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PubMedDate not supplied

Felodipine does not increase the reflux episodes in patients with gastroesophageal reflux disease.

BACKGROUND/AIMS: Calcium channel blocking agents have been reported to increase the risk of gastroesophageal reflux. However, whether felodipine, a newer calcium channel blocker, increases reflux episodes and decreases esophageal acid clearance in patients with gastroesophageal reflux disease has never been studied. Therefore, the aim of this study was to evaluate whether felodipine increases the incidence of gastroesophageal reflux in patients with gastroesophageal reflux disorder. METHODOLOGY: Nine patients with gastroesophageal reflux disease, 6 men and 3 women, with a mean age of 62.6 +/- 14.4 years (range: 37-80 years) were studied. They received ambulatory esophageal pH monitoring for 45.7-48 hours (mean: 47.1 +/- 0.8 hours). Various pH parameters were evaluated during a similar interval of monitoring time before and after receiving 5 mg of felodipine. RESULTS: No significant difference was noted in any pH parameter by the Wilcoxon signed Ranks test, including reflux episodes (P = 0.552), reflux episodes longer than 5 min (P = 0.683), esophageal acid clearance (P = 0.663) and fraction time of pH < 4 (P = 0.752) before and after the use of felodipine. CONCLUSIONS: Felodipine does not increase reflux episodes or impair esophageal acid clearance in patients with gastroesophageal reflux disease.

Adult↗

PubMedDate not supplied

Hospitalizations for bacterial endocarditis after renal transplantation in the United States.

PURPOSE: The national rate of and risk factors for bacterial endocarditis in renal transplant recipients has not been reported. METHODS: Retrospective registry study of 33,479 renal transplant recipients in the United States Renal Data System (USRDS) between 1 July 1994 and 30 June 1997. Hospitalizations for a primary diagnosis of bacterial endocarditis (ICD-9 codes 421.x) within three years after renal transplant were assessed. RESULTS: Renal transplant recipients had an unadjusted incidence ratio for endocarditis of 7.84 (95% confidence interval 4.72-13.25) in 1996. In multivariate analysis, a history of hospitalization for valvular heart disease (adjusted odds ratio (AOR), 25.81, 95% confidence interval 11.28-59.07), graft loss (AOR, 2.81, 95% CI 1.34-5.09), and increased duration of dialysis prior to transplantation were independently associated with hospitalizations for bacterial endocarditis after transplantation. Hospitalization for endocarditis was associated with increased patient mortality in Cox Regression analysis, hazard ratio 4.79, 95% CI 2.97-6.76. CONCLUSIONS: The overall incidence of bacterial endocarditis was much greater in renal transplant recipients than in the general population, although it is still relatively infrequent. Independent risk factors for bacterial endocarditis in the renal transplant recipients were identified, the most significant of which was valvular heart disease. Endocarditis substantially impacts renal transplant recipient survival.

Adolescent↗