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Quan S, Frolkis A, Milne K, Molodecky N, Yang H, Dixon E, Ball CG, Myers RP, Ghosh S, Hilsden R, van Zanten SV, Kaplan GG. Upper-gastrointestinal bleeding secondary to peptic ulcer disease: Incidence and outcomes. World J Gastroenterol 2014; 20:17568-17577. [PMID: 25516672 PMCID: PMC4265619 DOI: 10.3748/wjg.v20.i46.17568] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/08/2014] [Accepted: 05/26/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).
METHODS: Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta, Canada from 2004 to 2010 (n = 7079) using the International Classification of Diseases Codes (ICD-10). A subset of the data was validated using endoscopy reports. Positive predictive value and sensitivity with 95% confidence intervals (CI) were calculated. Incidence of UGIB secondary to PUD was calculated. Logistic regression was used to evaluate surgery, in-hospital mortality, and 30-d readmission to hospital with recurrent UGIB secondary to PUD. Co-variants accounted for in our logistic regression model included: age, sex, area of residence (i.e., urban vs rural), number of Charlson comorbidities, presence of perforated PUD, undergoing upper endoscopy, year of admission, and interventional radiological attempt at controlling bleeding. A subgroup analysis (n = 6356) compared outcomes of patients with gastric ulcers to those with duodenal ulcers. Adjusted estimates are presented as odds ratios (OR) with 95%CI.
RESULTS: The positive predictive value and sensitivity of ICD-10 coding for UGIB secondary to PUD were 85.2% (95%CI: 80.2%-90.2%) and 77.1% (95%CI: 69.1%-85.2%), respectively. The annual incidence between 2004 and 2010 ranged from 35.4 to 41.2 per 100000. Overall risk of surgery, in-hospital mortality, and 30-d readmission to hospital for UGIB secondary to PUD were 4.3%, 8.5%, and 4.7%, respectively. Interventional radiology to control bleeding was performed in 0.6% of patients and 76% of these patients avoided surgical intervention. Thirty-day readmission significantly increased from 3.1% in 2004 to 5.2% in 2010 (OR = 1.07; 95%CI: 1.01-1.14). Rural residents (OR rural vs urban: 2.35; 95%CI: 1.83-3.01) and older individuals (OR ≥ 65 vs < 65: 1.57; 95%CI: 1.21-2.04) were at higher odds of being readmitted to hospital. Patients with duodenal ulcers had higher odds of dying (OR = 1.27; 95%CI: 1.05-1.53), requiring surgery (OR = 1.73; 95%CI: 1.34-2.23), and being readmitted to hospital (OR = 1.54; 95%CI: 1.19-1.99) when compared to gastric ulcers.
CONCLUSION: UGIB secondary to PUD, particularly duodenal ulcers, was associated with significant morbidity and mortality. Early readmissions increased over time and occurred more commonly in rural areas.
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Xie Y, Zhu Y, Zhou H, Lu ZF, Yang Z, Shu X, Guo XB, Fan HZ, Tang JH, Zeng XP, Wen JB, Li XQ, He XX, Ma JH, Liu DS, Huang CB, Xu NJ, Wang NR, Lu NH. Furazolidone-based triple and quadruple eradication therapy for Helicobacter pylori infection. World J Gastroenterol 2014; 20:11415-11421. [PMID: 25170230 PMCID: PMC4145784 DOI: 10.3748/wjg.v20.i32.11415] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 03/19/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy of furazolidone-based triple and quadruple therapy in eradicating Helicobacter pylori (H. pylori) in a multi-center randomized controlled trial.
METHODS: A total of 720 H. pylori positive patients with duodenal ulcer disease were enrolled at 10 different hospitals in Jiangxi province in China. The patients were randomly assigned to four treatment groups as follows: patients in Groups 1 and 3 received rabeprazole (10 mg), amoxicillin (1000 mg) and furazolidone (100 mg) twice daily for 7 and 10 d, respectively; patients in Groups 2 and 4 received rabeprazole (10 mg), bismuth (220 mg), amoxicillin (1000 mg) and furazolidone (100 mg) twice daily for 7 and 10 d, respectively. The primary outcome measure was H. pylori eradication rate 4 wk after treatment by intention-to-treat and per protocol analysis, while the secondary outcome measures were symptom and sign changes at the end of treatment and 4 wk after the end of treatment, as well as the proportion of patients who developed adverse events.
