[Comparison of 2 treatment schemes to eradicate Helicobacter pylori]. / Comparación de dos esquemas de tratamiento para erradicar Helicobacter pylori.

INTRODUCTION: Anti secretory drugs, antimicrobials and bismuth salts are used with variable success to eradicate Helicobacter pylori. AIM: To assess the effectiveness and rates of reinfection of two therapeutic modalities H pylori infection in adult patients with duodenal ulcer or non ulcer dyspepsia. METHODS: During upper gastrointestinal endoscopy, 5 antral and 2 fundic biopsies were obtained and sent for microbiological and anatomopathological study. Patients infected with Helicobacter pylori were randomly assigned to receive during two weeks omeprazole 20 mg od plus amoxicillin 500 mg tid (group A) or bismuth subsalicylate 260 mg bid, metronidazole 250 mg tid and amoxicillin 500 mg tid (group B). A new endoscopy with antral and fundic biopsies was performed to all patients four weeks after discontinuing treatment and six months later to those in whom H pylori was eradicated. RESULTS: Eighty patients (40 in each treatment group) completed the treatment and follow up. H pylori was eradicated in 22 patients of group A (55%) and 28 of group B (70%). Minor adverse effects were reported by 5 patients in group A (12%) and 11 in group B (27.5%). Six months later, reinfection was documented in 12 patients of group A and 8 of group B (54% and 30% of those with successful treatment respectively). Ten of twenty five patients with duodenal ulcer had reinfections, but there was only one ulcer relapse. CONCLUSIONS: These two treatment modalities have similar results.

[Non ulcerative dyspepsia: relationship of symptomatology, gastritis and Helicobacter pylori]. / Dispepsia no ulcerosa: relaciones entre sintomatología, gastritis y Helycobacter pylori.

BACKGROUND: histological alterations of gastric mucosa and its colonization by Helicobacter pylori are postuled to be implicated in the pathogenesis of non ulcer dyspepsia. AIM: to study the possible relationships between histological gastritis and Helicobacter pylori in non ulcer dyspepsia symptomatology. PATIENTS AND METHODS: fifty four patients (39 females) with non ulcer dyspepsia whose ages ranged from 17 to 68 years were subjected to an upper GI endoscopy with gastric mucosa biopsy samples for histological study and microbiological identification of Helicobacter pylori. Gastrointestinal complains were blindly quantified using a scored questionnaire. RESULTS: thirty one subjects (57.4%) had Helicobacter pylori in their gastric mucosa. There was acute inflammatory activity in 26 of the 31 patients with Helicobacter pylori (81%) and 15 of 23 without Helicobacter (65%). The median score of symptoms was 7 (range 2-13) in patients with Helicobacter and 6 (range 2-10) in patients without Helicobacter. CONCLUSIONS: there were no significant differences in gastric mucosa acute inflammatory activity and non ulcer dyspepsia symptomatology between patients with or without Helicobacter pylori colonization of gastric mucosa.

Eficacia y seguridad de ranitidina 150mg vs 300 mg dos veces por día en úlcera duodenal / Effectiveness and safety of ranitidine 150 mg vs 300 mg twice a day in duodenal ulcer

Trescientos noventa y cuatro pacientes con úlcera duodenal diagnosticada endoscópica fueron randomizados para recibir ranitidina 150 mg bid o ranitidina 300 mg bid en un estudio multicéntrico, prospectivo, doble-ciego, llevado a cabo en 7 países latinoamericanos. La endoscopía a las 4 semanas mostró curación completa de las úlceras en 171 de 196 pacientes (87.2%) tratados con ranitidina 150 mg bid y 178 de 198 (89.9%) tratados con ranitidina 300 mg bid. Ambos regímenes de tratamientos fueron igualmente efectivos, reduciendo rápidamente la incidencia de los síntomas ulcerosos. Es probable que el regimen de dosis elevadas con ranitidina sea adecuado en pacientes con enfermedad ulcerosa severa

Eficacia y seguridad de ranitidina 150mg vs 300 mg dos veces por día en úlcera duodenal / Effectiveness and safety of ranitidine 150 mg vs 300 mg twice a day in duodenal ulcer

Trescientos noventa y cuatro pacientes con úlcera duodenal diagnosticada endoscópica fueron randomizados para recibir ranitidina 150 mg bid o ranitidina 300 mg bid en un estudio multicéntrico, prospectivo, doble-ciego, llevado a cabo en 7 países latinoamericanos. La endoscopía a las 4 semanas mostró curación completa de las úlceras en 171 de 196 pacientes (87.2%) tratados con ranitidina 150 mg bid y 178 de 198 (89.9%) tratados con ranitidina 300 mg bid. Ambos regímenes de tratamientos fueron igualmente efectivos, reduciendo rápidamente la incidencia de los síntomas ulcerosos. Es probable que el regimen de dosis elevadas con ranitidina sea adecuado en pacientes con enfermedad ulcerosa severa (AU)

[Effectiveness and safety of 150 mg vs 300 mg ranitidine twice a day in duodenal ulcer]. / Eficacia y seguridad de Ranitidina 150 mg vs 300 mg dos veces por día en ulcera duodenal.

