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Salceda-Otero JC, Lozoya-González D, Peláes-Luna M, Baquera-Hereida J. [Clinical Images. Gastric infection by Strongyloides]. Rev Gastroenterol Mex 2010; 75:324-325. [PMID: 20959182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- J C Salceda-Otero
- Unidad de Endoscopia Avanzada, Centro Médico ABC, México, D. F., Mexico
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52
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Badmos KB, Ojo OS, Olasode OS, Arigbabu AO. Gastroduodenitis and Helicobacter pylori in Nigerians: histopathological assessment of endoscopic biopsies. Niger Postgrad Med J 2009; 16:264-267. [PMID: 20037622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Morphologic changes seen in the endoscopic biopsies are dynamic and could be predictive of more important sequelae of chronic H. pylori gastritis such as gastric carcinoma and lymphoma. The objective of the study was to review the biopsy appearances of endoscopic gastroduodenal biopsies using the updated Sydney System of classification in order to throw some light on the biology of gastroduodenitis. METHODS A retrospective review of all endoscopic gastroduodenal biopsies received in the department of Morbid Anatomy of Obafemi Awolowo University Teaching Hospitals Complex between 1994 and 2003 was undertaken. Grading of the chronicity, activity, atrophy, H. pylori density and metaplasia were done using the updated Sydney System of classification and grading. RESULTS A total of 1047 gastric and 47 duodenal biopsies from 1047 patients were reviewed. There was evidence of significant chronic gastritis in 98.1% of the gastric biopsies and in 78.0% of these, H. pylori was the main identifiable aetiological agent. Marked atrophic changes and intestinal metaplasia that are known to predispose to gastric malignances were seen in 4.9% and 9.3% of our cases respectively. Chronic duodenitis was seen in 83% of the duodenal biopsies and in 29.6%, H. pylori was seen on a background of gastric metaplasia. CONCLUSION The prevalence of H. pylori was high and it was the single most important aetiological factor responsible for the biopsy changes associated with chronic gastroduodenitis.
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Affiliation(s)
- K B Badmos
- Department of Morbid Anatomy and Forensic Medicine,Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State
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53
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Zawadzka-Gralec A, Wróblewska M, Szaflarska-Popławska A, Mierzwa G, Parzecka M, Bała G, Slusarska-Kopala J, Czerwionka-Szaflarska M. [The analysis of usefulness different diagnostic methods in children and adolescents with Helicobacter pylori infection]. Pol Merkur Lekarski 2009; 26:24-28. [PMID: 19391502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED A diagnostics of Helicobacter pylori infection in children and adolescents in practice sometimes is still difficult. Qualification to the tests for detecting infection with invasive and noninvasive methods should start from diligent anamnesis. THE AIM OF THE STUDY Is to present the clinical course and results of diagnostic tests in children and adolescents with suspicion of Helicobacter pylori infection. MATERIAL AND METHODS One hundred patients aged between 18 months and 18 years who underwent endoscopy with gastric biopsies, histology, culture and 13carbon urea breath test. There were 36 boys and 64 girls in analysed group, 10% of them were preschool children, 42% school children and 48% teenagers older than 12 years RESULTS Patients were symptomatic and most frequent were dyspeptic symptoms (91%). A symptom duration time was varied from several days to several years. On the basis of endoscopy and histology gastritis and/or duodenitis were found in 92 patients, esophagitis and gastritis in 5 patients, duodenal ulcer in 2 patients, in 1 case gastric and duodenal mucosa was normal. Helicobacter pylori infection was histopathologically confirmed in 37 patients. In 15 cases Helicobacter pylori strains were isolated with full in vitro sensitivity to amoxicillin, claritromycin and metronidazol. Urea breath test was conducted in 85 analyzed patients and 51 of them had abnormal result. CONCLUSIONS In clinical picture of Helicobacter infection most frequent were dyspepstic symptoms and by endoscopy chronic gastritis and/or duodenitis were shown. Culture of Helicobacter pylori has a limited usefulness in practice especially in patients who underwent antibiotic/eradication therapy. The statistical significant concordance occurred between culture and noninvasive 13carbon urea breath test.
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Affiliation(s)
- Anna Zawadzka-Gralec
- Uniwersytet Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy, Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii.
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Zambelli A, Villanacci V, Buscarini E, Albarello L, Viardi L, di Stefano O, Bassotti G. Confocal endomicroscopic aspects in Whipple's disease. Gastrointest Endosc 2008; 68:373-4; discussion 374. [PMID: 18514653 DOI: 10.1016/j.gie.2008.02.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 02/19/2008] [Indexed: 12/10/2022]
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55
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Hori K, Ikeuchi H, Nakano H, Uchino M, Tomita T, Ohda Y, Hida N, Matsumoto T, Fukuda Y, Miwa H. Gastroduodenitis associated with ulcerative colitis. J Gastroenterol 2008; 43:193-201. [PMID: 18373161 DOI: 10.1007/s00535-007-2143-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2007] [Accepted: 11/07/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ulcerative colitis (UC) is regarded as confined to the colorectum; however, there are several case reports showing upper gastrointestinal involvement. The aim of this study was to examine the prevalence and characteristics of gastroduodenitis associated with UC (GDUC). METHODS Esophagogastroduodenoscopy with biopsies was prospectively performed on 250 UC patients (134 men, 116 women; mean age, 42 years; 162 with colectomy, 163 with pancolitis). Criteria for GDUC were created on the basis of endoscopic and histological comparisons with non-UC controls, and the prevalence and characteristics were statistically analyzed. RESULTS GDUC was defined endoscopically as friable mucosa (erosive or ulcerative mucosa with contact or spontaneous bleeding), granular mucosa (multiple white spots almost without a red halo), or, conditionally, multiple aphthae (multiple white spots surrounded by a red halo, clinically excluding other disorders such as Crohn's disease). The prevalence of GDUC was 19/250 (7.6%). The clinical characteristics included more extensive colitis, lower dose of prednisolone, higher prevalence of pouchitis, and longer postoperative period. In our population, the presence of pancolitis and a lower dose of prednisolone were significant risk factors for developing GDUC in multivariate analysis. CONCLUSIONS The high prevalence of GDUC suggests that the gut inflammatory reaction in UC may not be restricted to the large intestine. Administered steroids might conceal GDUC, and more aggressive UC such as active pancolitis may be related to the development of GDUC.
