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Rev. cient. cienc. salud ; 6: 1-8, 30-01-2024.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1531235


Introducción. La dispepsia no investigada es un síndrome que se caracteriza por la sensación de plenitud, molestias epigástricas, náuseas, entre otros síntomas, ya sea de forma recurrente o episodios aislados, para lo cual no se ha realizado una endoscopia para determinarla etiología. Para el diagnóstico clínico se utilizan los criterios de Roma IV. Materiales y Métodos. Estudio observacional descriptivo de corte transversal. Los alumnos del ciclo preclínico de la Universidad del Pacífico fueron sometidos al test diagnóstico OnSite H. PyloriAb Combo Rapid Test de CTK Biotech inc, que consiste en la técnica de inmunoensayo cromatográfico para detectar de forma cualitativa la presencia de anticuerpos en sangre. Los estudiantes completaron un cuestionario sobre los síntomas y factores de riesgo para adquirir dispepsia. Resultados. Se estudiaron 156 estudiantes con una edad media fue de 22,1 años, el 65% del sexo femenino, 55,1% del departamento Central. La prevalencia de dispepsia no investigada fue de 32,7%; y de anticuerpos anti H. Pylori14%. El 13% informó ser fumador de al menos 1 cigarrillo/día, el 71% refirió beber alcohol, y el 45% consumir AINES con una elevada frecuencia. Conclusión.La prevalencia de la dispepsia no investigada es elevada y seria imperativo adjudicarle una causa, o categorizarla como dispepsia funcional para poder emplear medidas terapéuticas. También es importante la identificación y control de posibles factores de riesgo para la patología. Palabras clave: dispepsia; helicobacter pylori; gastroenterología

Introduction. Uninvestigated dyspepsia is a syndrome characterized by a feeling of fullness, epigastric discomfort, nausea, among other symptoms, whether recurrent or isolated episodes, for which an endoscopy has not beenperformed to determine the etiology. For clinical diagnosis,the Rome IV criteria are used. Material and Methods.A cross-sectional descriptive observational study.Students from the preclinical cycle of the Universidad del Pacíficowere subjected to the OnSite H. PyloriAb Combo Rapid Test diagnostic test, from CTK Biotech inc, consistingin the chromatographic immunoassay technique to qualitatively detect the presence of antibodies in the blood.The students filled out a questionnaireon symptoms and risk factors to acquire dyspepsia. Results.A total of 156 students were studied with anaverage age of22.1 years, 65% female, 55,1% from the Central department. The prevalence of uninvestigated dyspepsia was 32,7%andof anti-H. Pyloriantibodies 14%;13% claimedto be a smoker of at least 1 cigarette/day, 71% reporteddrinking alcohol, and 45% consuming NSAIDs with a high frequency. Conclusion.The prevalence of uninvestigated Dyspepsia is high and it would be imperative to assign a cause or categorize it as functional dyspepsia in order to usetherapeutic measures. It is also important to identifyand control possible risk factors for the pathology. Key words: dyspepsia; helicobacter pylori; gastroenterology

Humans , Male , Female , Adult , Dyspepsia , Helicobacter pylori , Gastroenterology
Hepatología ; 4(2): 116-122, 2023. tab, fig
Article in Spanish | LILACS, COLNAL | ID: biblio-1429013


Los hemangiomas hepáticos se consideran las lesiones benignas hepáticas más comunes. Se de-nominan hemangiomas gigantes cuando su diámetro supera los 5 cm. La etiología es poco clara y su mayor prevalencia se ubica en mujeres de mediana edad. A continuación, se presenta el caso de una paciente de 73 años con dispepsia tipo distrés postprandial. La paciente acudió a consulta donde se documentó una masa heterogénea en segmentos hepáticos VI y VII con componente exofítico, realce periférico y llenado centrípeto en fases tardías. Recibió manejo sintomático con buena respuesta clínica y continúa en seguimiento. La presentación de este caso clínico obedece a que el hemangioma hepático es diagnosticado, por lo general, de forma incidental por imágenes abdominales realizadas desde un enfoque distinto en el paciente, y por las numerosas consultas al servicio de salud por síntomas diferentes a los directamente relacionados con el hemangioma hepá-tico. Adicionalmente, puede generar complicaciones asociadas al efecto de masa, y su prevalencia dentro de las lesiones hepáticas benignas es considerable

Hepatic hemangiomas are the most common benign tumors of the liver. They are called giant he-mangiomas when their diameter exceeds 5 cm. The pathophysiology is unclear, and middle-aged women have the highest prevalence. The case of a 73-year-old woman with dyspepsia postprandial distress syndrome is presented. The patient had a heterogeneous mass in the liver segments VI and VII with an exophytic component, peripheral enhancement, and centripetal filling in late phases. The patient received symptomatic treatment with adequate clinical response and continues in observa-tion. The presentation of this clinical report is due to the fact that hepatic hemangioma is generally diagnosed incidentally by abdominal imaging performed from a different approach, and to the numerous visits to the health service due to symptoms other than those directly related to hepatic hemangioma. Additionally, it can involve mass-related complications, and the prevalence within benign liver lesions is substantial.

