Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Once the effects of short-term data analysis of new medical technology appear clear, additional or long-term analyses are infrequently performed on subsequent information. This often leads to incomplete understanding of the technology's full medical, social, and economic effects. Available data for the Federal Republic of Germany on mortality, hospitalization, and work loss due to gastric and duodenal ulcer and gastritis/duodenitis allowed long-term analysis of direct and indirect impacts on the population from 1975 through 1984. Mortality rates declined for all ages (p less than 0.01) except for those age 75 and older, and nearly equally for all study diagnoses. Hospital discharge rates for all diagnoses rose slowly and steadily, while those for persons diagnosed with gastric ulcer, duodenal ulcer or gastritis/duodenitis declined sharply (p = 0.04). Declines of hospital discharges were greater for men than for women. The ongoing decline in rates of mortality and hospital discharges increased after 1977. Rates of work loss per 10,000 population-at-risk for study diagnoses were either stable or increasing until 1979, after which there was a marked decline (p = 0.03 for gastric ulcer, p = 0.02 for duodenal ulcer, p = 0.008 for gastritis/duodenitis). Work loss due to study diseases declined as a percentage of work loss for all diseases during the later study years. Only by examining many years' data could the accelerating declines be discerned, not only for mortality and hospitalizations, which have been examined before, but also for work loss, an infrequently analyzed effect of disease.
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PMID:Long-term technology assessment. Mortality, hospitalization, and work loss due to peptic ulcer and gastritis/duodenitis in the Federal Republic of Germany. 1029 69

In the pediatric population, the associations of Helicobacter pylori with gastritis, gastric ulcer, duodenitis and duodenal ulcer, and with duodenal gastric surface metaplasia and disorders of the D cell- G cell axis resulting in hypergastrinemia, are well established and in many ways resemble their counterparts in adults. Eradication of H pylori invariably results in the reversal of these diseases with time. There are also suggestions that gastric surface metaplasia is more extensive in children with H pylori, and may be the site of duodenal H pylori infection and associated duodenal erosions or ulcers. There is no consensus as to whether H pylori in children is more or less severe than in adults. In one pediatric cohort, H pylori was associated with increased intensity of inflammation, while other studies suggest that acute inflammation may be less intense in children overall but that chronic inflammation may be increased in intensity, including lymphoid hyperplasia, which in turn may correlate with endoscopic nodularity. Lymphoid hyperplasia and nodular gastritis appear to be more frequent in children than in adults and usually regress following H pylori eradication. However, in children, other diseases or morphological abnormalities, including some loss of glands (atrophy), occasionally intestinal metaplasia, lymphoproliferative diseases including low grade mucosal-associated lymphoid tissue lymphoma, lymphocytic gastritis and hypertrophic gastritis/Menetrier's disease, are much less frequently associated with H pylori than in adults. Other associations are rarely seen in children, primarily because the time required for these to develop takes the individual to adulthood; for example, while intestinal metaplasia occurs in the pediatric population, the complications of adenoma/dysplasia and carcinoma are rare. In adults, inflammatory and hyperplastic polyps, atrophic gastritis and pernicious anemia, and in some patients granulomas (granulomatous gastritis), may also be associated with H pylori infection. Greater awareness of the spectrum of diseases associated with H pylori may well lead to their increased recognition in the pediatric population. Some diseases, particularly Crohn's disease, but also human immunodeficiency virus infection, have a negative association with H pylori that appears not to be simply a result of the excess antibiotic therapy that these patients receive. These variations in association and reactions to H pylori, some of which are age-related, may allow the different host responses to H pylori that occur in humans to be examined.
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PMID:Pathobiology of Helicobacter pylori infection in children. 1051 59

