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1.
Arq. gastroenterol ; 58(2): 202-209, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285321

ABSTRACT

ABSTRACT BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%). CONCLUSION: Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.


RESUMO CONTEXTO: A hemorragia digestiva alta não varicosa (HDANV) secundária à úlcera péptica é uma emergência médica digestiva e pode ser uma reação adversa a medicamento severa. OBJETIVO: Estimar a frequência de HDANV secundária à doença péptica. MÉTODOS: Estudo prospectivo e epidemiológico realizado em um hospital brasileiro terciário de referência, no período de julho de 2016 a dezembro de 2019. Os laudos de endoscopia gastrointestinal alta foram avaliados diariamente. O diagnóstico de HDANV secundária para úlcera péptica foi definido por achados endoscópicos de úlcera péptica e lesões gástricas erosivas e sintomas clínicos. A frequência de diagnóstico de HDANV secundária à úlcera péptica foi estimada por meio da razão entre o número de pacientes diagnosticados e o número de pacientes submetidos à endoscopia gastrointestinal alta no mesmo período. RESULTADOS: Um total de 2.779 laudos endoscópicos (2.503 pacientes) foram avaliados e 178 pacientes foram elegíveis. A frequência total de diagnóstico de HDANV secundária à úlcera péptica foi de 7,1%. A frequência anual de diagnósticos entre 2017 e 2019 variou de 9,3% a 5,7%. A maioria dos pacientes era do sexo masculino (72,8%); auto-declarado branco (71,8%); idoso (56,7%); e não possuía histórico familiar ou pessoal de doenças gastrointestinais (60,1%). 90% dos pacientes apresentaram úlcera péptica e melena (62,8%). Os pacientes faziam uso crônico de ácido acetilsalicílico como antiagregante plaquetário (29,3%), outros antiplaquetários (21,9%) e anticoagulantes orais (11,2%); e fizeram uso e uso de anti-inflamatórios não esteroidais na semana anterior ao início dos sintomas clínicos de HDANV (25,8%). CONCLUSÃO: Cerca de sete em cada 100 pacientes admitidos em um hospital terciário e submetidos à endoscopia gastrointestinal alta foram diagnosticados com HDANV secundária à úlcera péptica.


Subject(s)
Humans , Male , Peptic Ulcer/complications , Peptic Ulcer/epidemiology , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/epidemiology , Referral and Consultation , Prospective Studies , Tertiary Care Centers
3.
Rev. costarric. salud pública ; 27(1): 65-78, ene.-jun. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-960276

ABSTRACT

Resumen Desde el descubrimiento de Helicobacter pylori como agente infeccioso patógeno en el ser humano se ha ligado con diferentes enfermedades gástricas en el ser humano (úlcera péptica, adenocarcinoma gástrico y linfoma MALT). En los últimos años se ha encontrado además su potencial relación etiológica con enfermedades extradigestivas, tales como la anemia por deficiencia de hierro y la púrpura trombocitopénica inmune. El entendimiento de los mecanismos de defensa del huésped así como los factores de virulencia y patogenicidad de la bacteria ha permitido establecer indicaciones en las que la erradicación mediante antibióticos brinda un beneficio clínico, principalmente para las enfermedades gástricas. Recientemente ha aparecido creciente evidencia del beneficio de esta terapia en otras condiciones digestivas y no digestivas e incluso se ha demostrado un potencial impacto con la estrategia de tamizaje y erradicación poblacional de la bacteria para enfermedades de alta morbimortalidad como el cáncer gástrico. El aumento de la utilización de terapia antimicrobiana ha ido de la mano de la emergencia de la resistencia a los antibióticos empleados, lo cual acarrea un problema de salud pública. Esta revisión temática pretende actualizar los conceptos biológicos y clínicos de la infección y demostrar que esta infección aun debe considerarse como emergente.


Abstract Since the discovery of Helicobacter pylori as a pathogenic infectious agent in humans, it has been linked to different gastric diseases in humans (peptic ulcer, gastric adenocarcinoma and MALT lymphoma). In recent years, its potential etiological relationship with extradigestive diseases has also been found, such as iron deficiency anemia and immune thrombocytopenic purpura. The understanding of the host defense mechanisms as well as the virulence and pathogenicity factors of the bacteria has allowed us to establish indications in which antibiotic eradication provides a clinical benefit, mainly for gastric diseases. Recently there has been growing evidence of the benefit of this therapy in other digestive and non-digestive conditions and has even shown a potential impact with the population's screening and eradication strategy of the bacteria for diseases of high morbidity and mortality such as gastric cancer. The increase in the use of antimicrobial therapy has gone hand in hand with the emergence of resistance to the antibiotics used, which leads to a public health problem. This thematic review aims to update the biological and clinical concepts of the infection and demonstrate that this infection should still be considered as emerging.


