Search

Your search keyword '"Locke, G. Richard"' showing total 530 results
Start Over Author "Locke, G. Richard"
530 results on '"Locke, G. Richard"'

74. Do published guidelines for evaluation of Irritable Bowel Syndrome reflect practice?

Author

Bertram Susan L, Wollan Peter C, Locke G Richard, Lydick Eva, Yawn Barbara P, and Kurland Margary J

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Abstract Background The only US guidelines listed in the National Guideline Warehouse for the diagnosis of Irritable Bowel Syndrome (IBS) are the expert opinion guidelines published by The American Gastroenterology Association. Although the listed target audience of these guidelines includes family physicians and general internists, the care recommended in the guidelines has not been compared to actual primary care practice. This study was designed to compare expert opinion guidelines with the actual primary care provided and to assess outcomes in the 3 years following the IBS diagnosis. Methods This is a retrospective medical record review study using a random sample of incident IBS cases from all Olmsted County, Minnesota providers diagnosed between January 1, 1993 and December 31, 1995. Data was collected on all care and testing provided to the subjects as well as 3-year outcomes related to the IBS diagnosis. Results Of the 149 IBS patients, 99 were women and the mean age was 47.6 years. No patient had all of the diagnostic tests recommended in the guidelines. 42% had the basic blood tests of CBC and a chemistry panel. Sedimentation rate (2%) and serum thyroxine level (3%) were uncommon. Colon imaging studies were done in 41% including 74% of those over the age of 50. In the 3 years following the diagnosis, only one person had a change in diagnosis and no diagnoses of gastro-intestinal malignancies were made in the cohort. Conclusions Primary care practice based diagnostic evaluations for IBS differ significantly from the specialty expert opinion-based guidelines. Implementation of the specialty guidelines in primary care practice would increase utilization with apparent limited improvement in diagnostic outcomes.

Published
2001
Full Text
View/download PDF

76. Development and Validation of a Symptom-Based Activity Index for Adults With Eosinophilic Esophagitis

Author

Leung, John, Locke, G. Richard, Drouin, Eric, Gonsalves, Nirmala, Spergel, Jonathan M., Wu, Tsung Teh, Alexander, Jeffrey A., Yang, Guang Yu, Chehade, Mirna, Maurer, Elisabeth, Dellon, Evan S., Aceves, Seema S., Butterfield, Joseph H., Krishna, Murli, Hirano, Ikuo, Crowell, Michael D., Gupta, Sandeep K., Straumann, Alex, Netzer, Peter, Zwahlen, Marcel, Armstrong, David, Kita, Hirohito, Kern, Emily, Taft, Tiffany H., Orbelo, Diana M., Yost, Kathleen J., De Petris, Giovanni, Katzka, David A., DeVault, Kenneth R., Lim, Kaiser, Ramirez, Francisco C., Lewis, John C., Guyatt, Gordon H., Moawad, Fouad J., Haas, Nadine A., Francis, Dawn L., Arora, Amindra S., Safroneeva, Ekaterina, Woosley, John T., Panczak, Radoslaw, Foxx-Orenstein, Amy, Enders, Felicity T., Harris, Lucinda A., Nguyen, Cuong C., Kagalwalla, Amir F., Murray, Joseph A., Achem, Sami R., Furuta, Glenn T., Lee, James J., Enav, Benjamin, Bussmann, Christian, Schoepfer, Alain M., Pasha, Shabana F., Sheikh, Javed, Collins, Margaret H., Romero, Yvonne, Fleischer, David E., Smyrk, Thomas C., Wo, John M., Attwood, Stephen E., Coslovsky, Michael, Yan, Pu, Alpan, Oral, Umar, Sarah B., Kuehni, Claudia E., and Weiler, Catherine R.

Abstract

Standardized instruments are needed to assess the activity of eosinophilic esophagitis (EoE), to provide endpoints for clinical trials and observational studies. We aimed to develop and validate a patient-reported outcome (PRO) instrument and score, based on items that could account for variations in patients’ assessments of disease severity. We also evaluated relationships between patients’ assessment of disease severity and EoE-associated endoscopic, histologic, and laboratory findings.

Published
2014
Full Text
View/download PDF

77. Overlap of dyspepsia and gastroesophageal reflux in the general population: one disease or distinct entities?

Author

Choung, Rok Seon, Locke, G. Richard, Schleck, Cathy D., Zinsmeister, Alan R., and Talley, Nicholas J.

