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Sample records for aspirin-associated gastroduodenal ulcer

  1. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved by the D......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved...... serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  2. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  3. Route of children at ulcerative gastroduodenal bleedings

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    Сергій Олександрович Сокольник

    2015-07-01

    Full Text Available Aim. To elaborate the step-by-step differential algorithm of the motion of children with ulcerative gastroduodenal bleedings. Methods. There were examined 45 patients with gastroduodenal bleeding of ulcerative genesis using clinical, sociometric, genealogic, immune-enzyme, biochemical, endoscopic, functional methods. In the complex treatment for stop bleeding 13 patients underwent argon-plasma coagulation and the other – irrigation with aminocapronic acid. An efficiency of treatment was evaluated using epidemiologic and statistical methods.Results. At presence of an appropriate clinical symptomatology, burdened genealogic anamnesis, laboratory changes it is necessary to carry out an emergency endoscopic examination. In the case of continuing bleeding or instable homeostasis it is recommended to carry out an endoscopic hemostasis using argon-plasma coagulation, in conditions of the high risk of relapse of bleeding – the repeated course of argon-plasma coagulation. After stabilization - an examination for helicobacter infection, conservative therapy and dynamic observation with detection of risk of relapse of bleeding and elaboration of individualized medioprophylactic program.Conclusions. The use of step-by-step differentiated diagnostic and treatment algorithm of the motion in patients with ulcerative disease complicated with gastroduodenal bleeding allows detect the main spectrum of diagnostic researches faster and choose the tactics of treatment and therefore improve an efficiency of medical help for patient and shorten the term of inpatient treatment. 

  4. [The causes of recurrent ulcerative gastroduodenal bleeding].

    Science.gov (United States)

    Lipnitsky, E M; Alekberzade, A V; Gasanov, M R

    To explore microcirculatory changes within the first 48 hours after admission, to compare them with clinical manifestations of bleeding and to define the dependence of recurrent bleeding from the therapy. The study included 108 patients with ulcerative gastroduodenal bleeding who were treated at the Clinical Hospital #71 for the period 2012-2014. There were 80 (74.1%) men and 28 (25.9%) women. Age ranged 20-87 years (mean 54.4±16.8 years). Patients younger than 45 years were predominant (33.4%). J. Forrest classification (1974) was used in endoscopic characterization of bleeding. Roccal Prognostic Scale for gastroduodenal bleeding was applied in all patients at admission to assess the risk of possible recurrence. Patients were divided into 2 groups. Group 1 included 53 (49.1%) patients without recurrent bleeding; group 2-55 (50.1%) patients who had recurrent bleeding within the first two days of treatment. Investigation of microcirculation showed the role of vegetative component including blood circulation centralization, blood flow slowing, blood cells redistribution providing sufficient blood oxygenation. By the end of the first day we observed pronounced hemodilution, decreased blood oxygenation, blood flow restructuring with its acceleration above 1 ml/s, violation of tissue oxygenation, signs of hypovolemia. These changes were significantly different from group 2 and associated with circulatory decentralization with possible pulmonary microcirculation disturbances and interstitial edema. This processes contribute to disruption of tissue oxygenation. We assume that recurrent bleeding in group 2 was caused by fluid therapy in larger volumes than it was necessary in this clinical situation. Infusion therapy should be significantly reduced for the debut of gastroduodenal ulcerative bleeding. Sedative therapy is advisable to reduce the influence of central nervous system.

  5. Risk factors for reintervention after surgery for perforated gastroduodenal ulcer

    DEFF Research Database (Denmark)

    Hasselager, R B; Lohse, N; Duch, P

    2016-01-01

    BACKGROUND: Perforated gastroduodenal ulcer carries a high mortality rate. Need for reintervention after surgical repair is associated with worse outcome, but knowledge on risk factors for reintervention is limited. The aim was to identify prognostic risk factors for reintervention after perforated...... gastroduodenal ulcer in a nationwide cohort. METHODS: All patients treated surgically for perforated gastroduodenal ulcer in Denmark between 2003 and 2014 were included using data from the Danish Clinical Register of Emergency Surgery. Potential risk factors for reintervention were assessed, and their crude...... and adjusted associations calculated by the competing risks subdistribution hazards approach. RESULTS: A total of 4086 patients underwent surgery for perforated gastroduodenal ulcer during the study interval. Median age was 71·1 (i.q.r. 59·6-81·0) years and the overall 90-day mortality rate was 30·8 per cent...

  6. [Aspects of therapeutic approach in hemorrhage in gastroduodenal ulcers].

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    Klucár, J; Hut'an, M; Korec, M

    1990-03-01

    The most dramatic complications of gastroduodenal ulcers are haemorrhage. According to the literature 20-25% of chronic ulcers bleed. The authors analyze a group of 71 patients treated on account of bleeding gastric or duodenal ulcers. In indications for operation the authors emphasize endoscopic criteria elaborated by Forrest.

  7. Úlcera gastroduodenal em potros Gastroduodenal ulcer in foals

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    Antonio Cezar de Oliveira Dearo

    1995-01-01

    Full Text Available Dentre as inúmeras patologias que acometem os eqüinos jovens, as úlceras gástricas situam-se como uma das mais importantes. MURRAY et al. (1987 trabalhando com potros clinicamente normais, constatou uma prevalência de úlceras da ordem de 51%. O mesmo autor realizando gastroscopia em 45 equinos com idade entre 1 e 24 anos, observou a presença de úlceras em 93% dos animais (MURRAY, 1988. De etiologia não completamente definida, acredita-se que inúmeros fatores estejam envolvidos na gênese das úlceras gastroduodenais, sendo o estresse um dos mais importantes. Um desequilíbrio entre os fatores de agressão e proteção da mucosa gástrica é sugerido, onde uma vez ocorrendo o predomínio dos fatores de agressão, a formação das úlceras estaria determinada. De acordo com o tipo, presença ou ausência de sinais clínicos, localização das lesões na mucosa gástrica e possíveis complicações de sua ocorrência, quatro síndromes clínicas são reconhecidas em potros: 1 úlceras assintomáticas ou "silenciosas"; 2 úlceras sintomáticas ou "ativas"; 3 úlceras perfuradas e, 4 obstrução gástrica ou duodenal. O diagnóstico deve ser baseado na história clínica, sinais clínicos, resposta à terapia e principalmente nos achados do exame gastroscópico. O tratamento pode ser feito utilizando-se drogas inibidoras da secreção ácida, protetores de mucosas, anti-ácidos, análogos da prostaglandina e estimulantes de motilidade intestinal. Quando indicado emprega-se o tratamento cirúrgico.Among the great number of pathologies that affect young horses, gastric ulcers are considered one of the most important. MURRAY et al. (1987 working with clinically normal foals established a prevalence of gastric ulcers of 51%. The same author after carrying out 1988. Although its aethiology hasn't been well established, a variety of factors are suspected to be involved in its genesis, where stress plays an important role. A disruption of the

  8. Root Cause Analysis of Gastroduodenal Ulceration After Yttrium-90 Radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Marnix G. E. H. [Stanford University School of Medicine, Division of Interventional Radiology (United States); Banerjee, Subhas [Stanford University School of Medicine, Division of Gastroenterology and Hepatology (United States); Louie, John D.; Abdelmaksoud, Mohamed H. K. [Stanford University School of Medicine, Division of Interventional Radiology (United States); Iagaru, Andrei H. [Stanford University School of Medicine, Division of Nuclear Medicine and Molecular Imaging (United States); Ennen, Rebecca E.; Sze, Daniel Y., E-mail: dansze@stanford.edu [Stanford University School of Medicine, Division of Interventional Radiology (United States)

    2013-12-15

    IntroductionA root cause analysis was performed on the occurrence of gastroduodenal ulceration after hepatic radioembolization (RE). We aimed to identify the risk factors in the treated population and to determine the specific mechanism of nontarget RE in individual cases. Methods: The records of 247 consecutive patients treated with yttrium-90 RE for primary (n = 90) or metastatic (n = 157) liver cancer using either resin (n = 181) or glass (n = 66) microspheres were reviewed. All patients who developed a biopsy-proven microsphere-induced gastroduodenal ulcer were identified. Univariate and multivariate analyses were performed on baseline parameters and procedural data to determine possible risk factors in the total population. Individual cases were analyzed to ascertain the specific cause, including identification of the culprit vessel(s) leading to extrahepatic deposition of the microspheres. Results: Eight patients (3.2 %) developed a gastroduodenal ulcer. Stasis during injection was the strongest independent risk factor (p = 0.004), followed by distal origin of the gastroduodenal artery (p = 0.004), young age (p = 0.040), and proximal injection of the microspheres (p = 0.043). Prolonged administrations, pain during administration, whole liver treatment, and use of resin microspheres also showed interrelated trends in multivariate analysis. Retrospective review of intraprocedural and postprocedural imaging showed a probable or possible culprit vessel, each a tiny complex collateral vessel, in seven patients. Conclusion: Proximal administrations and those resulting in stasis of flow presented increased risk for gastroduodenal ulceration. Patients who had undergone bevacizumab therapy were at high risk for developing stasis.

  9. N-butyl cyanoacrylate embolotherapy for acute gastroduodenal ulcer bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Kim, Ji Hoon; Koh, Young Hwan; Han, Dae Hee; Cha, Joo Hee; Seong, Chang Kyu; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2007-01-15

    Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.

  10. Cholangiohepatitis and pancreatitis secondary to severe gastroduodenal ulceration in a foal

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    Buote, Melanie

    2003-01-01

    A 2-month-old foal was presented with clinical signs of colic. Gastroduodenal ulceration was suspected. A poor response to medical treatment and signs of gastroduodenal obstruction led to celiotomy and an attempted bypass procedure. The foal was euthanized and postmortem examination revealed gastric ulceration, segmental duodenal stenosis, and severe chronic cholangiohepatitis and pancreatitis.

  11. COMBINATION OF SEVERE GASTRODUODENAL ULCER AND HEMOPHILIA B IN A CHILD. CLINICAL CASE

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    E. Y. Dyakonova

    2015-01-01

    Full Text Available Gastroduodenal ulcer is less common and milder in children than in adults. Gastroduodenal ulcer complications, such as hemorrhage, penetration etc. are even less common. Recurrent ulcerous defect hemorrhage is a reason to expand diagnostic search and involve various specialists, primarily hematologists, into the diagnosis establishing process. The article presents a clinical case of a child with gastroduodenal ulcer complicated with recurrent hemorrhage not terminated with the standard therapy; thus, additional diagnostic testing was performed. This helped to detect a hematological disease and determine an optimal therapy amount.

  12. A Challenging Case of a Large Gastroduodenal Artery Pseudoaneurysm after Surgery of a Peptic Ulcer

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    Rocio Santos-Rancaño

    2015-01-01

    Full Text Available We report a 48-year-old man in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum and gastroduodenal artery causing pseudoaneurysm. The lesion was found and evaluated by contrast-enhanced computed tomography (that revealed a large pseudoaneurysm of 83 mm × 75 mm in diameter and by angiography and then treated with transcatheter embolization leading to a complete resolution of the lesion. The case is rare and important for several reasons. First, we demonstrate that pseudoaneurysm of the gastroduodenal artery caused by a duodenal ulcer can occur and present a diagnostic challenge (as far as we know, only three cases have been reported previously in the literature. Second, this case report focuses on the importance of ligation of the gastroduodenal artery when bleeding of peptic ulcers occurs. Additionally, we present an overview of the relevant literature.

  13. Low-dose aspirin-associated upper gastric and duodenal ulcers in Japanese patients with no previous history of peptic ulcers.

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    Kawamura, Naohiko; Ito, Yoshitsugu; Sasaki, Makoto; Iida, Akihito; Mizuno, Mari; Ogasawara, Naotaka; Funaki, Yasushi; Kasugai, Kunio

    2013-11-12

    Long-term administration of low-dose aspirin (LDA) is associated with a greater risk of adverse events, including gastroduodenal ulcers. The purpose of this study was to identify the risk factors for and assess the role of medication use in the development of peptic ulcer disease in Japanese patients with no history of peptic ulcers. Consecutive outpatients receiving LDA (75 mg/day) who underwent esophagogastroduodenoscopy between January and December 2010 were enrolled. Clinical parameters, peptic ulcer history, concomitant drugs, the presence of Helicobacter pylori infection, reason for endoscopy, and endoscopic findings were analysed. Of 226 total patients, 14 (6.2%) were endoscopically diagnosed with peptic ulcer. Age, sex, current smoking status, current alcohol consumption, endoscopic gastric mucosal atrophy, and abdominal symptoms were not significantly associated with peptic ulcers. Diabetes mellitus was more frequent (42.9% vs. 16.5%; P = 0.024) in patients with peptic ulcers than in those without peptic ulcers. Using multiple logistic regression analysis, co-treatment with anticoagulants or proton pump inhibitors (PPIs) was significantly associated with increased and decreased risk for peptic ulcer, respectively (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.19 - 28.99; P = 0.03 and OR, 0.13; 95% CI, 0.02 - 0.73; P = 0.02, respectively). Co-treatment with additional antiplatelet agents, H2-receptor antagonists, angiotensin II Type 1 receptor blockers, angiotensin-converting enzyme inhibitor, 3-hydroxy-3-methylglutaryl-CoA reductase inhibitor, or nonsteroidal anti-inflammatory drugs was not associated with peptic ulcer development. The use of PPIs reduces the risk of developing gastric or duodenal ulcers in Japanese patients taking LDA without pre-existing gastroduodenal ulcers. However, this risk is significantly increased in both patients ingesting anticoagulants and patients with diabetes. These results may help identify

  14. Non-operative treatment for perforated gastro-duodenal peptic ulcer in Duchenne Muscular Dystrophy: a case report

    OpenAIRE

    Brinkman, Justus-Martijn; Oddens, Jorg R; Van Royen, Barend J; Wever, Jan; Olsman, Jan G

    2004-01-01

    Abstract Background Clinical characteristics and complications of Duchenne muscular dystrophy caused by skeletal and cardiac muscle degeneration are well known. Gastro-intestinal involvement has also been recognised in these patients. However an acute perforated gastro-duodenal peptic ulcer has not been documented up to now. Case presentation A 26-year-old male with Duchenne muscular dystrophy with a clinical and radiographic diagnosis of acute perforated gastro-duodenal peptic ulcer is treat...

  15. Pathogenetic Features of Gastroduodenal Peptic Ulcer Associated with Hypertension and Diabetes Mellitus Type 2

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    I.O. Sitsinska

    2016-03-01

    Full Text Available The development and course of gastroduodenal peptic ulcer are associated with the strains of H.pylori (сagA+ vacA+, сagA+ vacА–, сagA– vacA+, сagA– vacA– that was found in patients in the presence of comorbidity and in its absence. In the group of patients with gastroduodenal peptic ulcer combined with hypertension and diabetes mellitus type 2, сagA+ vacA+ strains were found in 14 individuals (45.16 %, сagA+ vacA– — in 4 (12.9 %, сagA– vacA+ — in 13 (41.43 %, and in patients with gastroduodenal peptic ulcer — in 4 (13.79 %, 8 (27.59 % and 16 (55.17 % persons, respectively. The impact of H.pylori strains is associated with the changes of proteolytic and fibrinolytic activity. Given the comorbidity and the role of strains in the development of underlying disease, there has been revealed a probable reduction in the level of albumin lysis, azocasein lysis and an increase in azocol lysis compared with reduced total fibrinolytic activity, non-enzymatic fibrinolytic enzyme activity and increased enzymatic fibrinolytic activity. The use of baseline anti-Helicobacter pylori therapy and probiotics (Lactobacterium, Bifidobacterium provides a positive result.

  16. [The effect of proximal-selective vagotomy in gastroduodenal ulcer].

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    Muller, C; Martinoli, S; Allgöwer, M

    1984-05-26

    In a recently concluded prospective multicenter trial, pyloric (PU) and prepyloric (PPU) ulcers showed a significantly higher recurrence rate after proximal gastric vagotomy (PGV) without drainage than duodenal (DU) or gastric ulcers (GU). The secretory pattern of the PU and PPU cannot explain the failure of PGV. However, PU and PPU (and some GU) exhibit a distinct and probably irreversible alteration of the muscular layer at the pylorus and distal antrum. This could be one factor which helps to explain the failure of vagotomy alone in these ulcer types. To deal with this antropyloric distrophy, addition of drainage or antrectomy to PGV must be considered. A refined concept for surgical treatment of peptic ulcer is proposed.

  17. Gastro-duodenal peptic ulcer perforation | Dakubo | East African ...

    African Journals Online (AJOL)

    -Lamptey. Abstract. Objectives: To determine the epidemiology of, and define the morbidity and mortalityfactors following emergency surgery for patients with perforated peptic ulcer disease in Accra, Ghana. Design: A retrospective and ...

  18. Non-operative treatment for perforated gastro-duodenal peptic ulcer in Duchenne Muscular Dystrophy: a case report

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    Wever Jan

    2004-01-01

    Full Text Available Abstract Background Clinical characteristics and complications of Duchenne muscular dystrophy caused by skeletal and cardiac muscle degeneration are well known. Gastro-intestinal involvement has also been recognised in these patients. However an acute perforated gastro-duodenal peptic ulcer has not been documented up to now. Case presentation A 26-year-old male with Duchenne muscular dystrophy with a clinical and radiographic diagnosis of acute perforated gastro-duodenal peptic ulcer is treated non-operatively with naso-gastric suction and intravenous medication. Gastrointestinal involvement in Duchenne muscular dystrophy and therapeutic considerations in a high risk patient are discussed. Conclusion Non-surgical treatment for perforated gastro-duodenal peptic ulcer should be considered in high risk patients, as is the case in patients with Duchenne muscular dystrophy. Patients must be carefully observed and operated on if non-operative treatment is unsuccessful.

  19. Non-operative treatment for perforated gastro-duodenal peptic ulcer in Duchenne muscular dystrophy: a case report.

    Science.gov (United States)

    Brinkman, Justus-Martijn; Oddens, Jorg R; Van Royen, Barend J; Wever, Jan; Olsman, Jan G

    2004-01-08

    Clinical characteristics and complications of Duchenne muscular dystrophy caused by skeletal and cardiac muscle degeneration are well known. Gastro-intestinal involvement has also been recognised in these patients. However an acute perforated gastro-duodenal peptic ulcer has not been documented up to now. A 26-year-old male with Duchenne muscular dystrophy with a clinical and radiographic diagnosis of acute perforated gastro-duodenal peptic ulcer is treated non-operatively with naso-gastric suction and intravenous medication. Gastrointestinal involvement in Duchenne muscular dystrophy and therapeutic considerations in a high risk patient are discussed. Non-surgical treatment for perforated gastro-duodenal peptic ulcer should be considered in high risk patients, as is the case in patients with Duchenne muscular dystrophy. Patients must be carefully observed and operated on if non-operative treatment is unsuccessful.

  20. Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda

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    Lawrence Tsongo

    2015-11-01

    Full Text Available Introduction: To meet key millennium development goals, the rural population needs to be reached for health assessment and service delivery. Gastroduodenal ulcer disease is a common ailment affecting the health of people in Uganda. A cross-sectional study was conducted at Bwera Hospital in Kasese district of western Uganda, to establish the prevalence and predisposing factors of Helicobacter pylori among gastroduodenal ulcer disease patients. Methods: A sample of 174 patients with symptoms of gastroduodenal ulcer disease was purposively obtained. Using two laboratory test methods, the prevalence of H. pylori among these patients was determined. A structured questionnaire was administered to participants to establish their demographic background and selected aspects of their lifestyle. Finally, the results obtained by enzyme-linked immunosorbent assay (ELISA and immunochromatographic rapid test (IRT were compared. Results: We established the prevalence of H. pylori as 29.9% (52/174 by ELISA and 37.4% (65/174 by IRT. Cigarette smoking, poor sanitation, and lack of formal education were the significant predisposing factors with p-values <0.05. The two tests gave identical results in 87.9% of the patients. Discussion: The prevalence of H. pylori by IRT and ELISA test methods was similar to what has been reported elsewhere in developed countries; but was lower than previously reported in developing countries including Uganda. The previous studies in Uganda were carried out in the urban population and on young children; and some used antibody-detection methods only, therefore leading to different prevalence as a result of difference in study population and methods.

  1. Comparative analysis of assessment methods for operational and anesthetic risks in ulcerative gastroduodenal bleeding

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    Potakhin S.N.

    2015-09-01

    Full Text Available Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK, proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

  2. Periodic activity of secretory glands of stomach in ulcer erosion of gastro-duodenal zone

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    A. I. Rudenko

    2005-12-01

    Full Text Available It was fixed, that development of atophanum-carbacholimun ulcer of the gastroduodenal zone invoked various changes of secretory activity of the stomach. The changes directly depend on a progress of pathological process. As this takes place the reaction of stomach secretory glands varies under the stimulation with histamine: the decrease of stomach secretory glands’ work capacity till 10th day and its increase after 10–15th day were observed. Disorders of the glands’ ultradian rhythms at initial stages of modeling of gastrointestinal nervous regulation disturbances testify to dependence of periodic activity of gastrointestinal tract on resistance of regulatory mechanisms correlation.

  3. [CD25-positivity and efficacy of roncoleukin in complex treatment of patients with gastroduodenal ulcers complicated by hemorrhage].

    Science.gov (United States)

    Eĭvazova, K A; Gasanov, I A

    2011-08-01

    In 72 patients, suffering gastroduodenal ulcer disease recombinant interleukin-2 (LL-2) Roncoleukin ("Biotech", Russia) was applied in complex of treatment. The main populations of immunocytes, containing cellular-tissue receptor IL-2 CD25, were investigated in specimen from various zones of gastroduodenal mucosa and peripheral blood. There was established the trustworthy hyperexpression of CD25 in patients while gastrointestinal hemorrhage. Roncoleukin inclusion into the complex of treatment of patients have promoted more effective normalization of affinity of various immunocytes type towards IL-2 receptors, clinical signs occurrence of the disease elimination and the ulcer defect epithelization acceleration.

  4. Platelet aggregation measurement for assessment of hemostasis failure mechanisms in patients with gastroduodenal ulcer bleeding

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    Barinov E

    2013-08-01

    Full Text Available Edward Barinov,1 Oksana Sulaieva,1 Yuriy Lyakch,2 Vitaliy Guryanov,2 Petr Kondratenko,3 Yevgeniy Radenko3 1Department of Histology, Cytology, and Embryology, 2Department of Medical, Biological Physics, Medical Informatics, and Biostatistics, 3Department of Surgery and Endoscopy, M Gorky Donetsk National Medical University, Donetsk, Ukraine Background: The purpose of this study was to identify factors associated with the risk of unsustainable hemostasis in patients with gastric and duodenal ulcer bleeding by in vitro assessment of platelet reactivity using artificial neural networks. Methods: Patients with gastroduodenal ulcers complicated by bleeding were studied. Platelet aggregation was measured using aggregometry with adenosine diphosphate 5 µM, epinephrine 2.5 µM, 5-hydroxytryptophan 10 µM, collagen 1 µM, and thrombin 0.06 NIH Unit/mL as agonists. Multiple logistic regression was used to evaluate the independent relationship between demographic, clinical, endoscopic, and laboratory data and in vitro assessment of platelet reactivity and local parameters of hemostasis in patients with ulcer bleeding. Results: Analysis of platelet aggregation in patients with gastroduodenal ulcer bleeding allowed the variability of platelet response to different agonists used in effective concentration which induces 50% platelet aggregation (EC50 to be established. The relationship between platelet aggregation and the spatial-temporal characteristics of ulcers complicated by bleeding was demonstrated. Adrenoreactivity of platelets was associated with time elapsed since the start of ulcer bleeding and degree of hemorrhage. The lowest platelet response to collagen and thrombin was detected in patients with active bleeding (P< 0.001 and unsustainable recent bleeding (P < 0.01. Decreased adenosine diphosphate-induced platelet aggregation in patients with ulcer bleeding was correlated with the platelet response to thrombin (r = 0.714, P < 0.001 and collagen (r

  5. [The current problems of the surgical procedure in acute hemorrhages from gastroduodenal ulcers].

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    Losev, R Z; Chirkov, Iu V

    1996-01-01

    The article presents results of treatment of bleeding gastroduodenal ulcers in 1010 patients for 23 years. The active temporizing policy during the first 8 years resulted in 8.1% lethality while the active methods gave 8.24% lethality in six times greater number of patients. In the active policy urgent and emergency operations were performed on 43.6% of the patients with postoperative lethality 12.9%. Lethality among non-operated patients was 4.6%. Using the active surgical methods allowed lethality to be substantially decreased in the group of non-operated patients. The postoperative lethality was stabilized due to a less amount of recurrent bleedings and of "operations of despair". Recommendations are given to restrict the indications for Billroth-2 gastric resections because of a great risk of incompetent stump of the duodenum. Wider using the organ-saving operations is recommended, especially in elderly patients and against the background of haemorrhagic shock. The growing amount of patients with ulcerous gastroduodenal bleedings (which has become 2.4 times greater for the recent 15 years) makes further investigations in this direction very actual.

  6. [Principal characteristics of the endoscopic programmed hemostasis in ulcerative gastroduodenal bleedings in patients with high operational-anesthesiological risk].

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    Timen, L Ia; Trubitsyna, I E; Chikunova, B Z

    2013-01-01

    Application of the endoscopic programmed hemostasis for patients with ulcer gastroduodenal bleedings and with high operational-anesthetic risk provided metabolic rehabilitation (5% solutions of glucose and ascorbic acid) for the purpose of prevention of recurrence of the bleedings which have arisen after a hemostasis at 5.5% of patients.

  7. Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment : Double-blind, randomized, placebo-controlled trial

    NARCIS (Netherlands)

    de Leest, Helena T. J. I.; Steen, Kirsti S. S.; Lems, Willem F.; Bijlsma, Johannes W. J.; de Laar, Mart A. F. J. van; Huisman, A. Margriet; Vonkeman, Harald E.; Houben, Harry H. M. L.; Kadir, Sylvana W.; Kostense, Piet J.; van Tulder, Maurits W.; Kuipers, Ernst J.; Boers, Maarten; Dijkmans, Ben A. C.

    2007-01-01

    Background: Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are the major causes of gastroduodenal ulcers. Studies on the benefit of eradication of H. pylori in NSAID users yielded conflicting results. Objective: To investigate whether H. pylori eradication in patients on

  8. Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: double-blind, randomized, placebo-controlled trial

    NARCIS (Netherlands)

    de Leest, Helena T.J.I.; Steen, Kirsti S.S.; Lems, Willem F.; Bijlsma, Johannes W.J.; van de Laar, Mart A F J; Huisman, A. Margriet; Vonkeman, Harald Erwin; Houben, Harry H.M.L.; Kadir, Sylvana W.; Kostense, Piet J.; van Tulder, Maurits W.; Kuipers, Ernst J.; Boers, Maarten; Dijkmans, Ben A.C.

    2007-01-01

    Background: Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are the major causes of gastroduodenal ulcers. Studies on the benefit of eradication of H. pylori in NSAID users yielded conflicting results. Objective: To investigate whether H. pylori eradication in patients on

  9. Life-threatening Duodenal Ulcer Bleeding from a Ruptured Gastroduodenal Artery Aneurysm in a Patient with Neurofibromatosis Type 1.

    Science.gov (United States)

    Im, Kyu Sung; Kim, Sunyong; Lim, Jun Uk; Jeon, Jung Won; Shin, Hyun Phil; Cha, Jae Myung; Joo, Kwang Ro; Lee, Joung Il; Park, Jae Jun

    2015-09-01

    Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding.

  10. [Mucosal changes in the periulcer zone and endocrine system in patients with gastroduodenal ulcer, complicated by hemorrhage].

    Science.gov (United States)

    Trofimov, M V

    2014-07-01

    Examination of patients, suffering gastroduodenal ulcer, complicated by hemorrhage, was conducted, using clinical, microbiological, immunohistochemical methods and chromatomassspectrography. Enhanced activity of inducible NO-synthase, contamination of periulcer zone with microorganisms Klebsiella pneumoniae, Streptococcus beta-haemoliticus, enhancement of contents of catecholamines and serotonin in the blood serum were revealed. These changes are most expressed in severe blood loss, unstable local endoscopic hemostasis, high risk of a recurrent hemorrhage occurrence. The data obtained permit to prognosticate severity of a pathologic process course and to improve the treatment programe.

  11. Treatment of gastroduodenal ulcers with cimetidine in combination with low-dose propantheline

    DEFF Research Database (Denmark)

    Paerregaard, A; Hendel, L; Schultz-Larsen, K

    1983-01-01

    Fifty-eight adult outpatients with endoscopically verified gastric, prepyloric or duodenal ulcers completed a double-blind trial of treatment with either cimetidine, 1 g daily, plus propantheline, 45 mg daily (group A) or cimetidine, 1 g daily, plus placebo (group B). After neither three nor six...... weeks of treatment was there any significant difference between the two groups with regard to ulcer healing or symptomatic relief. The ulcers of 22 (79%) of the 28 patients in group A and 25 (83%) of the 30 patients in group B were healed after six weeks, and 93% of the patients in both groups became...... painfree. We were thus not able to show any advantage in combining cimetidine treatment for ulcer healing with low-dose propantheline. In a small open trial the patients with healed ulcers received prophylactic treatment for 12 months with 1) cimetidine 800 mg daily, 2) cimetidine 400 mg at bedtime plus...

  12. Gastroduodenal peptic ulcer and Helicobacter pylori infection in children and adolescents

    OpenAIRE

    Bittencourt, Paulo F.S.; Gifone A Rocha; Penna,Francisco J.; Queiroz,Dulciene M M

    2006-01-01

    OBJETIVO: Apresentar aspectos relevantes relativos à úlcera péptica gastroduodenal e à infecção pelo Helicobacter pylori na criança e adolescente. FONTES DOS DADOS : Livros técnicos e bases de dados MEDLINE e LILACS de 1966 a 2006. SÍNTESE DOS DADOS : A úlcera péptica na criança e adolescente pode ser primária, associada à infecção pelo H. pylori, ou secundária, na qual os mecanismos etiopatogênicos dependem da doença de base. A infecção é adquirida predominantemente na infância, com taxas de...

  13. Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

    Directory of Open Access Journals (Sweden)

    Istvan Rácz

    2012-01-01

    Full Text Available The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD durations of 5.45±12.9 hours and 6.9±13.2 hours, respectively (P=0.29. Actively bleeding ulcers were detected in 46/240 (19.2% of cases in the pantoprazole group as compared with 23/93 (24.7% in the saline infusion group (P=0.26. Different durations of pantoprazole infusion (0–4 hours, >4 hours, and >6 hours had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02 and P=0.04. Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

  14. Mortality forecast from gastroduodenal ulcer disease for different gender and age population groups in Ukraine

    Directory of Open Access Journals (Sweden)

    Duzhiy I.D.

    2016-03-01

    Full Text Available Until 2030 the ulcer mortality will have a growing trend as estimated by the World Health Organization. Detection of countries and population groups with high risks for the ulcer mortality is possible using forecast method. The authors made a forecast of mortality rate from complicated ulcer disease in males and females and their age groups (15-24, 25-34, 35-54, 55-74, over 75, 15 - over 75 in our country. The study included data of the World Health Organization Database from 1991 to 2012. The work analyzed absolute all-Ukrainian numbers of persons of both genders died from the ulcer causes (К25-К27 coded by the 10th International Diseases Classification. The relative mortality per 100 000 of alive persons of the same age was calculated de novo. The analysis of distribution laws and their estimation presents a trend of growth of the relative mortality. A remarkable increase of deaths from the ulcer disease is observed in males and females of the age after 55 years old. After the age of 75 years this trend is more expressed.

  15. [Prophylaxis of acute postoperative gastroduodenal ulcers at the patients with colorectal cancer].

    Science.gov (United States)

    Subbotin, V M; Zitta, D V; Terekhina, N A

    2007-01-01

    Effective method for prophylaxis of acute postoperative gastric ulcers and erosions was developed. The core of this method is ozone therapy in preoperative period. Intensity of blood serum and erythrocytes chemiluminescence and ATPase activity of erythrocytes were studied at 86 patients with colorectal cancer before surgery and at 1st and 4th days of postoperative period. It was demonstrated that preoperative ozone therapy promoted normalization of free radical reactions and ATPase activity at postoperative period.

  16. Emergency gastroduodenal artery embolization by sandwich technique for angiographically obvious and oblivious, endotherapy failed bleeding duodenal ulcers

    Energy Technology Data Exchange (ETDEWEB)

    Anil, G., E-mail: ivyanil10@gmail.com [Department of Diagnostic Imaging, National University Hospital (Singapore); Department of Radiology, Changi General Hospital (Singapore); Tan, A.G.S.; Cheong, H.-W.; Ng, K.-S.; Teoh, W.-C. [Department of Radiology, Changi General Hospital (Singapore)

    2012-05-15

    Aim: To determine the feasibility, safety, and efficacy of adopting a standardized protocol for emergency transarterial embolization (TAE) of the gastroduodenal artery (GDA) with a uniform sandwich technique in endotherapy-failed bleeding duodenal ulcers (DU). Materials and methods: Between December 2009 and December 2010, 15 patients with endotherapy-failed bleeding DU were underwent embolization. Irrespective of active extravasation, the segment of the GDA supplying the bleeding DU as indicated by endoscopically placed clips was embolized by a uniform sandwich technique with gelfoam between metallic coils. The clinical profile of the patients, re-bleeding, mortality rates, and response time of the intervention radiology team were recorded. The angioembolizations were reviewed for their technical success, clinical success, and complications. Mean duration of follow-up was 266.5 days. Results: Active contrast-medium extravasation was seen in three patients (20%). Early re-bleeding was noted in two patients (13.33%). No patient required surgery. There was 100% technical success, while primary and secondary clinical success rates for TAE were 86.6 and 93.3%, respectively. Focal pancreatitis was the single major procedure-related complication. There was no direct bleeding-DU-related death. The response time of the IR service averaged 150 min (range 60-360 min) with mean value of 170 min. Conclusion: Emergency embolization of the GDA using the sandwich technique is a safe and highly effective therapeutic option for bleeding DUs refractory to endotherapy. A prompt response from the IR service can be ensured with an institutional protocol in place for such common medical emergencies.

  17. Short- and long-term results of transcatheter embolization for massive arterial hemorrhage from gastroduodenal ulcers not controlled by endoscopic hemostasis

    Science.gov (United States)

    Loffroy, Romaric; Guiu, Boris; Mezzetta, Lise; Minello, Anne; Michiels, Christophe; Jouve, Jean-Louis; Cheynel, Nicolas; Rat, Patrick; Cercueil, Jean-Pierre; Krausé, Denis

    2009-01-01

    BACKGROUND AND AIM: Severe bleeding from gastrointestinal ulcers is a life-threatening event that is difficult to manage when endoscopic treatment fails. Transcatheter embolization has been suggested as an alternative treatment in this situation. The present study reports on the efficacy and long-term outcomes of transcatheter embolization after failed endoscopic treatments were assessed in high-operative-risk patients. METHODS: A retrospective review of 60 consecutive emergency embolization procedures in hemodynamically unstable patients (41 men, 19 women; mean [±SD] age 69.4±15 years) was conducted. Patients were referred for selective angiography between 1999 and 2008 after failed endoscopic treatment of massive bleeding from gastrointestinal ulcers. Mean follow-up was 22 months. RESULTS: Embolization was feasible and successful in 57 patients. Sandwich coiling of the gastroduodenal artery was used in 34 patients, and superselective occlusion of the terminal feeding artery (with glue, coils or gelatin particles) was used in 23 patients. Early rebleeding occurred in 16 patients and was managed with endoscopy (n=8), reembolization (n=3) or surgery (n=5). No major embolization-related complications occurred. Sixteen patients died within 30 days after embolization (including three who died from rebleeding) and 11 died thereafter. No late bleeding recurrences were reported. CONCLUSIONS: Selective angiographic embolization is safe and effective for controlling life-threatening bleeding from gastroduodenal ulcers. The procedure usually obviates the need for emergency surgery in these high-risk patients. Survival depends chiefly on underlying conditions. PMID:19214287

  18. [Comparative estimation of an acute gastroduodenal ulcers, complicated by hemorrhage according to indexes of enzymatic-biochemical spectrum of the blood].

    Science.gov (United States)

    Bobkov, O V

    2004-07-01

    Comparative estimation of methods of endoscopic hemostasis and treatment of an acute gastroduodenal ulcers, complicated by hemorrhage, was done: in 22 patients the conventional methods were applied, in 41-endoscopic hemostasis, using flatorization with the help of ozone-oxygen mixture and subsequent ozone insufflations. For the treatment efficacy control the endoscopic monitoring was used, there were studied cytobiochemical indexes of the dehydrogenases complex activity and of peroxide oxygenation of lipids. It was established, that ozonotherapy, even applied solely, guarantees the erosions healing in 3 days on average with simultaneous approximation to the norm of cytobiochemical indexes investigated.

  19. Interobserver variation in the endoscopic diagnosis of gastroduodenal ulcer scars: implications for clinical management of NSAIDs users

    Directory of Open Access Journals (Sweden)

    Ishimura Norihisa

    2011-10-01

    Full Text Available Abstract Background A clinical history of peptic ulcer has been reported to be associated with a high rate of ulcer recurrence in nonsteroidal anti-inflammatory drug (NSAID users. Therefore, it is a very important issue to precisely know the previous history prior to NSAIDs administration. To clarify the possible difficulty to identify the history, we determined the sensitivity and diagnostic concordance of endoscopy for the identification of ulcer scars indicative of previous clinical history of peptic ulcer diseases. Methods The first study enrolled 200 consecutive patients with a clinical history of gastric or duodenal ulcers previously confirmed by esophagogastroduodenoscopy. The sensitivity of endoscopy for identifying scars was determined for these patients. In the second study, the extent of interobserver agreement was determined for 47 endoscopists who identified ulcer scars in endoscopic photographs of 30 sites of previous active gastric ulcers and 30 sites of previous active duodenal ulcers. The kappa coefficient of reliability was calculated to measure the interobserver agreement on the diagnosis of ulcer scars. Results Out of 190 patients eligible for analysis, 104 (54.7% were found to have gastric or duodenal ulcer scars on endoscopy; there were no gastric or duodenal ulcer scars seen in the remaining patients (45%. In the second study, the kappa values for endoscopic diagnosis of gastric and duodenal ulcer scars were 0.14 (95% CI 0.13-0.16 and 0.29 (95% CI 0.27-0.32, respectively. The addition of indigo-carmine chromoendoscopy did not provide a statistically significant improvement in diagnostic concordance in patients with gastric ulcer scar since the kappa value for chromoendoscopic diagnosis was 0.15; 95% CI 0.13-0.17 as low as for un-contrasted scars. Conclusions The sensitivity and concordance of endoscopic diagnosis of gastric and duodenal ulcer scars are not satisfactory for the use of endoscopy only to identify previous

  20. Úlcera péptica gastroduodenal e infecção pelo Helicobacter pylori na criança e adolescente Gastroduodenal peptic ulcer and Helicobacter pylori infection in children and adolescents

    Directory of Open Access Journals (Sweden)

    Paulo F. S. Bittencourt

    2006-10-01

    Full Text Available OBJETIVO: Apresentar aspectos relevantes relativos à úlcera péptica gastroduodenal e à infecção pelo Helicobacter pylori na criança e adolescente. FONTES DOS DADOS : Livros técnicos e bases de dados MEDLINE e LILACS de 1966 a 2006. SÍNTESE DOS DADOS : A úlcera péptica na criança e adolescente pode ser primária, associada à infecção pelo H. pylori, ou secundária, na qual os mecanismos etiopatogênicos dependem da doença de base. A infecção é adquirida predominantemente na infância, com taxas de prevalência que variam de 56,8 a 83,1% nas crianças que vivem nas regiões mais pobres do Brasil e de aproximadamente 10% nas crianças abaixo de 10 anos de idade nos países desenvolvidos. A infecção pode ser diagnosticada por métodos invasivos, que investigam a presença da bactéria, ou de DNA, RNA ou produtos bacterianos em fragmentos de biópsia da mucosa gástrica obtida à endoscopia; também pode ser diagnosticada através de métodos não-invasivos, que compreendem a pesquisa de anticorpos anti-H. pylori em amostras de soro, urina ou saliva, a pesquisa de antígenos da bactéria nas fezes e o teste respiratório com uréia marcada com carbono-13. O método de escolha para o diagnóstico da úlcera péptica é a endoscopia digestiva alta, com a vantagem adicional de, durante o procedimento, permitir a obtenção de fragmentos de mucosa gástrica para o diagnóstico da infecção e estudo histopatológico. CONCLUSÕES: A infecção por H. pylori é a principal causa de úlcera péptica na infância. A erradicação da bactéria com antimicrobiano é acompanhada de cura da doença, sendo, portanto, indicada em todas as crianças H. pylori-positivas com úlcera péptica em atividade, recorrente, cicatrizada ou complicada.OBJECTIVE: To show important aspects of gastroduodenal peptic ulcer and of Helicobacter pylori infection in children and adolescents. SOURCES: Technical textbooks and MEDLINE and LILACS databases including

  1. [Tactics and results of treatment of acute hemorrhage in gastroduodenal erosive ulcers due to application of gastro-aggressive preparations].

    Science.gov (United States)

    Shapryns'kyĭ, V O; Romanchuk, V D; Koval', V M

    2014-09-01

    Results of treatment of 238 patients, suffering an acute gastrointestinal hemorrhage, occurring on background of application of medicinal preparations, were adduced. The incidence rate for an acute medicinal ulcers of foregut was analyzed, as well as possibilities for their treatment.

  2. Factors associated with gastro-duodenal disease in patients ...

    African Journals Online (AJOL)

    Background: There is a high prevalence of gastro-duodenal disease in sub Saharan Africa. Peptic ulcer disease in dyspeptic patients, 24.5%, was comparable to prevalence of gastro-duodenal disease among symptomatic individuals in developed countries (12 – 25%). Limited data exists regarding its associated risk ...

  3. Biopsychosocial Model of Gastroduodenal Pathology in Children

    Directory of Open Access Journals (Sweden)

    O.L. Lychkovska

    2016-02-01

    Full Text Available From the standpoint of the biopsychosocial model of medicine, the formation of gastroduodenal diseases occurs as a result of interaction of biological, psychoemotional and psychosocial factors. Contribution of each of them to the development of certain nosological entities of gastroduodenal pathology in children is not studied enough. Current study was aimed to investigate the contribution of biological, psychoemotional and psychosocial factors to the formation of various nosological entities of gastroduodenal pathology in children and correlation between them. Materials and methods. The study involved 83 children aged 6 to 11 years with gastroduodenal diseases. The control group consisted of 45 children who showed no somatic pathology. To analyze the value of certain factors in the development of gastroduodenal pathology in children, methods of multiple correlation and factor analysis were used. Results. The findings showed dominance of the role of psychoemotional and psychosocial factors in the formation of functional disorders of the stomach and duodenum and gastritis/gastroduodenitis, while in destructive forms of gastroduodenal pathology, contribution of biological factors was predominant. Heterogeneity of functional dyspepsia as nosologic entity was revealed — both risk factors for mucosal destruction and psychoemotional factors, which are typical for functional disorders, were of great value. This explains the different course of functional dyspepsia — in some cases it is non-progressive, when the disorder remains functional for decades, and in others — this is the first stage of the continuum «functional dyspepsia — gastritis/gastroduodenitisulcer». Conclusion. Formation of gastroduodenal diseases, their course, prognosis are determined by the combination of risk factors. Defining their role in each case will enable to individualize the treatment and prevention approaches and to increase their efficiency, perhaps by

  4. Clinical features and treatment of ulcerative colitis-related severe gastroduodenitis and enteritis with massive bleeding after colectomy.

    Science.gov (United States)

    Uchino, Motoi; Matsuoka, Hiroki; Bando, Toshihiro; Hirata, Akihiro; Sasaki, Hirofumi; Hirose, Kei; Takesue, Yoshio; Nakamura, Shiro; Tomita, Naohiro; Ikeuchi, Hiroki

    2014-02-01

    Ulcerative colitis (UC) has been recognised as a systemic immune disorder that is not as restricted as colitis. UC-related gastrointestinal lesions with bleeding can develop soon after colectomy and can progress rapidly. Therefore, we considered the clinical features and treatment of these UC-related lesions. We reviewed the patient data in our UC surgery database to evaluate its prevalence and features. We found 7/1,100 patients with UC-related lesions between January 2000 and April 2013. These lesions developed at a mean of 24 (range 8-480) days after colectomy. Six of the seven patients suffered from gastrointestinal bleeding as an initial symptom that rapidly developed into massive bleeding or perforations. All of the patients were diagnosed with pancolitis; at the time of colectomy, fulminant, severe, moderate, and mild colitis were presented by four, one, one, and one patients, respectively. All patients with enteritis had consecutively developed other infectious complications, including anastomotic leakage, pyoderma gangrenosum, wound infection, and pneumonia. Although patients with bleeding did not respond to treatment with corticosteroids, they responded well to infliximab soon after its administration. Although six of the seven patients showed cytomegalo virus re-activation in blood or pathological examinations, ganciclovir was not effective in its elimination. Although UC-related lesions with an unknown aetiology can occur after colectomy, immediate examination and treatment are required if gastrointestinal bleeding is found after surgery. Because gastrointestinal bleeding from UC-related lesions can worsen rapidly and may be related to mortality, early potent immunosuppressive therapy should be considered.

  5. Prevalence of gastroduodenal lesions in chronic nonsteroidal anti ...

    African Journals Online (AJOL)

    At endoscopy, only 10 (13.9%) patients had normal gastroduodenal mucosa. Gastritis was the most prevalent lesion occurring in 50% of the patients. Peptic ulcer disease had a point prevalence of 30.5% (duodenal ulcers 22.2%, and gastric ulcers 8.3%). Other lesions at endoscopy were duodenitis 16.7%, gastric erosions ...

  6. Helicobacter pylori in gastroduodenal perforation

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    Bharat B Dogra

    2014-01-01

    Full Text Available Background:peptic ulcers were earlier believed to be caused by dietary factors, gastric acid, and stress. However, in 1983, Warren and Marshall identified the correlation between Helicobacter pylori (H. pylori and peptic ulcers. It is now well established that most of the peptic ulcers occur as a result of H. pylori infection. But the co-relation between perforated peptic ulcer and H. pylori infection is not yet fully established. Aims and objectives : to study the prevalence of H. pylori infection in patients with perforated peptic ulcer. Materials and methods: this was a prospective study carried out in all cases of perforated peptic ulcer reporting in surgical wards of a medical college during 2008-2010. A total of 50 cases, presenting as acute perforation of duodenum and stomach during this period, formed the study group. After resuscitation, all the cases were subjected to emergency exploratory laparotomy. The exact site of perforation was identified, biopsy was taken from the ulcer margin from 2-3 sites and the tissue was sent for H. pylori culture and histopathological examination. Simple closure of perforation, omentoplasty, thorough peritoneal lavage and drainage was carried out. Results: out of the 50 cases of perforated peptic ulcer, 38 happened to be males, and only 12 were females. The age of the patients ranged from 20 to 70 years. All the patients underwent only emergency laparotomy. As many as 46 cases (92% turned out to be positive for H. pylori and only four cases (8% were negative for this infection. Postoperatively, patients who were found to be positive for H. pylori were put on anti-H. pylori treatment. Conclusion: there was a high prevalence of H. pylori infection in patients with perforated gastroduodenal ulcers.

  7. [Surgical treatment of ulcer].

