Gastric epithelial polyps: a retrospective endoscopic study of 12974 symptomatic patients.

This is a retrospective endoscopic study on the incidence of gastric epithelial polyps (adenomas, hyperplastic, inflammatory) in 12,974 consecutive symptomatic Greek adults submitted to endoscopy during a 4-year period, in two endoscopy units. A total of 258 polyps were found in 157 patients (1.2%), 80 males and 77 females (age: 22-87 years); 67.5% of these patients were older than 60 years. Two hundred and two (202) polyps were totally removed. In 43 patients (27%), more than one polyp was found. Polyps were mainly hyperplastic (75.6%). Adenomas were found in 6.6%, and only in patients older than 50 years. Hyperplastic and inflammatory polyps were equally distributed in males and females. A male predominance was observed in adenomas (2:1). Most of the polyps were in the antrum (43.8%) and were hyperplastic (75.2%). Of 501 previously operated patients (gastrectomy or gastrojejunostomy), 26 (5.2%) had polyps. No adenomas were seen in the anastomosis area. Most of the polyps (61.9%) were smaller than 0.5 cm; 13.3% were greater than 1 cm. No coincidence of polyps with gastric cancer was observed.

GC and C3 serum groups in ulcerative colitis.

The phenotypes and allele frequencies of two serum protein systems (GC and C3) were studied in 91 consecutive patients with ulcerative colitis and compared with healthy controls. No significant differences were found as far as GC was concerned. However, significant differences were observed in C3: the C3*F allele and C3FS phenotype were more frequent in patients than in controls.

Triple therapy eradicated H. pylori equally in patients pretreated with omeprazole or ranitidine. A 12-month follow-up.

The aim of this study was twofold: first, to investigate the effectiveness of a standard triple therapy (tripotassium dicitrato bismuthate, 125 mg q.i.d., tetracycline hydrochloride 500 mg q.i.d., and metronidazole 500 mg t.i.d.) in eradicating Helicobacter pylori in patients with duodenal ulcer successfully healed with omeprazole or ranitidine; second, to examine the influence of the eradication on duodenal ulcer recurrence rate after 12 months. Two hundred forty-five consecutive H. pylori-positive patients with healed duodenal ulcer either with omeprazole (20 mg/day, 126 patients) or with ranitidine (150 mg b.i.d., 119 patients) given at random, began triple therapy for 15 days. H. pylori eradication was looked for 4-5 weeks later by culture of biopsy material, hematoxylin-eosin stain, and rapid urease test. H. pylori-eradicated patients were followed up for 12 months. Endoscopy was carried out at the end of the follow-up or whenever symptoms appeared. Five patients (2.0%) withdrew because of triple-therapy-related side effects. The eradication rate was 92% (220 of 240 patients); no difference was found between those healed with omeprazole (93%, 114 of 123 patients) or ranitidine (91%, 106 of 117 patients). Of 220 successfully treated patients, 132 completed the 12-month follow-up. The duodenal ulcer recurrence rate was 4% (5 of 132 patients); 3% (2 of 70) in the omeprazole group and 5% (3 of 62) in the ranitidine group healed. All the recurrences were asymptomatic. H. pylori recurrence rate was 11% (14 of 132 patients); no difference was found between patients healed with omeprazole (10%, 7 of 70 patients) or with ranitidine (11%, 7 of 62 patients). All the recurrent duodenal ulcers occurred in H. pylori-positive patients (36%, 5 of 14 patients). Standard triple therapy after duodenal ulcer healing with omeprazole or ranitidine eradicates H. pylori in comparable high rates. Side effects were mild and dropouts were only 2%. Ulcer recurrence rate 12 months after eradication was low and comparable between those healed with omeprazole or ranitidine.

Colonic findings in cirrhotics with portal hypertension. A prospective colonoscopic and histological study.

Total colonoscopy was performed in 38 consecutive cirrhotics (15 alcoholic, 19 postviral, four unknown) with portal hypertension, 32 of whom were enrolled in a program of esophageal sclerotherapy because of variceal bleeding (Child's grading: A, 13; B, 21; C, 4 patients). In 34 of them, multiple biopsies from the colonic mucosa were taken. Fifty non-cirrhotics (roughly matched for age and sex with the patients) who were colonoscoped because of atypical abdominal complaints, served as controls for rectal varices, polyps, and hemorrhoids. Rectal varices occurred in 3 of 38 (7.9%) of cirrhotics with portal hypertension; they were found only in those who had undergone esophageal sclerotherapy, but no association with the number of sclerotherapies was documented; severity and etiology of cirrhosis did not seem to influence their presence. Hemorrhoids and polyps did not seem to occur more frequently in cirrhotics than in controls. Nonspecific inflammatory changes were observed macroscopically in 57.9% of the patients; these were significantly more common in postviral cirrhosis in comparison with alcoholic cirrhosis (p = 0.01967; 95% CI, 0.757-0.155) and, in particular, in the Child's B postviral cirrhosis as compared with the Child's B alcoholic cirrhosis (p = 0.01915; 90% CI, 0.942-0.320). In 15 patients, there was histological evidence of chronic or acute nonspecific inflammation; no associations with the severity or the etiology of the cirrhosis were found. No vascular ectasias or ectasia-like lesions were found.

A double-blind study of cimetidine in patients with duodenal or gastric ulcer in Greece.

The results of a double-blind study comparing oral cimetidine with placebo in the short-term treatment of endoscopically proven gastric and duodenal ulceration are presented. Cimetidine was used at a dosage of one gram per day and treatment continued over a period of 4 weeks. Greek patients' tolerance of the drug has been recorded. The outcome of treatment was significantly better for the group of patients who received cimetidine treatment.