Subject(s)
Celiac Disease/diagnosis , Adult , Diagnosis, Differential , Guidelines as Topic , HumansABSTRACT
No disponible
Subject(s)
Humans , Adult , Guidelines as Topic , Diagnosis, Differential , Celiac DiseaseSubject(s)
Colonic Neoplasms/diagnosis , Adult , Colorectal Neoplasms/diagnosis , Humans , Mass Screening/methods , Middle Aged , Time FactorsABSTRACT
No disponible
Subject(s)
Middle Aged , Adult , Humans , Time Factors , Mass Screening , Colorectal Neoplasms , Colonic NeoplasmsABSTRACT
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) delay peptic ulcer healing through mechanisms that are still not entirely understood. Growth factors play a significant role in healing. AIM: To evaluate whether exogenous administration of platelet-derived growth factor (PDGF) reverses the effect of indomethacin in experimental duodenal ulcers in rats and to define the potential mechanisms involved in this process. METHOD: Duodenal ulcer was induced in male Wistar rats with acetic acid. The rats were then administered indomethacin (2 mg/kg/day), PDGF-BB (30 ng/100 g/day), epidermal growth factor (EGF) (50 /kg/day) or famotidine (positive control) or the possible combinations of these. Macroscopic area, reduction in microscopic diameter, epithelial and granulation tissue proliferation, collagen secretion by granulation tissue, and gastric acid secretion were analyzed. RESULTS: Indomethacin delayed duodenal ulcer healing by decreasing cellular proliferation and inhibiting collagen secretion. PDGF and EGF accelerated healing and reversed the effects of indomethacin. The mechanisms involved were associated with an increase in collagen proliferation and secretion without affecting gastric acid secretion. Famotidine also accelerated healing and reversed the effect of indomethacin, and these effects were associated with a marked inhibition of gastric acid secretion and increase in collagen secretion by granulation tissue. CONCLUSIONS: Exogenous administration of PDGF and EGF accelerated healing and reversed the harmful effects of indomethacin in an experimental model of duodenal ulcer.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Anti-Ulcer Agents/pharmacology , Duodenal Ulcer/drug therapy , Epidermal Growth Factor/pharmacology , Indomethacin/pharmacology , Platelet-Derived Growth Factor/pharmacology , Wound Healing/drug effects , Acetic Acid , Animals , Duodenal Ulcer/chemically induced , Duodenal Ulcer/pathology , Famotidine/pharmacology , Male , Rats , Rats, WistarABSTRACT
El descubrimiento de Helicobacter pylori (H. pylori) ha sido el avance más importante de la gastroenterología en la última década. La implicación de este microorganismo en diversas patologías, fundamentalmente digestivas, pero también extradigestivas, Hacen que el tratamiento de esta infección constituya uno de los aspectos fundamentales relacionados con la bacteria. Sin embargo, el ritmo vertiginoso con el que se desarrollan los conocimientos y el elevado número de trabajos llevados a cabo en los últimos años, con resultados a menudo discordantes, hacen que exista cierto grado de confusión en el manejo de esta infección, lo que conduce con frecuencia a una mala praxis médica. El objetivo de este capítulo es, en primer lugar, revisar las indicaciones del tratamiento erradicador, y posteriormente las pautas erradicadoras recomendadas en la actualidad. Finalmente serán considerados los factores predictores del éxito terapéutico y las perspectivas futuras en el tratamiento de esta infección tan prevalente (AU)
Subject(s)
Humans , Helicobacter pylori , Bacterial Infections , Bacterial Infections/drug therapyABSTRACT
The case of a 66-year-old women admitted for the study of chronic diarrhea and an important deterioration in her general state is reported. Following the study undertaken the presence of a gastrocolic fistula was observed without clarifying the nature of the same thereby leading to surgical treatment. Anatomopathologic analysis confirmed the presence of a gastrocolic fistula in relation to Crohn's disease. The origin of these fistulas is usually neoplastic and the presentation as a complication of an inflammatory disease is very infrequent.
