ABSTRACT
Peptic ulcer disease (PUD) has been described in the absence of Helicobacter pylori (Hp) infection, suggesting that different factors are involved in its etiopathogenesis. We investigated prevalence and characteristics of Hp-negative (Hp-) PUD in an area of Northern Italy and calculated the rate of Hp-positive (Hp+) patients with PUD in whom Hp might be coincidental and not causal. Four hundred nine consecutive patients with endoscopically diagnosed PUD were enrolled in seven hospitals. Hp infection was assessed by rapid urease test and histologic examination. The attributable risk percentages in different age groups were calculated by appropriate formulas. Of 409 patients, 31 (7.6%) were Hp- (gastric, 8.3%; duodenal, 7.6%). Age, nonsteroidal antiinflammatory drug (NSAID) consumption, and complication rates were significantly higher in Hp-than Hp+ patients with duodenal ulcers (DUs). Of the Hp-patients with DU, 58% did not use NSAIDs. In patients with Hp+ DU, the attributable risk percentage for Hp infection in patients aged <40 years, 40-60 years, or >60 years was 98%, 88%, and 66%, respectively. The prevalence of Hp- PUD was about 8%, mainly unrelated to any known etiologic factor. In about one-third of Hp+ patients with PUD aged over 60 years, Hp infection might be coincidental and not causal.
Subject(s)
Peptic Ulcer/epidemiology , Adult , Aged , Aged, 80 and over , Duodenal Ulcer/epidemiology , Duodenal Ulcer/microbiology , Female , Humans , Male , Middle Aged , Peptic Ulcer/etiology , Peptic Ulcer/microbiology , Prevalence , Risk FactorsABSTRACT
A Doppler examination is a valuable adjunct to a complete echocardiographic examination. It has the capability of measuring normal and abnormal velocities of blood flow noninvasively. For the first time, this procedure allows noninvasive quantitation of stenotic gradients, intracardiac pressures, and blood flow as well as semiquantitative assessment of regurgitant lesions. With this procedure, the operator must progress through a learning curve in order to gain a complete understanding of the examination techniques, the limitations of the instruments, and the Doppler physics principles before applications can be made to clinical practice. Evaluation of other aspects of Doppler echocardiography, such as color-flow mapping and assessment of diastolic events, portends great promise for the role of this procedure in the future.
Subject(s)
Echocardiography , Adult , Aortic Valve Insufficiency/diagnosis , Aortic Valve Stenosis/diagnosis , Blood Flow Velocity , Blood Pressure , Cardiac Output , Echocardiography/instrumentation , Echocardiography/methods , Echocardiography/trends , Humans , Mitral Valve Insufficiency/diagnosis , Mitral Valve Stenosis/diagnosis , Physical Phenomena , Physics , Pulmonary Valve Insufficiency/diagnosis , Pulmonary Valve Stenosis/diagnosis , Tricuspid Valve Insufficiency/diagnosis , Tricuspid Valve Stenosis/diagnosisABSTRACT
One approach to teaching clinical skills to dietetic interns and students has been described. This approach has been taken to promote the use of on-going dietitian-client relationships where appropriate and to help prepare dietitians to function optimally in such situations. It is hoped that other, different programs will emerge with similar goals, the overall impact being one of developing the potential of dietitians as primary health care professionals in their field of expertise.