Subject(s)
Epidemiologic Factors , Helicobacter pylori , Communicable Diseases, Emerging , Drug Resistance, Bacterial , Peptic Ulcer/epidemiology , Gastrointestinal Neoplasms/epidemiology
4.
Braz. oral res. (Online) ; 32: e77, 2018. tab, graf
Article in English | LILACS | ID: biblio-952154

ABSTRACT

Abstract Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. Methods: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers' self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Facial Pain/epidemiology , Temporomandibular Joint Disorders/epidemiology , Migraine Disorders/epidemiology , Peptic Ulcer/physiopathology , Peptic Ulcer/epidemiology , Facial Pain/physiopathology , Brazil/epidemiology , Temporomandibular Joint Disorders/physiopathology , Comorbidity , Logistic Models , Sex Factors , Prevalence , Cross-Sectional Studies , Musculoskeletal Diseases/physiopathology , Musculoskeletal Diseases/epidemiology , Neck Pain/physiopathology , Neck Pain/epidemiology , Diabetes Complications/physiopathology , Diabetes Mellitus/physiopathology , Diabetes Mellitus/epidemiology , Gastritis/complications , Gastritis/physiopathology , Gastritis/epidemiology , Middle Aged , Migraine Disorders/physiopathology
5.
Arq. gastroenterol ; 53(3): 152-155, tab
Article in English | LILACS | ID: lil-787350

ABSTRACT

ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.


RESUMO Contexto A infecção por Helicobacter pylori é altamente prevalente no mundo, especialmente nos países em desenvolvimento, e sua presença na mucosa gastroduodenal está associada com o desenvolvimento de úlcera péptica e outras patologias. A erradicação do H. pylori melhora a histologia da mucosa em pacientes com úlcera péptica. Objetivo Determinar se a recorrência da infecção por H. pylori ocorre cinco anos ou mais após a erradicação confirmada em pacientes com úlcera péptica. Além disso, buscou-se determinar a taxa de recorrência. Método Retrospectivo e longitudinal, o estudo foi baseado em uma amostra de 201 pacientes oriundos da região Oeste do Paraná, Brasil. Os pacientes foram diagnosticados com úlcera gástrica e/ou duodenal, no período de 1990-2000, e foram seguidos por pelo menos cinco anos após a erradicação com sucesso do H. pylori. Pacientes com recorrência precoce - nos primeiros cinco anos após a erradicação - foram excluídos da amostra. Resultados - Após um tempo médio de seguimento de oito anos, 180 pacientes (89,55%) permaneceram negativos e 21 (10,45%) tornaram-se positivos para a presença de H. pylori. Novas úlceras apareceram em dois terços dos pacientes com recorrência da bactéria. Conclusão A recorrência da infecção por H. pylori ocorre em longo prazo - mesmo se a infecção tiver sido erradicada com sucesso e os pacientes permanecido livres de recorrência nos primeiros cinco anos de seguimento.


Subject(s)
Humans , Male , Female , Adult , Peptic Ulcer/epidemiology , Helicobacter pylori , Helicobacter Infections/epidemiology , Peptic Ulcer/drug therapy , Recurrence , Time Factors , Brazil/epidemiology , Retrospective Studies , Follow-Up Studies , Longitudinal Studies , Helicobacter Infections/prevention & control , Helicobacter Infections/drug therapy , Drug Therapy, Combination , Middle Aged , Anti-Ulcer Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use
6.
Arq. gastroenterol ; 52(1): 46-49, Jan-Mar/2015. tab, graf
Article in English | LILACS | ID: lil-746482

ABSTRACT

Background Peptic ulcer etiology has been changing because of H. pylori decline. Objectives To estimate peptic ulcer prevalence in 10 years-interval and compare the association with H. pylori and use of non-steroidal anti-inflammatory drugs. Methods Records assessment in two periods: A (1997-2000) and B (2007-2010), searching for peptic ulcer, H. pylori infection and non-steroidal anti-inflammatory drugs use. Results Peptic ulcer occurred in 30.35% in A and in 20.19% in B. H. pylori infection occurred in 73.3% cases in A and in 46.4% in B. Non-steroidal anti-inflammatory drugs use was 3.5% in A and 13.3% in B. Neither condition occurred in 10.4% and 20.5% in A and B respectively. Comparing both periods, we observed reduction of peptic ulcer associated to H. pylori (P=0.000), increase of peptic ulcer related to non-steroidal anti-inflammatory drugs (P=0.000) and idiopathic peptic ulcer (P=0.002). The concurrent association of H. pylori and non-steroidal anti-inflammatory drugs was also higher in B (P=0.002). Rates of gastric ulcer were higher and duodenal ulcer lower in the second period. Conclusions After 10 years, the prevalence of peptic ulcer decreased, as well as ulcers related to H. pylori whereas ulcers associated to non-steroidal anti-inflammatory drugs increased. There was an inversion in the pattern of gastric and duodenal ulcer and a rise of idiopathic peptic ulcer. .