RESULTS: The demographic data of the four groups were not significantly different. Overall, 666 patients completed the scheme and were re-assessed with the 13C-urea breath test. The intention-to-treat analysis of the H. pylori eradication rates in Groups 1, 2, 3 and 4 were 74.44%, 82.78%, 78.89% and 86.11%, respectively. The H. pylori eradication rate in Group 4 was significantly higher than that in Group 1. According to the per protocol analysis, the H. pylori eradication rates in Groups 1, 2, 3 and 4 were 81.21%, 89.22%, 85.54% and 92.26%, respectively. The H. pylori eradication rate in Group 4 was significantly higher than that in Group 1. The number of adverse events was 15 (8.3%), 16 (8.9%), 15 (8.3%) and 17 (9.4%) in Groups 1, 2, 3 and 4, respectively, including dizziness, vomiting, diarrhea, nausea, skin rash, itchy skin, and malaise. The symptoms were relieved without special treatment in all of the patients.
CONCLUSION: Both 7- and 10-d quadruple furazolidone-based therapies achieve satisfactory H. pylori eradication rates.
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Graham DY. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer. World J Gastroenterol 2014; 20:5191-5204. [PMID: 24833849 PMCID: PMC4017034 DOI: 10.3748/wjg.v20.i18.5191] [Citation(s) in RCA: 200] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/28/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease” or for “Sippy” diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases.
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Ji XQ, Du JF, Chen G, Chen G, Yu B. Efficacy of ilaprazole in the treatment of duodenal ulcers: A meta-analysis. World J Gastroenterol 2014; 20:5119-5123. [PMID: 24803828 PMCID: PMC4009550 DOI: 10.3748/wjg.v20.i17.5119] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 03/10/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the efficacy and tolerance of ilaprazole compared with other proton pump inhibitors (PPIs) in the treatment of duodenal ulcer.
METHODS: An electronic database search of Medline, Embase, the Cochrane controlled trials register, Web of Science, PubMed, and the Chinese Biomedical Literature Database (updated to July 2013), and manual searches were conducted. A meta-analysis of randomized controlled trials comparing the efficacy and tolerance of ilaprazole and other PPIs in the treatment of duodenal ulcers was performed.
RESULTS: Five articles involving 1481 patients were included. The meta-analysis showed no difference in the 4-wk healing rate between ilaprazole and other PPIs [89.7% vs 87.0%; relative risk (RR) = 1.02; 95%CI: 0.98-1.06; Z = 1.00; P = 0.32]. The results did not change in the sensitivity analyses. The meta-analysis indicated that the adverse effect rate in the ilaprazole group was lower than that in the control group, but the difference was not significant (9.7% vs 13.0%; RR = 0.81; 95%CI: 0.60-1.07; Z = 1.47; P = 0.14).
CONCLUSION: Ilaprazole is a highly effective and safe PPI in the treatment of duodenal ulcers. Ilaprazole can be recommended as a therapy for acid-related disorders, especially in Asian populations.
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Kupsky D, Shivashankar R, Loftus CG. An unusual cause for melena. MINNESOTA MEDICINE 2014; 97:46. [PMID: 24941595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Fortinsky KJ, Stall NM, Barkun AN. A 77-year-old man with nonvariceal upper gastrointestinal bleeding. CMAJ 2014; 186:363-5. [PMID: 24396097 DOI: 10.1503/cmaj.131288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Gerada J, Bonello J, Borg JS, Mifsud A, Vassallo M. Upper gastrointestinal endoscopy for patients with simple dyspepsia: the jury is still out. MINERVA GASTROENTERO 2014; 60:102-103. [PMID: 24632773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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58
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Simonova ZG, Martusevich AK, Tarlovaskaia EI. [The course of coronary heart disease concurrent with peptic ulcer disease: clinical and pathogenetic aspects]. TERAPEVT ARKH 2014; 86:33-36. [PMID: 24754066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To make a comprehensive evaluation of the efficiency of eradication therapy in patients with coronary heart disease (CHD) concurrent with peptic ulcer disease (PUD). SUBJECTS AND METHODS The results of treatment were studied in 112 patients with CHD concurrent with PUD who were randomized into 3 groups: 1) adequate eradication therapy during treatment for CHD; 2) antisecretory therapy; 3) treatment for CHD only. The trend in the clinical symptoms of the diseases and the results of an exercise test were assessed. RESULTS After eradication therapy, Group 1 patients displayed a reduction in the frequency of angina attacks by 62.6% and weekly nitroglycerin needs by 70.4% and an increase in exercise tolerance by 45.3%. In Group 2 patients on antisecretory therapy, the similar indicators changed by 30.7, 21.2, and 26.5%, respectively. Group 3 patients showed no significant change in the study indicators. CONCLUSION The findings suggest that eradication therapy has a positive impact on the course of CHD, which manifests itself as an antianginal effect and hence a change in the clinical picture.
