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 case of argyriasis in a 45-year-old woman is reported. When the patient was 34 she took for a period of 25 months a silver-containing pharmacological product (colloidal silicon with 0.5 percent of silver) in order to treat an intestinal dyspepsia with diarrheic episodes. A few months after discontinuing the treatment a cutaneous pigmentation of a greyish-blue color extending over the whole body, developed. There was also discoloration of the nails, hair, and of the oral and gingival mucosae. The differential diagnosis with other conditions that also develop anomalies of cutaneous pigmentation was established. It is thought that the appearance of the silver poisoning is due to different factors such as the quantity of silver intake, the individual sensitivity to the metal, and the greater or lesser period of exposure to sunlight. The importance of the skin biopsy in order to confirm the diagnosis is commented on. Typical pathologic findings include the presence of silver granules in the basal membrane of sudoriparous glands, around the pilosebaceous follicles, and in the connective tissue. Lastly, the authors insist on the necessity to avoid the prescription of silver-salt containing drugs as far as possible, since the cutaneous pigmentation is irreversible.
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PMID:[Argyriasis. Report of a case (author's transl)]. 52 74

A group of consecutive patients with ulcer dyspepsia were studied by endoscopy, antral and duodenal biopsy; by histologic determination of Helicobacter pylori (HP) and by silver staining (Warthin Starry technique). 68.31% were found to be infected. In those patients who showed chronic antritis (69.30% of the patients), HP was present in 92.85% of cases. In gastric and duodenal ulcer patients, similar rates were shown (76.47% and 76.92% respectively. In cases with normal histology findings HP was present in only 12.90% of cases. In the duodenum HP was scarce (7.92%) and there was always concomitant metaplasias. HP is strongly linked with mucosal lesions in our patients with ulcer dyspepsia. We wonder its responsibility in producing these lesions and about the need of performing specific treatment against HP in this patients.
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PMID:[Helicobacter pylori in patients with ulcerative dyspepsia]. 134 Jun 76

Helicobacter pylori (formerly Campylobacter pylori) has been recently described as a gastritis-associated bacterium. We examined endoscopic biopsies of 100 patients with dyspepsia and found H. pylori in the gastric antrum of 34 (34%) by either culture, urease tests and/or histology. Thirty-one out of 41 patients (75.6%) confirmed to have chronic active gastritis histologically had H. pylori in their gastric antrum compared to 3 out of 59 patients (5.1%) with dyspepsia but normal histology (p less than 0.01). Histological examination, using gram stain and the Warthin-Starry Silver stain, detected 29 of the 34 positive cases (85.3%); urease test, 26 cases (76.5%) and culture, 22 cases (64.7%). A combination of histological examination and urease test increased the detection rate to 97.1%. Therefore we felt that for the detection of H. pylori in endoscopic biopsies, culture, which is time consuming and expensive, is not necessary in routine diagnosis as it did not improve the diagnostic rate over a combination of histology and urease test. A comparative study on three media (blood agar, chocolate agar and Skirrow's agar) used in the isolation of the organism showed that non-selective blood agar and chocolate agar were superior to Skirrow's agar. The strains isolated appeared to be homogeneous in their morphological and biochemical characteristics.
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PMID:Detection of Helicobacter pylori from endoscopic biopsies and the biochemical characteristics of these isolates. 210 69

The occurrence of Campylobacter pylori (CP) was studied in 180 patients referred for endoscopy. The bacterium was detected by culture, histology (Warthin-Starry staining) and urease test of antral biopsy samples. Patient groups were formed according to endoscopic diagnoses, clinical symptoms and antral mucosal histology. 50 CP positive patients with chronic antral gastritis were treated by bismuth subsalicylate (2,4 g/day) for 3 weeks. Positivity by culture and/or silver-stained histology proved to be the most reliable way for detecting CP. CP was proved in about 30% in patients with normal gastroduodenum (13/42) or with stump gastritis (4/15), in 75% with endoscopic antral gastritis (51/68) and in 89% with duodenal ulcer (49/55). A close relationship between CP and histological chronic antral gastritis could be demonstrated. No causal link between CP positive chronic active antral gastritis and non-ulcer dyspepsia could be verified. The decrease in histological activity of chronic gastritis and in dyspeptic complaints after bismuth salt therapy was found to be independent of CP elimination. The results of control investigations following a therapy-free interval of 7-10 days speak in favour of CP recolonialisation within a relativelly short period. It can be concluded that, despite the undeniable relationship between CP and chronic antral gastritis and duodenal ulcer, further studies are necessary to clarify the clinical relevance of the CP infection.
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PMID:[Has Campylobacter pylori infection any clinical relevance? Methodologic, epidemiologic and clinical studies]. 268 46

