Hemorragias de vías digestivas altas asociada a helicobacter pylori en Barranquilla (Atl, Co) entre los años 2021 a 2023

datacite.rightshttp://purl.org/coar/access_right/c_f1cf
dc.contributor.advisorCadena Bonfanti, Andrés Angelo
dc.contributor.advisorGonzález Torres, Henry Joseth
dc.contributor.authorJiménez Lacouture, Carlos Andrés
dc.date.accessioned2024-07-15T22:32:59Z
dc.date.available2024-07-15T22:32:59Z
dc.date.issued2024
dc.description.abstractLas hemorragias de vías digestivas altas (HVDA) asociada con H. pilori son unaafección en la que se produce sangrado en cualquier parte del tubo digestivo. Puede ser visible a simple vista o detectarse mediante pruebas de laboratorio. Objetivo: Evaluar la incidencia de la hemorragia de vías digestivas altas asociada a Helicobacter pylori en una clínica de 4to nivel de complejidad en Barranquilla (Atl, CO) entre los años 2021 a 2023 Metodología: Se llevó a cabo un estudio retrospectivo en Magangué (Bol, CO). Se realizó un censo de los pacientes mayores de 18 años que llegaron a la sala de emergencias debido a HVDA. Se realizó estadística descriptiva, medidas de tendencia central para los datos cuantitativo y frecuencia y porcentaje para los cualitativos Se compararon las medianas entre los grupos (fallecidos vs sobrevivientes) en función del resultado. La significancia estadística fue de p < 0.05. El software estadístico R-CRAN versión 4.3.0. Resultados: El estudio examinó a 329 pacientes con HVDA, y se incluyeron en el análisis final a 44 (13%) pacientes con positividad de infección por H. pylori. Se observó una distribución similar de edad por género, con una mediana general de 60 años. Aunque no se encontraron diferencias significativas en la distribución de diagnósticos de ingreso entre hombres y mujeres, se identificó una mayor prevalencia de hipertensión arterial en hombres (45%) en comparación con mujeres (15%). La gastritis crónica (75%), y la UGI (23%) fueron los hallazgos patológicos más frecuentes. No hubo diferencia en la prevalencia de ACI, gastritis aguda/crónica y UGI entre masculinos y femeninas. Se observó una mayor prevalencia de hematemesis en femeninas comparado con masculinos (40% vs 24%), mientras que la melena fue más frecuente en masculinos (76% vs 60%) (p=0.3). Se observó que en general, la mayoría de las UGI se clasificaron como IIA (50%), seguido de la clasificación III (40%) y la clasificación IB (10%). No se observaron diferencias significativas en la estadificación entre mujeres y hombres (p>0.92). Este estudio subraya la importancia de comprender las características clínicas y patológicas de los pacientes con HVDA con infección por H. pylori, lo que podría contribuir a mejores estrategias de detección y tratamiento de esta patología. Conclusión: La identificación de patrones específicos en diferentes subgrupos de pacientes podría contribuir a mejorar las estrategias de detección, diagnóstico y tratamiento de esta patología en Barranquilla. La presencia de hipertensión arterial como comorbilidad significativa en hombres sugiere que el manejo integral de los pacientes con HVDA debe incluir un enfoque en el control de la presión arterial, especialmente en poblaciones de riesgo.spa
