PMID- 24665577
OWN - NLM
STAT- MEDLINE
DCOM- 20150709
LR  - 20190918
IS  - 0042-8450 (Print)
IS  - 0042-8450 (Linking)
VI  - 71
IP  - 2
DP  - 2014 Feb
TI  - Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection 
      and without exposure to non-steroidal anti-inflammatory drugs.
PG  - 183-90
AB  - BACKGROUND/AIM: A high risk of bleeding in Helicobacter pylori (H. 
      pylori)-negative, non-steroidal anti-inflammatory drugs (NSAID)-negative ulcers 
      highlights the clinical importance of analysis of the changing trends of peptic 
      ulcer disease. The aim of the study was to investigate the risk factors for ulcer 
      bleeding in patients with non-H. pylori infection, and with no NSAIDs use. 
      METHODS: A prospective study included patients with endoscopically diagnosed 
      ulcer disease. The patients were without H. pylori infection (verified by 
      pathohistology and serology) and without exposure to NSAIDs and proton pump 
      inhibitors (PPI) within 4 weeks before endoscopy. After endoscopy the patients 
      were divided into 2 groups: the study group of 48 patients with bleeding ulcer 
      and the control group of 47 patients with ulcer, but with no bleeding. Prior to 
      endoscopy they had completed a questionnaire about demographics, risk factors and 
      habits. The platelet function, von Willebrand factor (vWF) and blood groups were 
      determined. Histopathological analysis of biopsy samples were performed with a 
      modified Sydney system. The influence of bile reflux was analyzed by Bile reflux 
      index (BRI). RESULTS: Age, gender, tobacco and alcohol use did not affect the 
      bleeding rate. The risk of bleeding did not depend on concomitant diseases (p = 
      0.509) and exposure to stress (p = 0.944). Aspirin was used by 16/48 (33.3%) 
      patients with bleeding ulcer, as opposed to 7/47 (14.9%) patients who did not 
      bleed (p = 0.036). Abnormal platelet function had 12/48 (25.0%) patients who 
      bled, as opposed to 2/47 (4.3%) patients who did not bleed (p = 0.004). Patients 
      with BRI < 14 bled in 79.2%, and did not bleed in 57.4% of the cases (p = 0.023). 
      There was no statistical difference between groups in regards to blood groups and 
      range of vWF. Antrum atrophy was found in 14/48 (29.20%) patients with bleeding 
      ulcer and in only 5/47 (10.6%) patients who had ulcer without bleeding (p = 
      0.024). CONCLUSION: Abnormal platelet function, aspirin use and antrum atrophy 
      were the risk factors for ulcer bleeding in non-H. pylori, non- NSAIDs ulcer 
      disease.
FAU - Smolovic, Brigita
AU  - Smolovic B
FAU - Stanisavljevic, Dejana
AU  - Stanisavljevic D
FAU - Golubovic, Mileta
AU  - Golubovic M
FAU - Vuckovic, Ljiljana
AU  - Vuckovic L
FAU - Milicic, Biljana
AU  - Milicic B
FAU - Djuranovic, Srdjan
AU  - Djuranovic S
LA  - eng
PT  - Journal Article
PL  - Serbia
TA  - Vojnosanit Pregl
JT  - Vojnosanitetski pregled
JID - 21530700R
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aspirin/adverse effects
MH  - Blood Platelet Disorders/physiopathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peptic Ulcer/*etiology/pathology
MH  - Peptic Ulcer Hemorrhage/*etiology/pathology
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - Prospective Studies
MH  - Pyloric Antrum/pathology
MH  - Risk Factors
EDAT- 2014/03/29 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/03/27 06:00
PHST- 2014/03/27 06:00 [entrez]
PHST- 2014/03/29 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - 10.2298/vsp1402183s [doi]
PST - ppublish
SO  - Vojnosanit Pregl. 2014 Feb;71(2):183-90. doi: 10.2298/vsp1402183s.