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)

This study was conducted to evaluate the efficacy and safety of intravenous sulbactam/ampicillin followed by oral sultamicillin. Parenteral sulbactam/ampicillin was administered for 7 to 14 days to 152 in-patients with moderate to severe infections. All patients were treated with sulbactam/ampicillin, but only 140 patients received oral sultamicillin therapy. Eighty-nine men and 63 women participated in this study. Infections included intraabdominal (42 cases), respiratory tract (52 cases), skin and soft tissue (29 cases), urinary tract (16 cases), and miscellaneous infections (14 cases) that included typhoid fever, gastroenteritis, septicemia, and surgical wound infection. Six (4%) patients reported six study drug-related adverse experiences. Gastrointestinal side effects were most common and included epigastric burning and indigestion. Diarrhea was not reported and no patient discontinued drug therapy because of an adverse event. Laboratory abnormalities were infrequent and clinically insignificant. Overall, 98% of the 114 evaluable patients achieved clinical cure or improvement following treatment with sulbactam/ampicillin and sultamicillin. Cured or improved patients in each diagnostic group were 97% for intraabdominal infections, 100% for respiratory tract infections, 100% for skin and soft tissue infections, 100% for urinary tract infection, and 91% for other types of infections. Only 2 (2%) patients were judged to be treatment failures. Microbiologic efficacy, or eradication, was 86% overall, ranging from 75 to 100%. Persistence of pathogens occurred in 5%, and eradication with development of a superinfection occurred in 4%. Fifty-seven percent (30/50) of the isolates tested were resistant to ampicillin alone whereas only 21% (9/42) were resistant to sulbactam/ampicillin (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sulbactam/ampicillin followed by oral treatment with sultamicillin for medical and surgical infections. 268 17

Thirty-three patients with multiple myeloma (11 untreated, 15 refractory and seven relapsed patients) have received vincristine and adriamycin infusion therapy with oral dexamethasone (VAD). The median number of course received was five. In addition 16 patients with lymphoid malignancy have received a median of four courses of VAD. Three patients who relapsed after VAD have received further VAD therapy making 52 patient treatments assessable for toxicity. Ten per cent had nausea, 4 per cent vomiting, 4 per cent total alopecia, 25 per cent constipation, 33 per cent paraesthesiae, 8 per cent proximal myopathy, 33 per cent dyspepsia, 23 per cent proven bacteraemia, and 19 per cent chest infections. Infections were not usually associated with neutropenia. Shingles was seen in four patients with myeloma, but none of the patients with lymphoid malignancy. The response rate in myeloma was 9/11, for previously untreated patients, 3/7 for relapsed, and 8/15 for refractory patients. Responses have been seen in other lymphoid malignancies-1/2 patients with relapsed acute lymphoblastic leukaemia had a complete remission. Two out of seven patients with chronic lymphocytic leukaemia achieved a partial remission, and a further three had a clinical improvement. Three out of six patients with non-Hodgkin lymphoma and one patient with macroglobulinaemia achieved a partial remission.
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PMID:VAD chemotherapy--toxicity and efficacy--in patients with multiple myeloma and other lymphoid malignancies. 311 84

Infections with Entamoeba histolytica do not necessarily cause disease in those infected. The parasite may act as commensal (cysts living in the bowel) or it may cause a broad spectrum of clinical illness. Some of the factors causing overt disease are poorly understood. An acute amebic dysentery is accompanied by bloody stools, abdominal pain and indigestion. The most important extraintestinal complication of an amebic infection is a liver abscess causing severe pain, fever, nausea and vomiting. The diagnosis of an amebic infection is based upon isolation of the parasite from the stools. Extraintestinal amebiasis is diagnosed - apart from the clinical picture - by serology. For treatment of intestinal amebiasis so-called contact-amebicides can be recommended. An amebic abscess of the liver usually responds well to dehydroemetine, metronidazole or any other derivative or imidazole and chloroquine. Surgical treatment of amebic liver abscess is only required if complications arise.
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PMID:[Amebiasis]. 628 39