Contexto A etiologia da úcera péptica vem apresentando mudanças devido à redução da infecção pelo H. pylori. Objetivos Estimar a prevalência da úlcera péptica em dois períodos com intervalo de 10 anos e comparar a associação com a infecção pelo H. pylori com o uso de anti-inflamatórios não esteroides. Métodos Revisão de prontuários em dois períodos: A (1997-2000) e B (2007-2010), com busca por úlcera péptica, H. pylori e uso de anti-inflamatórios não esteroides (AINE). Resultados Úcera péptica apresentou frequência de 30,35% em A e 20,19% em B. Infecção por H. pylori ocorreu em 73,3% em A e em 46,4% em B. Uso de anti-inflamatórios não esteroides ocorreu em 3,5% em A e em 13,3% em B. Nenhuma dessas condições esteve associada em 10,4% e 20,5% das úlceras em A e B, respectivamente. Comparando os dois períodos, houve redução da úlcera péptica associada à H. pylori (P=0,000), aumento das úlceras associadas ao uso de anti-inflamatórios não esteroides (P=0,000) e aumento de úlceras idiopáticas (P=0,002). A associação concomitante de H. pylori e anti-inflamatórios não esteroides foi também mais alta em B (P=0,002). Úlceras gástricas aumentaram e úlceras duodenais diminuíram em B. Conclusões No intervalo de 10 anos, a prevalência de úlcera péptica diminuiu assim como as úlceras relacionadas com H. pylori e houve um aumento das úlceras associadas ao uso de anti-inflamatórios não esteroides. Houve inversão na frequência das lesões gástricas e duodenais e aumento da prevalência da úlcera idiopática. .


Subject(s)
Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Helicobacter pylori , Helicobacter Infections/complications , Peptic Ulcer/chemically induced , Peptic Ulcer/microbiology , Brazil/epidemiology , Cross-Sectional Studies , Helicobacter Infections/epidemiology , Prevalence , Peptic Ulcer/epidemiology , Risk Factors
7.
Epidemiol. serv. saúde ; 24(1): 145-154, Jan-Mar/2015. tab, graf
Article in Portuguese | LILACS | ID: lil-741459

ABSTRACT

Estimar a mortalidade e a prevalência da úlcera péptica no Brasil e suas macrorregiões, segundo sexo e faixa etária, em 2008. Métodos: a prevalência foi estimada pelo Sistema de Informações Hospitalares, considerando-se os casos internados como casos de úlcera complicada e ajustes conforme a cobertura do Sistema Único de Saúde; a mortalidade foi calculada com dados do Sistema de Informações sobre Mortalidade, segundo metodologia dos estudos de carga de doença. Resultados: no Brasil, a prevalência de úlcera em homens e mulheres foi de 0,2 por cento e 0,1 por cento, respectivamente; a taxa de mortalidade nacional, de 3,0/100 mil habitantes (3,6/100 mil em homens; 2,3/100 mil em mulheres); as prevalências e taxas de mortalidade aumentaram com a idade, independentemente do sexo, com maiores valores entre homens. Conclusão: evidencia-se a relevância da úlcera péptica no cenário brasileiro e a necessidade de pesquisas para estimativas mais precisas de sua ocorrência no país...


To estimate peptic ulcer prevalence and mortality in Brazil and its regions, by gender and age group in 2008. Methods: prevalence was estimated based on Hospital Information System data adjusted according to Unified Health System (SUS) service coverage. Ulcer complications were taken to be hospitalized cases. Mortality was calculated using Mortality Information System data, according to the methodology proposed by global burden of disease studies. Results: overall peptic ulcer prevalence in Brazil was 0.2 per cent in males and 0.1 per cent in females; mortality rate was 3.0/100,000 inhabitants (3.6/100,000 males and 2.3/100,000 females); prevalence and mortality increased with advancing age in both sexes, with highest values found in males. Conclusion: this study highlights the importance of peptic ulcers on the Brazilian health scenario and the need for further research for more precise estimates of the occurrence of this disease in our country...