Humans , Hemangioma , Therapeutics , Dyspepsia , Liver , Neoplasms
Chinese Acupuncture & Moxibustion ; (12): 1435-1440, 2023.
Article in English | WPRIM | ID: wpr-1007507


OBJECTIVES@#To observe the effects of electroacupuncture (EA) at "Neiguan" (PC 6) and "Zusanli"(ST 36) on the gastric emptying rate, the level of serotonin (5-HT) and the protein expression of motilin (MTL), ghrelin, substance P (SP) and vasoactive intestinal peptide (VIP) in the antral tissue of the rats with functional dyspepsia (FD) and explore the effect mechanism of EA in treatment of FD.@*METHODS@#A total of 21 SPF male SD rat pups were randomly divided into a normal group, a model group and an EA group, with 7 rats in each group. In the model group and the EA group, FD model was prepared by the gavage with 0.1% sucrose iodoacetamide solution combined with the modified small platform method. After the successful modeling, EA was applied to "Neiguan" (PC 6) and "Zusanli"(ST 36) in the rats of the EA group, with disperse-dense wave, 20 Hz/100 Hz in frequency, stimulated for 30 min, once daily, for 7 days consecutively. Before and after intervention, the general condition of the rats was observed in each group. After the completion of intervention, the gastric emptying rate was measured, the morphological changes of gastric antral tissue were observed using HE staining, the level of 5-HT was detected with ELISA method, and the protein expression of MTL, ghrelin, SP, and VIP was determined with Western blot method in the antral tissue of rats.@*RESULTS@#In the normal group, the rats were in a good mental state, with lustrous fur, flexible movement and the increase of food intake and body mass. In the model group, the rats were poor in mental state, lack of lustre in fur, preference for the body curled up, reduced activity and response; and a part of rats had loose stool, obviously enlarged gastric body and gastric food retention. In the EA group, the general condition of rats, e.g. the mental state, food intake and activity, were improved, the gastric body got smaller obviously and the gastric food retention was reduced when compared with the model group. The antral structure was intact, the glands were rich and no injury of the gastric mucosa was found, e.g. inflammatory reaction and edema in the rats of each group. Compared with the normal group, the gastric emptying rate was decreased (P<0.01), 5-HT level was increased (P<0.01), the protein expression of MTL and ghrelin was reduced (P<0.01) and that of VIP was elevated (P<0.01) in the rats of the model group. The gastric emptying rate was increased (P<0.01), 5-HT level was decreased (P<0.01), and the protein expression of MTL and ghrelin was elevated (P<0.05, P<0.01) in the rats of the EA group when compared with those in the model group.@*CONCLUSIONS@#Electroacupuncture at "Neiguan" (PC 6) and "Zusanli"(ST 36) may effectively relieve gastric dysfunction, strengthen gastric motility and promote gastric emptying so as to alleviate the symptoms of dyspepsia in FD rats, and its mechanism may be related to the regulation of gastrointestinal hormones in the antral tissue.

Rats , Male , Animals , Electroacupuncture , Dyspepsia/therapy , Rats, Sprague-Dawley , Ghrelin , Gastrointestinal Hormones , Serotonin , Vasoactive Intestinal Peptide , Acupuncture Points
China Journal of Chinese Materia Medica ; (24): 555-561, 2023.
Article in Chinese | WPRIM | ID: wpr-970492


This study was conducted to evaluate the efficacy and safety of Simotang Oral Liquid in the treatment of functional dyspepsia in adults. "Simotang Oral Liquid" "Simotang" "Si Mo Tang" "Si Mo Tang Oral Liquid" were used for retrieval of the relevant papers from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, Springer Link, and Web of Science from database inception to June 2021. Randomized controlled trial(RCT) of Simotang Oral Liquid in the treatment of functional dyspepsia in adults was screened out for Meta-analysis which was conducted in RevMan 5.3. A total of 16 RCTs were included. Meta-analysis showed that compared with the control group, Simotang Oral Liquid increased the total response rate and lowered the traditional Chinese medicine syndrome scores, serum cholecystokinin(CCK), serum nitric oxide(NO), and incidence of adverse reactions. However, the serum substance P(SP) had no statistical difference between the two groups. Simotang Oral Liquid is effective and safe in the treatment of functional dyspepsia in adults. However, this study has evidence and limitations, so the conclusions need to be further verified by large sample and multicenter clinical studies.

Adult , Humans , Databases, Factual , Drugs, Chinese Herbal/therapeutic use , Dyspepsia/drug therapy , Medicine, Chinese Traditional , Multicenter Studies as Topic , Randomized Controlled Trials as Topic
China Journal of Chinese Materia Medica ; (24): 2249-2259, 2023.
Article in Chinese | WPRIM | ID: wpr-981356


This study aimed to evaluate the efficacy and safety of Biling Weitong Granules in the treatment of stomach ache disorder. Randomized controlled trial(RCT) of Biling Weitong Granules in the treatment of digestive diseases with stomach ache disorder as the primary symptom was retrieved from Chinese and English electronic databases and trial registration platforms from database inception to June 10, 2022. Two investigators conducted literature screening and data extraction according to the screening criteria. The Cochrane risk-of-bias tool(v 2.0) was used to assess the risk of bias in the included studies. Analyses were performed using RevMan 5.4 and R 4.2.2, with summary estimates measured using fixed or random effects models. The primary outcome indicators were the visual analogue scale(VAS) scores and stomach ache disorder symptom scores. The secondary outcome indicators were clinical recovery rate, Helicobacter pylori(Hp) eradication rate, and adverse reaction/events. Twenty-seven RCTs were included with a sample size of 2 902 cases. Meta-analysis showed that compared with conventional western medicine treatments or placebo, Biling Weitong Granules could improve VAS scores(SMD=-1.90, 95%CI[-2.18,-1.61], P<0.000 01), stomach ache disorder symptom scores(SMD=-1.26, 95%CI[-1.71,-0.82], P<0.000 01), the clinical recovery rate(RR=1.85, 95%CI[1.66, 2.08], P<0.000 01), and Hp eradication rate(RR=1.28, 95%CI[1.20, 1.37], P<0.000 01). Safety evaluation revealed that the main adverse events in the Biling Weitong Granules included nausea and vomiting, rash, diarrhea, loss of appetite, and bitter mouth, and no serious adverse events were reported. Egger's test showed no statistical significance, indicating no publication bias. The results showed that Biling Weitong Granules in the treatment of digestive system diseases with stomach ache disorder as the primary symptom could improve the VAS scores and stomach ache disorder symptom scores of patients, relieve stomach ache disorder, and improve the clinical recovery rate and Hp eradication rate, with good safety and no serious adverse reactions. However, the quality of the original studies was low with certain limitations. Future studies should use unified and standardized detection methods and evaluation criteria of outcome indicators, pay attention to the rigor of study design and implementation, and highlight the clinical safety of the medicine to provide more reliable clinical evidence support for clinical application.