dc.description.abstractUpper gastrointestinal bleeding (UGIB) associated with H. pylori is a condition in which bleeding occurs anywhere in the digestive tract. It can be visible to the naked eye or detected through laboratory tests. Objective: To evaluate the incidence of upper gastrointestinal bleeding associated with Helicobacter pylori in a level 4 complexity clinic in Barranquilla (Atl, CO) between the years 2021 and 2023. Methodology: A retrospective study was conducted in Magangué (Bol, CO). A census was taken of patients over 18 years old who arrived at the emergency room due to UGIB. Descriptive statistics, measures of central tendency for quantitative data, and frequency and percentage for qualitative data were used. Medians were compared between groups (deceased vs. survivors) based on the outcome. Statistical significance was set at p < 0.05. The statistical software R-CRAN versión 4.3.0 was used. Results: The study examined 329 patients with UGIB, and 44 (13%) patients with positive H. pylori infection were included in the final analysis. A similar age distribution was observed by gender, with an overall median age of 60 years. Although no significant differences were found in the distribution of admission diagnoses between men and women, a higher prevalence of arterial hypertension was identified in men (45%) compared to women (15%). Chronic gastritis (75%), and UGI (23%) were the most frequent pathological findings. There was no difference in the prevalence of acute myocardial infarction, acute/chronic gastritis, and UGI between males and females. A higher prevalence of hematemesis was observed in females compared to males (40% vs 24%), while melena was more frequent in males (76% vs 60%) (p=0.3). It was observed that in general, the majority of the UGIs were classified as IIA (50%), followed by classification III (40%) and classification IB (10%). No significant differences were observed in the staging between women and men (p>0.92). This study underscores the importance of understanding the clinical and pathological characteristics of patients with UGIB with H. pylori infection, which could contribute to better detection and treatment strategies for this pathology. Conclusion: The identification of specific patterns in different patient subgroups could contribute to improving detection, diagnosis, and treatment strategies for this pathology in Barranquilla. The presence of arterial hypertension as a significant comorbidity in men suggests that comprehensive management of patients with UGIB should include a focus on blood pressure control, especially in at-risk populations.eng
dc.format.mimetypepdf
dc.identifier.urihttps://hdl.handle.net/20.500.12442/14842
dc.language.isospa
dc.publisherEdiciones Universidad Simón Bolívarspa
dc.publisherFacultad Ciencias de la Saludspa
dc.rights.accessrightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectHemorragia de vías digestivas altasspa
dc.subjectHospitalizaciónspa
dc.subjectEstancia hospitalariaspa
dc.subjectMortalidadspa
dc.subjectGastroenterologíaspa
dc.subject.keywordsUpper gastrointestinal bleedingeng
dc.subject.keywordsHospitalizationeng
dc.subject.keywordsHospital stayeng
dc.subject.keywordsMortalityeng
dc.subject.keywordsGastroenterologyeng
dc.titleHemorragias de vías digestivas altas asociada a helicobacter pylori en Barranquilla (Atl, Co) entre los años 2021 a 2023spa
dc.type.driverinfo:eu-repo/semantics/other
dc.type.spaOtros
dcterms.referencesGargallo C, García PA, Gomollón F. Infección por Helicobacter pylori. Medicine (Baltimore). 2012;11(2):90–6.spa
