Talking about gastritis & peptic ulcer disease ( definetions , clinical picture , diagnosis & treatment , complications ) , all informations are Up tu date of 2017
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Image result for gastritis
Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers.
Talking about gastritis & peptic ulcer disease ( definetions , clinical picture , diagnosis & treatment , complications ) , all informations are Up tu date of 2017
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Image result for gastritis
Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers.
Gastritis is a condition in which the stomach
lining—known as the mucosa—is inflamed. The stomach lining contains special
cells that produce acid and enzymes, which help break down food for digestion,
and mucus, which protects the stomach lining from acid. When the stomach lining
is inflamed, it produces less acid, enzymes, and mucus.
Gastritis may be acute or chronic. Sudden,
severe inflammation of the stomach lining is called acute gastritis. Inflammation
that lasts for a long time is called chronic gastritis. If chronic gastritis is
not treated, it may last for years or even a lifetime.
Erosive gastritis is a type of gastritis that
often does not cause significant inflammation but can wear away the stomach
lining. Erosive gastritis can cause bleeding, erosions, or ulcers. Erosive
gastritis may be acute or chronic.
The relationship between gastritis and
symptoms is not clear. The term gastritis refers specifically to abnormal
inflammation in the stomach lining. People who have gastritis may experience
pain or discomfort in the upper abdomen, but many people with gastritis do not
have any symptoms.
The term gastritis is sometimes mistakenly
used to describe any symptoms of pain or discomfort in the upper abdomen. Many
diseases and disorders can cause these symptoms. Most people who have upper
abdominal symptoms do not have gastritis.
In this slide, you can understand the concept of Nausea and vomiting normally called "puke.''
Difference between Nausea and vomiting.
Causes of Vomiting.
Diet in Vomiting
Treatment in Vomiting.
Treatment of Vomiting in Pregnancy.
PPT download link.
https://drive.google.com/open?id=1beZMVQ75fdiGJlJDbGJKK3MGio6zgpLfTu9flkBSutk
Video Link:
https://youtu.be/ZvUiGpjt3zc
Hiatal hernia
Synonyms Hiatus hernia
Hiatalhernia.gif
A drawing of a hiatal hernia
Specialty Gastroenterology, general surgery
Symptoms Taste of acid in the back of the mouth, heartburn, trouble swallowing[1]
Complications Iron deficiency anemia, volvulus, bowel obstruction[1]
Types Sliding, paraesophageal[1]
Risk factors Obesity, older age, major trauma[1]
Diagnostic method Endoscopy, medical imaging, manometry[1]
Treatment Raising the head of the bed, weight loss, medications, surgery[1]
Medication H2 blockers, proton pump inhibitors[1]
Frequency 10–80% (US)[1]
[edit on Wikidata]
A hiatal hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest.
This presentation is about peptic ulcer disease , including:Pathomorphology,etiology,symptoms,complications,diagnosis and pharmacotherapy,asurgical intervention and prevention...
Gastritis is a condition in which the stomach
lining—known as the mucosa—is inflamed. The stomach lining contains special
cells that produce acid and enzymes, which help break down food for digestion,
and mucus, which protects the stomach lining from acid. When the stomach lining
is inflamed, it produces less acid, enzymes, and mucus.
Gastritis may be acute or chronic. Sudden,
severe inflammation of the stomach lining is called acute gastritis. Inflammation
that lasts for a long time is called chronic gastritis. If chronic gastritis is
not treated, it may last for years or even a lifetime.
Erosive gastritis is a type of gastritis that
often does not cause significant inflammation but can wear away the stomach
lining. Erosive gastritis can cause bleeding, erosions, or ulcers. Erosive
gastritis may be acute or chronic.
The relationship between gastritis and
symptoms is not clear. The term gastritis refers specifically to abnormal
inflammation in the stomach lining. People who have gastritis may experience
pain or discomfort in the upper abdomen, but many people with gastritis do not
have any symptoms.
The term gastritis is sometimes mistakenly
used to describe any symptoms of pain or discomfort in the upper abdomen. Many
diseases and disorders can cause these symptoms. Most people who have upper
abdominal symptoms do not have gastritis.
In this slide, you can understand the concept of Nausea and vomiting normally called "puke.''
Difference between Nausea and vomiting.
Causes of Vomiting.
Diet in Vomiting
Treatment in Vomiting.
Treatment of Vomiting in Pregnancy.