    Science.gov (United States)

    Ungeheuer, E; Schröder, D; Lüders, K

    1978-04-27

    The standard of today in surgical treatment of the duodenal and gastric ulcer in Germany is shown. Positive and negative aspects of the different methods are discussed. Special technics are recommended for the different types of gastroduodenal ulcera.

  8. Ulcers

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Ulcers KidsHealth / For Teens / Ulcers What's in this article? ... is that the real story? What Is an Ulcer? An ulcer is a sore, which means it's ...

  9. [Lactose tolerance in children with chronic gastroduodenal zone diseases].

    Science.gov (United States)

    Klimov, L Ia

    2003-01-01

    We determined the dependence of the frequency of lactose intolerance, particular features of the clinical presentation and laboratory showings on lactase deficiency on the basis of a complex clinical, anamnestic and laboratory study of 149 children with chronic gastroduodenal pathologies. It was established that the prevalence of lactose intolerance in children with superficial gastroduodenitis amounts to 58.8%, in children with erosive gastroduodenitis--66.7% and in children with stomach ulcers--83.3%. During the oral lactose load and a subsequent laboratory study we revealed an impairment of the hydrolytic function of small intestines accompanied by an increase of fecal excretion of carbohydrates (lactose and monosaccharides) as well as a considerable enhancement of bacterial fermentation. The detection of fecal excretion of the total glycoprotein hexoses characterizes a disorder of the morphofunctional state of the gastrointestinal tract in children with intestinal enzymopathies.

  10. Gastroduodenal Complications After Concurrent Chemoradiation Therapy in Patients With Hepatocellular Carcinoma: Endoscopic Findings and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Chon, Young Eun [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Beom Kyung [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cha, Jihye [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Seung Up; Park, Jun Yong; Ahn, Sang Hoon; Han, Kwang-Hyub; Chon, Chae Yoon [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of); Shin, Sung Kwan, E-mail: kaarma@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Do Young, E-mail: dyk1025@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of)

    2011-12-01

    Purpose: Concurrent chemoradiation therapy (CCRT) is useful in advanced hepatocellular carcinoma (HCC), but little is known about radiation-induced gastroduodenal complications following therapy. To determine risk factors, we investigated the prevalence and patterns of gastroduodenal complications following CCRT using endoscopy. Methods and Materials: Enrolled in the study were 123 patients treated with CCRT for unresectable HCC between January 1998 and December 2005. Radiation-induced gastroduodenal complications were defined as radiation gastritis/duodenitis, radiation gastric/duodenal ulcer, or other gastroduodenal toxicity associated with radiation, based on Common Terminology Criteria for Adverse Events (CTCAE 3.0). Serious gastroduodenal complications were defined as events occurring within 12 months from completion of CCRT, those requiring prompt therapeutic intervention, or symptoms equivalent to Grade 3 or 4 radiation-related gastroduodenal toxicity, including nausea or vomiting, based on CTCAE 3.0. Results: A month after completion of CCRT, 65 (52.8%) patients displayed endoscopic evidence of radiation-induced gastroduodenal complications. Radiation gastric and duodenal ulcers were found in 32 (26.0%) and 20 (16.3%) patients, respectively; radiation gastritis and duodenitis were found in 50 (40.7%) and 42 (34.1%) patients, respectively. Radiation-related bleeding was observed in 13 patients (10.6%). Serious gastroduodenal complications occurred in 18 patients (14.6%) and were significantly more frequent in patients with liver cirrhosis than in those without cirrhosis (p = 0.043). There were no radiation-related deaths. Conclusions: Endoscopically detectable radiation-induced gastroduodenal complications were common in HCC following CCRT. Although serious complications were uncommon, the frequency was higher in patients with liver cirrhosis; thus, these patients should be closely monitored when receiving CCRT.

  11. adolescents with gastroduodenal disease

    Directory of Open Access Journals (Sweden)

    Monika Maria Biernat

    2014-08-01

    Full Text Available Introduction: Infection with Helicobacter pylori is a major cause of chronic gastritis and peptic ulcer disease in children and its consequences in adulthood can lead to serious complications, including in particular the development of gastric cancer. Our aim was to analyze the relationship between the occurrence of selected genes such as cagA, vacA, iceA, and babA2 determining pathogenicity of H. pylori strains and clinical outcome in children.Material and methods: The study was performed on H. pylori strains isolated from biopsies taken from 130 children and adolescents with non-ulcer dyspepsia (NUD, gastric and duodenal ulcers (PUD and gastroesophageal reflux disease (GERD. Genes such as cagA, vacA (allelic variants: s1/ s2, m1/m2, iceA (allelic variants: iceA1, iceA2 and babA2 were determined by polymerase chain reaction (PCR.Results: The cagA gene was detected in 79/130 (60.8% H. pylori isolates. The presence of the cagA gene was significantly associated with duodenal ulcer (p<0.05. The vacAs1/m1 genotype as more frequent in children with ulcers than in other groups, whereas the vacAs2/m2 genotype was more frequent in patients with gastritis and GERD. The iceA1, iceA2 and babA2 genes were present in 59/130 (45.4%, 27/130 (21% and 30/130 (23.1% of the strains, respectively. The vacAs1/cagA+ genotype was most frequently observed in strains isolated from children with PUD. The predominant genotype in children with NUD and GERD was vacAs2/cagA-/iceA1+/babA2-.Conclusion: The study showed a high incidence of strains with increased virulence, possessing cagA, vacAs1 and iceA1 genes in symptomatic children with H. pylori infection.

  12. Diagnosis of Helicobacter pylori infection in patients with bleeding ulcer disease: rapid urease test and histology Diagnóstico mediante endoscopia de la infección por Helicobacter pylori en pacientes con úlcera gastroduodenal y hemorragia digestiva: test rápido de ureasa e histología

    Directory of Open Access Journals (Sweden)

    M. Castro-Fernández

    2004-06-01

    Full Text Available Introduction: the endoscopic diagnosis of Helicobacter pylori infection in patients with bleeding peptic ulcer is limited by a decreased sensitivity in standard invasive tests, rapid urease test and histology. There is controversy about the convenience of using one, neither, or both diagnostic tests. Aims: to evaluate the results of simultaneously performed rapid urease test and histology in the diagnosis of Helicobacter pylori infection (H. pylori in patients with bleeding peptic ulcer. Patients and methods: we included 173 patients, 98 male and 75 female, with an average age of 62 years (18-88, with upper gastrointestinal bleeding secondary to duodenal ulcer (115 or gastric ulcer (58, diagnosed within 24 hours after hospital admission. None of the patients had received treatment for H. pylori, proton pump inhibitors or antibiotics in the two weeks prior to the upper gastrointestinal bleeding episode. H. pylori infection was investigated in all patients by two antral biopsy samples for histological study (hematoxilin-eosin and one or two antral biopsies for rapid urease test (Jatrox®-H.p.-test. In cases with a negative urease test and histology, a 13C urea breath test was performed. Infection was considered present when at least one invasive test or the breath test was positive, whereas both invasive tests and the breath test had to be negative to establish an absent infection. Results: 152 patients (88% showed H. pylori infection, 104 patients (90% with duodenal ulcer and 48 patients (83% with gastric ulcer. In all 119 cases (78% were diagnosed by the urease test and 112 cases (74% by histology. Both methods were used to diagnose 134 of 152 cases (88% (p Introducción: el diagnóstico de la infección por Helicobacter pylori, mediante endoscopia, en pacientes con úlcera gastroduodenal y hemorragia digestiva está limitado por la disminución de la sensibilidad de los métodos invasivos habituales, test de la ureasa e histología. Existen

  13. [Endothelial dysfunction in pathogenesis of duodenal ulcer].

    Science.gov (United States)

    Oparin, A G; Oparin, A A

    2002-01-01

    It is shown that in patients with ulcer associated with Helicobacter pylori (HP) there is a close correlation between the severity of the lesion of gastroduodenal protective mucous barrier and that of endothelial dysfunction manifesting in elevated level of endothelin-1, serum levels of TBK-active products, inhibition of blood flow and narrowing of the celiac trunk. The correlation becomes stronger with expanding contamination of gastroduodenal mucosa with HP. Thus, HP may participate in breaking the protective mucous barrier in endothelial dysfunction.

  14. Successful selective angiographic embolisation of a gastroduodenal ...

    African Journals Online (AJOL)

    New endoscopic and endovascular therapies have revolutionised the management of complex traumatic visceral aneurysms. A pseudoaneurysm of the gastroduodenal artery following penetrating abdominal trauma was successfully managed by selective angiographic embolisation.

  15. [Risk factors associated with gastroduodenal lesions in a Douala referral hospital (Cameroon)].

    Science.gov (United States)

    Eloumou Bagnaka, S A F; Luma Namme, H; Noah Noah, D; Essomba, N E; Malongue, A; Manga, A; Tzeuton, C; Biwole Sida, M

    2016-01-01

    The causes of gastroduodenal lesions are multifactorial, and few studies have assessed the impact of each of these factors in Africa. The aim of this study was to identify factors associated with the occurrence of gastroduodenal lesions in Cameroon. This prospective, analytical study took place over a 5-month period in the endoscopy unit of the Douala General Hospital. Lifestyle, medical history, demographic, and clinical variables were collected. Infection with Helicobacter pylori was determined with a rapid urease (CLO) test. Multivariate regression was used to determine risk factors. The study included 234 of 265 patients seen in the department over the study period. Gastroscopy was normal for 54.2% of the subjects. The prevalence of peptic ulcers was 17.1% and of inflammatory lesions 26.4%. Risk factors associated with a gastroduodenal lesion were: age greater than 60 years [OR age = 2.953; 95% CI: 1.399 to 6.231; p = 0.004], H. pylori infection [OR = 2.953; 95% CI: 1.399 to 6.231; p = 0.003] and regular NSAID use [OR = 0.912; 95% CI: 0.112 to 2.733; p = 0.044] either a month before the examination or over the long term. Age greater than 60 years, NSAID consumption, and H. pylori infection are associated with the occurrence of gastroduodenal lesions.

  16. Helicobacter pylori genetic diversity and gastro-duodenal diseases in Malaysia.

    Science.gov (United States)

    Gunaletchumy, Selva Perumal; Seevasant, Indran; Tan, Mun Hua; Croft, Laurence J; Mitchell, Hazel M; Goh, Khean Lee; Loke, Mun Fai; Vadivelu, Jamuna

    2014-12-11

    Helicobacter pylori infection results in diverse clinical conditions ranging from chronic gastritis and ulceration to gastric adenocarcinoma. Among the multiethnic population of Malaysia, Indians consistently have a higher H. pylori prevalence as compared with Chinese and Malays. Despite the high prevalence of H. pylori, Indians have a relatively low incidence of peptic ulcer disease and gastric cancer. In contrast, gastric cancer and peptic ulcer disease incidence is high in Chinese. H. pylori strains from Chinese strains predominantly belong to the hspEAsia subpopulation while Indian/Malay strains mainly belong to the hspIndia subpopulation. By comparing the genome of 27 Asian strains from different subpopulations, we identified six genes associated with risk of H. pylori-induced peptic ulcer disease and gastric cancer. This study serves as an important foundation for future studies aiming to understand the role of bacterial factors in H. pylori-induced gastro-duodenal diseases.

  17. A review of the management of perforated duodenal ulcers at a ...

    African Journals Online (AJOL)

    EB

    Abstract. Background: Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure. Objective: To determine the patterns of presentation and mode of management of duodenal ulcer perforations. Methods: Retrospective review of patients with duodenal ulcer ...

  18. Management of Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Disease by Acid Suppression

    Directory of Open Access Journals (Sweden)

    R Lad

    1999-01-01

    Full Text Available One major cause of peptic ulceration is the use of nonsteroidal anti-inflammatory drugs (NSAIDs. The precise mechanisms through which NSAIDs cause peptic ulceration are unknown, but the discovery that they reduce the production of ‘cytoprotective’ prostaglandins led to the hypothesis that coadministration of exogenous prostaglandins heals and prevents NSAID-induced gastroduodenal ulcers and other mucosal lesions. Studies using high doses of misoprostol have shown that it does have a protective effect; however, gastrointestinal intolerance of this prostaglandin E2 analogue is common. Early indications that acid suppression was effective in the management of NSAID-related peptic ulcers came from studies showing that gastric ulcers could be healed by omeprazole in patients who continued to take NSAIDs. Other studies suggested that acid suppression reduces the incidence of mucosal lesions but that standard dose ranitidine protects only against duodenal lesions. Subsequent studies reported that higher dose H2 receptor antagonist therapy can protect against both gastric and duodenal ulcers during continued NSAID therapy. An ideal therapeutic strategy would heal NSAID-related ulcers and prevent the development of new NSAID-related lesions and complications in patients who are unable to discontinue NSAID therapy. A number of recent studies indicate that effective acid-suppressive treatment with the proton pump inhibitor omeprazole can achieve these aims. Overall, data from recent studies show that acid suppression with the proton pump inhibitor omeprazole at a dose of 20 mg daily is the most effective means of healing NSAID-associated gastroduodenal lesions and that it is the most effective prophylactic therapy. In the long run, the role of omeprazole will have to be evaluated with respect to its cost effectiveness compared with other strategies and with respect to the development of less damaging NSAIDs.

  19. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H

    2012-08-01

    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  20. Gastro-duodenal peptic ulcer perforation | Dakubo | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 86, No 3 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  1. Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Grassi, Roberto; Romano, Stefania E-mail: stefromano@libero.it; Pinto, Antonio; Romano, Luigia

    2004-04-01

    Introduction: Gastro-duodenal perforations may be suspected in patients with history of ulceration, who present with acute pain and abdominal wall rigidity, but radiological findings in these cases may be unable to confirm a clinical diagnosis. The aim of our study was to report our experience in the diagnosis of gastro-duodenal perforation by conventional radiography, US and CT examinations. Material and methods: We retrospectively reviewed medical records of 166 consecutive patients who presented in the last 2 years to our institutions with symptoms of acute abdomen and submitted to surgery at the Emergency Unit of the ''A.Cardarelli'' Hospital of Naples with a surgical finding of perforated gastro-duodenal ulcer. The evidence of free intraperitoneal air on abdominal plain film was considered as a direct or suggestive finding of perforation. Evidence of intraperitoneal free fluid and/or reduced intestinal peristalsis at sonographic examination were considered indirect signs of gastro-duodenal perforation. Evidence of free peritoneal gas at CT was considered as a direct evidence of gastro-duodenal perforation. Results: Twenty patients underwent immediate surgery with no preoperative imaging evaluation, in 10 of them the site of perforation was found in a juxta-pyloric region and in the others at level of duodenum. In 146 patients submitted to serial radiological investigations before surgery, the site of perforation was in 56 (38.3%) duodenal, in 52 (35.6%) juxta-pyloric, in 28 (19.1%) gastric and in 10 (6.8%) pyloric. The cause of perforation was in all cases gastric or duodenal ulceration, in seven cases involving pancreatic parenchyma. In 110 (75.4%) patients with direct findings of perforation, in 94 cases (85.5%) the correct diagnosis was established on abdominal plain film, in two (1.8%) with radiographic and sonographic examinations and in 14 (12.7%) on CT findings. In 36 (24,6%) patients with no direct findings of perforation, only 24

  2. ULCERA GASTRODUODENAL EM CÃES

    Directory of Open Access Journals (Sweden)

    Francisco Assis Uma Costa

    1993-12-01

    Full Text Available As ulcerações no sistema digestivo de cães são consideradas raras. São descritos dois casos de úlcera gastroduodenal em cães. O primeiro animal apresentou úlcera no duodeno próxima!. O segundo mostrou úlcera perfurada na região pilórica do estômago. Nenhum dos animais apresentou evidências de sangramento, mas as lesões eram profundas e arredondadas. Não houve evidência de patologias concorrentes.

  3. Mouth ulcers

    Science.gov (United States)

    Oral ulcer; Stomatitis - ulcerative; Ulcer - mouth ... Mouth ulcers are caused by many disorders. These include: Canker sores Gingivostomatitis Herpes simplex ( fever blister ) Leukoplakia Oral cancer ...

  4. Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Defreyne, Luc; De Schrijver, Ignace; Vanlangenhove, Peter; Kunnen, Marc [Department of Radiology and Medical Imaging, Ghent University Hospital (Belgium)

    2002-01-01

    Extrahepatic arteriovenous fistulas involving the gastroduodenal artery and the portal venous system are rare and almost always a late complication of gastric surgery. Secondary portal hypertension and mesenteric ischemia may provoke abdominal pain, upper and lower gastrointestinal hemorrhage, diarrhea, and weight loss. Until recently, surgical excision has been the therapy of choice with excellent results. The authors report a case of gastroduodenal arterioportal fistula with a rare large interpositioned aneurysm in a cardiopulmonary-compromised patient who was considered a non-surgical candidate. The gastroduodenal arterioportal fistula was occluded endovascularly by means of a detachable balloon. A survey of the literature of this rare type of arterioportal fistula is included. (orig.)

  5. Peptic ulcer

    Science.gov (United States)

    ... hemorrhage - peptic ulcer; G.I. bleed - peptic ulcer; H. pylori - peptic ulcer; Helicobacter pylori - peptic ulcer ... of the stomach by bacteria called Helicobacter pylori ( H pylori ). Most people with peptic ulcers have these bacteria ...

  6. [The biochemical composition of the bile and the function of the protective mucosal barrier in peptic ulcer patients].

    Science.gov (United States)

    Oparin, A G; Khakimov, M T; Chonka, V Iu; Mendzherer, A; Pandeĭ, I

    1991-05-01

    The state of the protective mucosa barrier was studied in 87 patients with ulcer disease by means of determination of the level of PAS-positive substances and acid mucopolysaccharides in the gastric and duodenal mucosa. It was found that changes of the biochemical composition of the bile produced an essential influence on the reduction of protective properties of the gastroduodenal mucosa barrier, especially in the presence of gastroduodenal reflux.

  7. Regional features of gastroduodenal disease, associated with Helicobacter pylori infection, in the North Ossetia

    Directory of Open Access Journals (Sweden)

    E. A. Kornienko

    2011-01-01

    Full Text Available The aim of this study was to evaluate the structure of gastroduodenal disorders, virulent feathers of Helicobacter pylori (HP strains and efficacy of eradication therapy in children of the North Ossetia (Alania. 1265 children from 4 till 18 years old were examined, НР was found in 84%. 53% of HP(+ atients had erosions and ulcers of the stomach and duodenum. Strains, resistant to clarithromycin, were revealed in 13% of the patients. We have estimated efficacy of 4 regimes of eradication therapy. Regimes, that included clarithromycin and metronidazole, had the lowest efficacy the worst compliance. The best results were observed in triple therapy, including PPI, amoxicillin and bismuth, and quadrotherapy with PPI amoxicillin, bismuth and nifuratel. The duration of therapy should not be shorter than 10 days.

  8. Helicobacter Pylori and CagA: Relationships With Esophageal and Gastroduodenal Disorders in Iranian Patients

    Directory of Open Access Journals (Sweden)

    Omid Teymournejad

    2015-05-01

    Full Text Available Background: The severity of Helicobacter pylori infection is associated with virulence factors of the bacteria and host immune response. H. pylori has several virulence factors which a number of them are essential to emerge clinical outcomes. Cytotoxin-associated gene A (CagA is the most important H. pylori virulence factor. Objectives: The aim of our study was to assess a significant relationship between presence of cagA and severity of clinical manifestation in esophageal and gastroduodenal disorders. Patients and Methods: A total of 240 gastric biopsies were collected between March 2012 and August 2013 from Tehran's hospitals. Three sets of biopsy specimens were obtained from the antrum and rapid urease tests, histological examination, Polymerase Chain Reaction (PCR assay were performed on the biopsy specimens. Results: One hundred and eight (45% of biopsy specimens were positive with rapid urease test and ureC gene PCR. Moreover, thirty eight (35.1% of positive specimens had cagA gene. The rate of gastric and duodenum inflammation was more in patients who carried CagA positive H. pylori strains. Whereas less inflammation and sever lesions in esophagus were found in CagA negative H. pylori strains. Conclusions: Our study demonstrates a strong relationship between CagA and esophageal and gastroduodenal disorders. The number of CagA negative H. pylori was larger than CagA positive in esophagus lesion grade A, C, and D. Therefore, cagA may have a protective effect on some esophageal diseases. In addition, the number of CagA positives was larger than CagA negative H. pylori in gastric antrum and duodenum ulcer. Thus, CagA play a role to emerge peptic and duodenal ulcers.

  9. Úlcera gastroduodenal: problemática de la morbilidad

    Directory of Open Access Journals (Sweden)

    Luis Manuel Fernández Machín

    2000-10-01

    Full Text Available Se realizó un estudio descriptivo, restrospectivo en 4 consultorios atendidos por Médicos de la Familia, pertenecientes al Policlínico "Plaza de la Revolución" para señalar los principales problemas de salud que afectan la morbilidad por úlcera gastroduodenal, en el período comprendido desde enero de 1996 hasta diciembre de 1997. El sexo masculino representó el 65,7 % de la muestra en estudio y los grupos de edades de mayor prevalencia fueron de 31 a 40 años y de 51 a 60. El 42,1 % de los pacientes que refirieron antecedentes patológicos familiares de afecciones gastroduodenales desarrollaron úlcera gastroduodenal. La localización duodenal se presentó en un 77,1 % de los casos. El café fue el más frecuente de los hábitos tóxicos, siguiéndole el alcohol; entre los medicamentos ingeridos, la aspirina representó el 17,1 % de los casos. Los esquemas de tratamiento más empleados fueron la cimetidina y otros medicamentos (74,3 %, los regímenes lácteos (65,7 % y los antiácidos (62,9 %. La endoscopia y la radiología (40 % asociada a la endoscopia fueron los métodos más frecuentes para el diagnóstico. Asimismo, el sangramiento digestivo alto fue la complicación más observada (28,6 %A descriptive and retrospective study was conducted in 4 family physician?s offices from the Plaza de la Revolución? Polyclinic to stress the main health problems affecting morbidity from peptic ulcer between January, 1996, and December, 1997. Males accounted for 65,7 % of the sample under study, whereas the highest prevalence was observed in the age groups 31-40 and 51-60. 42,1 % of the patients who had pathological family history of gastroduodenal disorders developed peptic ulcer.The duodenal localization was present in 77,1 % of the cases. Coffee was the most frequent of the toxic habits, followed by alcohol. Among the drugs taken by the patients, aspirin represented 17,1 % of the cases. The most used schemes of treatment were cimetidine and

  10. Aspirin and omeprazole for secondary prevention of cardiovascular disease in patients at risk for aspirin-associated gastric ulcers.

    Science.gov (United States)

    García-Rayado, Guillermo; Sostres, Carlos; Lanas, Angel

    2017-08-01

    Cardiovascular disease is the most important cause of morbidity and mortality in the world and low-dose aspirin is considered the cornerstone of the cardiovascular disease prevention. However, low-dose aspirin use is associated with gastrointestinal adverse effects in the whole gastrointestinal tract. In this setting, co-therapy with a proton pump inhibitor is the most accepted strategy to reduce aspirin related upper gastrointestinal damage. In addition, some adverse effects have been described with proton pump inhibitors long term use. Areas covered: Low-dose aspirin related beneficial and adverse effects in cardiovascular system and gastrointestinal tract are reviewed. In addition, this manuscript summarizes current data on upper gastrointestinal damage prevention and adverse events with proton pump inhibition. Finally, we discuss the benefit/risk ratio of proton pump inhibitor use in patients at risk of gastrointestinal damage taking low-dose aspirin. Expert commentary: Nowadays, with the current available evidence, the combination of low-dose aspirin with proton pump inhibitor is the most effective therapy for cardiovascular prevention in patients at high gastrointestinal risk. However, further studies are needed to discover new effective strategies with less related adverse events.

  11. [Surgical approach of gastroduodenal neuroendocrine neoplasms].

    Science.gov (United States)

    Fendrich, V; Bartsch, D K

    2016-04-01

    Gastroduodenal neuroendocrine tumors are rare but an increase in incidence has been recognized worldwide over the past 35 years. At the same time the prognosis of patients has substantially improved because the majority of these tumors can now be detected at an early stage. Neuroendocrine neoplasms (NENs) of the stomach are the most frequent neoplasms of neuroendocrine origin in the gastrointestinal tract. The therapeutic management of these tumors is complicated by the fact that they must be classified not only by staging and grading but also according to their pathophysiological background (types). These types differ in biological behavior and therefore have an influence on the therapeutic concept. Because more than 90 % of duodenal NENs are often asymptomatic and are as a rule identified at a curable stage, resection of the tumor should always be the first line of therapy. The therapeutic strategies vary from local endoscopic resection (duodenotomy with excision) up to pancreas retaining duodenectomy and pylorus retaining or classical Whipple procedures. This article presents the various surgical approaches to gastric and duodenal NENs.

  12. Síndrome de Rapunzel: tricobezoar gastroduodenal

    Directory of Open Access Journals (Sweden)

    David Loja

    2003-03-01

    Full Text Available El Síndrome de Rapunzel es una forma inusual de tricobezoar gástrico con extensión al intestino. Está compuesto de pelo, moco y fragmentos de alimentos en descomposición. Reportamos el caso de una adolescente de 18 años de edad que es admitida en nuestra institución con antecedente de depresión mayor, en tratamiento irregular en el año previo e historia de 5 meses de náuseas, vómitos y pérdida ponderal de 15 kg. Los hallazgos del examen incluyeron distensión y dolor abdominal. Tenía anemia severa y en la serie gastroduodenal mostró defecto de relleno gástrico. El diagnóstico fue confirmado con la gastroscopia. La gastrotomía reveló un gran tricobezoar con extensión duodenal, el que fue extraído. Fue dada de alta sin complicaciones.

  13. Ugh! Ulcers

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Ugh! Ulcers KidsHealth / For Kids / Ugh! Ulcers What's in this ... real story? Let's find out. What Is an Ulcer? An ulcer (say: UL-sur) is a sore, ...

  14. METABOLIC ASPECTS OF GASTRODUODENAL PATHOLOGY IN CHILDREN SIBERIA

    Directory of Open Access Journals (Sweden)

    Eduard Vilyamovich Kasparov

    2016-09-01

    Full Text Available In a review shown the main aspects of the research work on the study of metabolic issues of formation, progression and rehabilitation of gastroduodenal pathology in children of Siberia as one of the most important pathophysiological aspects, along with other equally important factors that determine the epidemiological situation of pathology in the region. Within the exposition of this issue is emphasized on special actuality of this direction for the Siberian region, and primarily for its northern territories. It was concluded that the population features of the gastroduodenal diseases course in children should be considered in their treatment and prevention, what, unfortunately, not taken into account.

  15. [Mucosal immune response to Helicobacter pylori in children with gastroduodenal diseases and allergy].

    Science.gov (United States)

    Mazurina, S A; Ilintseva, N V; Gervazieva, V B

    2014-01-01

    In children with chronic gastritis/gastroduodenitis, erosions and ulcer of stomach and duodenum and associated allergic diseases (asthma, allergic rhinitis, atopic dermatitis) CagA, sIgA and IgE antibodies to the H. pylori were determined by ELISA in the supernatants of feces. H. pylori infection was determined according to "Maastricht IV". The frequency and contents of CagA did not differ among the groups we studied. However, in children with positive urease test the contents of CagA was significantly higher (p = 0.03) compared with other children. The highest levels of sIgA were found in the feces supernatants from non-allergic children with CG/CGD and were associated with H. pylori infection. The immune response in children with erosions and ulcer of stomach and duodenum and in children with allergy was presented the sIgE to H. pylori. Also, the negative correlation between the level sIgE to H. pylori and content sIgA was found in children with allergy. Thus, increased IgE indicates not only allergy, but also acts as a protective role in the development of anti-infective immunity.

  16. The effect of cocaine on gastric mucosal PGE2, LTC4 and ulcerations

    Directory of Open Access Journals (Sweden)

    L. D. G. Angus

    1993-01-01

    Full Text Available The association between cocaine use and acute gastroduodenal perforation is known. The effect of cocaine and stress on gastric mucosal ulceration and the levels of prostaglandin E2 (PGE2 and leukotriene C4 (LTC4 was studied in 40 Sprague–Dawley rats. Controls received intraperitoneal (i.p. saline, ten received i.p. cocaine (35 mg/kg, ten were stressed by the cold restraint method, and ten had i.p. cocaine and stress. Cocaine alone did not induce ulceration, but decreased PGE2 levels. Stress alone caused ulceration, but was not associated with a change in either PGE2 or LTC4 levels. When combined with stress, however, cocaine caused a three-fold increase in ulceration and a significant increase in PGE2 and LTC4 levels. Stress may predispose the cocaine addict to loss of gastroduodenal mucosal integrity, which is related to an imbalance of PGE2 and LTC4 synthesis.

  17. Effects of the novel histamine H2-receptor antagonist (+/-)-(E)-1-[2-hydroxy-2-(4-hydroxyphenyl)ethyl]-3-[2-[[[5- (methylamino)methyl-2-furyl]methyl]thio]ethyl]-2-(methylsulfonyl) guanidine on gastric secretion and gastroduodenal ulcers in rats.

    Science.gov (United States)

    Amagase, K; Kato, S; Yamamoto, H; Okabe, S

    1996-02-01

    The effects of (+/-)-(E)-1-[2-hydroxy-2-(4-hydroxyphenyl)ethyl]-3-[2- [[[5-(methylamino)methyl-2-furyl] methyl]thio]ethyl]-2-(methylsulfonyl)guanidine (CAS 140695-21-2, T-593), a new histamine H2-receptor antagonist, on gastric secretion and experimental gastric and duodenal lesion/ulcer models in rats were examined. The drug administered orally or intraduodenally significantly and dose-dependently inhibited both basal and histamine-stimulated acid secretion. Pepsin output was also inhibited by the drug nearly dose-dependently. The acid-inhibitory effect of T-593 persisted for 12 h after a single oral administration. T-593 potently protected the gastric mucosa against water-immersion stress-, indometacin- and HCl.acetylsalicylic acid-induced lesions, but it had no effect on HCl.ethanol-induced lesions. T-593 significantly prevented the development of mepirizole-induced duodenal ulcers. Spontaneous healing of kissing gastric ulcers was significantly enhanced when T-593 was administered for 14 days. The antisecretory and antilesion/antiulcer effects of T-593 were similar to those of ranitidine and omeprazole. It is concluded that T-593 is a potent antisecretory and antiulcer drug.

  18. A rare case of Cystic artery arising from Gastroduodenal artery ...

    African Journals Online (AJOL)

    An uncommon anatomical variation in the origin and course of cystic artery was found during human cadaveric dissection in our laboratory. A blood vessel was seen arising from the gastroduodenal artery about 1 cm distal to its origin from the common hepatic artery. The vessel when traced towards its termination was found ...

  19. Corneal Ulcer

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Corneal Ulcer Sections What Is a Corneal Ulcer? Corneal Ulcer ... Diagnosis Corneal Ulcer Treatment What Is a Corneal Ulcer? Leer en Español: ¿Qué es una Úlcera de ...

  20. Peptic Ulcers

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Peptic Ulcers KidsHealth / For Parents / Peptic Ulcers What's in this ... age — even kids — can develop ulcers. About Peptic Ulcers An ulcer is a sore, which means it's ...

  1. Stomach ulcer

    Science.gov (United States)

    ... the acid and enzymes by a mucous lining. Ulcers are caused when there is an imbalance between ... protect the lining of the stomach. Symptoms of ulcers may include bleeding. On rare occasions, an ulcer ...

  2. Correction of Hypoxia and Free Radical Oxidation Processes in Gastroduodenal Hemorrhages

    Directory of Open Access Journals (Sweden)

    S. S. Morgunov

    2007-01-01

    Full Text Available The present investigation was to study the clinical efficacy of the substrate antihypoxant-antioxidant Reamberin used in the correction of tissue hypoxia and free radical oxidation (FRO in patients with severe blood loss of ulcerous etiology. The paper presents the results of the investigation of Reamberin used in the therapy of posthemorrhagic hypoxia, by simultaneously evaluating metabolism and the parameters of lipid peroxidation (LPO and the antioxidative system (AOS in patients with ulcerative gastroduodenal hemorrhage (UGDH.Materials and methods. Thirty-six patients with UGDH with a circulating blood volume (CBV deficit of 30—40% and a globular volume of 50—60% were examined. Systemic hemodynamics was examined by the integral body theography method by means of a Diamant rheoanalyzer. The values of blood oxygen-transport function were determined and calculated. For rapid expression and evaluation of the summary state of FRO, a procedure for the recording of activated H2O2 chemiluminescence was used in the presence of Fe2+. Metabolic disturbances were judged from the concentration of lactate and glucose.Results. Acute blood loss of ulcerous etiology has been found to cause significant systemic hemodynamic and microcirculatory disorders and impairments of metabolism, oxygen balance, and tissue perfusion and to intensify FRO and LPO processes, and the use of 1.5% Reamberin in a volume of 800 ml/day substantially reduces the degree of specific cell metabolic disturbances in critical conditions, such as tissue hypoxia, mitochondrial dysfunction, FRO activation, LPO-AOS imbalance.Conclusion. Inclusion of Reamberin in the intensive care of acute blood loss diminishes the manifestations of tissue hypoxia and improves oxygen delivery and consumption. The agent activates the antioxidative system, inhibits LPO processes in the ischemic tissues, and reduces the severity of pathological effects of hypoxia during reperfusion and reoxygenation. 

  3. [Oral ulcers].

    Science.gov (United States)

    Bascones-Martínez, Antonio; Figuero-Ruiz, Elena; Esparza-Gómez, Germán Carlos

    2005-10-29

    Ulcers commonly occur in the oral cavity, their main symptom being pain. There are different ways to classify oral ulcers. The most widely accepted form divides them into acute ulcers--sudden onset and short lasting--and chronic ulcers--insidious onset and long lasting. Commonest acute oral ulcers include traumatic ulcer, recurrent aphthous stomatitis, viral and bacterial infections and necrotizing sialometaplasia. On the other hand, oral lichen planus, oral cancer, benign mucous membrane pemphigoid, pemphigus and drug-induced ulcers belong to the group of chronic oral ulcers. It is very important to make a proper differential diagnosis in order to establish the appropriate treatment for each pathology.

  4. Prevalence of EPIYA motifs in Helicobacter pylori strains isolated from patients with gastroduodenal disorders in northern Iran

    Directory of Open Access Journals (Sweden)

    Abolghasem Ajami

    2013-02-01

    Full Text Available Background: Cytotoxin-associated gene A (CagA-positive strains of Helicobacter pylori are associated with gastroduodenal diseases. Evidences have suggested that the type of H pylori CagA EPIYA motifs may be associated with specific disorders (i.e., gastritis, peptic ulcer, or gastric cancer.  We investigated the prevalence of different EPIYA motifs (A, B, C, or D in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal (GI endoscopy. Materials and Methods: H. pylori strains were isolated from biopsy specimens of 220 patients with dyspepsia symptoms. The presence of glmM gene, as a housekeeping gene CagA and pattern of cagA EPIYA motifs were genotyped using by polymerase chain reaction (PCR method.The association between the type of motifs and disease state determined by the Chi-square test, Fisher’s exact test, and logistic regression.Results: CagA-positive H. pylori were identified in 125(57% of patients with gastrointestinal disorders, of whom 36(28.6% were isolated from gastritis, 31 (24.6% from duodenal ulcer, and 58 (46.4% from gastric cancer. The frequency of pattern of cagA EPIYA motifs were 39 (31.2% AB motifs, 54 (43.2% ABC motifs, and 32 (25.6% ABCC motifs and not detected D motifs. Gastric cancer risk was estimated to be 2.57 times higher in patients infected by strains with ABCC motif when compared with gastritis and duodenal ulcer patients (P=0.03. Moreover, patients with C- containing motifs were 2.27 times more likely to be affilicted with gastric cancer than duodenal ulcer. AB motif was more associated with gastritis and duodenal ulcer than ABC and ABCC motifs. Conclusion: The results suggested that cag-EPIYA ABCC might be associated with gastric cancer, while EPIYA-AB might be is associated with duodenal ulcer.

  5. Gastroduodenal artery steal syndrome during liver transplantation: intraoperative diagnosis with Doppler ultrasound and management

    National Research Council Canada - National Science Library

    Nishida, Seigo; Kadono, Jun; DeFaria, Werviston; Levi, David M; Moon, Jang I; Tzakis, Andreas G; Madariaga, Juan R

    2005-01-01

    .... We present the recognized case of a gastroduodenal artery (GDA) steal syndrome that was diagnosed with intraoperative Doppler ultrasound and treated with GDA ligation during the liver transplantation...

  6. Experimental and clinical application of laser doppler flowmetry in gastric and duodenal ulcerative bleedings

    Directory of Open Access Journals (Sweden)

    Afanasieva G.A.

    2011-12-01

    Full Text Available The research goal is to develop a new objective diagnostic method of prerecurrence syndrome that will prognose bleeding recurrence from gastroduodenal ulcers. Materials and methods. Method of laser Doppler flowmetry (LDF of the regional perfusion of tissue has been used. The experimental part has been done on 30 white laboratory rats. Characteristics of regional tissue perfusion in the simulation and laser hemostasis of bleeding have been studied. Gastroduodenal endoscopy has been performed with laser Doppler flowmetry (ELDF in clinical conditions to predict the recurrence of ulcerative bleeding. The prognostic method of gastroduodenal ulcerative bleeding was used in 58 patients hospitalized with such pathology and activity of bleeding Forrest II. Results. The study of microcirculation parameters and experimental hemostasis has showed the possibility of using LDF to measure its performance. Effective hemostasis has been accompanied by a significant decrease in perfusion. On the basis of microcirculation parameters in ulcerative bleeding, medical adrenaline test has been proposed for an objective verification pre-recurrence syndrome. To evaluate the effectiveness of endoscopic hemostasis perfusion has been measured before and after its implementation. Conclusion. ELDF has objectified the prognosis of ulcerative bleeding recurrence, verified pre-recurrence syndrome and evaluated the efficacy of endoscopic hemostasis

  7. [Aphthous ulcers and oral ulcerations].

    Science.gov (United States)

    Vaillant, Loïc; Samimi, Mahtab

    2016-02-01

    Aphthous ulcers are painful ulcerations located on the mucous membrane, generally in the mouth, less often in the genital area. Three clinical forms of aphthous ulcers have been described: minor aphthous ulcers, herpetiform aphthous ulcers and major aphthous ulcers. Many other conditions presenting with oral bullous or vesiculous lesions orulcerations and erosions can be mistaken for aphthous ulcers. Currently, treatment of aphthous ulcers is palliative and symptomatic. Topical treatments (topical anesthetics, topical steroids and sucralfate) are the first line therapy. Recurrent aphthous stomatitis (RAS) is defined by the recurrence of oral aphthous ulcers at least 4 times per year. RAS is often idiopathic but can be associated with gastro-intestinal diseases (i.e. celiac disease, inflammatory bowel diseases), nutritional deficiencies (iron, folates...), immune disorders (HIV infection, neutropenia) and rare syndromes. Behçet's disease is a chronic, inflammatory, disease whose main clinical feature is recurrent bipolar aphthosis. Colchicine associated with topical treatments constitutes a suitable treatment of most RAS. Thalidomide is the most effective treatment of RAS but its use is limited by frequent adverse effects. Oral ulcers can be related to a wide range of conditions that constitute the differential diagnoses of aphthous ulcers. Oral ulcers are classified into three main groups: acute ulcers with abrupt onset and short duration, recurrent ulcers (mainly due to postherpetic erythema multiforme) and chronic ulcers (with slow onset and insidious progression). Acute oral ulcers are due to trauma, bacterial infections (including acute necrotizing ulcerative gingivitis), deep fungal infection, gastro-intestinal (namely inflammatory bowel disease) or systemic diseases. Chronic oral ulcers may be drug-induced, or due to benign or malignant tumors. Every oral solitary chronic ulcer should be biopsied to rule out squamous cell carcinoma. A solitary palatal ulcer

  8. Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sun Hyun [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Mi-Sook, E-mail: mskim@kcch.re.kr [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Cho, Chul Koo; Kang, Jin-Kyu; Lee, Sang Yeob; Lee, Kyung-Nam [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Lee, Dong Han [CyberKnife Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Han, Chul Ju; Yang, Ki Young [Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Sang Bum [Department of General Surgery, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2012-11-15

    Purpose: To identify the predictors for the development of severe gastroduodenal toxicity (GDT) in patients treated with stereotactic body radiotherapy (SBRT) using 3 fractionations for abdominopelvic malignancies. Methods and Materials: From 2001 to 2011, 202 patients with abdominopelvic malignancies were treated with curative-intent SBRT. Among these patients, we retrospectively reviewed the clinical records of 40 patients with the eligibility criteria as follows: 3 fractionations, follow-up period {>=}1 year, absence of previous radiation therapy (RT) history or combination of external-beam RT and the presence of gastroduodenum (GD) that received a dose higher than 20% of prescribed dose. The median SBRT dose was 45 Gy (range, 33-60 Gy) with 3 fractions. We analyzed the clinical and dosimetric parameters, including multiple dose-volume histogram endpoints: V{sub 20} (volume of GD that received 20 Gy), V{sub 25}, V{sub 30}, V{sub 35}, and D{sub max} (the maximum point dose). The grade of GDT was defined by the National Cancer Institute Common Toxicity Criteria version 4.0, and GDT {>=}grade 3 was defined as severe GDT. Results: The median time to the development of severe GDT was 6 months (range, 3-12 months). Severe GDT was found in 6 patients (15%). D{sub max} was the best dosimetric predictor for severe GDT. D{sub max} of 35 Gy and 38 Gy were respectively associated with a 5% and 10% probability of the development of severe GDT. A history of ulcer before SBRT was the best clinical predictor on univariate analysis (P=.0001). Conclusions: We suggest that D{sub max} is a valuable predictor of severe GDT after SBRT using 3 fractionations for abdominopelvic malignancies. A history of ulcer before SBRT should be carefully considered as a clinical predictor, especially in patients who receive a high dose to GD.

  9. Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, H. [Sungkyunkwan Univ., Seoul (Korea, Republic of). Dept. of Health Sciences and Technology; Oh, D.; Park, H.C.; Han, Y.; Lim, D.H. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Radiation Oncology; Kang, S.W. [Korea Univ., Seoul (Korea, Republic of). Dept. of Radiologic Science; Paik, S.W. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Medicine

    2013-07-15

    Purpose: The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). Patients and methods: A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the {>=} grade 2 GD toxicity were investigated. Results: Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V{sub 25} for stomach and V{sub 35} for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for {>=} grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V{sub 25} {<=} 6.3 % and 57.1 % for V{sub 25} > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V{sub 35} > 5.4 % and 45.9 % for V{sub 35} > 5.4 %. By multivariate analysis including the clinical factors, V{sub 25} for stomach and V{sub 35} for duodenum were the significant factors. Conclusion: EGD revealed that GD toxicity is common following RT for HCC. V{sub 25} for the stomach and V{sub 35} for the duodenum were the significant factors to predict {>=} grade 2 GD toxicity. (orig.)

  10. Distribution of Helicobacter pylori virulence markers in patients with gastroduodenal diseases in Pakistan

    Directory of Open Access Journals (Sweden)

    Ahmad Zubair

    2009-11-01

    Full Text Available Abstract Background Helicobacter pylori (H. pylori infection is known to be associated with a spectrum of gastroduodenal diseases. We studied the association of H. pylori virulence markers cytotoxin-associated gene (cagA and vacuolating associated cytotoxin gene (vacA alleles in patients with non ulcer dyspepsia (NUD, gastric ulcer (GU, gastric carcinoma (GC and duodenal ulcer (DU. Methods H. pylori infection established by both rapid urease test and histology were studied. The cagA and vacA allelic status was determined by polymerase chain reaction (PCR. Sequencing of vacA i1 and i2 PCR product was carried out. Results Two hundred and twenty-four patients were included, 141 (63% were males with a mean age of 45 ± 16, range 16-83 years. The virulence marker cagA was associated with GU in 20(63% (p = 0.04, DU in 23(72% (p = 0.003 and GC in 29(73% (p = 0.001 compared to NUD in 51(42%. VacA s1am1 was associated with GU in 23(72% (p = 0.001, DU in 17(53% (p vacA s1bm1 was also associated with GU in 9(28% (p = 0.001, DU in 12(37% (p CagA in 55(45% (p = 0.037, vacA s1am1 in 51(51% (P s1bm1 in 25(56% (p = 0.002, s1am2 32(30% (p s1bm2 29(69% (p = 0.004 were also associated with moderately active chronic inflammation. Conclusion CagA was negative in majority of NUD patients with H. pylori infection. However, cagA was associated with peptic ulcer and GC. VacA allele's s1am1 and s1bm1 were associated with H. pylori associated diseases and inflammation.

  11. Diagnostic value of blood urea and bilirubin levels determination in patients with gastroduodenal zone diseases

    Directory of Open Access Journals (Sweden)

    I. B. Zhakun

    2017-12-01

    Full Text Available The study of relationships of urea and bilirubin blood levels in patients with Helicobacter pylori associated gastroduodenal pathology (HP-aGDP has the considerable relevance for clinicians, since these indicators represent the status and function of the gastroduodenal zone. The aim of this study was to estimate changes of bilirubin and urea blood levels in patients with HP-aGDP before and after treatment. Materials and methods. Our study has included 59 patients of the main group with different HP-aGDP and 40 patients of the control group with community-acquired pneumonia (CAP. Results. In patients with HP-aGDP the doubly severe reduction of urea concentration was observed in significantly greater number of patients, while half of the patients in the controls had an increase of its level by 10.4 %. The bilirubin concentration decrease was more pronounced (37.1 % vs. 3.5 % and significant (p < 0.05 in patients with HP-aGDP. Its rate depended on the dynamics of urea exactly in patients with HP-aGDP and it was more pronounced in case of urea reduction (p < 0.05. Thus, the revealed association of bilirubin and urea levels changes, namely their decrease owing to the treatment, was inherent only to patients with HP-aGDP unlike to the patients with CAD. We also determined the involvement of lipid, carbohydrate and protein metabolism, electrolytes, composition of blood in the processes of local and systemic inflammation caused by HP and its relationship with adaptive reactions, which generally depended on other individual characteristics of patients in the study group (age, duration of disease, ulcer size, etc.. Conclusions. The monitoring of urea and bilirubin blood levels in patients especially with HP-aGDP during the eradication has a specific diagnostic and prognostic value. The bilirubin level in such cases reflects the severity of cholestasis, inflammatory lesions of the duodenal mucosa, comorbid hepatobiliary disease, while the urea level

  12. Peptic Ulcer

    Science.gov (United States)

    A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small ... and goes for several days or weeks Peptic ulcers happen when the acids that help you digest ...

  13. Gastritis Cystica Polyposa with Gastroduodenal Intussuception: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Soon Hyuk; Bae, Il Hun; Park, Kil Sun; Lee, Seung Young; Jeon, Min Hee; Cho, Bum Sang; Kamg, Min Ho [Dept. of Radilogy, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of); Ryu, Dong Hee [Dept. of Surergy, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of); Lee, Ho Chang [Dept. of Pathology, College of Medicine and Medical Research Institute, Chonbuk National University, Chonju (Korea, Republic of)

    2011-04-15

    Gastritis cystica polyposa is an uncommon benign lesion that normally occurs on the gastric side of a gastroenterostomy site but is rarely found in patients without a prior history of stomach surgery. We report a case of a 41-year-old woman with gastrodeuodenal intussusception due to gastritis cystica polyposa that developed in an unoperated stomach. CT revealed gastroduodenal intussusception and a cystic and solid mass with fat density in the second portion of the duodenum. Surgery and a pathologic examination confirmed gastritis cystica polyposa.