dcterms.referencesBurbano LMM, Yusunguaira MVB, Burbano CM, Sierra DS, Isaías H. Causas más frecuentes de Hemorragia en Tubo Digestivo Alto de origen no variceal en paciente mayor de 50 años en Colombia. Rev Navarra Médica. 2018;4(2):14–21.spa
dcterms.referencesBloom N, Reenen J Van. NBER Work Pap. 2013;89.eng
dcterms.referencesElghuel A. The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis. Libyan J Med. 2011 Mar;6.eng
dcterms.referencesColombiana R. Gastroenterología. 2018;7440(2).spa
dcterms.referencesHernández R. Enfermería Global FACTORES DE RIESGO QUE INCREMENTAN LA MORBIMORTALIDAD EN PACIENTES CON HEMORRAGIA DIGESTIVA ALTA RISK FACTORS THAT INCREASE MORBI-MORTALITY IN GASTROINTESTINAL BLEEDING. 2011;1–18.spa
dcterms.referencesMartinez Salinas GA, Figueroa Navarro PP, Toro Perez JI, García Carrasco C, Csendes Juhasz A. Conducta actual frente a la Hemorragia Digestiva Alta: Desde el diagnóstico al tratamiento. Rev Cir (Mex) [Internet]. 2021 Nov 30;73(6). Available from: https://revistacirugia.cl/index.php/revistacirugia/article/view/1132spa
dcterms.referencesCortés P. Clasificación de Forrest. Gastroenterol latinoam No. 2010;21(1):59–62.spa
dcterms.referencesClinic M. Infección por Helicobacter pylori ( H . pylori ) Descripción general Síntomas Causas. :10–3.eng
dcterms.referencesPajares García JM, Pajares-Villarroya R, Gisbert JP. Helicobacter pylori: Resistencia a los antibióticos. Rev Esp Enfermedades Dig. 2007;99(2):63–70.spa
dcterms.referencesDiGregorio AM, Alvey H. Gastrointestinal Bleeding. StatPearls. 2023.spa
dcterms.referencesBrooks J, Warburton R, Beales ILP. Prevention of upper gastrointestinal haemorrhage: current controversies and clinical guidance. Ther Adv Chronic Dis. 2013 Sep;4(5):206–22.eng
dcterms.referencesAlonso Aguirre P. Hemorragia digestiva alta no varicosa. Rev Española Enfermedades Dig. 2014 Jan;106(1):63–63.spa
dcterms.referencesKim BSM, Li BT, Engel A, Samra JS, Clarke S, Norton ID, et al. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol. 2014 Nov;5(4):467–78.eng
dcterms.referencesChaikitamnuaychok R, Patumanond J. Upper Gastrointestinal Hemorrhage: Development of the Severity Score. Gastroenterol Res. 2012 Dec;5(6):219–26.eng
dcterms.referencesCampuzano-Maya G. Hematologic manifestations of Helicobacter pylori infection. World J Gastroenterol. 2014 Sep;20(36):12818–38.eng
dcterms.referencesDunn BE. Pathogenic mechanisms of Helicobacter pylori. Gastroenterol Clin North Am. 1993 Mar;22(1):43–57.eng
dcterms.referencesKusters JG, van Vliet AHM, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006 Jul;19(3):449–90.eng
dcterms.referencesTorres Jiménez F, Torres Bayona C. Molecular pathophysiology in infection by Helicobacter pylori. Salud Uninorte. 2021 Aug;32(3):500–12.eng
dcterms.referencesOluwole FS. Helicobacter pylori: a pathogenic threat to the gastric mucosal barrier. Afr J Med Med Sci. 2015 Dec;44(4):289–96.eng
dcterms.referencesChen XQ, Zhang WD, Jiang B, Song YG, Reng RZ, Zhou DY. Reduced secretion of epidermal growth factor in duodenal ulcer patients with Helicobacter pylori infection. World J Gastroenterol. 2011;3(1):31.eng
dcterms.referencesLee MG, Barrow KO, Edwards CN. Helicobacter pylori infection in the Caribbean: update in management. West Indian Med J. 2001 Mar;50(1):8–10.eng
dcterms.referencesBorka Balas R, Meliț LE, Mărginean CO. Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children. Children. 2022 Sep;9(9):1359.eng