In contrast to the experience in the adults, there are limited data concerning the efficacy and safety of upper gastrointestinal endoscopy (UGIE) in paediatric patients. The information on this procedure is very scanty from non-western countries. We analysed 72 children evaluated in Gizan, Saudi Arabia, an area of high endemic hepatitis B and chronic liver disease. The indications comprised abdominal pain (49%), UGI bleeding (24%) and evaluation of suspected portal hypertension. No abnormality was detected in 33 (46%). Mucosal inflammatory lesions (oesophagitis, gastritis and duodenitis) are the commonest abnormal lesions, occurring in 24 (33%). Duodenal ulcer (4 cases) and gastric ulcer (1 case) were relatively few. No case of malignancy was found. Sclerotherapy for variceal bleeding was effective in 4 patients. Helicobacter pylori was detected in 12 of 23 patients and associated with histologically identified gastritis in the majority of these cases. It is concluded that paediatric UGIE is safe and useful in the diagnosis and therapeutic intervention for UGI diseases in children. Our findings provide additional information on the pattern of diseases among Saudi Arabian children.
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PMID:Upper gastrointestinal diseases in Saudi Arabian children. 1069 24

The clinical outcome of Helicobacter pylori infection may be associated with the cagA bacterial genotype. To investigate the cagA status of H. pylori-infected patients and the relationship between cagA and peptic ulcer disease, gastric biopsy specimens from 103 Caucasian patients in Brazil were analyzed by PCR. Since allelic variation in cagA exists and distinct H. pylori subgenotypes may circulate in different regions, PCR using primers for a variable 3' region of the cagA gene according to a Japanese methodology and for a consensus cagA 3' region used in Western methods was used for cagA detection. cagA was present in 53 (71%) of 75 H. pylori-positive cases when analyzed by the consensus region method and was associated with duodenal ulcer disease (P = 0.02), but not with gastric ulcer (P = 0.26), when compared to patients with duodenitis or gastritis. The variable region PCR method was able to detect 43 (57%) cagA-positive cases within the same group of H. pylori-positive patients and showed three subtypes of cagA (A, B/D, and C) that were not associated with clinical outcome. However, in 8 (18%) of the cases, more than one subtype was present, and an association between patients with multiple subtypes and disease outcome was observed when compared to patients with isolated subtypes (P = 0.048). cagA was a marker of H. pylori strains for duodenal ulcer disease in our population, and in spite of the differences in the 3' region of the cagA gene, the Japanese methodology was able to detect the cagA status in most cases. The presence of multiple subgenotypes of cagA was associated with gastric ulcer.
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PMID:Consensus and variable region PCR analysis of Helicobacter pylori 3' region of cagA gene in isolates from individuals with or without peptic ulcer. 1141 45

A prospective study was performed to evaluate the epidemiological characteristics, clinical outcome and to determine the cause of bleeding in patients admitted to the Cayetano Heredia National Hospital with the diagnosis of gastrointestinal bleeding. Between August 1994 and May 1995, 100 patients were admitted, 86 patients with upper gastrointestinal bleeding and 14 with lower gastrointestinal bleeding. The mean age for the former was 45,25 years and the male/female ratio was 3.5/1. The main complaints were tarry stools and haematemesis in 56,9% and 26,7% only with melena. A history of non steroidal antiinflamatory drugs intake within 48 hours before the bleeding episode was obtained in 19,7% and alcohol ingestion was observed in 19,7%. In 36% of the patients a history of a previous episode of bleeding was obtained. The major causes of bleeding were duodenal ulcer in 38,3%, acute lesions of the gastric mucosa in 20,9%, gastric ulcer in 11,6% and esophageal varices in 5,8%, Mallory Weiss syndrome in 4,6%, gastric carcinoma in 2,3%, prolapse gastropaty 2,3%, esophagitis in 2,3%, esophageal ulcer 1,1 %, duodenitis 1,1%, arteriovenus malformations in 1,1%. The etiology of the hemorrhage could not be established in 8% of cases. The diagnostic rate of endoscopy was 91,7%.In 66% of the patients the endoscopy was carried out within the 24 hours of admission 20,9% of the patients had other potential bleeding lesions 9,1% of the patients had a new episode of bleeding during hospitalization and surgery was needed in 11,6%. Injectotheraphy was done in 7 (8,13%) patients (4 for variceal 2 for duodenal and 1 for gastric bleeding ) The overall mortality was 3,4% Fourteen patients with lower gastrointestinal bleeding were evaluated. The mean age was 53,14 years and the male/female ratio was 1.6/1. The main complaint was hematochezia. The major causes of bleeding were hemorrhoidal disease in 64,2% and rectal cancer in 14,28%.
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PMID:[GASTROINTESTINAL BLEEDING IN PATIENTS ADMITTED TO THECAYETADNO HEREDIA PUBLIC HOSPITAL] 1221 99

