Abstract:
BACKGROUND:Antibiotic prophylaxis can reduce the incidence of the first episode and recurrent episodes of spontaneous bacterial peritonitis (SBP) in high-risk cirrhotic patients. However, recent data suggest that SBP prophylaxis may be underused. It is unclear how many cases of cirrhosis that develop SBP might actually be prevented with antibiotic prophylaxis. AIMS:To determine the number of "preventable" cases of SBP and the adherence to standard guidelines for the use of antibiotic prophylaxis. METHODS:A retrospective analysis of our patients diagnosed with SBP was performed. AASLD Guidelines (2004) for SBP prophylaxis include prior SBP, gastrointestinal (GI) hemorrhage, ascitic fluid (AF), protein ≤ 1 g/dl, or serum bilirubin ≥ 2.5 mg/dl. "Preventable (P) SBP" was defined as SBP occurring where prophylaxis was indicated but was not administered. "Non-preventable (NP) SBP" was defined as SBP that occurred despite proper adherence to the guidelines. "Inevitable (I) SBP" were those cases of SBP occurring in the absence of a documented indication for prophylaxis. RESULTS:A total of 259 patients with cirrhosis underwent paracentesis; 29 had confirmed SBP. Eighteen of the 29 patients (62%) had "P-SBP", one (3%) had "NP-SBP", and ten (34%) had "I-SBP". In the P-SBP cases, the overlooked indications for prophylaxis were GI hemorrhage (n, %) (8, 44%), serum bilirubin ≥ 2.5 mg/dl (6, 33%), prior SBP (2, 11%) and AF protein ≤ 1 g/dl (2, 11%). Of the P-SBP, 78% were community-acquired; 22% were nosocomial. In-hospital mortality in the P-SBP was 16% (n = 3). Only one-third of patients who survived SBP received long-term outpatient prophylaxis after discharge. CONCLUSIONS:Many cases of SBP could be prevented by adhering to the AASLD guidelines. GI hemorrhage is the most frequently overlooked indication for SBP prophylaxis. Studies identifying the reasons for non-adherence to guidelines and developing interventions to increase utilization are warranted.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Ngamruengphong S,Nugent K,Rakvit A,Parupudi Sdoi
10.1007/s10620-011-1647-5subject
Has Abstractpub_date
2011-09-01 00:00:00pages
2728-34issue
9eissn
0163-2116issn
1573-2568journal_volume
56pub_type
杂志文章abstract:PURPOSE:The purpose of this study was to assess safety, efficacy, and clinical outcomes following transcatheter arterial embolization (TAE) of acute gastrointestinal (GI) bleeding. MATERIALS AND METHODS:Ninety-five patients (male:female ratio = 53:42, mean age 62 years) that underwent 95 TAEs for GI hemorrhage between...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-012-2547-z
更新日期:2013-07-01 00:00:00
abstract::Gastroesophageal reflux and clearance of the refluxed material can be measured by plotting a time-activity curve from an esophageal area of interest after 1 mCi of 99mTc sulfur colloid is placed in the stomach. Control subjects do not have peaks exceeding a value twice that of the baseline count levels. Reflux patient...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01311246
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND AND AIM:To explore the CT signs which permit estimation of clinically severe portal hypertension (PH) [≥ 12 of hepatic vein pressure gradient (HVPG)]. METHODS:One-hundred and seven consecutive patients who underwent HVPG measurement in the PH group and 52 controls were included. The diameters of main portal...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-014-3149-8
更新日期:2014-09-01 00:00:00
abstract::Selected aspects of bile acid metabolism were assessed in six women with primary biliary cirrhosis and varying degrees of cholestasis. Urinary bile acid excretion was markedly increased and correlated highly with serum levels. In three patients in whom urinary bile acids were separated by chromatography, the majority ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01313580
更新日期:1981-05-01 00:00:00
abstract::Clostridium difficile (CD) is one of the most common causes of diarrhea in solid organ transplantation (SOT). Between 1996 and 2005, a total of 2474 solid organ transplants were performed at our institution, of which 43 patients developed CD-associated diarrhea. There were 3 lung, 3 heart, 20 liver, 8 kidney-pancreas,...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-007-9770-z
更新日期:2007-11-01 00:00:00
abstract::Data on performance characteristics of flexible sigmoidoscopy (FS) between age groups are limited. This study evaluates screening FS in subjects > or = 75 years of age (elderly) compared with ages 50-74 years (general screening population). Data were collected on patient characteristics, insertion depth, procedural di...
journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章
doi:10.1007/s10620-005-3022-x
更新日期:2005-11-01 00:00:00
abstract::The objective of this study was to determine if HCV can be transmitted from patient to patient in psychiatric institutions and to determine possible routes of infection. We did a cross-sectional survey of 196 Japanese psychiatric patients tested for HCV and HBV markers and 400 age- and sex-matched controls. Anti-HCV w...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1005472812403
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Transmembrane and ubiquitin-like domain-containing 1 protein (Tmub1) negatively regulates liver regeneration. However, whether this regulation involves posttranscriptional modification of Tmub1 expression is unknown. AIM:The aim of the study was to investigate whether microRNA (miR)-27a/b regulates posttran...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-018-5113-5
更新日期:2018-09-01 00:00:00
abstract::In addition to cholecystokinin, other hormones have been suggested to be involved in regulation of postprandial gallbladder contraction. We aimed to evaluate effects of growth hormone (GH) on gallbladder contractility and cholecystokinin release. Gallbladder and gastric emptying (by ultrasound) and cholecystokinin rel...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/b:ddas.0000020515.75879.2f
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Alcoholic hepatitis (AH) is a serious clinical syndrome often associated with muscle wasting. Myostatin, a member of the transforming growth factor-β superfamily, has been studied in diseases with muscle wasting; however, the role of myostatin in AH is unknown. AIMS:To investigate the association between my...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
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更新日期:2020-10-19 00:00:00
abstract:BACKGROUND:Endoscopic ablation of duodenal ampullary malignancy has not been fully assessed. AIMS:The study aimed to evaluate the efficacy and safety of Endoscopic retrograde cholangiopancreatograpy (ERCP)-guided radiofrequency ablation (RFA) for inoperable ampullary cancer. METHODS:Patients with inoperable ampullary...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-019-05849-3
更新日期:2020-05-01 00:00:00
abstract::Possible differences in the abilities of esophageal body and lower esophageal sphincter muscles to utilize substrates to support agonist-induced contractions were studied. Strips of longitudinal, circular, and lower esophageal sphincter muscle from the opossum esophagus were first contracted to approximately 70% of th...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01297447
更新日期:1991-08-01 00:00:00
abstract::A gangliocytic paraganglioma (GP) is an extremely rare neurogenic tumor nearly located in the second portion of the duodenum and has been regarded as benign. We report a case of duodenal GP in a 53-year-old man. The GP arose in the second portion of the duodenum and was shown by histological examination to consist of ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-006-9370-3
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Currently there is no consensus on the optimal management of small-for-size syndrome following liver transplantation. Here we describe a technique to alleviate portal hypertension and improve the hepatocyte reperfusion in small-for-size liver transplantation in a Lewis rat model. METHODS:The rats underwent ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-020-06055-2
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. AIMS:To examine associations between various birth characteristics and BE, and whether these associations a...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-015-3967-3
更新日期:2016-04-01 00:00:00
abstract::The characteristic features of a 48-year-old male presenting with isolated acromegaly caused by a GRH-producing pancreatic endocrine tumor bearing no relation to MEN1 was reported. The clinical features, laboratory findings, and sellar enlargement were improved after removal of the pancreatic tumor. The resected pancr...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1018818811199
更新日期:1997-07-01 00:00:00
abstract::Achalasia has been described following fundoplication and is attributed to vagal nerve damage during surgery. Similarly, other traumatic events to the distal esophagus may be linked to the development of achalasia. Operative and nonoperative trauma as a possible factor in the development of achalasia was studied. A re...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-004-9577-0
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND AND AIMS:Avoidance of gluten is critical for individuals with celiac disease (CD), but there is also concern that "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). We examined the associations of QOL with energy lev...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-018-4936-4