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Affiliation(s)
- Kazutoshi Hori
- Department of Endoscopy Center, Hyogo College of Medicine, Nishinomiya, 663-8501, Japan
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56
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Li XB, Ge ZZ, Chen XY, Liu WZ. Duodenal gastric metaplasia and Helicobacter pylori infection in patients with diffuse nodular duodenitis. ACTA ACUST UNITED AC 2008; 40:897-902. [PMID: 17653441 DOI: 10.1590/s0100-879x2006005000117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Accepted: 04/26/2007] [Indexed: 11/22/2022]
Abstract
Whether the regression of gastric metaplasia in the duodenum can be achieved after eradication of Helicobacter pylori is not clear. The aim of the present study was to investigate the relationship between H. pylori infection and gastric metaplasia in patients with endoscopic diffuse nodular duodenitis. Eighty-six patients with endoscopically confirmed nodular duodenitis and 40 control patients with normal duodenal appearance were investigated. The H. pylori-positive patients with duodenitis received anti-H. pylori triple therapy (20 mg omeprazole plus 250 mg clarithromycin and 400 mg metronidazole, all twice daily) for one week. A control endoscopy was performed 6 months after H. pylori treatment. The H. pylori-negative patients with duodenitis received 20 mg omeprazole once daily for 6 months and a control endoscopy was performed 2 weeks after treatment. The prevalence of H. pylori infection was 58.1%, and the prevalence of gastric metaplasia was 57.0%. Seventy-six patients underwent endoscopy again. No influence on the endoscopic appearance of nodular duodenitis was found after eradication of H. pylori or acid suppression therapy. However, gastric metaplasia significantly decreased and complete regression was achieved in 15/28 patients (53.6%) 6 months after eradication of H. pylori, accompanied by significant improvement of other histological alterations. Only mild chronic inflammation, but not gastric metaplasia, was found in the control group, none with H. pylori infection in the duodenal bulb. Therefore, H. pylori infection is related to the extent of gastric metaplasia in the duodenum, but not to the presence of diffuse nodular duodenitis.
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Affiliation(s)
- X B Li
- Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Diseases, Medical College of Shanghai Jiaotong University, Shanghai, China.
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57
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Shubina ME, Iakhontova OI. [The role of different factors affecting the duodenum in chronic viral hepatitis B]. Klin Med (Mosk) 2008; 86:53-56. [PMID: 18819349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of the present study was to determine the frequency and the character of duodenal lesions in patients with chronic viral hepatitis B (CVH-B), to elucidate the dependence of these parameters on the activity and duration of hepatitis, virulence, and portal blood flow. A total of 206 patients with CVH-B were examined. It was found that CVH-B was associated with the development of chronic duodenitis in 23.3% of the patients. Endoscopic studies revealed different degree of affection of duodenal mucosa. Superficial focal and moderately severe duodenitis occurred more frequently (in 33.3 and 37.5% of the patients) than manifest duodenitis (12.5%). Erosive duodenitis concomitant with Helicobacter pylori infection was diagnosed in 16.7% of the patients. The main factors contributing to the development of chronic duodenitis included viral infection, its intensity, duration of hepatitis, and disturbed portal circulation. Severity of duodenitis was closely related to the severity of CVH-B.
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Talley NJ, Walker MM, Aro P, Ronkainen J, Storskrubb T, Hindley LA, Harmsen WS, Zinsmeister AR, Agréus L. Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case-control study. Clin Gastroenterol Hepatol 2007; 5:1175-83. [PMID: 17686660 DOI: 10.1016/j.cgh.2007.05.015] [Citation(s) in RCA: 228] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Functional abnormalities of the duodenum have been observed in non-ulcer dyspepsia. We aimed to identify whether eosinophils in the upper gastrointestinal tract are a biomarker for non-ulcer dyspepsia. METHODS A random sample of an adult Swedish population (n = 1001; mean age, 54 y; 51% female) underwent upper endoscopy. Non-ulcer dyspepsia cases (n = 51, Rome II) and randomly selected controls (n = 48) were identified. Two blinded independent observers assessed the gastroduodenal eosinophil counts. Eosinophils were quantified by counting the number per 5 high-power fields at each of 5 sites (cardia, body, antrum, D1 duodenal bulb, and D2 second portion of duodenum), and total counts were summed over the 5 fields at each site. RESULTS The odds ratio for non-ulcer dyspepsia (vs asymptomatic controls) in subjects with high duodenal bulb eosinophil counts (median, >/=22, relative to <22) was 11.7 (95% confidence interval, 3.9-34.9), adjusting for age, sex, and H pylori; similar results were observed in D2 (odds ratio = 7.3; 95% confidence interval, 2.9-18.1). A significant association with the number of eosinophil clusters was detected in the duodenum, with higher values in non-ulcer dyspepsia (P < .01). By immunostaining with major basic protein antibody in a subset of duodenal biopsy specimens, eosinophil degranulation was observed in non-ulcer dyspepsia (7 of 15 vs 0 of 5 controls; P = .11). Gastric eosinophil counts were overall not significantly increased in non-ulcer dyspepsia vs controls. Early satiety was associated with eosinophilia in D1 (P = .01) and D2 (P = .02), adjusting for age, sex, and H pylori. CONCLUSIONS Duodenal eosinophilia may characterize a subset of adults with non-ulcer dyspepsia.
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Del Valle J. A 65-year-old woman with recurrent duodenal erosions and an increased gastrin level: approach to a patient with hypergastrinemia. Clin Gastroenterol Hepatol 2007; 5:1024-6. [PMID: 17825770 DOI: 10.1016/j.cgh.2007.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- John Del Valle
- Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, Michigan, USA
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60
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Abstract
The ABO blood group system was discovered by Karl Landsteiner in 1901. Since then, scientists have speculated on an association between different pathologies and the ABO blood group system. The aim of this pilot study was to determine the significance between different blood types of the ABO blood group system and certain pathologies. We included 237 patients with known diagnosis, blood group, sex, and age in the study. As a statistical method, the Chi-square test was chosen. In some cases, a significant association between the blood groups and defined diseases could be determined. Carriers of blood group O suffered from ulcus ventriculi and gastritis (X(2)1 = 78.629, p < 0.001), colitis ulcerosa and duodenitis (X(2)1 = 5.846, p < 0.016), whereas male patients carrying blood group A tended to contract different types of tumours. In patients with intestinal tumours, females with blood group A were more likely to develop the pathology, whereas in males, the blood group O dominated. The development of cholelithiasis was found, above all, in patients with blood group O, which differed from other research where a correlation between this pathology and blood group A was found.
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Affiliation(s)
- Ursula Jesch
- Interuniversity College for Health and Development Graz, Castle of Seggau, Austria.