dcterms.referencesCurado MP, de Oliveira MM, de Araújo Fagundes M. Prevalence of Helicobacter pylori infection in Latin America and the Caribbean populations: A systematic review and meta-analysis. Cancer Epidemiol. 2019 Jun;60:141–8.eng
dcterms.referencesPilotto A, Leandro G, Di Mario F, Franceschi M, Bozzola L, Valerio G. Role of Helicobacter pylori infection on upper gastrointestinal bleeding in the elderly: a casecontrol study. Dig Dis Sci. 1997 Mar;42(3):586–91.eng
dcterms.referencesCary P. Helicobacter pylori. CMAJ. 1998;158(7):869.eng
dcterms.referencesBaena Diez JM, Garcí;a Lareo M, Martí Fernández J, Leon Marin I, Muniz Llama D, Teruel Gila J, et al. Prevalencia de la infección por Helicobacter pylori en atención primaria: Estudio seroepidemiológico. Aten Primaria. 2002;29(9):553–7.eng
dcterms.referencesElshair M, Ugai T, Oze I, Kasugai Y, Koyanagi YN, Hara K, et al. Impact of socioeconomic status and sibling number on the prevalence of Helicobacter pylori infection: a cross-sectional study in a Japanese population. Nagoya J Med Sci. 2022 May;84(2):374–87.eng
dcterms.referencesNabavi-Rad A, Azizi M, Jamshidizadeh S, Sadeghi A, Aghdaei HA, Yadegar A, et al. The Effects of Vitamins and Micronutrients on Helicobacter pylori Pathogenicity, Survival, and Eradication: A Crosstalk between Micronutrients and Immune System. J Immunol Res. 2022;2022:4713684.eng
dcterms.referencesWeng CY, Xu JL, Sun SP, Wang KJ, Lv B. Helicobacter pylori eradication: Exploring its impacts on the gastric mucosa. World J Gastroenterol. 2021 Aug;27(31):5152–70.eng
dcterms.referencesWang YK, Li C, Zhou YM, Zeng L, Li YY, Huang SL, et al. Histopathological Features of Helicobacter pylori Infection in Gastric Mucosa. J Inflamm Res. 2022 Nov;Volume 15:6231–43.eng
dcterms.referencesXu W, Xu L, Xu C. Relationship between Helicobacter pylori infection and gastrointestinal microecology. Front Cell Infect Microbiol. 2022 Aug;12.eng
dcterms.referencesWilkins T, Wheeler B, Carpenter M. Upper gastrointestinal bleeding in adults: Evaluation and management. Am Fam Physician. 2020;101(5):294–300.eng
dcterms.referencesAntunes C, Copelin II EL. Upper Gastrointestinal Bleeding. StatPearls. 2023.eng
dcterms.referencesVillanueva Herrero JA, Abdussalam A, Kasi A. Rectal Exam. StatPearls. 2023.eng
dcterms.referencesJaben I, Sasso R, Rockey DC. Hemoglobin Monitoring in Acute Gastrointestinal Bleeding: Are We Monitoring Blood Counts Too Frequently? Am J Med. 2021 May;134(5):682–7.eng
dcterms.referencesJohn R Saltzman, MD, FACP, FACG, FASGE A. Approach to acute upper gastrointestinal bleeding in adults. Mark Feldman, MD, MACP, AGAF, FACG. 2023eng
dcterms.referencesGrady E. Gastrointestinal bleeDing scintigraphy in the early 21st century. J Nucl Med. 2016;57(2):252–9.eng
dcterms.referencesOrpen-Palmer J, Stanley AJ. A Review of Risk Scores within Upper Gastrointestinal Bleeding. J Clin Med. 2023 May;12(11).eng
dcterms.referencesGuillermo Martínez S, Pedro Figueroa N, Javier Toro P, Carlos García C, Attila Csendes J. Current behavior against upper digestive hemorrhage: From diagnosis to treatment. Rev Cir (Mex). 2021;73(6):728–43.eng
dcterms.referencesDos Santos AA, Carvalho AA. Pharmacological therapy used in the elimination of Helicobacter pylori infection: a review. World J Gastroenterol. 2015 Jan;21(1):139–54.eng
dcterms.referencesLiou TC, Lin SC, Wang HY, Chang WH. Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleeding. World J Gastroenterol. 2006 May;12(19):3108–13.eng
