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Corrected QT interval in cirrhosis:A systematic review and metaanalysis

World Journal of Hepatology 2023年第9期15卷 1060-1083页

作者： Vasileios Periklis Papadopoulos konstantinos mimidis Dialysis AKESIOS Dialysis CenterXanthi 67150Greece First Department of Internal Medicine Democritus University of ThraceAlexandroupolis 68100Greece

BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the ***,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been *** the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely *** To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver *** In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after ***-three studies were considered *** concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were *** Newcastle-Ottawa quality assessment scale appraised the quality of the eligible *** estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and ***,sensitivity analysis,and meta-regressions were applied to assess *** QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterog

关键词： Liver cirrhosis Corrected QT interval Child-Pugh stage Model for end-stage liver disease score Liver transplantation Meta-analysis

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Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease

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World Journal of Gastroenterology 2004年第8期10卷 1180-1182页

作者： AnthieGatopoulou konstantinosmimidis GeorgeMinopoulos konstantinos mimidis EfthimiosSivridis AlexandraGiatromanolaki Alexandros Polichronidis NikolaosLirantzopoulos Endoscopy Unit Democritus University of ThraceAlexandroupolisGreece First Department of Surgery Democritus University of ThraceAlexandroupolisGreece First Department of Internal Medicine Democritus University of Thrace AlexandroupolisGreece Department of Pathology Democritus University of ThraceAlexandroupolisGreece Second Department of Surgery Democritus University of ThraceAlexandroupolisGreece

AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains *** available data on the histological changes in NERD and the effect on Hpyloriinfection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpyloriinfection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with *** all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of Hpyloriinfection was 70%.Twenty-nine patients out of 50 (58%) were NERD *** statistical significance was observed between the H pyloristatus and *** remaining 21 (42%) were diagnosed as follows:13 (26%),6 (12%),2(4%) with esophagitis grade A,B and C respectively.A statistically significant correlation was observed between the Hpylori+ and esophagitis grade A,as well as between Hpylori-and grade *** from 2 patients were not included because of insufficient ***,a basal zone hyperplasia was found in 47 (97.91%) patients,alterations of glycogen content in 47 (97.91%),papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%),chronic inflammation in 21 (43.75%),infiltration with eosinophils,neutophils and T-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%) *** correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION:Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux ***,Hpyloriinfection may not act as an important factor in patients with NERD.

关键词： Helicobacter pylori Biopsy Endoscopy, Gastrointestinal Esophagitis, Peptic Female Gastroesophageal Reflux Helicobacter Infections Humans Hyperplasia Male Middle Aged Prospective Studies

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Use of a device that applies external kneading-like force on the abdomen for treatment of constipation

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World Journal of Gastroenterology 2005年第13期11卷 1971-1975页

作者： konstantinos mimidis David Galinsky Efraim Rimon Vassilios Papadopoulos Yehuda Zicherman Dimitrios Oreopoulos Democritus University of Thrace Faculty of Health Sciences Kaplan Medical Center ADM Ltd Toronto Western Hospital

AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients. METHODS: Thirty constipated elderly patients were randomly selected from two nursing homes. They were instructed to use the device once daily for 20 min. Rate of bowel movements, volume and consistency of stool and the use of laxantia were all recorded during a 3-wk baseline period and for 12-wk treatment period. Colonic transit time (CTT) was measured in 13 patients by radiopaque markers during the baseline and at the end of treatment. RESULTS: Bowel movement rate (BM/week) increased from 1.4±0.4 BM/wk during baseline to 3.9±0.8 BM/wk during treatment (P<5.0×10-7). Stool amount that was 'low' in 30 patients during baseline increased in 21 patients at the end of the study period (x2 = 19.048-P= 1.3×10-5). Stool consistency,that was 'hard' in 25 patients and 'soft' in 5 patients during baseline, ameliorated in 23 patients at the end of the study (only 2 patients referred 'hard' stool) (x2 = 21.043-P= 4.0×10-6). The mean baseline CTT measured was 92.3±32.3 h at baseline and decreased to 49.4±31.3 h during the study period (P = 0.000208). No side effects were observed during the study period. CONCLUSION: External mechanical vibration of the abdomen reduced CTT and helped to relieve severe constipation in elderly constipated patients.

关键词： Constipation Laxatives Colon transit time

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Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

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World Journal of Gastroenterology 2005年第9期11卷 1365-1368页

作者： konstantinos C Thomopoulos konstantinos P mimidis George J Theocharis Anthie G Gatopoulou Georgios N Kartalis Vassiliki N Nikolopoulou Department of Internal Medicine the First Department of Internal Medicine

AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy. The purpose of this study was to describe the causes and clinical outcome of these patients. METHODS: From January 1999 to October 2003, 111 patients with acute upper gastrointestinal bleeding (AUGIB) were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001 with AUGIB who were not taking warfarin. RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (P<0.05). No identifiable source of bleeding could be found in 33 patients (29.7%) compared to 31/604 (5.1%) patients not receiving anticoagulants (P=0.0001). The majority of patients with concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%) patients not taking a great dose of NSAIDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported. Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy. CONCLUSION: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants. Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

关键词： AUGIB Anticoagulant therapy Endoscopy

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