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61
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Abstract
Cow's milk protein enteropathy is a symptom complex that composed of severe diarrhoea and malnutrition. This disorder is caused by non-immunoglobulin E-mediated food allergy. Its clinical features and natural course have been explained in many reports, of different types of cow's milk and soy reactions. In the present article, we describe a newborn patient who presented with chronic diarrhoea and failure to thrive diagnosed as cow's milk protein enteropathy. The duodenal biopsy revealed granulomatous duodenitis which has not been described before. Her clinical and pathological findings responded well to cow's milk elimination. We suggest that food allergies should be considered in differential diagnosis of patients with chronic diarrhoea and failure to thrive.
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Affiliation(s)
- Ozlem Y Ozbek
- Faculty of Medicine, Department of Pediatrics, Baskent University, Ankara, Turkey.
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62
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Navarro-Llavat M, Domènech E, Masnou H, Ojanguren I, Mañosa M, Lorenzo-Zúñiga V, Boix J, Gassull MA. Collagenous duodeno-ileo-colitis with transient IgG deficiency preceded by Yersinia enterocolitica intestinal infection: case report and review of literature. Gastroenterología y Hepatología 2007; 30:219-21. [PMID: 17408550 DOI: 10.1157/13100588] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A case-report of a man with chronic diarrhoea is presented. After an unsuccessful treatment of an intestinal yersioniosis, the diagnosis of collagenous intestinal disease affecting duodenum, ileum and colon was made. In addition, a IgG transient deficiency was observed. The literature about gastrointestinal involvement, concomintant infection by Yersinia and IgG deficiency in collagenous colitis is reviewed.
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Affiliation(s)
- Mercè Navarro-Llavat
- Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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63
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Golovanova ES, Paltusova ES, Aminova AI. [The effects of metacine and anapriline course therapy on the morphofunctional changes in the gastric mucosa of patients with chronic gastroduodenitis]. Klin Med (Mosk) 2007; 85:45-9. [PMID: 17564038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The article analyzes the influence of course treatment with vegetomodulating preparations on morphofunctional changes in the gastric and duodenal mucosa. Thirty-eight patients with chronic gastroduodenitis dwelling in ecologically unfavorable territories were examined and treated. The study demonstrated positive changes in the histomorphological picture of the gastroduodenal mucosa in children who received conventional standard therapy in combination with the beta-adrenoblocker anaprilin and the M-cholinolytic atropine compared to controls who received only the basic therapy.
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64
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Fedorov AA, Gromov AS, Sapronenok SV, Kurochkin VI, Zhernakova ZM. [Ozone therapy in gastroduodenal pathology associated with Helicobacter pylori]. Vopr Kurortol Fizioter Lech Fiz Kult 2006:34-7. [PMID: 17201222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Three methods of ozone therapy (intravenous injection of ozonized physiologic saline, oral intake of ozonized low-mineral water and combination of the two treatments) were compared by efficacy in 215 patients with gastroduodenal pathology associated with Helicobacter pilori. All the techniques of ozone therapy proved effective in relation to regress of clinical symptoms, regeneration processes, eradication of Helicobacter pylori, but the combined regimen was the best.
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Ikeuchi H, Hori K, Nishigami T, Nakano H, Uchino M, Nakamura M, Kaibe N, Noda M, Yanagi H, Yamamura T. Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis. World J Gastroenterol 2006; 12:5913-5. [PMID: 17007066 PMCID: PMC4100681 DOI: 10.3748/wjg.v12.i36.5913] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We experienced a very rare case of ulcerative colitis (UC) accompanied with analogous lesions in the stomach, duodenum, and ileal J -pouch. Ileal J-pouch anal anastomosis was performed on a 29-year old woman in 1996. Six years later, she was admitted again to our hospital because of epigastralgia, nausea, watery diarrhea and low fever. Based on the results of endoscopic examination, we diagnosed it as pouchitis. Moreover, on hypotonic duodenography, expansion of the duodenal bulb and the descending portion were poor. Kerckring folds disappeared with typical lead-pipe appearance. The pathogenesis of the gastric and duodenal lesion in this patient was similar to that of the colonic lesions of UC. For the gastroduodenal lesions in this patient, symptomatic remission was obtained following administration of crushed mesalazine tablets (1500 mg/d) for 14 d with continuous administration of omeprazole. Firstly we used ciprofloxacin to treat pouchitis. On the fifth day, she got a fever because of catheter infection. In the catheter culture, methicillin-resistant Staphylococcus aureus (MRSA) was detected. Therefore we changed ciprofloxacin to vancomycin hydrochloride (Vancomycin®). Vancomycin was very effective, and the stool frequency dramatically improved in three days. Now she continues to take mesalazine, but her condition is stable and there has been no recurrence of pouchitis.
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Affiliation(s)
- Hiroki Ikeuchi
- Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
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Blanchard SS, Gerrek M, Czinn S, Chelimsky G, Seaman D, Siegel C, Splawski J. Food protein sensitivity with partial villous atrophy after pediatric liver transplantation with tacrolimus immunosuppression. Pediatr Transplant 2006; 10:529-32. [PMID: 16712617 DOI: 10.1111/j.1399-3046.2006.00501.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report three pediatric liver transplant recipients receiving tacrolimus immunosuppression presented with vomiting, heme-positive stools and failure to thrive, who had subtotal villous atrophy in their histology because of food protein sensitivity. Case findings and current literature of the casual relationship between tacrolimus and food allergies briefly reviewed.
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Affiliation(s)
- Samra Sarigol Blanchard
- Department of Pediatric Gastroenetrology, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA
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Abstract
The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis.
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Affiliation(s)
- S Serra
- Department of Pathology, University Health Network and Toronto Medical Laboratories, Toronto, Ontario, Canada.
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68
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Shcherbak VA. [Lipid peroxidation of gastric juice lipids in children with gastroduodenitis]. Klin Lab Diagn 2006:14-7. [PMID: 16756157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
A hundred and nine patients aged 9-16 years who had chronic gastroduodenitis (CGD) were examined. All the children had an exacerbation of gastroduodenitis. In patients with erosive and superficial gastroduodenitis, the gastric juice levels of primary, secondary, and intermediate lipid peroxidation (LPO) products were higher than those in controls and in patients with other endoscopic forms. The increased acid-secreting function causes a rise of gastric juice LPO products. Helicobacter pylori persistence leads to the increased accumulation of LPO products in the gastric juice. The pathogenetic significance of impaired LPO in the development of CGD is discussed.