Subject(s)
Humans , Male , Female , Morbidity , Peptic Ulcer/epidemiology , Peptic Ulcer/mortality , Statistics as Topic
8.
Article in English | AIM, AIM | ID: biblio-1258661

ABSTRACT

Introduction The incidence of perforated peptic ulcer remains high in low and middle-income countries. Mortality can be significant; and early surgical management with careful evaluation of pre-operative risk factors is essential. The purpose of this study was to describe the clinical outcomes of surgical treatment for perforated peptic ulcer disease in Liberia and to explore risk factors for adverse outcomes.Methods This study prospectively examined 20 consecutive patients undergoing primary closure with omental patch for perforated pre-pyloric or duodenal peptic ulcer at the John F. Kennedy Medical Centre (JFKMC) in Monrovia; Liberia from May 2009 to March 2010. Pre-operative information was captured in a questionnaire. Risk factors were assessed for univariate and multivariate associations with in-hospital mortality.Results Median age was 33 years and 85 were males. A majority of the patients (70) had a history of gastritis and antacid use. Median time from beginning of symptoms to surgery was 4.5 days. Over-all in-hospital mortality following surgical therapy for perforated peptic ulcer disease was 35. Median length of stay among survivors was 16 days; and death occurred at median 1 day after admission. Long symptom duration and age 30 years of age were significantly associated with in-hospital mortality on univariate (? = 2.60 [0.18-5.03]; p = 0.035) and multivariate testing (? = 2.95 [0.02-5.88]; p =0.049). Conclusion Peptic ulcer disease and its treatment represent a potentially substantial source of morbidity and mortality in limited-resource settings. In this case series; surgical treatment for perforated peptic ulcer disease carried a high mortality; and the results highlight the potential for public health systems strengthening to prevent poor health outcomes. Peptic ulcer disease in low- and middle-income countries presents unique epidemiology and treatment challenges that may differ significantly from evidence-based guidelines in high-income countries


Subject(s)
Liberia , Peptic Ulcer/diagnosis , Peptic Ulcer/epidemiology , Peptic Ulcer/surgery
10.
Article in Korean | WPRIM | ID: wpr-194210

ABSTRACT

Helicobacter pylori can cause variety of upper gastrointestinal disorders such as peptic ulcer, mucosa associated lymphoid tissue (MALT)-lymphoma, and gastric cancer. The prevalence of H. pylori infection has significantly decreased in Korea since 1998 owing to active eradication of H. pylori. Along with its decrease, the prevalence of peptic ulcer has also decreased. However, the mean age of gastric ulcer increased and this is considered to be due to increase in NSAID prescription. Gastric cancer is one of the leading causes of cancer deaths in Korea and Japan, and IARC/WHO has classified H. pylori as class one carcinogen of gastric cancer. Despite the decreasing prevalence of H. pylori infection, the total number of gastric cancer in Korea has continuously increased from 2006 to 2011. Nevertheless, the 5 year survival rate of gastric cancer patients significantly increased from 42.8% in 1993 to 67% in 2010. This increase in survival rate seems to be mainly due to early detection of gastric cancer and endoscopic mucosal dissection treatment. Based on these findings, the prevalence of peptic ulcer is expected to decrease even more with H. pylori eradication therapy and NSAID will become the main cause of peptic ulcer. Although the prevalence of gastric cancer has not changed along with decreased the prevalence of H. pylori, gastric cancer is expected to decrease in the long run with the help of eradication therapy and endoscopic treatment of precancerous lesions.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Gastrointestinal Diseases/complications , Helicobacter Infections/complications , Humans , Lymphoma, B-Cell, Marginal Zone/epidemiology , Peptic Ulcer/epidemiology , Prevalence , Stomach Neoplasms/etiology
11.
Arq. gastroenterol ; 51(2): 155-161, Apr-Jun/2014. tab
Article in English | LILACS | ID: lil-713592

ABSTRACT

Objectives To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori). Methods A search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries. Results It was observed that the prevalence of H. pylori infection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylori shows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries. Discussion The observations might be suggestive of H. pylori being only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum. .


Objetivos Revisar a etiopatogenia da doença ulcerosa péptica com base em revisão de estudos sobre a correlação entre Helicobacter pylori (H. pylori) e doença ulcerosa péptica. Métodos Foi realizada busca nas bases de dados MEDLINE, LILACS e PubMed, e em livros brasileiros e estrangeiros referentes à incidência e prevalência de infecção pelo H. pylori e de doença ulcerosa péptica em várias populações de diferentes países. Resultados Observamos que a prevalência da infecção pelo H. pylori é semelhante em indivíduos com doença ulcerosa péptica e a população geral; que existem diferenças entre países no que tange as prevalências de infecção e a de úlceras péptica gástrica e duodenal e que, em muitos países, a prevalência de infecção pelo H. pylori se mantém estável, enquanto a prevalência de doença ulcerosa péptica está em queda. A prevalência de doença ulcerosa péptica na ausência de infecção pelo H. pylori varia de 20% a 56% nos países ocidentais. Discussão As observações sugerem que o H. pylori constituiria somente mais um fator a ser somado ao rol dos agressores na gênese da doença ulcerosa péptica. Assim, estaríamos retornando ao conceito de que as úlceras pépticas, gástrica e duodenal, têm etiologia multifatorial e decorreriam, como era admitido no passado, do desequilíbrio entre fatores agressivos e defensivos da mucosa. O foco dos estudos deveria ser redirecionado à identificação dos fatores defensivos e de outros fatores agressivos além dos bem conhecidos H. pylori e medicamentos anti-inflamatórios não-esteróides, desde que esses dois agentes não cobrem todo o espectro ...