Humans , Dyspepsia , Abdominal Pain , Stomach Diseases
Chinese Acupuncture & Moxibustion ; (12): 622-626, 2023.
Article in Chinese | WPRIM | ID: wpr-980770


OBJECTIVE@#To compare the clinical efficacy of acupuncture with different frequencies in the treatment of patients with functional dyspepsia (FD).@*METHODS@#A total of 90 patients with FD were randomly divided into a 3-time acupuncture treatment per week group (3-A group, 31 cases, 2 cases dropped off), a 1-time acupuncture treatment per week group (1-A group, 30 cases, 2 cases dropped off) and a control group (29 cases, 2 cases dropped off). In the two acupuncture groups, the acupoints were Zhongwan (CV 12) and bilateral Tianshu (ST 25), Neiguan (PC 6), Liangqiu (ST 34), Yanglingquan (GB 34), Zusanli (ST 36) and Taichong (LR 3), stimulated 3 times a week and once a week, respectively; and the treatment was given consecutively for 4 weeks. In the control group, no intervention was adopted, but the compensatory therapy was provided after the end of follow-up. The scores of the symptom index of dyspepsia (SID), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were compared among the 3 groups before treatment, after 4 weeks of treatment and in 4 and 8 weeks after treatment completion separately. The score of Nepean dyspepsia life quality index (NDLQI) was evaluated before treatment, after 2 and 4 weeks of treatment and in 4 and 8 weeks after treatment completion.@*RESULTS@#After 4 weeks of treatment and in 4 and 8 weeks after treatment completion, the scores of SID, SAS and SDS were all reduced in the 3-A group and the 1-A group when compared with the scores before treatment (P<0.000 1, P<0.05). After 4 weeks of treatment, the scores of SID, SAS and SDS in the two acupuncture groups were lower than those in the control group (P<0.000 1). After 2 and 4 weeks of treatment, the increased values of NDLQI score in the two acupuncture groups were all higher than those in the control group (P<0.05). In 4 and 8 weeks after treatment completion, the scores of SID, SAS and SDS in the 3-A group were lower than those in the 1-A group (P<0.001, P<0.05), and the increased values of NDLQI score in the 3-A group were higher than those in the 1-A group (P<0.000 1).@*CONCLUSION@#Acupuncture given 3 times per week is superior to the treatment given once per week in the aspects of relieving the clinical symptoms, improving the quality of life and regulating the emotional state in patients with FD. This efficacy is persistent for 8 weeks after treatment completion.

Humans , Dyspepsia/therapy , Quality of Life , Acupuncture Therapy , Acupuncture Points , Emotions
China Journal of Chinese Materia Medica ; (24): 5397-5403, 2023.
Article in Chinese | WPRIM | ID: wpr-1008737


Functional dyspepsia(FD) is a prevalent functional gastrointestinal disease characterized by recurrent and long-lasting symptoms that significantly impact the quality of life of patients. Currently, western medicine treatment has not made breakthrough progress and mainly relies on symptomatic therapies such as gastrointestinal motility agents, acid suppressants, antidepressants/anxiolytics, and psychotherapy. However, these treatments have limitations in terms of insufficient effectiveness and safety. Traditional Chinese medicine(TCM) possesses unique advantages in the treatment of FD. Through literature search in China and abroad, it has been found that the mechanisms of TCM in treating FD is associated with various signaling pathways, and research on these signaling pathways and molecular mechanisms has gradually become a focus. The main signaling pathways include the SCF/c-Kit signaling pathway, 5-HT signaling pathway, CRF signaling pathway, AMPK signaling pathway, TRPV1 signaling pathway, NF-κB signaling pathway, and RhoA/ROCK2/MYPT1 signaling pathway. This series of signaling pathways can promote gastrointestinal motility, alleviate anxiety, accelerate gastric emptying, reduce visceral hypersensitivity, and improve duodenal micro-inflammation in the treatment of FD. This article reviewed the research on TCM's regulation of relevant signaling pathways in the treatment of FD, offering references and support for further targeted TCM research in the treatment of FD.

Humans , Dyspepsia/genetics , Medicine, Chinese Traditional , Quality of Life , Gastrointestinal Agents/therapeutic use , Signal Transduction
São Paulo med. j ; 140(2): 199-206, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1366037


Abstract BACKGROUND: Gastrointestinal (GI) symptoms are frequent complaints from individuals with nonalcoholic fatty liver disease (NAFLD). Dyspepsia is a universal clinical symptom and is among the most common GI complaints observed in the general population, but its prevalence in the population with NAFLD has not been previously investigated. OBJECTIVE: To compare the prevalence of functional dyspepsia (FD) between patients with NAFLD and controls without liver disease. DESIGN AND SETTING: Cross-sectional study at the Outpatient Liver Clinic, University Hospital, Belo Horizonte, Brazil. METHODS: We included 96 NAFLD patients and 105 controls without liver disease. All participants were assessed for GI symptoms in accordance with the Rome III criteria. Evaluation methods included a questionnaire for FD (validated in Brazil), laboratory tests and upper GI endoscopy. RESULTS: Mean age and sex were similar between the groups. The NAFLD group presented higher frequency of proton-pump inhibitor usage (31.3% vs 4.8%; P < 0.001) and prevalence of FD (25.0% versus 12.4%; P = 0.021). The symptom frequencies were as follows: postprandial distress, 22.9% versus 11.4% (P = 0.030); postprandial fullness, 18.8% versus 10.5% (P = 0.095); early satiation, 8.3% versus 5.7% (P = 0.466); and epigastric pain or burning, 18.8% versus 5.7% (P = 0.004), in NAFLD patients and controls, respectively. Multivariate analysis demonstrated that female sex (odds ratio, OR 6.97; 95% confidence interval, CI: 1.51-32.12; P = 0.013) and NAFLD diagnosis (OR 2.45; 95% CI: 1.14-5.27; P = 0.021) were independently associated with FD occurrence. CONCLUSION: FD occurs more frequently in individuals with NAFLD than in controls without hepatic disease.

