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)

The systemic IgG response to Helicobacter pylori was examined in 70 patients with gastric cancer. H pylori IgG antibodies were assayed by enzyme linked immunosorbent assay (ELISA), and serological recognition of H pylori antigens was characterised by western blotting. A percentage of 78.5 were seropositive by ELISA. Two of five patients under age 50 were seronegative. Positivity was unrelated to age, sex, tumour type, or site. Ninety one per cent of ELISA positive cancer patients recognised the H pylori cytotoxin associated 120 kilodalton (kD) protein, significantly more than a control group of 47 ELISA positive patients with non-ulcer dyspepsia (72%). Four of 15 ELISA negative cancer patients also showed recognition of this protein in western blots. Mucosal IgA responses to H pylori were examined by immunoblotting supernatants of in vitro cultured resected antral mucosa in an overlapping group of 19 gastric cancer patients. Eighteen had a positive response, including 10 of 11 negative for H pylori by biopsy urease testing. The systemic and local immunoblotting results show that the high seroprevalence of H pylori antibodies detected by ELISA is nevertheless an underestimate of past infection. Dyspepsia screening policies based solely on H pylori ELISA would miss some young patients with gastric cancer. Further study of the relation of the H pylori cytotoxin to gastric precancerous lesions is warranted.
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PMID:Systemic and mucosal humoral responses to Helicobacter pylori in gastric cancer. 824 98

The seroprevalence of IgG antibodies to Helicobacter pylori (Hp-Ab) was studied in 47 patients (29M, 18F, mean age +/- SD: 62.44 +/- 12.63 years) with non-cardia gastric carcinoma using an enzyme-linked immunosorbent assay. Controls were: a) 50 healthy people well-matched with the cancer patients; b) 50 patients with dyspepsia well matched with the cancer patients. Hp-Ab were detected in 72.3% of patients with gastric carcinoma, in 68% of healthy people and in 88% of dyspeptics. No significant associations were found between H. pylori infection and gastric cancer patients as a whole (odds ratio: 1.23, 95% CI: 0.514-2.95). In addition, no significant associations were found between H. pylori infection and the various subsets of cancer patients. These findings do not support an association between H. pylori infection and non-cardia gastric carcinoma in Greece.
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PMID:Non-cardia gastric adenocarcinoma and Helicobacter pylori infection. 828 Aug 97

The authors analyse the incidence of myoid tumours of the stomach in comparison to bowl cancer as a whole and identify the different anatomopathological varieties (benign leiomyoma, leiomyosarcoma and Martin-Stout's bizarre leiomyoma). Symptoms are usually subtle and development slow: important factors are the site of onset (antro-pyloric in 60% of cases, body 25% and cardias 15%), the type of tumour growth (intra- or extraluminal or mixed) and tumour size which may sometimes be considerable. Four categories of patients are identified on the basis of symptoms shown: a) asymptomatic (chance diagnosis), b) aspecific (vague symptoms such as epigastralgia, dyspepsia, ecc.), c) symptomatic (presence of abdominal mass, chronic anemia, ecc.), d) complicated (onset of complications the most frequent of which is acute hemorrhage). The clinical data reported here refers to 4 patients (3 males and 1 female) aged between 53 and 75 years old. In one case diagnosis was made by chance, in 2 cases diagnosis followed acute hemorrhage of the upper digestive tract, and in the case of the woman clinical controls began following the finding of a voluminous abdominal mass. Diagnosis was based on traditional radiology and EGDscopy, as well as ultrasonography and CT. Treatment was surgical in all cases (two enucleations of the lesion and two atypical gastric resections). In the light of the authors' personal experience and data reported in the literature, the discussion focuses attention on the problems of diagnosis and therapy, in particular the various options facing the surgeon in the form of operating tactics.
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PMID:[Myoid tumors of the stomach. Our experience]. 829 Jan 54

We studied 2253 consecutive dyspeptic patients, without clinical evidence of organic disease, who were referred to our open access endoscopy service. The aim was to assess whether the various clinical patterns of dyspepsia can be considered a valid guideline for the appropriate use of endoscopy. According to the symptomatological patterns, our patients were defined as sufferers from 1) ulcer-like (973 patients), 2) reflux-like (857), and 3) dysmotility-like dyspepsia (423). In our patient population, which reflects the general population of our city, the dysmotility-like type of dyspepsia was the least frequent (19%), whereas the ulcer-like (43%) and the reflux-like (38%) dyspepsia were almost equivalent. A negative endoscopy (35.7%) occurred significantly (p < 5 x 10(-4)) more often in dysmotility-like than in ulcer-like (26.3%) and reflux-like dyspepsia (25.7%). Furthermore, in dysmotility-like dyspepsia, we observed no malignancies in patients less than 60 yr old, and no gastric ulcers in patients less than 50 yr old. In the latter subgroup of patients (under 50 yr), duodenal ulcers and esophagitis were rare (occurring in only one and five, respectively, out of 145 patients). In ulcer-like and reflux-like dyspepsia, abnormal endoscopic findings occurred frequently (in 73.5% and 74.1%, respectively), and no relationship with patients' age was observed. Our data indicate that patients under 50 yr old with dysmotility-like dyspepsia can be considered a kind of population for which endoscopy is inappropriate. However, because the prevalence of dysmotility-like dyspepsia was 19% (423/2253) in our patient sample, and only 7.15% of them were under 50 yr old (161/2253), we can obtain only a small percentage of reduction in endoscopic service load if the guideline of age < 50 yr is adopted.
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PMID:Are clinical patterns of dyspepsia a valid guideline for appropriate use of endoscopy? A report on 2253 dyspeptic patients. 831 31