PPT download link.
https://drive.google.com/open?id=1beZMVQ75fdiGJlJDbGJKK3MGio6zgpLfTu9flkBSutk
Video Link:
https://youtu.be/ZvUiGpjt3zc
Hiatal hernia
Synonyms Hiatus hernia
Hiatalhernia.gif
A drawing of a hiatal hernia
Specialty Gastroenterology, general surgery
Symptoms Taste of acid in the back of the mouth, heartburn, trouble swallowing[1]
Complications Iron deficiency anemia, volvulus, bowel obstruction[1]
Types Sliding, paraesophageal[1]
Risk factors Obesity, older age, major trauma[1]
Diagnostic method Endoscopy, medical imaging, manometry[1]
Treatment Raising the head of the bed, weight loss, medications, surgery[1]
Medication H2 blockers, proton pump inhibitors[1]
Frequency 10–80% (US)[1]
[edit on Wikidata]
A hiatal hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest.
This presentation is about peptic ulcer disease , including:Pathomorphology,etiology,symptoms,complications,diagnosis and pharmacotherapy,asurgical intervention and prevention...
Specific gravity is the ratio of the density of a substance to the density of a reference substance; equivalently, it is the ratio of the mass of a substance to the mass of a reference substance for the same given volume.
By: Sarchia Khursheed
Peptic ulcer ( a medical study)- definition, causes, pathophysiology etc martinshaji
Peptic ulcers include:
Gastric ulcers that occur on the inside of the stomach
Esophageal ulcers that occur inside the hollow tube (esophagus) that carries food from your throat to your stomach
Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)
It's a myth that spicy foods or a stressful job can cause peptic ulcers. Doctors now know that a bacterial infection or some medications — not stress or diet — cause most peptic ulcers.
this is a detailed study on peptic ulcer
please comment
thank you
Gastritis
Pathophysiology:
Gastritis is the inflammation of the stomach lining due to the injury of the mucosal layer that serves as a protectant from its stomach acid. Exposure of the mucosa to stomach acid can lead to swelling, inflammation, and pain.
There are two types of gastritis:
Acute Gastritis – short-lived without any longterm damage
Chronic Gastritis – longterm damage to the gastric mucosa
Causes:
Helicobacter pylori
Long term use of NSAIDs
Aspirin
Alcohol
Excessive amounts of caffeine
High stress levels
Smoking
Intolerance to spicy/citric food
Signs & Symptoms:
Nausea and vomiting
Sudden gastric pain
Gastric bleeding
Heartburn
Anorexia
Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs. It may also be caused by any of the following:
Helicobacter pylori (H. pylori): A bacteria that lives in the mucous lining of the stomach; without treatment, the infection can lead to ulcers, and in some people, stomach cancer.
Bile reflux: A backflow of bile into the stomach from the bile tract (that connects to the liver and gallbladder)
Infections caused by bacteria and viruses
How Is Gastritis Diagnosed?
To diagnose gastritis, your doctor will review your personal and family medical history, perform a thorough physical evaluation, and may recommend any of the following tests:
Upper endoscopy. An endoscope, a thin tube containing a tiny camera, is inserted through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may perform a biopsy, a procedure in which a tiny sample of tissue is removed and then sent to a laboratory for analysis.
Blood tests. The doctor may perform various blood tests, such as checking your red blood cell count to determine whether you have anemia, which means that you do not have enough red blood cells. They can also screen for H. pylori infection and pernicious anemia with blood tests.
Fecal occult blood test (stool test). This test checks for the presence of blood in your stool, a possible sign of gastritis.
Diagnostic Tests:
Extraction of gastric mucosal sample(biopsy) via endoscopy.
What Is the Treatment for Gastritis?
Treatment for gastritis usually involves:
Taking antacids and other drugs (such as proton pump inhibitors or H-2 blockers) to reduce stomach acid
Avoiding hot and spicy foods
For gastritis caused by H. pylori infection, your doctor will prescribe a regimen of several antibiotics plus an acid blocking drug (used for heartburn)
If the gastritis is caused by pernicious anemia, B12 vitamin shots will be given.
Eliminating irritating foods from your diet such as lactose from dairy or gluten from wheat
Once the underlying problem disappears, the gastritis usually does, too.
You should talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
Gastritis is inflammation of the stomach lining, which may last for a short or long time. Treatment usually addresses the underlying cause, such as medications, stress, or handwashing practices.
Gastritis is a term that describes episodes of nausea and vomiting after eating. It occurs when the mucosa or stomach lining is inflamed, causing heartburn or bloating. However, people who get gastritis may not develop any symptoms regardless of the underlying cause — bacterial or otherwise.
There are two typesTrusted Source of gastritis:
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Definition
Gastritis Describes A Group Of Conditions With One Thing In Common: Inflammation
Of The Lining Of The Stomach. The Inflammation Of Gastritis Is Most Often The Result
Of Infection With The Same Bacterium That Causes Most Stomach Ulcers. Injury,
Regular Use Of Certain Pain Relievers And Drinking Too Much Alcohol Also Can
Contribute To Gastritis.