  14. Indomethacin decreases gastroduodenal mucosal bicarbonate secretion in humans

    DEFF Research Database (Denmark)

    Mertz-Nielsen, A; Hillingsø, Jens; Bukhave, K

    1995-01-01

    BACKGROUND: Cyclooxygenase inhibitors reduce mucosal bicarbonate secretion in the duodenum, but the evidence for their effect on bicarbonate secretion in the stomach remains controversial. We have, therefore, studied how indomethacin influences gastroduodenal bicarbonate secretion and luminal...... release of prostaglandin (PG) E2 by means of a method that enables simultaneous measurements in the stomach and the duodenum. METHODS: Gastric and duodenal perfusions were performed twice in random order during control conditions or after pretreatment with indomethacin (100 mg intravenously) in eight...... basal and stimulated bicarbonate secretion, both in the stomach and in the duodenum....

  15. Yttrium-90 microsphere induced gastrointestinal tract ulceration

    Directory of Open Access Journals (Sweden)

    Rikabi Ali A

    2008-09-01

    Full Text Available Abstract Background Radiomicrosphere therapy (RT utilizing yttrium-90 (90Y microspheres has been shown to be an effective regional treatment for primary and secondary hepatic malignancies. We sought to determine a large academic institution's experience regarding the extent and frequency of gastrointestinal complications. Methods Between 2004 and 2007, 27 patients underwent RT for primary or secondary hepatic malignancies. Charts were subsequently reviewed to determine the incidence and severity of GI ulceration. Results Three patients presented with gastrointestinal bleeding and underwent upper endoscopy. Review of the pretreatment angiograms showed normal vascular anatomy in one patient, sclerosed hepatic vasculature in a patient who had undergone prior chemoembolization in a second, and an aberrant left hepatic artery in a third. None had undergone prophylactic gastroduodenal artery embolization. Endoscopic findings included erythema, mucosal erosions, and large gastric ulcers. Microspheres were visible on endoscopic biopsy. In two patients, gastric ulcers were persistent at the time of repeat endoscopy 1–4 months later despite proton pump inhibitor therapy. One elderly patient who refused surgical intervention died from recurrent hemorrhage. Conclusion Gastrointestinal ulceration is a known yet rarely reported complication of 90Y microsphere embolization with potentially life-threatening consequences. Once diagnosed, refractory ulcers should be considered for aggressive surgical management.

  16. Аctivity of stomach secretory glands and the nitrergic mechanisms of their regulatiоn under the condition of the adrenalin ulcer simulation

    Directory of Open Access Journals (Sweden)

    O. V. Razuvaeva

    2009-01-01

    Full Text Available Participating of nitrergic link in the regulation of secretory activity in the stomach was investigated in the intact rats under the condition of ulcerous damage in the gastro-duodenal area. It was found that in the intact rats NO decreases the acid gastric secretion. On the early stages of the ulcer development the nitrergic mechanisms of regulation execute the protective adaptation-compensative function of the mucous coat of stomach, but in remote terms these mechanisms lose such ability.

  17. [Venous ulcer].

    Science.gov (United States)

    Böhler, Kornelia

    2016-06-01

    Venous disorders causing a permanent increase in venous pressure are by far the most frequent reason for ulcers of the lower extremity. With a prevalence of 1 % in the general population rising to 4 % in the elderly over 80 and its chronic character, 1 % of healthcare budgets of the western world are spent on treatment of venous ulcers. A thorough investigation of the underlying venous disorder is the prerequisite for a differenciated therapy. This should comprise elimination of venous reflux as well as local wound management. Chronic ulcers can successfully be treated by shave therapy and split skin grafting. Compression therapy is a basic measure not only in venous ulcer treatment but also in prevention of ulcer recurrence. Differential diagnosis which have to be considered are arterial ulcers, vasculitis and neoplasms.

  18. Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study.

    Science.gov (United States)

    Nguyen, Tung L; Uchida, Tomohisa; Tsukamoto, Yoshiyuki; Trinh, Dung T; Ta, Long; Mai, Bang H; Le, Song H; Thai, Ky D; Ho, Dung D; Hoang, Hai H; Matsuhisa, Takeshi; Okimoto, Tadayoshi; Kodama, Masaaki; Murakami, Kazunari; Fujioka, Toshio; Yamaoka, Yoshio; Moriyama, Masatsugu

    2010-09-30

    The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail. Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing. Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh. H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.

  19. Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study

    Science.gov (United States)

    2010-01-01

    Background The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail. Methods Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing. Results Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh. Conclusions H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh. PMID

  20. Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study

    Directory of Open Access Journals (Sweden)

    Okimoto Tadayoshi

    2010-09-01

    Full Text Available Abstract Background The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail. Methods Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing. Results Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh. Conclusions H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between

  1. Palatal ulceration.

    Science.gov (United States)

    Sardana, Kabir; Bansal, Shuchi

    2014-01-01

    Palatal ulcers are a common presentation and can be conveniently divided into developmental and acquired causes, the latter of which is subdivided into acute and chronic causes. Most commonly seen dermatologic causes have associated skin manifestations. Acute and multiple ulcers are usually infectious or drug induced in origin. Recurrent ulcers are largely dominated by aphthosis, while chronic ulcers are seen in immunocompromised patients and can occasionally be malignant. It is essential to involve the oral and maxillofacial surgeons early in the therapeutic management to tackle the inevitable complications that may ensue in the chronic cases. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. THE CLINICAL MANIFESTATIONS AND COURSE OF DUODENAL ULCER DISEASE AFTER PERFORATED ULCER

    Directory of Open Access Journals (Sweden)

    L. A. Lyubskaya

    2014-01-01

    Full Text Available Objective: to compare clinical manifestations, course, mental status in duodenal ulcer (DU patients with a history of perforated ulcer and its uncomplicated course.Subjects and methods. One hundred and thirteen patents with DU were examined. Group 1 included 61 patients with uncomplicated DUand Group 2 comprised 52 patients with a history of perforated ulcer. A comparison group consisted of 20 patients who had undergone laparotomy. Physical and mental status examinations, esophagogastroduodenoscopy (EGDS, and 24-hour pH-metry were performed.Results. Classical pain syndrome was observed in 75 % of the patients with uncomplicated DU. Prior to perforation, the pain and dyspeptic syndromes were distinguished only by a significantly lower degree in Group 2; following perforation, the pain syndrome was recorded more frequently, it was more extensive, meal-unrelated, and similar to that in the patients who had undergone laparotomy and had diminished appetite (36.5 %. EGDS showed that the complicated course was accompanied by the significantly higher incidence of erosive esophagitis (21.2 %, gastritis (51.9 %, duodenitis (25.0 %, multiple ulcers (28.8 %, and larger ulcers. 24-hour pH-metry indicated that the level of hyperacidity in Group 2 was higher and the circadian intragastric pH variations were less marked than those in uncomplicated DU. The patients with a history of perforated ulcer showed a high rate of anxiety and depressive changes. Conclusion. In complicated DU, marked monotonic hyperacidity causes common erosive-ulcerative lesions in the gastroduodenal area in relatively mild pain syndrome, late referrals, and long-term ulcer healing. After perforation followed by wound closure, the pain and dyspeptic syndromes become more pronounced, which is associated with anxiety and depressive changes in the mental status, as well as with early referrals and less healing time.

  3. Stasis dermatitis and ulcers

    Science.gov (United States)

    Venous stasis ulcers; Ulcers - venous; Venous ulcer; Venous insufficiency - stasis dermatitis; Vein - stasis dermatitis ... the skin Skin turns dark brown Skin sores (ulcers) may develop (called a venous ulcer or stasis ...

  4. Transcatheter arterial embolization of a pseudoaneurysm of gastroduodenal artery: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Han, Young Min; Kang, Sung Soo; Lee, Jeong Min; Chung, Jin Young; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University School of Medicine, Chonju (Korea, Republic of)

    1997-01-01

    Gastroduodenal artery pseudoaneurysm is a relatively rare and potentionally life-threatening complication of chronic pancreatitis, which is thought to occur because of autodigestion of arterial walls by pancreatic enzymes. Embolotherapy should probably be the first method of treatment, since surgical treatment carries a high risk of mortality and morbidity. We report the case of 30-year-old male with gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis which was successfully treated by transcatheter embolization using Gianturco spring coils.

  5. Hunner's Ulcers

    Science.gov (United States)

    ... instrument with a heated tip or a laser technique. Resection of ulcers : cutting around and removing the ulcers from ... Provider Registry Order Educational Materials CME/CEU IC Reading List Living with IC ... Sources of Fiber What to Eat The IC Plate™ Foods ...

  6. Treatment with ghrelin accelerates the healing of acetic acid-induced gastric and duodenal ulcers in rats.

    Science.gov (United States)

    Ceranowicz, P; Warzecha, Z; Dembinski, A; Sendur, R; Cieszkowski, J; Ceranowicz, D; Pawlik, W W; Kuwahara, A; Kato, I; Konturek, P C

    2009-03-01

    Recent studies have shown that ghrelin exhibits gastroprotective effects. The aim of present study was to examine the influence of ghrelin administration on the healing of chronic gastric and duodenal ulcers and to evaluate the role of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in this process. In pituitary-intact or hypophysectomized rats, chronic gastric and duodenal ulcers were induced by acetic acid. After induction of ulcers, rats were treated intraperitoneally twice a day with saline, ghrelin (4, 8 or 16 nmol/kg/dose) or IGF-1 (20 nmol/kg/dose) for six or ten days. In animals with intact pituitary, treatment with ghrelin increased serum level of GH and IGF-1. These effects were accompanied by the increase in mucosal cell proliferation, mucosal blood flow and healing rate of gastric and duodenal ulcers. After hypophysectomy, the significant increase in serum level of endogenous ghrelin was observed, but the healing of gastric and duodenal ulcers was delayed. This effect was accompanied by a significant decrease in serum concentration of endogenous GH and IGF-1, and reduction in mucosal blood flow and DNA synthesis. In hypophysectomized rats, administration of exogenous ghrelin was without any effect on serum level of GH and IGF-1, healing rate of gastroduodenal ulcers or mucosal cell proliferation. In contrast to this effect, administration of IGF-1 increased mucosal cell proliferation, healing rate of gastroduodenal ulcers and mucosal blood flow in hypophysectomized rats. Treatment with ghrelin accelerates healing of chronic gastroduodenal ulcers and this effect is mediated by the release of endogenous GH and IGF-1.

  7. Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors

    Directory of Open Access Journals (Sweden)

    Susan Levenstein

    1999-01-01

    Full Text Available The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery of Helicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes such as war and earthquakes lead to surges in hospitalizations for complicated ulcers, and stress or anxiety can worsen ulcer course. Many known ulcer risk factors, including smoking, nonsteroidal anti-inflammatory drug use, heavy drinking, loss of sleep and skipping breakfast, can increase under stress; the association of low socioeconomic status with ulcer is also accounted for in part by psychosocial factors. Among possible physiological mechanisms, stress may induce gastric hypersecretion, reduce acid buffering in the stomach and the duodenum, impair gastroduodenal blood flow, and affect healing or inflammation through psychoneuroimmunological mechanisms. Psychosocial factors seem to be particularly prominent among idiopathic or complicated ulcers, but they are probably operative in run of the mill H pylori disease as well, either through additive effects or by facilitating the spread of the organism across the pylorus, while gastrointestinal damage by nonsteroidal anti-inflammatory drugs can also be potentiated by stress. Although the clinical importance of peptic ulcer is fading along with the millenium, due to secular trends and new therapies, it remains worthy of study as a splendid example of the biopsychosocial model.

  8. Pressure ulcers

    National Research Council Canada - National Science Library

    Reddy, Madhuri

    2011-01-01

    Unrelieved pressure or friction of the skin, particularly over bony prominences, can lead to pressure ulcers in up to one third of people in hospitals or community care, and one fifth of nursing home residents...

  9. High Prevalence of Helicobacter pylori hopQ II Genotype Isolated from Iranian Patients with Gastroduodenal Disorders

    Directory of Open Access Journals (Sweden)

    Amin Talebi Bezmin Abadi

    2014-01-01

    Full Text Available Helicobacter pylori plays an important role in the pathogenesis of chronic gastritis, peptic ulceration, and noncardia gastric cancer. Several putative virulence factors for H. pylori have been identified including vacA, babA, and iceA. HopQ is one of the outer membrane proteins involved in bacterial adherence to gastric mucosa and has been suggested to also play a role in the virulence of H. pylori. Due to the substantial geographic differences in the prevalence of H. pylori virulence factors reported, the main purpose of the current study was to investigate the association between different H. pylori virulence hopQ alleles (types I and II and patients with gastroduodenal disorders. The presence of H. pylori and hopQ alleles in gastric biopsy specimens was identified by specific PCR assays. H. pylori type II hopQ was found to be significantly associated with gastric cancer patients (odds ratio: 3.47, 95% CI: 1.56–5.89. Information about the prevalence of H. pylori hopQ type II can be used for determining the high-risk diseases type which is actually colonized by H. pylori hopQ type II positive strains. The presence of H. pylori hopQ type II should be investigated in different geographical regions as confirmatory findings may provide a definite biomarker attributed to the pathogenesis of certain severe digestive diseases.

  10. [Hemorrhagic stress lesions in the gastroduodenal mucosa. Incidence and therapy].

    Science.gov (United States)

    Radovanović, D; Stojanović, D; Kalaba, J

    1995-01-01

    We have observed 428 patients with hemorrhages of the upper gastrointestinal tract; 7% of patients with stress lesions of the gastroduodenal mucosa being the cause of hemorrhages (4.9% were erosional stress hemorrhages and 2.1% were stress ulcera). Surgery is the most common cause of stress hemorrhages of the stomach and duodenum. They occur during the first 5 days after the surgery, whereas 70.59% (n = 12) occur during the first 72 hours. The localization of erosional hemorrhages of the stomach mucosa is mostly diffuse and that is why they are numerous (78.6% of the third degree) and hemorrhages are mostly heavy (the case with stress hemorrhages). Chronic peptic ulcera, especially duodenal (62.5% duodenal ulcera and 37.5% stomach ulcera) present an expressed risk factor for the occurrence of hemorrhagic erosions under the influence of the stress factor. The most common localization of the stress hemorrhagic ulcus is duodenum (66.7%) which is a potential danger for occurrence of the heaviest arterial hemorrhages. After major surgeries and during postoperative periods patients must be preventively protected by "antiulcus therapy" (especially patients with ulcera).

  11. Role of dietary polyphenols in the management of peptic ulcer.

    Science.gov (United States)

    Farzaei, Mohammad Hosein; Abdollahi, Mohammad; Rahimi, Roja

    2015-06-07

    Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.

  12. Role of dietary polyphenols in the management of peptic ulcer

    Science.gov (United States)

    Farzaei, Mohammad Hosein; Abdollahi, Mohammad; Rahimi, Roja

    2015-01-01

    Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer. PMID:26074689

  13. Effect of sustained-release isosorbide dinitrate on post-prandial gastric emptying and gastroduodenal motility in healthy humans

    DEFF Research Database (Denmark)

    Madsen, J L; Rasmussen, S L; Linnet, J

    2004-01-01

    and gastroduodenal motility after a meal. Eleven healthy volunteers participated in a double-blind, placebo-controlled, cross-over study. Each subject ingested 40 mg isosorbide dinitrate orally as a sustained-release formulation or oral placebo, in random order. Gastric emptying and gastroduodenal motility were...

  14. Risk Factors for Upper GI Damage in Low-Dose Aspirin Users and the Interaction Between H. pylori Infection and Low-Dose Aspirin Use.

    Science.gov (United States)

    Iijima, Katsunori; Shimosegawa, Tooru

    2015-01-01

    Nowadays, low-dose aspirin is widely administered at low dose as an antithrombotic drug for the prevention of cerebrovascular and cardiovascular diseases. However, aspirin, even at a low dose, can induce varying degrees of gastroduodenal mucosal injury (erosion, ulcer, ulcer bleeding). Hence, co-prescription of proton pump inhibitors with low-dose aspirin is recommended for those at high risk for adverse gastroduodenal events. At present, a history of peptic ulcer, especially that of complicated ulcer, is the most important risk factor for low-dose aspirin-associated gastroduodenal adverse events. Additionally, concomitant use of non-steroidal anti-inflammatory drugs including COX-2 selective inhibitors, anti-platelet agents, anti-coagulants, and oral corticosteroid is recognized to increase the risk for adverse gastroduodenal events in low-dose aspirin users. H. pylori infection could also be associated with the increased risk for adverse gastroduodenal events in low-dose aspirin users, especially in patients with histories of peptic ulcers. Therefore, eradication therapy for such patients can prevent ulcer recurrence. However, the efficacy of eradication therapy on low-dose aspirin-related gastroduodenal lesions in unselected H. pylori-positive lowdose aspirin users without histories of peptic ulcers remains to be clarified.

  15. Endovascular Treatment of a Gastroduodenal Artery Pseudoaneurysm Rupture after a Car Accident

    Directory of Open Access Journals (Sweden)

    Sofia Dutra

    2017-09-01

    Full Text Available The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of ‘backdoor’ and ‘frontdoor’ embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography. With this case description we intend to highlight the rarity of the pseudoaneurysm rupture of the gastroduodenal artery and to emphasize the importance of an interventional radiology response that had a fundamental role in the endovascular treatment, in an emergency context.

  16. Gastroduodenal Intussusception Caused by a Peutz- Jeghers Polyp in a Young Child: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Jae Eun; Cho, Bum Sang; Lee, Seung Young; Jeon, Min Hee; Lee, Ji Hyuk; Lee, Ho Chang; Koo, Ji Hae [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2010-09-15

    Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz- Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp

  17. [Neurosis and genetic theory of etiology and pathogenesis of ulcer disease].

    Science.gov (United States)

    Kolotilova, M L; Ivanov, L N

    2014-01-01

    Based on the analysis of literature data and our own research, we have developed the original concept of etiology and pathogenesis of peptic ulcer disease. An analysis of the literature shows that none of the theories of pathogenesis of peptic ulcer disease does not cover the full diversity of the involved functions and their shifts, which lead to the development of ulcers in the stomach and the duodenum. Our neurogenic-genetic theory of etiology and pathogenesis of gastric ulcer and duodenal ulcer very best explains the cause-and-effect relationships in the patient peptic ulcer, allowing options for predominance in one or the other case factors of neurosis or genetic factors. However, it is clear that the only other: combination of neurogenic factor with genetically modified reactivity of gastroduodenal system (the presence of the target organ) cause the chronicity of the sores. The theory of peptic ulcer disease related to psychosomatic pathologies allows us to develop effective schema therapy, including drugs with psychocorrective action. On the basis of our theory of the role of Helicobacter pylori infection is treated as a pathogenetic factor in the development of peptic ulcer disease.

  18. The Cost of an Upper Gastroduodenal Endoscopy: An Activity-Based Approach

    Directory of Open Access Journals (Sweden)

    Ralph Crott

    2002-01-01

    Full Text Available The cost of medical procedures is often unknown, but is nevertheless crucial for setting reimbursement and health care policies. The cost of an upper gastroduodenal endoscopy was investigated in ambulatory adults in a large academic hospital in the province of Quebec, from the perspective of the hospital.

  19. [Gastroduodenal system state and levels of gastro-intestinal peptides in workers exposed to fluor compounds].

    Science.gov (United States)

    Fedorov, A A; Gromov, A S

    2007-01-01

    Studies in 45 cryolite production workers (facing chronic gastritis and gastroduodenitis) demonstrated that the diseases in them have moderate inflammatory activity, atrophy of gastric lining contaminated with Helicobacter pylori, hypergastrine mia, hypopancreozymine mia and hyposecretine mia in half of the examinees.

  20. Oropharynx Ulceration

    Directory of Open Access Journals (Sweden)

    Lauren Sylwanowicz

    2017-09-01

    Full Text Available History of present illness: A 31-year-old male presented to the emergency department (ED with worsening constant left sided throat pain over the past four months. The patient reports that he was brushing his teeth when his dog jumped onto his back causing his toothbrush to puncture the back of his throat, resulting in immediate bleeding and discomfort. The bleeding subsided and the patient did not seek medical care. The pain radiated to his left ear and the back of the neck. He also noted a change in his voice. The day before presenting to the ED the patient noted subjective fevers, hemoptysis and drooling, which led him to seek medical care. Significant findings: The photograph demonstrates an area of ulcerative tissue at the left palatine tonsil without surrounding erythema or purulent drainage. The computed tomography (CT scan shows a large ulceration of the left soft palate and palatine tonsil (red arrow. There is no evidence of skull base osteomyelitis. There is suppurative lymphadenopathy with partial left jugular vein compression due to mass effect (yellow highlight. There is mild nasopharyngeal airway narrowing with architectural distortion (blue arrow, but no other evidence of airway obstruction. Discussion: The oral cavity is prone to trauma leading to the formation of superficial ulcerations. There are many causes of mechanical trauma, most commonly accidental biting. Chemical, electrical and thermal insults are also possibilities. Poor fitting dental devices and fractured or malformed teeth can also be etiologies.1 Traumatic ulcerations are most common in children given bruxism and thumb sucking. However, a broad differential must be considered including malignant and premalignant lesions, infections of the oral mucosa, aphthous ulcerations and autoimmune diseases.2, 3 Chronic ulcerations are associated with superimposed infection, but there has not been established an association of malignant transformation of the oral mucosa after

  1. Venous Ulcers

    Science.gov (United States)

    Caprini, J.A.; Partsch, H.; Simman, R.

    2013-01-01

    Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence. PMID:26236636

  2. Herbal Remedy: An Alternate Therapy of Nonsteroidal Anti-Inflammatory Drug Induced Gastric Ulcer Healing

    Directory of Open Access Journals (Sweden)

    Ananya Chatterjee

    2014-01-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are one of the most commonly used therapeutic drug groups used worldwide for curing an array of health problems like pain, inflammation, cardiovascular complications, and many other diseases, but they may cause different side effects including gastroduodenal disorders. So, there is a growing interest and need to search for nontoxic, antiulcer formulations from medicinal plants to treat NSAIDs induced gastric ulcer. Extensive research has reported on many natural plants like Camellia sinensis, Phyllanthus emblica, Myristica malabarica, Piper betle, Picrorhiza kurroa, and so forth, and their active constituents reduced NSAIDs induced gastric ulcer via their antioxidative as well as immunomodulatory activity. Therefore, use of herbal formulations in daily life may prevent NSAIDs induced gastric ulceration and other side effects.

  3. Embolisation of the Gastroduodenal Artery is Not Necessary in the Presence of Reversed Flow Before Yttrium-90 Radioembolisation

    Energy Technology Data Exchange (ETDEWEB)

    Daghir, Ahmed A., E-mail: ahmeddaghir@doctors.net.uk [Imperial College Healthcare NHS Trust, Department of Radiology (United Kingdom); Gungor, Hatice [Imperial College Healthcare NHS Trust, Department of Oncology (United Kingdom); Haydar, Ali A. [Barts and the London NHS Trust, Department of Radiology (United Kingdom); Wasan, Harpreet S. [Imperial College Healthcare NHS Trust, Department of Oncology (United Kingdom); Tait, Nicholas P. [Imperial College Healthcare NHS Trust, Department of Radiology (United Kingdom)

    2012-08-15

    Introduction: The gastroduodenal artery (GDA) is usually embolised to avoid nontarget dispersal before yttrium-90 (Y{sup 90}) radioembolisation to treat liver metastases. In a minority of patients, there is retrograde flow in the GDA. The purpose of this study was to determine if there is any increased risk from maintaining a patent GDA in patients with reversed flow. Materials and Methods: A retrospective review was performed of all patients undergoing Y{sup 90} radioembolisation at our institution. The incidence of toxicities arising from nontarget radioembolisation by way of the GDA (gastric/duodenal ulceration, gastric/duodenal bleeding, and pancreatitis) and death occurring within 2 months of treatment were compared between the reversed and the antegrade GDA groups. Results: Ninety-two patients underwent preliminary angiography. Reversed GDA flow was found on angiography in 14.1% of cases; the GDA was not embolised in these patients. The GDA was coiled in 55.7% of patients with antegrade GDA flow to prevent inadvertent dispersal of radioembolic material. There was no increased toxicity related to nontarget dispersal by way of the GDA, or increased early mortality, in patients with reversed GDA flow (P > 0.05). Conclusion: In patients with reversed GDA flow, maintenance of a patent GDA before administration of Y{sup 90} radioembolisation does not increase the risk of toxicity from nontarget dispersal. Therapeutic injection, with careful monitoring to identify early vascular stasis, may be safely performed beyond the origin of the patent GDA. A patent GDA with reversed flow provides forward drive for infused particles and may allow alternative access to the hepatic circulation.

  4. Venous ulcer review

    Science.gov (United States)

    Bevis, Paul; Earnshaw, Jonothan

    2011-01-01

    Clinical question: What is the best treatment for venous ulcers? Results: Compression aids ulcer healing. Pentoxifylline can aid ulcer healing. Artificial skin grafts are more effective than other skin grafts in helping ulcer healing. Correction of underlying venous incompetence reduces ulcer recurrence. Implementation: Potential pitfalls to avoid are: Failure to exclude underlying arterial disease before application of compression.Unusual-looking ulcers or those slow to heal should be biopsied to exclude malignant transformation. PMID:21673869

  5. Therapeutic effect of D-002 (abexol) on gastric ulcer induced experimentally in rats.

    Science.gov (United States)

    Molina, Vivian; Carbajal, Daisy; Arruzazabala, Lourdes; Más, Rosa

    2005-01-01

    D-002 is a mixture of higher aliphatic primary alcohols isolated from beeswax, wherein triacontanol is the most abundant alcohol, with antioxidant and anti-ulcer properties. Since compounds with cytoprotective and antioxidant effects can improve healing of gastroduodenal ulcer induced by noxious agents, this work investigated the healing effect of D- 002 on acute and chronic gastric ulcers induced with indomethacin and acetic acid, respectively, in rats. Acute gastric ulcer was induced with single oral doses of indomethacin (20 mg/kg). Treatments with D-002 at 50, 100, and 200 mg/kg or vehicle were administered 3 hours after ulcer induction. Three hours later, rats were sacrificed, and the stomach was removed for quantifying the lesions. Chronic gastric ulcer was induced by 50 microL of 80% acetic acid application on the anterior serosal surface of the glandular stomach during 20 seconds. Twenty-four hours later D-002 at 50, 100, and 200 mg/kg or vehicle was administered for 5 days. At the end of the treatment, animals were fasted for 24 hours and sacrificed, the stomachs were removed, and the lesions were quantified. D-002 orally administered at 100 and 200 mg/kg acutely significantly healed gastric ulcers induced with indomethacin by 39% and 56% compared with positive controls, respectively. Also, D-002 at 200 mg/kg, but not at 50 or 100 mg/kg, administered orally for 5 days after ulcer induction exerted a significant healing effect (65.8% inhibition) in gastric ulcers induced with acetic acid. In conclusion, this work demonstrated that D-002 administered after ulcer induction induced effective healing of acute and chronic gastric ulcers provoked by, respectively, indomethacin and acetic acid.

  6. Complex endoscopic treatment of acute gastrointestinal bleeding of ulcer origin

    Directory of Open Access Journals (Sweden)

    V. V. Izbitsky

    2013-06-01

    Full Text Available Gastrointestinal bleeding (GIB is determined in 20-30% of patients with peptic ulcer disease. Acute gastrointestinal bleeding is on the first place as the main cause of deaths from peptic ulcer ahead of the other complications. Rebleeding occurs in 30-38% of patients. Materials and Methods For getting of the objective endoscopic picture in patients with bleeding gastroduodenal ulcers we used the classification of J.A. Forrest in our study: Type I - active bleeding: • I a - pulsating jet; • I b - stream. Type II - signs of recent bleeding: • II a - visible (non-bleeding visible vessel; • II b - fixed thrombus - a clot; • II c - flat black spot (black bottom ulcers. Type III - ulcer with a clean (white down. Integrated endoscopic hemostasis included: irrigation of ulcer defect and area around it with 3% hydrogen peroxide solution in a volume of 10 - 30ml; Injection of 2-4 mL of diluted epinephrine (1:10000 for hemostasis; use of Argon plasma coagulation. Results and Discussion Integrated endoscopic stop of bleeding was performed in 57 patients who were examined and treated at the Department of Surgery from 2006 to 2012. In 16 patients bleeding was caused by gastric ulcer. Gastric ulcer type I localization according to classification (HD Johnson, 1965 was determined in 9 patients, type II - in 2 patients, type III – in 5 patients. In 31 patients bleeding was caused by duodenal peptic ulcer, in 4 patients - erosive gastritis, 1 - erosive esophagitis, and in 5 patients - gastroenteroanastomosis area peptic ulcer. Final hemostasis was achieved in 55 (96.5% patients. In 50 (87.7% patients it was sufficient to conduct a single session of complex endoscopic treatment. In 5 (8.8% patients – it was done two times. In 2 (3.5% cases operation was performed due to the recurrent bleeding. The source of major bleeding in these patients was: chronic, duodenal ulcer penetrating into the head of the pancreas in one case complicated by subcompensated

  7. Age and sex influence on formation of gastroesophageal reflux disease in children with chronic gastroduodenitis

    Directory of Open Access Journals (Sweden)

    Chemenkov Yu.V.

    2013-12-01

    Full Text Available The research goal is to investigate age and sex influence on formation of gastroesophageal reflux disease in children with chronic gastroduodenitis. Material and Methods. Features of acidity in esophagus and cardial part of stomach was studied in 175 children aged 4 to 17 years with chronic gastroduodenitis by pH-monitoring. pH-monitoring was carried by «Gastroscan-24». Age and sex characteristics have been identified on examination results. Results. Children of preschool age experience the most unfavorable reflux from the stomach to the esophagus. Boys experience the pathological reflux more severely. Conclusions: Effectiveness of esophageal clearance is lower in children of preschool age. Pathological reflux progresses are more favorably in a standing position, especially in children of preschool age. Pathological reflux occurs more often in the supine position and has a longer and more aggressive course in preschool age boys.

  8. Oral Ulcerations

    Directory of Open Access Journals (Sweden)

    Brandon Fetterolf

    2015-12-01

    Full Text Available A 35-year-old male presented with lower gum pain associated with fever, chills, and sore throat. His medical history included intravenous drug use, human immunodeficiency virus infection, and hepatitis C. Physical exam revealed tachycardia, a temperature of 38.9°C, anterior cervical lymphadenopathy, halitosis, an edematous lower lip, and purulent ulcers anterior and posterior to lower central incisors with marked tenderness and erythema (Figure. His laboratory work was notable for a low white blood cell count (2.6 thousand/µl, neutropenia (0.11 thousand/µl, a low absolute CD4 lymphocyte count (0.5 thousand/µl, and elevated C-reactive protein (129mg/L and sedimentation rate (23mm/hr. A computed tomography study showed a 0.5×1.3×0.3cm abscess anterior to the mandibular symphysis.

  9. Solitary rectal ulcer syndrome and stercoral ulcers.

    Science.gov (United States)

    Edden, Yair; Shih, Shirley S; Wexner, Steven D

    2009-09-01

    Colonic ulcerations can affect the entire colon and rectum, and have variable clinical presentation according to the anatomic location and underlying pathology. Diverse causes may lead to colonic ulceration, such as inflammatory bowel diseases, oral drugs (mostly nonsteroidal anti-inflammatory drugs), local or diffuse ischemia, and different intestinal microorganisms. An ulcer may also herald a concealed malignant disease. In most cases, colonic ulcerate is associated with diffuse colitis in the acute setup or with inflammatory bowel diseases, and to the lesser extent the ulceration is defined as solitary. This article focuses on two of the less commonly diagnosed diseases: solitary rectal ulcer syndrome and stercoral ulceration, both related to local tissue ischemia and often seen in the elderly population.

  10. Hepatocellular Carcinoma Complicated by Gastroduodenal Obstruction: Palliative Treatment with Metallic Stent Placement

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ye Jin; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Song, Ho-Young; Park, Jung-Hoon; Na, Han Kyu; Kim, Pyeong Hwa; Fan, Yong [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of)

    2012-10-15

    Purpose: To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC). Methods: Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C. Results: Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients could eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death. Conclusion: Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC.

  11. Venous ulcer review

    OpenAIRE

    Bevis, Paul; Earnshaw, Jonothan

    2011-01-01

    Paul Bevis, Jonothan Earnshaw Department of Vascular Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UKDate of preparation: 3 February 2011Conflict of interest: None declared.Clinical question: What is the best treatment for venous ulcers?Results: Compression aids ulcer healing. Pentoxifylline can aid ulcer healing. Artificial skin grafts are more effective than other skin grafts in helping ulcer healing. Correction of underlying venous incompetence reduces ulcer recu...

  12. Perforated Gastric Ulcer Associated with Anti-Angiogenic Therapy

    Directory of Open Access Journals (Sweden)

    Diogo Libânio

    2017-08-01

    Full Text Available Anti-angiogenic therapy with bevacizumab, an inhibitor of vascular endothelial growth factor, is commonly used in metastatic colorectal cancer and is rarely associated with gastrointestinal perforation, perforation being more frequent in the primary tumor site or at the anastomotic level. We present the case of a 64-year-old male with stage IV rectal adenocarcinoma who was on palliative chemotherapy with FOLFOX and bevacizumab. After the 4th chemotherapy cycle, our patient started fever and epigastric pain. He was hemodynamically stable, and signs of peritoneal irritation were absent. There were no alterations in the abdominal X-ray, and C-reactive protein was markedly elevated. A CT scan revealed a de novo thickness in the gastric antrum. Upper digestive endoscopy showed an ulcerated 40-mm lesion in the angulus, with a 20-mm orifice communicating with an exsudative cavity revested by the omentum. A conservative approach was decided including fasting, broad-spectrum intravenous antibiotics, and proton-pump inhibitors. Subsequent gastroduodenal series showed no contrast extravasation, allowing the resumption of oral nutrition. Esophagogastroduodenoscopy after 8 weeks showed perforation closure. Biopsies did not show neoplastic cells or Heliobacter pylori infection. Although the success in the conservative management of perforation allowing the maintenance of palliative chemotherapy (without bevacizumab, the patient died after 4 months due to liver failure. The reported case shows an uncommon endoscopic finding due to a rare complication of anti-angiogenic therapy. Additionally, it reminds clinicians that a history of gastroduodenal ulcers should be actively sought before starting anti-angiogenic treatment and that suspicion for perforation should be high in these cases.

  13. Ischemic ulcers - self-care

    Science.gov (United States)

    ... ulcers - self-care; Arterial insufficiency ulcer self-care; Ischemic wounds - self-care; Peripheral artery disease - ulcer; Peripheral ... arteries ( atherosclerosis ) are the most common cause of ischemic ulcers. Clogged arteries prevent a healthy supply of ...

  14. Diabetic foot disease: impact of ulcer location on ulcer healing

    DEFF Research Database (Denmark)

    Pickwell, KM; Siersma, Volkert Dirk; Kars, M

    2013-01-01

    Healing of heel ulcers in patients with diabetes is considered to be poor, but there is relatively little information on the influence of ulcer location on ulcer healing.......Healing of heel ulcers in patients with diabetes is considered to be poor, but there is relatively little information on the influence of ulcer location on ulcer healing....

  15. Profilaxia das úlceras associadas ao estresse Prophylaxis of ulcers associated with stress

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Pompilio

    2010-06-01

    Full Text Available INTRODUÇÃO: As úlceras da mucosa gastroduodenal que aparecem após graves insultos têm sido chamadas de úlceras associadas ao estresse ou, mais genericamente, de "doença mucosa associada ao estresse" (DMAE. São conhecidas desde a Antiguidade e apesar de relacionarem-se com altos índices de morbidade e mortalidade, esquemas de profilaxia no intuito de minimizar seus riscos, só foram introduzidos recentemente. Os inibidores da bomba de prótons têm desempenhado papel importante nesse cenário. MÉTODOS: O presente artigo é uma breve revisão sobre seu uso dentro do contexto clínico da profilaxia do sangramento gastrointestinal relacionado ao estresse.INTRODUCTION: Gastroduodenal mucosal ulcers that appear after severe insults have been called ulcers associated with stress or, more generally, "mucosal disease associated with stress" (DMAE. Are known since antiquity and although linked with high morbidity and mortality, prevention schemes in order to minimize their risk, were introduced only recently. The proton pump inhibitors have played an important role in this scenario. METHODS: This article is a brief review of its use within the clinical context of prophylaxis of gastrointestinal bleeding due to stress.

  16. Endoscopic laser Doppler flowmetry in the experiment and in the bleeding gastric and duodenal ulcer clinic

    Science.gov (United States)

    Kapralov, S. V.; Shapkin, Y. G.; Lychagov, V. V.; Tuchin, V. V.

    2007-05-01

    One of the most complex problems of emergency surgery is the choice of surgical tactics to deal with bleeding peptic ulcer. Endoscopic hemostasis is prescribed to patients with continuing bleedings and prerelapse syndrome. But till nowdays the objective verification of the prerelapse condition had not been worked out. What is more there are no objective criteria to judge the effectiveness of the carried endohemostasis. The aim of the study was to work out a new objective diagnostic method of pre-recurrence syndrome that can be able to make prognosis for possible gastroduodenal ulcer bleeding recurrence more precise. Laser Doppler flowmetry was the method of studies the regional perfusion. The device used in this work was made at the Optics and Biophysics Department of Saratov State University.

  17. Types of Ulcerative Colitis

    Science.gov (United States)

    ... Colitis? > Types of Ulcerative Colitis Types of Ulcerative Colitis Email Print + Share If you are diagnosed with ... abdomen may occur in active disease. Left-sided Colitis Continuous inflammation that begins at the rectum and ...

  18. High Serum Pepsinogen I and beta Helicobacter pylori Infection Are Risk Factors for Aspirin-Induced Gastroduodenal Injury.

    Science.gov (United States)

    Shan, Jing; Lei, Hongjun; Shi, Wei; Sun, Xiaobin; Tang, Yu; Ren, Chunrong

    2018-01-01

    Whether gastric hyperchlorhydria and Helicobacter pylori infection contribute to aspirin-induced gastroduodenal injury still lacks evidence. Because serum pepsinogens (PGs) and gastrin-17 (G17) can reflect gastric acid secretion, this study intended to elucidate whether serum PGs, serum G17, and H. pylori infection are associated with aspirin-induced gastrointestinal injury. A total of 60 patients taking low-dose aspirin for more than 1 month were enrolled in this study. Serum PG I, PG II, and G17 were determined using ELISA. A 14C-urea breath test was used for the detection of an H. pylori infection. The modified Lanza score was used to evaluate the degree of gastroduodenal injury under endoscopy. The median serum PG I level was significantly higher in the intensive gastroduodenal injury (IGI) group compared to that in the mild gastroduodenal injury group (155.0 vs. 116.6 ng/mL, p = 0.006). The H. pylori infection rate was significantly higher in the IGI group (73 vs. 40%, p = 0.037). Receiver operator characteristic curves analysis revealed that the cutoff value of PG I was 123 ng/mL, with 80% sensitivity and 61.4% specificity. H. pylori infection combined with PG I at >123 ng/mL had an OR (95% CI) of 15.8 (2.4 ± 104.5) for the prediction of aspirin-induced gastroduodenal injury. Key Messages: Serum PG I and H. pylori infection could be used to identify potential high-risk aspirin-induced gastroduodenal injury patients. © 2017 S. Karger AG, Basel.

  19. MORPHOLOGICAL TRAITS OF A CHRONIC GASTRODUODENITIS AT PRESCHOOLERS WITH VARIOUS AMYLOLYTIC ACTIVITY OF THE MIXED SALIVA

    Directory of Open Access Journals (Sweden)

    N. Ye. Sazanova

    2014-01-01

    Full Text Available Background: The aim of the study was to to estimate traits of the morphofunctional changes of a gastroduodenal mucous membrane at chronic inflammatory diseases of the upper digestive tract at preschoolers with various level of amylolytic activity of saliva. Patients and methods: 145 children at the age of 3–7 years with chronic inflammatory diseases of a stomach and duodenum are surveyed. The amylolytic activity of the mixed saliva by Smith-Roy-Ugolev amylolytic method was determined at patients. 2 clinical groups with account of median (the 50th percentile distribution of amylolytic activity of saliva are created: the first — with indicators below the median (n =72, the second — with indicators above or equal to the median (n =73. The endoscopic research (all children, histological research bioptates (n =63, morphometric analysis of a duodenum mucous membrane (n =26 were applied for the purpose of assessment of a morphofunctional condition of a stomach and duodenum. Results: It is established that predominant duodenum involvement, high frequency of isolated duodenitis, subatrophic and dystrophic changes of a duodenal mucous membrane, bigger intensity and depth of inflammatory process against lower level of nonspecific tissue protection, existence of signs of an allergic inflammation are characteristic for patients with low amylolytic activity of saliva. Conclusion: Determination of amylolytic activity of the mixed saliva at children with inflammatory diseases of a stomach and duodenum is available, noninvasive informative diagnostic test orienting in assessment of a character and extent of involvement of a gastroduodenal mucous membrane and allowing in due time to reveal the patients needing the profound inspection of gastroduodenal area and also to exclude food allergy.

  20. Sitting: pressure ulcer development.

    Science.gov (United States)

    Collins, F

    Seating is a major factor in pressure ulcer development, but it is frequently overlooked in the literature on pressure area management. Pressure ulcers are largely preventable and nurses are integral to the promotion of good practice. The author examines how implementing careful patient assessment, correct positioning and providing optimum seating equipment can help to reduce the risk of pressure ulcer development.

  1. Peptic Ulcer Disease

    Science.gov (United States)

    ... Home / Digestive Health Topic / Peptic Ulcer Disease Peptic Ulcer Disease Basics Overview An “ulcer” is an open sore. The word “peptic” means ... time when a gastroenterologist is referring to an “ulcer” the doctor means a peptic ulcer. The two ...

  2. Resultados en el tratamiento quirúrgico de la úlcera gastroduodenal perforada

    OpenAIRE

    Yandy Rodriguez Acosta; Rolando Delgado Figueredo; Reinaldo Jiménez Prendes; Jesús Iván González Batista; Daily Collazo Pérez; Dainelys Collazo Pérez

    2013-01-01

    Fundamento: En la actualidad el tratamiento de la úlcera gastroduodenal perforada ha experimentado importantes cambios; pues no sería indicado la cirugía antisecretora ni resectiva, ya que se puede conseguir el mismo efecto con los inhibidores de la bomba de protones y con la erradicación del Helicobacter pylori. La recidiva es infrecuente, aunque en ocasiones con la cirugía no definitiva los síntomas reaparecen y hasta surgen nuevas perforaciones. Objetivo: Describir los resultados obtenidos...

  3. Efficacy of Levofloxacin-Based Third-Line Therapy for the Eradication of Helicobacter pylori in Peptic Ulcer Disease

    Science.gov (United States)

    Lim, Joo Hyun; Kim, Sang Gyun; Song, Ji Hyun; Hwang, Jae Jin; Lee, Dong Ho; Han, Jae Pil; Hong, Su Jin; Kim, Ji Hyun; Jeon, Seong Woo; Kim, Gwang Ha; Shim, Ki-Nam; Shin, Woon Geon; Kim, Tae Ho; Kim, Sun Moon; Chung, Il-Kwon; Kim, Hyun-Soo; Kim, Heung Up; Lee, Joongyub; Kim, Jae Gyu

    2017-01-01

    Background/Aims The resistance rate of Helicobacter pylori is gradually increasing. We aimed to evaluate the efficacy of levofloxacin-based third-line H. pylori eradication in peptic ulcer disease. Methods Between 2002 and 2014, 110 patients in 14 medical centers received levofloxacin-based third-line H. pylori eradication therapy for peptic ulcer disease. Of these, 88 were included in the study; 21 were excluded because of lack of follow-up and one was excluded for poor compliance. Their eradication rates, treatment regimens and durations, and types of peptic ulcers were analyzed. Results The overall eradiation rate was 71.6%. The adherence rate was 80.0%. All except one received a proton-pump inhibitor, amoxicillin, and levofloxacin. One received a proton-pump inhibitor, amoxicillin, levofloxacin, and clarithromycin, and the eradication was successful. Thirty-one were administered the therapy for 7 days, 25 for 10 days, and 32 for 14 days. No significant differences were observed in the eradication rates between the three groups (7-days, 80.6% vs 10-days, 64.0% vs 14-days, 68.8%, p=0.353). Additionally, no differences were found in the eradiation rates according to the type of peptic ulcer (gastric ulcer, 73.2% vs duodenal/gastroduodenal ulcer, 68.8%, p=0.655). Conclusions Levofloxacin-based third-line H. pylori eradication showed efficacy similar to that of previously reported first/second-line therapies. PMID:27609487

  4. Efficacy of Levofloxacin-Based Third-Line Therapy for the Eradication of Helicobacter pylori in Peptic Ulcer Disease.

    Science.gov (United States)

    Lim, Joo Hyun; Kim, Sang Gyun; Song, Ji Hyun; Hwang, Jae Jin; Lee, Dong Ho; Han, Jae Pil; Hong, Su Jin; Kim, Ji Hyun; Jeon, Seong Woo; Kim, Gwang Ha; Shim, Ki-Nam; Shin, Woon Geon; Kim, Tae Ho; Kim, Sun Moon; Chung, Il-Kwon; Kim, Hyun-Soo; Kim, Heung Up; Lee, Joongyub; Kim, Jae Gyu

    2017-03-15

    The resistance rate of Helicobacter pylori is gradually increasing. We aimed to evaluate the efficacy of levofloxacin-based third-line H. pylori eradication in peptic ulcer disease. Between 2002 and 2014, 110 patients in 14 medical centers received levofloxacin-based third-line H. pylori eradication therapy for peptic ulcer disease. Of these, 88 were included in the study; 21 were excluded because of lack of follow-up and one was excluded for poor compliance. Their eradication rates, treatment regimens and durations, and types of peptic ulcers were analyzed. The overall eradiation rate was 71.6%. The adherence rate was 80.0%. All except one received a proton-pump inhibitor, amoxicillin, and levofloxacin. One received a proton-pump inhibitor, amoxicillin, levofloxacin, and clarithromycin, and the eradication was successful. Thirty-one were administered the therapy for 7 days, 25 for 10 days, and 32 for 14 days. No significant differences were observed in the eradication rates between the three groups (7-days, 80.6% vs 10-days, 64.0% vs 14-days, 68.8%, p=0.353). Additionally, no differences were found in the eradiation rates according to the type of peptic ulcer (gastric ulcer, 73.2% vs duodenal/gastroduodenal ulcer, 68.8%, p=0.655). Levofloxacin-based third-line H. pylori eradication showed efficacy similar to that of previously reported first/second-line therapies.

  5. Diagnosis of oral ulcers.

    Science.gov (United States)

    Schneider, L C; Schneider, A E

    1998-01-01

    Ulcers commonly occur in the mouth. Their causes range from minor irritation to malignancies and systemic diseases. Innocent solitary ulcerations, which result from trauma and infections, must be distinguished from squamous cell carcinomas, which also typically present as solitary ulcers. Multiple oral ulcers may be classified as acute, recurrent and/or chronic. The most common causes of rapid-onset oral ulcers include acute necrotizing ulcerative gingivitis, allergies and erythema multiforme. The two common forms of acute (short-term) recurrent oral ulcers, "cold sores" or "fever blisters," which are caused by the herpes simplex virus, and recurrent aphthous ulcers ("canker sores"), may be distinguished largely on the basis of their location. Most types of multiple chronic oral ulcers are associated with disturbances of the immune system. They include erosive lichen planus, mucous membrane pemphigoid and pemphigus vulgaris. Clinical criteria which are most useful in identifying the cause of oral ulcers are vesicles or bullae, which may not be seen because they rupture rapidly in the oral environment; constitutional signs and symptoms; and lesions on the skin and/or other mucosa. In some cases, diagnosis depends upon culture or biopsy, particularly with the application of immunofluorescence to the surgical specimen.