Helicobacter pylori (H. pylori) is the principal cause of peptic ulcer disease and important risk factor in gastric cancer. Gastric mucosal biopsy specimens taken from 110 patients were examined by polymerase chain reaction (PCR), culture and urease test. The ureA gene was detected in 52 out of 110 examined samples. The cagA gene was detected in 35 (67.3%) out of these 52 specimens (ureA+). This gene was presented in all of patients with stomach ulcer, in 75.0% of patients with duodenitis, 69.6% of patients with duodenal ulcer and 58.3% of patients with gastritis. H. pylori was detected by culture in 24 (25.3%) out of 95 samples. These results were confirmed by PCR. H. pylori was detected additionally in 20 samples only by PCR. This bacterium was detected more frequently by PCR than by culture (46.3% vs 25.3%). Results obtained by using three methods: culture, urease test and PCR were concordant in 47.0% (39 out of 83 patients). In 16 (19.3%) cases H. pylori was detected by two methods: urease test and PCR. Infection was detected only by PCR in 3 (3.6%) cases and in 25 cases (30.1%) only by urease test.
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PMID:[Comparison of diagnostic methods for Helicobacter pylori detection and identification of cagA gene in clinical specimens]. 1586 38

During the past 20 years the role of Helicobacter pylori have been topic of intensive research. Studies have established that H. pylori can cause acute and chronic gastritis, duodenitis, gastric peptic ulcers and duodenal ulcers non-ulcer dyspepsia and Weird diseases and syndroms. H. pylori has been identified as a risk factor for gastric cancer and MALT-lymphoma. Nearly more than 90% of patients with duodenal ulcus, more than 70% of those with gastric ulcer and more than 80% patients with the gastric cancer have H. pylori infection. The discovery of the infective nature of peptic diseases and involvement of of H. pylori in theirs aetiology has begin to change our views on haw to approach diagnosis and therapeutic treatment in the practice. For this aim have been developed several methods which can be used to diagnose of H. pylori: invasive as endoscopy and non-invasive such as urea-breath-test, detection of antigens in stool, detection of specific antibodies in patients sera by means of serological tests--ELISA and Immunblott, molecular tests PCR and fluorescence-in situ- hybridisation for the detection of H. pylori and its resistance for clarithromycine and metronidazole. There are several effective treatments which can cure gastric and duodenal ulcers as well as prevent theirs recurrences.
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PMID:[Helicobacter pylori--clinical manifestations, diagnosis and therapy]. 1640 30

A total of 10,000 patients underwent upper gastrointestinal endosopy examination between August 1979 and October 1994 at Tikur Anbessa Hospital, Addis Ababa. The major indications were dyspepsia (59.4%), upper gastrointestinal bleeding (18%) and liver disease (10.8%). The other indications include dysphagia (2.2%), gastric outlet obstruction (2.1%), postoperative dyspeptic symptoms (1.9%), weight loss and/or anemia (1.4%), epigastric mass (0.6%) and odynophagia 0.2%. The mean age of the patients and their sex ratio was 36 years and 2:1, respectively. Twenty eight percent of the patients had normal findings. The commonest abnormal findings include duodenal ulcer (41%), esophageal varices (9%), acute gastritis (6%), duodenitis (3.4%), and reflux esophagitis (2.3%). Benign gastric ulcer was rare. The ratio of duodenal ulcer to gastric ulcer was 19.1%. Duodenal ulcer (45.6%), esophageal varices (15.6) and acute gastritis (5.7%) were found to be the commonest causes of upper gastrointestinal bleeding. The endoscopy or histology diagnosis of cancer in both the esophagus and stomach was 2.8% and 1.3%, respectively. The agreement between endoscopy and histology in the diagnosis of esophageal and gastric cancer was 80%. There was no major complication related to endoscopy or premeditation. Endoscopy is a fairly accurate and safe procedure and therefore should be available and applied widely for the diagnosis of upper gastrointestinal diseases in Ethiopia.
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PMID:Upper gastrointestinal endoscopy: a review of 10,000 cases. 1689 26