Subjects
Adult, Male, Minnesota, Comorbidity, Middle Aged, Article, Cohort Studies, Risk Factors, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Gastroesophageal Reflux, Humans, Female, Dyspepsia, Aged
Abstract

The overlap of dyspepsia and gastroesophageal reflux (GER) is known to be frequent, but whether the overlap group is a distinct entity or not remains unclear. The aims of the study was to evaluate whether the overlap of dyspepsia and GER (dyspepsia-GER overlap) occurs more than expected due to chance alone, and evaluate the risk factors for dyspepsia-GER overlap.In 2008 and 2009, a validated Bowel Disease Questionnaire was mailed to a total of 8006 community sample from Olmsted County, MN. Overall, 3831 of the 8006 subjects returned surveys (response rate 48%). Dyspepsia was defined by symptom criteria of Rome III; GER was defined by weekly or more frequent heartburn and/or acid regurgitation.Dyspepsia and GER occurred together more commonly than expected by chance. The somatic symptom checklist score was significantly associated with dyspepsia-GER overlap vs GER alone or dyspepsia alone [OR = 1.9 (1.4, 2.5), and 1.6 (1.2, 2.1), respectively]. Insomnia was also significantly associated with dyspepsia-GER overlap vs. GER alone or dyspepsia alone [OR = 1.4 (1.1, 1.7), OR = 1.3 (1.1, 1.6), respectively]. Moreover, proton pump inhibitor use was significantly associated with dyspepsia-GER overlap vs dyspepsia alone [OR = 2.4 (1.5, 3.8)].Dyspepsia-GER overlap is common in the population and is greater than expected by chance.

Published
2011

78. Longitudinal Direct Medical Costs Associated with Constipation in Women

Author

Choung, Rok Seon, Branda, Megan E., Chitkara, Denesh, Shah, Nilay, Katusic, Slavica K., Locke, G. Richard, and Talley, Nicholas J.

Subjects
Adult, Socioeconomic Factors, Case-Control Studies, Minnesota, Humans, Female, Health Care Costs, Longitudinal Studies, Constipation, Article, Follow-Up Studies
Abstract

Although direct medical costs for constipation-related medical visits are thought to be high, to date, there have been no studies examining longitudinal resource utilisation in adults with constipation.To estimate the incremental direct medical costs associated with constipation in women.This is a nested case-control study. The study population consisted of all mothers of 5718 children in the population-based birth cohort born during 1976-1982 in a community. The cases presented to the medical facilities with constipation. The controls were randomly selected and matched to cases in a 2:1 ratio. Direct medical costs for constipated women and controls were collected for the years 1987-2002.We identified 168 women with a diagnosis of constipation. The total direct medical costs over the 15-year period for constipated subjects were more than double those of controls [$63 591 (95% CI: 49 786-81 396) vs. $24 529 (95% CI: 20 667-29 260)]. The overall out-patient costs for constipated women were $38 897 (95% CI: 31 381-48 253) compared to $15 110 (95% CI: 12 904-17 781) for controls. The median of annual out-patient visits for constipated women was 0.16 compared to 0.11 for controls.Women with constipation have significantly higher medical care utilisation and expenditures compared with women without constipation.

Published
2010

81. Risk Factors Associated with Symptoms of Gastroesophageal Reflux

Author

Locke, G. Richard III, Talley, Nicholas J., Fett, Sara L., Zinsmeister, Alan R., and Melton, L. Joseph III

Subjects
Gastroesophageal reflux -- Risk factors, Health, Health care industry
Abstract

BACKGROUND: Although patients with gastroesophageal reflux are often instructed to change their lifestyle, population-based data on the risk factors for reflux in the United States are lacking. METHODS: We performed a cross-sectional study in an age-and gender-stratified random sample of the population of Olmsted County, Minnesota. Residents aged 25 to 74 years were mailed a valid self-report questionnaire that measured reflux symptoms and potential risk factors. Logistic regression was used to estimate the odds ratios (OR) with 95% confidence intervals (CI) for reflux symptoms (heartburn or acid regurgitation) associated with potential risk factors. RESULTS: Overall, 1,524 (72%) of 2,118 eligible subjects responded. A body mass index [is greater than] 30 kg/m2 (OR = 2.8; CI, 1.7 to 4.5), reporting an immediate family member with heartburn or disease of the esophagus or stomach (OR = 2.6; CI, 1.8 to 3.7), a past history of smoking (OR = 1.6; CI, 1.1 to 2.3), consuming more than seven drinks per week (OR = 1.9; CI, 1.1 to 3.3), and a higher psychosomatic symptom checklist score (OR per 5 units = 1.4; CI, 1.3 to 1.6) were independently associated with frequent (at least weekly) reflux symptoms. CONCLUSION: Obesity is a strong risk factor for gastroesophageal reflux, although the value of weight reduction remains to be proven. That family history was also a risk factor suggests that there may be a genetic component to the disorder. Am J Med. 1999;106:642-649. [C]1999 by Excerpta Medica, Inc.