  6. Segmental embolization of the gastroduodenal artery in a case of a perforated pseudoaneurysm and gastrointestinal bleeding; Segmentembolisation der Arteria gastroduodenalis bei perforiertem Pseudoaneurysma und gastrointestinaler Massivblutung

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R. [Inst. fuer Diagnostische Radiologie der Friedrich-Alexander-Univ. Nuernberg-Erlangen (Germany); Inst. fuer Diagnostische und Interventionelle Radiologie der Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany); Cavallaro, A.; Bautz, W. [Inst. fuer Diagnostische Radiologie der Friedrich-Alexander-Univ. Nuernberg-Erlangen (Germany)

    2004-07-01

    We present the history of a woman suffering from an extensive gastrointestinal bleeding due to liver cirrhosis and chronic pancreatitis. Selective angiogram of the celiac artery revealed a pseudoaneurysm of the gastroduodenal artery caused by inflammatory wall penetration. The life-threatening hemorrhage was completely stopped by embolization with three stainless steel coils after microcatheter engagement of the gastroduodenal artery. The particularity of this case is the restricted embolization of the aneurysm vessel segment, so the collateral circulation of the gastroduodenal and pancreaticoduodenal artery could be preserved. (orig.)

  7. Marjolin's warty ulcer.

    Science.gov (United States)

    Sharma, Amit; Schwartz, Robert A; Swan, Kenneth G

    2011-02-01

    Marjolin's ulcer refers to malignant change within burn scar. The French surgeon Jean-Nicolas Marjolin is honored with the eponym. Marjolin described the "warty ulcer" in the first edition of Dictionnaire de Medécine. In his description, Marjolin did not actually state that this ulcer represented malignant transformation. Credit for noting the specific association involved in Marjolin's ulcer belongs to Caesar Hawkins, an English Surgeon, who described skin cancer arising in burn and flogging scars. Copyright © 2010 Wiley-Liss, Inc.

  8. Definition and Facts for Peptic Ulcers (Stomach Ulcers)

    Science.gov (United States)

    ... For Health Professionals Diabetes Discoveries & Practice Blog Health Communication Programs FAQs ... (Stomach Ulcers) Definition & Facts Related Topics Section Navigation Peptic Ulcers (Stomach ...

  9. Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity

    DEFF Research Database (Denmark)

    Frøkjaer, J B; Bergmann, S; Brock, C

    2016-01-01

    , using transcutaneous electrical vagal nerve stimulation (t-VNS) and deep slow breathing (DSB) respectively, could increase musculoskeletal pain thresholds and enhance gastroduodenal motility in healthy subjects. METHODS: Eighteen healthy subjects were randomized to a subject-blinded, sham......-controlled, cross-over study with an active protocol including stimulation of auricular branch of the vagus nerve, and breathing at full inspiratory capacity and forced full expiration. Recording of cardiac derived parameters including cardiac vagal tone, moderate pain thresholds to muscle, and bone pressure......BACKGROUND: The parasympathetic nervous system, whose main neural substrate is the vagus nerve, exerts a fundamental antinociceptive role and influences gastrointestinal sensori-motor function. Our research question was to whether combined electrical and physiological modulation of vagal tone...

  10. Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.

    Science.gov (United States)

    Yang, Jia-Hua; Zhang, Min; Zhao, Zhi-Hua; Shu, Yu; Hong, Jun; Cao, Yi-Jun

    2015-02-21

    Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermittent, colicky abdominal pain, nausea, and vomiting for over 4 wk accompanied by a weight loss. A diagnosis of gastric intussusception was made by computed tomography. A Billroth II distal gastrectomy was then performed, and complete en bloc removal (R0 resection) was achieved. Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.

  11. Treatment of malignant gastroduodenal obstruction with using a newly designed complex expandable nitinol stent: initial experiences

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Mi Hee; Ko, Ji Ho; Lee, Eun Jung; Oh, Kyeng Seung; Huh, Jin Do; Cho, Young Duk; Park, Seun Ja [College of Medicine, Kosin University, Busan (Korea, Republic of); Jung, Gyoo Sik [Ulsan Hospital, Ulsan (Korea, Republic of)

    2005-12-15

    We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were investigated during the follow up period. Stent placement was successful in all the patients. After stent placement, the symptoms improved in all but one patient. During the follow up, stent migration occurred in one patient (3%) at 34 days after the procedure. Despite the stent migration, the patient was able to resume a soft diet. Six patients developed recurrent symptoms of obstruction with tumor overgrowth at a mean of 145 days after the procedure; all the patients underwent coaxial placement of an additional stent with good results. One patient showed recurrence of obstruction due to tumor in-growth, and this was treated by placement of a second stent. Two patients with stent placement in the duodenum suffered from jaundice 26 days and 65 days, respectively, after their procedures. Placement of the newly designed complex expandable nitinol stent seems to be effective for the palliative treatment of malignant gastroduodenal obstructions. The new stent also seems to help overcome the

  12. Ulcerative Colitis - Multiple Languages

    Science.gov (United States)

    ... Expand Section Ulcerative Colitis: MedlinePlus Health Topic - English Colitis ulcerativa: Tema de salud de MedlinePlus - español (Spanish) National Library of Medicine Ulcerative Colitis - español (Spanish) Bilingual PDF Health Information Translations Ukrainian ( ...

  13. Marjolin's Ulcers: A Review

    African Journals Online (AJOL)

    Alasia Datonye

    Method: Literatures on marjolin's ulcers were sourced from available journals and internet based searches using Pubmed, Medline and Google search. Results: The incidence of Marjolin's ulcers appears higher in developing countries. First recognized in the first century AD, a lot is yet to be understood about the evolution ...

  14. Treatment of peptic ulcer

    NARCIS (Netherlands)

    Tytgat, G. N.

    1998-01-01

    The current therapy of choice for all Helicobacter pylori-associated ulcer disease is eradication therapy. Although adequate therapeutic regimens are currently available, often still ineffective therapies are tried. Cure of the infection essentially eliminates the ulcer diathesis. Cure of the

  15. The stress ulcer syndrome

    NARCIS (Netherlands)

    H.A. van Essen

    1986-01-01

    textabstractThe stress ulcer syndrome is described in this thesis. This syndrome is seen in patients admitted to intensive care departments or being treated in field hospitals, in disaster areas, or battle fields. Acute mucosal lesions associated with burns (Curling's ulcers) and central nervous

  16. Study of Relationship Between the Blood Supply of the Extrahepatic Bile Duct and Duct Supply Branches from Gastroduodenal Artery on Imaging and Anatomy

    Directory of Open Access Journals (Sweden)

    Jie Dai

    2015-01-01

    Full Text Available Background: Liver transplantation has become the treatment of choice for patients with end-stage acute or chronic hepatic disease. Bile duct complications are common events after liver transplantation. The aim of this study was to evaluate the blood supply of the human bile duct and identify the underlying mechanisms of bile duct complications after liver transplantation. Methods: The duct supply branches from gastroduodenal artery and blood supply of extrahepatic bile duct system were re-evaluated through selective hepatic angiography from 600 patients. In addition, 33 cadavers were injected with latex casting material into the common hepatic artery, then the extrahepatic bile duct and the branches from the common hepatic artery were carefully dissected to visualize the gastroduodenal artery and its branching to the extrahepatic bile duct. Results: The bile duct artery arose from the branch of the gastroduodenal artery in 8.1% (49/600. Of these 49 individuals, the bile duct artery was supplied by the gastroduodenal artery (61.22%, 30/49, the proper hepatic artery (14.29%, 7/49, or both the gastroduodenal artery and the proper hepatic artery (24.49%, 12/49. In our study of 33 cadavers, the percentage that the bile duct artery arose from the gastroduodenal artery was 27.27%. The blood supply to the bile extrahepatic bile ducts was divided into different segments and formed longitudinal and arterial network anastomosed on the walls of the duct. Conclusions: There is a close relationship between the duct supply branches from gastroduodenal artery and the blood supplying patterns of the extrahepatic bile duct system. In liver transplant surgery, the initial part of the gastroduodenal artery is preferred to be preserved in the donor liver. It is of great significance to improve the success rate of operation and reduce complications.

  17. Study of Relationship Between the Blood Supply of the Extrahepatic Bile Duct and Duct Supply Branches from Gastroduodenal Artery on Imaging and Anatomy

    Science.gov (United States)

    Dai, Jie; Wu, Xiao-Feng; Yang, Chun; Li, Hong-Jun; Chen, Ya-Liang; Liu, Guo-Zhen; Song, Yi-Zhi; Wu, Huan-Huan; Ding, Jin-Li; Li, Ning

    2015-01-01

    Background: Liver transplantation has become the treatment of choice for patients with end-stage acute or chronic hepatic disease. Bile duct complications are common events after liver transplantation. The aim of this study was to evaluate the blood supply of the human bile duct and identify the underlying mechanisms of bile duct complications after liver transplantation. Methods: The duct supply branches from gastroduodenal artery and blood supply of extrahepatic bile duct system were re-evaluated through selective hepatic angiography from 600 patients. In addition, 33 cadavers were injected with latex casting material into the common hepatic artery, then the extrahepatic bile duct and the branches from the common hepatic artery were carefully dissected to visualize the gastroduodenal artery and its branching to the extrahepatic bile duct. Results: The bile duct artery arose from the branch of the gastroduodenal artery in 8.1% (49/600). Of these 49 individuals, the bile duct artery was supplied by the gastroduodenal artery (61.22%, 30/49), the proper hepatic artery (14.29%, 7/49), or both the gastroduodenal artery and the proper hepatic artery (24.49%, 12/49). In our study of 33 cadavers, the percentage that the bile duct artery arose from the gastroduodenal artery was 27.27%. The blood supply to the bile extrahepatic bile ducts was divided into different segments and formed longitudinal and arterial network anastomosed on the walls of the duct. Conclusions: There is a close relationship between the duct supply branches from gastroduodenal artery and the blood supplying patterns of the extrahepatic bile duct system. In liver transplant surgery, the initial part of the gastroduodenal artery is preferred to be preserved in the donor liver. It is of great significance to improve the success rate of operation and reduce complications. PMID:25635427

  18. [Corrective effects of electromagnetic radiation in a millimeter wavelength range on the parameters of oxidative stress after standard anti-helicobacterial therapy in patients with ulcer disease].

    Science.gov (United States)

    Ivanishkina, E V; Podoprigorova, V G

    2012-01-01

    We assessed the possibilities of correction of oxidative stress parameters in the serum and gastroduodenal mucosa using electromagnetic radiation in a millimeter wavelength range in 127 patients with gastric and duodenal ulcer after eradication therapy. Control group included 230 healthy subjects. Parameter of lipid oxidation by free radicals were measured by direct methods (hemiluminescence and EPR-spectroscopy). The results show that standard eradication therapy does not influence parameters of oxidative stress. More pronounced effect of electromagnetic radiation in a millimeter wavelength range may be due to the correction of prooxidant-antioxidant and antioxidant disbalance. This observation provides pathogenetic substantiation for the inclusion of this physical method in modern therapeutic modalities.

  19. High Frequency of vacA s1m2 Genotypes Among Helicobacter pylori Isolates From Patients With Gastroduodenal Disorders in Kermanshah, Iran.

    Science.gov (United States)

    Pajavand, Hamid; Alvandi, Amirhooshang; Mohajeri, Parviz; Bakhtyari, Somaye; Bashiri, Homayoon; Kalali, Behnam; Gerhard, Markus; Najafi, Farid; Abiri, Ramin

    2015-11-01

    Helicobacter pylori infection and related diseases outcome are mediated by a complex interplay between bacterial, host and environmental factors. Several distinct virulence factors of H. pylori have been shown to be associated with different clinical outcomes. Here we focused on vacA and cagA genotypes of H. pylori strains isolated from patients with gastric disorder. The aim of this study was to determine the frequency of two toxins and genotypes of VacA toxin in patients referred to a central hospital in the west of Iran (Imam Reza hospital, Kermanshah) during 2011 - 2012. Samples were collected from patients infected with H. pylori. Gastric biopsy specimens from the stomach antrum and corpus were cultured. PCR analysis was performed for genotyping H. pylori vacA and cagA genes. Helicobacter pylori was isolated from 48% (96/200) of patients with gastroduodenal disorders. In 81/96 (84%) cases, the cagA gene was present. Among different genotypes of vacA, two s1m2 and s2m2 genotypes were dominant with frequency of 39.5% and 50%, respectively. The frequency of the s1m1 genotype was 7.2% (7/96), which is much lower than elsewhere. H. pylori isolates with positive results for cagA gene and vacA s1m2 genotypes showed statistically significant correlation with peptic ulcer (s1m2 13/34 [38.2%] P = 0.003). However, isolates of H. pylori infection with cagA gene and vacA s2m2 genotypes were significantly associated with development of gastritis (s2m2 41/42 [97.6%] P = 0.000). About 90% of H. pylori strains potentially contained vacA s2m2 and s1m2 genotypes. Infection with H. pylori strain containing the cagA gene or the vacA s1m1 and s1m2 genotypes was associated with increased incidence of peptic ulcer disease (PUD).

  20. Endoscopia gastroduodenal após administração de nimesulida, monofenilbutazona e meloxicam em cães Gastroduodenal endoscopy after nimesulide, monophenylbutazone and meloxicam administration in dogs

    Directory of Open Access Journals (Sweden)

    P.R.S. Costa

    2007-08-01

    Full Text Available Avaliaram-se os aspectos da mucosa gastroduodenal em cães tratados experimentalmente com nimesulida, monofenilbutazona e meloxicam. Foram formados quatro grupos com oito cães. Os grupos 1, 2 e 3 receberam, respectivamente, tratamento com nimesulida, monofenilbutazona e meloxicam durante 21 dias, e o grupo 4 foi utilizado como controle. Todos os animais foram avaliados por exames endoscópicos do estômago e duodeno antes do experimento e aos 10 e 21 dias de tratamento. Os cães não manifestaram qualquer alteração clínica ou laboratorial durante o período de estudo. A avaliação endoscópica da mucosa gastroduodenal apresentou apenas lesões consideradas de baixo grau. Esses antiinflamatórios mostraram-se seguros para o trato gastrintestinal de cães clinicamente saudáveis.The gastroduodenal mucosa in dogs experimentally treated with nimesulide, monophenylbutazone and meloxicam was evaluated. There were four groups with eight dogs in each. Groups one, two and three were given nimesulide, monophenylbutazone and meloxicam, respectively, during 21 days and group four was used as control. All animals were evaluated by gastroduodenoscopy before the study and on the 10th and 21st days. The dogs did not show any clinical or laboratorial changes during the study. The endoscopic evaluation of gastroduodenal mucosa showed only low degree lesions. These anti-inflammatory drugs showed to be safe for the gastrointestinal tract in healthy dogs.

  1. Increased expression of matrix metalloproteinase-9 associated with gastric ulcer recurrence.

    Science.gov (United States)

    Li, Sen-Lin; Zhao, Jing-Run; Ren, Xiao-Yan; Xie, Jia-Ping; Ma, Qing-Zhu; Rong, Qiu-Hua

    2013-07-28

    To compare matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in gastric ulcer (GU) and chronic superficial gastritis (CSG). This study enrolled 63 patients with GU and 25 patients with CSG. During upper gastroduodenal endoscopy, we took samples of gastric mucosa from the antrum and ulcer site from patients with GU, and samples of antral mucosa from patients with CSG. Mucosal biopsy tissues were cultured for 24 h, and the culture supernatant was measured for levels of MMP-9 and TIMP-1. After receiving eradication therapy for Helicobacter pylori (H. pylori) and 8 wk proton-pump inhibitor therapy for GU, follow-up endoscopy examination was performed after 6 mo and whenever severe symptoms occurred. Levels of MMP-9 and TIMP-1 at the ulcer site or in the antrum were significantly higher in GU than CSG patients. MMP-9 levels at the ulcer site were significantly higher than in the antrum in GU patients, and had a significantly positive correlation with TIMP-1. MMP-9 levels were significantly higher in H. pylori-positive than H. pylori-negative GU and CSG patients. Levels of MMP-9 or TIMP-1 at the ulcer site were associated with the histological severity of activity and inflammation. About 57 GU patients were followed up, and seven had GU recurrence. H. pyloriinfection and MMP-9 levels were risk factors for the recurrence of GU adjusted for age and sex by multiple logistic regression analysis. MMP-9 may perform an important function in gastric ulcer formation and recurrence.

  2. Pressure Ulcers Surveillance Report

    Directory of Open Access Journals (Sweden)

    Zehra Esin Gencer

    2015-04-01

    Full Text Available Objective: Pressure ulcer is a chronic wound. It reduces the quality of life of the elderly and individuals with restricted range of motion. It prolongs hospital stay and increases the risk of complications. The cost is quite high. Preventive actions for the prevention of pressure ulcers should be developed. Planning protocols and standards of care are among the main targets. Material and Method: Research was conducted in one-year period between 2012 May and 2013 May on patients who were followed up in Akdeniz University Hospital clinics and intensive care unit with pressure ulcers. The research population consisted of 569 patients. Patient data were recorded in SPSS 16 for Windows program. Statistical analyzes were performed with retrospective methods. The demographic characteristics of patients with pressure ulcers were analyzed as frequency and descriptive statistics. Prevalence and incidence of one year were calculated. Results: Of the patients, 58% were males, 42% were females. Of the patients, 36% were in the age range of 61-80 years, and their average length of stay was 42,9 days. Of the patients, 70% were at stage 2 and 3. In 15% of patients pressure ulcers occurred on the first day of hospitalization. Pressure ulcers were developed between days 2 and 10 in 59% of the patients. Prevalence rate was 2.5%, the incidence was 1.9%, the prevalence rate was 5.9% in the intensive care unit. Conclusion: It is easier to prevent pressure ulcers than treating.

  3. Hemoglobinopathies and Leg Ulcers.

    Science.gov (United States)

    Alavi, Afsaneh; Kirsner, Robert S

    2015-09-01

    Major hemoglobinopathies, including sickle cell anemia, are becoming a global health issue. Leg ulcers are the most common cutaneous manifestation of sickle cell disease and an important contributor to morbidity burden in this population. Leg ulcers following sickling disorders are extremely painful, and hard to heal. The clinical evidence for the optimal management of these ulcers is limited. Treating the cause and the strategies to prevent sickling are the mainstay of treatment. The basic principles of wound bed preparation and compression therapy is beneficial in these patients. © The Author(s) 2015.

  4. Peripheral Ulcerative Keratitis

    Science.gov (United States)

    ... Abbreviations Weights & Measures ENGLISH View Professional English Deutsch Japanese Espaniol Find information on medical topics, symptoms, drugs, ... oval in shape. Diagnosis A doctor's evaluation Sometimes culture The diagnosis of peripheral ulcerative keratitis is suspected ...

  5. Perforated peptic ulcer

    DEFF Research Database (Denmark)

    Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M

    2015-01-01

    Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter...... need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research....

  6. Ulcerated cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2015-01-01

    Full Text Available This is a case of a twenty-nine year old male patient who was referred to our dermatology service with an ulcerative lesion of the left cheek of approximately 4 cm, circular, with well-defined borders and a clean base of granulation tissue, as well as 2 ulcerated nodular lesions. The rest of the physical exam was within normal limits.

  7. Gastroduodenal mucosal prostaglandin generation in patients with Helicobacter pylori before and after treatment with bismuth subsalicylate.

    Science.gov (United States)

    Avunduk, C; Suliman, M; Gang, D; Polakowski, N; Eastwood, G L

    1991-04-01

    To determine whether Helicobacter pylori has an effect on gastroduodenal mucosal prostaglandin generation, mucosal biopsies were obtained from the gastric body, antrum, and duodenal bulb of 30 patients who were undergoing upper gastrointestinal endoscopy for clinical indications. One biopsy from the gastric body and one from the antrum were tested for urease activity (urea broth) and one biopsy from each area including the duodenum was processed for histology. Two other biopsies form each area were incubated and the accumulation of prostaglandin E2 and 6-keto prostaglandin F1 alpha in the incubation medium was measured by radioimmunoassay. Twelve of the 17 H. pylori-positive patients and seven of the 13 H. pylori-negative patients agreed to take bismuth subsalicylate (Pepto-Bismol) two tablets four times a day for four weeks. One week after treatment, these patients again underwent endoscopy and the above studies. This study indicates that: (1) mucosal PGE2 generation may be increased in the duodenum, gastric body, and antrum in H. pylori-positive patients compared to H. pylori-negative patients, and (2) treatment with bismuth subsalicylate for four weeks results in reduction of mucosal PGE2 in the duodenum, gastric body, and antrum of H. pylori-positive patients and fails to eradicate H. pylori or reduce gastric inflammation.

  8. Evaluation of Clinicopathological and Risk Factors for Nonmalignant H. Pylori Associated Gastroduodenal Disorders in Iraqi Patients.

    Science.gov (United States)

    Al-Ezzy, Ali Ibrahim Ali

    2015-12-15

    To determine the risk factors associated with H. pylori infection and possible correlation with clinicopathological parameters. Gastroduodenal biopsies were examined by rapid urease test and Gram staining. Cag A cytotoxin was detected by in situ hybridization. Risk of H. pylori acquisition reported as following: Males have 1.38 fold, rural residents have 0.63 fold, Nonsmokers have 0.39 fold, mild smokers have 18 fold, and moderate smokers have 1.4 fold while heavy smokers have 1 fold. A person who's in contact with animals has 1.52 fold risks. Illiterates and patients with primary education have 5.36 & 3 fold risk respectively. Patients under proton pump inhibitor (PPI) therapy have 1.02 fold. Patients under NSAID therapy have 3.48 fold while nonalcoholic Patients have 0.75 fold. Patients using tap water have 0.45 fold risk. H. pylori infection positively correlated with age, weight loss, and heartburn. H. pylori inversely correlated with endoscopic diagnosis, Cag A positivity, and education level. Cag A positivity correlated with animal contact and NSAID usage. Several life style factors, education, animal contact, using of PPI, and NSAIDs increase the risk of H. pylori infection. Weight loss and heartburn cardinal signs for H. pylori infection. Endoscopic diagnosis and clinicopathological parameters not strictly associated with Cag A positivity.

  9. Gastroduodenal artery steal syndrome during liver transplantation: intraoperative diagnosis with Doppler ultrasound and management.

    Science.gov (United States)

    Nishida, Seigo; Kadono, Jun; DeFaria, Werviston; Levi, David M; Moon, Jang I; Tzakis, Andreas G; Madariaga, Juan R

    2005-03-01

    Arterial steal syndrome (ASS) after liver transplantation has been reported. ASS causes arterial hypo-perfusion of the graft liver and devastating consequences. However, the diagnosis tends to be delayed. We present the recognized case of a gastroduodenal artery (GDA) steal syndrome that was diagnosed with intraoperative Doppler ultrasound and treated with GDA ligation during the liver transplantation. The patient had variation of hepatic artery anatomy (low bifurcation of the hepatic artery). Graft liver had the common hepatic artery and aberrant left hepatic artery. Doppler ultrasound of the liver was performed after the arterial reconstruction between the donor common hepatic artery and recipient right hepatic artery. It showed low hepatic arterial flow. There is no backflow bleeding from the donor aberrant left hepatic artery stump. After ligating big GDA, hepatic arterial waveform inside the liver drastically improved and strong backflow bleeding was recognized from the donor left aberrant hepatic artery stump. The current case should show the efficacy of intraoperative Doppler ultrasound of the liver on ASS and alert clinician to ligate GDA to prevent ASS if hepatic arterial flows are suboptimal.

  10. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  11. Buruli Ulcer (Mycobacterium ulcerans Infection)

    Science.gov (United States)

    ... Fact files Questions & answers Features Multimedia Contacts Buruli ulcer ( Mycobacterium ulcerans infection) Fact sheetUpdated February 2017 Key facts Buruli ulcer is a chronic debilitating disease caused by Mycobacterium ...

  12. Acute oral ulcers.

    Science.gov (United States)

    Lehman, Julia S; Rogers, Roy S

    2016-01-01

    Accurate diagnosis of acute oral ulcers can be challenging. Important historic details include the pattern of recurrence, anatomic areas of involvement within the mouth and elsewhere on the mucocutaneous surface, associated medical symptoms or comorbidities, and symptomology. Careful mucocutaneous examination is essential. When necessary, biopsy at an active site without ulceration is generally optimal. Depending on the clinical scenario, supplemental studies that may be useful include cultures; perilesional biopsy for direct immunofluorescence testing; and evaluation for infectious diseases, gluten sensitivity, inflammatory bowel disease, human immunodeficiency virus infection, connective tissue diseases, or hematinic deficiencies. Clinicians should maintain a broad differential diagnosis when evaluating patients with acute oral ulcers. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Differences in Genome Content among Helicobacter pylori Isolates from Patients with Gastritis, Duodenal Ulcer, or Gastric Cancer Reveal Novel Disease-Associated Genes▿ †

    Science.gov (United States)

    Romo-González, Carolina; Salama, Nina R.; Burgeño-Ferreira, Juan; Ponce-Castañeda, Veronica; Lazcano-Ponce, Eduardo; Camorlinga-Ponce, Margarita; Torres, Javier

    2009-01-01

    Helicobacter pylori establishes a chronic infection in the human stomach, causing gastritis, peptic ulcer, or gastric cancer, and more severe diseases are associated with virulence genes such as the cag pathogenicity island (PAI). The aim of this work was to study gene content differences among H. pylori strains isolated from patients with different gastroduodenal diseases in a Mexican-Mestizo patient population. H. pylori isolates from 10 patients with nonatrophic gastritis, 10 patients with duodenal ulcer, and 9 patients with gastric cancer were studied. Multiple isolates from the same patient were analyzed by randomly amplified polymorphic DNA analysis, and strains with unique patterns were tested using whole-genome microarray-based comparative genomic hybridization (aCGH). We studied 42 isolates and found 1,319 genes present in all isolates, while 341 (20.5%) were variable genes. Among the variable genes, 127 (37%) were distributed within plasticity zones (PZs). The overall number of variable genes present in a given isolate was significantly lower for gastric cancer isolates. Thirty genes were significantly associated with nonatrophic gastritis, duodenal ulcer, or gastric cancer, 14 (46.6%) of which were within PZs and the cag PAI. Two genes (HP0674 and JHP0940) were absent in all gastric cancer isolates. Many of the disease-associated genes outside the PZs formed clusters, and some of these genes are regulated in response to acid or other environmental conditions. Validation of candidate genes identified by aCGH in a second patient cohort allowed the identification of novel H. pylori genes associated with gastric cancer or duodenal ulcer. These disease-associated genes may serve as biomarkers of the risk for severe gastroduodenal diseases. PMID:19237517

  14. [Peculiarities of constellation of parental pairs as risk factors and resistance-factors in the formation of gastroduodenal pathology in children].

    Science.gov (United States)

    Lychkovs'ka, O L; Hnateĭko, O Z; Kulachkovs'ka, I Iu; Semen, V D

    2014-01-01

    Current study is dedicated to determination of psychosocial factors of predisposition and resistance to the formation of upper gastrointestinal pathology in children. For the examination of parental pairs Minnesota Multiphasic Personality Inventory (MMPI) questionnaire and genealogical method Family Study were used. There were revealed following risk-factors of the formation of gastroduodenal pathology in children: the dominant mother's position; passive and shun father's behavior; protracted conflicts; hidden hostility between the parents; poor support, emotional warmth, and unity in the family; available external control of the family. Described family constellation can promote basic conflict in patients with gastroduodenal pathology by F. Alexander. This could be an indication for the family psychological counselling, which can be regarded as a "reserve" for increasing of the effectiveness of treatment and prevention of gastroduodenal pathology in children.

  15. Giant Ulcerative Dermatofibroma

    Directory of Open Access Journals (Sweden)

    Turgut Karlidag

    2013-01-01

    Full Text Available Dermatofibroma is a slowly growing common benign cutaneous tumor characterized by hard papules and nodules. The rarely seen erosions and ulcerations may cause difficulties in the diagnosis. Dermatofibrosarcoma protuberans, which is clinically and histopathologically of malignant character, displays difficulties in the diagnosis since it has similarities with basal cell carcinoma, epidermoid carcinoma, and sarcomas. Head and neck involvement is very rare. In this study, a giant dermatofibroma case, which is histopathologically, ulcerative dermatofibroma, the biggest lesion of the head and neck region and seen rarely in the literature that has characteristics similar to dermatofibrosarcoma protuberans, has been presented.

  16. Dysplasia in Ulcerative Colitis

    OpenAIRE

    RH Riddell

    1990-01-01

    Patients at highest risk for developing cancer in ulcerative colitis are those with ‘extensive’ or total involvement of the large bowel who have had the disease for at least seven years. Dysplasia is used as a marker bur has many problems including those of sampling, reproducibility and management. The risk in patients with colitis is unclear particularly in those with left-sided or distal ulcerative colitis. In countries at high risk from colorectal cancer about 4 to 6% of the population can...

  17. Klinefelter Syndrome With Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Narendra G

    1999-01-01

    Full Text Available Leg ulcers are frequently caused by venous insufficiency, arterial insufficiency, neuropathy, or a combination of these factors. Klinefelter syndrome in association with chronic leg ulcers have been reported earlier. We report a case of Klinefelter syndrome with non- healing ulcer. The diagnosis of the Klinefelter syndrome was confirmed by karyotyping.

  18. An Assessment of Radiologically Inserted Transoral and Transgastric Gastroduodenal Stents to Treat Malignant Gastric Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Bethany H. T., E-mail: bmiller@doctors.org.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Griffiths, Ewen A., E-mail: Eagriffiths@doctors.org.uk [The New Queen Elizabeth Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Pursnani, Kishore G., E-mail: Kish.Pursnani@lthtr.nhs.uk; Ward, Jeremy B., E-mail: Jeremy.Ward@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Stockwell, Robert C., E-mail: Robert.Stockwell@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Chorley and South Ribble Hospital, Department of Radiology (United Kingdom)

    2013-12-15

    IntroductionSelf-expanding metallic stents (SEMS) are used to palliate malignant gastric outlet obstruction (GOO) and are useful in patients with limited life expectancy or severe medical comorbidity, which would preclude surgery. Stenting can be performed transorally or by a percutaneous transgastric technique. Our goal was to review the outcome of patients who underwent radiological SEMS insertion performed by a single consultant interventional radiologist. Methods: Patients were identified from a prospectively collected database held by one consultant radiologist. Data were retrieved from radiological reports, multidisciplinary team meetings, and the patients' case notes. Univariate survival analysis was performed. Results: Between December 2000 and January 2011, 100 patients (63 males, 37 females) had 110 gastroduodenal stenting procedures. Median age was 73 (range 39-89) years. SEMS were inserted transorally (n = 66) or transgastrically (n = 44). Site of obstruction was the stomach (n = 37), duodenum (n = 50), gastric pull-up (n = 10), or gastroenterostomy (n = 13). Seven patients required biliary stents. Technical success was 86.4 %: 83.3 % for transoral insertion, 90.9 % for transgastric insertion. Eleven patients developed complications. Median GOO severity score: 1 pre-stenting, 2 post-stenting (p = 0.0001). Median survival was 54 (range 1-624) days. Post-stenting GOO severity score was predictive of survival (p = 0.0001). Conclusions: The technical success rate for insertion of palliative SEMS is high. Insertional technique can be tailored to the individual depending on the location of the tumor and whether it is possible to access the stomach percutaneously. Patients who have successful stenting and return to eating a soft/normal diet have a statistically significant increase in survival.

  19. A case of an unruptured hepatic aneurysm on the common hepatic artery at the junction of the gastroduodenal and proper hepatic arteries treated with transcatheter arterial embolization.

    Science.gov (United States)

    Imai, Yusuke; Hirooka, Masashi; Koizumi, Yohei; Nakamura, Yoshiko; Watanabe, Takao; Yoshida, Osamu; Tokumoto, Yoshio; Takeshita, Eiji; Abe, Masanori; Hiasa, Yoichi

    2017-01-01

    Hepatic aneurysms are rare, but can prove fatal once they rupture. Transcatheter arterial embolization (TAE) is performed as a prophylactic treatment. The position of the aneurysm determines the degree of difficulty of TAE. Maintaining blood flow to the liver can become difficult, particularly when the aneurysm is at an arterial junction. The patient was a 72-year-old man diagnosed with a hepatic aneurysm. The aneurysm was situated on the common hepatic artery at the junction of the gastroduodenal and proper hepatic arteries. TAE was performed with framing, followed by coil embolization. Blood flow to the liver was maintained via the gastroduodenal artery. Appropriate framing is important for safe and efficient TAE.

  20. Marjolin's Ulcers: A Review

    African Journals Online (AJOL)

    Alasia Datonye

    Background: Marjolin's ulcers though thought to be rare have been reported to have a higher incidence in sub-Saharan Africa. These tumours typically run an aggressive course with a poor prognosis. Late presentation has been reported to be typical of these cancers and some of the reasons adduced for this, are difficulties ...

  1. Diabetes - foot ulcers

    Science.gov (United States)

    ... and disinfected. The wound is probed with a metal instrument to see how deep it is and ... of the ulcer area. This will help speed healing. Be sure to wear shoes that DO NOT put a lot of ... - self-care Diabetes - preventing heart attack and stroke Diabetes - ...

  2. Genital ulcers in women

    NARCIS (Netherlands)

    Bruisten, Sylvia M.

    2003-01-01

    Women who are in a low socioeconomic status are most vulnerable to genital ulcer disease (GUD). GUD is recognized as an important co-factor for acquisition of HIV. GUD etiology has been elucidated in the past decade, with the availability of multiplex polymerase chain reaction. Worldwide, herpes

  3. Duodenal ulcer disease

    NARCIS (Netherlands)

    Tytgat, G. N.

    1996-01-01

    An overview is given of the pathogenic mechanisms involved in Helicobacter pylori-associated duodenal and gastric ulceration. Special attention is given to the role of microbial virulence factors, the effects on gastric acid secretion and the development of 'gastric type' metaplasia in the duodenal

  4. Lithium Battery Diaper Ulceration.

    Science.gov (United States)

    Maridet, Claire; Taïeb, Alain

    2016-01-01

    We report a case of lithium battery diaper ulceration in a 16-month-old girl. Gastrointestinal and ear, nose, and throat lesions after lithium battery ingestion have been reported, but skin involvement has not been reported to our knowledge. © 2015 Wiley Periodicals, Inc.

  5. Ulcerative Lesions in Behcet's Disease

    Directory of Open Access Journals (Sweden)

    Ümit Türsen

    2012-01-01

    Full Text Available Ulcerative lesions in Behcet’s disease (BD are regarded as important manifestation for diagnosis. Various kinds of ulcerative lesions appear in patients with BD. They present as orogenital ulcers, necrotizing vasculitis and pyoderma gengrenosum. Gastrointestinal system involvement (Gis in Behçet’s disease affects all areas from the esophagus to the anus. Most authors believe that the Gis manifestations of Behçet’s disease should be confined to aphthous ulcers, which can occur throughout the Gis tract. All patients with oro-genital and Gis ulcerations should be fully investigated to establish a definitive diagnosis and eliminate the possibility of an underlying BD.

  6. From Bench to Bedside and Back – Report on the European Helicobacter pylori Study Group Xth International Workshop on Gastroduodenal Pathology and Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1998-01-01

    Full Text Available The Xth International Workshop on Gastroduodenal Pathology and Helicobacter pylori was held in Lisbon, Portugal, from September 12 to 14, 1997. State-of-the-art reviews and research findings were presented to over 2000 participants. This review focuses on important new developments and serves as a rapid communication of clinically relevant material.

  7. Bleeding from duodenal ulcer in a patient with bilio-pancreatic diversion.

    Science.gov (United States)

    Garancini, Mattia; Luperto, Margherita; Delitala, Alberto; Maternini, Matteo; Uggeri, Franco

    2011-12-01

    Scopinaro's bilio-pancreatic diversion is considered as an acceptable malabsorptive surgical approach for the treatment of morbid obesity. We describe a case of acute recurrent gastro-intestinal bleeding in a patient with a previous Scopinaro's bilio-pancreatic diversion. At the first admission in our department, gastroscopy, colonoscopy, contrast-enhanced computerized tomography and angiography resulted negative for active bleeding. Hypovolemic shock indicated laparotomy and an intraoperative enteroscopy performed through a small enterotomy showed an ulcerative perforation sourced in an ischemic portion of a distended duodenal stump, with a bleeding branch of gastro-duodenal artery at the bottom. Hemorrhage was stopped with stitches. Two years later a new episode of duodenal bleeding associated with severe malnutrition occurred. A covered chronic ischemic perforation sustained by duodenal distension due to biliopancreatic limb sub-obstruction appeared to be the most probable etiology of the recurrent duodenal bleeding. The patient underwent again to laparotomy and adhesiolysis; hemorrhage was stopped by means of ligation of gastroduodenal artery and bilio-pancreatic diversion was converted into a standard Roux-en-Y gastroenterostomy with an entero-entero anastomosis 40 cm from the Treitz ligament in order to restore an anatomo-functional condition guaranteeing normal absorption and intestinal transit. After Scopinaro's bilio-pancreatic diversion duodenal bleeding can represent a rare serious presentation of biliopancreatic limb obstruction; because of the complex anatomical reconstruction performed during this intervention, the duodenum results unavailable during upper gastro-intestinal endoscopy, and if a duodenal bleeding is suspected laparotomy followed by enteroscopy represents an effective diagnostic approach.

  8. Necrotizing ulcerative gingivitis

    OpenAIRE

    Rayhana Malek; Amina Gharibi; Nadia Khlil; Jamila Kissa

    2017-01-01

    Necrotizing ulcerative gingivitis (NUG) is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in t...

  9. Arteriosclerosis, amputation and peptic ulcer

    Science.gov (United States)

    Bouhoutsos, J.; Barabas, A. P.; Martin, Peter

    1972-01-01

    In a series of 400 consecutive patients with arteriosclerosis seen in two peripheral vascular clinics, we confirm the previously reported association with peptic ulcer. The incidence was almost 25% both in patients with occlusive disease (300) and with aneurysm (100). The accepted expectation of peptic ulcer in the same age-group is 6 or 7% (Jones, Kirk & Bloor, 1970; McManus, 1966). Patients with peptic ulcer, or the history of one, had a significantly higher amputation rate than those without a peptic ulcer. PMID:4650780

  10. Doença de Crohn gastroduodenal ¾ relato de quatro casos e revisão da literatura

    Directory of Open Access Journals (Sweden)

    ABRAHÃO Jr Luiz João

    2001-01-01

    Full Text Available Racional -- A doença de Crohn pode acometer todo o tubo digestivo, porém o envolvimento gastroduodenal é classicamente descrito como raro (0,5% a 13%. Objetivos - Descrever os achados clínicos, radiológicos, endoscópicos e o tratamento de quatro pacientes com doença de de Crohn gastroduodenal e rever a literatura. Pacientes e Métodos - Quatro pacientes (um homem de 24 anos e três mulheres de 37, 66 e 74 anos com epigastralgia, emagrecimento e febre baixa foram acompanhados nos hospitais das Universidades Federais do Rio de Janeiro e Fluminense. Diarréia intermitente e artralgia/artrite estavam presentes em dois e uma paciente foi operada de urgência por síndrome de obstrução pilórica. Exames laboratoriais revelaram anemia em uma das pacientes, sendo normais nos demais. Os estudos baritados revelaram ulcerações aftóides no estômago e duodeno, assim como ulcerações em íleo terminal e deformidades em ambos. Os achados endoscópicos compreenderam úlceras aftóides e serpiginosas e lesões polipóides no antro gástrico e úlceras geográficas em duodeno. Colonoscopia foi realizada em dois pacientes, revelando ileíte ulcerada em um e pancolite ulcerada em outro. O exame histopatológico revelou processo inflamatório crônico inespecífico sem granulomas, sendo excluídas outras causas de doença granulomatosa gástrica. Instituído tratamento com prednisona e inibidores de bomba de prótons, com remissão da doença em dois pacientes e evolução para síndrome de estenose pilórica em um (submetido a gastroenteroanastomose. Conclusão - A doença de Crohn gastroduodenal possui características clínicas, terapêuticas e prognósticas distintas. O avanço da endoscopia digestiva e a adoção de novos critérios para o diagnóstico histopatológico tem demonstrado incidência maior (17 a 75% que a previamente relatada.

  11. Novel mechanisms and signaling pathways of esophageal ulcer healing: the role of prostaglandin EP2 receptors, cAMP, and pCREB.

    Science.gov (United States)

    Ahluwalia, Amrita; Baatar, Dolgor; Jones, Michael K; Tarnawski, Andrzej S

    2014-09-15

    Clinical studies indicate that prostaglandins of E class (PGEs) may promote healing of tissue injury e.g., gastroduodenal and dermal ulcers. However, the precise roles of PGEs, their E-prostanoid (EP) receptors, signaling pathways including cAMP and cAMP response element-binding protein (CREB), and their relation to VEGF and angiogenesis in the tissue injury healing process remain unknown, forming the rationale for this study. Using an esophageal ulcer model in rats, we demonstrated that esophageal mucosa expresses predominantly EP2 receptors and that esophageal ulceration triggers an increase in expression of the EP2 receptor, activation of CREB (the downstream target of the cAMP signaling), and enhanced VEGF gene expression. Treatment of rats with misoprostol, a PGE1 analog capable of activating EP receptors, enhanced phosphorylation of CREB, stimulated VEGF expression and angiogenesis, and accelerated esophageal ulcer healing. In cultured human esophageal epithelial (HET-1A) cells, misoprostol increased intracellular cAMP levels (by 163-fold), induced phosphorylation of CREB, and stimulated VEGF expression. A cAMP analog (Sp-cAMP) mimicked, whereas an inhibitor of cAMP-dependent protein kinase A (Rp-cAMP) blocked, these effects of misoprostol. These results indicate that the EP2/cAMP/protein kinase A pathway mediates the stimulatory effect of PGEs on angiogenesis essential for tissue injury healing via the induction of CREB activity and VEGF expression.

  12. "Stress" is 80 Years Old: From Hans Selye Original Paper in 1936 to Recent Advances in GI Ulceration.

    Science.gov (United States)

    Szabo, Sandor; Yoshida, Masashi; Filakovszky, Janos; Juhasz, Gyorgy

    2017-01-01

    The first scientific publication on 'general adaption syndrome', or as we know today 'biologic stress' has been published in Nature in 1936 by the 29-year old Hans Selye. His results in that short publication that contained no references or illustrations, were based on experiments in rats that were exposed to severe insults/ stressors, but his idea about a 'nonspecific bodily response' originated from his observations of sick patients whom he had seen as a medical student and young clinician. Autopsy of stressed rats revealed three major, grossly visible changes: hyperemia and enlargement of the adrenals, atrophy of the thymus and lymph nodes as well as hemorrhagic gastric erosions/ulcers (the "stress triad"). Based on this and additional observations, he concluded that the key master organ in stress reactions is the adrenal cortex (although he also accepted the limited and short lasting effect of catecholamines released from the adrenal medulla) which stimulated by an increased secretion of ACTH, secreted by the anterior pituitary gland. He thus identified the first molecular mediators of the stress reaction, i.e., steroids released from the adrenal cortex that we call today glucocorticoids, based on his classification and naming of steroids. At the end of a very productive life in experimental medicine, Selye recognized that under both unpleasant and demanding stressors as well as positive, rewarding stimuli adrenal cortex releases the same glucocorticoids and only certain brain structures may distinguish the stimuli under distress and eustress - terms he introduced in 1974, that also contained his last definition of stress: the nonspecific response of the body on any demand on it. After brief description of the history of stress research, the rest of this review is focused on one element of stress triad, i.e., gastroduodenal ulceration, especially its pathogenesis, prevention and treatment. Following a short description of acute gastroprotection, discovered by

  13. Рrediction risk factors of gastroesophageal reflux disease in children and adolescents with chronic gastroduodenal pathology

    Directory of Open Access Journals (Sweden)

    L. M. Boiarskа

    2013-12-01

    Full Text Available Introduction. According to the modern literature gastroesophageal reflux disease (GERD is multifactorial illness. The main risk factors of its development are acid-peptic factor, Н.pylori, the autonomic nervous system dysfunction, rapid growth, heredity, burdened perinatal history, dysplasia of connective tissue structures (DCTS, environmental factors and lifestyle. Among the contradictory questions is intercurrent factors influence on the development and course of the disease. Aim of the work. To determine the risk factors for GERD in children and adolescents with chronic gastroduodenal pathology with the creation of mathematical forecasting model of the disease development and course. Materials and methods. The study involved 138 children with chronic gastroduodenal pathology who were treated inZaporozhyeCityPediatricHospital #5, aged 9 to 17 years. The main group consisted of 97 children with GERD (Group 1 - 46 children with GERD with esophagitis, Group 2 - GERD without esophagitis, comparison group comprised 41 children without clinical and endoscopic manifestations of the esophagus pathology. The following methods were conducted: clinical and medical history, instrumental - fibroesophagogastroduodenoscopy, intragastric pH-metry, ambulatory around-the clock pH monitoring in the esophagus, functional - Holter cardiac monitoring, respiratory HELIK urease test, mathematics and statistics - variational statistics, correlation analysis, binary logistic regression and multivariate regression analysis. Study results. According to the clinical and anamnestic analysis identified risk factors for GERD in children with chronic gastroduodenal pathology: hereditary predisposition (RR=1,79(1,27-2,66, р<0,05, abnormal pregnancy (ВР=1,62(1,31-1,81, р<0,05, early artificial feeding (RR = 1.31 (1,03-1,6, р<0,05, the presence of neurological symptoms during the first year life (RR = 1,32 (1,01-1,51, p <0.05, impaired diet (RR = 1,92 (1,24-2,82, p <0

  14. [Lung edema and erosive gastroduodenitis as a sequela of inappropriate use of an adrenaline dose aerosol after wasp sting].

    Science.gov (United States)

    Balda, B R; Ludwig, A

    1997-03-01

    Epinephrine (adrenaline) is an important drug in the treatment of severe anaphylactic reactions. Along with other drugs such as H1-antihistamines and glucocorticosteroids, it is found in every first aid kit for at-risk individuals, such as those who are allergic to insect stings. Subcutaneous or intramuscular injections if carried out by an untrained individual or the patient himself might give rise to potential problems. Therefore, it is common to prescribe epinephrine pressure aerosol as a safer alternative. If epinephrine aerosol is overused, it can cause serious problems. A patient developed by self-medication following a wasp sting lung edema as well as an erosive gastroduodenitis. She consumed two aerosol vials each of which contained about 73 mg of adrenaline. In order to avoid such incidents it is crucial that every doctor provides his or her patient with sufficient oral and written information regarding the correct use fo epinephrine inhalers.

  15. Úlcera gastroduodenal en caldas, comentarios a una estadística de cinco años

    OpenAIRE

    Campo Posada, Arturo

    2010-01-01

    Revisión de las teorías etiopatogénicas de la úlcera gastroduodenal: 1a. Teoría gástrica; 2a. Teoría hiperclorhídrica; 3a. Teoría funcional; 4a. Teoría infecciosa; 5a. Teoría neurovegetativa; 6a. Teoría vascular; 7a. Teoría constitucional; 8a. Teoría de la carencia de aminoácidos; 9a. Teoría alérgia. Casos. Complicaciones. Tratamiento. Síntomas. Úlcera gástrica. Úlceras cancerizadas.