dcterms.referencesJung K, Moon W. Role of endoscopy in acute gastrointestinal bleeding in real clinical practice: An evidence-based review. World J Gastrointest Endosc. 2019 Feb;11(2):68–83.eng
dcterms.referencesSeeras K, Qasawa RN, Prakash S. Truncal Vagotomy. StatPearls. 2023.eng
dcterms.referencesManning-Dimmitt LL, Dimmitt SG, Wilson GR. Diagnosis of gastrointestinal bleeding in adults. Am Fam Physician. 2005;71(7):1339–46.eng
dcterms.referencesObeidat M, Teutsch B, Rancz A, Tari E, Márta K, Veres DS, et al. One in four patients with gastrointestinal bleeding develops shock or hemodynamic instability: A systematic review and meta-analysis. World J Gastroenterol. 2023 Jul;29(28):4466– 80.eng
dcterms.referencesNarayanan M, Reddy KM, Marsicano E. Peptic Ulcer Disease and Helicobacter pylori infection. Mo Med. 2018;115(3):219–24.eng
dcterms.referencesPino T. RH, Montealegre Losada A, Sanabria García D, Cortes Serrato A. Hemorragia de vías digestivas altas de urgencia en el HUN: correlación clínicoendoscópica. RFS Rev Fac Salud. 2010;2(2):55–60.eng
dcterms.referencesLi B, Chen J, Zhang CQ, Wang GC, Hu JH, Luo JJ, et al. The pharmacodynamic effect of terlipressin versus high-dose octreotide in reducing hepatic venous pressure gradient: a randomized controlled trial. Ann Transl Med. 2021;9(9):793–793.eng
dcterms.referencesLoperfido S, Nieri A. [Blood transfusions in hemorrhage of the upper digestive tract]. Minerva Chir. 1989 Oct;44(19):2073–6.eng
dcterms.referencesHébuterne X, Vanbiervliet G. Feeding the patients with upper gastrointestinal bleeding. Curr Opin Clin Nutr Metab Care. 2011 Mar;14(2):197–201.eng
dcterms.referencesFikree A, Byrne P. Management of functional gastrointestinal disorders. Clin Med. 2021 Jan;21(1):44–52.eng
dcterms.referencesZoricić I, Vukusić D, Rasić Z, Crvenković D, Lojo N, Sever M. [A contribution to surgical treatment of gastric and duodenal ulcer hemorrhage in critically unstable patients]. Acta Med Croatica. 2010 Mar;64(1):51–4.eng
dcterms.referencesLabenz J, Peitz U, Köhl H, Kaiser J, Malfertheiner P, Hackelsberger A, et al. Helicobacter pylori increases the risk of peptic ulcer bleeding: a case-control study. Ital J Gastroenterol Hepatol. 1999 Mar;31(2):110–5.eng
dcterms.referencesLabenz J, Börsch G. Role of Helicobacter pylori Eradication in the Prevention of Peptic Ulcer Bleeding Relapse. Digestion. 1994;55(1):19–23.eng
dcterms.referencesThirupathaiah K, Jayapal L, Amaranathan A, Vijayakumar C, Goneppanavar M, Nelamangala Ramakrishnaiah VP. The Association Between Helicobacter Pylori and Perforated Gastroduodenal Ulcer. Cureus. 2020 Mar;12(3):e7406.eng
dcterms.referencesMouly C, Chati R, Scotté M, Regimbeau JM. Therapeutic management of perforated gastro-duodenal ulcer: Literature review. J Visc Surg. 2013 Nov;150(5):333–40.eng
dcterms.referencesKoop AH, Palmer WC, Stancampiano FF. Gastric outlet obstruction: A red flag, potentially manageable. Cleve Clin J Med. 2019 May;86(5):345–53.eng
dcterms.referencesÖztekin M, Yılmaz B, Ağagündüz D, Capasso R. Overview of Helicobacter pylori Infection: Clinical Features, Treatment, and Nutritional Aspects. Dis (Basel, Switzerland). 2021 Sep;9(4).eng
dcterms.referencesCagnoni M, Pagnini C, Crovaro M, Aucello A, Urgesi R, Pallotta L, et al. Evaluation of Accuracy and Feasibility of a New-Generation Ultra-Rapid Urease Test for Detection of Helicobacter pylori Infection. Gastrointest Disord. 2022 Aug;4(3):205–13.eng
