiguchi, Kiyohide Fushimi, Atsuo Yamada, Yoshihiro Hirata, Kazuhiko KoikeAbstract:Bleeding of the Lower Gastrointestinal Tract requires hospitalization and can cause in-hospital death in the most serious cases; however, only a few studies have evaluated in-hospital death from bleeding of the Lower Gastrointestinal Tract. The aim of this study was to investigate the in-hospital mortality of patients with bleeding of the Lower Gastrointestinal Tract and elucidate the factors associated with it using a large-scale database. We analyzed a nationwide database in Japan retrospectively. From the Diagnosis Procedure Combination database, we exTracted data on patients who were admitted with visible blood in stool between July 1, 2010 and March 31, 2012. We assessed age, sex, comorbidity, cause of bleeding, type of hospital, medications, body mass index (BMI), and need for blood transfusion and treatments. A multivariable logistic regression model was used to examine factors associated with blood transfusion and in-hospital death. A total of 30,846 patients were identified. The median age was 74 years, and 52.0 % of patients were male. A total of 782 patients died in hospital (2.5 %), and 8,060 patients (26.1 %) needed blood transfusion. In a multivariate analysis, in-hospital death was significantly associated with being older or male; comorbidities, including congestive heart failure, renal disease, and mild to severe liver disease; the cause of bleeding; a nonacademic hospital; nonsteroidal anti-inflammatory drug use; Lower BMI; and requirements for blood transfusion, interventional radiology, and surgery. Most factors were similarly associated with blood transfusion. In-hospital mortality was 2.5 % and was associated with age, sex, comorbidities, cause of bleeding, type of hospital, nonsteroidal anti-inflammatory drug use, BMI, blood transfusion, and requirements for treatments.
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postoperative polymyxin b hemoperfusion and mortality in patients with abdominal septic shock a propensity matched analysis
Critical Care Medicine, 2014Co-Authors: Masao Iwagami, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Kent Doi, Takehiro Matsubara, Naoki Yahagi, Eisei NoiriAbstract:Objectives:To examine the effect of postoperative polymyxin B hemoperfusion on mortality in patients with abdominal septic shock triggered by Lower Gastrointestinal Tract perforation, identifying subpopulations of patients who may benefit from this treatment.Design:Propensity-matched analysis.Settin
Eisei Noiri - One of the best experts on this subject based on the ideXlab platform.
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postoperative polymyxin b hemoperfusion and mortality in patients with abdominal septic shock a propensity matched analysis
Critical Care Medicine, 2014Co-Authors: Masao Iwagami, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Kent Doi, Takehiro Matsubara, Naoki Yahagi, Eisei NoiriAbstract:Objectives:To examine the effect of postoperative polymyxin B hemoperfusion on mortality in patients with abdominal septic shock triggered by Lower Gastrointestinal Tract perforation, identifying subpopulations of patients who may benefit from this treatment.Design:Propensity-matched analysis.Settin
Carolin Tonus - One of the best experts on this subject based on the ideXlab platform.
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long term results of endoscopic balloon dilatation of Lower Gastrointestinal Tract strictures in crohn s disease a prospective study
World Journal of Gastroenterology, 2009Co-Authors: Klaus Stienecker, Daniel Gleichmann, Ulrike Neumayer, Joachim H Glaser, Carolin TonusAbstract:AIM: To examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. METHODS: A total of 25 patients (20 female and five male: aged 18-75 years), with at least one symptom of stricture not passable with the standard colonoscope and with a confirmed scarred Crohn’s stricture of the Lower Gastrointestinal Tract, were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control. RESULTS: Eleven strictures were located in the colon, 13 at the anastomosis after ileocecal resection, three at the Bauhin valve and four in the ileum. Four patients had two strictures and one patient had three strictures. Of the 31 strictures, in 30 was balloon dilatation successful in a single endoscopic session, so that eventually the strictures could be passed easily with the standard colonoscope. In one patient with a long stricture of the ileum involving the Bauhin valve and an additional stricture of the ileum which were 15 cm apart, sufficient dilatation was not possible. This patient therefore required surgery. Improvement of abdominal symptoms was achieved in all cases which had technically successful balloon dilatation, although in one case perforation occurred after dilatation of a recurrent stricture. Available follow-up was in the range of 54-118 mo (mean of 81 mo). The relapse rate over this period was 46%, but 64% of relapsing strictures could be successfully dilated again. Only in four patients was surgery required during this follow-up period. CONCLUSION: We conclude from these initial results that endoscopic balloon dilatation, especially for short strictures in Crohn’s disease, can be performed with reliable success. Perforation is a rare complication. It is our opinion that in the long-term, the relapse rate is probably higher than after surgery, but usually a second endoscopic treatment can be performed successfully, leading to a considerable success rate of the endoscopic procedure.
Lee H Bouwman - One of the best experts on this subject based on the ideXlab platform.
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subcutaneous cervical emphysema and pneumomediastinum due to a Lower Gastrointestinal Tract perforation
World Journal of Gastroenterology, 2008Co-Authors: Georg B Schmidt, Maarten W G A Bronkhorst, Henk H Hartgrink, Lee H BouwmanAbstract:This case report describes a 69-year-old man presen-ting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a Lower Gastrointestinal Tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.
Anirban Maitra - One of the best experts on this subject based on the ideXlab platform.
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relative abundance of sars cov 2 entry genes in the enterocytes of the Lower Gastrointestinal Tract
Genes, 2020Co-Authors: Jaewon J Lee, Scott Kopetz, Eduardo Vilar, John Paul Shen, Ken Chen, Anirban MaitraAbstract:There is increasing evidence of Gastrointestinal (GI) infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We surveyed the co-expression of SARS-CoV-2 entry genes ACE2 and TMPRSS2 throughout the GI Tract to assess potential sites of infection. Publicly available and in-house single-cell RNA-sequencing datasets from the GI Tract were queried. Enterocytes from the small intestine and colonocytes showed the highest proportions of cells co-expressing ACE2 and TMPRSS2. Therefore, the Lower GI Tract represents the most likely site of SARS-CoV-2 entry leading to GI infection.
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relative abundance of sars cov 2 entry genes in the enterocytes of the Lower Gastrointestinal Tract
bioRxiv, 2020Co-Authors: Jaewon J Lee, Scott Kopetz, Eduardo Vilar, John Paul Shen, Ken Chen, Anirban MaitraAbstract:COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world and was declared a pandemic by the World Health Organization, thus leading to a rapid surge in the efforts to understand the mechanisms of transmission, methods of prevention, and potential therapies. While COVID-19 frequently manifests as a respiratory infection, there is evidence for infection of the Gastrointestinal (GI) Tract with documented viral RNA shedding in the stool of infected patients. In this study, we aimed to investigate the expression of ACE2 and TMPRSS2, which are required for SARS-CoV-2 entry into mammalian cells, from single-cell RNA sequencing (scRNA-seq) datasets of five different parts of the GI Tract: esophagus, stomach, pancreas, small intestine, and colon/rectum.
