Duodenitis: histopathological and endoscopic study: critical analysis of parasitic duodenits and white spot

In the study we examined several types of chronic duodenitis, such as, nonspecific, parasitic and those associated to other pathologies, in order to verify the amin histopathological alterations; to correlate endoscopical alterations on light microscopy; to analyze the "white spot" of the duodenal mucosa in parasitic diseases and other types of duodenitis. In 213 endoscopies with 2130 biopsies, we found chronic duodenitis as a difuse process in 91.5 per cent of the cases. Histopathological and morphological correlations show 78.3 per cent "agreement", 18 per cent "false negative" and 3.7 per cent "false positive". However, normal mucosa occured in 86,3 per cent of "false negative"; erosive duodenal pathology was 10.8 per cent of the total cases being classified into: "autonomous" - 26 per cent, "simultaneous" - 9 per cent, portal hypertension - 13 per cent, giardiasis-9 per cent and strongyloidiasis-39 per cent; complete erosions, located in the duodenal bulb, were suggestive of parasitic diseases

Use of ampicilin plus ranitidine for Helicobacter pylori gastritis

Helicobacter pylori (formerly Campylobacter pylori) is now recognized as an etiological factor in gastritis and duodenal ulcers and probably also gastric ulcers. Eradication of the bacteria is fundamental to avoid ulcer relapse. Although bismuth salts have been shown to be effective for treatment, they are not commercially available in Brazil. We report an attempt to treat patients with Helicobacter pylori-associated gastritis with ampicilin (1000 mg twice daily for one month) and compare the results with the conventional treatment used in Brazil (ranitidine, 300 mg daily for one month) and with a combination of the two drugs. We studied 44 patients with histologically confirmed gastritis and with Helicobacter pylori, who were examined at the beginning and after one month of treatment. Ampicilin associated with ranitidine was better than ampicilin or ranitidine alone for the treatment of gastritis. Although ampicilin may be more efficient in patients with lower acid output we did not find a statistically significant difference between these two groups (ampicilin vs drug combination), perhaps owing to the small number of patients studied. When ampicilin was with ranitidine there was 25% normalization of the histological picture of the gastric mucosa. We conclude that ampicilin in combination with ranitidine may be a useful treatment for Helicobacter pylori-associated gastritis

Campylobacter pylori in dyspeptic patients

The presence of Campylobacter pylori in gastric mucosa of patients with dyspeptic complaints has been described. The association of the symptoms and endoscopic and histopathologic alterations with the presence of the bacterium still remains unknown. 117 patients were studied with respect to dyspeptic symptoms, endoscopic and histopathologic examinations, microbiological analysis and urease test to detect Campylobacter pylori. Campylobacter pylori was found in 77 per cent of all patients. Of these 36.8 per cent had normal gastric mucosa and 84.7 per cent presented gastritis. There was no association between the symptoms, the endoscopic and histological findings.

Tratamento de pacientes portadores de dispepsia alta ou de úlcera peptica com preparaçöes de Espinheira-santa (Maytenus ilicifolia) / Treatment of Patients of High Dyspepsia or Peptic Ulcers with Maytenus ilicifolia Preparations

Em esquema duplo-cego, vinte e três pacientes diagnosticados como portadoes de dispepsia alta näo-ulcerosa foram alocados para receber, durante 28 dias, duas cápsulas contendo 200 mg cada de liofilizado de abafo de espinheira-santa (treze pacientes) ou cápsulas contendo açucar mascavo como placebo (onze pacientes). Apenas um paciente do grupo espinheira-santa näo terminou o tratamento contra cinco desistências do grupo placebo, sendo a diferença estatisticamente significante. O grupo espinheira-santa também apresentou melhora estatisticamente significante, em relaçäo ao grupo placebo, no que diz respeito a sintomatologia dispéptica global, e, particularmente, nos sintomas de azia e dor. Näo houve queixas de efeitos colaterais produzidos pela espinheira-santa. Vinte pacientes com úlceras pépticas, diagnosticadas endoscopicamente, passaram a receber, em esquema duplo-cego, duas cápsulas diárias com 200 mg de liofilizado de espinheira-santa (dez pacientes) ou cápsulas de palcebo (dez pacientes). Dado o número de desistências (cinco e quatro, respectivamente) e das cicatrizaçöes de úlceras terem ocorrido também no grupo placebo, os resultados näo diferiram estatisticamente