[Nitrate contaminated drinking water from private wells has an impact on the size and functional state of the thyroid gland in schoolchildren]. / Nitrátmi kontaminovaná pitná voda z domácich studní ovplyvnuje vel'kost' a funkcný stav stítnej zl'azy u skolopovinných detí.

UNLABELLED: The authors compared the size of the thyroid gland, assessed by ultrasonographic examination of its volume and the functional state of the thyroid by examination of the serum level of TSH and anti-TPO antibodies in 492 pupils aged 10 and 13 years in two close agricultural areas. The areas differed above all as to the nitrate content of drinking water. In communities where the source of drinking water were private wells (nitrate area), as much as 68.1% of the water samples had a nitrate content > 50 mg/l and 46.4% samples > 100 mg/l. In communities where the source of drinking water was a water main with a known source (control area) the water samples did not exceed 50 mg/l (73.7% > 15 mg/l and 26.3% > 50 mg/l. RESULTS: Pupils from the nitrate area had a larger thyroid gland similarly as older pupils from the control area. A volume above 7 ml/m2 in the nitrate area was recorded in the group of 10-year olds in 25/99 (27.7%) and in the group of 13-year-old ones in 33/154 (21.4%), while in the control area it was in the 10-year-old ones 11/92 (11.9%) and in the 13-year-old ones 16/156 (10.2%, P < or = 0.01). In the nitrate area TSH > 5 mIU/l was recorded in 5.6% and higher anti-TPO antibodies in 2.6% pupils. In the control area the corresponding figure was 1.1% pupils, P < or = 0.01.

[Therapy of Helicobacter pylori infection using Lactobacillus acidophilus]. / Terapija Helicobacter pylori infekcije primenom Lactobacillusa acidohpilus.

INTRODUCTION: In vitro experiments with Lactobacillus acidophilus have revealed its inhibitory effect on Helicobacter pylori and its application in treatment of Helicobacter pylori positive gastritis was examined. MATERIAL AND METHODS: 15 patients have undergone gastroscopy with biopsy and by histopathological examination. Helicobacter pylori positive gastritis was detected. During a two-month period these patients took acidophilus milk (3 x 250 ml a day) prepared according to a special protocol and which contained 4 x 10(9)-1 x 10(10) live cells of Lactobacillus acidophilus at the moment of preparation. Lactobacillus acidophilus strain NAS, gained from lyophilized preparation Bio-Nate (Natren Inc. USA) was used as a test organism. Control gastroscopy was performed 2 months later. RESULTS: 14 patients have completed the examination. All of them were satisfied with the taste of acidophilus milk and could stand it well, whereas in 6 out of 14 Helicobacter pylori was eradicated. DISCUSSION: Helicobacter pylori eradication therapy is recommended in all cases of Helicobacter pylori positive gastritis associated with peptic ulcer, as well as in absence of ulcer when subjective difficulties occur. Antibiotic therapy is often unsuccessful and most often associated with risks of significant adverse effects, being the consequence of intestinal microflora disorders. The aim of using Lactobacillus acidophilus in the therapy is to reduce risks of adverse effects. In our study, by using acidophilus milk only, without other therapy, eradication of Helicobacter pylori was achieved in 6 out of 14 patients. All patients could stand the therapy well and were satisfied with the taste of the preparation. The number of examinees was small in regard to making conclusions, but the results are encouraging and show that apart from established in vitro effect. Lactobacillus acidophilus has a potential in vivo effect.

[Diseases of the upper segment of the gastrointestinal tract and Helicobacter pylori infection]. / Oboljenja gornjih segmenata gastrointestinalnog trakta i infekcija Helicobacterom pylori.

Helicobacter pylori infection is the most frequent infection in humans. It is assumed that over 50% of total world population suffer from this infection. Chronic gastritis is the most usual consequence of this infection. Development of peptic ulcer appears in case of 10 to 20 percent of infected people with the increased risk of malignancy. In the group of 819 examined patients at the Clinic for gastroenterology and hepatology of the Institute for internal diseases, the presence of helicobacter pylori was confirmed in case of 69.18% of patients. The infection was equally observed in both sexes and its frequency was higher with the increase of age, reaching its peak in the sixth decade of life (75.24%). The highest frequency was found in patients with duodenal ulcer (84.85%) and hyperplastic stomach polyp (81.82%) and lowest in case of resected stomach (56.52%). We also establish the dependence of the type and degree of pathohistological changes and the Helicobacter pylori infection.

[Helicobacter pylori in patients with diseases of the upper part of the gastrointestinal tract]. / Helicobacter pylori u bolesnika sa oboljenjima gornjih delova gastrointestinalnog trakta.

