[Palliative endoscopic treatment of malignant gastroduodenal obstructions with uncovered enteral stents]. / Malignus gastroduodenalis obstrukció endoszkópos palliációja fedetlen enteralis stenttel.

INTRODUCTION: Palliative treatment of malignant gastroduodenal obstructions with enteral stents is an effective and safe method, and a viable alternative to gastroenterostomy. AIM: The authors present the most common malignancies behind gastroduodenal obstructions, the aspects of stent selections, insertion techniques, technical and clinical success rates, and possible procedure-related complications. METHOD: Between 1 March, 2013 and 9 April, 2015 nineteen patients were treated with uncovered, self-expandable enteral stents. Out of the 19 patients, 6 were females and 13 males, with an average age of 67 years. Indications of stenting were peripyloric ventricular tumour in five cases, malignancies of the duodenum, gastroenteralis anastomosis, Vater papilla and gallbladder in one case respectively, pancreatic tumor in seven cases and bile duct malignancies in three cases. RESULTS: The technical success rate of stent placement was 100%. The evaluation of clinical success was analised on the basis of the Gastric Outlet Obstruction Scoring System. CONCLUSIONS: The use of enteral stents in malignant gastroduodenal obstructions is a reliable and safe method, which promptly decreases symptoms of the patients and improves their quality of life.

Management of peptic ulcer bleeding in different case volume workplaces: results of a nationwide inquiry in hungary.

The aim of this study was to conduct a national survey to evaluate the recent endoscopic treatment and drug therapy of peptic ulcer bleeding (PUB) patients and to compare practices in high and low case volume Hungarian workplaces. A total of 62 gastroenterology units participated in the six-month study. A total of 3033 PUB cases and a mean of 8.15 ± 3.9 PUB cases per month per unit were reported. In the 23 high case volume units (HCV), there was a mean of 12.9 ± 5.4 PUB cases/month, whereas in the 39 low case volume units (LCV), a mean of 5.3 ± 2.9 PUB cases/month were treated during the study period. In HCV units, endoscopic therapies for Forrest Ia, Ib, and IIa ulcers were significantly more often used than in LCV units (86% versus 68%; P = 0.001). Among patients with stigmata of recent haemorrhage (Forrest I, II), bolus + continuous infusion PPI was given significantly more frequently in HCV than in LCV units (49.6% versus 33.2%; P = 0.001). Mortality in HCV units was less than in LCV units (2.7% versus 4.3%; P = 0.023). The penetration of evidence-based recommendations for PUB management is stronger in HCV units resulting lower mortality.

[Seroprevalence of Helicobacter pylori infection and anti-CagA positivity in the county Szabolcs-Szatmár-Bereg]. / Helicobacter pylori szeroprevalencia és anti-CagA pozitivitás Szabolcs-Szatmár-Bereg megyében.

The authors studied the seroprevalence of Helicobacter pylori infection and the risk factors for infection, among adult volunteers from Szabolcs-Szatmár-Bereg county, East Hungary in year 2000. Sera were collected from 756 adults (328 males, 428 females, m/f = 1.5:2; mean age 42.4 yrs.; range 18-69 yrs.). Anti-Helicobacter pylori IgG and anti-CagA IgG antibodies were identified serologically using a sensitive ELISA technique. A questionnaire was completed to obtain necessary informations. The overall rate of seropositivity was 58.6% (45.2% in those aged 18-29 and 69.6% in those aged 50-59). Seropositivity was significantly higher in rural population than in urban area (p < 0.001), sharing a bed (p < 0.001), if parents were manual workers (p < 0.001), between keepers of cat (p < 0.005). The authors found a significant inverse correlation between Helicobacter pylori infection and educational level (p < 0.001), income (p < 0.005), absence of water supply and sanitation (childhood: p < 0.001, adulthood: p < 0.05). There were no significant differences in Helicobacter pylori infection related to gender, subject's occupation, smoking and drinking habits, gastric symptoms, family history of ulcer or gastric cancer. 67.5% of Helicobacter pylori positives were anti-CagA positives too. Helicobacter pylori positivity is higher than in developed countries, and than in the more developed county Vas.