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69
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Imai A, Oyamada H, Wada M, Naito Y, Yoshida N, Yoshikawa T. [A case of Henoch-Schönlein purpura with relapse of ileitis and duodenitis for a short period]. Nihon Shokakibyo Gakkai Zasshi 2006; 103:310-5. [PMID: 16688962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
A 60-year old man admitted our hospital due to abdominal pain, melena and arthralgia. There was purpura on his legs. On admission, the abdominal CT showed segmental mural thickening of terminal ileum and ascites. On the 4th hospital day, the abdominal CT showed severe mural thickening of the third portion of duodenum. On the 8th hospital day, the abdominal CT showed severe mural thickening of terminal ileum. We reported a rare case of Henoch-Schönlein purpura with relapse of ileitis and duodenitis for a short period which could be examined on the abdominal CT.
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Affiliation(s)
- Akito Imai
- Department of Gastroenterology, Yamashiro Public Hospital
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70
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Filimonov RM, Musaeva OM. [Laser therapy in rehabilitation of patients with primary chronic gastroduodenitis]. Vopr Kurortol Fizioter Lech Fiz Kult 2006:10-3. [PMID: 16752818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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71
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Wischmann M, Buchwald AB. [20-year old woman with diarrhea of unknown etiology]. Internist (Berl) 2006; 47:287-8, 290-2. [PMID: 16416301 DOI: 10.1007/s00108-005-1546-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report on a 20-year old woman who suffered from watery diarrhea. The results of the histology and the serology as well as clinical symptoms lead us to the diagnosis of sprue. Under specific gluten-free diet the diarrhea frequency was reduced. After a few weeks the patient returned to hospital again because of watery diarrhea. Histological examination of duodenal biopsy specimen showed a protracted infectious duodenitis and a secondary villous flattening of the small bowel. This diagnosis was a life-threatening illness that needed antibiotic treatment. These patients receive parenteral nutrition as long as the villous have not been recovered from the flattening. Additionally octreotid can be given to reduce the frequency of the diarrhea.
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Affiliation(s)
- M Wischmann
- I. Medizinische Klinik, Städtisches Krankenhaus Kiel GmbH, Akademisches Lehrkrankenhaus des Universitätsklinikums Schleswig-Holsteins.
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Rabelo-Gonçalves EMA, Nishimura NF, Zeitune JMR. Development of a BALB/c mouse model of Helicobacter pylori infection with fresh and frozen bacteria. Biol Res 2005; 38:101-9. [PMID: 15977415 DOI: 10.4067/s0716-97602005000100012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An experimental model for H. pylori infection was established by intragastrically challenging BALB/c mice with 1 ml (10(8) CFU/ml) of suspension for two consecutive days. Animals were divided into three groups. GA: mice inoculated with fresh bacteria; GB: mice inoculated with frozen bacteria, and GC: mice inoculated with brucella broth (control group). Animals were killed at 7, 14, 21, 28, 35 and 60 days pi and fragments of stomach and duodenum were collected, paraffin embedded and stained by hematoxylin-eosin and Giemsa. The results showed that challenged mice exhibited mild duodenitis and gastritis. In group GA, infiltration in the duodenum was lymphoplasmacytic until day 35; in group GB, it was lymphomonocytic for 60 days pi. In the stomach, H. pylori induced lymphomonocytic infiltration that was present from days 7 to 60 in group GA. In group GB, it was only present from days 14 to 35. In conclusion, our data suggested that freezing altered pathogenic properties of H. pylori and probably inhibited expression of bacterial antigens and consequently the establishment and maintenance of infection. Although the animals developed mild duodenitis and gastritis, the BALB/c mouse is not susceptible to developing peptic ulcers during H. pylori infection.
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Garza A, Waldman AJ, Mamel J. A case of toxic epidermal necrolysis with involvement of the GI tract after systemic contrast agent application at cardiac catheterization. Gastrointest Endosc 2005; 62:638-42. [PMID: 16185990 DOI: 10.1016/j.gie.2005.06.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Accepted: 06/29/2005] [Indexed: 02/08/2023]
Affiliation(s)
- Austin Garza
- Department of Digestive Diseases and Nutrition, Department of Cardiology, University of South Florida, Tampa, Florida 33612, USA
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74
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Affiliation(s)
- Egidio Barbi
- Department of Paediatrics, I.R.C.C.S. Burlo Garofolo, Trieste, Italy
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75
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Moriyama T, Matsumoto T, Jo Y, Yada S, Hirahashi M, Yao T, Iida M. Mucosal proinflammatory cytokine and chemokine expression of gastroduodenal lesions in Crohn's disease. Aliment Pharmacol Ther 2005; 21 Suppl 2:85-91. [PMID: 15943853 DOI: 10.1111/j.1365-2036.2005.02480.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The stomach and the duodenum are frequent sites of involvement by diminutive lesions in Crohn's disease (CD). AIM To assess mucosal proinflammatory cytokines and chemokines in gastroduodenal lesions of CD. METHODS 13C-Urea breath test and upper endoscopy were performed in 29 CD patients and seven control subjects, and biopsy specimens were obtained from the gastric cardia and the duodenum. Histology and mucosal levels of IL-1beta, IL-8/CXCL8 and RANTES/CCL5 were assessed and compared according to the presence of gastric cardial lesion [bamboo joint-like appearance (BJA)] and duodenal lesion (notched appearance, aphthous erosion and polypoid lesion). In 11 CD patients, these procedures were repeatedly performed after administration of famotidine. RESULTS H. pylori was less frequently positive in CD patients than in controls (10% vs. 71%, P = 0.003). Prevalence of cardial and duodenal lesion was significantly higher in CD than in controls (59% vs. 0%, P = 0.008 for gastric lesion; 45% vs. 0%, P = 0.034 for duodenal lesion). There were no differences in IL-1beta, IL-8 and RANTES between CD and controls. Duodenal mucosal IL-1beta and IL-8 were significantly higher in positive duodenal lesion than in negative duodenal lesion. However, there were no such differences with respect to cardial lesions. Endoscopic findings remained unchanged after administration of famotidine, while there was a trend towards decreases in IL-1beta and IL-8 in the gastric cardia. CONCLUSIONS The pathogenesis of diminutive lesions of CD may be different between the stomach and the duodenum. Famotidine may not have a therapeutic effect on duodenal lesion in CD.
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Affiliation(s)
- T Moriyama
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Fukuoka, Japan.
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76
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Affiliation(s)
- Sophie Aalaei
- Department of Pathology, Rush University Medical Center, Chicago, Ill 60612, USA.
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77
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Abstract
AIM: To investigate the ultrastructural and morphological changes of non-specific duodenitis (NSD) in an attempt to grade them according to the extent of the lesions.
