Objectives: This study aimed to determine the prevalence of gastro-esophageal reflux disease (GERD) in Filipino patients on maintenance hemodialysis (HD) and investigate the demographic, clinical, and renal profiles of HD patients with and without GERD. Methodology: This was a cross-sectional, multicenter study using a validated GERD questionnaire (GERDQ) with a Filipino translation. Patients above 18 years-old undergoing hemodialysis as outpatients were included. A GERDQ score of ≥8 was regarded as having GERD. Logistic regression analysis was conducted using variables that exhibited a significant correlation coefficient on two group comparisons as factors, with the presence or absence of GERD as the dependent variable. Results: Included in our analysis were 264 patients, from which 36 had a GERDQ score of ≥8 (13.64% 95%CI 9.98-18.35). Factors associated with having a score of ≥8 include the following: (1) having CHD (COR 4.041, 95%CI 1.89-8.64, p<0.001), (2) being on insulin (COR 2.599, 95%CI 1.25-5.42, p=0.011), (3) anemia (COR 4.508, 95%CI 1.91-10.64, p=0.001), (4) diagnosis of both HTNKD and DKD (COR 3.853, 95%CI 1.15-12.96, p=0.029), (5) previous diagnosis of GERD (COR 6.655, 95%CI 3.18-13.91, p<0.001), (6) previous intake of antacids (COR 2.622, 95%CI 1.17-5.89, p=0.020), (7) those employed (COR 2.332, 95%CI 1.15-4.75, p=0.020), (8) alcohol consumption (COR 2.477, 95%CI 1.23-5.01, p=0.012), and (9) smoking (COR 2.405, 95%CI 1.19-4.86, p=0.014). Conclusion The prevalence of GERD in Filipino HD patients from three centers in Tarlac City was 13.64% and may be associated with several clinical factors such as heart disease, insulin use, anemia, hypertensive and diabetic kidney disease, previous diagnosis of GERD, use of antacids, with employment, smoking, and alcohol use. A comprehensive understanding of the relationship among these clinical factors awaits further studies in a larger number of patients.
Prevalence ; Gastroesophageal Reflux ; Renal Insufficiency, Chronic ; Renal Dialysis

Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

BACKGROUND/AIMS: The effects of Histamine-2 receptor antagonists and proton pump inhibitors on the gastrointestinal motility have not yet been sufficiently investigated. The aim of this study was to determine the effects of intravenous bolus administration of famotidine and omeprazole on the rate of gastric emptying using the continuous 13C breath test (BreathID system, Exalenz Bioscience Ltd, Israel). METHODS: Twelve healthy male volunteers participated in this randomized, 3-way crossover study. After fasting overnight, the subjects were randomly assigned to receive 20 mg of famotidine, 20 mg of omeprazole or 20 mL of saline alone by intravenous bolus injection before a test meal (200 kcal per 200 mL, containing 100 mg of 13C-acetate). Gastric emptying was monitored for 4 hours after the ingestion of test meal by the 13C-acetic acid breath test performed using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, the T1/2, Tlag, GEC, beta and kappa, were observed among the 3 test conditions. CONCLUSIONS: The study revealed that intravenous administration of gastric acid suppressant drugs had no significant influence on the rate of gastric emptying in comparison with that of saline alone as a placebo. Our results indicating the absence of any effect of either famotidine or omeprazole on accelerating the rate of gastric emptying suggest that both medications can be administered safely to patients suffering from hemorrhagic peptic ulcers who need to be kept nil by mouth from the viewpoint of possible acceleration of gastrointestinal motility in the clinical setting.
Acceleration ; Administration, Intravenous ; Breath Tests ; Cross-Over Studies ; Eating ; Famotidine ; Fasting ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Male ; Meals ; Mouth ; Omeprazole ; Peptic Ulcer ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Stress, Psychological

Introduction: Reflux is one of the most common gastrointestinal symptoms among dialysis patients. This may be associated with several clinical factors such as comorbidities and subsequent polypharmacy. However, this remains unrecognized and untreated. Objectives: The objectives of this study were to determine the prevalence of Gastroesophageal Reflux Disease (GERD) in Filipino patients on maintenance hemodialysis (HD) and to investigate associated demographic, clinical, and renal profiles of HD patients with and without GERD. Methods: This was a cross-sectional, multicenter study using a validated GERD questionnaire (GERDQ) translated into Filipino. Patients above 18 years old undergoing hemodialysis as outpatients were included. Several clinical factors such as demographic, clinical, and renal profiles were analyzed based on the absence and presence of GERD with a predetermined cut-off value of eight or above. Results: Included in our analysis were 264 patients, from which 36 had GERDQ score of ≥ 8 (13.64% 95%CI 9.98-18.35). Factors associated with having score of ≥ 8 included the following: (1) having chronic heart disease or CHD (COR 4.041, 95%CI 1.89-8.64, p<0.001), (2) being on insulin (COR 2.599, 95%CI 1.25-5.42, p=0.011), (3) anemia (COR 4.508, 95%CI 1.91-10.64, p=0.001) (4) diagnosis of both hypertensive kidney disease and diabetes kidney disease (COR 3.853, 95%CI 1.15-12.96, p=0.029), (5) previous diagnosis of GERD (COR 6.655, 95%CI 3.18-13.91, p<0.001), (6) previous intake of antacids (COR 2.622, 95%CI 1.17-5.89, p=0.020), (7) being employed (COR 2.332, 95%CI 1.15-4.75, p=0.020) (8) alcohol consumption (COR 2.477, 95%CI 1.23-5.01, p=0.012), and (9) smoking (COR 2.405, 95%CI 1.19-4.86, p=0.014). Conclusion In our study, the prevalence of GERD in Filipino HD patients was 13.64% and may be associated with several clinical factors such as heart disease, insulin use, anemia, hypertension, diabetic kidney disease, previous diagnosis of GERD, use of antacids, being employed, smoking, and alcohol use. A comprehensive understanding of the relationships between these clinical factors awaits further studies in a larger number of patients.
Gastroesophageal Reflux ; Renal Insufficiency, Chronic ; Renal Dialysis

Objective: The aims of this study were to (i) clarify whether there are differences between bereaved families and medical staffs in their preferences for life-prolonging treatments, and (ii) investigate the factors associated with preferences for life-prolonging treatments. Methods: Cross-sectional internet survey was conducted in October 2019. Participants are bereaved families(n=618), physicians(n=206), nurses(n=206), and care workers(n=206) who registered with the internet survey company. We asked the subjects about the relative importance of 36 components of a good death in dementia and their preferences for 7 treatment items that they might need at the end of life. Results: Statistically significant differences in end-of-life medical preference between bereaved families and medical professionals included “Nutrition from gastrostomy when oral intake is difficult” (p<0.01), “Surgery for life-threatening disease” (p<0.01). As a result of logistic regression analysis, a surrogate decision-maker among bereaved family members tended to wish intravenous infusion (OR: 1.62, p=0.02) and continuation of oral medicine (OR: 1.74, p<0.01). The medical professionals who regarded good relationships with people as a requirement of good end-of-life care tended to wish surgery (OR: 2.15, p<0.01) and life-prolonging treatment (OR: 2.00, p=0.01). Conclusions: This result suggest that since the medical preferences between medical staff and the family members don’t necessarily correspond, medical professionals need to take it into consideration when they discuss the treatment options.