Humans , Female , Dyspepsia/diagnosis , Dyspepsia/epidemiology , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/epidemiology , Abdominal Pain , Prevalence , Cross-Sectional Studies
Ibom Medical Journal15 ; 15(3): 209-214, 2022. tales, figures
Article in English | AIM | ID: biblio-1398625


Background and Objective: Dyspepsia is one of the most common complaints encountered in the general outpatient and gastroenterology clinics in Nigeria. Histopathological assessment of endoscopic gastric mucosa biopsy is crucial to delineate the exact cause of dyspepsia to guide patients' management. This study aimed to determine and document the histopathological basis of dyspepsia among dyspeptic patients at our facility. Material sand Methods: This was a three year descriptive retrospective study and the materials consisted of all gastric endoscopic biopsies taken from clinically diagnosed dyspeptic patients sent to the Department of Histopathology of the Federal Medical Centre, Owerri, Nigeria. Results: The biopsies were from 64 (53.2%) male patients and 56 (46.8%) female patients, giving a male to female ratio of 1.14:1. The age range of the patients was 28-82 years with a mean of 56 years at presentation. Helicobacter Pylori (H. Pylori) bacilli were identified in the samples of 42 (35%) patients but absent in samples of 78 (65%) patients. The histopathological pattern of the aetiological basis of dyspepsia in this study consisted of gastritis (96, 80%), functional (17, 14.2%), adenocarcinoma (4, 3.3%) and polyps (3, 2.5%). H. Pylori bacilli were seen only in patients with gastritis (42/96, 43.8%), and it affected 19 (45.2%) male patients and 23 (54.8%) female patients. Chronic active H. Pylori associated gastritis (24, 25%) was the most common form of gastritis seen during the study period. Conclusion: The main organic cause of dyspepsia in our setting was chronic gastric followed in the distant by gastric adenocarcinoma and polyp. Dyspepsia and H. Pylori associated gastritis did not show a significant gender predilection

Humans , Endoscopy, Gastrointestinal , Dyspepsia , Biopsy , Adenocarcinoma
Rev. colomb. radiol ; 33(2): 5785-5787, jun 2022. imag
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1435029


El pólipo fibroide inflamatorio gástrico es una entidad clínico-patológica rara, la cual representa una incidencia del 0,1 % de todos los pólipos gástricos.Con mayor frecuencia afecta a adultos en un amplio rango de edad, cuyo pico de incidencia es entre la sexta y séptima décadas de la vida. Las lesiones son predominantemente asintomáticas y se detectan incidentalmente en la endoscopia o en las imágenes realizadas por causas no relacionadas. Ocasionalmente, los pólipos fibroides provocan sintomatología, ya sea por su gran tamaño que causa obstrucción de la salida gástrica, o por la erosión de la mucosa que se presenta con sangrado gastrointestinal superior manifiesto u oculto.

The gastric inflammatory fibroid polyp is a rare clinical-pathological entity, representing an incidence of 0.1% of all gastric polyps. It most frequently affects adults in a wide age range, and its incidence peak is between the sixth and seventh decades of life. The lesions remain predominantly asymptomatic and are detected incidentally on endoscopy or imaging for unrelated causes. Occasionally, fibroid polyps cause symptoms due to their large size causing gastric outlet obstruction, or due to mucosal erosion presenting with overt or occult upper gastrointestinal bleeding.

Pyloric Antrum , Tomography, X-Ray Computed , Dyspepsia
Chinese Acupuncture & Moxibustion ; (12): 767-772, 2022.
Article in Chinese | WPRIM | ID: wpr-939530


OBJECTIVE@#To observe the effect of electroacupuncture (EA) at "Zusanli" (ST 36) on duodenal mast cells, nerve growth factor (NGF) and neurotrophic tyrosine kinase receptor type 1 (NTRK1), and to explore the mechanism of electroacupuncture at Zusanli (ST 36) on functional dyspepsia (FD).@*METHODS@#Sixty SPF-grade 10-day-old SD rats were randomly divided into a normal group, a model group, a ketotifen group and an EA group, 15 rats in each group. The FD model was prepared by iodoacetamide combined with rat tail clamping method in the model group, the ketotifen group and the EA group. The rats in the ketotifen group were injected intraperitoneally with ketotifen (1 mg•kg-1•d-1) for 7 days; the rats in the EA group were treated with EA at bilateral "Zusanli" (ST 36), with disperse-dense wave, frequency of 2 Hz/50 Hz and intensity of 0.5 mA, 20 min each time, once a day for 14 days. The gastric emptying rate and small intestinal propulsion rate in each group were observed; the morphology of duodenal mucosa was observed by HE staining; the toluidine blue staining was used to observe the number and degranulation of mast cells in duodenal mucosa; the protein and mRNA expressions of NGF, NTRK1 in duodenum were detected by Western blot and real-time PCR; the level of interleukin-1β (IL-1β) in duodenum was measured by ELISA.@*RESULTS@#Compared with the normal group, the gastric emptying rate and small intestinal propulsion rate in the model group were decreased (P<0.01); compared with the model group, the gastric emptying rate and small intestinal propulsion rate in the ketotifen group and the EA group were increased (P<0.01); the small intestinal propulsion rate in the EA group was higher than that in the ketotifen group (P<0.01). In the model group, local defects in duodenal mucosa were observed with a small amount of inflammatory cell infiltration; no obvious abnormality was found in duodenal mucosa of the other groups. Compared with the normal group, the mast cells of duodenal mucosa in the model group were increased significantly with significant degranulation; compared with the model group, the mast cells of duodenal mucosa in the ketotifen group and the EA group were decreased significantly, and the degranulation was not obvious. Compared with the normal group, the protein and mRNA expressions of NGF, NTRK1 as well as the level of IL-1β in duodenum in the model group were increased (P<0.01); compared with the model group, the protein and mRNA expressions of NGF, NTRK1 as well as the levels of IL-1β in duodenum in the ketotifen group and the EA group were decreased (P<0.01, P<0.05); compared with the ketotifen group, the mRNA expression of NGF, as well as the protein and mRNA expressions of NTRK1 in duodenum in the EA group were decreased (P<0.05, P<0.01).@*CONCLUSION@#EA at "Zusanli" (ST 36) could inhibit the activation of duodenal mast cells and regulate the expressions of NGF and its receptor to improve the low-grade inflammatory response of duodenum, resulting in treatment effect on FD.