Published
1999

89. Reply

Author

Bharucha, Adil E., primary, Locke, G. Richard, additional, and Pemberton, John H., additional

Published
2013
Full Text
View/download PDF

90. Outcomes of Ultrasound-Guided Trigger Point Injection for Abdominal Wall Pain.

Author

Alnahhas, Mhd, Oxentenko, Shawn, Locke, G., Hansel, Stephanie, Schleck, Cathy, Zinsmeister, Alan, Farrugia, Gianrico, Grover, Madhusudan, Alnahhas, Mhd Firas, Oxentenko, Shawn C, Locke, G Richard 3rd, Schleck, Cathy D, and Zinsmeister, Alan R

Subjects
ABDOMINAL wall, ULTRASONIC imaging, ABDOMINAL pain, HEALTH outcome assessment, INJECTIONS, DISEASES, ABDOMEN, HUMAN body, LIDOCAINE, STEROIDS, RETROSPECTIVE studies, METHYLPREDNISOLONE, BUPIVACAINE, PHARMACODYNAMICS
Abstract

Background: Abdominal wall pain (AWP) is an important cause of chronic abdominal pain. History and physical examination are critical to the diagnosis of AWP. Trigger point injection (TPI) using either a steroid or a local anesthetic or a combination of both is often used to treat AWP.Aim: To determine the efficacy of ultrasound-guided TPI and to determine the predictors of a successful response.Methods: Patients who received ultrasound-guided TPI between July 2010 and June 2011 were surveyed. The primary outcome was determined using the Treatment Efficacy Questionnaire (TEQ). Electronic medical records were reviewed to determine patient, pain and TPI characteristics. Linear regression was used to determine the predictors of a successful response on the TEQ.Results: Right upper quadrant was the most common site of AWP, and the median pain duration was 12 months. Pain was rated as >8 (1-10 scale) by 57 % and 30 % described it as an ache. Narcotic use was reported in 38 %, and 73 % had a history of at least one abdominal surgery. Forty-four of the 120 (37 %) patients met the criteria for responder on the TEQ. Compared to before treatment, 36 % reported being "significantly better" and 22 % "slightly better." Multiple linear regression analysis showed that higher somatization negatively predicted response. None of the other historical, examination or TPI characteristics were associated with response to the TPI.Conclusion: TPI can provide significant, long-term symptom relief in a third of patients with chronic abdominal pain attributed to AWP. Somatization was inversely related to the treatment success. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

93. Polymorphisms of 5-HTT LPR and GNß3 825C>T and Response to Antidepressant Treatment in Functional Dyspepsia: A Study from The Functional Dyspepsia Treatment Trial

Author

Saito, Yuri A, Locke, G Richard, Almazar, Ann E, Bouras, Ernest P, Howden, Colin W, Lacy, Brian E, DiBaise, John K, Prather, Charlene M, Abraham, Bincy P, El-Serag, Hashem B, Moayyedi, Paul, Herrick, Linda M, Szarka, Lawrence A, Camilleri, Michael, Hamilton, Frank A, Schleck, Cathy D, Tilkes, Katherine E, Zinsmeister, Alan R, and Talley, Nicholas J

Abstract

Objectives:The Functional Dyspepsia Treatment Trial reported that amitriptyline (AMI) was associated with adequate relief of functional dyspepsia (FD) symptoms, but the pharmacogenetics of antidepressant response in FD are not known. GNß3 825C>T CC genotype has been previously linked to FD and TT genotype to antidepressant response in depression. The ss genotype of the 5-HTT LPR variant of the serotonin transporter gene (SLC6A4) has been linked to selective serotonin reuptake inhibitor (SSRI) response. We aimed to examine whether GNß3 825C>T and 5-HTT LPR polymorphisms result in differential treatment effects in FD patients receiving antidepressant therapy.Methods:Participants were randomized to receive placebo, 50?mg AMI, or 10?mg escitalopram (ESC). The primary end point was adequate relief for =5 weeks of the last 10 weeks. Genotyping of GNß3 825C>T and 5-HTT LPR was performed utilizing PCR-based methods.Results:GNß3 825C>T and 5-HTT LPR genotype data were available for 256 (88%) and 246 (84%) patients, respectively. Both polymorphisms were in Hardy–Weinberg equilibrium. In tests for differential treatment, neither 5-HTT LPR nor GNß3 825C>T genotype influenced response to therapy (P=0.89 and P=0.54, respectively). Although there was a tendency for a more favorable response to ESC in the SS/LS genotype compared to the LL genotype groups (40% vs. 31% reporting adequate relief of FD symptoms) among those in the ESC treatment arm, this was not significant (P=0.43).Conclusions:GNß3 825C>T and 5-HTT LPR genetic variants do not alter treatment response to tricyclic and SSRI antidepressants in FD.

Published
2017
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results