  16. Effects of oral 3% hydrogen peroxide used as an emetic on the gastroduodenal mucosa of healthy dogs.

    Science.gov (United States)

    Niedzwecki, Alicia H; Book, Bradley P; Lewis, Kristin M; Estep, J Scot; Hagan, Joseph

    2017-03-01

    To characterize the extent of mucosal injury on the upper gastrointestinal tract following oral administration of 3% hydrogen peroxide (H2 O2 ) to induce emesis in normal dogs. Prospective clinical study. Specialty referral hospital. Seven staff-owned, healthy, adult dogs. Six dogs were assigned to the H2 O2 group and 1 dog was assigned as the apomorphine control. Dogs were anesthetized for gastroduodenoscopy with gross inspection and gastroduodenal biopsies at time 0 and 4 hours, 24 hours, 1 week, and 2 weeks following administration of oral 3% H2 O2 or subconjunctival apomorphine. Gross esophageal, gastric, and duodenal mucosal lesion scoring was performed by 2 blinded, experienced scorers. Biopsy samples were evaluated histologically by a veterinary pathologist. Grade I esophagitis was noted in 2 dogs at 4 hours and in 1 dog at 2 weeks, while grade III esophagitis was observed in 1 dog 1 week following H2 O2 administration. At 4 hours, gastric mucosal lesions were visualized in all dogs, and lesions worsened by 24 hours. Mild to moderate duodenal mucosal lesions were visualized up to 24 hours after administration. Histopathology identified the most severe gastric lesions at 4 hours as hemorrhage; at 24 hours as degeneration, necrosis, and mucosal edema; and at 1 week as inflammation. By 2 weeks, most visual and histopathologic lesions were resolved. No histopathologic lesions were identified at any time point in the dog administered apomorphine. Significant visual and histopathologic gastric lesions occurred following administration of 3% H2 O2 in all dogs. Less severe visual duodenal lesions were identified. As compared to H2 O2 dogs, minimal gross gastroduodenal lesions and normal histopathology were identified in the apomorphine control. © Veterinary Emergency and Critical Care Society 2016.

  17. Helicobacter pylori and Peptic Ulcers

    Centers for Disease Control (CDC) Podcasts

    2010-08-17

    In this podcast, CDC's Dr. David Swerdlow discusses the relationship between Helicobacter pylori and peptic ulcer disease and trends in hospitalization rates for peptic ulcer disease in the United States between 1998 and 2005.  Created: 8/17/2010 by National Center for Emerging and Zoonotic Infectious Diseases.   Date Released: 8/17/2010.

  18. Leg ulcers due to hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D

    2006-01-01

    Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.

  19. Venous ulcer: what is new?

    Science.gov (United States)

    Raffetto, Joseph D; Marston, William A

    2011-01-01

    The pathophysiology of venous dermal abnormality in chronic venous ulcers is reflective of a complex interplay that involves sustained venous hypertension, inflammation, changes in the microcirculation, cytokine and matrix metalloproteinase activation, and altered cellular function. Red blood cells and macromolecules extravasate into the interstitium and activate endothelial cells. Endothelial expression of specific adhesion molecules recruits leukocytes and causes diapedesis of these cells into the dermal microvasculature, promoting an inflammatory response with activation of cytokines and proteinases. Altered cell function enhances a state of vulnerability in the surrounding tissues, initiating specific changes associated with venous disease. Ultimately, the persistent inflammatory-proteinase activity leads to advanced chronic venous insufficiency and ulcer formation. The mainstay of therapy in venous ulcer abnormality is correction of the underlying venous hypertension through compression therapy and/or surgery. Understanding the science involved in the pathophysiology of venous ulcer formation has led to the development of adjunctive treatment directed at the dysregulated molecular pathways. Randomized clinical trials are critical for determining the most effective evidence-based treatments for venous ulcer, and this review discusses important trials that have had a significant impact on venous ulcer healing. In addition, the authors have included subsections referred to as "Translational Implications for Therapy" in the basic science sections of the review to help bridge the basic science knowledge with clinical applications that may help to modulate the molecular abnormalities in the pathophysiologic cascade leading to venous ulcers.

  20. A new pressure ulcer conceptual framework

    NARCIS (Netherlands)

    Coleman, S.; Nixon, J.; Keen, J.; Wilson, L.; McGinnis, E.; Dealey, C.; Stubbs, N.; Farrin, A.; Dowding, D.; Schols, J.M.; Cuddigan, J.; Berlowitz, D.; Jude, E.; Vowden, P.; Schoonhoven, L.; Bader, D.L.; Gefen, A.; Oomens, C.W.; Nelson, E.A.

    2014-01-01

    AIM: This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework. BACKGROUND: Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR

  1. Pressure ulcers presentations and management at Kenyatta ...

    African Journals Online (AJOL)

    Most of the ulcers were located along bony prominence points of the pelvic girdle and the proximal femur. Most of the ulcers in this study were treated conservatively, with only a few ulcers subjected to surgical interventions. For the ulcers treated with surgical interventions the early outcome was good, however studies need ...

  2. Esophageal ulcer and alendronate

    Directory of Open Access Journals (Sweden)

    Angelo Paulo Ferrari Junior

    Full Text Available OBJECTIVE: To describe a case of esophageal ulcer associated with the use of alendronate. CASE REPORT: This is the fifth case ever described in the literature according to our bibliographic review. In our patient, the association between the drug and the esophageal lesions was masked by the presence of a hiatal hernia, potentially a cause of the esophageal lesion. The persistence of the lesions despite high doses of anti-reflux therapy called attention to the possibility of the relationship. The esophageal lesion healed soon after suspension of alendronate. DISCUSSION: The authors present a review of the literature and point to the need for diagnostic investigation, to suspend such a drug from patients who experience dyspeptic symptoms while using it.

  3. Perforated Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    Jessa Baker

    2016-09-01

    Full Text Available History of present illness: A 53-year-old male with a history of daily alcohol abuse presented with sudden onset epigastric pain. The pain radiated to the right upper abdominal quadrant and was associated with shortness of breath and nausea. The patient’s vitals were notable for blood pressure of 181/107 and a heart rate of 124. He was in moderate distress and had a firm, distended abdomen with diffuse tenderness to palpation, without rebound or guarding. Significant findings: In the chest radiograph, there was obvious free air under the both the right diaphragm (above the liver and the left diaphragm, consistent with pneumoperitoneum. Discussion: A perforated ulcer is a surgical emergency. Overall mortality has been shown to be approximately 6.2%.1 Rapid diagnosis is essential as prognosis improves if treatment is initiated within the first six hours and worsens after 12 hours.2 The sensitivity for detecting pneumoperitoneum on plain radiography ranges from 50%-80%3-8 with specificity of 53%.7 An upright chest radiograph can detect as little as one to two milliliters of air.9,10 If free air is not seen on a posteroanterior (PA upright chest radiograph, an upright lateral chest radiograph can be obtained, which is more sensitive (98% sensitivity.8,11 About 10%-20% of ruptured ulcers will not present with visible free-air under the diaphragm on plain x-ray.12 In this case, given the free air seen on chest radiograph and peritoneal signs on exam, the patient was taken straight to the operating room for general surgery.

  4. Current management of mesenteric extrahepatic arterioportal fistulas: report of a case treated with a gastroduodenal artery stent graft and literature review.

    Science.gov (United States)

    Krishan, Sonal; McPherson, Simon; Pine, James; Hayden, Jeremy

    2010-02-01

    Spontaneous arteriovenous fistulation of a pseudoaneurysm into superior mesenteric vein (SMV) has rarely been reported. We present the case of a 61-year-old woman who presented with a post pancreatic arterioportal fistula (APF) that was successfully managed by stent graft (SG) placement in the gastroduodenal artery (GDA). We also review the published experience of the endovascular management of mesenteric extrahepatic APFs. This review demonstrates the evolution from open surgical to endovascular management for majority of these patients.

  5. Nonsteroidal anti-inflammatory drugs: add an anti-ulcer drug for patients at high risk only. Always limit the dose and duration of treatment with NSAIDs.

    Science.gov (United States)

    2011-09-01

    In addition to their cardiac, renal, hepatic, cutaneous and neuropsychological adverse effects, nonsteroidal anti-inflammatory drugs (NSAIDs) can have severe effects on the entire gastrointestinal tract, including bleeding, perforation and occlusion. Which anti-ulcer drugs reduce the risk of the severe gastrointestinal adverse effects of NSAIDs, and which patients should receive them? To answer these questions, we conducted a review of the literature, using the standard Prescrire methodology. The main risk factors for severe gastrointestinal adverse effects during NSAID therapy are: a high dose regimen; age over 65 years; a history of gastric or duodenal ulcer or gastrointestinal bleeding; heavy use of both alcohol and tobacco; and concomitant treatment with a corticosteroid, antiplatelet drug, anticoagulant, or selective serotonin reuptake inhibitor (SSRI) antidepressant. Gastrointestinal symptoms and ulceration (on endoscopy) are poor predictors of severe gastrointestinal reactions. A meta-analysis examined randomised placebo-controlled trials of misoprostol in more than 11 000 patients. The results were mainly based on a large trial including about 9000 rheumatoid arthritis patients with an average age of 68 years. Misoprostol (400 microg to 800 microg/day, in 4 doses) prevented about 4 severe gastroduodenal events when 1000 patients over 60 years of age were treated for 6 months. Diarrhoea and other mild gastrointestinal disorders were frequent. There are no randomised trials comparing proton pump inhibitors (PPIs) and histamine H2 receptor antagonists versus misoprostol or versus placebo therapy for the prevention of severe adverse effects associated with NSAIDs. PPIs and H2 antagonists both reduce the incidence of gastric or duodenal ulceration detected by routine endoscopy. A randomised trial compared an H2 antagonist (famotidine) versus a PPI (pantoprazole) in 128 patients with an average age of 69 years who had a very high risk of serious gastrointestinal

  6. Helicobacter pylori and gastroduodenal pathology: New threats of the old friend

    Directory of Open Access Journals (Sweden)

    Sechi Leonardo A

    2005-01-01

    Full Text Available Abstract The human gastric pathogen Helicobacter pylori causes chronic gastritis, peptic ulcer disease, gastric carcinoma, and mucosa-associated lymphoid tissue (MALT lymphoma. It infects over 50% of the worlds' population, however, only a small subset of infected people experience H. pylori-associated illnesses. Associations with disease-specific factors remain enigmatic years after the genome sequences were deciphered. Infection with strains of Helicobacter pylori that carry the cytotoxin-associated antigen A (cagA gene is associated with gastric carcinoma. Recent studies revealed mechanisms through which the cagA protein triggers oncopathogenic activities. Other candidate genes such as some members of the so-called plasticity region cluster are also implicated to be associated with carcinoma of stomach. Study of the evolution of polymorphisms and sequence variation in H. pylori populations on a global basis has provided a window into the history of human population migration and co-evolution of this pathogen with its host. Possible symbiotic relationships were debated since the discovery of this pathogen. The debate has been further intensified as some studies have posed the possibility that H. pylori infection may be beneficial in some humans. This assumption is based on increased incidence of gastro-oesophageal reflux disease (GERD, Barrett's oesophagus and adenocarcinoma of the oesophagus following H. pylori eradication in some countries. The contribution of comparative genomics to our understanding of the genome organisation and diversity of H. pylori and its pathophysiological importance to human healthcare is exemplified in this review.

  7. Recurrence of Acute Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    RJ Bailey

    1994-01-01

    Full Text Available Nizatidine, 300 mg once nightly, was compared with cimetidine, 800 mg once nightly, for treatment of 212 adult out-patients with acute duodenal ulcers in an eight-week randomized, double-blind, multicentre trial. Patients were endoscoped at weeks 2, 4 and 8, regardless of ulcer healing status. No significant differences in ulcer healing rates between treatment groups were seen at weeks 2 and 4, but at week 8, nizatidine had a significantly higher ulcer healing rate (P=0.036 than cimetidine (86% versus 74%, respectively. Patients with healed ulcers at either week 2 or week 4 had a final endoscopy performed at week 8. The rate of ulcer recurrence was significantly greater (P=0.021 in the cimetidine group at week 8 compared with the nizatidine group: 21% versus 7.3%, respectively. Increasing tolerance to H2 receptor antagonist therapy with prolonged use may explain the higher recurrence rate of cimetidine. Both drugs provided equally rapid and effective symptomatic relief from epigastric pain after two weeks of therapy. Both were equally safe and free from treatment-related adverse effects.

  8. Management of Chronic Pressure Ulcers

    Science.gov (United States)

    2009-01-01

    Executive Summary In April 2008, the Medical Advisory Secretariat began an evidence-based review of the literature concerning pressure ulcers. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/tech/tech_mn.html to review these titles that are currently available within the Pressure Ulcers series. Pressure ulcer prevention: an evidence based analysis The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario: projections of the Ontario Pressure Ulcer Model (field evaluation) Management of chronic pressure ulcers: an evidence-based analysis Objective The Medical Advisory Secretariat (MAS) conducted a systematic review on interventions used to treat pressure ulcers in order to answer the following questions: Do currently available interventions for the treatment of pressure ulcers increase the healing rate of pressure ulcers compared with standard care, a placebo, or other similar interventions? Within each category of intervention, which one is most effective in promoting the healing of existing pressure ulcers? Background A pressure ulcer is a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in conjunction with shear and/or friction. Many areas of the body, especially the sacrum and the heel, are prone to the development of pressure ulcers. People with impaired mobility (e.g., stroke or spinal cord injury patients) are most vulnerable to pressure ulcers. Other factors that predispose people to pressure ulcer formation are poor nutrition, poor sensation, urinary and fecal incontinence, and poor overall physical and mental health. The prevalence of pressure ulcers in Ontario has been estimated to range from a median of 22.1% in community settings to a median of 29.9% in nonacute care facilities. Pressure ulcers have been shown to increase the risk of mortality among geriatric patients by

  9. Necrotizing ulcerative gingivitis

    Directory of Open Access Journals (Sweden)

    Rayhana Malek

    2017-01-01

    Full Text Available Necrotizing ulcerative gingivitis (NUG is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in the pathogenesis of NUG. The treatment of NUG is organized in successive stages: first, the treatment of the acute phase that should be provided immediately to stop disease progression and to control patient's feeling of discomfort and pain; second, the treatment of the preexisting condition such as chronic gingivitis; then, the surgical correction of the disease sequelae like craters. Moreover, finally, maintenance phase that allows stable outcomes. This case report describes the diagnosis approach and the conservative management with a good outcome of NUG in a 21-year-old male patient with no systemic disease and probable mechanism of pathogenesis of two predisposing factors involved.

  10. Necrotizing Ulcerative Gingivitis.

    Science.gov (United States)

    Malek, Rayhana; Gharibi, Amina; Khlil, Nadia; Kissa, Jamila

    2017-01-01

    Necrotizing ulcerative gingivitis (NUG) is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in the pathogenesis of NUG. The treatment of NUG is organized in successive stages: first, the treatment of the acute phase that should be provided immediately to stop disease progression and to control patient's feeling of discomfort and pain; second, the treatment of the preexisting condition such as chronic gingivitis; then, the surgical correction of the disease sequelae like craters. Moreover, finally, maintenance phase that allows stable outcomes. This case report describes the diagnosis approach and the conservative management with a good outcome of NUG in a 21-year-old male patient with no systemic disease and probable mechanism of pathogenesis of two predisposing factors involved.

  11. Wavelet-analysis of gastric microcirculation in rats with ulcer bleedings

    Science.gov (United States)

    Pavlov, A. N.; Semyachkina-Glushkovskaya, O. V.; Pavlova, O. N.; Bibikova, O. A.; Kurths, J.

    2013-10-01

    Nitric oxide (NO) plays an important role in regulation of central and peripheral circulation in normal state and during hemorrhagic stress. Because the impaired gastric mucosal blood flow is the major cause of gastroduodenal lesions including ulcer bleeding (UB), we study in this work the NO-ergic mechanism responsible for regulation of this blood flow. Our study is performed in rats with a model of stress-induced UB using laser Doppler flowmetry (LDF) that characterizes the rate of blood flow by measuring a Doppler shift of the laser beam scattered by the moving red blood cells. Numerical analysis of LDF-data is based on the discrete wavelet-transform (DWT) using Daubechies wavelets aiming to quantify influences of NO on the gastric microcirculation. We show that the stress-induced UB is associated with an increased level of NO in the gastric tissue and a stronger vascular sensitivity to pharmacological modulation of NO-production by L-NAME. We demonstrate that wavelet-based analyses of NO-dependent regulation of gastric microcirculation can provide an effective endoscopic diagnostics of a risk of UB.

  12. Adrenergic mechanism responsible for pathological alteration in gastric mucosal blood flow in rats with ulcer bleeding

    Science.gov (United States)

    Semyachkina-Glushkovskaya, O. V.; Pavlov, A. N.; Semyachkin-Glushkovskiy, I. A.; Gekalyuk, A. S.; Ulanova, M. V.; Lychagov, V. V.; Tuchin, V. V.

    2014-09-01

    The adrenergic system plays an important role in regulation of central and peripheral circulation in normal state and during hemorrhage. Because the impaired gastric mucosal blood flow (GMBF) is the major cause of gastroduodenal lesions, including ulcer bleeding (UB), we studied the adrenergic mechanism responsible for regulation of GMBF in rats with a model of stress-induced UB (SUB) using the laser Doppler flowmetry (LDF). First, we examined the effect of adrenaline on GMBF in rats under normal state and during UB. In all healthy animals the submucosal adrenaline injection caused a decrease in local GMBF. During UB the submucosal injection of adrenaline was accompanied by less pronounced GMBF suppression in 30,3% rats with SUB vs. healthy ones. In 69,7% rats with SUB we observed the increase in local GMBF after submucosal injection of adrenaline. Second, we studied the sensitivity of gastric β2-adrenoreceptors and the activity of two factors which are involved in β2-adrenomediated vasorelaxation-KATP -channels and NO. The effects of submucosal injection of isoproterenol, ICI118551 and glybenclamide on GMBF as well as NO levels in gastric tissue were significantly elevated in rats with SUB vs. healthy rats. Thus, our results indicate that high activation of gastric β2-adrenoreceptors associated with the increased vascular KATP -channels activity and elevated NO production is the important adrenergic mechanism implicated in the pathogenesis of UB.

  13. Oxidant-antioxidant balance in the blood and tissues of gum of the rats with experimental gastroduodenitis

    Directory of Open Access Journals (Sweden)

    Romanenko O.H.

    2013-03-01

    Full Text Available To study the initial changes in the periodontal tissues in diseases of the upper gastrointestinal tract, the study of the oxidant-antioxidant balance in the gum tissue and serum of rats with experimental gastro¬duo¬denitis was conducted. Increase in MDA in homogenates of the gums and blood serum by 1,5 and 2 times, and the level of catalase by the 3,9 and 1,6 times, respectively was registered. The level of superoxide dismutase in gin¬gival tissues and serum of rats with gastroduodenitis did not changeas com¬pared to control animals. Such changes are characteristic of hypoxia state. Activation of free radical oxidation of lipids in gum homogenates is not accompanied by increased oxidative modification of proteins, which is manifested by absence of significant changes in the main marker and aldehydphenilhydrazons ketonphenilhydrazons. When malondialdehyde content in the gum tissue a blood serum of rats increases in the experiment relative intensity and compensation of antiperoxid protection is observed, leading to the formation of endogenous oxygen that keeps cells activity in hypoxic conditions. With increase of intensity of oxidative stress, obviously, decompensation of antiperoxid protection and partial loss of the barrier function by epithelial cells occurs; this increases the possibility of inflammation development in the gums.

  14. Nutrition and ulcerative colitis.

    Science.gov (United States)

    Burke, A; Lichtenstein, G R; Rombeau, J L

    1997-03-01

    The role of diet in the aetiology and pathogenesis of ulcerative colitis (UC) remains uncertain. Impaired utilization by colonocytes of butyrate, a product of bacterial fermentation of dietary carbohydrates escaping digestion, may be important. Sulphur-fermenting bacteria may be involved in this impaired utilization. Oxidative stress probably mediates tissue injury but is probably not of causative importance. Patients with UC are prone to malnutrition and its detrimental effects. However, there is no role for total parenteral nutrition and bowel rest as primary therapy for UC. The maintenance of adequate nutrition is very important, particularly in the peri-operative patient. In the absence of massive bleeding, perforation, toxic megacolon or obstruction, enteral rather than parenteral nutrition should be the mode of choice. Nutrients may be beneficial as adjuvant therapy. Butyrate enemas have improved patients with otherwise recalcitrant distal colitis in small studies. Non-cellulose fibre supplements are of benefit in rats with experimental colitis. Eicosapentaenoic acid in fish oil has a steroid-sparing effect which, although modest, is important, particularly in terms of reducing the risk of osteoporosis, but it seems to have no role in the patient with inactive disease. gamma-Linolenic acid and anti-oxidants also are showing promise. Nutrients may also modify the increased risk of colorectal carcinoma. Oxidative stress can damage tissue DNA but there are no data published at present on possible protection from oral anti-oxidants. Butyrate protects against experimental carcinogenesis in rats with experimental colitis. Folate supplementation is weakly associated with decreased incidence of cancer in UC patients when assessed retrospectively. Vigilance should be maintained for increased micronutrient requirements and supplements given as appropriate. Calcium and low-dose vitamin D should be given to patients on long-term steroids and folate to those on

  15. The effects of antidepressants on gastric ulcer

    Directory of Open Access Journals (Sweden)

    Mehmet Latif Güneş

    2013-12-01

    Full Text Available In their daily practice, psychiatrists often experience gastriccomplaints in patients beside psychiatric disorders.Peptic ulcer is one of the diseases, which accompanyto psychiatric disorders including mainly depression. Itis shown that antidepressants can inflame the bleedingsincluding gastrointestinal (GI bleedings, while they havepositive effect on ulcer healing. In this review, studies,which conducted about the positive or negative effects ofantidepressant drugs on ulcer treatment were examined.Accordingly; it was found that opipramol, amitriptyline,imipramine that of tricyclic antidepressants was found tobe helpful in healing of the ulcer. It was stated that SelectiveSerotonin Reuptake Inhibitors generally inflamedulcers, exceptionally fluvoxamine and fluoxetine reducedulcer; moclobemide that of monoamine-oxidase inhibitorand tianeptine and mirtazapine that of atypical antidepressantshad positive effect in ulcer healing. To be carefulin choosing the appropriate antidepressant in psychiatricpatients with gastric ulcer is important in the prognosisof both ulcer and depression.Key words: peptic ulcer; depression; antidepressant drugs

  16. Wound cleansing for pressure ulcers.

    Science.gov (United States)

    Moore, Zena E H; Cowman, Seamus

    2013-03-28

    Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the elderly, malnourished or acutely ill, who cannot reposition themselves. Pressure ulcers impose a significant financial burden on health care systems and negatively affect quality of life. Wound cleansing is considered an important component of pressure ulcer care. This systematic review seeks to answer the following question: what is the effect of wound cleansing solutions and wound cleansing techniques on the rate of healing of pressure ulcers? For this third update, we searched the Cochrane Wounds Group Specialised Register (searched 3 January 2013); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12); Ovid MEDLINE (2010 to November Week 3 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations December 31, 2012); Ovid EMBASE (2010 to 2012 Week 52); and EBSCO CINAHL (2010 to 21 December 2012). Randomised controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion if they reported an objective measure of pressure ulcer healing. Two review authors extracted data independently and resolved disagreements through discussion. A structured narrative summary of the included studies was conducted. For dichotomous outcomes, risk ratio (RR), plus 95% confidence intervals (CI) were calculated; for continuous outcomes, mean difference (MD), plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified. Two review authors independently assessed each included study using the Cochrane Collaboration tool for assessing risk of bias. One additional eligible study was identified from the updated searches, one study was added to the table of excluded studies. A total of three studies (169 participants) met the inclusion criteria for the

  17. Nonhealing Ulcer: Acroangiodermatitis of Mali

    Directory of Open Access Journals (Sweden)

    Neeraj Varyani

    2011-01-01

    Full Text Available An 18-year-old male presented with a nonhealing wound on left lower limb, pain and swelling over multiple joints, weight loss, and yellowish discoloration of eyes and urine for the past 4 years. On examination, the patient had pallor, icterus, and generalized lymphadenopathy with a nonhealing unhealthy ulcer over left medial malleolus. He had deformed joints with hepatomegaly and splenomegaly. His laboratory investigations were positive for antinuclear antibody (ANA and anticardiolipin antibody (ACLA. Synovial fluid analysis showed inflammatory findings. Biopsy of margin of the ulcer showed findings consistent with Acroangiodermatitis of Mali. The patient was treated with disease-modifying antirheumatic drugs (DMARDs and aspirin for juvenile idiopathic arthritis and secondary antiphospholipid antibody syndrome (APS, respectively. The ulcer was managed conservatively with systemic antibiotics and topical steroids along with limb elevation and compression elastic stockings. The patient's symptoms improved significantly, and he is in our followup.

  18. Anti-ulcer potential of Oxystelma esculentum

    OpenAIRE

    Devang J Pandya; Indermeet Singh Anand

    2011-01-01

    Oxystelma esculentum is a perennial twiner growing near water-logged areas in the Indian subcontinent. It is used traditionally in stomach ulcers. The present work deals with the investigation of anti-ulcer potential of O. esculentum. The plant was successively extracted with solvents of varying polarities, which served as the test extracts. Anti-ulcer effect was checked in Wistar rats using aspirin- and ethanol-induced acute ulcer models. The petroleum ether extract was found to possess the ...

  19. 38 CFR 4.110 - Ulcers.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Ulcers. 4.110 Section 4... DISABILITIES Disability Ratings The Digestive System § 4.110 Ulcers. Experience has shown that the term “peptic ulcer” is not sufficiently specific for rating purposes. Manifest differences in ulcers of the stomach...

  20. Ulcerative Keratitis: incidence, seasonal distribution and ...

    African Journals Online (AJOL)

    The seasonal distribution of corneal ulcer was highest in month June 11(18.0%). Complications from the ulcers included central leucoma 19 (31.2%) and panophthalmitis 6 (9.9%). Conclusion: The incidence rate of ulcerative keratitis is 0.6% occurring highest in the month of June with more bacterial than fungal isolates.

  1. Healing of elderly patients with diabetic foot ulcers, venous stasis ulcers, and pressure ulcers.

    Science.gov (United States)

    Brem, Harold; Tomic-Canic, Marjana; Tarnovskaya, Alina; Ehrlich, H Paul; Baskin-Bey, Edwina; Gill, Kiran; Carasa, Miriam; Weinberger, Sarah; Entero, Hyacinth; Vladeck, Bruce

    2003-01-01

    Although elderly patients have physiologic impairments in wound healing, their wounds should be expected to heal with the same frequency of closure as those in younger populations, albeit at a slower rate. However, compared to the general population, the elderly population has a higher incidence of chronic wounds: diabetic foot ulcers, pressure ulcers, and venous stasis ulcers. Experimental and clinical data indicate physiologically impaired healing is characterized by decreased angiogenesis and synthesis of critical growth factors. Further, compared to younger populations, the elderly have a higher rate of mortality associated with specific morbidities, such as sepsis and acute respiratory distress. As these morbidities may develop directly from the wound, early intervention is mandated. In this report, 40 consecutive elderly patients (65-102 years old) with chronic wounds were analyzed. All patients were provided the same treatment protocol and healing was defined as 100% epithelization and no drainage. Despite the wounds presenting in a nonhealing and/or infected state, 73% of these chronic wounds in elderly patients healed. This suggests that elderly patients with diabetic foot ulcers, pressure ulcers, and venous stasis ulcers close their wounds at a similar frequency as younger patients. Therefore, early intervention and comprehensive treatment that includes safe topical therapies, in addition to growth factors and cellular therapy used for chronic wounds, ensure these patients will be spared the morbidities of pain, amputation, osteomyelitis, and even death. We hypothesize that if all elderly patients with chronic wounds are provided early treatment, morbidities (e.g., amputation, sepsis, pain) and associated costs will decrease.

  2. Associations between gastric sensorimotor function, depression, somatization, and symptom-based subgroups in functional gastroduodenal disorders: are all symptoms equal?

    Science.gov (United States)

    Clauwaert, N; Jones, M P; Holvoet, L; Vandenberghe, J; Vos, R; Tack, J; Van Oudenhove, L

    2012-12-01

    Previous work indicated that psychosocial factors (depression and somatization) are more strongly associated with symptom severity and weight loss in functional dyspepsia (FD) than gastric sensorimotor function. However, there is conflicting evidence regarding the association of these etiopathogenetic factors with Rome III symptom-based subgroups in FD [epigastric pain syndrome (EPS), postprandial distress syndrome (PDS)]. We aimed to test whether gastric sensitivity and emptying, depression, and somatization are differentially associated with empirically derived functional gastroduodenal disorders (FGD) symptom factors in one comprehensive model. In 259 tertiary care FD patients, we studied gastric sensorimotor function with barostat and gastric emptying breath test. Depression, somatization, and FGD symptoms were measured using self-report questionnaires. Confirmatory factor analysis (CFA) on 7 FGD symptoms was used to determine the fit of a latent variable structure based on Rome III symptom-based subgroups. Structural equation modeling (SEM) was used to test the putative relationships of the symptom factors with gastric sensorimotor function, depression, and somatization. The results of the CFA show a good fit [C(min) /DF = 1.54, CFI(comparative fit index) = 0.97] for the three-factor solution based on Rome III subgroups. The SEM also fitted the data well (C(min) /DF = 1.24, CFI = 0.98) and demonstrated that gastric sensitivity and depression are associated with PDS and nausea and vomiting. Gastric emptying is uniquely associated with EPS and somatization is strongly associated with all three symptom factors. Confirmatory factor analysis confirms the existence of three FGD symptom factors, corresponding to Rome III symptom-based subgroups. The SEM results suggest that different psychobiological mechanisms may play a role in these subgroups. © 2012 Blackwell Publishing Ltd.

  3. Mucosal healing in ulcerative colitis

    DEFF Research Database (Denmark)

    Seidelin, Jakob Benedict; Coskun, Mehmet; Nielsen, Ole Haagen

    2013-01-01

    Ulcerative colitis (UC) is a colonic inflammatory condition with a substantial impact on the quality of life of affected persons. The disease carries a cumulative risk of need of colectomy of 20-30% and an estimated cumulative risk of colorectal cancer of 18% after 30 years of disease duration...

  4. [Ulcerative colitis and cytomegalovirus infection].

    Science.gov (United States)

    Tárraga Rodríguez, I; Ferreras Fernández, P; Vicente Gutiérrez, M; de Arriba, J J; García Mouriño, M L

    2003-02-01

    Colitis ulcerous and citomegalovirus infection association have been reported in medical literature in sometimes, althougth this prevalence have lately increased. We report a case record of this association and do a review of this subject. It is not clear what factors are involved in this association, being necessary hore studies to know them.

  5. Update on peripheral ulcerative keratitis

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    Yagci A

    2012-05-01

    Full Text Available Ayse YagciEge University, School of Medicine, Department of Ophthalmology, Izmir, TurkeyAbstract: Ulcerative inflammation of the cornea occurs in the perilimbal cornea, and is associated with autoimmune collagen vascular and arthritic diseases. Rheumatoid arthritis is the most frequent underlying disease. The tendency for peripheral location is due to the distinct morphologic and immunologic characteristics of the limbal conjunctiva, which provides access for circulating immune complexes to the peripheral cornea via the capillary network. Deposition of immune complexes in the terminal ends of limbal vessels initiates immune-mediated vasculitis, and causes inflammatory cell and protein leakage due to vessel wall damage. Development of peripheral ulcerative keratitis associated with systemic disease may represent worsening of a potentially life-threatening disease. Accompanying scleritis, particularly the necrotizing form, is usually observed in severe cases, which may result in corneal perforation and loss of vision. Although first-line treatment with systemic corticosteroids is indicated for acute phases, immunosuppressive and cytotoxic agents are required for treatment of peripheral ulcerative keratitis associated with multisystem disorders. Recently, infliximab, a chimeric antibody against proinflammatory cytokine tumor necrosis factor-alpha, was reported to be effective in cases refractory to conventional immunomodulatory therapy. The potential side effects of these therapies require close follow-up and regular laboratory surveillance.Keywords: autoimmune disease, peripheral ulcerative keratitis, treatment, tumor necrosis factor-alpha

  6. CONTACT LENS RELATED CORNEAL ULCER

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    AGARWAL P

    2010-01-01

    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  7. Perforated Peptic Ulcer: new insights

    NARCIS (Netherlands)

    M.J.O.E. Bertleff (Marietta)

    2011-01-01

    textabstractMuch has been written on perforated peptic ulcer (PPU) during the last hundred years. In 1500, when necropsies were first allowed, often a small hole was found in the anterior wall of the stomach, giving an explanation for symptoms of acute abdominal pain, nausea, vomiting which often

  8. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Emergency Pancreatoduodenectomy with Preservation of Gastroduodenal Artery for Massive Gastrointestinal Bleeding due to Duodenal Metastasis by Clear Cell Renal Cell Carcinoma in a Patient with Celiac Artery Stenosis

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    Kyriakos Neofytou

    2014-01-01

    Full Text Available Duodenal metastasis from renal cell carcinoma is rare, and even rarer is a massive gastrointestinal bleeding from such tumours. Coeliac occlusive disease, although rarely symptomatic, can lead to ischaemic changes with anastomotic dehiscence and leaks when a patient undergoes pancreatoduodenectomy. A 41-year-old man with known metastasis to the adrenal glands and the second part of the duodenum close to the ampulla of Vater from clear cell renal cell carcinoma was admitted to our department due to massive gastrointestinal bleeding from the duodenal metastasis. Endoscopic control of the bleed was not possible, while the bleeding vessel embolization was able to control the haemorrhage only temporarily. An angiography during the embolization demonstrated the presence of stenosis of the coeliac artery and also hypertrophic inferior pancreaticoduodenal arteries supplying the proper hepatic artery via the gastroduodenal artery (GDA. The patient underwent emergency pancreatoduodenectomy with preservation of the gastroduodenal artery. The patient had an uneventful recovery and did not experience further bleeding. Also the blood flow to the liver was compromised as shown by the normal liver function tests (LFTs postoperatively. To the best of our knowledge, this is the first report of a preservation of the GDA during an emergency pancreatoduodenectomy.

  10. Compression for venous leg ulcers.

    Science.gov (United States)

    O'Meara, Susan; Cullum, Nicky A; Nelson, E Andrea

    2009-01-21

    Around one percent of people in industrialised countries will suffer from a leg ulcer at some time. The majority of these leg ulcers are due to problems in the veins, resulting in an accumulation of blood in the legs. Leg ulcers arising from venous problems are called venous (varicose or stasis) ulcers. The main treatment has been a firm compression garment (bandage or stocking) in order to aid venous return. There is a large number of compression garments available and it is unclear whether they are effective in treating venous ulcers and which compression garment is the most effective. To undertake a systematic review of all randomised controlled trials of the clinical effectiveness of compression bandage or stocking systems in the treatment of venous leg ulceration.Specific questions addressed by the review are:1. Does the application of compression bandages or stockings aid venous ulcer healing? 2. Which compression bandage or stocking system is the most effective? For this update we searched the Cochrane Wounds Group Specialised Register (14/10/08); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4 2008); Ovid MEDLINE (1950 to October Week 1 2008); Ovid EMBASE (1980 to 2008 Week 41) and Ovid CINAHL (1982 to October Week 1 2008). No date or language restrictions were applied. Randomised controlled trials recruiting people with venous leg ulceration that evaluated any type of compression bandage system or compression hosiery were eligible for inclusion. Comparators included no compression (e.g. primary dressing alone, non-compressive bandage) or an alternative type of compression. Trials had to report an objective measure of ulcer healing in order to be included (primary outcome for the review). Secondary outcomes of the review included ulcer recurrence, costs, quality of life, pain, adverse events and withdrawals. There was no restriction on date, language or publication status of trials. Details of eligible studies were

  11. Management of ulcers in lymphoedematous limbs

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    Vishnu M Karnasula

    2012-01-01

    Full Text Available Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care.

  12. Toll-Like Receptor 4 Wild Type Homozygozity of Polymorphisms +896 and +1196 Is Associated with High Gastrin Serum Levels and Peptic Ulcer Risk.

    Science.gov (United States)

    Pohjanen, Vesa-Matti; Koivurova, Olli-Pekka; Huhta, Heikki; Helminen, Olli; Mäkinen, Johanna M; Karhukorpi, Jari M; Joensuu, Tapio; Koistinen, Pentti O; Valtonen, Jarno M; Niemelä, Seppo E; Karttunen, Riitta A; Karttunen, Tuomo J

    2015-01-01

    Toll-like receptor 4 is a part of the innate immune system and recognizes Helicobacter pylori lipopolysaccharide. The goal of this study was to analyze the role of Toll-like receptor 4 polymorphisms +896 (rs4986790) and +1196 (rs4986791) in the pathogenesis of Helicobacter pylori related gastroduodenal diseases in relation to gastric secretion and inflammation. Toll-like receptor 4 polymorphisms, serum gastrin-17 and pepsinogen I and II concentrations were determined, and gastroscopies with histopathological analyses were performed to 216 dyspeptic patients. As genotype controls, 179 controls and 61 gastric cancer patients were studied. In our study, the Toll-like receptor 4 +896 and +1196 polymorphisms were in total linkage disequilibrium. The homozygous wild types displayed higher gastrin-17 serum concentrations than the mutants (p = 0.001) and this effect was independent of Helicobacter pylori. The homozygous wild types also displayed an increased risk for peptic ulcers (OR: 4.390). Toll-like receptor 4 genotypes did not show any association with Helicobacter pylori positivity or the features of gastric inflammation. Toll-like receptor 4 expression was seen in gastrin and somatostatin expressing cells of antral mucosa by immunohistochemistry. Our results suggest a role for Toll-like receptor 4 in gastric acid regulation and that the Toll-like receptor 4 +896 and +1196 wild type homozygozity increases peptic ulcer risk via gastrin secretion.

  13. Intestinal microbiota and ulcerative colitis.

    Science.gov (United States)

    Ohkusa, Toshifumi; Koido, Shigeo

    2015-11-01

    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  14. Prevalence and risk factors of atrophic gastritis and intestinal metaplasia in a Korean population without significant gastroduodenal disease.

    Science.gov (United States)

    Kim, Nayoung; Park, Young Soo; Cho, Sung-Il; Lee, Hye Seung; Choe, Gheeyoung; Kim, In Wook; Won, Yoo-Deok; Park, Ji Hyun; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung

    2008-08-01

    The prevalence of gastric cancer and Helicobacter pylori infection is unacceptably high in Korea. This study was performed to evaluate the prevalence of atrophic gastritis (AG) and intestinal metaplasia (IM) and to identify their risk factors with respect to H. pylori virulence factors, and environmental and host factors, in Korean population without significant gastroduodenal disease. The study cohort consisted of 389 subjects (> or = 16 years). AG and IM were scored histologically using the Sydney classification in the antrum and body, respectively. Prevalences and bacterial factors (i.e. cagA, vacA m1, and oipA), environmental factors (i.e. smoking and alcohol), and host factors (i.e. genetic polymorphisms of IL-1B-511, IL-1RN, TNF-A-308, IL-10-592, IL-10-819, IL-10-1082, IL-8-251, IL-6-572, GSTP1, p53 codon 72, and ALDH2) were evaluated. Prevalences of AG in the antrum and body were 42.5% and 20.1%, and those of IM were 28.6% and 21.2%, respectively. The presences of AG and IM were significantly higher in H. pylori-positive than in the H. pylori-negative subjects. Multivariate analysis showed that the risk factors for AG were H. pylori infection, age > or = 61 years, and cagA and vacA m1 positivity. For IM the risk factors were H. pylori infection, age > or = 61 years, a smoking history (rather than current smoking), strong spicy food, occupation (unemployed or nonprofessional vs. professional), and the presence of IL10-592 C/A as opposed to A/A. In addition, IL6-572 G carrier was found to have a protective effect against IM development as compared with C/C. H. pylori infection was most important risk factor of AG and IM. Bacterial factors were found to be important risk factor for AG but environmental and host factors were more important for IM.

  15. Management of pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Turner, Dan; Levine, Arie; Escher, Johanna C

    2012-01-01

    Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR......) of the literature and a robust consensus process. The present article is a product of a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)....

  16. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

    Full Text Available Introduction Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended. Case Outline The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. . As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now. Conclusion The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome. .

  17. Gastric Ulcers Syndrome in Donkeys

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    Abelardo Morales Briceño

    2015-09-01

    Full Text Available This study aimed to describe gastric ulcer in donkeys. 10 donkeys (Equus asinus were studied in Bodonal de la Sierra, Badajoz-Extremadura, Spain. They were referred for necropsy and dead due to non-digestive causes. 4 males and 6 females were examined. The ages were classified of 4-16 years old. The stomach and gastric mucosa was evaluated for classified Merrit, 2003. Samples of gastric tissue were collected. The samples fixed in formalin were processed by conventional histological techniques and examined by histopathology. None of the donkeys presented clinical signs for gastric ulcers syndrome. Of the 10 donkeys studied, 10% had Grade 0; 30% Grade 1; 40% Grade 2; 10% Grade 3; and 10% Grade 4. In 30% (3/10 parasites such as Gasterophilus sp. were observed. The histological slices revealed severe damage on the gastric mucosa, a loss of continuity of the gastric mucosa with corium exposure, and subchorionic edema with parakeratotic hyperkeratosis, together with a mixed lymphoplasmocytic mononuclear infiltrate. In conclusion, we reported gastric ulcers syndrome in donkeys in Spain.

  18. Infliximab for refractory oral ulcers.

    Science.gov (United States)

    Ryu, Hee Jung; Seo, Mi Ryoung; Choi, Hyo Jin; Baek, Han Joo

    2014-01-01

    Recurrent oral ulcer (ROU) is a common condition that significantly impacts quality of life. It is often related to systemic diseases, such as Behçet's disease (BD), Crohn's disease, and ulcerative colitis. Treatment of ROU depends on its severity: from topical agents for mild cases to systemic agents, such as corticosteroids, azathioprine, or other immunosuppressants for severe cases. Recently, good results have been reported with infliximab in refractory ROU. However, the optimal dosage and treatment duration have not been determined and the cost and potential side effects should be considered. We report on four patients who received a single-dose infliximab for refractory ROU. Two patients had refractory ROU with no underlying disease; one of them had soft palate perforation accompanied by severe oral ulcers. The two other patients had ROU of BD without major organ involvement. All patients received a single infusion of infliximab and an additional infusion was given on demand in one patient. Infliximab showed a rapid, good response in three patients and was also effective in improving the acute inflammation in the perforation of the soft palate, which had been resistant to conventional therapies. These effects diminished over a few weeks, but the ROU were tolerable and it was not necessary to increase steroids or add another medicine for about 1 year. We suggest that a single infusion of infliximab can be considered for refractory ROU. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Gastric ulcer bleeding: diagnosis by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Voloudaki, Argyro; Tsagaraki, Kaliopi; Mouzas, John; Gourtsoyiannis, Nickolas

    1999-06-01

    A case of CT demonstration of a bleeding gastric ulcer is presented, in a patient with confusing clinical manifestations. Abdominal CT was performed without oral contrast medium administration, and showed extravasation of intravenous contrast into a gastric lumen distended with material of mixed attenuation. It is postulated that if radiopaque oral contrast had been given, peptic ulcer bleeding would probably have been masked. CT demonstration of gastric ulcer bleeding, may be of value in cases of differential diagnostic dilemmas.

  20. Trophic ulcers in the carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Abelardo Q.-C. Araújo

    1993-09-01

    Full Text Available A patient with carpal tunnel syndrome (CTS and trophic ulcers is described. Despite the healing of the ulcers after surgery for CTS, the severe sensory deficit and the electrophysiological tests have not shown any significant improvement. We think these findings argue against the hypothesis of the sensory deficit being responsible for the trophic ulcers. We favor a major role for the sympathetic disturbances as the main cause for those lesions.

  1. Therapeutics for Equine Gastric Ulcer Syndrome.

    Science.gov (United States)

    Zavoshti, Fereydon Rezazadeh; Andrews, Frank M

    2017-04-01

    Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are necessary for prevention of recurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Confocal laser endomicroscopy in ulcerative colitis

    DEFF Research Database (Denmark)

    Karstensen, John Gásdal; Săftoiu, Adrian; Brynskov, Jørn

    2016-01-01

    was to correlate colonic confocal laser endomicroscopy (CLE) in ulcerative colitis with histopathology and macroscopic appearance before and after intensification of medical treatment. METHODS: Twenty-two patients with ulcerative colitis in clinical relapse and 7 control subjects referred for colonoscopy were...... colitis compared with inactive ulcerative colitis...... is an emerging endoscopic technique that reproducibly identifies mucosal changes in ulcerative colitis. With the exception of crypt changes, endomicroscopic features appear to improve slowly with time after medical treatment. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01684514.)....

  3. Ischemic Gastropathic Ulcer Mimics Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Saleh Daher

    2016-01-01

    Full Text Available Gastric ulcer due to mesenteric ischemia is a rare clinical finding. As a result, few reports of ischemic gastric ulcers have been reported in the literature. The diagnosis of ischemic gastropathy is seldom considered in patients presenting with abdominal pain and gastric ulcers. In this case report, we describe a patient with increasing abdominal pain, weight loss, and gastric ulcers, who underwent extensive medical evaluation and whose symptoms were resistant to medical interventions. Finally he was diagnosed with chronic mesenteric ischemia, and his clinical and endoscopic abnormalities resolved after surgical revascularization of both the superior mesenteric artery and the celiac trunk.

  4. Ulcer pain in patients with venous leg ulcers related to antibiotic treatment and compression therapy.

    Science.gov (United States)

    Akesson, Nina; Oien, Rut Frank; Forssell, Henrik; Fagerström, Cecilia

    2014-09-01

    The aim of this study was to compare venous leg ulcer patients with and without ulcer pain to see whether ulcer pain affected the use of antibiotic treatment and compression therapy throughout healing. A total of 431 patients with venous leg ulcers were included during the study period. Every patient was registered in a national quality registry for patients with hard-to-heal leg, foot, and pressure ulcers. A high incidence of ulcer pain (57%) was found when the patients entered the study. Patients with ulcer pain had been treated more extensively with antibiotics both before and during the study period. Throughout healing there was a significant reduction of antibiotic use among patients in the 'no pain' group, from 44% to 23% (P=0.008). There was no significant difference between the two groups concerning compression therapy (85% vs. 88%), but 12% of patients in the 'pain' group did not get their prescribed compression compared with 6% of patients in the 'no pain' group. The groups did not differ significantly in terms of ulcer duration, ulcer size or healing time. This study shows a high incidence of ulcer pain, confirming that pain has a great impact on patients with venous leg ulcers. Results further suggest that the presence of ulcer pain increases the prescription of antibiotics but does not affect the use of compression therapy. Several advantages were found from using a national quality registry. The registry is a valuable clinical tool showing the importance of accurate diagnosis and effective treatment.

  5. Exostectomy for chronic midfoot plantar ulcer in Charcot deformity

    DEFF Research Database (Denmark)

    Laurinaviciene, R.; Kirketerp-Moeller, K.; Holstein, Per Evald

    2008-01-01

    Charcot midfoot ulcers are rare and very difficult to heal, with surgery being an option. This retrospective study assessed healing rates, complications, and the incidence of re-ulceration and other foot ulcer problems following exostectomies Udgivelsesdato: 2008/2......Charcot midfoot ulcers are rare and very difficult to heal, with surgery being an option. This retrospective study assessed healing rates, complications, and the incidence of re-ulceration and other foot ulcer problems following exostectomies Udgivelsesdato: 2008/2...