METHODS: Biopsies were taken from the mucosa of duodenal bulb of 44 patients selected from the patients undergoing upper gastrointestinal endoscopy for epigastric discomforts. From each patient, two pinch biopsies on the same area were obtained from duodenal bulb. One was for scanning electron microscopy and the other was stained with hematoxylin-eosin, Warthin-Starry silver and both were then examined under light microscope. A total of 12 specimens (three from each degree of the normal and I-III of NSD diagnosed and graded by histology) selected from the 44 patients were dehydrated, critical point dried, coated with gold palladium and examined under a JEOL JSM-30 scanning electron microscope (SEM) at 20 kV.
RESULTS: According to the ultrastructural morphologic changes, non-specific duodenitis was divided into normal (as control group), mild, moderate and severe degrees according to results of SEM. The normal villi of duodenal bulb were less than 0.2 mm. There were inflammation cells, occasionally red blood cells and macrophages on the mucosal epithelial surface. Erosion and desquamation of epithelium could be seen. Three cases (25%, 3/12) had gastric metaplasia and Helicobacter pylori (H pylori) infection could be found in 5 cases (41.67%, 5/12) in duodenal bulb mucosa. The most distinctive feature was the ulcer-like defect on the surface of epithelial cells.
CONCLUSION: Non-specific duodenitis is a separate entity disease caused by different factors. SEM is of value as an aid in the diagnosis of mucosal diseases of duodenum.
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Affiliation(s)
- Cheng-Xin Wang
- Department of Pathology and Pathophysiology, School of Medicine and Life Sciences, Jianghan University, Wuhan 430056, Hubei Province, China.
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78
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Smirnova LE, Shpak LV, Vinogradov VF. [Peculiarities of ulcerous and erosive lesions of gastroduodenal zone in patients with arterial hypertension]. Klin Med (Mosk) 2005; 83:43-7. [PMID: 15941143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The aim of the research was to evaluate peculiarities of ulcerous and erosive lesions of gastroduodenal zone (UELGDZ) in patients with arterial hypertension (AH). The authors studied clinical and endoscopic parameters in 442 patients with UELGDZ and AH, and 160 patients without AH (control group). The feature of the AH group was more frequent HP-invasion, aggravation of ulcerous process, development of complicated and atypical forms of the disease. In the patients with AH the clinical manifestations of chronic erosive gastritis were more diverse and severe; unfavorable clinical course prevailed. Risk of cardiovascular complications varied from low to very high, correlating with the severety of AH and UELGDZ.
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79
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Affiliation(s)
- Oren K Fix
- Section of Gastroenterology, Boston University Medical Center, Boston, MA, USA
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80
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Dohi T, Fujihashi K, Koga T, Etani Y, Yoshino N, Kawamura YI, McGhee JR. CD4+CD45RBHi interleukin-4 defective T cells elicit antral gastritis and duodenitis. Am J Pathol 2004; 165:1257-68. [PMID: 15466391 PMCID: PMC1618629 DOI: 10.1016/s0002-9440(10)63385-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We have analyzed the gastrointestinal inflammation which develops following adoptive transfer of IL-4 gene knockout (IL-4(-/-)) CD4(+)CD45RB(Hi) (RB(Hi)) T cells to severe combined immunodeficient (SCID) or to T cell-deficient, T cell receptor beta and delta double knockout (TCR(-/-)) mice. Transfer of IL-4(-/-) RB(Hi) T cells induced a similar type of colitis to that seen in SCID or TCR(-/-) recipients of wild-type (wt) RB(Hi) T cells as reported previously. Interestingly, transfer of both wt and IL-4(-/-) RB(Hi) T cells to TCR(-/-) but not to SCID mice induced inflammation in the gastric mucosa. Notably, TCR(-/-) recipients of IL-4(-/-) RB(Hi) T cells developed a more severe gastritis with erosion, apoptosis of the antral epithelium, and massive infiltration of macrophages. This gastritis was partially dependent on the indigenous microflora. Recipients of both wt and IL-4(-/-) RB(Hi) T cells developed duodenitis with multinuclear giant cells, expansion of mucosal macrophages, and dendritic cells. Full B cell responses were reconstituted in TCR(-/-) recipients of RB(Hi) T cells; however, anti-gastric autoantibodies were not detected. We have now developed and characterized a novel model of chronic gastroduodenitis in mice, which will help in our understanding of the mechanisms involved in chronic inflammation in the upper gastrointestinal tract of humans.
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Affiliation(s)
- Taeko Dohi
- Department of Gastroenterology, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
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81
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Affiliation(s)
- Rk Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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82
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Ballesteros Amozurrutia MA. [Helicobacter pylori and duodenal gastric metaplasia]. Rev Gastroenterol Mex 2004; 69:301. [PMID: 15765985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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83
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Maciorkowska E, Kaczmarski M, Kondej-Muszyńska K, Kemona A, Kowalczuk J, Musaibili S. [Clinical picture and morphological changes of upper intestinal tract mucosa in children with Helicobacter pylori infection]. Pol Merkur Lekarski 2004; 17:311-5. [PMID: 15690690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The authors analysed clinical picture and morphological (macroscopic and histopathologic) changes in gastric and duodenal mucosa in 150 children diagnosed with Helicobacter pylori infection chosen randomly among the hospitalized in 1998-2000 years.
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84
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Bătaga SM, Toma F, Mocan S, Bătaga T. [Giardia lamblia and duodenal involvement]. Bacteriol Virusol Parazitol Epidemiol 2004; 49:145-50. [PMID: 16938937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
UNLABELLED Giardia lamblia (GL) is one of the causes of diarrhoea. GL is a frequent parasite in our country. In the literature, endoscopic aspects of Giardia duodenitis are mentioned. Some authors tried even to make the diagnosis on endoscopic criteria. AIM The purpose of the study is to find the endoscopic and histopathology changes produced by giardiasis. METHODS 214 patients entered this study and underwent upper digestive endoscopy. Duodenal and gastric multiple biopsies were taken. Biopsies were stained with hematoxylin-eosine for Helicobacter pylori and Giemsa for Giardia lamblia. CP-test was also performed for Helicobacter and duodenal aspirate for giardiasis. RESULTS The results indicates a high incidence of endoscopic and histopathology duodenitis in patients with giardiasis. The whitish spots on the erythematous duodenitis (60, 46%) and concentric ex-ulcerations (4, 16%) might be considered specific. On histology samples all the cases presented duodenitis, the first degree duodenitis was the most common (76, 63%). CONCLUSIONS It is concluded that there are specific endoscopic and histopathology features of giardiasis.