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Didigov MT, Durleshter VM, Kliuchnikov OI. [The method of duodenal bulb plasty in case of complicated chronic ulcer of back wall of the duodenal bulb]. Khirurgiia (Mosk) 2014:12-15. [PMID: 24816380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It was proposed the method of organ-preserving surgical treatment of chronic ulcers of back wall of duodenal bulb complicated by decompensated stenosis and penetration in intrapancreatic part of common bile duct (RF patent number 2476164 from 27.02.2013). 12 patients were operated by using of this technique. One patient had post-operative pancreatitis. There were not lethal outcomes.
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Etonyeaku AC, Agbakwuru EA, Akinkuolie AA, Omotola CA, Talabi AO, Onyia CU, Kolawole OA, Aladesuru OA. A review of the management of perforated duodenal ulcers at a tertiary hospital in south western Nigeria. Afr Health Sci 2013; 13:907-13. [PMID: 24940311 PMCID: PMC4056487 DOI: 10.4314/ahs.v13i4.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure. OBJECTIVE To determine the patterns of presentation and mode of management of duodenal ulcer perforations. METHODS Retrospective review of patients with duodenal ulcer perforations seen at the Obafemi Awolowo University Teaching Hospital between June 2001 and July 2011. Patients' records were reviewed for demography, duration of disease, probable risk factors, type of surgery and complications. Data obtained was analyzed using SPSS 15.0. RESULT Forty- five patients were reviewed. There were 37 males (82.2%). Mean age was 39.7years (range 15-78years). There were 10 (22.6%) students and 8(17.8%) farmers. NSAIDs abuse (11), previous peptic ulcer disease (2), and no prior dyspeptic symptoms (20) constituted 24.4%, 4.4% and 44.4% respectively of cases. Seven (16%) patients presented less than 24 hours of onset of illness. Forty one perforations (91.1%) involved the first part of duodenum. Twenty two (49%) patients had Graham's omental patch. We had one (2.2%) failed repair and six (13.3%) mortalities. CONCLUSION Late presentation of duodenal ulcer perforation is common with high mortality. Pragmatic surgical intervention with Graham's omentopexy with broad spectrum antibiotics is still commonly practiced.
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Yamanaka K, Miyatani H, Yoshida Y, Asabe S, Yoshida T, Nakano M, Obara S, Endo H. Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster. World J Gastroenterol 2013; 19:7426-7432. [PMID: 24259974 PMCID: PMC3831225 DOI: 10.3748/wjg.v19.i42.7426] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 09/12/2013] [Accepted: 09/29/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.
METHODS: Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster.
RESULTS: In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous year’s positive rate of 75% (P < 0.05).
CONCLUSION: Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.
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Fonseca J, Meira T, Nunes A. [Endoscopic diagnosis of an intramural hematoma presenting as an anticoagulant ileus]. REVISTA DE GASTROENTEROLOGIA DE MEXICO 2013; 78:249-250. [PMID: 24290725 DOI: 10.1016/j.rgmx.2013.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 06/18/2013] [Accepted: 06/21/2013] [Indexed: 06/02/2023]
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Chen MY, He CY, Meng X, Yuan Y. Association of Helicobacter pylori babA2 with peptic ulcer disease and gastric cancer. World J Gastroenterol 2013; 19:4242-4251. [PMID: 23864790 PMCID: PMC3710429 DOI: 10.3748/wjg.v19.i26.4242] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 04/03/2013] [Accepted: 05/17/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the association between babA2 gene and peptic ulcer disease (PUD) and gastric cancer (GC) in Helicobacter pylori-infected populations.