更新日期:2018-06-01 00:00:00
abstract::The efficacy of comaruman CP, a pectin of marsh cinquefoil Comarum palustre L., was investigated using a model of acetic acid-induced colitis in mice. Mice were administered comaruman CP orally 2 days prior to rectal injection of 5% acetic acid and examined for colonic damage 24 hr later. Colonic inflammation was char...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-005-9034-8
更新日期:2006-09-01 00:00:00
abstract::There is a high incidence of Campylobacter pylori in the gastric mucosa of patients with duodenal ulcer, gastric ulcer, and nonulcer dyspepsia. Factors that lead to development of this infection are unknown. We hypothesized that delayed solid-phase gastric emptying, a condition characterized by antral stasis, might pr...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01540043
更新日期:1989-11-01 00:00:00
abstract::Barrett's esophagus (BE) is intestinal metaplasia of the lower esophagus and a precursor lesion for esophageal adenocarcinoma (EAC). Both are important health issues as they have rising incidences in the Western world. Improving the management of BE relies on understanding the underlying biology of this disease, but t...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,评审
doi:10.1007/s10620-016-4109-2
更新日期:2016-07-01 00:00:00
abstract::The changes in plasma and duodenal cholecystokinin (CCK) concentrations after pancreatic duct occlusion were examined in rats. The rats were sacrificed 1, 3, 7, 10, 14, and 30 days after occlusion of the duct. Histological examination showed acute inflammation on days 1 and 3 after duct occlusion, interstitial fibrosi...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01307730
更新日期:1992-03-01 00:00:00
abstract::We explored the hemodynamic effects of rapid injection of 0.9% saline and arterial blood into the canine superior mesenteric artery in anesthetized animals. Mesenteric artery blood flow and pressure were measured in the vessel distal to the site of injection. Injection rates were at or below the rate of blood flow in ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01309495
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Although direct percutaneous endoscopic jejunal feeding tube placement is an increasingly accepted method of providing small-bowel access for long-term enteral nutrition, it is reliant on push enteroscopy and remains a technically challenging procedure with significant failure rates. Double-balloon enterosco...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-010-1306-2
更新日期:2011-02-01 00:00:00
abstract::On the basis of previous studies in our laboratory we postulated that the ethanol-induced alteration in jejunal morphology was the result of its effect on the microcirculation. The present study was undertaken to examine the validity of this hypothesis. Accordingly, the effects of intraluminal ethanol perfusion (3.0 a...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01311730
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Neuromediators produced by enteric nervous system regulate inflammatory processes via interacting with enteric immune system. Role of γ-aminobutyric acid (GABA), which is also a neuromediator, has been implicated in autoimmune diseases like multiple sclerosis, type 1 diabetes, and rheumatoid arthritis, where...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-017-4662-3
更新日期:2017-10-01 00:00:00
abstract::Phosphorylation/dephosphorylation of intracellular proteins are important steps in the regulation of cell growth. Okadaic acid, an inhibitor of the serine/threonine protein phosphatases 1 and 2A, is a potent tumor promoter. This effect may be through the inhibition of dephosphorylation (termed "hyperphosphorylation") ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF02093599
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Hepatic encephalopathy (HE) is considered reversible regarding mental status but may not be cognitively in single-center studies. AIM:To evaluate persistence of learning impairment in prior HE compared to those who never experienced HE (no-HE) in a multicenter study. METHODS:A total of 174 outpatient cirrh...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,多中心研究
doi:10.1007/s10620-016-4425-6
更新日期:2017-03-01 00:00:00
abstract::An intussusception of the small intestine in association with a long tube usually occurs in the vicinity of the mercury-filled bag and can be visualized radiographically by instilling barium directly into the tube. On rare occasions, an intussusception develops in the proximal jejunum and is difficult to recognize. We...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01318698
更新日期:1986-06-01 00:00:00
abstract::This article [1] is retracted at the request of Editor-in-Chief. ...
journal_title:Digestive diseases and sciences
pub_type: 已发布勘误,撤回出版物
doi:10.1007/s10620-019-05932-9
更新日期:2019-11-11 00:00:00