Is duodenal ulcer a seasonal disease? A retrospective endoscopic study of 3105 patients.

The monthly pattern of distribution of endoscopically diagnosed duodenal ulcer disease was evaluated for the years 1975-1989. A retrospective review of 3105 endoscopies performed for peptic disease was recorded and analyzed. Among them, 2020 endoscopies revealed duodenal bulb deformity, and 1035 revealed the presence of acute duodenal ulcer. Chi-square analysis of the data for goodness of fit revealed statistical differences for certain months. Slightly more patients with chronic deformity presented in June and November, whereas more patients with acute duodenal ulcer presented in July, November, and December (p < 0.001). The ratio of acute to chronic disease was nearly constant throughout the year. The Edwards chi 2 test for seasonal trends did not reveal any seasonality (p > 0.75). The differences observed in June-July and November-December, as compared with the rest of the year, were so small that they should not be relied upon for the clinical management of peptic disease.

[Incompetence of the sphincter of Oddi in duodenal ulcer disease].

The association of post-bulbar duodenal scarring and incompetence of the sphincter of Oddi is rare. Radiographic and endoscopic procedures should exclude concomitant neoplastic disease invading the duodenum, and duodenal Crohn's disease. The pancreatico-biliary system should be visualized before attributing ampullar reflux to duodenal ulcer disease. The treatment is that of the primary disease.

Campylobacter pylori in Israel: prospective study of prevalence and epidemiology.

Antral biopsy samples were taken from 147 patients undergoing gastroscopy. Campylobacter pylori was cultivated from 100 of these patients. C. pylori was isolated from 76% of the specimens showing any degree of histologic gastritis, but from only 11% of specimens with completely normal histology. A questionnaire was completed on all patients and included demographic, epidemiologic and clinical information. Sephardic origin, smoking, and a bad taste in the mouth were more prevalent in the campylobacter-positive group. Previous use of antibiotics was negatively associated with the presence of C. pylori. Histologically confirmed gastritis was highly associated with the presence of C. pylori, especially in the moderate or severe grades in which 84% of biopsy specimens were positive. C. pylori was also cultivated from 50% of patients with mild gastritis, in 88% of patients with duodenal ulcer and in 71% of patients with gastric ulcer. The presence of C. pylori in 11% of normal specimens and the absence of C. pylori in 24% of specimens with gastritis further raises the question of the exact role played by C. pylori in the etiology of gastritis.

Ornithine decarboxylase: an unreliable marker for the identification of population groups at risk for colonic neoplasia.

Ornithine decarboxylase (ODC) is the first and rate-limiting enzyme in the polyamine biosynthetic pathway. Polyamines have been studied as potential markers of neoplastic diseases, including colonic cancer. Previous studies have pointed out the possible value of this enzyme as a biochemical marker of colonic neoplasia, we studied 100 patients undergoing diagnostic total colonoscopy. There were 40 normal controls and 20 patients in each of the following groups: 1) family members of patients diagnosed as having colonic tumors, 2) patients with adenomas, and 3) patients with colonic adenocarcinoma. Six forceps biopsies were obtained from the normal-appearing sigmoid mucosa for the analysis of ODC. No difference was found among the four groups studied. We therefore conclude that ODC is unreliable for clinical use as a biochemical marker for the identification of population groups at risk for colonic neoplasia.