METHODS: We evaluated the relationship between babA2 and clinical outcomes (PUD and GC) using a meta-analysis. A literature search was performed using the PubMed and Web of Science databases for relevant case-control studies that met the defined inclusion criteria. The ORs and 95%CIs were calculated to estimate the association between babA2 genotype and clinical outcomes. A fixed-effect or random-effect model was performed depending on the absence or presence of significant heterogeneity.
RESULTS: A total of 25 articles with 38 studies met the inclusion criteria and were finally included in this meta-analysis. The results showed that the babA2 genotype was significantly associated with an increased risk of PUD (OR = 2.069, 95%CI: 1.530-2.794, P < 0.001) and especially in the subgroup of duodenal ulcer (OR = 1.588, 95%CI: 1.141-2.209, P = 0.006). Moreover, a significant association between babA2 gene and PUD and duodenal ulcer (OR = 2.739, 95%CI: 1.860-4.032, P < 0.001; OR = 2.239, 95%CI: 1.468-3.415, P < 0.001, respectively) was observed in western countries but not in Asian countries.
CONCLUSION: We demonstrated that the presence of babA2 may be associated with increased risks for PUD, especially duodenal ulcer, in western countries.
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Yoon H, Oh D, Park HC, Kang SW, Han Y, Lim DH, Paik SW. Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma. Strahlenther Onkol 2013; 189:541-6. [PMID: 23703401 DOI: 10.1007/s00066-013-0343-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/06/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). PATIENTS AND METHODS A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the ≥ grade 2 GD toxicity were investigated. RESULTS Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V25 for stomach and V35 for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for ≥ grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V25 ≤ 6.3 % and 57.1 % for V25 > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V35 ≤ 5.4 % and 45.9 % for V35 > 5.4 %. By multivariate analysis including the clinical factors, V25 for stomach and V35 for duodenum were the significant factors. CONCLUSION EGD revealed that GD toxicity is common following RT for HCC. V25 for the stomach and V35 for the duodenum were the significant factors to predict ≥ grade 2 GD toxicity.
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Borodach AV. [Ulcer disease: the state of art]. Khirurgiia (Mosk) 2013:38-42. [PMID: 24300577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Romashchenko PN, Maĭstrenko NA, Korovin AE, Sibirev SA, Sidorchuk PA. [New approaches in treatment of patients with perforated duodenal ulcer]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 2013; 172:42-50. [PMID: 24340972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The results of examination and treatment of 152 patients with perforated duodenal ulcer were analyzed with the aim to make the ground of systemic approach to their surgical treatment in consideration of contemporary achievements of laboratorial and instrumental diagnostics and the opportunities of minimally invasive surgery. The results of conducted clinical study showed that in order to establish the correct preoperative diagnosis and the choice of rational treatment of patients with perforated duodenal ulcer it is necessary to conduct a purposeful complex investigation, including an assessment of general somatic state and the operative-anaesthetic risk of patients and changes of pyloroduodenal zone and the severity of peritonitis and prediction of lethality. The diagnostic algorithm let the authors make a diagnosis of perforated duodenal ulcer before the operation and decide on an adequate volume of surgical intervention. It is established, that the integral assessment of the examination results and surgery, the evaluation of the titres of antibody to ulcerogenic strains Helicobacter pylori, studying of psychophysiological profile of patient can justify the complex program of medicamentous therapy in postoperative period, providing the remission of peptic ulcer.
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Liubskaia LA, Kolesnikova II, Grigor'eva IV. [Clinical and endoscopic features and treatment problems in patients with perforated duodenal ulcer]. TERAPEVT ARKH 2013; 85:51-54. [PMID: 24640668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To compare clinical and endoscopic findings and standard therapy results in duodenal ulcer disease (DUD) patients with and without a history of perforated ulcer. SUBJECTS AND METHODS One hundred and thirteen patients with recurrent DUD, including 61 patients with uncomplicated DUD (Group 1) and 52 patients with a history of perforated ulcer (Group 2) were examined. Esophagogastroduodenoscopy (EGDS) and 24-hour pH-metry were performed in addition to physical examination. Ulcer scarring was evaluated during control EGDS. RESULTS 75% of the patients with uncomplicated DUD were observed to have classical pain syndrome and the pain was milder, more extensive, and food-unrelated in the patients who had sustained perforation. Decreased appetite was more common in uncomplicated DUD (35%). EGDS showed that complicated DUD was accompanied by a significantly higher detection rate of erosive esophagitis (20%), gastritis (52%), duodenitis (25%), multiple ulcers (28%), and larger ulcer sizes. 35% of the patients who had experienced duodenal ulcer perforation exhibited an inadequate antisecretory effect of standard omeprazole doses, which was followed by the increase in ulcer scarring time by an average of 1.2 days. CONCLUSION In the patients with perforated DUD, the history was typified by less pronounced, more extended, and food-unrelated pain, esophageal and gastroduodenal erosive damages, multiple ulcerative defects, large ulcer sizes than in those with uncomplicated DUD, as well as resistance to standard omeprazole dose in one third of the cases, and delayed ulcer scarring.