dcterms.referencesIaniro G, Molina‐Infante J, Gasbarrini A. Gastric Microbiota. Helicobacter. 2015 Sep;20(S1):68–71.eng
dcterms.referencesZuluaga Arbelaez N, Sierra-Vargas EC, Guevara-Casallas LG, Pérez-Viana S. Estrategias terapéuticas para Helicobacter pylori en Colombia. CES Med. 2021;35(3):244–56.eng
dcterms.referencesGravina AG, Zagari RM, De Musis C, Romano L, Loguercio C, Romano M. Helicobacter pylori and extragastric diseases: A review. World J Gastroenterol. 2018 Aug;24(29):3204–21.eng
dcterms.referencesCardos AI, Maghiar A, Zaha DC, Pop O, Fritea L, Miere Groza F, et al. Evolution of Diagnostic Methods for Helicobacter pylori Infections: From Traditional Tests to High Technology, Advanced Sensitivity and Discrimination Tools. Diagnostics (Basel, Switzerland). 2022 Feb;12(2).eng
dcterms.referencesCorral JE, Mera R, Dye CW, Morgan DR. Helicobacter pylori recurrence after eradication in Latin America: Implications for gastric cancer prevention. World J Gastrointest Oncol. 2017 Apr;9(4):184–93.eng
dcterms.referencesHafiz TA, D’Sa JL, Zamzam S, Visbal Dionaldo ML, Aldawood E, Madkhali N, et al. The Effectiveness of an Educational Intervention on Helicobacter pylori for University Students: A Quasi-Experimental Study. J Multidiscip Healthc. 2023 Jul;Volume 16:1979–88.eng
dcterms.referencesOtero R. W, Trespalacios R. AA, Otero P. L, Vallejo O. MT, Torres Amaya M, Pardo R, et al. Guía de práctica clínica para el diagnóstico y tratamiento de la infección por Helicobacter pylori en adultos. Rev Colomb Gastroenterol. 2015;30:17–33.spa
dcterms.referencesYen HH, Wu PY, Wu TL, Huang SP, Chen YY, Chen MF, et al. Forrest Classification for Bleeding Peptic Ulcer: A New Look at the Old Endoscopic Classification. Diagnostics (Basel, Switzerland). 2022 Apr;12(5).eng
dcterms.referencesCardos IA, Zaha DC, Sindhu RK, Cavalu S. Revisiting Therapeutic Strategies for H. pylori Treatment in the Context of Antibiotic Resistance: Focus on Alternative and Complementary Therapies. Molecules. 2021 Oct;26(19).eng
dcterms.referencesPopa DG, Obleagă CV, Socea B, Serban D, Ciurea ME, Diaconescu M, et al. Role of Helicobacter pylori in the triggering and evolution of hemorrhagic gastroduodenal lesions. Exp Ther Med. 2021 Oct;22(4):1147.eng
dcterms.referencesJiang F, Guo CG, Cheung KS, Leung WK. Long-term risk of upper gastrointestinal bleeding after Helicobacter pylori eradication: a population-based cohort study. Aliment Pharmacol Ther. 2021 Nov;54(9):1162–9.eng
dcterms.referencesCoresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007 Nov;298(17):2038–47.eng
dcterms.referencesKovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022 Apr;12(1):7–11.eng
dcterms.referencesRivera H D, Martínez M JD, Tovar C JR, Garzón O MA, Hormaza A N, Lizarazo JI, et al. Original articles Characterization of patients with non-varicose upper GI bleeding at a Level. Rev Colomb Gastroenterol [Internet]. 2013;28(4):278– 85. Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120- 99572013000400002&lng=e&nrm=iso&tlng=es%0Ahttp://www.scielo.org.co/scielo. php?script=sci_abstract&pid=S0120- 99572013000400002&lng=e&nrm=iso&tlng=eseng
dcterms.referencesAntunes C, Copelin II EL. Upper Gastrointestinal Bleeding. StatPearls. 2024.eng
dcterms.referencesCherian MP, Mehta P, Kalyanpur TM, Hedgire SS, Narsinghpura KS. Arterial interventions in gastrointestinal bleeding. Semin Intervent Radiol. 2009 Sep;26(3):184–96.eng
