Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study was performed on gastric carcinomas to establish the prevalence of Helicobacter pylori infection in gastric epithelium adjacent to the tumour. A total of 105 carcinomas were studied. The overall prevalence of Helicobacter pylori infection was 59%. The prevalence in different age cohorts from patients with gastric carcinoma was compared with that in patients suffering from non-ulcer dyspepsia and, based on serological testing, with that in healthy blood donors. The presence of Helicobacter pylori in cancer patients aged 41-50 and 51-60 was significantly higher than in blood donors. No difference was seen in comparison with non-ulcer dyspepsia patients. The presence of Helicobacter pylori showed an inverse correlation with the extent of intestinal metaplasia. The intestinal type of carcinoma was associated with a higher bacterial load than the diffuse type. These data suggest that the presence of Helicobacter pylori in gastric mucosa could play a role in the pathogenesis of gastric carcinoma, especially in the young age group.
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PMID:Helicobacter pylori and gastric carcinoma. 179 61

Three major areas of medicine are identified in which there is a need for new antiemetic drugs. These are the nausea and vomiting arising from gastrointestinal motility disturbances (functional dyspepsia, diabetic neuropathy, classical migraine), the sickness evoked by abnormal motion, and the severe emesis experienced by cancer patients as a result of certain cytotoxic therapies. For gastrointestinal-related nausea, selective stimulants of gut motility are suggested to form the basis for a new type of antiemetic therapy. In motion sickness, there has been progress in the understanding of the illness, but little advance in the development of new drugs that selectively prevent this type of sickness. In cancer chemo- and radio-therapy, the discovery that selective 5-HT3 (5-HT, 5-hydroxytryptamine) receptor antagonists can prevent severe cytotoxic-evoked emesis now promises to radically change the type of antiemetic therapy given to these patients. This type of antiemetic compound and the pharmacology of the new 5-HT3 receptor antagonists are, therefore, discussed in detail.
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PMID:New antiemetic drugs. 217 55

Based on clinical and histopathological features, three different types of chronic gastritis can be distinguished: gastritis A is confined to the proximal stomach and is the result of an autoimmunological process with antibodies against parietal cells and intrinsic factor. It is a rare disorder and may lead to pernicious anaemia. Distal, antral gastritis B is caused by an infection of the gastric mucosa with Helicobacter pylori (HP). Its incidence increases with age (greater than 50% above age 50). Gastritis C may be caused by drugs and alcohol but is mainly found in gastric remnants after partial resection as a consequence of biliary reflux. Gastritis A rarely causes symptoms. A relationship between gastritis B and C and non-ulcer dyspepsia (NUD) is highly controversial. Gastritis B is very closely associated with peptic ulcer disease. HP-positive antral gastritis seems to be the prerequisite for ulcer formation. All 3 types of gastritis carry an increased risk of malignancy, which seems to be positively correlated with hypoacidity, the chronicity of the inflammation and the histopathological feature of intestinal metaplasia. Noninvasive diagnostic tests (serology, breath tests, scintigraphy) are available, but the diagnosis of gastritis is still mainly based on endoscopy and biopsy. Treatment of gastritis A is not possible. Gastritis B can be healed by eradication of HP using bismuth salts and antibiotics but only combinations of 2-3 compounds seem to afford long-term positive results. Further clinical trials are needed to determine whether such treatment is justified in patients with gastritis and NUD. In patients with chronic recurrent peptic ulcers eradication of HP prevents relapses and heals ulcer disease. Gastritis C complicated by severe symptoms or ulcer can only be successfully treated by a biliary diversion, i.e. Roux-Y-gastrojejunostomy. The discovery that gastritis B is caused by HP improves our understanding of peptic ulcer disease and will change therapeutic concepts.
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PMID:[Chronic gastritis. Pathogenesis, clinical aspects and therapy]. 221 59

During 1968-1988 one endoscopist performed 3154 endoscopic examinations of the upper gastrointestinal tract and detected 400 (13%) malignancies. Endoscopy was indicated in persisting dyspepsia or abnormal findings on X-ray examination of the stomach. In 242 patients earlier subjected to partial gastrectomy 7% stomach cancers were found. No difference existed in the incidence of stomach cancer between patients with either BI and BII gastrectomy. Initially no malignancy was detected in 9 (2.3%) patients. The maximum diagnostic delay was 5 months in these patients. This finding underlines the necessity of a strict follow-up scheme when studying malignancies.
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PMID:[Evaluation of the roentgenological and endoscopic diagnosis in malignities of the proximal digestive tract]. 226 75

Symptomatic patients referred to an open-access upper gastrointestinal endoscopy completed a detailed, self-administered questionnaire aimed at assessing the predictive value of history in dyspepsia. Nine hundred and thirty patients were suitable for analysis. Of these, 29% were found to have organic dyspepsia. A substantial overlap of symptoms and demographic data was found among the various endoscopic diagnoses. Discriminating variables were identified by stepwise logistic regression analysis and included in predictive score models. Pain relieved by antacids, age above 40 years, previous peptic ulcer disease, male sex, symptoms provoked by berries, and night pain relieved by antacids and food were found to predict organic dyspepsia with a sensitivity and specificity of approximately 70%, when applied on the observed material. Similar probabilities were found for score models of peptic ulcer and esophagitis. In general, the low prevalence of organic diseases resulted in low positive and high negative predictive values. Accordingly, the main impact of the predictive models may be to reduce the number of negative endoscopies rather than to predict a precise diagnosis. Independent of disease category and age, 41% of the subjects expressed a fear of malignancy, emphasizing the value of reassurance from a negative endoscopy.
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PMID:The predictive value of history in dyspepsia. 239 82