Antral biopsy specimens from 89 consecutive patients with nonulcer dyspepsia and erosive prepyloric changes included in a prospective, randomized, double-blind 4-wk study of the effect of an aluminum-magnesium antacid (120 mmol/day) or pirenzepine (50 mg b.i.d.) vs. placebo were examined histologically. Campylobacter pylori (CP) was found by light microscopy of silver-stained sections in 25 patients (28%). Campylobacter pylori-positive patients were on average older than CP-negative patients (p = 0.02). There was a strong association between CP colonization and acute inflammation (p less than 0.001), both being rare in the absence of chronic inflammation. During treatment with antacids, the density of CP decreased (p less than 0.001) without any improvement of the inflammatory reaction. On the contrary, the number of patients with gastritis tended to increase after antacids as compared with placebo (p less than 0.10). A separate analysis showed no symptomatic effect of the drugs. Thus, neither nonulcer dyspepsia nor erosive prepyloric changes are strongly associated with antral CP colonization or acute inflammation. Aluminum-magnesium antacids may suppress antral CP infection without healing the gastritis or relieving symptoms.
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PMID:Antacids reduce Campylobacter pylori colonization without healing the gastritis in patients with nonulcer dyspepsia and erosive prepyloric changes. 329 81

Campylobacter pylori, a gram-negative microaerophilic bacterium, has been implicated in the genesis of human gastritis, dyspepsia, and gastroduodenal ulceration. Previous attempts to reproduce the diseases in conventional laboratory animal species have been unsuccessful. To determine if neonatal gnotobiotic piglets were susceptible to C. pylori, we orally challenged two litters (n = 17) with 10(9) CFU after pretreating them with cimetidine. Controls housed in separate units received nothing or peptone water alone. Piglets were examined 1, 2, 3, and 4 weeks after challenge. Colonization by the bacterium and inflammation of the gastric mucosa persisted throughout the study period. Organisms were revealed by Warthin-Starry silver stain to reside between the mucus layer and the gastric epithelium. Culturing of samples from sites along the gastrointestinal tract revealed that the bacterium colonized essentially only the gastric and proximal duodenal mucosae. Gross pathological changes were restricted to the stomachs of infected piglets and consisted of submucosal edema, increased gastric mucus production, and progressive development of mucosal lymphoid follicles. Microscopic lesions consisted of transient neutrophilic infiltrates followed by diffuse and follicular infiltrations of mononuclear leukocytes into the mucosa and submucosa. Alcian blue-periodic acid-Schiff stains suggested that the infection resulted in the depletion of mucopolysaccharide production by deep gastric glands. These data indicate that gnotobiotic piglets reproduce many of the features of diseases associated with C. pylori in humans.
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PMID:Establishment of gastric Campylobacter pylori infection in the neonatal gnotobiotic piglet. 366 63

Anorexia, epigastric discomfort, nausea, and vomiting may result from disordered gastric motility and emptying. These features have been found in many adults with anorexia nervosa, but have never been investigated in early onset anorexia nervosa. In 14 patients with early onset anorexia nervosa (eight of whom had upper gastrointestinal tract symptoms), six children with other eating disorders, four children with non-ulcer dyspepsia, and 10 controls matched for age and sex, the non-invasive technique of surface electrogastrography was used to measure fasting and postprandial gastric antral electrical control activity, which underlies antral motility. The electrical signal was recorded by four bipolar silver/silver chloride electrodes attached to the upper abdomen, amplified and low pass filtered at 0.33 Hz before being displayed on a polygraph, digitised at 1 Hz, and stored on the hard disk of a personal computer for later offline analysis. Patients with non-ulcer dyspepsia had gastric antral dysrhythmias. No significant difference was found in the mean (SD) dominant frequency of the antral electrical control activity between patients with early onset anorexia nervosa (2.86 (0.35) cycles/minute (cpm)), patients with other eating disorders (3.14 (0.65) cpm), and controls (3.00 (0.46) cpm). The amplitude of electrical control activity increased postprandially in all but one subject and the fasting/postprandial amplitude ratio did not significantly differ between patients with early onset anorexia nervosa and controls, though patients with longer established disease had a smaller increase in amplitude. Gastric antral electrical dysrhythmias are not a feature of early onset anorexia nervosa and therefore do not induce or perpetuate food refusal in this disorder.
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PMID:Normal gastric antral myoelectrical activity in early onset anorexia nervosa. 821 43