Fifty-two of 142 (37%) American ex-prisoners of war that worked on the Burma-Thailand Railroad during World War II were found to have previously unrecognized symptomatic Strongyloides stercoralis infections. A characteristic urticarial creeping skin eruption on the abdomen, buttocks and thighs occurred in 92%. Infection was also associated with pruritus ani, abdominal pain, indigestion, heartburn, and diarrhea. Demonstration of larvae in ether-formalin stool concentrates in these chronic low density infections required 5 hours of microscopy per case to detect 90% of positive cases. Therapy with thiabendazole resulted in a clinical cure in 93% and a microscopic cure in 100%; but was associated with frequent side effects. Chronic strongyloidiasis should be considered in veterans of Far East conflicts and in others with intimate soil contact in rural Strongyloides stercoralis-endemic areas who present with recurrent creeping skin eruption, abdominal pain, and eosinophilia.
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PMID:Chronic strongyloidiasis in World War II Far East ex-prisoners of war. 669 84

Infection with Helicobacter pylori (H.p.) leads to mostly asymptomatic chronic gastritis. However, H.p. plays a role in peptic ulcer, giant fold gastritis (Menetrier's disease), and possibly in gastric carcinoma and low-grade MALT lymphoma. Whether functional dyspepsia also represents a Helicobacter-induced entity is questionable. H.p. should be eradicated in patients with peptic ulcer disease, Menetrier+s disease and - but in controlled studies only - in MALT lymphomas. Triple therapy with low-dose proton pump inhibitors and two antibiotics is the most favourable treatment compared to dual therapy with omeprazole and amoxicillin/clarithromycin despite the unresolved question of the development of drug resistance.
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PMID:[Therapy of Helicobacter infection]. 897 55

Helicobacter pylori infection is an important cause of peptic ulcer disease and chronic gastritis. Infection with this bacterium stimulates the production of immunoglobulin (Ig) G antibody. Salivary IgG antibody tests to detect H pylori infection offer a convenient and noninvasive method of diagnosis. To evaluate an IgG salivary antibody kit, saliva was collected from 157 out-patients with dyspepsia referred for endoscopy to a tertiary centre. A salivary IgG ELISA antibody assay was performed using the Helisal Helicobacter pylori (IgG) assay kit, and at least four gastric biopsies were obtained. H pylori infection was confirmed by demonstration of the organism on Warthin-Starry silver stain (sensitivity 85%, specificity 55%). The prevalence of infection with H pylori was 30%. When the analysis was redone, excluding those treated with eradication therapy, the results were similar (sensitivity 86%, specificity 58%). The positive predictive value of the assay was 45% and the negative predictive value was 90%. Despite the ease of sampling, the assay used has limited diagnostic utility, lacking the predictive value to indicate which patients referred with dyspeptic symptoms to a tertiary care setting are infected with H pylori.
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PMID:Evaluation of salivary antibodies to detect infection with Helicobacter pylori. 928 80

Infection with Helicobacter pylori is accepted as the primary cause of peptic ulcer disease, and there is evidence to suggest its role in other gastrointestinal disorders. An estimated 20% to 40% of the Canadian population is infected with H pylori; however, clinically relevant disease is present in only approximately 10% to 20% of these individuals. Therefore, it is crucial to identify the diseases for which eradication of H pylori is beneficial to ensure that patients do not receive unnecessary treatment. In patients with ulcers induced by long term treatment with nonsteroidal anti-inflammatory drugs, preliminary results suggest that eradication of H pylori may reduce the risk of peptic ulcer bleeding. Furthermore, a benefit has been observed for the eradication of H pylori before patients commence therapy with a nonsteroidal anti-inflammatory drug. An association between the presence of H pylori and specific dyspeptic symptoms has yet to be established; however, there may be a subset of patients with functional dyspepsia who benefit from the eradication of H pylori. The relationship between gastroesophageal reflux disorder and H pylori infection remains unclear. In Canada, the recommended therapy for the eradication of H pylori is seven days of twice-daily treatment with a proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole. Although the proton pump inhibitors are treated as a class for use in these regimens, there is suggestion that a faster onset of action may lead to a higher rate of eradication.
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PMID:Update on the role of H pylori infection in gastrointestinal disorders. 1133 27

