Assuntos
Colangite/etiologia , Cálculos Biliares/complicações , Pancreatite Crônica/etiologia , Idoso , Colangiopancreatografia Retrógrada Endoscópica , Colangite/diagnóstico , Drenagem , Duodenoscopia , Cálculos Biliares/diagnóstico , Cálculos Biliares/terapia , Humanos , Icterícia Obstrutiva/etiologia , Masculino , Pancreatite Crônica/diagnóstico , Pancreatite Crônica/terapia , Radiografia Abdominal/métodos , Tomografia Computadorizada por Raios XAssuntos
Candidíase/complicações , Candidíase/patologia , Estenose Esofágica/etiologia , Esofagite/microbiologia , Esofagite/patologia , Adulto , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Transtornos de Deglutição/etiologia , Estenose Esofágica/diagnóstico , Esofagite/tratamento farmacológico , Esofagoscopia , Feminino , Fluconazol/uso terapêutico , HumanosRESUMO
BACKGROUND/AIMS: Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is recognized as the most important etiology in the pathogenesis of peptic ulcers. We investigated the efficacy of proton pump inhibitor (PPI)-based triple therapy in patients with chronic liver disease and peptic ulcer. PATIENTS AND METHODS: One hundred sixty-three patients with LC or chronic hepatitis (CH) with a peptic ulcer and proven H. pylori infection were included. The combination of PPI, amoxicillin (1.0 g), and clarithromycin (500 mg), each given twice daily, was administered for 1 or 2 weeks. The eradication of H. pylori was determined by the rapid urease test, histology, or the 13C-urea breath test at least 4 weeks after completing the treatment. RESULTS: The eradication rate of H. pylori was similar between the LC and CH groups; 82.6% and 88.1%, respectively. In addition, there were no significant differences in eradication rates between the patients with Child-Pugh class A and Child-Pugh class B/C disease. The side effects in each group were generally mild. Only the serum ALT levels showed a significant correlation with the success of H. pylori eradication in both the LC and CH groups. CONCLUSION: The PPI-based triple therapy achieves high eradication rates for H. pylori infection, in patients with chronic liver disease, without significant side effects.
Assuntos
Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Hepatite Crônica/microbiologia , Cirrose Hepática/microbiologia , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica/microbiologia , Adulto , Alanina Transaminase/sangue , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Testes Respiratórios , Claritromicina/uso terapêutico , Esquema de Medicação , Quimioterapia Combinada , Endoscopia do Sistema Digestório , Feminino , Infecções por Helicobacter/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/diagnóstico , Inibidores da Bomba de Prótons/uso terapêutico , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
OBJECTIVE: To determine guidelines for management of CIN1 by evaluating its natural history. METHODS: One hundred fifty-eight patients were diagnosed with CIN1 had colposcopy follow-up with or without cytology every three months. RESULTS: Colposcopically directed biopsy confirmed progression to CIN2 or CIN3 in 17 of 158 (10.7%) patients, persistence of CIN1 in 87 (55%) patients, regression to normal in 54 (34.2%) patients during the 5-year follow-up period. The percentage of abnormal Pap tests were 39%, 64%, and 71% in the regression, persistent, and progression groups, respectively. The percentage of HPV-positive tests were 16%, 29%, 65% in regression, persistent, and progression groups, respectively. CONCLUSIONS: Of the patients who were diagnosed with CIN1 and monitored by colposcopy for 60 months, 34% had disease regression, 55% had persistent disease, and 11% had progressive disease. HPV DNA testing is more informative than the Pap test in the prediction of disease progression.