• 22
    Dec
  • DYSPEPSIA IN AFRICAN-AMERICAN AND HISPANIC PATIENTS: RESULTS

The study included 357 African-American patients (178 males, 179 females) and 321 Hispanic patients (154 males, 167 females) (Table 1). The most frequent alarm features among the study population was age (>50 years) followed by anemia, weight loss, and gastrointestinal bleeding. About three-quarters of the patients (72%) were over 50 years of age. The prevalence of alarm features increased with age, being more frequent among the older age group (76-98 years old) than the younger age group (22-50 years old). All of the alarm features were statistically different between age groups with the exception of gastrointestinal bleeding, loss of appetite, and early satiety (Table 2).

Six-hundred-seventy-eight patients were investigated using UGI endoscopy and/or UGI-series barium radiographs. Five-hundred-thirty patients had endoscopy only, 88 patients had barium radiographs only, and 60 patients had both studies. Endoscopic and/or radiological evaluation of the 678 study patients shown in Table 3 demonstrated that the commonest findings were erosive esophagitis (13%), duodenal ulcers (13%), gastric ulcers (11%), and esophageal varices (10%). Other less frequent findings were cancers of the stomach, esophagus, pancreas, and the presence of UGI lymphoma. Twelve patients had more than one lesion. The positive endoscopic and/or radiological findings were more frequent among the older age groups than in the younger age group. There was a statistically significant difference between the age groups for the presence of gastric ulcer (Table 3). cialis professional 20 mg

Table 1. Patient Demography

Variables

African Americans (N=357)

Hispanics (N=321)

Total

Age Groups (Years) Males (N=178) N(%) Females (N=179) N(%) Males (N=154) N(%) Females (N=167) N(%)

N(%)

22-50

53 (30)

49 (27)

43 (28)

44 (26)

189 (28)

51-75

86 (48)

79 (44)

71 (46)

74 (44)

310 (46)

76-98

39 (22)

51 (28)

40 (26)

49 (29)

179 (26)

Individual alarm features as an indicator of the presence of a lesion were examined. Dysphagia and the presence of an abdominal mass were the most significant features indicating an underlying lesion. Almost all the patients presenting with these two features (96% and 91%, respectively) were found to have a lesion by endoscopy and/or radiology. Gastrointestinal bleeding, anemia, and weight loss represented the second category of the alarm features to indicate the presence of a lesion in the patients. The majority of the patients presented with these features (85%, 75%, and 70%, respectively) were found to have a lesion. Early satiety and loss of appetite were not good indicators for a lesion, since the percentage of patients presenting with these two features were not statistically different in relation to the presence of a lesion (p>0.05). tadalis sx 20

Table 2. Prevalence of the Presence of Alarm Features among 678 Patients by Age Groups

Features

Total (N=678) N(%) Group 1 (N=18?) N(%) Age Groups* Group 2 (N=310) N(%) Group 3 (N=179) N(%)

P Value

Age >50

489 (72)

0(0)

310 (100)

179 (100)

Anemia

88 (13)

13(7)

42 (14)

33 (18)

0.005
Loss of weight

86 (13)

11 (6)

39 (13)

36 (20)

0.0001

Gastrointestinal bleeding 65 (10)

15(8)

27 (9)

23 (13)

0.2
Loss of appetite

49(7)

9(5)

21 (7)

19(11)

0.06
Early satiety

40 (6)

7(4)

19(6)

14(8)

0.3
Abdominal mass

23 (3)

1 (1)

9(3)

13(7)

0.004
Dysphagia

23 (3)

1 (1)

10(3)

12(7)

0.004

The association between the presence of alarm features and the endoscopic and/or radiological findings was examined for each age group. Alarm features were associated with the presence of lesions in all age groups. Overall, the odds for patients who presented with one or more alarm features of having a lesion were three times higher than the odds for those with no alarm features (weighted OR=3.07, 95% CI=2.2-4.4). canadian antibiotics

Table 3. Endoscopic Findings by Age Group

Lesions Total (N=678) N(%)

Group 1 (N=189) N(%)

Age Groups* Group 2 (N=310) N(%)

Group 3 (N=17?) N(%) P-Value
Erosive esophagitis

88 (13)

20 (11) 36 (12)

32 (18)

0.1
Duodenal ulcers

85 (13)

25 (13) 32 (10)

28 (16)

0.1
Gastric ulcer

72(11)

12(6) 34(11)

26 (15)

0.01
Esophageal varices

70 (10)

20(11) 31 (10)

19(11)

0.9
Cancer of stomach

21 (3)

2(1) 11 (4)

8(4)

0.1
Cancer of esophagus

20 (3)

2(1) 12(4)

6(3)

0.2
Cancer of pancreas

10(1)

0(0) 4(1)

6(3)

0.04
UGI lymphoma

3 (0.4)

1 (1) 2(1)

0(0)

0.4
* Age groups: group 1 =22-50 years; group 2=51- 75 years; group 3=76-98 years

Tests for H. pylori were done in 278 (41%) of our patients, of whom 125 (45%) were positive and received pylori therapy. There was evidence of symptomatic improvement of dyspepsia in 40 (32%) H. pylori-positive patients pylori therapy. However, records were not available to determine how many of these 125 patients had their H. pylori eradicated. We were also not able to ascertain from the medical records whether treatment influenced the long-term clinical outcome. In our study, 11 of 21 (52%) patients with cialis professional 20 mg of the stomach were positive for H. pylori.

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