Animals , Rats , Acupuncture Points , Duodenum/metabolism , Dyspepsia/therapy , Electroacupuncture , Ketotifen , Mast Cells/metabolism , Nerve Growth Factor/metabolism , RNA, Messenger , Rats, Sprague-Dawley , Receptor, trkA/genetics
Chinese Journal of Contemporary Pediatrics ; (12): 387-391, 2022.
Article in Chinese | WPRIM | ID: wpr-928619


OBJECTIVES@#To study the association between functional dyspepsia (FD) and serum levels of brain-gut peptides including calcitonin gene-related peptide (CGRP), nesfatin-1, and ghrelin in children.@*METHODS@#A total of 38 children with FD who attended Shengjing Hospital of China Medical University from November 2019 to December 2020 were enrolled as the FD group. Thirty-four healthy children were enrolled as the control group. Serum samples were collected from all of the children. Enzyme-linked immunosorbent assay was used to measure serum levels of CGRP, ghrelin, and nesfatin-1 for comparison between the two groups. The scores of clinical symptoms were determined for the children with FD. Spearman rank correlation analysis was used to investigate the correlation of symptom scores with the serum levels of brain-gut peptides.@*RESULTS@#The FD group had significantly higher serum levels of nesfatin-1 and CGRP than the control group (P<0.05), while there was no significant difference in the serum level of ghrelin between the two groups (P>0.05). The serum level of nesfatin-1 was positively correlated with the symptom score of early satiety (rs=0.553, P<0.001), but was not significantly correlated with the total score of FD (rs=0.191, P=0.250). The serum level of CGRP was positively correlated with the scores of abdominal pain (rs=0.479, P=0.002) and belching (rs=0.619, P<0.001) and the total score of FD (rs=0.541, P<0.001).@*CONCLUSIONS@#CGRP and nesfatin-1 may play an important role in the pathophysiological process of FD.

Child , Humans , Abdominal Pain , Brain , Calcitonin Gene-Related Peptide , Dyspepsia/diagnosis , Ghrelin
Más Vita ; 3(4): 33-40, dic. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1355015


La gastritis es una enfermedad con una alta morbilidad a nivel mundial, el principal factor de riesgo es la infección por Helicobacter pylori. Objetivo: Describir las características clínicas, histopatológica y endoscópicas en una población con gastritis crónica. Material y métodos: Se realizó un estudio observacional de tipo descriptivo, retrospectivo, se incluyeron 49 pacientes que acudieron a la consulta externa del área de gastroenterología, de 18 a 65 años, a quienes se realizó el estudio histopatológico y endoscópico en el Servicio de Gastroenterología en el Hospital General Quevedo, de Los Ríos-Ecuador, durante septiembre 2017 ­ septiembre 2018. Resultados: Se observó predominio del género masculino (65%); en mayores de 40 años (55%), la epigastralgía y la sensación de acidez estomacal, 39% y 35% respectivamente, fueron los síntomas más frecuentes, La positividad para Helicobacter pylori, alcanzó el 86%, y la lesión no erosiva un 73%, existió mayor presencia de la forma no atrófica (84%) sobre la atrófica. Conclusiones: La gastritis crónica predominó en el grupo etario mayor a 40 años y de género masculino, siendo los factores de riesgo de mayor prevalencia la infección por Helicobacter pylori y los asociados al consumo de antiinflamatorios no esteroideos, mala alimentación, alcohol y tabaco, los síntomas como epigastralgía y la sensación de acidez estomacal fueron los más frecuentes. El hallazgo endoscópico fue mayor para las formas no erosivas, y de acuerdo a la histopatología la gastritis no atrófica antral moderada fue la más frecuente(AU)

Gastritis is a disease with high morbidity worldwide, the main risk factor is Helicobacter pylori infection. Objective: To describe the clinical, histopathological and endoscopic characteristics in a population with chronic gastritis. Material and methods: An observational, descriptive, retrospective study was carried out, including 49 patients who attended the outpatient consultation of the gastroenterology area, aged 18 to 65 years, who underwent a histopathological and endoscopic study in the Gastroenterology Service at the Quevedo General Hospital, Los Ríos-Ecuador, during September 2017 - September 2018. Results: A predominance of the male gender was observed (65%); In people over 40 years of age (55%), epigastralgia and the sensation of heartburn, 39% and 35% spectively, were the most frequent symptoms, the positivity for Helicobacter pylori, reached 86%, and the non-erosive lesion 73 %, there was a greater presence of the non-atrophic form (84%) over the atrophic one. Conclusions: Chronic gastritis predominated in the age group over 40 years of age and male, the most prevalent risk factors being Helicobacter pylori infection and those associated with the consumption of non-steroidal anti-inflammatory drugs, poor diet, alcohol and tobacco. symptoms such as epigastric pain and the sensation of heartburn were the most frequent. The endoscopic finding was greater for non-erosive forms, and according to histopathology, moderate antral non-atrophic gastritis was the most frequent(AU)

Humans , Male , Female , Adult , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal , Helicobacter pylori/drug effects , Dyspepsia/etiology , Gastric Mucosa/pathology , Gastritis/physiopathology , Peptic Ulcer , Signs and Symptoms , Biopsy , Pharmaceutical Preparations , Endoscopy, Gastrointestinal , Acidity , Gastroenterology
Rev. colomb. gastroenterol ; 36(3): 322-326, jul.-set. 2021. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1347347