  6. Ulcer-free survival following management of foot ulcers in diabetes.

    Science.gov (United States)

    Pound, N; Chipchase, S; Treece, K; Game, F; Jeffcoate, W

    2005-10-01

    Measures of healing rate may not give a complete indication of the effectiveness of overall management of diabetic foot ulcers. Apart from healing and speed of healing, the outcomes of greatest importance to the patient are avoidance of any amputation and remaining free from any recurrence. We have documented the number of patients presenting with diabetic foot ulcers who become ulcer free and examined the value of documenting ulcer-free survival. All referrals to a specialist diabetic foot clinic over a 31-month period were analysed and outcomes were determined after a minimum follow-up of 6 months. Three hundred and seventy patients were referred with a total of 1031 ulcers. One hundred and twenty-one (32.7%) never became ulcer free: 56 (46.3% of 121) remained unhealed, the ulcers of 12 (9.9% of 121) had been resolved by amputation, two remained unhealed after amputation (1.7% of 121) and 51 (13.8% of 370) had died. Two hundred and thirty-one (62.4% of 370) became ulcer free at some stage. Five of these were excluded because of an earlier amputation. Ninety-one of the remaining 226 (40.3%) developed a recurrent or new ulcer after a median 126 days. Of the 135 who did not have a recurrence, 133 (58.8% of 226; 35.9% of 370) survived ulcer free and with limbs intact, while two died. Outcome was unknown in 18 (4.9%). Those who never became ulcer free were older (P ulcer had a greater prevalence of neuropathy (P = 0.027) than those who remained ulcer free. The use of ulcer-free survival can be used as an indication of the effectiveness of foot ulcer management. It could be adopted as a measure to compare performance between different specialist units.

  7. Mucosal healing in ulcerative colitis

    DEFF Research Database (Denmark)

    Seidelin, Jakob Benedict; Coskun, Mehmet; Nielsen, Ole Haagen

    2013-01-01

    Ulcerative colitis (UC) is a colonic inflammatory condition with a substantial impact on the quality of life of affected persons. The disease carries a cumulative risk of need of colectomy of 20-30% and an estimated cumulative risk of colorectal cancer of 18% after 30 years of disease duration...... epithelial cells and other cells of the mucosa are discussed. The biochemistry of wound healing in UC provides the basis for the subsequent description of how these pathways are affected by the current medications, and what can be learnt on how to design future treatment regimens for UC based on targeting...

  8. Cholescintigraphy in the evaluation of gastroduodenal reflux in children with gastritis - preliminary report; Cholescyntygrafia w badaniu refluksu dwunastniczo-zoladkowego u dzieci z zapaleniem zoladka - doniesienie wstepne

    Energy Technology Data Exchange (ETDEWEB)

    Lass, P.; Szarszewski, A.; Romanowicz, G.; Mizan, K.; Gumkowska-Kaminska, B.; Slominski, J.M. [Akademia Medyczna, Gdansk (Poland)

    1994-12-31

    We assessed by means of Tc-99m-HEPIDA cholescintigraphy the gastroduodenal reflux in 28 children with endoscopic signs of gastric biliary reflux. Those children were selected from a group of 190 children who underwent endoscopy because of abdominal pain disorders. We found the positive cholescintigraphic test in 67% of children. In 6 control tests after 4-months treatment with cisapride we found the withdrawal of cholescintigraphic signs, which corresponded with the improvement of clinical signs. The authors consider the cholescintigraphic examination useful in evaluation of biliary reflux in children, for the sake of more non-invasive character in comparison to endoscopy and X-ray contrast imaging after catheterizing of duodenum. (author). 9 refs.

  9. Duodenal application of Li+ in a submaximal therapeutic dose inhibits exocrine pancreatic secretion and modulates gastro-duodenal myoelectrical activity in a conscious pig model

    DEFF Research Database (Denmark)

    Naughton, Violetta; Hedemann, Mette Skou; Naughton, Patrick Joseph

    2013-01-01

    for electromyography of smooth muscles, and with a pancreatic duct catheter and a duodenal T-cannula for collection and re-entrant flow of pancreatic juice. After the recovery period, on alternative days, each animal was tested once with an intraduodenal infusion of Li+ (100 mmol·L–1 C3H5LiO3, 10 mL·kg−1·h−1) for 1 h......This study tested whether duodenal application of lithium inhibits gastroduodenal motility, and whether it suppresses secretion from the exocrine pancreas. Five suckling pigs, 16–18 days old, were surgically fitted with 3 serosal electrodes on the wall of the gastric antrum and the duodenum...

  10. Gastroduodenal lipomatosis. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Devlies, F. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Hoe, L. van [Dept. of Radiology, University Hospitals, Leuven (Belgium); Leemans, A.M. [Dept. of Pathology, University Hospitals, Leuven (Belgium); Ponette, E. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Paepe, I. de [Dept. of Radiology, University Hospitals, Leuven (Belgium)

    1997-04-01

    fomparison of CT studies performed in 1990 and 1995 revealed no progression. Endoscopic biopsies were obtained repeatedly; there were no signs of malignancy. Optical microscopy of the duodenal biopsies showed a well-preserved villous architecture, normal surface, and cryptic epithelial cells, and, in the lamina propria, a significant increase in inflammatory cells, focally infiltrating the surface epithelium. Besides this pattern of chronic duodenitis, an increased amount of mature adipocytes in the submucosa was found. Although the Brunner glands were still well preserved, they were, however, partially irregular because of the presence of adipocytes in the intervening stroma, The adipose tissue was indeed not incapsulated, nor well circumscribed, suggesting a lipomatosis, rather than a lipoma. The size of the samples did, however, not allow a proper distinction between those conditions. (orig./AJ). With 4 figs.

  11. Association between ulcer site and outcome in complicated peptic ulcer disease

    DEFF Research Database (Denmark)

    Lolle, Ida; Møller, Morten Hylander; Rosenstock, Steffen Jais

    2016-01-01

    OBJECTIVE: Mortality rates in complicated peptic ulcer disease are high. This study aimed to examine the prognostic importance of ulcer site in patients with peptic ulcer bleeding (PUB) and perforated peptic ulcer (PPU). MATERIALS AND METHODS: DESIGN: a nationwide cohort study with prospective...... and adjusted association between ulcer site (gastric and duodenal) and the outcome measures of interest were assessed by binary logistic regression analysis. RESULTS: Some 20,059 patients with PUB and 4273 patients with PPU were included; 90-d mortality was 15.3% for PUB and 29.8% for PPU; 30-d mortality...... was 10.2% and 24.7%, respectively. Duodenal bleeding ulcer, as compared to gastric ulcer (GU), was associated with a significantly increased risk of all-cause mortality within 90 and 30 d, and with re-intervention: adjusted odds ratio (OR) 1.47 (95% confidence interval 1.30-1.67); p 

  12. Vulval Ulcers | Rogers | Obstetrics and Gynaecology Forum

    African Journals Online (AJOL)

    The vulval ulcers that are seen in obstetrics and gynaecological practice in South Africa are most commonly caused by sexually transmitted diseases, especially herpes simplex infection. These ulcers have become more common due to the Human immunodeficiency virus (HIV) epidemic, and are also responsible for ...

  13. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, R. H.; Rozendaal, M; Wouters-Wesseling, W; Buskens, E.; Keller, P; Haalboom, JRE

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU

  14. Oesophageal Ulceration in Human Immunodeficiency Virus Infected ...

    African Journals Online (AJOL)

    Objective. To determine the aetiology of oesophageal ulceration in HIV-infected patients. Design. A retrospective clinical, endoscopic and histopathological analysis of patients with confirmed HIV infection and an oesophageal ulcer diagnosed on endoscopy. Setting. A tertiary referral, gastrointestinal clinic in Cape Town.

  15. [Treatment of patients with trophic ulcer].

    Science.gov (United States)

    Karapetian, G É; Iakimov, S V; Mikitin, I L; Kochetova, L V; Pakhomova, R A

    2014-01-01

    The authors present the investigation of inpatient treatment of 137 patients with trophic ulcers of venous aethiology. All the patients were hospitalized in the "Road clinical hospital" on the Krasnoyarsk station. A comparative analysis of treatment results of the patients with trophic ulcers using different medical methods was made. The efficacy of combined use of low-frequency ultrasound and ozone therapy was proved.

  16. Corynebacterium macginleyi isolated from a corneal ulcer

    Directory of Open Access Journals (Sweden)

    Kathryn Ruoff

    2010-02-01

    Full Text Available We report the isolation of Corynebacterium macginleyi from the corneal ulcer culture of a patient, later enrolled in the Steroids for Corneal Ulcer Trial (SCUT. To our knowledge this is the first published report from North America of the recovery of C. macginleyi from a serious ocular infection.

  17. Perforated peptic ulcer: How to improve outcome?

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Adamsen, Sven; Wøjdemann, Morten

    2008-01-01

    Despite the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased....

  18. Helicobacter pylori infection and duodenal ulcer disease

    NARCIS (Netherlands)

    Tytgat, G. N.; Noach, L. A.; Rauws, E. A.

    1993-01-01

    H. pylori is undoubtedly the dominant factor in the multifactorial peptic ulcer diathesis. We should not ignore the other contributing factors but rather try to identify how they interact with the organism and initiate the ulcerative process. The interplay of acid attack and mucosal defence is

  19. Diabetic foot ulcer teams in Norwegian hospitals.

    Science.gov (United States)

    Robberstad, Mari; Bentsen, Signe Berit; Berg, Tore Julsrud; Iversen, Marjolein M

    2017-09-19

    The national clincial guidelines for diabetes recommend that diabetic foot ulcers be treated by interdisciplinary diabetic foot ulcer teams. This study aims to survey the extent of diabetic foot ulcer teams in the specialist health service in Norwegian hospitals and to describe their clinical composition, organisation and working routines. The study is cross-sectional with the use of a questionnaire survey. The criteria for participating were somatic hospitals with 24-hour operations and a specialist function for patients with diabetes mellitus. A total of 41 hospitals participated of the 51 that fulfilled the criteria. Altogether 17 of 41 hospitals had diabetic foot ulcer teams. The teams had a broad clinical composition and followed national recommendations for surveying risk factors and treatment of diabetic foot ulcers. Nine foot ulcer teams had written routines for assessment, five used the Noklus diabetes patient records to document ulcer treatment, and ten had planned interdisciplinary meetings. Only one-quarter of the teams included both medical and surgical competence in the planned interdisciplinary collaboration. The diabetic foot ulcer teams had broad clinical competence and followed national clinical guidelines. The teams had a short waiting time for the initial consultation, half had written guidelines, and 60 % had planned interdisciplinary meetings. Far fewer had included both medical and surgical competence in the planned interdisciplinary collaboration.

  20. Complex interventions for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.

    2015-01-01

    BACKGROUND: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent.

  1. Umbilical cord ulceration and jejunal atresia

    African Journals Online (AJOL)

    The association between umbilical cord ulceration and congenital intestinal atresia is being increasingly reported and carries a high mortality. We report on a case of jejunal atresia associated with massive fetal haemorrhage from an umbilical cord ulcer. Fetal distress noted on continuous fetal heart monitoring allowed for ...

  2. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    153 CME April 2013 Vol. 31 No. 4. Corneal ulcers: For the general practitioner. A corneal ulcer is a defect in the epithelial layer of the cornea. e general practitioner may play an important role in early management and appropriate referral. Incidence varies and depends on aetiology. S Ballim, MB ChB, Dip Ophth (SA), FC ...

  3. Ulcer recurrence after in-hospital treatment for recalcitrant venous leg ulceration.

    Science.gov (United States)

    Reeder, S; de Roos, K-P; de Maeseneer, M; Sommer, A; Neumann, H A M

    2013-05-01

    Leg ulceration caused by chronic venous disease occurs in 1% of the adult Western population. A majority of these patients is successfully treated in the outpatient setting. A minority of patients is hospitalized, most frequently because of the lack of healing tendency. The literature provides recurrence rates for ulcer disease, but lacks specific data on recurrence rates after in-hospital treatment of recalcitrant venous leg ulcers. To investigate time to ulcer recurrence after in-hospital treatment of venous leg ulceration. A multicentre, retrospective cohort study of patients admitted for leg ulceration between 1996 and 2007 was conducted. Data could be collected for 107 of the patients. Of these, 27 had conservative treatment (bed rest, local wound care, pain management) and 48 patients underwent surgical ulcer treatment with (n = 19) or without (n = 29) initial vacuum-assisted closure (VAC) treatment. The treatment method was 'miscellaneous' in the remaining 32 patients. Median admission time was 30 days, median percentage of closure at discharge was 95%, and median time to ulcer recurrence 60 days. The Mann-Whitney U-test showed significant differences between the conservative group and the surgery group, the latter having a longer length of hospital stay (P ulcer closure (P ulcer recurrence (P = 0.273). Comparable differences were demonstrated between the conservative group and the VAC plus surgery group. No significant differences could be demonstrated between the surgically treated patients and those treated by VAC and surgery. Hospital stay is significantly shorter in cases of surgical treatment of recalcitrant venous leg ulcers. Most ulcers recur within 2 months after hospital discharge. Recurrence of venous leg ulcers after hospital admission is independent of the method of treatment and cause of ulceration. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

  4. Duodenoscopic appraisal of duodenal ulcer in dogs

    Directory of Open Access Journals (Sweden)

    S Kavitha

    Full Text Available Aim: To assess the usefulness of duodenoscopy in the diagnosis of duodenal ulcers in dogs. Materials and Methods: Sick dogs with chronic gastrointestinal problems were physically examined and samples were collected for haematology, biochemistry and faecal examination. Duodenal biopsies, duodenal contents and brush cytology were obtained via duodenoscopy. Results: Seven duodenal ulcers cases were recorded, higher incidences was recorded in Labrador retriever, 2-4 years of aged male dogs. Significantly decreased Hb (9.10 ± 0.25 g/dl, RBCs (4.39 ± 0.19 mill/cu.mm and albumin (2.343b ± 0.13 g/dl level were noticed. Hyperaemia with ulceration of duodenal mucosa was observed. Conclusion: Duodenoscopy is very much useful for detection of duodenal ulceration and provided a sensitive technique for early diagnosis of mucosal lesions and ulceration. [Vet. World 2012; 5(7.000: 420-423

  5. Ulcers

    Science.gov (United States)

    ... Reye SyndromeTeenage Pregnancy and Birth Control AccessRead Article >>Teenage Pregnancy and Birth Control Access Check Your Symptoms Find ... harmful to the brain and liver. It often…Teenage Pregnancy and Birth Control AccessRead Article >>Kids and TeensTeenage ...

  6. [REAL-TIME PCR IN THE COMPLEX DIAGNOSTICS OF COMBINED PATHOLOGY OF THE PERIODONTIUM AND GASTRO-DUODENAL ZONE].

    Science.gov (United States)

    Yanushevich, O O; Mayev, I V; Ayvazova, R A; Shibaeva, A V; Shevelev, A B

    2015-01-01

    Biological material of 92 patients (18-85 years old) with different severity chronic periodontitis were analyzed for bacterial pathogen colonization by using Dentofol kit (DNA-technology, Moscow). The cohort included 70 individuals with chronic gastritis, 2 patients with gastric and duodenal ulceration and 20 individuals with no gastric/duodenal pathology. The tight- est association with severity of the chronic periodontitis in the analyzed sub-cohort with the chronic gastritis was found with the prevalence of a complex T. for sythensis/T. denticola. Key contribution of this complex to progression of periodon- titis in males of the eldest group (above 55) was hypothesized. This data essentially differ from published results of other research groups where T. forsythensis and T. denticola were never reported as the principal causative agents of the chronic periodonitis in the gender/age/combined pathology normalized cohorts.

  7. DIABETIC FOOT ULCERS MICROBIOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    P. Rajagopal

    2016-08-01

    Full Text Available BACKGROUND AND OBJECTIVES Infections of all types are more common in patients with diabetes, on the basis of outcome of retrospective study in Canada. Many types of infections are very common in diabetic than non-diabetic patients. Foot is the most common site. Diabetic foot infections range from mild infections to limb threatening conditions. Most require emergency medical attention. Diabetic foot infection is a global burden and projected to increase from 246 million people to over 380 million people by the year 2025. Many people with diabetes develop complications that seriously affect their quality and length of life. Lower limb complications are common, particularly foot ulcers and gangrene. Development of these complications is attributed to individual risk factors, poverty, racial and ethnic differences, and quality of local and national health care systems. The wide variations noted suggest that best practices in low incidence areas could easily be adapted in high incidence areas to reduce the burden of complications. Almost every infection begins in a wound, often as neuropathic ulceration or a traumatic break in the skin. Infections that begin as a small problem may progress to involve soft tissue, bones and joints. Because of these morbidity and occasional mortality by these foot infections several authoritative groups have recently developed guidelines for assessing and treating diabetic foot. METHODOLOGY 100 Diabetic patients with foot ulcers were admitted and wounds were classified using wagner’s classification. Pus was sent for culture and sensitivity and treated accordingly. RESULTS In our study the most common organism cultured from the wound with diabetes mellitus was staphylococcus. The most sensitive drug for these organisms was found to be chloramphenicol on most occasions. CONCLUSION The rationale of pus culture and sensitivity is not only to definitively treat the diabetic wound after the culture sensitivity report is

  8. Acute Necrotizing Ulcerative Gingivitis (ANUG

    Directory of Open Access Journals (Sweden)

    Nicholas E. Kman

    2017-04-01

    Full Text Available History of Present Illness: A 34-year-old HIV positive female presented to the emergency department with a three-week history of swollen, painful gums. She had difficulty eating and chewing, along with aches and general malaise. The patient was an everyday smoker and was not taking any antiretroviral medication. Significant findings: Physical examination revealed inflamed gingiva, ulceration, and soft tissue necrosis (Image 1 along with mandibular lymphadenopathy (not shown. Given her symptoms, poor oral care, and her immunocompromised state, she was given a diagnosis of Acute Necrotizing Ulcerative Gingivitis (ANUG or Vincent’s Angina. Discussion: Acute Necrotizing Ulcerative Gingivitis (ANUG, Vincent’s Angina, or Trench Mouth is the only periodontal disease in which bacteria invade non-necrotic tissue. The etiology is usually secondary to fusobacteria and spirochete overgrowth of bacteria which is normally present in the oral cavity. HIV infection, previous necrotizing gingivitis, poor oral hygiene, malnutrition, smoking, and stress are predisposing factors. Antibiotics and improved nutrition have significantly decreased the incidence of ANUG. The prevalence of ANUG among HIV infected patients varies from 4.3% to 16.0%. ANUG is 20.8 times more likely to be seen in AIDS patients with CD4 counts less than 200 cells/mm3. In developing countries, like those in Sub-Saharan Africa, incidence of ANUG is increasing among children with a prevalence as high as 23% in children under 10 years of age.1 Treatment for ANUG is multifactorial. Patients need good debridement under anesthesia so dental referral is imperative. Pain control with Ibuprofen or low dose opioids is indicated. Oral hygiene instructions include Chlorhexidine 0.12% twice daily, proper nutrition, appropriate fluid intake, and smoking cessation. For signs of systemic involvement, the recommended antibiotics are Amoxicillin and Metronidazole.2 If left untreated, ANUG may lead to rapid

  9. Compression Stockings for Treating Venous Leg Ulcers

    Directory of Open Access Journals (Sweden)

    J. P. Benigni

    2013-01-01

    Full Text Available Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle. Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit. In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.

  10. Determination of ulcer protecting effect of ethanol extract of ...

    African Journals Online (AJOL)

    chi

    2013-09-18

    Sep 18, 2013 ... temperature and stored for use. The anti-ulcer activity of the ... Key words: Gongronema latifolium, ulcer, protection, indomethacin, acid/ethanol. .... toxicity or fatality for 24 h. Effect of crude ethanol extract on Indomethacin-induced ulcer. The method of Urishidani et al. (1979) was utilized. Gastric ulceration ...

  11. Úlcera péptica gastroduodenal e infecção helicobacter pylori em crianças e adolescentes: fatores de risco do hospedeiro e da bactéria

    OpenAIRE

    Paulo Fernando Souto Bittencourt

    2006-01-01

    Artigo de revisão Úlcera péptica gastroduodenal na criança e no adolescente Objetivo: o presente trabalho tem por objetivo rever as principais publicações sobre a úlcera péptica gastroduodenal na criança e no adolescente. Fontes dos dados: a pesquisa bibliográfica foi realizada nas bases de dados Medline, de 1966 a 2005 e no Lilacs, de 1979 a 2003, em português, espanhol e inglês, utilizando-se as palavras chave, úlcera, péptica, crianças, adolescentes. Síntese dos dados: as úlceras pép...

  12. Tetracycline ulcers of the oesophagus

    Energy Technology Data Exchange (ETDEWEB)

    Winckler, K.

    1981-11-01

    Two cases of tetracycline ulcers of the oesophagus are reported and compared with thirteen other cases from the literature. In most cases, the patients had taken their capsules with little or no fluid just before going to bed. Some hours later they developed retrosternal pain that was intensified by swallowing. Endoscopy showed sharply demarcated greyish-white areas of mucosal damage which represented layers of stratified squamous cells, separated by oedema, and a dense neutrophilic infiltration of the lamina propria and the muscularis mucosa. Roentgenology was unsuitable to detect the lesions. They healed without complications within one to six weeks. Prolonged retention of the capsules in the oesophagus is thought to cause the mucosal damage. Patients on oral tetracycline or doxycycline treatment should therefore be instructed to take their capsules with a meal or with copious water and not just before going to bed.

  13. Left Ventricular Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Tarek Saleh

    2010-07-01

    Full Text Available Left ventricular thrombi usually occur in the setting of an acute myocardial infarction, left ventricular aneurysm, or dilated cardiomyopathy. In the absence of ventricular wall motion abnormalities, they are rare. This report describes a patient with ulcerative colitis in whom two-dimensional echocardiography revealed a left intraventricular mass. Thrombosis in ulcerative colitis is a serious condition and can occur in a very young population. This case also shows that left ventricular thrombi can occur in the active setting of ulcerative colitis.

  14. Diabetic foot ulcers: Part II. Management.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  15. [Contact eczema in patients with leg ulcers].

    Science.gov (United States)

    Degreef, H; Dooms-Goossens, A; Gladys, K

    1986-01-01

    Patients with leg ulcers or varicose eczema suffer much more often from contact eczema due to the local application of pharmaceutical preparations than patients suffering from other dermatological problems (even those of eczematous origin). This contact allergy may concern not only the active ingredient but also the excipient, the preservative, or even the perfume. In all cases of leg ulcers, of varicose eczema, but also of badly healed ulcers, epicutaneous tests should be carried out with all the components of the pharmaceutical preparations concerned. Moreover, the pharmaceutical industry really must perfect non-allergenic preparations.

  16. The personality patterns in patients with duodenal ulcer and ulcer-like dyspepsia and their relationship to the course of the diseases. Hvidovre Ulcer Project Group

    DEFF Research Database (Denmark)

    Jess, P; Eldrup, J

    1994-01-01

    OBJECTIVES. To compare personality characteristics in duodenal ulcer patients and patients with ulcer-like dyspepsia from the primary health sector with duodenal ulcer patients from a hospital and to evaluate the relationship of the personality characteristics to the course of the diseases. DESIGN......, Denmark. SUBJECTS. Sixty hospital patients with duodenal ulceration and 17 patients with duodenal ulceration plus 25 patients with ulcer-like dyspepsia from the primary health sector. MAIN OUTCOME MEASURES. MMPI scores. RESULTS. The hospital patients differed from the two other groups of patients...

  17. A young man with nonhealing venous ulcers

    NARCIS (Netherlands)

    Vloedbeld, M. G.; Venema, A. W.; Smit, A. J.

    A 35-year-old man presented with nonhealing ulcers at an atypical location on his left foot, caused by a combination of venous insufficiency (after deep venous thrombosis) and arterial insufficiency. The underlying cause was Buerger's disease.

  18. Scientists Spot Genes Behind Crohn's, Ulcerative Colitis

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_166957.html Scientists Spot Genes Behind Crohn's, Ulcerative Colitis Large study finds key ... Researchers say they've come closer to pinpointing genes linked with inflammatory bowel diseases such as Crohn's ...

  19. Sunitinib induced pyoderma gangrenosum-like ulcerations

    Directory of Open Access Journals (Sweden)

    Akanay-Diesel S

    2011-11-01

    Full Text Available Abstract Pyoderma gangrenosum is a non-infectious neutrophilic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α - and -β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment.

  20. Tannins, Peptic Ulcers and Related Mechanisms

    Science.gov (United States)

    de Jesus, Neyres Zinia Taveira; de Souza Falcão, Heloina; Gomes, Isis Fernandes; de Almeida Leite, Thiago Jose; de Morais Lima, Gedson Rodrigues; Barbosa-Filho, Jose Maria; Tavares, Josean Fechine; da Silva, Marcelo Sobral; de Athayde-Filho, Petrônio Filgueiras; Batista, Leonia Maria

    2012-01-01

    This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products. PMID:22489149

  1. Tannins, Peptic Ulcers and Related Mechanisms

    Directory of Open Access Journals (Sweden)

    Leonia Maria Batista

    2012-03-01

    Full Text Available This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products.

  2. Tannins, peptic ulcers and related mechanisms.

    Science.gov (United States)

    de Jesus, Neyres Zinia Taveira; de Souza Falcão, Heloina; Gomes, Isis Fernandes; de Almeida Leite, Thiago Jose; de Morais Lima, Gedson Rodrigues; Barbosa-Filho, Jose Maria; Tavares, Josean Fechine; da Silva, Marcelo Sobral; de Athayde-Filho, Petrônio Filgueiras; Batista, Leonia Maria

    2012-01-01

    This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products.

  3. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid...... and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  4. Gastric diverticulosis and ulcerations in bitches

    African Journals Online (AJOL)

    ADEYEYE

    2014-01-08

    Jan 8, 2014 ... confirmed through contrast radiography (using barium meal), hemogram, and ultrasonography. Management was effected using gastroplasty resulting in complete recovery from the initial clinical presentation. Keywords: Canine, Contrast radiography, Pyloroplasty, Gastric diverticulosis, Ulcerations.

  5. Chronic Leg Ulcers in Drug Abusers

    Directory of Open Access Journals (Sweden)

    Mittal Radha

    2000-01-01

    Full Text Available Four young males with chronic non pitting swelling of lower legs associated with multiple ulcers, scars and pigmentation after parenteral drug abuse were observed in the Dermatovenereology department during last one year. Three of them had active ulcers which healed with withdrawal of offending drug, use of systemic and topical antibiotics and B-complex. All cases were referred to the deaddiction centre. The characteristic clinical features helped in the diagnosis even before history of drug abuse was obtained.

  6. Medical device-related pressure ulcers

    OpenAIRE

    Black JM; Kalowes P

    2016-01-01

    Joyce M Black,1 Peggy Kalowes2 1Adult Health and Illness Department, College of Nursing, University of Nebraska Medical Center, Omaha, NE, 2Nursing Research and Innovation, Long Beach Memorial Miller Children’s & Women’s Hospital, Long Beach, CA, USA Abstract: Pressure ulcers from medical devices are common and can cause significant morbidity in patients of all ages. These pressure ulcers appear in the shape of the device and are most often found from the use of ox...

  7. Perianal Ulcer in an Asian Man.

    Science.gov (United States)

    Pillai, Nilanthy Sharon Anthony; Oh, Choon Chiat; Fung, Michelle Chan Mei; Wijaya, Limin

    2017-01-01

    A 79-year-old Chinese man presented with a 2-month history of pruritic, tender ulceration covering his perianal region. He was initially treated with oral amoxicillin/clavulanic acid and vancyclovir, with no improvement. His history included hypertension. On physical examination, there was a 1.5-cm solitary, pink shallow ulcer with a tender erythematous base on the right side of the buttock cleft (Figure 1).

  8. The economics of adalimumab for ulcerative colitis.

    Science.gov (United States)

    Xie, Feng

    2015-06-01

    Ulcerative colitis is a chronic inflammatory disease, characterized by diffuse mucosal inflammation in the colon. Adalimumab, as a TNF-α blocker, offers a safe and efficacious treatment option for patients with moderate to severe ulcerative colitis and refractory or intolerant to conventional medications; however, its cost-effectiveness profile has not yet been well established. Future economic evaluations should choose appropriate comparators in the context of target-reimbursement decision making and focus on cost-effectiveness over a long time horizon.

  9. Solitary ulcerated congenital giant juvenile xanthogranuloma

    Directory of Open Access Journals (Sweden)

    Su Yuen Ng

    2015-01-01

    Full Text Available A 3-month-old female patient with a giant ulcerated nodule over the back since birth was diagnosed as congenital giant juvenile xanthogranuloma (JXG based on clinical and histopathological examination. Congenital giant JXG with ulceration at birth is a rare presentation of JXG and commonly misdiagnosed. This case emphasizes the importance of being aware of the myriad presentations of JXG in order to make a correct diagnosis and avoid unnecessary investigations or treatment.

  10. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer

    Science.gov (United States)

    Graham, David Y

    2014-01-01

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease” or for “Sippy” diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori

  11. Non-contact ulcer area calculation system for neuropathic foot ulcer.

    Science.gov (United States)

    Shah, Parth; Mahajan, Siddaram; Nageswaran, Sharmila; Paul, Sathish Kumar; Ebenzer, Mannam

    2017-08-11

    Around 125,785 new cases in year 2013-14 of leprosy were detected in India as per WHO report on leprosy in September 2015 which accounts to approximately 62% of the total new cases. Anaesthetic foot caused by leprosy leads to uneven loading of foot leading to ulcer in approximately 20% of the cases. Much efforts have gone in identifying newer techniques to efficiently monitor the progress of ulcer healing. Current techniques followed in measuring the size of ulcers, have not been found to be so accurate but are still is followed by clinicians across the globe. Quantification of prognosis of the condition would be required to understand the efficacy of current treatment methods and plan for further treatment. This study aims at developing a non contact technique to precisely measure the size of ulcer in patients affected by leprosy. Using MATLAB software, GUI was designed to process the acquired ulcer image by segmenting and calculating the pixel area of the image. The image was further converted to a standard measurement using a reference object. The developed technique was tested on 16 ulcer images acquired from 10 leprosy patients with plantar ulcers. Statistical analysis was done using MedCalc analysis software to find the reliability of the system. The analysis showed a very high correlation coefficient (r=0.9882) between the ulcer area measurements done using traditional technique and the newly developed technique, The reliability of the newly developed technique was significant with a significance level of 99.9%. The designed non-contact ulcer area calculating system using MATLAB is found to be a reliable system in calculating the size of ulcers. The technique would help clinicians have a reliable tool to monitor the progress of ulcer healing and help modify the treatment protocol if needed. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  12. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer.

    Science.gov (United States)

    Graham, David Y

    2014-05-14

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician's believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for "surgical disease" or for "Sippy" diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases.

  13. Compression for preventing recurrence of venous ulcers.

    Science.gov (United States)

    Nelson, E Andrea; Bell-Syer, Sally E M

    2014-09-09

    Up to 1% of adults will have a leg ulcer at some time. The majority of leg ulcers are venous in origin and are caused by high pressure in the veins due to blockage or weakness of the valves in the veins of the leg. Prevention and treatment of venous ulcers is aimed at reducing the pressure either by removing/repairing the veins, or by applying compression bandages/stockings to reduce the pressure in the veins.The majority of venous ulcers heal with compression bandages, however ulcers frequently recur. Clinical guidelines therefore recommend that people continue to wear compression, usually in the form of hosiery (tights, stockings, socks) after their ulcer heals, to prevent recurrence. To assess the effects of compression (socks, stockings, tights, bandages) in preventing the recurrence of venous ulcers. If compression does prevent ulceration compared with no compression, then to identify whether there is evidence to recommend particular levels of compression (high, medium or low, for example), types of compression, or brands of compression to prevent ulcer recurrence after healing. For this second update we searched The Cochrane Wounds Group Specialised Register (searched 4 September 2014) which includes the results of regular searches of MEDLINE, EMBASE and CINAHL; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8). Randomised controlled trials (RCTs)evaluating compression bandages or hosiery for preventing the recurrence of venous ulcers. Two review authors undertook data extraction and risk of bias assessment independently. Four trials (979 participants) were eligible for inclusion in this review. One trial in patients with recently healed venous ulcers (n = 153) compared recurrence rates with and without compression and found that compression significantly reduced ulcer recurrence at six months (Risk ratio (RR) 0.46, 95% CI 0.27 to 0.76).Two trials compared high-compression hosiery (equivalent to UK class 3) with

  14. Effect of chronic aspirin ingestion on epithelial proliferation in rat fundus, antrum, and duodenum

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    Eastwood, G.L.; Quimby, G.F.

    1972-05-01

    We studied the effect of chronic aspirin ingestion on gastroduodenal epithelial proliferation by feeding rats aspirin in the drinking water. A control group of rats received plain water. At the end of 4 wk, (3H)-thymidine was given intravenously to label proliferating cells, and the rats were killed 1 h later. Sections of fundus, antrum, and proximal duodenum were processed for light autoradiography. We found that chronic aspirin ingestion stimulated epithelial proliferation in fundic mucosa but had no effect in the antrum. In the duodenum, aspirin increased proliferation in the lowest four crypt-cell positions, which most likely indicates an increase in stem-cell production. None of the tissues contained evidence of inflammation or ulceration. The proliferative effects of aspirin may help explain the previously observed phenomenon of mucosal adaptation in the rat after repeated exposure to aspirin. Further, if human gastroduodenal epithelium responds in a similar manner to chronic aspirin exposure, the effects on proliferation may explain in part the distribution of aspirin-associated ulcers.

  15. Surgical management of ulcerative colitis.

    Science.gov (United States)

    Bennis, Malika; Tiret, Emmanuel

    2012-01-01

    Surgery is the only curative option in the treatment of ulcerative colitis. Despite advances in the medical management surgery is required in about a third of patients. In the acute setting surgery is indicated when medical treatment fails to improve an episode of acute severe colitis. The intervention of choice is a staged colectomy with end ileostomy and preservation of the rectal stump in the first instance. Indications for elective surgery are failure of medical therapy and malignant transformation. The surgical options include conventional proctectomy with ileostomy or a Kock's continent ileostomy and colectomy with an ileorectal anastomosis. The current gold standard is restorative proctocolectomy with ileal pouch-anal anastomosis. Most frequently the technique includes a J pouch with a stapled anastomosis and temporary faecal diversion with a loop ileostomy. Laparoscopic pouch surgery is a feasible and safe option with an excellent cosmetic result. Although the morbidity remains significant after surgery, the quality of life is good with a satisfactory long-term functional outcome.

  16. Golimumab in unresponsive ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Lippert E

    2014-05-01

    Full Text Available Elisabeth Lippert, Martina Müller, Claudia Ott University Hospital Regensburg, Department of Internal Medicine I, Regensburg, Germany Abstract: Ulcerative colitis (UC is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines and the biologics providing blockade of tumor necrosis factor (TNF, the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. Keywords: anti-TNF, biological therapy, inflammatory bowel disease

  17. Pseudomembranous colitis complicating ulcerative colitis.

    Science.gov (United States)

    Kawaratani, Hideto; Tsujimoto, Tatsuhiro; Toyohara, Masahisa; Kin, Kenichi; Taniguchi, Tomoyasu; Shirai, Yasuyo; Ikenaka, Yasuhide; Nakayama, Masaki; Fujii, Hisao; Fukui, Hiroshi

    2010-10-01

    Clostridium difficile toxin (CD toxin) causes antibiotic-associated colitis, or pseudomembranous colitis (PMC). Although CD toxin is sometimes found in the stools of patients with ulcerative colitis (UC), UC is rarely complicated by PMC. We report herein a case of PMC complicating UC, and present a review of the literature. A 71-year-old woman was diagnosed as having UC of the left colon, and treated with prednisolone and mesalazine. Later, however, lumbar spinal stenosis was also detected. After surgery for lumbar spinal stenosis, she suffered postoperative infection of the lumbar region. After 3-week treatment with antibiotics, she developed diarrhea, bloody stools, and abdominal pain. Colonoscopy revealed PMC of the cecum, ascending colon, sigmoid colon, and rectum. Stools were positive for CD toxin. As cefotiam hydrochloride, levofloxacin hydrate (LVFX), and prednisolone were suspected as the causative agents, she was treated with 1.5 g vancomycin (VCM) daily for 2 weeks without ceasing LVFX. Her symptoms improved, and colonoscopy confirmed resolution of PMC. The possibility of PMC should be considered in UC patients treated with antibiotics, immunosuppressive agents or corticosteroids who complain of gastrointestinal symptoms. These patients should be thoroughly investigated by several modalities, including colonoscopy and CD toxin testing. © 2010 The Authors. Digestive Endoscopy © 2010 Japan Gastroenterological Endoscopy Society.

  18. Oral ulcers: clinical aspects. A tool for dermatologists. Part II. Chronic ulcers.

    Science.gov (United States)

    Muñoz-Corcuera, M; Esparza-Gómez, G; González-Moles, M A; Bascones-Martínez, A

    2009-06-01

    Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In this second part of this two-part review, chronic oral ulcers are reviewed.

  19. Oral ulcers: clinical aspects. A tool for dermatologists. Part I. Acute ulcers.

    Science.gov (United States)

    Muñoz-Corcuera, M; Esparza-Gómez, G; González-Moles, M A; Bascones-Martínez, A

    2009-04-01

    Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In the first part of this two-part review, acute oral ulcers are reviewed.

  20. Massage therapy for preventing pressure ulcers.

    Science.gov (United States)

    Zhang, Qinhong; Sun, Zhongren; Yue, Jinhuan

    2015-06-17

    Pressure ulcers affect approximately 10% of patients in hospitals and the elderly are at highest risk. Several studies have suggested that massage therapy may help to prevent the development of pressure ulcers, but these results are inconsistent. To assess the evidence for the effects of massage compared with placebo, standard care or other interventions for prevention of pressure ulcers in at-risk populations.The review sought to answer the following questions:Does massage reduce the incidence of pressure ulcers of any grade?Is massage safe in the short- and long-term? If not, what are the adverse events associated with massage? We searched the Cochrane Wounds Group Specialised Register (8 January 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 1), Ovid MEDLINE (1946 to 8 January 2015), Ovid MEDLINE (In-Process Other Non-Indexed Citations 8 January 2015), Ovid EMBASE (1974 to 8 January 2015), and EBSCO CINAHL (1982 to 8 January 2015). We did not apply date or language restrictions. We planned to include all randomised controlled trials (RCTs) and quasi-randomised controlled trials (Q-RCTs) that evaluated the effects of massage therapy for the prevention of pressure ulcers. Our primary outcome was the proportion of people developing a new pressure ulcer of any grade. Two review authors independently carried out trial selection. Disagreements were resolved by discussion. No studies (RCTs or Q-RCTs) met the inclusion criteria. Therefore, neither a meta-analysis nor a narrative description of studies was possible. There are currently no studies eligible for inclusion in this review. It is, therefore, unclear whether massage therapy can prevent pressure ulcers.

  1. Factors associated with poor healing and recurrence of venous ulceration.

    Science.gov (United States)

    Labropoulos, Nicos; Wang, Eric D; Lanier, Steven T; Khan, Sami U

    2012-01-01

    Plastic surgeons are often approached for wound management and closure of chronic venous ulcers that fail to heal despite multimodal management. The authors present a retrospective analysis of a large series of venous ulcers to determine factors predicting nonhealing and recurrence. Consecutive patients with chronic venous ulcers (≥ 2-cm diameter) were examined for the presence of superficial, perforating, or deep venous disease, including reflux and/or obstruction. Treatment included compression, venous ligation, stripping, thermal ablation, sclerotherapy, and local wound care. Ulcers refractory to 6 months of treatment were defined as nonhealing ulcers. Data were analyzed for differences in baseline patient and ulcer characteristics and clinical course of nonhealing ulcers. Data were compared using Wilcoxon rank sum, chi-square, and Fisher's exact tests using Sigma Stat and SPSS, with α set at p ulcers in 127 patients. Factors associated with ulcer nonhealing included advanced age, increased body mass index, history of deep venous thrombosis, noncompliance with compression therapy, and large ulcer area. One hundred thirty-one of the ulcers (85.6 percent) healed within 6 months and 147 (96 percent) of the ulcers ultimately healed without the need for operative plastic surgical intervention. A thorough understanding of risks and expected clinical course is required for assessment of the nonhealing venous ulcer. The authors recommend identification and correction of underlying venous abnormality and a minimum of at least 6 months of compression and local wound care followed by reassessment of venous function before operative plastic surgical intervention should be considered. Risk, III.

  2. Salivary enzymes in peptic ulcer disease.

    Science.gov (United States)

    Motamedi, Mojdeh; Mansour-Ghanaei, Fariborz; Sariri, Reyhaneh; Vesal, Mahmoud

    2013-01-01

    Peptic ulcer, the common disease of the upper gastro-intestinal tract, occurs in about 5-10% of the world's population. Therefore, diagnosis of trace disease progression with a noninvasive method is of prime importance in the field of healthcare research. The aim of this study was to evaluate the validity of salivary enzymes as noninvasive biomarkers for peptic ulcer. In practice, 34 peptic ulcer patients and 30 healthy subjects donated their un-stimulated saliva samples after 8 h of fasting. The activity of some selected enzymes was measured using appropriate enzymatic assay methods. The results indicated an overall alternation in enzymatic activity of saliva in patients suffering from peptic ulcer. Biological activity of a-amylase, peroxidase and lactate dehydrogenase, showed significantly higher values in almost all patients as compared to control subjects. Based on the results of salivary enzyme activity, it was concluded that besides the influence of their peptic ulcer on enzyme activity of saliva, the considerably higher activity of a-amylase could also be related to the major role of the enzyme on physiological oxidative stress.

  3. Prevention and treatment of diabetic foot ulcers.

    Science.gov (United States)

    Lim, Jonathan Zhang Ming; Ng, Natasha Su Lynn; Thomas, Cecil

    2017-03-01

    The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

  4. [Infected pressure ulcers: evaluation and management].

    Science.gov (United States)

    Iori, Ido; Pizzini, Attilia Maria; Arioli, Dimitriy; Favali, Davide; Leone, Maria Cristina

    2009-09-01

    Pressure ulcers in elderly individuals can cause significant morbidity and mortality and are a major economic burden to the health care system. Prevention should be the ultimate objective of pressure ulcer care, and it requires an understanding of the pathophysiology leading to pressure ulcers and the means of reducing both intrinsic and extrinsic risk factors. Clinical examination often underestimates the degree of deep-tissue involvement, and its findings are inadequate for the detection of associated osteomyelitis. Microbiological data, if obtained from deep-tissue biopsy, are useful for directing antimicrobial therapy, but they are insufficient as the sole criterion for the diagnosis of infection. Imaging studies, such as computed tomography and magnetic resonance imaging, are useful, but bone biopsy and histopathological evaluation remain the "gold standard" for the detection of osteomyelitis. The goals of treatment of pressure ulcers should be resolution of infection and promotion of wound healing. A combination of surgical debridement and medical interventions may be required. Systemic antimicrobial therapy should be used for patients with serious pressure ulcers infections, including those with spreading cellulitis, bacteremia or osteomyelitis.

  5. Immunosuppressive and biologic therapy for ulcerative colitis.

    Science.gov (United States)

    Ardizzone, Sandro; Cassinotti, Andrea; de Franchis, Roberto

    2012-12-01

    Recent insight into the pathogenesis of ulcerative colitis have led to the development of new treatment options. A better understanding of IBD pathophysiology has progressively led to a more frequent use of immunosuppressants and biologics. The use of the conventional immunomodulators, such as azathioprine, 6-mercaptopurine, methotrexate, cyclosporine and tacrolimus, and anti-TNF-α agents, such as infliximab and adalimumab, in the treatment of ulcerative colitis are reviewed. Moreover, the ongoing studies evaluating the efficacy of emerging immunosuppressants in treating patients with ulcerative colitis are discussed. An effort is made to explore some critical areas in which early and more diffuse use of these agents may be advocated. Ulcerative colitis is a chronic condition mainly affecting young people in their more productive age, and determining high indirect costs to the patient and to society. Thus, there is a need for optimizing and renewing our traditional therapeutic approach to UC, and new therapies beyond conventional treatment options possibly aiming to change the poor clinical course of many patients with ulcerative colitis. Keeping in mind this potentially new therapeutic scenario, there are some critical areas in which early and more diffuse use of conventional and emerging new immunomodulators is advocated.

  6. Rare cause of odynophagia: Giant esophageal ulcer.

    Science.gov (United States)

    Veroux, Massimiliano; Aprile, Giuseppe; Amore, Francesca F; Corona, Daniela; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-04-14

    Gastrointestinal complications are a frequent cause of morbidity after transplantation and may affect up to 40% of kidney transplant recipients. Here we report a rare case of idiopathic giant esophageal ulcer in a kidney transplant recipient. A 37-year-old female presented with a one-week history of odynophagia and weight loss. Upon admission, the patient presented cold sores, and a quantitative cytomegalovirus polymerase chain reaction was positive (10(5) copies/mL). An upper endoscopy demonstrated the presence of a giant ulcer. Serological test and tissue biopsies were unable to demonstrate an infectious origin of the ulcer. Immunosuppression was reduced and everolimus was introduced. An empirical i.v. therapy with acyclovir was started, resulting in a dramatic improvement in symptoms and complete healing of the ulcer. Only two cases of idiopathic giant esophageal ulcer in kidney transplant recipients have been reported in the literature; in both cases, steroid therapy was successful without recurrence of symptoms or endoscopic findings. However, this report suggests that correction of immune imbalance is mandatory to treat such a rare complication.

