Prescription of Proton Pump Inhibitors in Elderly Subjects in Real Life: A Retrospective Study in a Gastroenterology Department

The proton-pump inhibitor (PPI) is an effective and widely used treatment but may cause side effects, especially for the elderly. Materials and methods: this is a cross-sectional study including 45 patients older than 65 years, followed at our outpatient and treated with PPIs for at least a year. The indication for PPI, the results of any endoscopy, and the quality of the tolerance of these molecules is specified by the data folder. During the consultation, we conducted an interrogation to an update of the history and medications to our patients and a type checking of the molecule, the dose, and the quality of the observance. Results: patients were divided into 32 women and 13 men with a mean age of 75 ± 7 years (65–92). The average length of PPI use was 6 ± 4 years (1–16) with a consumption of a double dose for at least 1 year in 28.8% of cases. The prescribed dose was higher than the recommended dose in at least 15.5% of cases. PPIs were well tolerated. One patient had presented a microscopic colitis, revealed by diarrhea regressed after discontinuation of PPIs. Conclusion: PPIs were prescribed in elderly subjects by gastroenterologists, in a university center, with a high dose and long. In our series, this treatment is well tolerated in the elderly

A survey to explore the psychological and professional impact of change imposed by COVID-19

Aim: Staff of a department underwent a change following the COVID-19 pandemic. The objective of this study was to assess the psychological and professional impact of this change. Materials & methods: This is cross-sectional study, including all department staff conducted from 15 July 2021 to 15 August 2021 Results: All the staff concerned (n = 36) participated. Only 9.37% declared that they understood the change. The main problem encountered by participants was poor communication (86.2%). More than 75% among participants had a demotivation and 54.5% had resisted. The main cause of resistance was quality of organization (42.4%). Conclusion: Our study illustrates the difficulties encountered by actors involved in organizational change and the high risk of their resistance

Screening for renal impairment in viral hepatopathy B: it is time to begin

Aim: The aim of this study was to assess the value of routine screening for renal damage in cases of B viral infection, by looking for proteinuria and elevated creatinemia. Materials & methods: We investigate the frequency and associated factors of renal impairment in patients with viral B hepatopathy. Results: Pathological albuminuria was confirmed in 44.73%. The chronic kidney disease with slightly decreased filtration rate was found in 21.05%. In multivariate analysis, only BMI was an independent factor for pathological albuminuria (p = 0.013) and only age was an independent predictor of chronic kidney disease (p = 0.056). Conclusion: Urine dipstick and creatinemia are useful for routine screening in viral B hepatopathy especially in the elderly and overweight

Squamous cell carcinoma and Crohn's disease: a sometimes-challenging diagnosis

Aim: Non-melanoma skin cancers are more common in people with inflammatory bowel disease. However, these tumors can rarely mimic a cutaneous manifestation of the disease, which delays diagnosis and clouds prognosis. Observation: A 35-year-old man with stenosing and fistulizing ileocolic Crohn's disease developed squamous cell carcinoma mimicking a groin fold abscess. After surgical drainage of the abscess, despite antibiotics and therapy combining azathioprine with infliximab, the abscess has recurred. Biopsies revealed a cutaneous squamous cell carcinoma. Palliative radiotherapy-chemotherapy was initiated, but the patient died after 3 months. Conclusion: This observation illustrates the increased risk of non-melanoma skin cancers in inflammatory bowel disease patients, particularly those exposed to thiopurines, and the value of diagnosing them at an early stage

Alexithymia impairs quality of life in irritable bowel syndrome

Aim: Our objectives were to compare the frequency of alexithymia and the alteration of quality of life in irritable bowel syndrome (IBS) and to determine the factors associated with alexithymia and quality of life deterioration. Method: This is a comparative study which collected 80 IBS patients and 80 controls. Results: Quality of life was impaired in 75% of patients vs 37.5% (p < 0.0001). The prevalence of alexithymia was 50% in patients vs 1.2% (p < 0.0001). In multivariate analysis, an impaired quality of life was associated with alexithymia (p = 0.003). The factors associated with impaired quality of life were anxiety and alexithymia. Conclusion: Alexithymia was present in half of patients with IBS and its was associated with impaired quality of life