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85
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Kawakami E, Machado RS, Fonseca JA, Patrício FRS. [Clinical and histological features of duodenal ulcer in children and adolescents]. J Pediatr (Rio J) 2004; 80:321-5. [PMID: 15309235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To evaluate clinical and histological features of duodenal ulcer in children and adolescents. METHODS Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6-year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection. RESULTS Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74.4%), vomiting (30/43, 69.8%), postprandial fullness (23/43, 53.5%), weight loss (22/43, 51.2%), and abdominal tenderness (19/43, 44.2%). Upper gastrointestinal bleeding occurred in 19/43 (44.2%), whereas anemia occurred in (21/43, 48.8%). Helicobacter pylori infection was detected in 41/43 (95.3%). All infected patients presented acute chronic gastritis in antrum, with lymphomononuclear infiltrate predominance in 92% of them. Eradication of the bacterium occurred in 68.3%. Ulcer healing occurred in all eradicated patients and in 89% of non-eradicated patients. CONCLUSION Duodenal ulcer was associated with chronic gastritis due to Helicobacter pylori in the majority of patients. Many complications occurred, especially upper digestive bleeding.
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Affiliation(s)
- Elisabete Kawakami
- Universidade Federal de São Paulo--Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, SP
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86
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Kuznetsova AA, Natochin IV. [The study of physicochemical parameters of the blood serum and renal function in children with some pathology of the internal organs]. Fiziol Cheloveka 2004; 30:103-9. [PMID: 15344713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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87
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Suriani R, Venturini I, Actis GC, Rocca G, Rizzetto M, Cerutti E, Mazzucco D, Cardesi E, Zeneroli ML. Effect of Helicobacter pylori eradication on bulbitis and duodenal gastric metaplasia. Hepatogastroenterology 2004; 51:176-80. [PMID: 15011858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND/AIMS Duodenal gastric metaplasia seems to be linked to infection by Helicobacter pylori, to the extent of acid secretion and to bulbitis. An investigation was made of the relationship between bulbitis and duodenal gastric metaplasia, or whether bulbitis can arise along with duodenal gastric metaplasia after Helicobacter pylori eradication in an average of six years. METHODOLOGY We compared 22 patients with duodenal ulcers [male/female 16/6; (mean age+/-SD) 55+/-12 years] Helicobacter pylori-negative after eradication, with 23 Helicobacter pylori-positive patients free from active duodenal ulcers [male/female 17/6; (mean age+/-SD) 59+/-12 years]. RESULTS The bulbitis score was found to be lower in the Helicobacter pylori-negative than in the Helicobacter pylori-positive group (p=0.02). The duodenal gastric metaplasia score in the Helicobacter pylori-negative was higher than in the Helicobacter pylori-positive group (p=0.001). We failed to find any relationship between the presence of bulbitis and duodenal gastric metaplasia. We found a non-significant inverse correlation between the presence of duodenal gastric metaplasia and chronic body gastritis (p=0.07). CONCLUSIONS Bulbitis and duodenal gastric metaplasia may depend on different causal factors not related to Helicobacter pylori infection. The extension of duodenal gastric metaplasia with time following recovery from peptic ulcer disease may represent a mucosal protection factor against acid.
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Affiliation(s)
- Renzo Suriani
- Department of Gastroenterology Ospedale Nuovo, Rivoli, Italy
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88
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Korepanov AM, Shkliaev AE, Nikitin EN, Malakhova IG. [The duodenal epithelium in duodenal diseases]. Klin Med (Mosk) 2004; 82:29-30. [PMID: 15656395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The purpose of the study was to define duodenal epithelial function in duodenal diseases and to assess the potentialities of correction of detected dysfunctions. The electrical properties (EPs) of the duodenal epithelium were explored in patients with primary chronic duodenitis, duodenal peptic ulcer (DPU) on an exacerbation and in the late postoperative period after selective proximal vagotomy. Mucosal biopsy specimens were obtained at fibrogastroduodenoscopy with biopsy forceps and placed in a sign-alternating field with the parameters, adequate bioelectric epitheliocytic characteristics: 28 V at a voltage sign change rate of 1 Hz, and a current strength of 200 microA. Bioelectrical cell reactions (nuclear fluctuation amplitude) were recorded by light microscopy using a MOB-1A ocular micrometer at minutes 10, 30, and 60 of the onset of electrical field action. A significant reduction was found in the amplitude of duodenal epithelial nuclear fluctuations in the examinees, which was most pronounced in DPU on an exacerbation. Duodenal epithelial EPs were shown to undergo regular changes during therapy and may serve as an additional test in evaluating the efficiency of therapy.
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89
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Fortak B, Płaneta-Małecka I, Trojanowska-Lipczyk J, Czkwianianc E, Dyńiska E, Kozieł B. [The role of Candida sp. in etiopathogenesis of esophageal, gastric and duodenal mucosa inflammation in children]. Wiad Parazytol 2004; 50:381-6. [PMID: 16865941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
UNLABELLED The aim of the study was to demonstrate morphological traits of Candida-induced upper alimentary tract mucosa inflammation. The material for the study comprised 18 children aged 4 to 18 years treated at the I Department of Paediatrics and Gastroenterology, Institute Polish Mother Health Centre. In these children positive mycologic cultures were obtained from alimentary tract inflammed mucosa sections. Upper alimentary tract endoscopy was performed and macroscopic and microscopic evaluation was made. Children with excluded H. pylori infection, reflux disease, lambliosis and allergy were included into the investigated group. Savara-Muller's classification was used for oesophageal mucosa inflammation evaluation, whereas gastric and duodenal mucosa inflammation were assessed according to Tytgat. RESULTS the most frequent macro lesions concerned simultaneously gastric and duodenal mucosa (44.46%). 27.77% of patients demonstrated oesophagitis, gastritis and duodenitis. In histopathological examination inflammatory lesions in oesophageal mucosa were observed in 38.88% (most frequently I degree). Chronic gastritis was found in all children, non-active in 11 and active in 7. Duodenal mucosa demonstrated traits of chronic active inflammation in 8 children and chronic in 5 of them. CONCLUSIONS Candida fungi may be an etiopathogenetic factor of oesophageal, gastric and duodenal mucosa inflammation, Candida-induced mucosa inflammation is most frequently of chronic nature.