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postrelov NA, Plotnikov IV, Avalueva EB. [The penetrated parapapillary duodenal ulcer]. Khirurgiia (Mosk) 2013:67-68. [PMID: 23887330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Zhukova EA, Vidmanova TA, Viskova IN, Kolesov SA, Korkotashvili LV, Shirokova NI, Kan'kova NI. [Changes of epidermal growth factor level in blood serum, saliva and gastric juice in children with duodenal ulcer]. VESTNIK ROSSIISKOI AKADEMII MEDITSINSKIKH NAUK 2013:36-40. [PMID: 24741940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of our study is to investigate EGF content in biological mediums in children with duodenum ulcer depending on phase of the disease and different variants of its course. MATERIALS AND METHODS The present study was performed in Federal State Establishment "Nizhniy Novgorod Research Institute of Children Gastroenterology", Nizhniy Novgorod, Russia. 92 children, between the ages of 8 to 17, with duodenum ulcer were under observation. Endoscopy was performed by Pentax endoscope (FG-24V). EGF detection was performed in blood serum, gastric juice and saliva by ELISA method with Human EGF Kit, "Invitrogen", USA. RESULTS The peculiarities of EGF level changes in human biological mediums, depending on phase of the disease. The highest EGF level was detected with acute peptic ulcer in the presence of ulcerous defects. EGF level increasing was marked out in the remission phaseas ulcerous defects healing, and it didn't reach normal values in gastric juice. EGF content changes in biological mediums were revealed with different variants of duodenum ulcer clinical course in children. The lowest EGF level was marked out in blood, saliva and gastric juice with unfavorable course of the disease (frequent relapses, cicatricial-ulcerous strains formation), which can serve as a prognostic factor.
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Frei A. [Believing it all . . . ]. REVUE MEDICALE SUISSE 2012; 8:2146-2147. [PMID: 23173352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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71
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Salles VJA, Almeida RLD, Rodrigues MA. [Large subdiaphragmatic cystic image]. ACTA GASTROENTEROLOGICA LATINOAMERICANA 2012; 42:170-262. [PMID: 23214342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Agha R, Agha M. Severe occult upper gastrointestinal haemorrhage. QJM 2012; 105:679-81. [PMID: 21672946 DOI: 10.1093/qjmed/hcr085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Solovĭova HA. [Endoscopical features of precancer changes of the stomach in patients with chronic gastric erosions and biliary tract disease]. LIKARS'KA SPRAVA 2012:97-106. [PMID: 23534277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Frequency of the precancer changes of the stomach, diagnosed by using zoom-endoscopy, NBI, chromoscopy, in the three groups of patients: with gastric erosions and biliary tract diseases, with gastric erosions and duodenal ulcer disease, with gastric erosions and chronic gastritis is compared in the article. It is shown, that patients with gastric erosions and biliary tract diseases are characterized by bigger spreading of precancer changes: atrophy, intestinal metaplasia with predominant smalluently intestine in gastric body, intestine metaplasia in antral part of the stomach is revealed more freq in these category of patients. A strong correlation between endoscopical and morphological methods of investigation was demonstrated.
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Chen WC, Frenette C. Hepatic artery pseudoaneurysm: a rare cause of gastrointestinal bleeding in a post liver transplant patient. JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES : JGLD 2012; 21:125. [PMID: 22720295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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75
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Garg M, Strauchen JA, Warner RRP, Divino CM. Radioembolization-induced gastroduodenal ulcer. Am Surg 2012; 78:621-623. [PMID: 22546141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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