Infection by Helicobacter pylori is recognized as a risk factor for gastric cancer and peptic ulcer disease. Venezuela has regions with different gastric cancer risks; the Andean region has the highest gastric cancer mortality in the country. We performed a cross-sectional study on 357 patients who underwent endoscopy attending 2 private (n = 76) and one public hospital in Caracas, Venezuela (n = 215), and one public hospital in the Andes (n = 66) to determine H. pylori infection (by a rapid biopsy urease test and histology). The proportion of infected patients in Caracas was significantly higher in public hospitals (72%) than in private hospitals (46%; P = 0.00001), and there was no significant variation the Andes and Caracas (P = 0.7001). When analyzing the data from the public hospital in Caracas, we found that the frequency of infected patients was significantly higher during the rain (96%) than during the dry months (70%, P = 0.00000001). Differences in prevalence of infection in symptomatic patients was not related to the risk of gastric cancer but to socioeconomic differences. Rain-dependent factors that may be exacerbating the clinical activity of nonulcer dyspepsia in people infected with H. pylori deserve further study.
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PMID:Short report: socioeconomic and seasonal variations of Helicobacter pylori infection in patients in Venezuela. 1213 67

Helicobacter pylori is a causative organism for chronic gastritis and associated with peptic ulcer disease. Infection may be asymptomatic as well. Human immuno-deficiency virus infection predisposes to a multitude of opportunistic infections, many of them resulting in gastrointestinal symptoms. We studied the prevalence of H pylori co-infection with HIV and its correlation with gastrointestinal symptoms in HIV infected patients. Seventy-three consecutive HIV infected patients presenting to the medical out patient department of Postgraduate Institute of Medical Education & Research, Chandigarh, India, were included in the study. Antibodies (IgG) to H pylori were tested by ELISA. There were 43 males, 30 females; mean age 26.1 +/- 4.7 years. Risk factors for acquiring HIV infection was predominantly heterosexual exposure. Eleven patients presented with gastrointestinal symptoms. Thirty-five of the 73 (47.9%) patients had serological evidence of H pylori infection. Six of them had gastrointestinal symptoms. These were odynophagia in 5, dyspepsia in 4 and recent diarrhoea in 2. Twenty-four patients with H pylori infection had AIDS. There was no difference in the prevalence of H pylori infection between patients with and without AIDS.
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PMID:Helicobacter pylori in Indian HIV infected patients. 1263 75

Infection with Helicobacter pylori strains harboring determinants of pathogenicity may lead to a strong inflammatory response in gastric mucosa. In this work, we examined the frequency of the cagA, vacA and iceA genotypes in H. pylori strains isolated from Brazilian patients and correlated these with the clinical manifestations. H. pylori was isolated from 165 patients [30 with non-ulcer dyspepsia cases (NUD); 93 peptic ulcer disease (PUD): 31 gastric ulcers (GU) and 62 duodenal ulcer disease (DU); 18 with erosive gastritis (EG); and 24 gastroesophageal reflux disease (GERD)]. Allelic variants of cagA, vacA and iceA were identified using the polymerase chain reaction. More than one H. pylori strain was detected in 28 cases (17%), and these were excluded from the statistical analysis. We were unable to confirm an association between iceA status and clinical outcome. There was a strong association between the genotype cagA-positive vacA s1 and PUD. However, logistic regression analysis showed that vacA s1 was the only predictive factor for PUD (OR=4.19; 95% CI 1.95-8.98). The presence of the less virulent strain vacA s2 was related to GERD (OR=8.59; 95% CI 2.85-25.91). Our results support the hypothesis that virulent strains may protect against the development of GERD.
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PMID:Clinical relevance of the cagA, vacA and iceA genotypes of Helicobacter pylori in Brazilian clinical isolates. 1273 89


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