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Affiliation(s)
- Beata Fortak
- I Klinika Pediatrii i Gastroenterologii, Instytut Centrum Zdrowia Matki Polki, Lódź
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90
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Bienia A, Sodolski W, Luchowska E. The effect of chronic alcohol abuse on gastric and duodenal mucosa. Ann Univ Mariae Curie Sklodowska Med 2003; 57:570-82. [PMID: 12898897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Alcohol consumed in small quantities is not dangerous for health but if it is drunk in big amounts it has a negative effect on somatic and psychical health. A number of studies have been published on the harmful effect of ethanol on the nervous system, circulation, endocrine and immune systems. Ethyl alcohol can directly damage the mucosa of the alimentary tract. The studies conducted and published so far have estimated acute ethanol damage of gastric mucosa in experimental animals. The views found in literature on the effect of continuous consumption of ethanol on the stomach are differentiated. The purpose of the paper was to provide a morphological and functional analysis of stomach and duodendum in patients who continuously abuse alcohol. Besides, at attempt was made to find the answer to the question whether the changes observed in gastric mucosa point to any connection with the period of alcohol abuse. The study referred to 79 persons: 61 male aged 17-65 who had been chronically drinking alcohol for the period of 5-37 years and 18 persons aged 17-59 (9 male and 9 female) who had never drunk alcohol or who had drunk it only rarely and in small were divided into three groups differing with the period of addiction (I--5-10 years; II--10-20 years; III--over 20 years). Hydrochloric acid secretion in gastric juice was marked and gastroscopy was performed in all the examined patients. Gastroscopy estimated the appearance of the gastric and duodenal mucosa, while biopsy specimens were taken for histological examination from the pyloric area, the body of the stomach and the duodendal bulb. Hydrochloric acid secretion was determined using the Kay's aspiration method. Pentagastrin was used to stimulate gastric secretion. Within the group of 79 patients, gastric mucosa inflammation was observed in all patients chronically drinking alcohol and in 72% patients who were the control. Both groups differed considerably with the degree of progression of the inflammatory process, which was estimated with histological examination. Atrophic gastritis was observed only in patients addicted to alcohol. The appearance of atrophic changes pointed to a close relation with the period of addiction. 13 out of 14 people with this type of inflammation had been drinking alcohol for at least 10 years. The studies did not show any relation existing between the percentage of cases with atrophic inflammation and the kind of drinks or the content of ethanol in them. Examinations concerning the secretory function of the stomach showed lower values of hydrochloric acid secretion, both in basic conditions and after pentagastrin stimulation, in patients addicted to alcohol as compared to the control. The results prove that continuous abuse of alcohol predisposes to atrophic inflammation of the gastric mucosa, and the appearance of this type of inflammatory changes is related to the duration of addiction. The longer the addiction, the lower the secretion of hydrochloric acid is.
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Affiliation(s)
- Anna Bienia
- Department of Internal and Occupational Diseases, Institute of Rural Medicine, Lublin
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91
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Kos M, Zinkiewicz K, Stefanek J, Dabrowski A. Efficacy of the triple therapy: proton pomp inhibitors, amoxicillin and tynidazole in Helicobacter pylori infection treatment. Ann Univ Mariae Curie Sklodowska Med 2003; 57:161-6. [PMID: 12898919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The aim of the paper is to present the triple therapy results combined with the application of proton pump inhibitors with amoxicillin and tynidazole in treatment of the contagion caused by Helicobacter pylori. The therapy was carried out among 108 people after realization of endoscopic biopsy and with quick urease test. In the endoscopic investigation 72 people were found to have duodenum ulceration. Inflammation of mucous duodenum was found in 36 patients. Among 108 people under investigation 51.85% were men and 48.15% women. These people were aged between 15-81 (the average age was 44). After the use of eradication 99 out of 108 patients (91.66%) were cured. The lack of improvement was found in 9 people (8.34%). The age of these people varied from 18 to 75, which gives the average age 54.5 (this age is about 10 years and a half higher in relation to the average age of the examined group of patients). The results prove high efficiency of this schema of treatment in relation to comparatively low costs. They also indicate greater efficiency of the treatment of contagious caused by Helicobacter pylori in younger people.
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Affiliation(s)
- Marek Kos
- 2nd Department of General Surgery, Medical University of Lublin
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92
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Shkliaev AE, Nikitin EN, Malakhova IG. [Electrokinetic properties of cells in chronic duodenal diseases]. Klin Lab Diagn 2003:33-5. [PMID: 14971323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The electrokinetic properties of erythrocytes of the duodenal and buccal epitheliums were studied in patients with chronic duodenitis and with duodenal ulcer at exacerbation in the remote period after selective proximal vagotomy; the diagnostic value of the studied parameters was demonstrated, the presence of correlation bonds between them was shown.
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93
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Filimonova TR. [Combined use of electric sleep and hofitol in the treatment of primary chronic gastroduodenitis]. Vopr Kurortol Fizioter Lech Fiz Kult 2003:14-6. [PMID: 14753004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Primary chronic gastroduodenitis (PCGD) accounts for 60-85% of the diseases of the gastroduodenal zone. In our study 90 patients with PCGD were divided into three groups getting one of the following therapies: electric sleep, hofitol, electric sleep plus hofitol. The effects of the treatments were assessed with updated techniques including computed pH-metry. Hofitol showed a good effect on dyspepsia, enhanced the alkalizing ability of the duodenal bulb. Electric sleep relieved pain and asthenoneurotic syndromes, decreased high acidity of the gastric juice in the body of the stomach. Electric sleep in combination with hofitol normalized macroscopic picture of the upper gastrointestinal tract and corrected imbalanced immunity.
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94
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Gidaiatov AA, Alieva SA. [Upper gastrointestinal tract lesions in patients with nonspecific ulcerative colitis]. Klin Med (Mosk) 2003; 81:40-3. [PMID: 12856568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Endoscopic and morphological examinations of the upper gastrointestinal tract (GIT) were made in 80 patients with nonspecific ulcerative colitis (NUC). Tests for Helicobacter pylori infection and gastric juice acidity were also conducted. It was found that in many patients NUC was associated with development of nonspecific esophagitis, gastritis and duodenitis. The endoscopic examination revealed erosions of the abdominal esophagus in 13.8% cases, erosive-ulcerative alterations in the stomach and duodenum in 27.5% of NUC patients. The most marked changes occurred in patients with severe NUC. Alterations in the upper GIT were not related with either Hp or the acidity. Morphological examinations of the biopsies from the esophagus, stomach and duodenum demonstrated changes similar to those in biopsy material from the colon. The same type of morphological changes in mucosa from the upper GIT and the colon in NUC indicates that their pathogenesis is also the same.