Among the patients subjected to esophoagogastroduodenoscopy because of different clinical indications, 108 were examined for the presence of Helicobacter pylori in the antral gastric mucosa. Microbiological analysis of the antral gastric mucosa biopsies were conducted by direct microscopy, the urease test and by growing in nutritious media. Positive findings were recorded in 38 (86.36%) patients with endoscopically diagnosed chronic gastritis, 29 (80.56%) patients with duodenal ulcer and 19 (67.86%) patients with ventricular ulcer. The majority of the positive findings were recorded by direct microscopy--86 (79.63%) while the bacterial culture was positive in 66 (61.11%) cases.

[The postoperative status of the gastroduodenum--clinical and endoscopic analysis of 2 years' of hospital data]. / Postoperativna stanja gastroduodenuma--klinicka i endoskopska analiza dvogodisnjeg hospitalnog materijala.

In 72 patients operated on for gastric ulcer, hospitalized at the Clinic of Gastroenterology and Hepatology in Novi Sad within two years (1989, 1990) we analyzed clinical disorders, biochemical status and endoscopic findings. 75% of the patients were males and 25% females, mean age being 49 years. In 70.83% the two-thirds Billroth II resection was performed, in 15.28% the two thirds Billroth I resection, in 9.72% truncal vagotomy with pyloroplasty, while in 4.17% supraselective vagotomy was carried out. The mean period of time after the operation was 12 years. The majority of patients complained about gastrointestinal disorders, and manifest hemorrhage was detected in 4.17% of the patients. The symptoms of the afferent loop syndrome and early dumping syndrome were verified in one patient from each group. The endoscopic finding was normal in only 2.78%, reflux esophagitis in 6.94%, chronic gastritis with and without erosions in 86.11%, chronic anastomositis in 69.44%, recurrent ulcer in 29.16% out of which hemorrhagic ulcer was found in 4.17%. Malignant neoplasm of the stomach stump was endoscopically evidenced and histologically proved in 2.78%. Multiple associated endoscopic changes were found in 58.33%. The analysis indicates the diversity of postoperative disorders after one of the operations on gastroduodenum, requiring postoperative follow ups of the patients with subjective discomfort, appropriately set diagnosis and individual therapeutical approach to prevent more serious complications.

[Modern trends in the treatment of ulcer disease (clinical study of nizatidine "Galitidine")]. / Savremeni trendovi u lecenju ulkusne bolesti (Klinicko ispitivanje nizatidina "Galitidina").

By an analysis of nizatidine vs ranitidine activity, the authors show a contemporary controlled approach to the treatment of ulcer disease. In a prospective, randomized, double-blind, parallel comparative, multicentric study, the treatment of duodenal ulcer was carried out in 120 patients with H2-receptor blockers, nizatidine and ranitidine. The treatment lasted one or two months with endoscopic control of the results. The recovery of the ulcer nische in patients who received nizatidine, 150 mg twice daily over a month, was achieved in 89.75% of the cases, while in those who at the same time received ranitidine twice daily ulcer was suppressed in 84.61% of the patients; in those who received Nizatidine, 300 mg once daily it was suppressed in 88.24% of the patients. Statistically, x2 = 2.177 with p > 0.3 which shows that there is no statistically significant differences between the groups although the first group shows the best results. Adverse effects of the drugs were not observed.

[Therapy of resistant ascites using the peritoneojugular (Leveen shunt)]. / Terapija rezistentnog ascita peritoneojugularnim (Le Veen) santom.

Since 1984 the peritoneovenous shunt has been installed in 33 patients (10 females - 30.3%; 23 males - 69.7%) of the average age of 54 +/- 8, all in the phase of therapeutically resistant ascites (alcoholic cirrhosis 28 - 84.85%; 4 - 12.12% posthepatitic cirrhosis; and 1 - 3.03% hepatic amyloidosis). The control group consisted of 39 patients (11 females - 28.2% and 28 males - 71.8%) treated in an identical time span with the strict conduction of medicament-diet therapy. The aim of this study was to check the value of this method on our own clinical-patient material, and therefore establish the incidence of complications. By the use of a unique protocol we followed mortality, morbidity, body weight, belly circumference, diuresis, the ultrasonographic finding of the abdominal cavity and the complications which appeared. Out of the group operated on 19 (57%) of the patients died, and so did all the control group patients as well. The average life duration was 275 +/- 810 days in the group operated on, and 44 +/- 29 (p less than 0.005) in the control group. All those alive (14.33-42.42%) lived longer than six months. Six patients lived longer than one year (42.85%), 4 (28.47%) longer than two years, and one (7.14%) longer than three years. There is a statistically significant decrease in body weight, belly circumference, diuresis increase and the consequent ascites withdrawal. DIC occurred in 2 patients, shunt malposition in 2, saccular dilatation in 1, plastic peritonitis in 6, and ileus in 1 patient. Not one of the listed complications resulted by death.(ABSTRACT TRUNCATED AT 250 WORDS)