Gastritis May Occur Suddenly (Acute Gastritis), Or It Can Occur Slowly Over Time
(Chronic Gastritis). In Some Cases, Gastritis Can Lead To Ulcers And An Increased
Risk Of Stomach Cancer. For Most People, However, Gastritis Isn't Serious And
Improves Quickly With Treatment.
4. Symptoms
The Signs And Symptoms Of Gastritis Include:
• Gnawing Or Burning Ache Or Pain (Indigestion) In Your Upper
Abdomen That May Become Either Worse Or Better With Eating
• Nausea
• Vomiting
• A Feeling Of Fullness In Your Upper Abdomen After Eating
Gastritis Doesn't Always Cause Signs And Symptoms.
5. Causes
Gastritis Is An Inflammation Of The Stomach Lining.
Weaknesses In The Mucus-lined Barrier That Protects Your
Stomach Wall Allow Your Digestive Juices To Damage And
Inflame Your Stomach Lining. A Number Of Diseases And
Conditions Can Increase Your Risk Of Gastritis.
Gastritis Can Develop Suddenly (Acute Gastritis) Or
Gradually And Last For An Extended Period (Chronic
6. Risk factors
Bacterial infection
Regular use of pain relievers.
Older age.
Excessive alcohol use.
Stress.
Your own body attacking cells in your stomach.
Other diseases and conditions.
7. Complications
Left Untreated, Gastritis May Lead To Stomach Ulcers And Stomach
Bleeding. Rarely, Some Forms Of Chronic Gastritis May Increase Your
Risk Of Stomach Cancer, Especially If You Have Extensive Thinning Of
The Stomach Lining And Changes In The Lining's Cells
8. Tests and diagnosis
Tests For H. Pylori
Using A Scope To Examine Your Upper Digestive System
(Endoscopy).
X-ray Of Your Upper Digestive System.
9. Treatments and drugs
Treatment Of Gastritis Depends On The Specific Cause. Acute Gastritis
Caused By Nonsteroidal Anti-inflammatory Drugs Or Alcohol May Be
Relieved By Stopping Use Of Those Substances. Chronic Gastritis
Caused By H. Pylori Infection Is Treated With Antibiotics.
In Most Cases, You Also Take Medications That Treat Stomach Acid To
Reduce Your Signs And Symptoms And Promote Healing In Your
Stomach.
10. Medications used to treat gastritis include :
Antibiotic Medications To Kill H. Pylori. For H. Pylori In Your Digestive Tract, Your Doctor May
Recommend A Combination Of Antibiotics, Such As Clarithromycin (Biaxin) And Amoxicillin Or
Metronidazole (Flagyl), To Kill The Bacterium. Be Sure To Take The Full Antibiotic Prescription, Usually For
10 To 14 Days
Medications To Reduce Acid Production. Example : Ranitidine , Cimetidine
Medications That Block Acid Production And Promote Healing. These Drugs Include
The Prescription And Over-the-counter Medications Omeprazole (Prilosec), Lansoprazole
(Prevacid), Rabeprazole (Aciphex), Esomeprazole (Nexium), Dexlansoprazole (Dexilant)
And Pantoprazole (Protonix).
Antacids That Neutralize Stomach Acid.
11. References
Dickson BA, et al. Classification and diagnosis of gastritis and gastropathy.
http://www.uptodate.com/home. Accessed Nov. 3, 2013.
American College of Gastroenterology guideline on the management of Helicobacter pylori infection.
Bethesda, Md.: American College of Gastroenterology. http://gi.org/guideline/management-of-
helicobacter-pylori-infection. Accessed Nov. 3, 2013.
Gastritis. National Institute of Diabetes and Digestive and Kidney Diseases.
http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis/index.htm. Accessed Nov. 3, 2013.
Guidelines for the management of dyspepsia. Bethesda, Md.: American College of Gastroenterology.
http://gi.org/guideline/management-of-dyspepsia/. Accessed Nov. 3, 2013.
Jensen PJ, et al. Acute and chronic gastritis due to Helicobacter pylori.
http://www.uptodate.com/home. Accessed Nov. 3, 2013.
H. pylori and peptic ulcers. National Institute of Diabetes and Digestive and Kidney Diseases.
http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm. Accessed Nov. 3, 2013.
Mapel D, et al. The epidemiology, diagnosis, and cost of dyspepsia and Helicobacter pylori gastritis: A
case-control analysis in the southwestern United States. Helicobacter. 2013;18:54.
FDA drug safety communication: Possible increased risk of fractures of the hip, wrist and spine with the
use of proton pump inhibitors. U.S. Food and Drug Administration.
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm2
13206.htm. Accessed Nov. 3, 2013.