Symptoms of reflux-like dyspepsia and gastro-oesophageal reflux disease (GORD) are common problems in the community and in general practice. The 1-year prevalence of reflux-like dyspepsia is in the region of 30%, with many patients experiencing a range of other symptoms in addition to the principal complaint of retrosternal pain or burning. Although only a minority, about one-quarter, of these patients consult general practitioners about their problems, many of them have had symptoms for several years, and experience symptoms on a frequent, often daily, basis. The decision to consult a general practitioner often depends more upon patients' anxieties about the possibility of heart disease and cancer than on symptom severity. General practitioners need to address these issues, as well as attempting to make a safe, clinical diagnosis; this is aided by the findings that, at least in patients under the age of about 45, a reasonably confident clinical diagnosis can be made on the basis of symptoms alone, although older patients and those in whom alarm symptoms are present require timely investigation. The increasing availability of open-access endoscopy means that many of these patients can be managed entirely in general practice without the need for specialist referral. Management in general practice begins with a clear explanation of the mechanisms and significance of GORD and a direct response to patients' anxieties. Lifestyle factors may require modification before drug therapy begins.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastro-oesophageal reflux disease in general practice. 854 29

Although dyspeptic symptoms are very common, the vast majority of patients have modest symptoms and rarely seek medical advice. The major organic causes of dyspepsia are chronic peptic ulcer disease, gastro-oesophageal reflux disease and malignancy. Functional dyspepsia is very common. In the fit elderly patient, prompt investigation may be more appropriate than empirical treatment in view of the higher proportion of patients with organic disease and the likelihood of malignancy. The symptoms of peptic ulceration and gastro-oesophageal reflux disease are often atypical in the elderly population. Frail patients, especially those with multiple pathology, should be treated empirically in the first instance. Empirical treatment should be with histamine H2-receptor antagonists or prokinetic agents. Drug treatment is not always required in dyspepsia and should be avoided where possible, especially given the increased risk of drug interactions and poor compliance in the elderly. For those patients with documented non-malignant organic disease, the advent of the H2-receptor antagonists, proton pump inhibitors, prokinetic drugs and regimens which eradicate Helicobacter pylori means that treatment is almost always successful.
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PMID:Diagnosis and treatment of dyspepsia in the elderly. 857 90

Dyspepsia affects one in four Australians; of those who present in general practice, the majority will have functional or non-ulcer dyspepsia, with no structural explanation for their symptoms. Older patients who present for the first time with dyspepsia, and those with 'alarm features' deserve immediate investigation (preferably by upper endoscopy), to exclude cancer, peptic ulcer or oesophagitis. Other patients may be given empiric therapy (for example, a prokinetic or H2 blocker) initially, but require investigation if this fails. The role of Helicobacter pylori infection in functional dyspepsia is uncertain.
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PMID:Modern management of dyspepsia. 860 75

A 52-year-old male presented with urinary symptoms of frequency and hesitation. X-rays, ultrasound, and computerized tomography investigations were performed that indicated the diagnosis and position of an enteric duplication cyst. Elective surgery was performed to completely remove the duplication cyst. Histological examination showed that the cyst was lined by stratified squamous, ciliated, and gastric-type epithelium, with a muscularis mucosae and a muscularis Propria. No malignancy or dysplasia was seen. Duplications of the alimentary tract are uncommon congenital abnormalities. They may be multiple and arise at any level from the mouth to the anus. Usually observed early in life, a minority may remain unsuspected until adulthood. The clinical presentations may be vague and diverse depending on their location. These include pain, distention, dysphagia, dyspepsia, and complications involve bleeding, perforation, malignancy, and obstruction of the alimentary tract and vessels. Plain x-rays are of limited use in the diagnosis of duplications but ultrasound findings may be diagnostic, with computerized tomography useful in delineating surrounding structures. Once the diagnosis is established, surgical correction is the treatment of choice, preferably with complete removal.
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PMID:An unusual presentation of intestinal duplication with a literature review. 861 48

Chronic gastritis (CG) is the chronic inflammation of gastric mucosa associated with varying degrees of damage of superficial and glandular epithelia. The causes of CG are exogenous (mainly Helicobacter pylori) and endogenous. The process is concluded by atrophy of parenchyma. CG is associated with dyspepsia in approximately 50% of cases, but frequently with gastric and duodenal ulcer. The role of chronic atrophic gastritis (AG) is relevant in development of cancer or of other tumors like carcinoids and polyps. The specific secretive cells of the glandular parenchyma and of the superficial epithelium reveal a good correlation with secretory component behavior, but they are only partially influenced by H. pylori. It emerges that CG is an anatomic-functional condition. The cytofunctional profile in AG causes achlorhydria and therefore chronic luminal alkalosis. This condition favors intestinal metaplasia (IM) and important intraluminal troubles. Finally, nutritional deficiencies or H. pylori seem to interfere with the intragastric metabolism and therefore play a relevant role in the rise of IM.
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PMID:Chronic gastritis: its clinical and physiopathological meaning. 864 51

Although the role of duodenogastric reflux in the pathogenesis of reflux gastritis is firmly established, for other foregut diseases, such as chronic gastritis, esophagitis, functional dyspepsia, peptic ulcer, and malignancy, it remains controversial and only speculative. The aim of this paper is to review merits and flaws of the methods currently used for the detection of duodenogastric reflux, with emphasis on the newly developed method for 24-h bilirubin detection in the gastric and esophageal content, by a fiberoptic small-size probe (Bilitec 2000), and to summarize recent advances in understanding the role of duodenogastric reflux in foregut disorders, in an attempt to identify topics for future research.
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PMID:Duodenogastric reflux: an update. 867 24


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