Subject(s)
Humans , Helicobacter pylori , Helicobacter Infections/complications , Peptic Ulcer/etiology , Helicobacter Infections/epidemiology , Helicobacter Infections/microbiology , Peptic Ulcer/epidemiology , Peptic Ulcer/microbiology
12.
Niamey; Ministère de la Santé Publique - Institut de Santé Publique; 2014. 83 p.
Thesis in French | AIM, AIM | ID: biblio-1278031

ABSTRACT

Il a été procédé par une étude du type descriptive prospective du 1er novembre 2014 au 31 décembre 2014 sur l'analyse des habitudes alimentaires des personnes souffrant d'ulcère gastro-duodénal. Les objectifs de cette étude étaient de dégager les habitudes alimentaires des malades ulcéreux, les facteurs favorisant le développement de l'ulcère liés à l'habitude de vie et aux services de santé. L'ulcère gastro-duodénal connait depuis quelques années une fréquence importante parmi les maladies digestives et le nombre de cas de cette pathologie est en augmentation durant ces trois (3) dernières années au Niger (données S.N.I.S). Les facteurs de risque de la maladie ulcéreuse sont liés aux conditions hygiéno-diététiques des personnes, au stress et à l'infection d'Helicobacter pylori. Dans notre population, les conditions hygiéno-diététiques acceptables ne sont pas assurées. Aucune étude sur les ulcères gastro-duodénaux n'a été faite depuis 1985 au Niger, sauf en 2007 par Mahaman Issiakou c'est compte tenu de ces raisons que nous avons choisi de mener cette étude. L'étude a porté sur un échantillon de 90 malades ulcéreux sans limite d'âge ayant effectués l'examen de fibroscopie et 10 agents de santé. Les techniques de collecte de données utilisées étaient l'entretien avec les malades ulcéreux et l'administration du questionnaire aux agents de santé. Des résultats de cette étude, il ressort que les femmes sont plus touchées que les hommes avec 66,66 % des patients ulcéreux de sexe féminin et 33, 34 % de sexe masculin. 77,77% de nos malades ulcéreux sont des consommateurs d'excitants et que ces excitants constituent un facteur d'agression de la couche protectrice de la muqueuse. 17% de ces patients prennent la cola. Les excitants sont des facteurs de risque de la maladie ulcéreuse. Plus de la moitié des ulcéreux consomment des Antiinflammatoires Non Stéroïdiens (A.I.N.S), et ils font aussi recours au traitement traditionnel en cas des maladies. 77% des patients ont entendu parler de l'ulcère, c'est donc une maladie connue. Ces ulcéreux consomment des repas épicés, consomment des aliments aigres et en mangent des aliments graissés. Nos patients mangent des aliments favorisant l'apparition de l'ulcère. La majorité de nos ulcéreux sont stressés. Plus de la moitié consultent dans les formations sanitaires plus d'un an. Nos malades ont des manifestations typiques ulcéreuses. L'épigastralgie est plus fréquente parmi les signes des manifestations cliniques d'ulcère. 8 malades ont eu à faire leur contrôle durant notre étude ; parmi eux, 77,77% étaient satisfaits de la prise en charge. L'ulcère duodénal domine sur l'ulcère gastrique. Leur rapport est 2,77 à l'avantage de l'ulcère duodénal. Néanmoins, l'ulcère gastrique est plus fréquent chez la femme que chez l'homme avec un rapport de 1,08. Pour prévenir l'ulcère, nous formulons quelques recommandations : -Mener une politique de sensibilisation de la population sur les dangers de la prise excessive de certains excitants et sur la nécessité d'une consultation médicale le plus tôt possible en cas de manifestation clinique ulcéreuse. -Former les spécialistes en matière de gastro-entérologie qui assureront la bonne fonctionnalité du service. -Faire un traitement précoce de l'ulcère par l'éradication d'Hélicobacter Pylori qui est un facteur très important de l'ulcère. -Equiper le service de la médecine B3 par une nouvelle fibroscopie pour rendre plus accessibles les services à la population, et réparer l'ancienne


Subject(s)
Feeding Behavior , Niger , Peptic Ulcer/diagnosis , Peptic Ulcer/epidemiology
14.
Gut and Liver ; : 648-654, 2013.
Article in English | WPRIM | ID: wpr-162815