We evaluated the effects of the use of nonsteroidal anti-inflammatory drugs (NSAIDs) on endoscopic and histological findings in patients with rheumatoid arthritis (RA) before and after the eradication of Helicobacter pylori infection. Helicobacter pylori (H. pylori) eradication using lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 mg twice daily for 1 week was conducted in 44 patients (mean age: 56.5 years) with RA. Using the updated Sydney system, endoscopic and histological findings of the greater curvature of the antrum, the greater curvature of the upper corpus, and the lesser curvature of the lower corpus were compared before and after eradication, for a mean follow-up period of 3.5 months. Overall, H. pylori eradication was successful in 32 patients (72.7%). Of these 32 patients, 23 were NSAID users. In the successful eradication group, (1) there was no significant change on endoscopic findings, including gastric erythema and erosion in all three regions irrespective of NSAIDs use; (2) of 17 active ulcers before eradication in NSAIDs users, all healed except for one duodenal ulcer that persisted, where one patient newly developed a gastric ulcer, one developed erosive duodenitis, and two developed reflux esophagitis, all in NSAID users; (3) neutrophil infiltration and chronic inflammation were significantly improved in all three regions after H. pylori eradication irrespective of use of NSAIDs, while atrophic change and intestinal metaplasia did not change. In the eradication failure group; (1) there was no significant change on endoscopic and histological findings in the three regions; (2) two of three ulcers present before eradication on NSAID users persisted even after eradication, and no new cases of gastric ulcer or erosive duodenitis occurred. In conclusion, over a mean follow-up period of 3.5 months, use of NSAIDs in Japanese patients with RA did not impair the healing process of gastric and duodenal ulcers nor did it affect the endoscopic and histological improvements associated with H. pylori eradication.
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PMID:Nonsteroidal anti-inflammatory drug use does not affect short-term endoscopic and histologic outcomes after Helicobacter pylori eradication in patients with rheumatoid arthritis. 1756 79

The effects of fasting on peptic ulcer disease were evaluated in a prospective study, involving 23 fasting patients who underwent endoscopy before and after Ramadan. Eighteen patients took an H(2)-blocker (ranitidine, 150 mg twice daily) regularly at "Suhur" and "Iftar" as prescribed, while 5 were drug defaulters. On the first endoscopy the diagnosis in 4 patients was active acute duodenal ulcer (AADU), in 8 patients was active chronic duodenal ulcer (ACDU) in 8 patients was healed duodenal ulcer (HDU), in 2 patients was erosive duodenitis (ED), and in 1 patient was chronic gastric ulcer (CGU). All of the patients with AADU showed signs of healing on repeat endoscopy. None of the ACDU patients showed signs of healing on repeat endoscopy. Instead, 7 patients in this group bled during fasting. All of the 5 drug defaulters belonged to the ACDU group. One patient in the HDU group had developed an active ulcer near the previous scar, as which was seen on repeat endoscopy. The 2 patients with ED showed signs of healing, while the only patient with CGU had bled from the same ulcer as seen on repeat endoscopy. The results were compared with those of 15 nonfasting control subjects (6 patients with ACDU, 3 with HDU, and 6 with ED as diagnosed on the first endoscopy), who took an H(2)-blocker regularly. The repeat endoscopy did not show any change in these patients. In conclusion, we inferred that Ramadan fasting may prove hazardous in patients with peptic ulcer disease in general and with active chronic ulcers in particular, although the fact that only 23 patients volunteered for this study, of whom 5 were drug defaulters, is a limitation.
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PMID:Endoscopic evaluation of peptic ulcer disease during ramadan fasting. 1849 8


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