dcterms.referencesDumic I, Nordin T, Jecmenica M, Stojkovic Lalosevic M, Milosavljevic T, Milovanovic T. Gastrointestinal Tract Disorders in Older Age. Can J Gastroenterol Hepatol. 2019;2019:6757524.eng
dcterms.referencesGhlichloo I, Gerriets V. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). StatPearls. 2023.eng
dcterms.referencesStrate LL, Singh P, Boylan MR, Piawah S, Cao Y, Chan AT. A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. PLoS One. 2016;11(11):e0165278.eng
dcterms.referencesAl-Azayzih A, Al-Azzam SI, Alzoubi KH, Jarab AS, Kharaba Z, Al-Rifai RH, et al. Nonsteroidal Anti-inflammatory Drugs Utilization Patterns and Risk of Adverse Events due to Drug-Drug Interactions among Elderly Patients: A Study from Jordan. Saudi Pharm J SPJ Off Publ Saudi Pharm Soc. 2020 Apr;28(4):504–8.eng
dcterms.referencesMarx G, Koens S, von dem Knesebeck O, Scherer M. Age and gender differences in diagnostic decision-making of early heart failure: results of a mixedmethods interview-study using video vignettes. BMJ Open. 2022 Mar;12(3):e054025.eng
dcterms.referencesGooren LJG. Diagnostic approach to the aging male. World J Urol. 2002 May;20(1):17–22.eng
dcterms.referencesSiebenhüner K, Blaser J, Nowak A, Cheetham M, Mueller BU, Battegay E, et al. Comorbidities Associated with Worse Outcomes Among Inpatients Admitted for Acute Gastrointestinal Bleeding. Dig Dis Sci. 2022 Aug;67(8):3938–47.eng
dcterms.referencesYadav RS, Bargujar P, Pahadiya HR, Yadav RK, Upadhyay J, Gupta A, et al. Acute Upper Gastrointestinal Bleeding in Hexagenerians or Older (≥60 Years) Versus Younger (<60 Years) Patients: Clinico-Endoscopic Profile and Outcome. Cureus. 2021 Feb;13(2):e13521.eng
dcterms.referencesDiGregorio AM, Alvey H. Gastrointestinal Bleeding. StatPearls. 2024.eng
dcterms.referencesDelgado BJ, Lopez-Ojeda W. Estrogen. StatPearls. 2024.eng
dcterms.referencesSankaran-Walters S, Macal M, Grishina I, Nagy L, Goulart L, Coolidge K, et al. Sex differences matter in the gut: effect on mucosal immune activation and inflammation. Biol Sex Differ. 2013 May;4(1):10.eng
dcterms.referencesCatano J, Sacleux SC, Gornet JM, Camus M, Bigé N, Saliba F, et al. Gastrointestinal bleeding in critically ill immunocompromised patients. Ann Intensive Care. 2021 Aug;11(1):130.eng
dcterms.referencesBitar SM, Moussa M. The risk factors for the recurrent upper gastrointestinal hemorrhage among acute peptic ulcer disease patients in Syria: A prospective cohort study. Ann Med Surg. 2022 Feb;74:103252.eng
dcterms.referencesSahn B, Mamula P, Friedlander JA. Gastrointestinal Hemorrhage. Pediatr Gastrointest Liver Dis Sixth Ed. 2020;125-134.e3.eng
dcterms.referencesTajima A, Koizumi K, Suzuki K, Higashi N, Takahashi M, Shimada T, et al. Proton pump inhibitors and recurrent bleeding in peptic ulcer disease. J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S237-41.eng
dcterms.referencesLehmann CJ, Pho MT, Pitrak D, Ridgway JP, Pettit NN. Community-acquired Coinfection in Coronavirus Disease 2019: A Retrospective Observational Experience. Clin Infect Dis [Internet]. 2020 Jul 1; Available from: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa902/5865452eng
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sb.programaEspecialización en Medicina Internaspa
sb.sedeSede Barranquillaspa

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