In the study of a group of 178 unselected patients (105 men, 73 women, mean age 44.5 years), from a population at high risk for gastric carcinoma, who presented with chronic dyspepsia, a minimum of 8 gastric and oesophageal biopsy specimens were taken during upper gastro-intestinal endoscopy, and examined histologically and histochemically for the presence of Campylobacter pylori and other pathological lesions. Gastric colonisation by C. pylori was found in 75% of men and 68.4% of women. In 90% of patients with duodenal or gastric ulcer and in 71.6% of patients with non-ulcer and non-cancer dyspepsia there was a moderate or severe degree of bacterial colonisation. Association between C. pylori colonisation and microscopic evidence of type B gastritis, gastric or duodenal ulcer, gastric cancer, oesophagitis and oesophageal glycogenic acanthosis was found.
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PMID:The association of Campylobacter pylori with mucosal pathological changes in a population at risk for gastric cancer. 247 Jan 57

Nineteen patients with colorectal adenocarcinoma, three with cholangiocarcinoma, two with hepatocellular carcinoma, and one with carcinoid were treated with hepatic artery infusion chemotherapy. An implantable pump system was used to deliver floxuridine (FUdR), starting at 400 mg for 2 weeks with 2 weeks of rest. Eleven of 15 (73%) measurable patients with colorectal carcinoma responded. Of 6 complete responses, 4 were documented by laparotomy, including 1 with cholangiocarcinoma. Toxicity included dyspepsia and elevated liver function tests in all patients, gastric ulcer in 2, cholecystitis in 2, and sclerosing cholangitis in 3. Overall median survival for the colon cancer patients has not been reached at 16 months. Regional disease was controlled in the majority of patients treated with this regimen with acceptable toxicity and good quality of life.
Cancer Invest 1989
PMID:Hepatic perfusion with FUdR utilizing an implantable system in patients with liver primary cancer or metastatic cancer confined to the liver. 254 47

To identify factors associated with the decision to consult with dyspepsia, patients with dyspepsia were identified from a postal survey in the community. A random sample of 69 patients who had consulted their general practitioner and 66 patients with dyspepsia who had not consulted were interviewed in their homes. Differences in consultation behaviour were not explained by differences in self-reported severity or frequency of symptoms or by the presence of associated symptoms. The most striking difference between the two groups was concern among the consulters about the possible seriousness of symptoms. Consulters were also more likely to be worried about cancer and heart disease and to have experienced more disruptive or threatening life events than the non-consulters. These results emphasize the importance of looking beyond the presentation of common symptoms in general practice to patients' fears about the significance of the symptoms and to non-physical determinants of consultation behaviour.
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PMID:Factors affecting the decision to consult with dyspepsia: comparison of consulters and non-consulters. 255 4

Two hundred and fifty cases of biliary tract disease were studied as regards case history, physical and laboratory investigations, surgery and follow-up. It was found that females especially multipara were frequently affected; majority of cases were in 3rd to 5th decade of their life, rise in age showing decline in incidence. Majority of cases (82.4%) were vegetarians and had used vegetable fats (oriental diet). Most of the cases (98.8%) belonged to middle and poor class and were lean and thin. Pain in the right upper quadrant of the anterior abdominal wall had been the commonest symptom, in about half the cases it got aggravated by fatty meals. A mass was felt in the right hypochondrium in 29.6% and Murphy's sign was positive in 55.5% of cases. Radio-opaque calculi were present in 8% of cases, in another 10.8% the calculi were demonstrated by oral cholecystography, radiography could detect calculi in 47 (25.4%) cases and its overall diagnostic success rate has been low (56.8%). Ultrasonography proved more valuable tool for diagnosis; bile culture was positive in 8.8% of cases only for Esch coli, proteus, klebsiella, staphylococci or paracolon. Right subcostal incision gave the best results. Chronic cholecystitis with cholelithiasis (74%) was more common than acalculus cholecystitis (26%), incidence of carcinoma was 2.8%, and in 5 out of 7 cases malignancy was associated with cholelithiasis. Early diagnosis and cholecystectomy for gallstones can prevent malignancy. Surgery on the whole proved beneficial and it can be more rewarding if pre-operatively other causes of dyspepsia are either excluded or confirmed. Excluding cases of malignancy, the mortality has been quite low and thus acceptable.
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PMID:Gall bladder disease: an analytical report of 250 cases. 263

A study was carried out on 41 cases of early gastric cancer over a five year period (1983-1987) based on resected stomach specimens. Males (29) outnumbered females (12) by 2.4:1. Mean age was 63 years (Range 30-80 years), and there was an overwhelming Chinese preponderance (40, 97.6%). The indications for endoscopy were: dyspepsia (24, 58.5%), gastro-intestinal bleeding (14, 34.1%) and follow up of megaloblastic anaemia (3, 7.4%). The diagnosis of malignancy was unsuspected at endoscopy in 38 patients and the commonest finding was a chronic ulcer (35, 85.4%). Most of the lesions were located in the body (24, 58.5%) and along the lesser curvature (36, 87.8%). Depressed lesions (Type III and combined IIc + III) were the commonest macroscopic lesions. Intestinal type carcinoma was the commonest microscopic type (34, 82.9%). Submucosal infiltration was present in 19 (47.3%) and lymph node metastases in 4 (9.8%). There was only one death from carcinoma of the stomach (mortality 2.4%).
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PMID:Early gastric cancer in Singapore. 271 21


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