394 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine 150 bid o ranitidine 300 mg bid in a prospective double-blind multicenter trial conducted in seven LatinoAmerican countries. Endoscopy at 4 weeks showed complete ulcer healing en 171 of 196 patients (87.2%) treated with ranitidine 150 mg bid and 178 of 198 (89.9%) treated with ranitidine 300 mg bid. Both treatment regimens were equally effective at rapidly reducing the incidence of ulcer-related symptoms. It is possible that higher dosage regimen of ranitidine would be useful in patients with more severe duodenal ulcer disease.

Eficacia y seguridad de Ranitidina 150 mg vs 300 mg dos veces por día en ulcera duodenal. / [Effectiveness and safety of 150 mg vs 300 mg ranitidine twice a day in duodenal ulcer]

394 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine 150 bid o ranitidine 300 mg bid in a prospective double-blind multicenter trial conducted in seven LatinoAmerican countries. Endoscopy at 4 weeks showed complete ulcer healing en 171 of 196 patients (87.2

) treated with ranitidine 150 mg bid and 178 of 198 (89.9

) treated with ranitidine 300 mg bid. Both treatment regimens were equally effective at rapidly reducing the incidence of ulcer-related symptoms. It is possible that higher dosage regimen of ranitidine would be useful in patients with more severe duodenal ulcer disease.

[Treatment of gastric ulcer with sucralfate and famotidine]. / Tratamiento de la úlcera gástrica con sucralfato y famotidina.

We conducted a double blind random study on 79 patients with gastric ulcer: 39 received sucralfate, 1 g 4 times a day (Group 1) and 40 received a single evening dose of famotidine, 40 mg (Group 2). At 4 weeks, endoscopy revealed healing of the ulcer in 46% of patients in Group 1 and 40% in Group 2 (NS). At 8 weeks, corresponding figures were 90% and 75% (NS). All patients were able to complete treatment and minor side effects were reported from all patients, 36% with sucralfate and 28% with famotidine. Thus, sucralfate and famotidine are equally effective for therapy of gastric ulcer. The higher percentage of healing with sucralfate observed in this study was not statistically significant.

[Gastric cancer: advances in diagnosis and treatment]. / Cáncer gástrico: avances diagnósticos y terapéuticos.

The number of deaths from gastric cancer has decreased in the last decade in Chile, in spite of a constant number of admissions for the disease. The decrease in mortality may be ascribed to epidemiologic factors and advances in diagnosis and treatment of the disease. The main aspects of current radiologic and endoscopic diagnosis of gastric cancer, as well as criteria for surgical resection are discussed.

Pirenzepina: un anticolinergico diferente. / Pirenzipine: a different anticholinergic

La pirenzepina es un preparado hidrosoluble de estructura molecular triciclica.Posee un efecto antisecretor similar al de los anticolinergicos tradicionales, sin alcanzar igual magnitud en sus acciones sistemicas. Su afinidad selectiva como antagonista de ciertos receptores muscarinicos (M1) ha permitido su empleo en el tratamiento medico de la ulcera peptica. Algunas series europeas han obtenido resultados alentadores administrando 100 a 150 mg. diarios por via oral durante 4 a 6 semanas. Carece de efectos colaterales de trascendencia y el rol que le pudiera corresponder en el manejo habitual de la enfermedad ulcerosa, aun no ha sido bien establecido. Esta contraindicada en la esofagitis peptica de reflujo; su empleo es discutible en las lesiones gastricas agudas y de muy dudosa utilidad en los sindromes dispepticos

Valor diagnostico de las pruebas de laboratorio en los sindromes de malabsorcion. / Diagnostic value of laboratory tests in malabsorption syndromes

Se analizan los resultados obtenidos en nuestro laboratorio para las determinaciones de carotinemia, absorcion de vitamina A y D-xilosa. En 102 determinaciones de carotinemia despues de una carga de 50.000 unidades de vitamina A por tres dias, se observa que el 96,7% de los casos con SMA presentan valores inferiores a lo normal (55 mcgr/100ml) sin presentar diferencias notorias de este porcentaje de absorcion entre celiacos (93,6%) y no celiacos (100%). En 94 determinaciones de porcentaje de absorcion a las 4 horas de una dosis de 300.000 unidades de vitamina A tras una carga de 50.000 unidades diarias por 3 dias, se observa que el 75% de los casos con SMA tienen valores inferiores a lo normal (5% de absorcion), existiendo una clara diferencia de esta deficiencia entre celiacos (89,3%) y no celiacos (60,7%). En 20 pruebas de absorcion de D-xilosa tras la administracion de 25 gr de esta pentosa en 250 ml de agua se observan valores plasmaticos inferiores al normal (20 mg%) en 38,9% de los casos con SMA y valores urinarios inferiores al normal (4 gr/5 horas) en 61,7% de los casos, existiendo una diferencia notoria entre celiacos (87,7%) y no celiacos (45,5%)