ABSTRACT

BACKGROUND/AIMS: The aims of this study were to evaluate whether doctors and nurses in a single hospital were at an increased risk of acquiring Helicobacter pylori infection in 2011 and to identify risk factors for H. pylori seroprevalence. METHODS: Nurses (n=362), doctors (n=110), health personnel without patient contact (medical control, n=179), and nonhospital controls (n=359) responded to a questionnaire during a health check-up, which included questions on socioeconomic status, education level, working years, and occupation in 2011. The prevalence of H. pylori was measured by serology. RESULTS: The seroprevalence rate was 29.8% (nurses), 34.5% (doctors), 30.7% (medical control), and 52.9% (nonhospital control). Among younger subjects ( or =40 years of age. The risk factors for H. pylori seroprevalence were not different for health and nonhealth personnel. A multivariate analysis indicated that seropositivity significantly increased with age, the province of residence, and a gastroscopic finding of a peptic ulcer. CONCLUSIONS: The medical occupation was not associated with H. pylori infection. The seroprevalence of H. pylori in one hospital in 2011 was found to be 38.7%, most likely due to the improvement in socioeconomic status and hospital hygiene policy in Korea.


Subject(s)
Administrative Personnel , Adult , Age Factors , Antibodies, Bacterial/blood , Cross-Sectional Studies , Female , Helicobacter Infections/blood , Helicobacter pylori/immunology , Humans , Male , Medical Staff, Hospital , Middle Aged , Nursing Staff, Hospital , Occupational Health , Peptic Ulcer/epidemiology , Personnel, Hospital , Pharmacists , Prevalence , Republic of Korea/epidemiology , Residence Characteristics , Risk Factors , Seroepidemiologic Studies , Time Factors , Young Adult
15.
Article in English | IMSEAR | ID: sea-144782

ABSTRACT

Helicobacter pylori is a common bacterial infectious disease whose manifestations predominately affect the gastrointestinal tract. India is the prototypical developing country as far as H. pylori infection is concerned and more than 20 million Indians are estimated to suffer from peptic ulcer disease. Considering the high level of medical research and of the pharmaceutical industry, one would expect that India would be the source of much needed information regarding new therapies and approaches that remain effective in the presence of antimicrobial resistance, new methods to reliably prevent reinfection, and the development of therapeutic and preventive vaccines. Here we discuss H. pylori as a problem in India with an emphasis on H. pylori infection as a serious transmissible infectious disease. We discuss the pros and cons of eradication of H. pylori from the entire population and come down on the side of eradication. The available data from India regarding antimicrobial use and resistance as well as the effectiveness of various treatments are discussed. Rigorous ongoing studies to provide current regional antibiotic resistance patterns coupled with data concerning the success rate with different treatment regimens are needed to guide therapy. A systematic approach to identify reliably effective (e.g., 90% or greater treatment success) cost-effective regimens is suggested as well as details of regimens likely to be effective in India. H. pylori is just one of the health care problems faced in India, but one where all the resources are on hand to understand and solve it.


Subject(s)
Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Helicobacter Infections/prevention & control , Helicobacter Infections/surgery , Helicobacter Infections/therapy , Helicobacter Infections/transmission , Helicobacter pylori , Humans , India/epidemiology , Peptic Ulcer/drug therapy , Peptic Ulcer/epidemiology , Peptic Ulcer/prevention & control , Peptic Ulcer/surgery , Peptic Ulcer/therapy
16.
Article in English | IMSEAR | ID: sea-135687

ABSTRACT

Background & objectives Certain genotype(s) of Helicobacter pylori strains may play important role in the development of gastric cancer (GC) and peptic ulcer disease (PUD). This study was undertaken to investigate the association of cagA, cagA3/ region subtypes, babA2 and vacA genotypes of H. pylori with GC, PUD and non-ulcer dyspepsia (NUD) as there are no such studies from India. Methods A total of 348 consecutive adult patients (NUD 241, PUD 45, GC 62) undergoing upper gastrointestinal endoscopy between September 2002 and May 2007 in a tertiary referral centre at Lucknow, north India, were enrolled. H. pylori infection was diagnosed by rapid urease test, culture, histopathology and PCR. Genotyping for cagA, cagA3/ subtypes, babA2 and vacA was performed by PCR using sequence specific primers. Results H. pylori infection was higher in patients with PUD than with GC (80 vs. 56.5%, P < 0.01) and NUD (80 vs. 55.2%, P= 0.002). cagA positive H. pylori isolates were detected in 80 per cent in GC, 83.3 per cent in PUD and 76.7 per cent in NUD with no significant difference among them. Only A subtype of cagA3/ was detected and its distribution in GC, PUD and NUD was 68.8, 69.4 and 52.6 per cent respectively. Presence of babA2 genotype was 31.4 per cent and it had significant association with PUD when compared with NUD (52.8 vs. 26.3%, P<0.003). On univariate regression analysis, s1a allele was associated with GC (P<0.050) and s1a/m2 vacA genotype with both GC (P=0.014) and PUD (P=0.016). Interpretation & conclusions H. pylori infection was strongly associated with PUD with a very high proportion of patients with GC have s1a allele and s1a/m2 vacA genotype. Both s1a/m2 vacA genotype and babA2 are associated with PUD. The study shows that different virulence attributes of H. pylori are involved in different gastroduodenal disorders.