  7. Salivary enzymes in peptic ulcer disease

    Science.gov (United States)

    Motamedi, Mojdeh; Mansour-Ghanaei, Fariborz; Sariri, Reyhaneh; Vesal, Mahmoud

    2013-01-01

    Aim Peptic ulcer, the common disease of the upper gastro-intestinal tract, occurs in about 5–10% of the world's population. Therefore, diagnosis of trace disease progression with a noninvasive method is of prime importance in the field of healthcare research. The aim of this study was to evaluate the validity of salivary enzymes as noninvasive biomarkers for peptic ulcer. Materials and methods In practice, 34 peptic ulcer patients and 30 healthy subjects donated their un-stimulated saliva samples after 8 h of fasting. The activity of some selected enzymes was measured using appropriate enzymatic assay methods. Results The results indicated an overall alternation in enzymatic activity of saliva in patients suffering from peptic ulcer. Biological activity of a-amylase, peroxidase and lactate dehydrogenase, showed significantly higher values in almost all patients as compared to control subjects. Conclusions Based on the results of salivary enzyme activity, it was concluded that besides the influence of their peptic ulcer on enzyme activity of saliva, the considerably higher activity of a-amylase could also be related to the major role of the enzyme on physiological oxidative stress. PMID:25737890

  8. Medical device-related pressure ulcers

    Directory of Open Access Journals (Sweden)

    Black JM

    2016-08-01

    Full Text Available Joyce M Black,1 Peggy Kalowes2 1Adult Health and Illness Department, College of Nursing, University of Nebraska Medical Center, Omaha, NE, 2Nursing Research and Innovation, Long Beach Memorial Miller Children’s & Women’s Hospital, Long Beach, CA, USA Abstract: Pressure ulcers from medical devices are common and can cause significant morbidity in patients of all ages. These pressure ulcers appear in the shape of the device and are most often found from the use of oxygen delivery devices. A hospital program designed to reduce the number of pressure ulcers from medical devices was successful. The program involved the development of a team that focused on skin, the results were then published for the staff to track their performance, and it was found that using foam dressings helped reduce the pressure from the device. The incidence of ulcers from medical devices has remained at zero at this hospital since this program was implemented. Keywords: pressure ulcer, medical device related

  9. Topical phenytoin for treating pressure ulcers.

    Science.gov (United States)

    Hao, Xiang Yong; Li, Hong Ling; Su, He; Cai, Hui; Guo, Tian Kang; Liu, Ruifeng; Jiang, Lei; Shen, Yan Fei

    2017-02-22

    Pressure ulcers are common in clinical practice and pose a significant health problem worldwide. Apart from causing suffering to patients, they also result in longer hospital stays and increase the cost of health care. A variety of methods are used for treating pressure ulcers, including pressure relief, patient repositioning, biophysical strategies, nutritional supplementation, debridement, topical negative pressure, and local treatments including dressings, ointments and creams such as bacitracin, silver sulphadiazine, neomycin, and phenytoin. Phenytoin is a drug more commonly used in the treatment of epilepsy, but may play an important role in accelerating ulcer healing. To assess the effects of topical phenytoin on the rate of healing of pressure ulcers of any grade, in any care setting. In September 2016, we searched the following electronic databases to identify relevant randomized clinical trials: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library); Ovid MEDLINE; Ovid Embase; and EBSCO CINAHL Plus. We handsearched conference proceedings from the European Pressure Ulcer Advisory Panel, European Wound Management Association and the Tissue Viability Society for all available years. We searched the references of the retrieved trials to identify further relevant trials. We also searched clinical trials registries to identify ongoing and unpublished studies. There were no restrictions with respect to language, date of publication or study setting. We included all randomized controlled trials (RCTs) addressing the effects (both benefits and harms) of topical phenytoin on the healing of pressure ulcers of any grade compared with placebo or alternative treatments or no therapy, irrespective of blinding, language, and publication status. Two review authors independently selected studies, extracted information on participants, interventions, methods and results and assessed risk of bias using

  10. Anti-Ulcer Efficacy of Soluble Epoxide Hydrolase Inhibitor TPPU on Diclofenac-Induced Intestinal Ulcers

    Science.gov (United States)

    Goswami, Sumanta Kumar; Wan, Debin; Yang, Jun; Trindade da Silva, Carlos A.; Morisseau, Christophe; Kodani, Sean D.; Yang, Guang-Yu; Inceoglu, Bora

    2016-01-01

    Proton pump inhibitors such as omeprazole (OME) reduce the severity of gastrointestinal (GI) ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) but can also increase the chance of dysbiosis. The aim of this study was to test the hypothesis that preventive use of a soluble epoxide hydrolase inhibitor (sEHI) such as TPPU can decrease NSAID-induced ulcers by increasing anti-inflammatory epoxyeicosatrienoic acids (EETs). Dose- [10, 30, and 100 mg/kg, by mouth (PO)] and time-dependent (6 and 18 hours) ulcerative effects of diclofenac sodium (DCF, an NSAID) were studied in the small intestine of Swiss Webster mice. Dose-dependent effects of TPPU (0.001–0.1 mg/kg per day for 7 days, in drinking water) were evaluated in DCF-induced intestinal toxicity and compared with OME (20 mg/kg, PO). In addition, the effect of treatment was studied on levels of Hb in blood, EETs in plasma, inflammatory markers such as myeloperoxidase (MPO) in intestinal tissue homogenates, and tissue necrosis factor-α (TNF-α) in serum. DCF dose dependently induced ulcers that were associated with both a significant (P ulceration highest at 18 hours. Pretreatment with TPPU dose dependently prevented ulcer formation by DCF, increased the levels of epoxy fatty acids, including EETs, and TPPU’s efficacy was comparable to OME. TPPU significantly (P ulcers. PMID:26989141

  11. Anti-Ulcer Efficacy of Soluble Epoxide Hydrolase Inhibitor TPPU on Diclofenac-Induced Intestinal Ulcers.

    Science.gov (United States)

    Goswami, Sumanta Kumar; Wan, Debin; Yang, Jun; Trindade da Silva, Carlos A; Morisseau, Christophe; Kodani, Sean D; Yang, Guang-Yu; Inceoglu, Bora; Hammock, Bruce D

    2016-06-01

    Proton pump inhibitors such as omeprazole (OME) reduce the severity of gastrointestinal (GI) ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) but can also increase the chance of dysbiosis. The aim of this study was to test the hypothesis that preventive use of a soluble epoxide hydrolase inhibitor (sEHI) such as TPPU can decrease NSAID-induced ulcers by increasing anti-inflammatory epoxyeicosatrienoic acids (EETs). Dose- [10, 30, and 100 mg/kg, by mouth (PO)] and time-dependent (6 and 18 hours) ulcerative effects of diclofenac sodium (DCF, an NSAID) were studied in the small intestine of Swiss Webster mice. Dose-dependent effects of TPPU (0.001-0.1 mg/kg per day for 7 days, in drinking water) were evaluated in DCF-induced intestinal toxicity and compared with OME (20 mg/kg, PO). In addition, the effect of treatment was studied on levels of Hb in blood, EETs in plasma, inflammatory markers such as myeloperoxidase (MPO) in intestinal tissue homogenates, and tissue necrosis factor-α (TNF-α) in serum. DCF dose dependently induced ulcers that were associated with both a significant (P ulceration highest at 18 hours. Pretreatment with TPPU dose dependently prevented ulcer formation by DCF, increased the levels of epoxy fatty acids, including EETs, and TPPU's efficacy was comparable to OME. TPPU significantly (P ulcers. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  12. Mindfulness May Be Helpful for People with Ulcerative Colitis

    Science.gov (United States)

    ... Mindfulness May Be Helpful for People With Ulcerative Colitis Share: © Jupiter Images Mindfulness-based stress reduction (MBSR), ... and decrease perceived stress in people with ulcerative colitis. These findings come from a small pilot study ...

  13. Infliximab and complications after colectomy in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Bregnbak, David; Mortensen, Christian; Bendtsen, Flemming

    2012-01-01

    Infliximab treatment may increase the risk of subsequent postoperative complications in patients with ulcerative colitis. The main purpose of the present study therefore was to assess postoperative complications in patients who have undergone colectomy for ulcerative colitis with and without...

  14. Indomethacin-Induced Gastric Ulcer: Model in Female Wistar Rats ...

    African Journals Online (AJOL)

    Indomethacin-Induced Gastric Ulcer: Model in Female Wistar Rats. ... In this regard, an animal model experiment was carried-out to determine the ulcer-dose of indomethacin on female Wistar rats. Based on this objective, ... from 32 Countries:.

  15. Pressure ulcers in spinal cord injury patients in Gombe, Nigeria ...

    African Journals Online (AJOL)

    Pressure ulcers in spinal cord injury patients in Gombe, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN ... Key Words: Spinal cord injury, neurological impairment, pressure ulcer, prevention, pressure relieving devices

  16. Vedolizumab as induction and maintenance therapy for ulcerative colitis

    DEFF Research Database (Denmark)

    Feagan, Brian G; Rutgeerts, Paul; Sands, Bruce E

    2013-01-01

    Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis.......Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis....

  17. Use of Axathioprine for Nongranulomatous Ulcerative Jejunoileitis

    Directory of Open Access Journals (Sweden)

    Robert Enns

    1997-01-01

    Full Text Available Nongranulomatous ulcerative jejunoileitis (NGUJI is a rare, often fatal disorder that produces multiple nonmalignant small bowel ulcerations. A 55-year-old woman with presumed celiac disease presented with steroid-refractory diarrhea, weight loss and abdominal pain. A laparotomy was performed to exclude the possibility of a lymphomatous disorder, and multiple nonmalignant small bowel ulcerations were discovered. Despite a combination of treatment with total parenteral nutrition (TPN and prednisone 30 mg/day she continued to deteriorate. The addition of azathioprine to her treatment regimen resulted in marked clinical and biochemical improvement. Her enteroscopy normalized, and she was able to discontinue TPN and reduce her steroid requirements. Although azathioprine has been used occasionally to treat refractory sprue, there have been no reports of its use in NGUJI. In this case, azathioprine played a key role in the management of NGUJI and should be considered a treatment option for patients with this disorder.

  18. A new pressure ulcer conceptual framework.

    Science.gov (United States)

    Coleman, Susanne; Nixon, Jane; Keen, Justin; Wilson, Lyn; McGinnis, Elizabeth; Dealey, Carol; Stubbs, Nikki; Farrin, Amanda; Dowding, Dawn; Schols, Jos M G A; Cuddigan, Janet; Berlowitz, Dan; Jude, Edward; Vowden, Peter; Schoonhoven, Lisette; Bader, Dan L; Gefen, Amit; Oomens, Cees W J; Nelson, E Andrea

    2014-10-01

    This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework. Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework. Discussion Paper. The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010-2011) and an international expert group meeting (conducted December 2011). A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally. By integrating existing knowledge from epidemiological, physiological and biomechanical evidence, a theoretical causal pathway and new conceptual framework are proposed with potential implications for practice and research. © 2014 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  19. Endoscopic variceal ligation-induced ulcer bleeding

    Science.gov (United States)

    Cho, Eunae; Jun, Chung Hwan; Cho, Sung Bum; Park, Chang Hwan; Kim, Hyun Soo; Choi, Sung Kyu; Rew, Jong Sun

    2017-01-01

    Abstract This study was aimed to determine the risk factors of endoscopic variceal ligation-(EVL) induced ulcer bleeding. The prevalence of EVL-induced ulcer bleeding is reported to be 3.6%. However, there are only limited reports of this serious complication, and the risk factors and the treatment methods are not well established. A total of 430 patients who had undergone EVL in Chonnam National University Hospital from January 2014 to October 2016 were studied. EVL was performed for prophylaxis or acute hemorrhage. The patients were classified into 2 groups: a bleeding group (n = 33) and a non-bleeding group (n = 397). The patients who had endoscopically confirmed EVL-induced ulcer bleeding were included in the bleeding group. EVL-induced ulcer bleeding occurred in 7.7% (n = 33) of the patients. In a multivariate analysis, model for end-stage liver disease (MELD) score >10 (odds ratio [OR]: 3.42, 95% confidence interval [CI]: 1.10–10.64), concomitant GV F3 (OR: 14.1, 95% CI: 2.84–71.43), and detachment of o-ring bands on follow-up endoscopy (OR: 8.06, 95% CI: 2.55–25.64) were independent predictive factors of EVL-induced ulcer bleeding. Various endoscopic modalities were attempted for hemostasis (EVL in 8 cases [24.2%], endoscopic variceal obturation [EVO] with cyanoacrylate in 6 cases [18.2%], argon plasma coagulation [APC] in 1 case (3%), Sengstaken–Blakemore (SB) tube in 3 cases [9.1%]), and proton pump inhibitor therapy only in 15 cases (45.5%). MELD score >10, concomitant GV F3, and detachment of o-ring bands on follow-up endoscopy are risk factors for EVL-induced ulcer bleeding. PMID:28614248

  20. Systematic review of topic treatment for venous ulcers

    OpenAIRE

    Borges, Eline Lima; Caliri, Maria Helena Larcher; Haas, Vanderlei José

    2007-01-01

    Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. T...

  1. Primary sclerosing cholangitis and Biliary cirrhosis associated with Ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Aleem Ahmed Khan

    2011-07-01

    Full Text Available Primary sclerosing cholangitis and Ulcerative colitis are caused by progressive inflammation of the bile duct and large intestine respectively. The existence of any plausible association between Primary sclerosing cholangitis and Ulcerative colitis remains highly elusive. Little is known about the incidence and prevalence of primary sclerosing cholangitis with concomitant Ulcerative colitis in the Indian subcontinent. We report a case of Primary sclerosing cholangitis with long standing Ulcerative colitis which later also developed Primary biliary cirrhosis.

  2. Leg ulcers: a new symptom of Blau syndrome?

    Science.gov (United States)

    Dhondt, Veerle; Hofman, Sarah; Dahan, Karin; Beele, Hilde

    2008-01-01

    Blau syndrome is a rare autosomal dominant condition, typically defined by granulomatous polyarthritis, uveitis and skin eruption. Biopsy specimens demonstrate non-caseating granulomas in all lesions. We present a case of Blau syndrome associated with large recalcitrant leg ulcers. Biopsies taken in the leg ulcers of our patient systematically showed granulomas. Although leg ulcers have not previously been described as a part of Blau syndrome, we assume that the ulcerations in this case form part of Blau syndrome.

  3. Monitoring pressure ulcers in nursing homes.

    Science.gov (United States)

    Madsen, W; Leonard, M

    1997-12-01

    Clinical indicators may be used to monitor the quality of care delivery. Unfortunately, they are often viewed by nursing staff as unnecessary paper work. This study used Waterlow's Pressure Sore Risk Assessment Tool as the basis of a clinical indicator to monitor pressure ulcers within a nursing home. It was found that by closely monitoring the skin status of residents, preventative actions could be implemented, thereby minimizing the risk of pressure ulcer development. The advantage of utilizing such a tool is that it is seen to be clinically relevant for nursing staff while providing a bank of data for quality management.

  4. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  5. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping of at...... of atypical inflammatory bowel disease (IBD) patients. Our aim was to identify the prevalence of atypical disease patterns in new-onset pediatric UC using the Paris classification.......Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping...

  6. Leg ulcer in lepromatous leprosy - Case report*

    Science.gov (United States)

    Fernandes, Tania Rita Moreno de Oliveira; dos Santos, Talita Suzany Siqueira; Lopes, Ramon Rodrigues de Macedo

    2016-01-01

    In Brazil, leprosy is a widespread infectious and contagious disease. Clinicians and specialists view leprosy broadly as a systemic infection, since, in its manifestations, it mimics many conditions, such as rheumatic, vascular, ENT, neurological and dermatological diseases. There are few studies that characterize the factors associated with ulcers in leprosy. These injuries should be prevented and treated promptly to avoid serious problems like secondary infections, sepsis, carcinomatous degeneration and amputations. We describe a patient with ulcers on his legs, involving late diagnosis of lepromatous leprosy. PMID:27828650

  7. Endoscopic management of acute peptic ulcer bleeding.

    Science.gov (United States)

    Lu, Yidan; Chen, Yen-I; Barkun, Alan

    2014-12-01

    This review discusses the indications, technical aspects, and comparative effectiveness of the endoscopic treatment of upper gastrointestinal bleeding caused by peptic ulcer. Pre-endoscopic considerations, such as the use of prokinetics and timing of endoscopy, are reviewed. In addition, this article examines aspects of postendoscopic care such as the effectiveness, dosing, and duration of postendoscopic proton-pump inhibitors, Helicobacter pylori testing, and benefits of treatment in terms of preventing rebleeding; and the use of nonsteroidal anti-inflammatory drugs, antiplatelet agents, and oral anticoagulants, including direct thrombin and Xa inhibitors, following acute peptic ulcer bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Pressure ulcers: understanding the challenges of promoting quality

    OpenAIRE

    Ousey, Karen

    2010-01-01

    Pressure ulcers affect quality of life and general wellbeing, and create significant difficulties for patients, their carers and families. Pressure ulcers are associated with morbidity and mortality, and prove costly for healthcare providers. This article identifies the Government’s quality agenda and the importance of maintaining, developing and delivering quality care for the prevention of pressure ulceration.

  9. Buruli ulcers in Gulu Regional Referral Hospital, Northern Uganda ...

    African Journals Online (AJOL)

    Buruli ulcers (BU) is a disease caused by infection with Mycobacterium ulcerans. It is one of the most neglected but treatable tropical diseases. Cases of Buruli ulcers are extremely rare in Gulu District. It is because of this reason that we report a case of a 25 year old male patient who presented with Buruli ulcers on the right ...

  10. Diagnosis and management of common non-viral oral ulcerations ...

    African Journals Online (AJOL)

    The aetiology, diagnosis and management of the most common non-viral ulcerative disorders of the oral mucosa are discussed. These include traumatic ulcers, recurrent aphthous stomatitis, malignancy as well as oral ulceration associated with cutaneous pathology. South African Family Practice Vol. 49 (8) 2007: pp. 20-26 ...

  11. Dynamic sitting to prevent pressure ulcers in spinal cord injured

    NARCIS (Netherlands)

    Reenalda, Jasper

    2009-01-01

    At present, clinical interventions and research efforts are not fully successful in defining the risk of pressure ulcer development and as such in eventually preventing pressure ulcers. As a result, the prevalence and incidence values of pressure ulcers remain unacceptably high. It is common sense

  12. Brunner's glands of the rat during cysteamine ulceration

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1981-01-01

    Duodenal ulcers can be produced in rats by subcutaneous administration of cysteamine-HCl. The pathogenesis of these ulcers has not been fully explained. Increased acid secretion is necessary but not sufficient for ulcer production. In the present study we have observed pronounced alterations in t...

  13. Risk factors and prevalence of diabetic foot ulcers at Kenyatta ...

    African Journals Online (AJOL)

    Background: Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on ...

  14. [Marjolin ulcer; malignant degeneration in a chronic wound

    NARCIS (Netherlands)

    Jager, W.C.C. de; Walbeehm, E.T.; Wagner, T.; Gerritsen, M.J.P.

    2015-01-01

    BACKGROUND: A chronic ulcerating wound may turn malignant. The term 'Marjolin ulcer' is used to describe any skin malignancy which develops in an area of chronic ulceration, irritation or inflammation. It is generally a squamous cell carcinoma. CASE DESCRIPTION: A 66-year-old woman was admitted

  15. Diabetic foot ulcers – evidence-based wound management

    African Journals Online (AJOL)

    This article aims to summarise the available evidence in the wound management of diabetic foot ulcers to promote cost-effective evidence-based practice. Diabetic foot ulcers have a significant impact on the individual patient's quality of life, potential morbidity and even mortality. Diabetic foot ulcers also consume a.

  16. Helicobacter pylori : the causative agent of peptic ulcer ...

    African Journals Online (AJOL)

    This review examines Helicobacter pylori as an organism and as the causative agent of peptic ulcers. The review also examined the classification of ulcers, how the bacterium produces the ulcer, some of the virulence factors possessed by the organism, its metabolism and growth requirements. The incidence and ...

  17. Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcer: A Pilot Study

    African Journals Online (AJOL)

    Introduction. Globally, diabetic foot ulcers are one of the major public health problems leading to socioeconomic burden to the suffering individuals.[1,2] Around 15% of all diabetic patients develop a foot ulcer that is highly vulnerable to infections, at some time in their life.[3] Foot ulcer infections usually spread rapidly on ...

  18. Effects of delayed treatment on perforated peptic ulcers at Kenyatta ...

    African Journals Online (AJOL)

    Background: Perforations complicate up to 5-10% of peptic ulcer diseases. Mortality following peptic ulcer perforation can peak 29%. Of the factors that influence the outcome of peptic ulcer perforation, treatment delay is most important and modifi able. This study reviewed delay and how it affected outcome in patients ...

  19. Perforated gastric ulcer - reappraisal of surgical options | Madiba ...

    African Journals Online (AJOL)

    Background: The available operative procedures for perforated gastric ulcer are gastrectomy, ulcer excision and omental patch closure. This study analysed the outcome of these operative options in a single institution. Patients and methods: Seventy-two patients (mean age 43 years, 62 males) with perforated gastric ulcers ...

  20. Experience with Acute Perforated Duodenal Ulcer in a West African ...

    African Journals Online (AJOL)

    Background: The advent of proton pump inhibitors and helicobacter pylori eradication in the management of chronic peptic ulcer disease has reduced the operative treatment of this condition to its complications. Perforated duodenal ulcer remains a major life threatening complication of chronic peptic ulcer disease.

  1. Posterior perforation of gastric ulcer: a rare surgical emergency ...

    African Journals Online (AJOL)

    BACKGROUND:Gastric ulcer perforation is a rare surgical emergency.Posterior gastric ulcer is even rarer and usually has a delayed presentation with attendant greater morbidity and mortality. AIM:To report a case of posterior perforation of gastric ulcer and review the literature. CASE REPORT:A 65yr old driver was seen in ...

  2. Diabetic foot ulcers – evidence-based wound management: A ...

    African Journals Online (AJOL)

    This article aims to summarise the available evidence in the wound management of diabetic foot ulcers to promote cost-effective evidence-based practice. Diabetic foot ulcers have a significant impact on the individual patient's quality of life, potential morbidity and even mortality. Diabetic foot ulcers also consume a ...

  3. Giant lower oesophageal ulcer in a Bushman baby | Heydenrych ...

    African Journals Online (AJOL)

    The case of a giant, penetrating lower oesophageal ulcer in a 14-month-old Bushman baby is reported. This would probably be classified as a Barrett's ulcer. Histological examination showed that the ulcer developed in columnar epithelium and that there was normal stratified squamous oesophageal mucosa both ...

  4. Longitudinal study of influence of Helicobacter pylori on current risk of duodenal ulcer relapse. The Hvidovre Ulcer Project Group

    DEFF Research Database (Denmark)

    Clausen, M R; Franzmann, M B; Holst, C

    1992-01-01

    acid output, time of healing of the preceding ulcer, treatment of the present ulcer (cimetidine, antacids, or no treatment), or type and degree of gastritis. Thus, although H. pylori is prevalent in patients with duodenal ulcer disease, the present study indicates that H. pylori does not have...

  5. Soft tissue-anchored transcutaneous port attached to an intestinal tube for long-term gastroduodenal infusion of levodopa/carbidopa in Parkinson disease.

    Science.gov (United States)

    Nyman, Rickard; Lundgren, Dan; Nyholm, Dag

    2009-04-01

    To report experiences with a transcutaneous soft tissue-anchored titanium port (T-port) attached to an intestinal tube for gastroduodenal infusion of levodopa/carbidopa in patients with Parkinson disease, and to describe and analyze complications related to the T-port, gastrostomy technique, and intestinal tube placement. The T-port implantation and gastrostomy were done under local anesthesia in 15 patients (mean age, 64 years; range, 52-74 y). An intestinal tube (10 F) was attached to the T-port for duodenal/jejunal access. Three versions of the T-port have been tested (generations I-III). Our experience with T-ports covers 34.5 patient-years (mean, 2.3 y per patient). Maximum duration of use was 4.9 years. The major complications were perforation of the skin by the straight flange (three of five generation I ports), local infections (12 of 15 patients) resulting from leakage of levodopa/carbidopa (five of 11 generation II ports), problems with T-fasteners, and poor hygiene. Hypergranulation tissue was often seen as a result of local inflammation/infection resulting from levodopa/carbidopa leakage, poor hygiene, and/or an overly mobile T-port. The last version of the T-port (generation III), with more optimized implantation and gastrostomy techniques, seemed to considerably improve the results. The initial experience with the T-port system reveals that it may be a useful alternative to presently used gastrojejunostomy tubes. Several improvements of the T-port and placement technique were made. The T-port offers a potential advantage compared with standard techniques from an aesthetic point of view.

  6. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    the skin, e.g. herpes zoster scars, lid lacerations, burns. Lid malposition should be excluded. Facial nerve function must be assessed as dysfunction could affect ... Corneal in ltrate seen as haziness or whitening of the usually transparent cornea is universal to infective ulcers in varying degrees. is signi es the inflammatory ...

  7. Nonspecific Cecal Ulcer: An Obsolete Jargon

    Directory of Open Access Journals (Sweden)

    Duvuru Ram

    2013-04-01

    Full Text Available Non specific cecal ulcer (NSCU is a rare entity described by Cruveilhier in 1832. NSCU has no specific presenting features and it can mimic a host of conditions like appendicitis, diverticulosis and colonic carcinoma. Earlier, this terminology was used to depict those ulcers where it was not possible to make the exact diagnosis. There are only a few cases where a specific preoperative diagnosis was made. The number of NSCUs being reported recently is less. This is due to the advent of newer diagnostic techniques to identify the etiology of these ulcers. Hence the term NSCU is no longer employed in current literature because a specific diagnosis is attained in most ulcers. Therefore the term NSCU is no longer valid and its use should be largely restricted to those cases where a specific diagnosis is not possible even after exhausting the currently available investigative techniques. This article provides an overview of this outdated term and outlines how to proceed when NSCU is encountered in clinical practice. [J Interdiscipl Histopathol 2013; 1(2.000: 85-88

  8. [Management of a diabetic foot ulcer].

    Science.gov (United States)

    Ha Van, G

    2008-09-01

    A chronic diabetic foot ulcer requires a search for the etiology. The three main causes to search for are poor off-loading compliance, osteomyelitis, and peripheral vascular disease. The level of severity is measured with the U.T. classification and the level of infection with the classification of the International Consensus on the Diabetic Foot. Peripheral vascular disease must be precisely evaluated by Doppler ultrasound, which describes all the arteries of the lower limb. Angiography is required only in case of revascularization. Treatment of the ulcer includes strict off-loading, topical treatment, optimal treatment of hyperglycemia, and antibiotic therapy on a case-by-case basis for osteomyelitis and/or, angioplasty or by-pass procedures. Osteomyelitis can be treated by associating conservative surgery, antibiotic therapy, and off-loading. No amputation, even of one toe, must be done without a previous vascular check-up. Off-loading of the ulcer must be regularly checked. Poor off-loading compliance must be systematically investigated if the ulcer worsens or healing is delayed.

  9. Pressure ulcers - what to ask your doctor

    Science.gov (United States)

    ... pressure ulcers or to help them heal? When lying in bed: What positions are best when lying down? What types of padding or cushioning should ... the first to achieve this important distinction for online health information and services. Learn more about A. ...

  10. Peripheral lymphocyte subpopulations in recurrent aphthous ulceration

    DEFF Research Database (Denmark)

    Pedersen, A; Klausen, B; Hougen, H P

    1991-01-01

    Peripheral lymphocyte subsets--T-helper (CD4+), T-suppressor/cytotoxic (CD8+), and naive/virgin T cells/natural killer cells (CD45RA)--were studied quantitatively in 30 patients with recurrent aphthous ulceration (RAU) and 29 sex- and age-matched RAU-free control donors. The CD4+ percentage...

  11. Healing of chronic Barrett ulcers with omeprazole

    NARCIS (Netherlands)

    Hameeteman, W.; Tytgat, G. N.

    1986-01-01

    Three patients with a long-standing benign Barrett ulcer, resistant to treatment with high doses of either cimetidine or ranitidine, given for at least 3 months, were treated with 40 mg omeprazole daily for 9 wk. After 2 wk all symptoms had disappeared and at the end of treatment all three patients

  12. Cerebral Arterial Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  13. Cerebral arterial thrombosis in ulcerative colitis.

    Science.gov (United States)

    Casella, Giovanni; Cortelezzi, Claudio Camillo; Marialuisa, Delodovici; Cariddi Lucia, Princiotta; Elena Pinuccia, Verrengia; Baldini, Vittorio; Segato, Sergio

    2013-01-01

    Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD). We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  14. Microarray Assisted Gene Discovery in Ulcerative Colitis

    DEFF Research Database (Denmark)

    Brusgaard, Klaus

    Inflammatory Bowel disease (IBD) is a condition characterised by chronic recidivous inflammation of the bowel and intestine. IBD includes chron´s disease (CD) and ulcerative colitis (UC). The combined prevalence of CD and UC are app. 1 in 500 in the general Caucasian population. In 25% of the cases...

  15. Gastric Acid Secretion, Mucus Concentration and Ulceration ...

    African Journals Online (AJOL)

    This study was carried out to evaluate the effect of consumption (ingestion) of Cannabis sativa on the gastrointestinal tract using mucus concentration, acid secretion and ulceration in animal (rats) model as indices. Three groups of six (6) rats each were used. The control group were fed on rat chow only while another group ...

  16. Pressure ulcers presentations and management at Kenyatta ...

    African Journals Online (AJOL)

    Objective: To determine the presentation and management of patients with pressure ulcers. Design: A prospective study. Setting: The Kenyatta National Hospital (KNH) and National Spinal Injury Hospital (NSIH). Subjects: One hundred and thirteen patients were evaluated. Ninety six patients from KNH and seventeen from ...

  17. Golimumab for moderate to severe ulcerative colitis

    NARCIS (Netherlands)

    Strik, Anne S.; Berends, Sophie E.; Mathôt, Ron A.; D'Haens, Geert R.; Löwenberg, Mark

    2017-01-01

    Golimumab (GLM) is a subcutaneously administered human anti-tumor necrosis factor (TNF) agent that has been approved by the regulatory authorities for the treatment of moderate to severe ulcerative colitis (UC) in 2013. Areas covered: Maintained clinical remission rates up to 50% have been shown in

  18. Golimumab for the treatment of ulcerative colitis

    NARCIS (Netherlands)

    Löwenberg, Mark; de Boer, Nanne K. H.; Hoentjen, Frank

    2014-01-01

    The introduction of therapeutic antibodies against tumor necrosis factor (TNF) had a major impact on the treatment of ulcerative colitis (UC). Infliximab and adalimumab are powerful agents that are used for remission induction and maintenance therapy in UC and have an acceptable safety profile.

  19. Umbilical cord ulceration and jejunal atresia

    African Journals Online (AJOL)

    CASE REPORT. The association between umbilical cord ulceration and congenital intestinal atresia is being increasingly reported and carries a high mortality. ... known to be associated with a number of other congenital anomalies, including ... rhesus positive and both HIV and syphilis serology were negative. A scan for ...

  20. 130 DIABETIC FOOT ULCERS: CURRENT TRENDS IN ...

    African Journals Online (AJOL)

    drclement

    ABSTRACT. The Diabetic foot is the commonest complication of Diabetes and is a leading cause of hospitalization and prolonged in – patient treatment. Diabetic foot ulcer is far and away the most frequent indication for non traumatic lower limb amputations. Appropriate preventive measures as well as patient education will ...

  1. Unusual presentation of ulcerative postauricular swelling as ...

    African Journals Online (AJOL)

    The swelling became ulcerative and associated with progressive tinnitus and hoarseness of voice. The patient was investigated. Fine‑needle aspiration cytology suggested sebaceous cell carcinoma. Then excision biopsy was done, and histopathological examination of excised tissue confirmed the diagnosis. Extraorbital ...

  2. Infected pressure ulcers in elderly individuals.

    Science.gov (United States)

    Livesley, Nigel J; Chow, Anthony W

    2002-12-01

    Pressure ulcers in elderly individuals can cause significant morbidity and mortality and are a major economic burden to the health care system. Prevention should be the ultimate objective of pressure ulcer care, and it requires an understanding of the pathophysiology leading to pressure ulcers and the means of reducing both intrinsic and extrinsic risk factors. Clinical manifestations are protean, and early recognition requires a low threshold of suspicion. Clinical examination often underestimates the degree of deep-tissue involvement, and its findings are inadequate for the detection of associated osteomyelitis. Microbiological data, if obtained from deep-tissue biopsy, are useful for directing antimicrobial therapy, but they are insufficient as the sole criterion for the diagnosis of infection. Imaging studies, such as computed tomography and magnetic resonance imaging, are useful, but bone biopsy and histopathological evaluation remain the "gold standard" for the detection of osteomyelitis. The goals of treatment of pressure ulcers should be resolution of infection, promotion of wound healing, and establishment of effective infection control.

  3. EAMJ Dec Presure Ulcer 09.indd

    African Journals Online (AJOL)

    2009-12-01

    Dec 1, 2009 ... Pressure ulcer is a serious and common condition that spreads across all the medical disciplines. It is more common among the debilitated patients. While the above is so, the management of this condition has proved to be a nightmare to medical doctors, both in developed and developing countries.

  4. Perforated Duodenal Ulcer Presenting As Acute Appendicitis ...

    African Journals Online (AJOL)

    Background: Acute appendicitis has a lot of differential diagnoses. However, when there is perforated duodenal ulcer with the contents tracking into the right iliac fossa, it is often extremely difficult to distinguish this condition from acute appendicitis. Aims of study: To evaluate the diagnostic dilemma encountered in ...

  5. Ulcerating and stenosing enteropathy treated with misoprostol

    DEFF Research Database (Denmark)

    Havelund, Troels; Jensen, Boye L; Vinholt, Pernille Just

    2012-01-01

    A case of a 40-year-old man with chronic anaemia because of nonspecific ulcerating and stenosing enteropathy is presented. The diagnosis was made on the basis of capsule endoscopy, histology of resected ileum and no use of NSAIDs. He showed a clinical response to treatment with misoprostol...

  6. and the severity of peptic ulcer disease

    African Journals Online (AJOL)

    Furthermore, the correlation study was performed between CSE expression ... Aim:The expression of cystathionine-γ-lyase (CSE) was determined, and correlated with the severity of gastric ulcer disease. Methods: One hundred and .... hydrogen sulfide against oxidative stress in rat gastric mucosal epithelium. Toxicology ...

  7. Gastric heterotopia causing jejunal ulceration and obstruction

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... meal and follow-through study showed a proximal near-complete jejunal obstruction (Fig. ... gastric heterotopia. Sections of the resected small intestine showed ... gastric heterotopia in the small bowel is rare, and to our knowledge this is the first report of jejunal gastric heterotopia resulting in ulceration with ...

  8. ANTI-ULCER ACTIVITY OF LEGUMINOSAE PLANTS

    Directory of Open Access Journals (Sweden)

    Noemi D. PAGUIGAN

    Full Text Available Context Ulcer is the most common gastrointestinal disturbance resulting from an inadequate gastric mucosal defense. Several drugs are available in the market to address the disease; however, these drugs are associated with unnecessary side effects. Objectives Previous research have confirmed the efficacy of plant extracts for possible treatment of the disease. This research aims to evaluate the anti-ulcer properties of medicinal plants. Methods Methanol extracts from the leaves of Intsia bijuga, Cynometra ramiflora, Tamarindus indica, Cassia javanica, Cassia fistula, Bauhini purpurea, Senna spectabilis, Senna siamea and Saraca thaipingensis were evaluated for their anti-ulcer activity using HCl-ethanol as ulcerogen. Results All extracts showed inhibitory activity with I. bijuga, T. indica, S. spectabilis and S. thaipingensis exhibiting more than 50% inhibition. S. thaipingensis showed the highest activity at 80%. S. spectabilis and S. thaipingensis were partitioned further into hexane, ethyl acetate and aqueous fractions. The aqueous and ethyl acetate fractions of S. spectabilis showed significant increased in its activity while the hexane and ethyl acetate fractions of S. thaipingensis gave higher activity than its aqueous portions. Conclusions We conclude that plant extracts are potential sources of new anti-ulcer agents.

  9. Healing of cysteamine-induced duodenal ulcers in the rat

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1985-01-01

    by formation of new mucosa from the epithelium of the remaining parts of the crypts of Lieberkühn. The mucosa became completely normal within 15 days. Ulcers healed primarily by a contraction of the circular layer of the external muscle coat, thereby approaching the ulcer edges and reestablishing a complete...... of these therefore determined the healing of the ulcer. Only a few of these ulcers had healed after 50 days. After 100 and 150 days, approximately 50% had healed, and after 200 days still only 64% had healed. Thus the cysteamine ulcer with destroyed muscle coat has a very prolonged healing and thereby represents...

  10. Effect of Plantago australis leaves on different gastric ulcer models

    Directory of Open Access Journals (Sweden)

    M.E. Bürger

    Full Text Available The anti-ulcerogenic effect of the crude ethanolic extract (CEE of Plantago australis leaves was tested against ethanol-, indomethacin-, and cold restrain-induced stress ulcers. The CEE (500 and 1000 mg/kg reduced the lesion index (LI and the ulcer index in ethanol-induced ulcers, and the dose of 1000 mg/kg increased the amount of mucous. The highest dose of the CEE reduced the LI of cold restraint-induced stress ulcers when compared to the control group. The indomethacin-induced ulcers were not affected by this extract.

  11. Evaluation of Anti-ulcer Activity of Echinops Persicus on Experimental Gastric Ulcer Models in Rats

    Directory of Open Access Journals (Sweden)

    Ahmad Farajzadeh-Sheikh

    2010-12-01

    Full Text Available Extract of Echinops persicus is traditionally used for a long time in Iran for treatment of cough and constipation. This extract is produced by activity of bug (Situphilus spp. on the plant. We documented its anti-tussive effect in rats in our previous study.The aim of this study was to assess the anti-ulcer effect of Echinops persicus in an animal model. In this study we evaluated anti-ulcer effect of Echinops persicus by Shay's method in rats. In 3 groups of rats, pylorus was ligatured under anesthesia. The rats were euthanized after 19 hours later and number and level of ulcer in stomach was measured. In group 2 the extract was orally administered 45 minutes before pyloric ligature, and in group 3, it was administered intraperitoneally 20 minutes before pyloric ligature. The number of ulcers in stomach was significantly low in group 2 (P = 0.01 and 3 (P = 0.037 in comparison with group 1. The level of ulcer was significantly decreased in group 2 (P = 0.047 with comparison to group 1. We conclude that, Echinops extract can exhibit potentially cytoprotective and anti-ulcer activity.

  12. Development and Improvement of Simple Colonic Mucosal Ulcer during Treatment of Severe Ulcerative Colitis with Tacrolimus

    Directory of Open Access Journals (Sweden)

    Ayumi Ito

    2017-03-01

    Full Text Available Diarrhea, melena, and lower abdominal pain developed in a male in his 20s and colonoscopy showed pancolitis-type severe ulcerative colitis (UC. Treatment was initiated with 4,000 mg of 5-aminosalicylic acid and 60 mg/day of prednisolone, but the symptoms and inflammatory reaction worsened with prednisolone dose reduction. Tacrolimus was added to the treatment, which subsequently induced remission. Serial colonoscopies during the treatment showed improvement in ulcer and mucosal edema throughout the entire large intestine, but a new solitary round ulcer appeared at the end of the ileum. Since no signs of Behçet’s disease were noted, it was considered as a simple ulcer, a complication of UC. Tacrolimus treatment was continued based on continued improvement in clinical features and colonic mucosa, excluding the end of the ileum. Colonoscopy at 6 months after initiation of tacrolimus showed healing of the large intestinal mucosa, although mild congestion was still noted. The solitary round ulcer at the end of the ileum improved to a small erosion. We report the improvement of a simple ulcer that developed during tacrolimus treatment.

  13. [Ulcerative colitis and eosinophilic corpus gastritis].

    Science.gov (United States)

    Nagy, Ferenc; Molnár, Tamás; F Kiss, Zsuzsanna; Tiszlavicz, László; Lonovics, János

    2004-10-31

    Ulcerative colitis seldom associated with nutritive and/or salicylate allergy. Authors present a case of both allergic events at the course of the disease. In 1996 a 19-year-old girl was referred with a history of blood in stool as well as diarrhoea, suggesting ulcerative proctitis. Biopsy revealed ulcerative colitis of the rectum mucosa with eosinophilic infiltration and 20% peripheral eosinophilia was found. Allergic origin and worm infection were ruled out, and after tinidazol treatment, four year elapsed without any signs or symptoms. In December 2000 blood in stools and upper abdominal complaints developed without peripheral eosinophilia. Gastroscopy and biopsy showed a mild chronic gastritis. Olsalazine, budesonide enema and famotidin treatment were started, but then later changed to mesalazine and pantoprazol, because of the constant stomach complaints. The next five months passed without any symptoms. The patient had to break off her seashore journey in July 2000 because of stomach complaints, vomiting and exsiccosis. Peripheral eosinophilia (27.3%) was evident. Gastroscopy revealed erosive ulcers and the biopsy showed eosinophilic gastritis. Biopsies from the jejunum, duodenum and antrum as well as enteroscopy and biopsies from the rectum showed mild eosinophilic infiltration. An allergy test proved the presence of IgE against salicylate, egg protein, seafood protein and the lymphocyte transformation test was also positive against salicylate. Oral food challenges proved to be negative and the amino-salicylate treatment was stopped. After a temporary symptom free period, bloody stools reappeared in May 2003; the peripheral eosinophilia still existed, but had decreased (22.2%). Esomeprazol, and methyl-prednisolone containing enema (40 mg/day/2 weeks) followed by budesonide enema twice a week resulted in a symptom free period and peripheral eosinophilia became almost normalised (6.2%). The authors report a case having ulcerative proctitis first, than

  14. Prognostic stratification of ulcerated melanoma: not only the extent matters.

    Science.gov (United States)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J; Damsgaard, Tine E; Møller, Holger J; Bastholt, Lars; Nørgaard, Peter H; Steiniche, Torben

    2014-12-01

    For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions. From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78). The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions. Copyright© by the American Society for Clinical Pathology.

  15. [Concept of stress ulcer prevention. Is re-thinking necessary?].

    Science.gov (United States)

    Kress, S; Schilling, D; Riemann, J F

    1998-08-15

    The efficiency of stress ulcer prophylaxis in the prevention of gastrointestinal bleeding in critically ill patients has led to its widespread use. The lower incidence of stress ulcer bleeding, the side-effects and the cost of the prophylaxis have made it necessary targeting this preventive therapy to those patients most likely to benefit. Metaanalysis of studies on patients who received no stress ulcer prophylaxis showed few critically ill patients with important gastrointestinal bleeding. Patients who benefit most from receiving stress ulcer prophylaxis are critically ill patients with coagulopathy, or those requiring mechanical ventilation for more than two days. In patients with headinjuries, widespread burns or severe hypotension, the effects of stress ulcer prophylaxis have not been fully researched, but we would recommend administering stress ulcer prophylaxis in these cases. Following a recent metaanalysis, stress ulcer prophylaxis is performed either with H2-blockers (ranitidine, famotidine) or sucralfate.

  16. A New Diagnostic Clue to Osteomyelitis in Chronic Leg Ulcers.

    Science.gov (United States)

    Schattner, Ami; Dubin, Ina; Gelber, Moshe

    2016-05-01

    Chronic leg ulcers are not infrequently complicated by chronic osteomyelitis, which mandates special treatment but may not be evident on radiography. Inflammatory cytokines may cause reactive thrombocytosis in chronic osteomyelitis. Platelet counts were compared in a group of 24 inpatients with chronic leg ulcers and proven chronic osteomyelitis and 24 inpatients with chronic leg ulcers in whom osteomyelitis was not found. Mean and median platelet counts were significantly higher in the leg ulcer and osteomyelitis group vs the leg ulcer group (P 350 × 10(9)/L, sensitivity was 62.5%, but specificity was 91.7%, with a positive predictive value of 88%. Thrombocytosis in chronic leg ulcers is a new, simple, readily available and inexpensive clue to osteomyelitis in chronic leg ulcers when identified, but its absence cannot rule it out. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Actovegin administration in patients with ulcerated gout tophuses

    Directory of Open Access Journals (Sweden)

    M S Eliseev

    2005-01-01

    Full Text Available Objective. To study actovegin efficacy in the treatment of chronic skin ulcers due to ulceration of tophuses in pts with chronic tophaceous gout. Materials and methods. 6 pts with chronic tophaceous gout aged 52 to 77 years with disease duration from 6 to 20 years with longstanding persisting skin ulcers due to tophuses ulceration were included. In addition to allopuri- nol, steroid and nonsteroidal anti-inflammatory drugs they were treated with actovegin 20% intravenously and local applications of 2% actovegin gel. Clinical examination was performed before and after the course of therapy- Results. Two from six pts showed healing of single chronic ulcers to the end of the treatment course. In the remaining pts ulcer count and size decrease was achieved. Conclusion. Actovegin administration in combined therapy of chronic skin ulcers in pts with chronic tophaceous gout promoted healing of the defects in all cases.

  18. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper.

    Science.gov (United States)

    Posthauer, Mary Ellen; Banks, Merrilyn; Dorner, Becky; Schols, Jos M G A

    2015-04-01

    Nutrition and hydration play an important role in preserving skin and tissue viability and in supporting tissue repair for pressure ulcer (PrU) healing. The majority of research investigating the relationship between nutrition and wounds focuses on PrUs. This white paper reviews the 2014 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Nutrition Guidelines and discusses nutrition strategies for PrU management.

  19. Helical CT findings of gastric wall thickening by peptic ulcer : compared with gastric adenocarcinoma with ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Jung; Choi, Jong Chul; Seo, Keum Soo; Koo, Bon Sik; Park, Byeong Ho; Kim, Chung Ku; Lee, Ki Nam; Nam, Kyung Jin [College of Medicine, Dong A University, Pusan (Korea, Republic of)

    2000-02-01

    To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. Thirty-eight patients with pathologically proven gastric lesion (17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III)) underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence three discriminate layers of gastric wall, and enhancement pattern. The enhancement pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7%). All figures refer, respectively, to the two distinct conditions. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of

  20. Oral aspirin for treating venous leg ulcers.

    Science.gov (United States)

    de Oliveira Carvalho, Paulo Eduardo; Magolbo, Natiara G; De Aquino, Rebeca F; Weller, Carolina D

    2016-02-18

    Venous leg ulcers (VLUs) or varicose ulcers are the final stage of chronic venous insufficiency (CVI), and are the most common type of leg ulcer. The development of VLUs on ankles and lower legs can occur spontaneously or after minor trauma. The ulcers are often painful and exudative, healing is often protracted and recurrence is common. This cycle of healing and recurrence has a considerable impact on the health and quality of life of individuals, and healthcare and socioeconomic costs. VLUs are a common and costly problem worldwide; prevalence is estimated to be between 1.65% to 1.74% in the western world and is more common in adults aged 65 years and older. The main treatment for a VLU is a firm compression bandage. Compression assists by reducing venous hypertension, enhancing venous return and reducing peripheral oedema. However, studies show that it only has moderate effects on healing, with up to 50% of VLUs unhealed after two years of compression. Non-adherence may be the principal cause of these poor results, but presence of inflammation in people with CVI may be another factor, so a treatment that suppresses inflammation (healing ulcers more quickly) and reduces the frequency of ulcer recurrence (thereby prolonging time between recurrent episodes) would be an invaluable intervention to complement compression treatments. Oral aspirin may have a significant impact on VLU clinical practice worldwide. Evidence for the effectiveness of aspirin on ulcer healing and recurrence in high quality RCTs is currently lacking. To assess the benefits and harms of oral aspirin on the healing and recurrence of venous leg ulcers. In May 2015 we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. Additional searches were made in trial registers and reference lists of relevant publications for

  1. Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana.

