A rapid indication of Helicobacter pylori in patients with gastroduodenal pathology]

Rapid detection of H. pylori in samples from gastroduodenal patients is based on the use of standard ingredients made in the USSR: disks with urea from kits and indicator strips to show pH values of the Rifan type, within the pH range 5.8-7.4. This method helps detect pH changes emerging in H. pylori urea disintegration in the liquid and gaseous (air) phases. The sensitivity, specificity, and rate of the test are not inferior to those of the commercial urease test.     

Detection of nucleic acids in stomach and duodenal contents in patients with gastroduodenal pathology

The proposed method shows the velocity of gastroduodenal epitheliocyte exchange by evaluating the total content of nucleic acids in gastric and duodenal aspirates. The concentration of nucleic acids in the cavitary secretion phase reflects the state of the gastroduodenal mucosa and physicochemical properties of the mucus. Sixty patients with gastroduodenal diseases (chronic gastritis, chronic duodenitis from surface to atrophic and during exacerbation) were examined. Changes in the distribution of nucleic acids by phases of cavitary secretion were revealed. A decrease in the total content of nucleic acids in cavitary contents was paralleled by decreased activity of chronic gastritis and duodenitis and normalization of colloid and gel-forming properties of the mucus, which manifested by an essential increase of nucleic acids concentrations in the mucus and decrease in the gastric juice.     

Status of the glutathione system in gastroduodenal ulcers

Clinical and experimental studies demonstrated lowering of reduced glutathione, activation of glutathione reductase and peroxidase in peptic ulcer more pronounced in associated chronic hepatitis or non-ulcerative colitis. Clinical manifestations of the disease and biochemical shifts in glutathione system go in parallel. Disturbances of glutathione system seem to be involved in the origin and recurrences of gastroduodenal ulcer. New approaches are needed in therapeutic decisions and means in peptic ulcer especially in its combination with chronic hepatitis and non-ulcerative colitis.     

Erosive lesions in the gastroduodenal zone of patients with bronchial asthma

The purpose of the investigation was to study the frequency and clinicomorphological features of erosive lesions (EL) in the gastroduodenal zone (GDZ) of patients with bronchial asthma (BA). One hundred and sixty-three patients suffering from allergic BA of different degrees of severity were examined. The examination included clinical evaluation of the GDZ, esophagogastroduodenoscopy with gastric and duodenal mucosal biopsy, and subsequent analysis of the biopsy samples using histological, histochemical, morphometric methods, and electron microscopy. The frequency of EL in GDZ in BA patients was high (32.5%). The intensity of clinical symptoms, probably caused by concomitant gastroesophageal reflux disease, was low; dyspeptic syndrome prevailed. The morphological findings demonstrated the presence of gastric mucosal hyperergic inflammatory response to Helicobacter pylori infection, which was one of the factors determining the high frequency of EL in the pyloroantral zone in BA. The development of EL in the GDZ mucosa of BA patients was associated with parietal and endocrinal cell hyperplasia.     

Incidence of lesions in the gastroduodenal system in patients with bronchial asthma

Combined investigation of gastroduodenal system was carried out in 40 patients with bronchial asthma. The findings suggest that bronchial asthma is associated in the majority of cases with different gastroduodenal disorders. Mechanisms of the latter onset are considered. Knowledge of concomitant pathology would be of help in determining optimal individually-adjusted therapy of bronchial asthma.     

Upper gastroduodenal ulceration in arthritis patients treated with celecoxib

OBJECTIVE: To evaluate the comparative incidence of endoscopic gastroduodenal ulcers in patients with rheumatoid arthritis or osteoarthritis treated with celecoxib. DESIGN: Quantitative systematic review of randomized controlled trials. SUBJECTS: Patients (n = 4632) with rheumatoid arthritis or osteoarthritis reported in five trials. MAIN OUTCOME MEASURES: Rate ratios, rate differences, and the number needed to harm were calculated for the incidence of endoscopically documented gastroduodenal ulcers. RESULTS: Pooled rate ratios (RRs) relative to placebo for endoscopic ulcers at 12 weeks were 1.96 (95% CI 0.85 to 4.55) for celecoxib 100 mg twice daily and 2.35 (95% CI 1.02 to 5.38) for celecoxib 200 mg twice daily. There was no significant difference in gastroduodenal ulcers at 12 weeks between celecoxib 200 mg twice daily and celecoxib 100 mg twice daily; the corresponding pooled RR was 1.21 (95% CI 0.62 to 2.38). In contrast, celecoxib 200 mg twice daily was associated with a significantly lower rate of gastroduodenal ulcers than was naproxen 500 mg twice daily at 12 weeks (RR 0.24; 95% CI 0.17 to 0.33). On average, for every seven patients treated with naproxen, one more had an endoscopic ulcer than if they were treated with celecoxib. Celecoxib 200 mg twice daily also had a significantly lower risk of endoscopic ulcers than did either modified-release diclofenac 75 mg twice daily at 24 weeks (RR 0.24; 95% CI 0.11 to 0.52) or ibuprofen 800 mg three times daily at 12 weeks (RR 0.30; 95% CI 0.20 to 0.46). CONCLUSIONS: Endoscopic studies have shown that celecoxib, at a wide range of doses, is associated with a lower incidence of gastroduodenal ulcers than are diclofenac, ibuprofen, or naproxen. The incidence rates of gastroduodenal ulcers associated with celecoxib were similar, although not equivalent, to placebo. Head-to-head comparisons suggest that, at the wide range of doses studied (100-800 mg/d), there are no dose-related increases in endoscopic gastroduodenal ulcers with celecoxib. The results of longer term comparative trials of celecoxib based on clinical outcomes are needed to determine celecoxib's ultimate risk-benefit profile.     