Subject(s)
Adult , DNA Primers , Dyspepsia/epidemiology , Dyspepsia/microbiology , Female , Genome-Wide Association Study , Genotype , Helicobacter Infections/diagnosis , Helicobacter Infections/epidemiology , Helicobacter Infections/genetics , Helicobacter pylori/genetics , Helicobacter pylori/pathogenicity , Humans , India/epidemiology , Logistic Models , Male , Middle Aged , Peptic Ulcer/epidemiology , Peptic Ulcer/microbiology , Polymerase Chain Reaction , Stomach Neoplasms/epidemiology , Stomach Neoplasms/microbiology , Urease/diagnosis , Virulence
17.
Indian J Med Sci ; 2010 Sept; 64(9) 423-440
Article in English | IMSEAR | ID: sea-145563

ABSTRACT

Helicobacter pylori is a common bacterial infectious disease whose manifestations predominately affect the gastrointestinal tract. India is the prototypical developing country as far as H. pylori infection is concerned and more than 20 million Indians are estimated to suffer from peptic ulcer disease. Considering the high level of Medicine and of the pharmaceutical industry, one would expect that India would be the source of much needed information regarding new therapies and approaches that remain effective in the presence of antimicrobial resistance, new methods to reliably prevent reinfection, and the development of therapeutic and preventive vaccines. Here, we discuss H. pylori as an Indian problem with an emphasis on H. pylori infection as a serious transmissible infectious disease. We discuss the pros and cons of eradication of H. pylori from the entire population and come down on the side of eradication. The available data from India regarding antimicrobial use and resistance as well as the effectiveness of various treatments is discussed. Rigorous ongoing studies to provide current regional antibiotic resistance patterns coupled with data concerning the success rate with different treatment regimens are needed to guide therapy. A systematic approach to identify reliably effective (e.g., 90% or greater treatment success) cost-effective regimens is suggested as well as details of regimens likely to be effective in India. H. pylori is just one of the health care problems faced in India, but one where all the resources are on hand to understand and solve it.


Subject(s)
Drug Resistance, Bacterial , Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Helicobacter Infections/prevention & control , Helicobacter Infections/surgery , Helicobacter Infections/therapy , Helicobacter pylori/analysis , Helicobacter pylori/drug effects , Helicobacter pylori/isolation & purification , Humans , India/epidemiology , Peptic Ulcer/drug therapy , Peptic Ulcer/epidemiology , Peptic Ulcer/prevention & control , Peptic Ulcer/surgery , Peptic Ulcer/therapy
18.
Middle East Journal of Digestive Diseases. 2010; 2 (2): 78-83
in English | IMEMR | ID: emr-143833

ABSTRACT

Epidemiology of diseases changes over time with changes in socio-economic status, culture and health care systems. Gastroesophageal reflux disease [GERD] and peptic ulcer disease [PUD] are among the diseases whose epidemiology has changed over the past few decades in the west. Studies addressing the trend of GERD and PUD occurrence in Iran are lacking. We aimed to look at the time trends of GERD and PUD in a referral endoscopy clinic in Tehran, Iran. All patients with dyspeptic symptoms who underwent upper GI endoscopy from 1993 to 2005 [inclusive] in a tertiary outpatient GI referral center in Tehran were enrolled. Erosive esophagitis [EE, used as a proxy for GERD as a whole], PUD, rapid urease test [RUT] status and demographic characteristics were recorded from the endoscopy reports according to the year the endoscopy was performed. Over a period of 13 years, 8,029 endoscopic examinations were performed. The most common endoscopic diagnosis was EE that occurred in 4,808 patients [59.8%] followed by duodenal ulcer in 2,188 [27.3%] and gastric ulcer in 88 [1.1%]. Over 13 years [1995-2005], the proportion of EE increased from 14.1% in 1993 to 75.1% in 2005 among dyspeptic patients in this referral clinic. The proportion of each grade of GERD according to the Los Angeles classification was as follows: GERD-A 76.0%, GERD-B 20.9%, GERD-C 2.8% and GERD-D 0.3%. RUT positivity decreased from 71.4% to 9.5% during the study period. This study shows a remarkable increase in EE with a concomitant decrease in PUD and RUT positivity among dyspeptic patients in Tehran over a decade. This change in trend is important for future health care planning


