Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.5.1.5 (urease)
 7,257 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although more than a fourth of the adult population reports dyspeptic complaints, little is known about the prevalence of clinically relevant UGI endoscopic findings in these patients in comparison with asymptomatic volunteers. This type of information is required in order to assess the relative risks of organic dyspepsia and the sensitivity and specificity of dyspeptic complaints for peptic lesions. In an attempt to fill this gap, the authors compared two trials carried out in the German-speaking part of Switzerland: (a.) 172 adult asymptomatic volunteers (age 20-78 years, 74 females, 98 males) participated in an epidemiological trial to measure the prevalence of positive CLO-urease tests and of upper GI-tract lesions. (b.) 119 patients (age 18-84 years; 68 females, 51 males) consulting their family doctor because of upper digestive symptoms of at least 1 month's duration (epigastric pain or discomfort, heartburn, acid regurgitation, early satiety, bloating, etc.) were referred for UGI endoscopy as a screening procedure; functional dyspeptics were thereafter randomized to a double blind drug trial (not reported here). In both trials the gastric presence of Helicobacter pylori was measured by means of the CLO-urease test. Prevalences of lesions and of positive urease-tests in the dyspeptic population were compared with the sex and age adjusted prevalences registered in the control population.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic findings in volunteers and dyspeptic patients]. 805 29

Non-ulcer dyspepsia (NUD) means the presence of upper abdominal pain and discomfort and also nausea, vomiting, flatulence, heartburn and belching. It is estimated, that about 20-30% of all patients refer to a doctor because of dyspeptic symptoms. Helicobacter pylori (Hp) infections are diagnosed in about 60% of persons with NUD and in 80-100% of patients with clinical, endoscopic and histological diagnosis of gastritis. The authors decided to investigate a correlation between gastritis and Hp infection and a relationship between the influence of antibacterial therapy and Hp eradication from gastric mucus and to observe gastric mucosa condition. We examined 73 patients (range age 16-73): 40 females and 33 males. We employed the Sydney System for evaluation of gastric mucosa condition. The patients were divided into two groups: Hp-positive 50 persons and Hp-negative-23 persons. Hp infected subjects were treated with antibacterial drugs (bismuth + metronidazol + amoxycillin or bismuth + metronidazol + tetracycline) and Hp-negative only with bismuth. Hp eradication was obtained in 72.7% of patients treated with bismuth + metronidazol + amoxycillin and 76.4% of persons treated with bismuth + metronidazol + tetracycline. A statistically significant difference between these two kinds of antibacterial therapy was not noted. Both methods are equally effective. We observed also and improvement of the histological state of antrum and corpus gastric mucosa after therapy in comparison to changes before treatment. We noticed a decrease of dyspeptic complaint in 89.2% of Hp infected persons in whom Hp had been eradicated. Among Hp-negative 23 patients gastric mucosa was normal in 30% and chronic gastritis was found in 70% of subjects. Based upon the present results it seems very important and suitable to detect Hp organisms in gastric mucus of all dyspeptic patients who are endoscopically examined and biopsied at the same time. We would suggest to do an urease test and to take histological samples together with full endoscopic examination according to the Sydney System guidelines.
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PMID:Non-ulcer dyspepsia and Helicobacter pylori infection--morphological analysis according to the Sydney system--changes before and after treatment. 885 27

Male gender and smoking have an established discriminant value of increased risk for duodenal ulcers. The present analysis is focused on whether this could be generally enhanced by considering Helicobacter pylori status in dyspeptic patients consulting their primary physician. Patients were enrolled into our Dyspepsia Study if they met the following criteria: Symptoms for minimum one month, informed consent for drug trial, including upper gastrointestinal endoscopy (UGE), if required. All were prospectively screened for criteria suggesting an organic origin of the disorder such as nocturnal pain, severe pain, severe regurgitation or heartburn, loss of weight, pain relieved by food, age > 50 years. 16% of patients had one or more relevant lesion: 7.8% oesophagitis, 8.5% duodenal ulcers, and 1.8% gastric ulcers. Of the clinical criteria enumerated only nocturnal pain and/or severe regurgitation or heartburn had a marginal discriminant power (P < 0.1). In contrast smoking and/or positive CLO-urease test had a substantial and significant (P < 0.001), discriminant value both for oesophagitis and duodenal ulcers. Patients with both a positive CLO-urease test and who smoked accounted for only 16% of the population but for 46% of the lesions, but this was only 4% for the 42% subjects who were non-smokers and had a negative CLO-urease test. Positive H. pylori status and smoking appear to have an important and probably additive discriminant value to distinguish between organic and functional dyspepsia.
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PMID:Epidemiology of dyspepsia: discriminant value of smoking and Helicobacter pylori status as predictors of peptic lesions in primary care. 944 58

A 69-year-old-woman presented with acute epigastric pain, nausea, vomiting and heartburn. Endoscopy disclosed acute gastric mucosal lesions including mucosal edema, erosions, and ulcers with blood crusts in the antrum. Touch cytology and histological assessment obtained from the affected mucosa revealed acute neutrophilic gastritis and single longer and more coiled organisms than Helicobacter pylori, suggesting Helicobacter heilmannii. Electron micropragh confirmed the characteristic morphology. Despite a positive rapid urease test, H. pylori was not isolated by culture or detected by histology and Gram smears. Based on these findings, a diagnosis of acute gastric mucosal lesions associated with H. heilmannii infection was established. This was successfully treated with a 2-week triple therapy consisting of lansoprazole, clarithromycin and metronidazole with persistent endoscopic and histological remission. This is a rare case of H. heilmannii-associated acute gastric mucosal lesions, diagnosed by morphology using touch cytology and histology. The patient might benefit from antimicrobial treatment employing the regimen effective for H. pylori.
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PMID:A case of acute gastric mucosal lesions associated with Helicobacter heilmannii infection. 1239 Feb 13

We report the case of a patient with gastroesophageal reflux disease who developed gastric atrophy and intestinal metaplasia (IM) while on 20-year treatment with proton pump inhibitors. This is perhaps the first report in human beings. A 74-year-old man, who presented with heartburn, showed abnormally high gastric pH (average 6.57) on 24-hour dual channel pH-metry even after discontinuing acid suppressive drugs for one month. No significant esophageal acid exposure was noted, which may be related to an impairment of the acid secreting capacity of the stomach (percentage time esophageal pH<4 during 24-h period 0.3%). Upper gastrointestinal endoscopy was normal except for the prominent submucosal vessels in the body and fundus suggesting gastric atrophy. Histopathological examination of multiple biopsies from the body and antrum of stomach showed signs of gastric atrophy and IM. Rapid urease test and histopathology of gastric biopsies were negative for Helicobacter pylori. Anti-H.pylori IgG ELISA however, was positive. Patient was asked to stop all anti-secretory drugs and only prokinetics were prescribed following which his symptoms markedly improved. On follow-up, in April 2007, he developed symptoms of peripheral neuropathy; serum vitamin 812 level was low. He responded to parenteral vitamin 812 therapy. 24-h dual channel pH-metry repeated after one and a half years showed persistently high gastric pH (average pH 6.76). The patient remained well after discontinuing proton pump inhibitors and continuing prokinetics and vitamin B12 injections.
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PMID:Gastric atrophy and intestinal metaplasia in a patient on long-term proton pump inhibitor therapy. 1911 12