Hemodynamics of the minor circulation in patients with gastroduodenal ulcer on hypoxic therapy

Adaptation of patients with gastroduodenal ulcer (GDU) to intermittent normobaric hypoxia is effective in the treatment of this disease. Some GDU patients have functional pulmonary hypertension. Single procedure and a course of normobaric hypoxic therapy have no negative effect on pulmonary hemodynamics. Overloading of the right heart in GDU patients does not contraindicate a course of breathing gas hypoxic mixture created by Strelkov's apparatus.     

Laser therapy in a comprehensive treatment of patients with gastroduodenal ulcers

Long-term scarring and frequently recurrent ulcers are often found in patients with concomitant diseases such as ischemic heart disease or diabetes mellitus. Laser therapy may be a good alternative in such patients. Gastroduodenal ulcer sites were exposed to laser radiation (He-Ne and AG lasers ATOLL, VITA-01) in 182 patients. The laser treatment was indicated in the failure of a 3-month previous therapy or resistance to antisecretory and antibacterial drugs. Laser treatment is recommended to perform in specialized gastroenterological clinics for better selection of patients, especially those with gastroduodenal ulcer combined with ischemic heart disease and/or diabetes mellitus.     

The surgical procedure in patients with hemorrhaging perforating gastroduodenal ulcers]

The paper presented the results of surgical treatment of 277 patients with bleeding penetrating gastroduodenal ulcers. Gastric location of the ulcer was revealed in 52 patients and duodenal location in 225 ones. More commonly used resections of the stomach according to a Billroth-I method or suprapyloric resections versus the resection of the stomach according to method Billroth-II when used in the patients with gastric location of the ulcers helped to reduce the mortality from 23.1 to 0%. The wide usage of organ-sparing operations combined with vagotomy reduced the lethal outcomes of the disease from 13 to 5.5% versus the resection of the stomach. The rate of bleeding relapses in the early postoperative period which followed the suture of penetrating gastroduodenal ulcers was 25.9%. The dissection of ulcers or their elimination from the alimentary tract could be regarded as the methods of choice in case of palliative treatment. Surgical treatment of penetrating gastroduodenal ulcers should be performed prior to bleedings. Planned operative intervention should be performed in patients with deep gastric ulcer with diameter of 1.5 cm and more and pyloroduodenal ulcers with diameter of more than 1 cm.     

Clinical and immunologic correlations of gastroduodenal lesions in patients with bronchial asthma

To study local immunity of the stomach in bronchial asthma (BA) and the role of some immunity factors deficiency in development of gastroduodenal disturbances in BA patients, we have examined 271 male and female patients aged 18 to 60 years with exogenic and mixed BA of different severity. Gastroduodenal erosions were endoscopically diagnosed in 61 (22.5%) patients. We discovered that gastroduodenal pathology in BA develops in local deficiency of secretory IgA (sIgA) and high content of IgG and CIC in the gastric mucus. We registered a dose-dependent effect of long-term oral therapy with systemic glucocorticoids (SGC) in BA on gastroduodenal pathology and local immunity. Physiological doses reduce concentrations of IgG and CIC in gastric mucus and, by attenuation of immunocomplex reactions in gastric mucosa, decreased the rate of gastroduodenal erosions. Treatment with supraphysiological doses of SGC breaks specific defense of gastric mucosa and makes erosions more frequent. Thus, the above derangement of humoral immunity of the stomach in patients with non-hormone-dependent BA has common manifestations and direction with local immunity of the respiratory airways in BA suggesting involvement of "common immune system of the mucosas" in BA.     

The determination of C. pylori in patients with gastroduodenal diseases]

A total of 46 gastric mucosa biopsy specimens obtained during surgery and 90 gastric juice samples from patients with gastroduodenal diseases were examined. Campylobacter-like microorganisms were detected in 84.6 percent of biopsy specimens and in 73.9 percent of gastric juice samples (in gram-stained smears). Urease activity was detected in 75.9 and 13.3 percent, respectively. C. pylori growth in solid nutrient medium in microaerophilic conditions was observed in 44.2 and 5.7 percent of the examined samples, respectively. The studies have demonstrated the efficacy of using disks with urea from standard kits manufactured by the Research Institute for Epidemiology and Microbiology in the city of Gorky in the urease test.