Resumen Introducción: los estudiantes universitarios muchas veces realizan su alimentación en comederos ambulantes, lo que puede ser causa de sintomatología digestiva, pero esto no se ha evidenciado en estudios en dicha población. Objetivo: determinar si el consumo de alimentos en comederos ambulantes está asociado con síntomas dispépticos en los estudiantes de medicina peruanos. Material y métodos: se realizó un estudio multicéntrico de datos secundarios, del encuestado de 1797 estudiantes de medicina en ocho facultades de medicina, se calculó una potencia estadística del 93 %. El padecimiento de síntomas dispépticos se asoció con el antecedente de consumo de alimentos en comederos ambulantes. Se obtuvo estadísticas de asociación con modelos bivariados y multivariados. Resultados: El rango de dispepsia funcional varió entre el 9 % y el 28 % y el de consumo de alimentos en comederos ambulantes, entre 1 % y 5 %. En el análisis multivariado, consumir alimentos en comederos ambulantes era un factor asociado con la mayor frecuencia de padecer dispepsia funcional (razón de prevalencia ajustada [RPa]: 1,45; intervalo de confianza [IC] 95 %: 1,09-1,94; p = 0,010); además, otras variables que resultaron significativas fueron el sexo femenino (RPa: 1,40; IC 95 %: 1,15-1,71; p = 0,001) y los que comían en horarios similares (RPa: 0,76; IC 95 %: 0,61-0,94; p = 0,012), ajustadas por la edad y el semestre académico que cursaban. Conclusiones: Los estudiantes que consumían sus alimentos en comederos ambulantes tenían mayor frecuencia de padecer síntomas dispépticos, esto debe ser vigilado por las autoridades sanitarias y universitarias, ya que puede generar repercusiones a corto y largo plazo.

Abstract Introduction: University students often eat at street food stalls, which can cause various digestive symptoms, although this has not been evidenced in studies carried out in this population. Objective: To establish whether food consumption in street food stalls is associated with symptoms of dyspepsia in Peruvian medical students. Materials and methods: A secondary data analysis of a multicenter study was conducted. Of 1 797 medical students surveyed in eight medical schools, a statistical power of 93% was calculated. Symptoms of dyspepsia were associated with a history of food consumption in street food stalls. Association statistics were obtained with bivariate and multivariate models. Results: The prevalence of functional dyspepsia varied between 9-28% and food consumption in street stalls between 1-5%. In the multivariate analysis, eating food in the street was a factor associated with a greater frequency of suffering from functional dyspepsia (aPR: 1.45; 95%CI: 1.09-1.94; p=0.010). In addition, other significant variables were the female sex (aPR: 1.40; 95%CI: 1.15-1.71 p=0.001) and people eating at similar times (aPR: 0.76; 95%CI: 0.61-0.94; p=0.012) adjusted for age, and academic term. Conclusions: Dyspepsia symptoms were more common in students who ate their food from street stalls. This should be monitored by health and university authorities, as it can have short- and long-term consequences.

Humans , Male , Female , Adolescent , Adult , Students, Medical , Dyspepsia , Street Food , Population , Universities , Prevalence , Trust
Cienc. tecnol. salud ; 8(1): 82-92, 2021. il 27 c
Article in Spanish | LILACS, DIGIUSAC, LIGCSA | ID: biblio-1352960


Se determinó la respuesta inmunológica a proteínas recombinantes de Helicobacter pylori en pacientes dis-pépticos (adultos y niños), pacientes con cáncer gástrico y sus familiares asintomáticos adultos viviendo con ellos. Se utilizó la prueba recomLine® Helicobacter IgG e IgA, y con base en el reconocimiento de los factores de virulencia VacA y CagA se determinó si la cepa de H. pylori era de tipo I o II. El análisis de los datos fue descriptivo y analítico y se estimaron los intervalos de confianza de 95%, con un nivel de error de 0.05 y Odds ratio. El 58.7% (121/206) de los pacientes presentó la bacteria en tinción histológica de biopsia, positividad que disminuyó con la edad y daño histológico. La frecuencia de la respuesta a los anticuerpos IgG fue mayor que IgA, en ambos casos ésta fue menor en los niños. Las proteínas del H. pylori más reconocidas tanto por IgA como IgG fueron VacA y CagA, y la respuesta a las otras proteínas investigadas fue mayor al aumentar el daño histológi-co. La cepa tipo I fue la que predominó en la población en estudio con 66% (136/206). Se deben continuar con los estudios de prevalencia de la cepa tipo I del H. pylori y del reconocimiento de sus antígenos en la población guatemalteca a fin de determinar su utilidad en el diagnóstico y pronóstico de la infección.

The immune response to recombinant Helicobacter pylori proteins was determined in dyspeptic patients (adults and children), patients with gastric cancer and their asymptomatic adults' relatives living with them. The recomLine® Helicobacter IgG and IgA test was used and based on the recognition of the virulence factors VacA and CagA, it was determined whether the H. pylori strain was type I or II. The data analysis was descriptive and analytic, and 95% confidence intervals were estimated, with an error level of 0.05, and Odds ratio. The patients that presented the bacterium in histological biopsy were 58.7% (121/206), positivity that decreased with age and histological damage. The frecuency of response to IgG antibodies was higher than IgA, in both cases it was lower in children. VacA and CagA were the H. pylori proteins most recognized by both IgA and IgG and it was observed that the number of recognized proteins was greater with increasing histological damage. The type I strain was the one that predominated in the study population 66% (136/206). Prevalence studies of the type I strain of H. pylori ant the recognition of its antigens in the Guatemalan population should continue in order to determine its usefulness in the diagnosis and prognosis of infection.