Subject(s)
Crohn Disease/complications , Gastric Fistula/complications , Intestinal Fistula/complications , Aged , Female , HumansABSTRACT
OBJECTIVE: To compare the effects of long-term lansoprazole and omeprazole treatment (6 months) on serum gastrin levels. PATIENTS: Forty duodenal ulcer patients without previous treatment with proton pump inhibitors were randomized to receive either 20 mg/day or omeprazole or 30 mg/day of lansoprazole. Serum gastrin levels were determined on entry and every 2 months. On finalizing the study antral and fundic biopsies were obtained for immunohistochemical analysis of the enterochromaffin-like cell population. RESULTS: Before starting the treatment fasting serum gastrin was similar in both groups (108.7 +/- 60.9 pg/mL omeprazole; 102.7 +/- 56.9 pg/mL lansoprazole). The treatment with either omeprazole or lansoprazole increased serum gastrin levels, but the increase was mild, maximal at 2 months and similar between omeprazole and lansoprazole (113.44 +/- 114.9 pg/mL omeprazole vs 166.1 +/- 117.9 pg/mL lansoprazole; p > 0.05). When serum gastrin levels were individually analyzed by patient, most were below 200 pg/mL and only 3 patients (1 omeprazole/2 lansoprazole) had levels near 500 pg/mL which were not correlated with enterochromaffin-like cell hyperplasia. CONCLUSIONS: Long-term treatment with either omeprazole or lansoprazole is safe, at least during 6 months, and results in mild hypergastrinemia. No differences between these two drugs were observed.
Subject(s)
Anti-Ulcer Agents/adverse effects , Gastric Mucosa/pathology , Gastrins/blood , Omeprazole/analogs & derivatives , 2-Pyridinylmethylsulfinylbenzimidazoles , Anti-Ulcer Agents/therapeutic use , Double-Blind Method , Female , Humans , Lansoprazole , Male , Middle Aged , Omeprazole/adverse effects , Omeprazole/therapeutic use , Stomach Ulcer/drug therapy , Stomach Ulcer/pathologyABSTRACT
A study of the main prognostic factors and of the overall survival rate of gastric cancer (GC) is presented. It covered 895 cases diagnosed histopathologically in the province of Zaragoza (Spain) over a ten-year period (1980-1989). The analysis of the survival rate was carried out according to the Kaplan-Meier method and the Mantel-Haenszel test. The average overall survival rate of the sample was 6.5 months and the five-year survival rate was 16.5%. Lauren's intestinal histological type is associated with a better prognosis (a five-year survival rate of 25%) than the diffuse type (15%). The survival rate with regard to gastric wall invasion ranges from 78% for T1 tumors to 8% for T4 tumors (p < 0.0001). There are significant differences in survival rate between the TNM classification stages, ranging from a five-year survival rate of 77% for Stage I to 0% for Stage IV.
Subject(s)
Adenocarcinoma/mortality , Stomach Neoplasms/mortality , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Staging , Prognosis , Spain/epidemiology , Statistics, Nonparametric , Stomach Neoplasms/pathology , Stomach Neoplasms/therapy , Survival Analysis , Survival RateABSTRACT
The vast majority of peptic ulcers heal after treatment with either H2 receptor antagonists or omeprazole at standard doses. However, it is also recognized that a 5-10% of peptic ulcers will not heal. The possibility of identifying the factors associated with refractory ulcers would have important repercussions. Several retrospective and prospective studies have pointed out a number of clinical, environmental or intrinsic factors. In recent years 2 factors have emerged as the main cause of peptic ulcer. Helicobacter pylori infection and NSAID use, and these two factors might be involved in the pathogenesis of refractory ulcer.
Subject(s)
Peptic Ulcer/etiology , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Chronic Disease , Gastric Acid/metabolism , Helicobacter Infections/complications , Helicobacter pylori , Humans , Risk Factors , Smoking/adverse effectsABSTRACT
OBJECT: To study the frequency of inflammatory bowel disease in our area. MATERIAL AND METHODS: A retrospective, hospital-based analysis identifying potential cases, with a posterior study of case records following a predefined protocol, according to international standards in diagnosis. PATIENTS: All patients with a confirmed diagnosis of Crohn's disease, ulcerative colitis, or indeterminate colitis established between 1975 and 1992 at our Hospital. RESULTS: 222 cases (ulcerative colitis: 109; Crohn's disease 93; indeterminate colitis 20) were identified and a clear trend for an increased incidence was found for the three diagnoses; with annual incidence below 1 for them all in the 1975-1977 period versus 3.66; 3.33; and 1 respectively in the 1990-1992 period. This trend was evident both for ulcerative colitis and Crohn's disease. CONCLUSIONS: The global frequency of inflammatory bowel disease has increased in the last years in Zaragoza (Spain), and its incidence in now very similar to that reported in northern European countries. Possible factors associated with this phenomenon should be pursued in future studies.