Subject(s)
Humans , Female , Male , Gastroesophageal Reflux/diagnosis , Peptic Ulcer/diagnosis , Peptic Ulcer/epidemiology , Endoscopy, Gastrointestinal , Time
19.
Mali méd. (En ligne) ; 24(2): 1-3, 2009.
Article in French | AIM, AIM | ID: biblio-1265570

ABSTRACT

Le but de notre travail etait de preciser les aspects epidemiologiques; cliniques et endoscopiques des ulceres gastro duodenaux a l'Hopital Regional de Sikasso (HRS). Cette etude prospective s'etait deroulee de janvier 2002 a decembre 2003. Tous les patients ont subi une endoscopie digestive haute. Les ulceres gastro duodenaux ont represente 10;88de l'ensemble des endoscopies digestives. L'age moyen des patients etait de 42;51 + 14;60 ans avec un sex-ratio de 1;88 en faveur des hommes. Les couches socioprofessionnelles a revenu modeste etaient les plus representees. Les principaux signes cliniques etaient l'epigastralgie et la dyspepsie. L'ulcere siegeait tres souvent au bulbe


Subject(s)
Peptic Ulcer/diagnosis , Peptic Ulcer/epidemiology
20.
Gastroenterol. latinoam ; 19(3): 191-197, jul.-sept. 2008. tab, graf
Article in Spanish | LILACS | ID: lil-511203

ABSTRACT

Epidemiological studies have shown changes in upper digestive diagnosis in recent times. It has been observed especially in developed countries, consisting in a diminution of duodenal peptic ulcers and non cardial gastric cancer and an increase of symptoms and lesions attributable to gastroesophageal reflux. Both circumstances have been considered as a consequence of a reduction in the prevalence, of infection with Helicobacter pylori and its more aggressive strains. There is little information of Possible changes in our country, so we have studied our experience in years 1996 and 2006 observing the results of Helicohacter pylori presence through urease tests and biopsies in a 10 year period. Patients were assessed with endoscopy indicated for upper digestive symptoms in an open access University Endoscopy Center. The accuracy of the test compared with biopsies was similar in both years. We observed after a decade: increase in the number of examinations and urease tests similar percentages of normal endoscopies and those with esophagitis, gastritis, or ulcers. In patients studied for suspected gastroesophageal reflux, there were similar percentages of those with and without esophageal erosions. The Urease Test was positive in similar high percentage in duodenal ulcers, but showed decreased values in patients studied for reflux, both erosive and non erosive esophagitis and also in erosive gastritis. In conclusion, Helicobacter pylori infection is still important in duodenal ulcer, with reductions in other diagnosis, possibly as a consequence of differences in patients social status or the very common medication aiming at the eradication of the infection or control of gastroesophageal symptoms.


Estudios epidemiológicos han mostrado cambios en la incidencia de patologías digestivas consistentes en disminución de úlceras duodenales y cáncer gástrico y aumento de cuadros atribuidos a reflujo gastroesofágico. Ambas tendencias se han asociado a disminución de la tan difundida infección por Helicobacter pylori y sus cepas genéticamente más agresivas. El presente estudio tuvo come objeto revisar retrospectivamente los resultados de endoscopias en 1996 y 2006 para observar eventuales cambios en la patología de esófago y gastroduodenal. Los resultados en la última década indican: aumento del número de exámenes y de tests de ureasa; proporción similar, de: endoscopias normales, esofagitis erosiva, síntomas de reflujo no erosivo, gastritis erosiva, úlcera gástrica, úlcera duodenal; porcentaje similar de esofagitis erosiva y reflujo no erosivo en pacientes estudiados por síntomas sugerentes de reflujo gastroesofágico y disminución de la positividad del TU, significativamente en EE y GE. Pensamos que el Hp continúa siendo factor patogénico en UD y que la disminución de positividad en pacientes con RGE puede atribuirse a cambios en la composición de la población examinada y al uso de medicación que puede modificar su presencia en la mucosa de estómago, siendo similar la reducción en reflujo con y sin esofagitis erosiva.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Clinical Enzyme Tests , Endoscopy, Gastrointestinal , Esophagitis/diagnosis , Helicobacter Infections/epidemiology , Peptic Ulcer/diagnosis , Urease/analysis , Age and Sex Distribution , Chile/epidemiology , Esophagitis/epidemiology , Esophagitis/microbiology , Helicobacter pylori/isolation & purification , Incidence , Prevalence , Retrospective Studies , Sensitivity and Specificity , Peptic Ulcer/epidemiology , Peptic Ulcer/microbiology
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