Humans , Child , Adult , Stomach Neoplasms/immunology , Immunoglobulin A/immunology , Immunoglobulin G/immunology , Helicobacter pylori/immunology , Dyspepsia/immunology , Stomach Neoplasms/microbiology , Stomach Neoplasms/pathology , Biopsy , Recombinant Proteins/analysis , Recombinant Proteins/immunology , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Helicobacter pylori/isolation & purification , Helicobacter pylori/pathogenicity , Dyspepsia/microbiology , Dyspepsia/pathology , Guatemala
Acta Paul. Enferm. (Online) ; 34: eAPE001985, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1349828


Resumo Objetivo Identificar o histórico familiar de primeiro grau de câncer gástrico em pacientes com sintomas dispépticos atendidos em um serviço público de endoscopia. Métodos Estudo transversal, realizado com pacientes dispépticos que tinham indicação para realizar o exame de endoscopia digestiva alta. A associação entre o histórico familiar de câncer gástrico e os resultados do exame endoscópico foi verificada por meio dos testes de Qui-quadrado ou Fisher, e medida seu efeito por meio da razão de chance e intervalo de confiança em analises uni e multivariadas. Utilizou-se regressão logística na análise dos dados. Resultados Observou-se que dos 751 pacientes dispépticos investigados, 44 (5,9%) possuíam histórico familiar de câncer gástrico, destes a maioria era do sexo feminino (70,5%), com idade maior ou igual a 45 anos (56,8%). Os pacientes com histórico familiar de câncer gástrico tinham maiores chances de não apresentarem diagnostico endoscópico de úlcera péptica (p=0,05; RC=2,33; IC=0,99-5,48). Além de maiores chances de alterações na mucosa gástrica (p=0,05; RC=1,06; IC=1,04-1,08) e infecção pela Helicobacter pylori (p=0,04; RC=1,79; IC=0,94-3,39) mesmo após ajustes nas análises. Conclusão A alteração endoscópica da mucosa gástrica e a infecção pela Helicobacter pylori em pacientes com sintomas dispépticos, mostraram associação independente com o histórico familiar de câncer gástrico. Diante disso, faz-se necessário a elaboração de protocolos de assistência à saúde para melhor investigação e vigilância dos familiares de câncer gástrico, bem como ações de educação em saúde para orientar os pacientes a respeito do rastreio e prevenção do câncer gástrico.

Resumen Objetivo Identificar los antecedentes familiares de primer grado de cáncer gástrico en pacientes con síntomas dispépticos atendidos en un servicio público de endoscopía. Métodos Estudio transversal llevado a cabo con pacientes dispépticos que habían sido derivados a realizar un estudio de endoscopía digestiva alta. La relación entre los antecedentes familiares de cáncer gástrico y los resultados del estudio endoscópico fue verificada mediante la prueba χ2 de Pearson o de Fisher, y su efecto fue medido a través de la razón de momios y del intervalo de confianza en análisis uni y multivariados. Se utilizó la regresión logística en el análisis de los datos. Resultados Se observó que de los 751 pacientes dispépticos investigados, 44 (5,9 %) tenían antecedentes familiares de cáncer gástrico, de los cuales la mayoría era de sexo femenino (70,5 %), de 45 años o más (56,8 %). Los pacientes con antecedentes familiares de cáncer gástrico tenían mayores chances de no presentar diagnóstico endoscópico de úlcera péptica (p=0,05; RC=2,33; IC=0,99-5,48). Además de mayores probabilidades de alteraciones en la mucosa gástrica (p=0,05; RC=1,06; IC=1,04-1,08) e infección por Helicobacter pylori (p=0,04; RC=1,79; IC=0,94-3,39), inclusive después de ajustes en los análisis. Conclusión La alteración endoscópica de la mucosa gástrica y la infección por Helicobacter pylori en pacientes con síntomas dispépticos mostraron relación independiente con los antecedentes familiares de cáncer gástrico. Ante este escenario, es necesaria la elaboración de protocolos de atención a la salud para una mejor investigación y observación de los familiares de cáncer gástrico, así como también acciones de educación en salud para orientar a los pacientes sobre la detección y prevención del cáncer gástrico.

Abstract Objective To identify first-degree relative history of gastric cancer in patients with dyspeptic symptoms receiving care at a public endoscopy service. Methods A cross-sectional study, performed with dyspeptic patients referred for an upper gastrointestinal endoscopy. The association between the family history of gastric cancer and the findings of the endoscopic examination was verified using the Chi-square or Fisher tests, and its effect was shown using odds ratio and confidence interval in univariate and multivariate analyses. Logistic regression was used to analyze the data. Results Among the 751 dyspeptic patients enrolled, 44 (5.9%) had a family history of gastric cancer, mostly females (70.5%) aged 45 years or older (56.8%). Patients with a family history of gastric cancer were more likely to have no endoscopic diagnosis of peptic ulcer (p=0.05; OR=2.33; CI=0.99-5.48). In addition, higher chances of gastric mucosal changes (p=0.05; RC=1.06; CI=1.04-1.08) and Helicobacter pylori infection (p=0.04; RC=1.79; CI=0.94-3.39) were found, even after adjusting the analyses. Conclusion The endoscopic gastric mucosal changes and Helicobacter pylori infection in patients with dyspeptic symptoms showed an independent association with family history of gastric cancer. Therefore, it is necessary to develop health care protocols for better investigation and surveillance of gastric cancer relatives, as well as health education actions to guide patients regarding screening and prevention of gastric cancer.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Stomach Neoplasms/prevention & control , Endoscopy, Digestive System , Dyspepsia/diagnosis , Medical History Taking , Logistic Models , Cross-Sectional Studies
An. Fac. Cienc. Méd. (Asunción) ; 54(2): 145-150, 2021.
Article in Spanish | LILACS | ID: biblio-1281112


Paciente de sexo femenino de 60 años de edad, con antecedente de carcinoma ductal de mama izquierda, presentó dolor agudo en epigastrio que se acompaña de 6 meses de dispepsia, saciedad precoz y pirosis; con una pérdida de 9 kilogramos en 2 meses. Refirió coluria, negó ictericia y acolia. Las pruebas de función hepática mostraron un patrón de colestasis con elevación de gama glutamiltrasferasa (GGT) y fosfatasa alcalina (FA). Fue diagnosticada con un Colangiocarcinoma perihiliar basado en hallazgos abdominales de tomografía y resonancia, con un nódulo parenquimatoso en el segmento 8 del hígado como un tumor infiltrante periductal. El diagnóstico presuntivo fue el de Tumor de Klatskin, pero la anatomía patológica fue compatible con metástasis de carcinoma ductal de mama (CK7 + / GATA3 +). El informe complementario mostró HER-2 negativo y estrógeno negativo (ER) y progesterona (PR) por lo que el inmunofenotipo final fue ER- / PR-; HER2- con índice de proliferación Ki67 <5%, una metástasis de cáncer de mama triple negativo.