Antibodies to H.pylori were investigated in the serum of 50 patients with dyspepsia and 25 healthy controls with ELISA method. The antibody positivity was found in all of the 40 cases (100%) for whom H.pylori was demonstrated in at least two tests of rapid urease, Gram stain, culture and silver staining and in eight of the ten cases (80%) whom H.pylori tests were all negative. Twenty-two of the 25 healthy controls (88%) had also antibodies to H.pylori. The sensitivity of the test was found high (100%), but the specificity was found too low (20%).
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PMID:[Evaluation of the ELISA method for the diagnosis of Helicobacter pylori]. 826 42

Helicobacter pylori-like organisms (Hp) and polymorphonuclear leucocytes (PMNs) in 2614 gastroduodenal biopsies from 602 patients with dyspepsia, in Al Ain, United Arab Emirates, between October 1990 and October 1992, were histologically graded to determine the prevalence of Hp gastritis and their utilization in the evaluation of treatment efficacy in these patients. Symptoms of functional dyspepsia included, in order of frequency, abdominal pain or discomfort, flatulence, burning sensation, regurgitation, fullness, nausea, vomiting, bloating and belching. The biopsies were paraffin embedded, sectioned and stained with hematoxylin and eosin (H and E) to grade the inflammation. In addition to H and E, several special stains including modified Giemsa (MG), Wharthin-Starry silver and cold Ziehl-Neelsen stains were utilized to clearly identify Hp organisms. Giemsa method was found to be superior to other special stains in visualizing the Hp organisms in paraffin sections, and was utilized in every case. Two immunohistochemical markers for B cells (CD20) and T cells (CD45RO) were utilized for labeling lymphocytes infiltrating the lamina propria of the gastroduodenal biopsies in formalin-fixed paraffin-embedded sections. H and E and MG stained sections were utilized to count PMNs and Hp, and were graded 0, 1, 2, and 3, corresponding to none, mild, moderate, and severe grades of the Sydney system for classification of gastritis, respectively. Of the total initial 2318 endoscopic biopsies, 98.8% of the patients had suitable biopsies for histologic evaluation. Unsuitable biopsies were recovered from patients with gastric carcinoma. Inflammation was seen in 98.5% of 595 patients with suitable biopsies. In 74.5% of these patients the inflammation was active; 37.5, 32.5 and 4.5% had mild, moderate and severe active inflammation, respectively. In the remaining 24% of the 595 patients, the gastritis was chronic without activity or atrophic changes. As many as 73.6% of the patients with suitable biopsies were Hp positive; 39.8, 29.1 and 4.7% had grades 1, 2 and 3 Hp, respectively. Intestinal metaplasia was found in 28.9% of the 602 patients, and was seen more often in Hp positive than Hp negative patients (34.5 vs 14%, P < 0.005, for d.f. = 1; chi 2 = 10.35). Of the Hp positive patients, 172 and 46 patients attended the first and second follow-up endoscopy visits, respectively. The triple treatment was composed of one dose of tinidazole (2gm), doxycycline, 200 mg initial dose and 100 mg daily for two weeks, and bismuth subcitrate (Gist-Brocades nv, Delft, The Netherlands), 2 tablets twice daily for 4 weeks. After triple drug treatment, eradication of Hp was accomplished, histologically, in 38.4 and 45.7% of the patients on first and second follow-up visits, respectively. Thus, the Sydney system-based grading scale provides an objective histological evaluation of Hp gastritis for accurate prevalence studies, and may prove to be of value in estimating treatment efficacy.
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PMID:Grading Helicobacter pylori gastritis in dyspeptic patients. 881 77

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


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