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95
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Ohkusa T, Okayasu I, Miwa H, Ohtaka K, Endo S, Sato N. Helicobacter pylori infection induces duodenitis and superficial duodenal ulcer in Mongolian gerbils. Gut 2003; 52:797-803. [PMID: 12740333 PMCID: PMC1773688 DOI: 10.1136/gut.52.6.797] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2003] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is no direct evidence for an animal model of Helicobacter pylori induced duodenal ulcer. AIM In this study we evaluated the roles of bacterial strain and age of experimental animals in induction of duodenitis and duodenal ulcer in Mongolian gerbils after H pylori infection. METHODS Specific pathogen free Mongolian gerbils were inoculated orally with three bacterial strains (H pylori ATCC 43504, TN2GF4, and K-6, a clinical isolate from a patient with gastric cancer in our clinic). These strains have both the cagA gene and VacA. Five week old gerbils were used to emulate prematurity infection and 14 week old animals were used as mature test subjects. Animals were observed for 12 weeks after inoculation. Interleukin 8 (IL-8) production in gastric epithelial cells (MKN74) after coculture with the H pylori strains was measured by ELISA. RESULTS Gastritis and gastric ulcers were found in all gerbils infected with the three strains. However, duodenitis and gastric metaplasia were seen more frequently in gerbils infected with TN2GF4 and K-6 strains than in the ATCC 43504 infected or control groups (p<0.05). Superficial duodenal ulcers with severe duodenitis and gastric metaplasia were found in two gerbils inoculated at 14 weeks with the TN2GF4 strain but none at five weeks. The TN2GF4 strain stimulated significantly higher levels of IL-8 than ATCC 43504 and K6 strains (p=0.0039). CONCLUSIONS When injected into adult Mongolian gerbils, a specific strain (TN2GF4) of H pylori can induce duodenitis with gastric metaplasia and superficial duodenal ulcers. Induction of duodenal ulcer in an animal model fulfills the requirements of Koch's postulates for establishing a role for H pylori as a causative agent.
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Affiliation(s)
- T Ohkusa
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - I Okayasu
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - H Miwa
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - K Ohtaka
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - S Endo
- Animal Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - N Sato
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
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Konorev MR, Litviakov AM, Matveenko ME, Krylov IV, Kovalev AV, Riashchikov AA. [Principles of current classification of duodenitis]. Klin Med (Mosk) 2003; 81:15-20. [PMID: 12685228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The paper considers the principles of classification of chronic duodenitis. The current classification of chronic duodenitis may be divided into three parts: endoscopic, histological, and etiological. The characterizing terms of the endoscopic part are as follows: erythema, hemorrhages, atrophy, erosions, follicles. The endoscopic localization of duodenitis is as follows: proximal and distal portions (panduodenitis, including bulbitis in the proximal portion and postbulbitis in the distal portion, palpilitis). The nonspecific terms of the histological part are as follows: activity, inflammation, and atrophy. Its specific terms are: ventricular metaplasia, ventricular heterotopia, Helicobacter pylori, granulomas, lymphatic follicles, eosinophilic infiltration, lymphocytic infiltration. The following morphological categories of duodenitis are: nonatrophic, nodular, granulomatous, eosinophilic, and lymphocytic. The morphological localization of duodenitis is as follows: proximal and distal portions (panduodenitis, including bulbitis in the proximal portion and postbulbitis in the distal portion). The following degrees of its severity are: none changes, mild, moderate, and sever. The types (etiological factors) of duodenitis are as follows: acid-associated, drug-dependent, toxic (eliminating), and isolated nonspecific (idiopathic). Its special forms are: H. pylori-induced, granulomatous (Crohn's disease, sarcoidosis), nodal (Crohn's disease, sarcoidosis, acid-associated diseases), eosinophilic (unspecified allergens), lymphocytic (gluten-induced).
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Affiliation(s)
- William J Tremaine
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Abstract
BACKGROUND Chronic inflammation and gastric metaplasia are often observed in biopsy specimens from the duodenal bulb of Heliobacter pylori positive patients with duodenal ulcer disease (DU). AIMS We set out to investigate the prevalence of these lesions and their associations with other gastric and duodenal histopathological lesions. PATIENTS A total of 1255 consecutive patients who underwent upper gastrointestinal endoscopy were recruited into the present study. METHODS Two biopsy specimens were obtained from each of the following sites: duodenal bulb, gastric antrum, gastric body, and distal to the superior duodenal angle. These specimens were stained with hematoxylin-eosin, alcian blue periodic acid Schiff (pH 2.5) and modified Giemsa (Heliobacter pylori infection was determined only by histology). RESULTS The mean age of the study population was 57 years, and male:female ratio 1:1.6. Overall, 235 (19%) had gastric metaplasia and/or chronic inflammation in the duodenal bulb mucosa, and H. pylori organisms could be found in 17 (1%). In univariate analyses, gastric metaplasia and/or chronic duodenal bulb inflammation positively associated with male sex (p = 0.046), Heliobacter pylori-positive chronic gastritis (p = 0.033), villous atrophy of distal duodenal mucosa, i.e., coeliac disease (p < 0.001), duodenal ulcer (p < 0.001), and duodenal bulb deformity and scarring in endoscopy (p < 0.001), but not with age (p = 0.7) nor use of nonsteroidal anti-inflammatory drugs (p = 0.055). Multivariate analysis revealed that independent risk factors for gastric metaplasia and chronic inflammation in duodenal bulb were duodenal Heliobacter pylori infection (odds ratio 1.6, 95% confidence interval CI 1.1-2.1), and villous atrophy of the distal duodenal mucosa (odds ratio 12.7, 95% CI 4.4-36.5), while chronic atrophic gastritis was protective against them (odds ratio 0.5, 95% CI 0.3-0.8). CONCLUSIONS In addition to Heliobacter pylori infection, duodenal bulb gastric metaplasia and chronic inflammation may result from predisposition to toxic dietary components in gluten-sensitive subjects.
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Affiliation(s)
- M Voutilainen
- South Karelia Central Hospital, Department of Internal Medicine, Valto Käkelän katu 14 A, FIN-53130 Lappeenranta, Finland.
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Fedorova TA, Spirina LI, Chernekhovskaia NE, Kanareĭtseva TD, Sotnikova TI, Zhidkova NV, Anchukova EL. [The stomach and duodenum condition in patients with chronic obstructive lung diseases]. Klin Med (Mosk) 2003; 81:31-3. [PMID: 14664170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Examining the gastroduodenal mucosa (GDM) in 61 patients with chronic obstructive pulmonary diseases (COPD) showed changes in the areas studied in all cases. GDM atrophy increased with the severity of COPD. Helicobacter pylori are essential in developing gastric pathology in patients with mild bronchopulmonary disease. The severity of atrophic gastritis increases with the longer duration of COPD and with more severity of hypoxia and bronchial obstruction.
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