A 60-year-old female, with a medical history of a ductal carcinoma of the left breast, presented with sharp pain in epigastrium with 6 months of dyspepsia, early satiety and pyrosis and with the loss of 9 kilograms in 2 months. She referred choluria and denied jaundice and acholia. Liver function tests showed a cholestasis pattern with only elevated Gama Glutamyl Teransferase and alkaline phosphatase. She was diagnosed with a hilar cholangiocarcinoma based on abdominal CT and MRI findings, with a parenchymal nodule in segment 8 of the liver as a periductal infiltrating tumor. The presumed diagnosis was Klatskin Tumor, but the biopsied site was compatible with breast ductal carcinoma metastasis (CK7 + / GATA3 +). The complementary report showed negative HER-2 and negative estrogen (ER) and progesterone (PR) so the final immunophenotype is ER- / PR-; HER2- with proliferation index Ki67 <5%, a triple-negative breast cancer metastasis.

Carcinoma , Cholestasis , Carcinoma, Ductal, Breast , Dyspepsia , Alkaline Phosphatase , Acute Pain , Anatomy
Chinese Acupuncture & Moxibustion ; (12): 1276-1280, 2021.
Article in Chinese | WPRIM | ID: wpr-921045


Taking the clinical trial of acupuncture in treatment of postprandial distress syndrome as an example, this paper proposes that the acupuncture clinical trial protocol should be optimized in view of acupuncture prescription, acupuncture frequency and outcomes. Besides, the data quality of acupuncture clinical trial should be improved in consideration of data sharing and electronic data capture so as to provide a reference for the majority of researchers to optimize and implement acupuncture clinical trial.

Humans , Acupuncture Therapy , Clinical Trials as Topic , Dyspepsia/therapy , Research Personnel , Stomach Diseases/therapy , Treatment Outcome
Chinese Acupuncture & Moxibustion ; (12): 1084-1088, 2021.
Article in Chinese | WPRIM | ID: wpr-921014


OBJECTIVE@#To observe the efficacy difference between conventional needling depth and deep needling for dyspepsia after ischemic stroke.@*METHODS@#A total of 120 patients with dyspepsia after ischemic stroke were randomized into an observation group (60 cases, 4 cases dropped off) and a control group (60 cases, 3 cases dropped off). Basic treatment was given in the both groups. In the observation group, deep needling was applied at Zhongwan (CV 12), Tianshu (ST 25) and Liangmen (ST 21) for 60-70 mm, after even reinforcing-reducing manipulation of lifting-thrusting technique, the needles were withdrew to 35-50 mm. In the control group, the same acupoints as the observation group were selected and punctured for 25 mm. The needles were retained for 30 min, once a day, 6 times a week for 2 weeks in the both groups. The dyspepsia TCM symptom score was observed before treatment, 1 day and 1, 2 weeks into treatment, and the clinical efficacy was evaluated 2 weeks into treatment in the both groups.@*RESULTS@#The effective rate was 92.9% (52/56) in the observation group, which was superior to 78.9% (45/57) in the control group (@*CONCLUSION@#Conventional needling depth and deep needling can both improve the clinical symptoms in patients with dyspepsia after ischemic stroke, and deep needling has faster and better efficacy.

Humans , Acupuncture Therapy , Brain Ischemia , Dyspepsia/therapy , Ischemic Stroke , Stroke/therapy
The Filipino Family Physician ; : 182-197, 2021.
Article in English | WPRIM | ID: wpr-972020


Background@#Uninvestigated dyspepsia is a common complaint in family practice in the Philippines. Patients usually seek consult due to severity of symptoms which affect their quality of life. The goals of management are short- and long-term symptom control, with reversal of possible underlying mechanisms, achievable through a combination of pharmacologic and non-pharmacologic interventions.@*Objective@#The main objective of this pathway is to guide family physicians and primary care physicians in the assessment, diagnosis and management of adult patients with uninvestigated dyspepsia through a shared decision-making process.@*Method@#This clinical pathway is an update of the PAFP’s Clinical Pathways for the Management of Dyspepsia in Adults (2016). The current panel utilized the ADAPTE method and prioritized reviewing relevant clinical practice guidelines from 2017 to present. Grading of recommendation was achieved through a mixture of strength of available evidence and a consensus from a panel of experts.@*Summary of Recommendations@#The main changes in the recommendations in this update are as follows: symptom-based classification of dyspepsia, screening for anxiety and depression, family and SCREEM assessment; initiation of therapeutic trial for most patients to whom H. pylori testing is not available; extension of initial PPI treatment to 4-8 weeks, consideration of antacids/alginates for immediate symptom relief, consideration of tricyclic antidepressants for non-responders to initial treatment; symptom-based non-pharmacologic advice, consideration of counseling and other psychosocial interventions; empowerment for self-treatment and as-needed therapy for those who have completed the initial treatment regimen@*Dissemination and Implementation@#This guideline shall be disseminated and implemented at the clinic and organizational level. It will be published in the “The Filipino Family Physician” journal, social media platforms and will be disseminated through PAFP local chapters, training institutions and during the national convention. Non-FCM primary care physicians will also be reached through relevant agencies. It shall be included in the references required during training activities and national exams of accredited training institutions, in coordination with the PAFP committee on Residency Training. It shall be incorporated in checklists for compliance in audits and QA cycles, with support from the PAFP committee on Quality Assurance and that on Standards for Family Practice. Feedback on utility and applicability will be actively sought from the intended users and other stakeholders.

Dyspepsia , Community Health Services , Critical Pathways