    Science.gov (United States)

    Ackumey, Mercy M; Gyapong, Margaret; Pappoe, Matilda; Kwakye-Maclean, Cynthia; Weiss, Mitchell G

    2012-05-11

    Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra. Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher's exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents' narratives clarified illness experiences and meanings with reference to PC and PD variables. Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more

  2. Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana

    Directory of Open Access Journals (Sweden)

    Ackumey Mercy M

    2012-05-01

    Full Text Available Abstract Background Ghana is a Buruli ulcer (BU endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra. Methods Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD and perceived causes (PC among respondents with pre-ulcer and ulcer conditions. The Fisher’s exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents’ narratives clarified illness experiences and meanings with reference to PC and PD variables. Results Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%. Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5% and respondents who claimed they had no water contact, questioned the credibility of health messages Conclusions Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and

  3. Therapeutic ultrasound for venous leg ulcers.

    Science.gov (United States)

    Cullum, Nicky; Liu, Zhenmi

    2017-05-15

    Venous leg ulcers are a type of chronic, recurring, complex wound that is more common in people aged over 65 years. Venous ulcers pose a significant burden to patients and healthcare systems. While compression therapy (such as bandages or stockings) is an effective first-line treatment, ultrasound may have a role to play in healing venous ulcers. To determine whether venous leg ulcers treated with ultrasound heal more quickly than those not treated with ultrasound. We searched the Cochrane Wounds Specialised Register (searched 19 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library 2016, Issue 8); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations, MEDLINE Daily and Epub Ahead of Print) (1946 to 19 September 2016); Ovid Embase (1974 to 19 September 2016); and EBSCO CINAHL Plus (1937 to 19 September 2016). We also searched three clinical trials registries and the references of included studies and relevant systematic reviews. There were no restrictions based on language, date of publication or study setting. Randomised controlled trials (RCTs) that compared ultrasound with no ultrasound. Eligible non-ultrasound comparator treatments included usual care, sham ultrasound and alternative leg ulcer treatments. Two authors independently assessed the search results and selected eligible studies. Details from included studies were summarised using a data extraction sheet, and double-checked. We attempted to contact trial authors for missing data. Eleven trials are included in this update; 10 of these we judged to be at an unclear or high risk of bias. The trials were clinically heterogeneous with differences in duration of follow-up, and ultrasound regimens. Nine trials evaluated high frequency ultrasound; seven studies provided data for ulcers healed and two provided data on change in ulcer size only. Two trials evaluated low frequency ultrasound and both reported ulcers healed data.It is uncertain whether high

  4. Anabolic steroids for treating pressure ulcers.

    Science.gov (United States)

    Naing, Cho; Whittaker, Maxine A

    2017-06-20

    Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers. Anabolic steroids are considered because of their ability to stimulate protein synthesis and build muscle mass. Comprehensive evidence is required to facilitate decision making, regarding the benefits and harms of using anabolic steroids. To assess the effects of anabolic steroids for treating pressure ulcers. In March 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) comparing the effects of anabolic steroids with alternative treatments or different types of anabolic steroids in the treatment of pressure ulcers. Two review authors independently carried out study selection, data extraction and risk of bias assessment. The review contains only one trial with a total of 212 participants, all with spinal cord injury and open pressure ulcers classed as stage III and IV. The participants were

  5. Comparison of TAK-438 (Vonoprazan) to Lansoprazole in the Treatment of Gastric Ulcer Participants With or Without Helicobacter Pylori Infection

    Science.gov (United States)

    2017-05-24

    Gastric Ulcer; Peptic Ulcer; Gastrointestinal Diseases; Digestive System Diseases; Lansoprazole; Anti-Ulcer Agents; Gastrointestinal Agents; Proton Pump Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action

  6. Mammary Malignant Ulcer after Radiotherapy: Unpleasant Surprise.

    Science.gov (United States)

    Vindigni, Vincenzo; Kohlscheen, Eva; Kraljic, Tajna; Bassetto, Franco; Pavan, Chiara

    2017-04-01

    We present a case of a woman, 79 years old, followed by Psychiatry for depressive episodes after breast cancer removal. She was operated on for ductal breast carcinoma in 1983. Afterward she was submitted to adjuvant radiotherapy. She came to our attention for a chronic skin ulcer that developed into the radio-treated area about 4 years ago. We performed a skin biopsy and programed adipose tissue grafts to promote wound healing. The result of the biopsy was unexpected: dermal localization of not differentiated breast carcinoma. She is currently under systemic chemotherapy treatment. The key message is to always perform a skin biopsy of a chronic skin ulcer developed after breast cancer removal before planning surgical reconstruction.

  7. Necrotising Ulcerative Gingivitis: A Literature Review.

    Science.gov (United States)

    Dufty, James; Gkranias, Nikolaos; Donos, Nikos

    2017-01-01

    The literature surrounding necrotising ulcerative gingivitis (NUG) is extensive, yet the rare nature of this disease means that there is a lack of good quality research available. This paper aims to scrutinise the literature and provide an up-to-date summary of the available information. A literature search was performed electronically using the Cochrane Library, Ovid Medline, Embase, PubMed Clinical Queries and Google Scholar. Keyword searches were carried out, utilising MeSH terms and free text. English language articles primarily were included, with key foreign language (French and German) articles included where possible from the 1900s to the present day. Necrotising ulcerative gingivitis is a rare disease (prevalence importance should not be underestimated as one of the most severe responses to the oral biofilm. Risk factors must be investigated and addressed. Treatment should consist of gentle superficial debridement, oral hygiene instruction and prescription of mouthwash and antibiotics in severe cases.

  8. VENOUS ULCER--A NEW THERAPEUTIC APPROACH.

    Science.gov (United States)

    Popa, R F; Cazan, I; Baroi, Genoveva; Cazan, Simona; Lefter, G; Strobescu, Cristina

    2016-01-01

    Trophic leg ulcer is a major health problem affecting approximately 1-2% of the population, the incidence being higher in the elderly (70-80 years). It is a multifactorial condition, but the most common cause is chronic venous insufficiency. This can be attributed to reflux in the saphenous system and calf perforator vein incompetence. These were first described by Linton, the first intervention designed to correct perforator vein incompetence bearing his name. Today Linton's operation has been abandoned due to the large unaesthetic incision and great postoperative pain. Also, ulcer healing time is long (2 months) and recurrence rate is high. Currently a series of minimally invasive procedures are used to close these perforator veins, such as ultrasound-guided sclerotherapy. The advantages of these techniques are less discomfort to the patients, low rate of complications, short hospital stay.

  9. Treatment of ulcers with ablative fractional lasers.

    Science.gov (United States)

    Morton, Laurel M; Dover, Jeffrey S; Phillips, Tania J; Krakowski, Andrew C; Uebelhoer, Nathan S

    2015-03-01

    Chronic, nonhealing ulcers are a frustrating therapeutic challenge and investigation of innovative therapies continues to be an important research pursuit. One unique and newly applied intervention is the use of ablative fractional lasers. This technology has recently been employed for the treatment of hypertrophic, disfiguring and function-limiting scars, and was first shown to induce healing of chronic wounds in patients with persistent ulcers and erosions within traumatic scars. Recent reports suggest it may be applicable for other types of chronic wounds as well. The mechanism of action for this modality remains to be elucidated but possible factors include laser-induced collagen remodeling, photomicrodebridement and disruption of biofilms, and induction of a proper wound healing cascade. ©2015 Frontline Medical Communications.

  10. Factors Associated With Ulcer Healing and Quality of Life in Patients With Diabetic Foot Ulcer.

    Science.gov (United States)

    Spanos, Konstantinos; Saleptsis, Vasileios; Athanasoulas, Athanasios; Karathanos, Christos; Bargiota, Alexandra; Chan, Philip; Giannoukas, Athanasios D

    2017-03-01

    A prospective nonrandomized cohort study on consecutive diabetic patients with foot ulcer was undertaken to assess the factors associated with the healing process or limb salvage and evaluate the impact of their treatment on their quality of life. Quality of life was evaluated using Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire before and after treatment. A total of 103 diabetic patients with ulcer (mean age 69.7 ± 9.6 years, 77% male) were treated and followed up for 12 months. Ulcer healing, minor amputation, and major amputation rates were 41%, 41%, and 18%, respectively, while the mortality rate was 18%. Ulcer healing was associated with University of Texas wound grade 1 and the Study of Infections in Diabetic feet comparing Efficacy, Safety and Tolerability of Ertapenem versus Piperacillin/Tazobactam trial's diabetic foot infection wound score. Limb loss was associated with nonpalpable popliteal artery, longer in-hospital stay, and delay until referral. Quality of life was improved in all domains of DFS-SF ( P < .0001) throughout the cohort of our patients regardless of their outcome, and no outcome (healing, minor amputation, or major amputation) was superior to other. Significant improvement was observed in all domains of hygiene self-management after consultation during the follow-up period.

  11. Renal Aspects of Peptic Ulcer Pharmacology

    Directory of Open Access Journals (Sweden)

    Daniel Muruve

    1992-01-01

    Full Text Available Medications to treat peptic ulcer disease are used widely and may have adverse effects on renal function. Similarly, renal dysfunction may alter the pharmacokinetics of this diverse group of medications resulting in dosage adjustments. The older agents, antacids and sucralfate, allow absorption of cations (calcium, magnesium and aluminum which may result in toxicity. Newer medications (H2 blockers and omeprazole appear to have fewer side effects and be better tolerated with appropriate dosage adjustments.

  12. Recurrent oral ulcers--an overview.

    Science.gov (United States)

    Gaffar, A

    2001-01-01

    Recurrent oral ulcers (ROUs) are the most common oral mucosal disease. The etiology of ROUs is complex. The factors include mechanical trauma, genetics, stress, smoking, and viral and bacterial infections. Treatment modalities depend on the differential diagnosis of ROUs and could consist of antimicrobial agents, anti-inflammatory agents, immunomodulators, or over-the-counter medications. New therapy available in the form of a coating polymer, Colgate ORABASE Soothe.N.Seal, is clinically proven to provide rapid relief and healing of ROUs.

  13. Novel treatment options for ulcerative colitis

    OpenAIRE

    Vaughn, Byron P.; Moss, Alan C.

    2013-01-01

    The approved treatment options for patients with ulcerative colitis (UC) are currently limited to mesalamine or immunosuppressants. Patients who do not respond to mesalamine-based therapy can be treated with immunomodulators or anti-TNF antibody therapy. Failure or adverse reactions to these medications leaves the patient with little choice other than colectomy. However, novel insights into the pathogenic drivers of UC have led to new developments in drugs that promise clinical efficacy via m...

  14. Gastric schwannoma coexists with peptic ulcer perforation

    Directory of Open Access Journals (Sweden)

    Volkan İnce

    2011-09-01

    Full Text Available Gastric schwannoma is a benign neoplasm that originates from sheet of nerve cell in stomach. Differential diagnosis of gastrointestinal stromal tumors, (GISTs which have malign potential, than these tumors, which definite diagnosis is determined by histopathological and immunohistochemical methods have clinical significance due to gastric schwannomas have excellent progress after surgical resection. We presented a case of gastric schwannoma coexists with peptic ulcer perforation with guide of literature in this study.

  15. Pyoderma gangrenosum: A commonly overlooked ulcerative condition

    Directory of Open Access Journals (Sweden)

    Daniel Zunsheng Tay

    2014-01-01

    Full Text Available Background: Pyoderma ga ngrenosum (PG is a rare, inflammatory, destructive neutrophilic dermatosis, which mimics other ulcerative conditions. Materials and Methods: In a retrospective study based on patients diagnosed with PG over a 3-year period (2010-2013, we evaluated demographics, anatomical sites, number of lesions, subtypes, histopathology, associated conditions, treatment regimens, healing time, and recurrence. Results: Of our five patients, there were three males and two females, age ranging between 19 and 58 years (mean age 38 years. Four had single lesions localized to the lower limbs while one had multiple lesions (more than five over bilateral hands and legs. Ulcerative subtype was observed in all the patients. One exhibited pathergy. Skin biopsies were done in four patients, revealing dense neutrophilic infiltrates in three cases and leukocytoclastic vasculitis in one. Associated systemic diseases were observed in all patients, four having inflammatory bowel disease and one having both systemic lupus erythematosus and anti-phospholipid syndrome. The patients were all treated with systemic corticosteroids either alone or in combination with immunosuppressants (e.g., azathioprine, mycophenolate mofetil, tacrolimus, and wound dressing. Split-thickness skin graft was done in one patient. Complete healing was achieved in all patients, ranging from one to 3 months after diagnosis. No recurrence was reported. Conclusions: Systemic corticosteroids, either alone or in combination with steroid-sparing agents are the mainstay of treatment. Should family physicians encounter a rapidly progressing ulcer that has poor response to usual wound management, timely referral to dermatology should be made.

  16. Pressure ulcer assessment instruments: a critical appraisal.

    Science.gov (United States)

    Woodbury, M G; Houghton, P E; Campbell, K E; Keast, D H

    1999-05-01

    Numerous evaluation tools have been developed to document various aspects of wound status or appearance of pressure ulcers. These include the Pressure Sore Status Tool (PSST), Pressure Ulcer Scale for Healing (PUSH Tool), Sussman Wound Healing Tool (SWHT), Sessing scale, and the Wound Healing Scale (WHS). A critical appraisal of the literature was undertaken to examine the purpose and methods for the development of each instrument, the extent to which the instruments have been validated to date, the practicality of their use, and the work that remains to be done to establish their suitability for clinical and/or research purposes. All of these instruments have been developed to describe and evaluate change in pressure ulcer status over time with the exception of the WHS, which was developed as an alternative to reverse staging. More of the validation parameters have been addressed for the PSST and the Sessing scale than for the PUSH Tool, the SWHT, and the WHS. All of the instruments can be completed within approximately 5 minutes except the PSST, which requires 10 to 15 minutes to complete. For all instruments, experience with wounds and training in the use of the instrument are required to improve reliability. For each of the measurement instruments, suggestions are made that would complete necessary validation procedures and thus prepare the instruments for clinical and/or research purposes.

  17. Growth factors for treating diabetic foot ulcers

    DEFF Research Database (Denmark)

    Martí-Carvajal, Arturo J; Gluud, Christian; Nicola, Susana

    2015-01-01

    following treatment for diabetic foot ulcers (RR 0.64, 95% CI 0.14 to 2.94; P value 0.56, low quality of evidence)Although 11 trials reported time to complete healing of the foot ulcers in people with diabetes , meta-analysis was not possible for this outcome due to the unique comparisons within each trial......, failure to report data, and high number of withdrawals. Data on quality of life were not reported. Growth factors showed an increasing risk of overall adverse event rate compared with compared with placebo or no growth factor (255/498 (51.20%) versus 169/332 (50.90%); RR 0.83; 95% CI 0.72 to 0.96; I(2......) = 48%; eight trials; low quality evidence). Overall, safety data were poorly reported and adverse events may have been underestimated. AUTHORS' CONCLUSIONS: This Cochrane systematic review analysed a heterogeneous group of trials that assessed 11 different growth factors for diabetic foot ulcers. We...

  18. [Microbiology of pressure and vascular ulcer infections].

    Science.gov (United States)

    Ortiz Balbuena, Jorge; García Madero, Rodrigo; Segovia Gómez, Teresa; Cantero Caballero, Miriea; Sánchez Romero, Isabel; Ramos Martínez, Antonio

    2015-01-01

    Pressure ulcer (PU) infection is a significant clinical problem in many elderly patients. To determine the microbiology of PU and vascular ulcer (VU) infections by conducting a cross-sectional study of outpatients treated in a chronic wounds unit over an 18 month period. Sixty six patients with PU infection and 159 patients with an infected VU were identified. The PUs were located below the knee in 36 patients (52%). Patients with pressure ulcers had a higher proportion of institutionalization, cognitive impairment, inability to walk, and sphincter incontinence. There was a greater number of infections caused by Enterobacteriaceae (52%, P=.002) and fewer S. aureus infections (24%, P<.001) in patients with a PU compared to those with those with a VU. Forty-one percent of S. aureus strains isolated in all the patients were resistant to methicillin (MRSA). The proportion of Enterobacteriaceae infections was similar in patients with infection of pelvic girdle PU and in those located below the knee. PU patients suffer a higher rate of infection by enterobacteria. The most common pathogen in UV infections is S. aureus. The proportion of MRSA infection in patients with chronic wounds is high. The microbiology of the infection in the pelvic girdle PU is similar to those located below the knee. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  19. Medical and surgical treatment of chronic venous ulcers.

    Science.gov (United States)

    Cooper, Michol A; Qazi, Umair; Bass, Eric; Zenilman, Jonathan; Lazarus, Gerald; Valle, M Frances; Malas, Mahmoud B

    2015-01-01

    Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with CVU that have failed a 3-month period of compression dressing, debridement, and local wound care. We found that surgical treatment of the superficial venous system can decrease the time to healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Case Study Of Leech Application In Varicose Ulcer

    Directory of Open Access Journals (Sweden)

    Samaranayake G.V.P.

    2015-08-01

    Full Text Available Varicose ulcers are wounds that are thought to occur due to improper functioning of venous valves usually of the legs. They are the major occurrence of chronic wounds occurring in 70 to 90 of leg ulcer cases. In Sushrut Samhita where get the most scientific description of wound and its management. Similarly Sushrut has given the almost importance to Bloodletting therapy and considered leech as the most unique and effective method of bloodletting even in infected wounds and abscesses. Aforesaid description let us to try leech therapy in venous ulcer was advised to continue weekly application of leech around the ulcer which was followed by dressing with Seethodaka oil and Dashanga lepa. This leech therapy proved very effective and the ulcer healed completely within 30 days. However further evaluation is required to be done by taking a large samples size to prove its significant in treating Venous ulcer.

  1. Bipolar aphthosis presenting as mutilating genital ulcers in women

    Directory of Open Access Journals (Sweden)

    Gupta Somesh

    2004-11-01

    Full Text Available Three women with large, mutilating genital ulcers of long duration, destroying almost the lower half of the external genitalia, are reported. They had a history of recurrent oral ulcers as well. All patients had been diagnosed as having ′genital ulcer syndrome′ in the past and had been treated with antimicrobials. Histopathology of the biopsy from the margin of the ulcer revealed features of leukocytoclastic vasculitis. Considering the history, clinical features and histology, a diagnosis of bipolar aphthosis was made in all patients. All patients responded well to immunosuppressive therapy. The cases are reported because of the presence of genital ulcers of an unusually large size, mutilating character and their close similarity to genital ulcers due to sexually transmitted diseases, especially genital herpes and donovanosis.

  2. [Somatic pain sensitivity of conscious rats with chronic gastric ulcers].

    Science.gov (United States)

    Iarushkina, N I; Bogdanov, A I; Filaretova, L P

    2007-04-01

    The aim of the study was to investigate the effect of gastric ulcers on somatic nociception in conscious rats. The formation of kissing gastric ulcers was induced by luminal application of 60% acetic. Somatic pain sensitivity was tested by tail flick latency. Application of acetic acid resulted in gastric ulcer formation, somatic hyperalgesia and the appearance of typical signs of chronic stress (a long-lasting increase of plasma corticosterone level, adrenal gland hypertrophy and thymus gland involution). Natural healing of gastric ulcers was accompanied by restoration of pain sensitivity and attenuation of typical signs of chronic stress. Both natural healing of gastric ulcers and restoration of pain sensitivity were prevented by daily indomethacin administration. The results suggest that the formation of chronic gastric ulcers may trigger somatic hypersensitivity.

  3. Cryofibrinogenemia-Induced Cutaneous Ulcers: A Review and Diagnostic Criteria.

    Science.gov (United States)

    Grada, Ayman; Falanga, Vincent

    2017-02-01

    Chronic skin ulcers are frequently encountered in clinical practice and are often due to very heterogeneous etiologies. Cryofibrinogenemia is an unusual cause of non-healing skin ulcers. It is a small-vessel occlusive vascular disorder that results from the precipitation of cryofibrinogens in plasma. The lack of definitive diagnostic criteria means cryofibrinogenemia remains an under-diagnosed entity that causes significant morbidity. One of the most common manifestations of cryofibrinogenemia is skin ulceration. The presence of non-healing ulcers in otherwise healthy patients with no evidence of large-vessel disease should raise the suspicion of essential cryofibrinogenemia. An important clinical feature is the presence of microlivedo, which represents short hyperpigmented linear streaks around the ulcer or even distally about the foot. Histopathologic findings are microthrombi in the dermis and not confined exclusively to the ulcerated area. Cryofibrinogenemia can be secondary to an underlying disorder, so careful investigation to exclude other etiologies is always necessary.

  4. A sore spot in pediatrics: risk factors for pressure ulcers.

    Science.gov (United States)

    Samaniego, Irma A

    2003-01-01

    A retrospective, exploratory study was conducted as part of a performance improvement project examining pressure ulcer development in children. In 1 year, 69 children visited the hospital's wound clinic: 50 children had pressure ulcers, and 19 children had skin breakdown secondary to delayed operative wound healing. This article reviews findings from the 50 children with pressure ulcers. The primary diagnosis was myelodysplasia. Risk factors identified included (a) paralysis, (b) insensate areas, (c) high activity, and (d) immobility. The majority of the pressure ulcers occurred in the lower extremities, primarily the feet. As children get older or neurological condition deteriorates, sacral ulcers are seen particularly among wheelchair users. Pressure ulcers occur predominantly in the child's home environment.

  5. T-lymphocyte subsets in recurrent aphthous ulceration

    DEFF Research Database (Denmark)

    Pedersen, A; Klausen, B; Hougen, H P

    1989-01-01

    Peripheral T-lymphocyte subsets: T-helper (OKT4) and T-suppressor (OKT8) cells were studied quantitatively in 20 patients with recurrent aphthous ulceration (RAU) in ulcerative, as well as inactive, stages of the disease. The figures were compared with T-lymphocyte subsets from matched control...... in either stage compared with controls. The study support the hypothesis of recurrent aphthous ulceration being a disorder of immunodeficiency....

  6. Gastric pseudo-ulcers: membrana angularis and pyloric torus defects.

    Science.gov (United States)

    Peavy, P W; Clements, J L; Weens, H S

    1975-03-01

    The membrana angularis and pyloric torus defects are two physiologic bulges which can simulate ulcerations along the lesser curvature of the stomach. The muscular anatomy of the stomach and the mechanism which produces these pseudo-ulcers are discussed. Both pseudoniches can be seen transiently in normal individuals but occasionally are such prominence as to become diagnostic pitfalls. The features and significance of each pseudo-ulcer are reviewed in an attempt to facilitate recognition on the upper gastrointestinal barium examination.

  7. Ulcerative pododermatitis in a cat associated with Anatrichosoma sp.

    Science.gov (United States)

    Ramiro-Ibañez, F; Winston, J; O'Donnell, E; Mansell, J

    2002-01-01

    A 9-year-old castrated male Chartreaux cat was presented for an ulcerative pododermatitis of all 4 paws. A clinical exam was inconclusive and supportive therapy did not improve the condition. Histologic examination revealed an ulcerative and eosinophilic dermatitis associated with epidermal and dermal nematodes and ova consistent with the aphasmid Anatrichosoma sp. Treatment with ivermectin completely resolved the skin lesions. Anatrichosomiasis should be included in the differential diagnosis of ulcerative pododermatitis in cats, at least in the southwestern United States.

  8. Evaluation of skin perfusion pressure to assess refractory foot ulcers.

    Science.gov (United States)

    Kawai, M; Mihara, S; Takahagi, S; Iwamoto, K; Hiragun, T; Hide, M

    2017-05-02

    The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection. Clinical symptoms, ankle-brachial pressure index (ABPI) and SPP were assessed to evaluate the condition of each foot ulcer. Every foot ulcer was treated as independent, even if a participant had multiple ulcers. All ulcers for which we measured SPP were subject to the analysis. All ulcers were purely ischaemic in nature and were exclusively located on the foot or toes. Data were collected from 117 foot ulcers on 91 toes and feet from 65 patients. Almost all SPP values in healed cases were > 27 mmHg. There were three patients whose ulcers failed to heal by conservative treatments were complicated with severe infection. However, no effect of DM on the relationship between SPP values and prognosis was observed. Logistic regression analysis of all ulcers except for the 5 cases complicated with infection revealed that those with 30 mmHg or lower SPP values are likely to heal by conservative treatment with 23% or lower probability, whereas any ulcer with more than 50 mmHg SPP value and without severe infection may heal without the need for further operations with 80% or higher probability. The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM.

  9. Anti-ulcer activity of essential oil constituents.

    Science.gov (United States)

    Oliveira, Francisco de Assis; Andrade, Luciana Nalone; de Sousa, Elida Batista Vieira; de Sousa, Damião Pergentino

    2014-05-05

    Essential oils have attracted considerable worldwide attention over the last few decades. These natural products have wide-ranging pharmacological activities and biotechnological applications. Faced with the need to find new anti-ulcer agents and the great effort on the development of drugs for the treatment of ulcers, in this review, the anti-ulcer activities of 21 bioactive compounds found in essential oils are discussed.

  10. Buruli ulcer in an AIDS Patient | Bafende | South African Medical ...

    African Journals Online (AJOL)

    Buruli ulcer is a mycobacterial skin ulcer caused by Mycobacterium ulcerans, an acid-fast bacillus 3 - 6 μm long and 0.2 - 0.35 μm wide. It was first described in Australia. The name buruli ulcer derives from the Buruli district of Uganda where the disease was largely investigated. The lesions occur chiefly on the legs or arms.

  11. Healing properties of papain-based gel on oral ulcers

    OpenAIRE

    Martins, Manoela Domingues; Fernandes,Kristianne Porta Santos; Pavesi, Vanessa Christina Santos; França, Cristiane Miranda; Mesquita-Ferrari, Raquel Agnelli; Bussadori, Sandra Kalil

    2011-01-01

    The oral mucous membrane is prone to developing ulcers originating from traumatic or immunological processes. Aim: The aim of the present study was to perform a histological evaluation of the antiinflammatory and healing properties of PapacarieTM applied to oral ulcers. Methods: Fifty adult female albino Wistar rats were randomly separated into two groups: control and PapacarieTM. The animals were anesthetized, placed in prone position and ulcers were induced in the middle dorsum of the tongu...

  12. Unidentified angular recurrent ulceration responsive to antiviral therapy

    OpenAIRE

    Rahmi Amtha; Siti Aliyah Pradono

    2013-01-01

    Background: Recurrent ulcer on angular area is usually called stomatitis angularis. It is caused by many factors such as vertical dimension reduce, vitamin B12, and immune system deficiency, C. albicans and staphylococcus involvement. Clinically is characterized by painful fissure with erythematous base without fever. Purpose: to describe an unidentified angular ulcer proceeded by recurrent ulcers with no response of topical therapy. Case: An 18-years old male came to Oral Medicine clinic in ...

  13. Foam dressings for treating pressure ulcers.

    Science.gov (United States)

    Walker, Rachel M; Gillespie, Brigid M; Thalib, Lukman; Higgins, Niall S; Whitty, Jennifer A

    2017-10-12

    Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers. Each review will focus on a particular dressing type. To assess the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers in people with an existing pressure ulcer in any care setting. In February 2017 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; EBSCO CINAHL Plus and the NHS Economic Evaluation Database (NHS EED). We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) and cluster-RCTs, that compared the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers (Category/Stage II or above). Two review authors independently performed study selection, risk of bias and data extraction. A third reviewer resolved discrepancies between the review authors. We included nine trials with a total of 483 participants, all of whom were adults (59 years or older) with an existing pressure ulcer Category/Stage II or above. All trials had two arms, which compared foam dressings with other dressings for treating pressure ulcers.The certainty of evidence ranged from low to very low due

  14. Bronchiolitis obliterans organising pneumonia in a patient with ulcerative colitis.

    Science.gov (United States)

    Swinburn, C R; Jackson, G J; Cobden, I; Ashcroft, T; Morritt, G N; Corris, P A

    1988-01-01

    A young woman with ulcerative colitis developed pneumonia, which responded to corticosteroids. Histological examination showed this to be bronchiolitis obliterans organising pneumonia. Images PMID:3194883

  15. The need for a National Service Framework for leg ulcers.

    Science.gov (United States)

    Bulbulia, R A; Poskitt, K R

    2010-10-01

    Leg ulcers are common and costly to treat, and the quality of care provided to patients with this condition varies widely across the UK. The introduction of specialized community-based leg ulcer clinics in Gloucestershire has been associated with increased ulcer healing rates and decreased rates of ulcer recurrence, but this model of care has not been widely replicated. One way of ending this 'postcode lottery' is to produce a National Service Framework for leg ulcers, with the aim of delivering high-quality evidence-based care via such clinics under the supervision of local consultant vascular surgeons. Existing National Service Frameworks cover a range of common conditions that are, like leg ulceration, associated with significant morbidity, disability and resource use. These documents aim to raise quality and decrease regional variations in health care across the National Health Service, and leg ulceration fulfils all the necessary criteria for inclusion in a National Service Framework. Centrally defined standards of care for patients with leg ulceration, and the reorganization and restructuring of local services to allow the accurate assessment and treatment of such patients are required. Without a National Service Framework to drive up the quality of care across the country, the treatment of patients with leg ulcers will remain suboptimal for the majority of those who suffer from this common and debilitating condition.

  16. Idiopathic giant oesophageal ulcer and leucopoenia after renal transplantation.

    Science.gov (United States)

    van Boekel, G A J; Volbeda, M; van den Hoogen, M W F; Hilbrands, L B; Berden, J H M

    2012-10-01

    A 45-year-old male recipient of a renal allograft was admitted because of a giant oesophageal ulcer coinciding with leucopoenia. An extensive workup revealed no explanation for the ulcer and leucopoenia. Our final diagnosis by exclusion was an idiopathic giant oesophageal ulcer and late-onset neutropenia as consequences of rituximab induction therapy given during the transplant procedure. The patient fully recovered after treatment with prednisone. However, after four months, the ulcer and leucopoenia recurred and again successfully responded to treatment with prednisone.

  17. Pressure ulcer prevention is everyone's business: the PUPS project.

    Science.gov (United States)

    Blenman, Juliet; Marks-Maran, Di

    2017-03-23

    Prevention of pressure ulcers is one of the greatest healthcare challenges in terms of reducing patient harm. The literature shows that although numerous reports and policy documents have been published, pressure ulcer prevention remains an ongoing challenge. A number of innovations have been published offering practising nurses and managers ideas for raising awareness of skin care and preventing pressure ulcers. The majority of these have focused on patients in hospital settings with very little in the literature related to care-home and community initiatives. This article reports on an innovative approach to education for pressure ulcer prevention through collaboration between patients, carers and health and social care professionals.

  18. Recurrent corneal ulcerations associated with smokeable methamphetamine abuse.

    Science.gov (United States)

    Chuck, R S; Williams, J M; Goldberg, M A; Lubniewski, A J

    1996-05-01

    We studied a case of chronic, recurrent, bilateral, corneal ulcerations associated with smokeable methamphetamine abuse, commonly known as "ice," in an otherwise healthy 31-year-old woman. Every few months the patient had recurrent corneal ulcerations. Each time, she was hospitalized and treated successfully with topical antibiotics. Even though she had undergone numerous formal attempts at drug rehabilitation, she continued to have relapses, and ulceration recurred only during periods of smokeable methamphetamine abuse. Illicit use of smokeable methamphetamine may result in corneal ulceration.

  19. Eccrine syringofibroadenoma in a patient with a burn scar ulcer.

    Science.gov (United States)

    Ichikawa, E; Fujisawa, Y; Tateishi, Y; Imakado, S; Otsuka, F

    2000-09-01

    A 72-year-old woman with a burn scar on the calves of both legs developed an ulcer on her right heel, surrounded by multiple verrucous nodules and plaques. She had experienced similar verrucous lesions on both legs in the burn scar areas. Although the clinical diagnosis was Marjolin's ulcer, histologically the ulcer region showed thick fibrous tissue without any atypical epithelial cells. The verrucous lesions were consistent with the diagnosis of eccrine syringofibroadenoma (ESFA). Moreover, an ESFA-like growth pattern was seen in the elevated margin of the ulcer. Our findings suggest that these lesions developed as a result of reactive eccrine duct hyperplasia followed by skin tissue remodelling.

  20. 77 FR 24718 - Scientific Information Request on Chronic Venous Ulcers Treatments

    Science.gov (United States)

    2012-04-25

    ... Venous Ulcers Treatments AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Request...) is seeking scientific information submissions from manufacturers of chronic venous ulcer treatment medical devices. Scientific information is being solicited to inform our Chronic Venous Ulcers: A...

  1. Evalution of anti-ulcer activity of Polyalthia longifolia (Sonn.) Thwaites in experimental animals.

    Science.gov (United States)

    Malairajan, P; Gopalakrishnan, Geetha; Narasimhan, S; Veni, K Jessi Kala

    2008-06-01

    To evaluate the anti-ulcer activity of ethanol extract of leaves of Polyalthia longifolia (Sonn.) Thwaites. The ethanol extract of Polyalthia longifolia was investigated for its anti-ulcer activity against aspirin plus pylorous ligation induced gastric ulcer in rats, HCl -Ethanol induced ulcer in mice and water immersion stress induced ulcer in rats at 300 mg/kg body weight.p.o. A significant (P < 0.01, P < 0.001) anti ulcer activity was observed in all the models. Pylorous ligation showed significant (P< 0.01) reduction in gastric volume, free acidity and ulcer index as compared to control. It also showed 89.71% ulcer inhibition in HCl- Ethanol induced ulcer and 95.3% ulcer protection index in stress induced ulcer. This present study indicates that P. longifolia leaves extract have potential anti ulcer activity in the three models tested.

  2. Esophageal Ulcer as a Cause of Death: A Population-Based Study. Mortality of Esophageal Ulcer Disease.

    Science.gov (United States)

    Rantanen, Tuomo K; Sihvo, Eero I T; Räsänen, Jari V; Hynninen, Marja; Salo, Jarmo A

    2015-01-01

    This study aimed at defining the mortality and the nature of fatal complications that arise out of esophageal ulcer for one clearly defined geographical area. In this national, population-based study, the occurrence of fatal esophageal ulcer or ulcer requiring hospital treatment between January 1987 and December 2000 was assessed by the use of Finland's administrative databases. Medical records provided etiology of fatal ulcer and agonal symptoms. Due to an esophageal ulcer, 2,242 patients received treatment in Finnish hospitals, at an annual frequency of 3.2/100,000. Ulcer with hemorrhage (53.5%), perforation (38.4%), or aspiration pneumonia (2.3%) was the cause of death in 86 patients for an annual mortality of 0.12/100,000. Based on the number of ulcers treated, 3.8% cases ended fatally. Gastroesophageal reflux disease (GERD) seemed to be the etiologic factor for ulcer in 68 (79.0%) patients. The most common agonal symptoms were hematemesis (41.8%), abdominal pain (25.6%), melaena (22.1%), and dyspnea (17.4%). Twenty (23.3%) patients were found dead at home. The rarity of the disease, related disorders, and the diversity of symptoms make the complicated esophageal ulcer a diagnostic challenge. Effective monitored treatment for severe GERD may be an important step to prevent fatal outcome.

  3. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Science.gov (United States)

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, pdiabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

  4. Healing ulcers and preventing their recurrences in the diabetic foot

    Science.gov (United States)

    Sabapathy, S. Raja; Periasamy, Madhu

    2016-01-01

    Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers. Ulcer management must not only address the healing of ulcers but also should correct the altered bio-mechanics to reduce the focal pressure points and prevent recurrence. An analysis of 700 patients presenting with foot problems to the Diabetic Clinic of Ganga Hospital led to the stratification of these patients into four classes of incremental severity. Class 1 – the foot at risk, Class 2 – superficial ulcers without infection, Class 3 – the crippled foot and Class 4 – the critical foot. Almost 77.5% presented in either Class 3 or 4 with complicated foot ulcers requiring major reconstruction or amputation. Class 1 foot can be managed conservatively with foot care and appropriate foot wear. Class 2 in addition to measures for ulcer healing would need surgery to correct the altered bio-mechanics to prevent the recurrence. The procedures called surgical offloading would depend on the site of the ulcer and would need an in-depth clinical study of the foot. Class 3 would need major reconstructive procedures and Class 4 would need amputation since it may be life-threatening. As clinicians, our main efforts must be focused towards identifying patients in Class 1 and offer advice on foot care and Class 2 where appropriate surgical offloading procedure would help preserve the foot. PMID:28216809

  5. Anti-ulcer activity of Ipomoea batatas tubers (sweet potato

    Directory of Open Access Journals (Sweden)

    Vandana Panda

    2012-04-01

    Full Text Available Background: Peptic ulcers occur in that part of the gastrointestinal tract which is exposed to gastric acid and pepsin, i.e., the stomach and duodenum. Gastric and duodenal ulcers are common pathologies that may be induced by a variety of factors such as stress, smoking and noxious agents including non-steroidal anti-inflammatory drugs. Ipomoea batatas tubers (sweet potato contain ample amounts of antioxidants. It has been proven already by many scientific studies that antioxidants have ulcer healing properties. In reference to this, we tried assessing the ulcer healing effect of Ipomoea batatas tubers. Methods: The anti-ulcer activity of the tubers of Ipomoea batatas (sweet potato was studied in cold stress and aspirin-induced gastric ulcers in Wistar rats. Methanolic extracts of Ipomoea batatas tubers (TE at two doses, viz., 400 and 800 mg /kg were evaluated in cold stress and aspirin-induced gastric ulcer models using cimetidine and omeprazole respectively as standards. The standard drugs and the test drugs were administered orally for 7 days in the cold stressmodel and for 1 day in the aspirin-induced gastric ulcer model. Gastroprotective potential, status of the antioxidant enzymes {superoxide dismutase (SOD, catalase (CAT, glutathione peroxidase (GPx and glutathione reductase(GR} along with GSH, and lipid peroxidation were studied in both models. Results: The results of the present study showed that TE possessed gastroprotective activity as evidenced by its significant inhibition of mean ulcer score and ulcer index and a marked increase in GSH, SOD, CAT, GPx, and GR levels and reduction in lipid peroxidation in a dose dependant manner.Conclusion: The present experimental findings suggest that tubers of Ipomoea batatas may be useful for treating peptic ulcers.

  6. [Pharyngeal ulcer in patients with acquired immune deficiency syndrome].

    Science.gov (United States)

    Fang, Gaoli; Zhang, Luo; Wang, Chengshuo; Xiao, Jiang; Fu, Qian; Zhao, Hongxin

    2014-02-01

    To understand the high incidence of pharyngeal ulcer in patients with acquired immune deficiency syndrome (AIDS). By analyzing the clinical features in AIDS patients with pharyngeal ulcer, this study provided reference for clinicians. Twenty AIDS patients with pharyngeal ulcer were retrospectively analysed to explore its clinical features and mechanism, and to explore the feasible therapeutic methods. The patients generally had severe sore throat and dysphagia for 7 days to 8 months, resulting in significant weight loss. Common therapeutical method does not work. The ulcers developed mainly at vestibule of pharynx (10 cases), tonsil (3 cases), epiglottis (3 cases) and pyriform sinus (2 cases). Ulcer types included major aphthous ulcer (MaAU, 14 cases), fungal ulcer (2 cases), herpes zoster (1 case), ulcer secondary to drug eruption(1 case ), and lymphoma(2 cases). The disease course was long with CD4(+) T lymphocytes decreased significantly. Treatment was given with highly active antiretroviral therapy (HARRT), regulation of immune function, analgesic, anti-inflammatory and anti fungal. Treatment lasted from 2 weeks to 3 months, ulcer healed in 13 cases; 1 patient lost to follow-up, 6 patients dead. The manifestation of pharyngeal ulcer in AIDS patients has its particularity. It is often associated with a variety of opportunistic infection and tumors. Local treatment is preferred. HAART therapy and systemic comprehensive treatment play more important and effective role. Pharyngeal ulcer persists for a long time, complicated with fever, diarrhea and other symptoms. The history of blood transfusion, injection drug use or unsafe sexual behavior may predict HIV infection.

  7. Healing ulcers and preventing their recurrences in the diabetic foot

    Directory of Open Access Journals (Sweden)

    S Raja Sabapathy

    2016-01-01

    Full Text Available Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers. Ulcer management must not only address the healing of ulcers but also should correct the altered bio-mechanics to reduce the focal pressure points and prevent recurrence. An analysis of 700 patients presenting with foot problems to the Diabetic Clinic of Ganga Hospital led to the stratification of these patients into four classes of incremental severity. Class 1 – the foot at risk, Class 2 – superficial ulcers without infection, Class 3 – the crippled foot and Class 4 – the critical foot. Almost 77.5% presented in either Class 3 or 4 with complicated foot ulcers requiring major reconstruction or amputation. Class 1 foot can be managed conservatively with foot care and appropriate foot wear. Class 2 in addition to measures for ulcer healing would need surgery to correct the altered bio-mechanics to prevent the recurrence. The procedures called surgical offloading would depend on the site of the ulcer and would need an in-depth clinical study of the foot. Class 3 would need major reconstructive procedures and Class 4 would need amputation since it may be life-threatening. As clinicians, our main efforts must be focused towards identifying patients in Class 1 and offer advice on foot care and Class 2 where appropriate surgical offloading procedure would help preserve the foot.

  8. The personality pattern of duodenal ulcer patients in relation to spontaneous ulcer healing and relapse

    DEFF Research Database (Denmark)

    Jess, P; von der Lieth, L; Matzen, Peter

    1989-01-01

    compared with 30% of the controls (P less than 0.0001). Neuroticism was connected with a high frequency of relapse (P less than 0.05) whereas failure of spontaneous ulcer healing had no certain relation to personality disorders. Patients with non-neurotic personality disorders had more frequently suffered...

  9. Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type.

    Science.gov (United States)

    Chammas, N K; Hill, R L R; Edmonds, M E

    2016-01-01

    Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective study on DFU patients who attended King's College Hospital Foot Clinic and subsequently died. A control group of nonulcerated diabetic patients was matched for age and type of diabetes mellitus. The cause of death was identified from death certificates (DC) and postmortem (PM) examinations. There were 243 DFU patient deaths during this period. Ischaemic heart disease (IHD) was the major cause of death in 62.5% on PM compared to 45.7% on DC. Mean age at death from IHD on PM was 5 years lower in DFU patients compared to controls (68.2 ± 8.7 years versus 73.1 ± 8.0 years, P = 0.015). IHD as a cause of death at PM was significantly linked to neuropathic foot ulcers (OR 3.064, 95% CI 1.003-9.366, and P = 0.049). Conclusions. IHD is the major cause of premature mortality in DFU patients with the neuropathic foot ulcer patients being at a greater risk.

  10. Rectal ulcer with an elusive diagnosis: all that ulcers is not Crohn disease

    Science.gov (United States)

    A single rectal ulcer is an uncommon finding in children with gastrointestinal disease. Although inflammatory bowel disease (IBD) is foremost among the differential diagnoses, a primary immunological defect should not be forgotten. Because of the paucity of literature on the association of rectal ul...

  11. The personality pattern of duodenal ulcer patients in relation to spontaneous ulcer healing and relapse

    DEFF Research Database (Denmark)

    Jess, P; von der Lieth, L; Matzen, Peter

    1989-01-01

    One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were characterist......One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were...... characteristics of duodenal ulcer patients, and whether the presence of such possible personality disorders might influence the prognosis of the disease. Neuroticism occurred in 53% of the patients, but only in 5% of controls (P less than 0.0001). Overall, personality disorders were present in 69% of the patients...... compared with 30% of the controls (P less than 0.0001). Neuroticism was connected with a high frequency of relapse (P less than 0.05) whereas failure of spontaneous ulcer healing had no certain relation to personality disorders. Patients with non-neurotic personality disorders had more frequently suffered...

  12. Complex interventions for preventing diabetic foot ulceration.

    Science.gov (United States)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D

    2015-08-24

    Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent. Therefore, in clinical practice, preventive interventions directed at patients, healthcare providers and/or the structure of health care are often combined (complex interventions). To assess the effectiveness of complex interventions in the prevention of foot ulcers in people with diabetes mellitus compared with single interventions, usual care or alternative complex interventions. A complex intervention is defined as an integrated care approach, combining two or more prevention strategies on at least two different levels of care: the patient, the healthcare provider and/or the structure of health care. For the second update we searched the Cochrane Wounds Group Specialised Register (searched 22 May 2015), The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 4), The Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library 2015, Issue 4), The Health Technology Assessment Database (HTA) (The Cochrane Library 2015, Issue 4), The NHS Economic Evaluation Database (NHS EED) (The Cochrane Library 2015, Issue 4), Ovid MEDLINE (1946 to 22 May 2015), Ovid MEDLINE (In-Process & Other Non-Indexed Citations 21 May, 2015), Ovid EMBASE (1974 to 21 May, 2015) and EBSCO CINAHL (1982 to 22 May, 2015). Prospective randomised controlled trials (RCTs) which compared the effectiveness of combinations of preventive strategies, not solely patient education, for the prevention of foot ulcers in people with diabetes mellitus, with single interventions, usual care or alternative complex interventions. Two review authors were assigned to independently select studies, to extract study data and to assess risk of bias of included studies, using predefined

  13. Solitary Rectal Ulcer Syndrome: A Biopsychosocial Assessment

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    Hamed Daghaghzadeh

    2016-06-01

    Full Text Available Background: Solitary rectal ulcer syndrome (SRUS is a chronic disorder of the gastrointestinal tract and its etiology is not well understood. There is no specific treatment for this syndrome and patients with SRUS may, for years, experience many complications. The aim of the present research was the biopsychosocial study of patients with SRUS.Methods: The study participants consisted of 16 patients with SRUS (7 men and 9 women. Their medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings. Moreover, psychiatric and personality disorders [based on Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision (DSM IV-TR], psychosocial stressors, early life traumas, and coping mechanisms were assessed through structured interviews.Results: At presentation, mean age of the patients was 39 years (16 to 70. Common symptoms reported included rectal bleeding (93.8%, rectal self-digitations (81.2%, passage of mucous (75%, anal pain (75%, and straining (75%. Endoscopically, solitary and multiple lesions were present in 9 (60% and 4 (26.7% patients, respectively, and 87% of lesions were ulcerative and 13.3% polypoidal. The most common histological findings were superficial ulceration (92.85% and intercryptic fibromuscular obliteration (87.71%. Common psychosocial findings included anxiety disorders (50%, depression (37.5%, obsessive-compulsive personality disorder (OCPD or traits (62.5%, interpersonal problems (43.75%, marital conflicts (43.75%, occupational stress (37.5%, early life traumas, physical abuse (31.25%, sexual abuse (31.25%, dysfunctional coping mechanisms, emotional inhibition (50%, and non-assertiveness (37.5%.Conclusion: Given the evidence in this study, we cannot ignore the psychosocial problems of patients with SRUS and biopsychosocial assessment of SRUS is more appropriate than biomedical evaluation alone.

  14. Mycotic corneal ulcers in upper Assam

    Directory of Open Access Journals (Sweden)

    Reema Nath

    2011-01-01

    Full Text Available Purpose : To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. Materials and Methods: In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. Results: In 188 (60.6% cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%. The maximum (23.4% cases were reported during the paddy harvesting season in Assam (January and February. Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH mount. The commonest predisposing factor was corneal injury (74.5%. While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25% was the commonest isolate followed by Aspergillus species (19%, Curvularia species (18.5% and Penicillium species (15.2%. Yeasts were isolated in 2.7% (n=5 cases. Conclusions : Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.

  15. The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

    Science.gov (United States)

    Li, Dan

    2016-08-01

    To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete

  16. The personality patterns in patients with duodenal ulcer and ulcer-like dyspepsia and their relationship to the course of the diseases. Hvidovre Ulcer Project Group

    DEFF Research Database (Denmark)

    Jess, P; Eldrup, J

    1994-01-01

    . A prospective study using the Minnesota Multiphasic Personality Inventory (MMPI) with retesting of a subgroup of patients after a median observation period of 14 months. SETTING. Departments of Medical and Surgical Gastroenterology, Hvidovre University Hospital, and the primary health sector in Roskilde County......, Denmark. SUBJECTS. Sixty hospital patients with duodenal ulceration and 17 patients with duodenal ulceration plus 25 patients with ulcer-like dyspepsia from the primary health sector. MAIN OUTCOME MEASURES. MMPI scores. RESULTS. The hospital patients differed from the two other groups of patients...... by having higher scores of depression and anxiety (P MMPI. Contrary to the patients with persisting complaints, abnormal personality characteristics disappeared in patients without complaints (P

  17. Colonic biogeography in health and ulcerative colitis.

    Science.gov (United States)

    Lavelle, Aonghus; Lennon, Grainne; Winter, Desmond C; O'Connell, P Ronan

    2016-09-02

    The relevance of biogeography to the distal gut microbiota has been investigated in both health and inflammatory bowel disease (IBD), however multiple factors, including sample type and methodology, microbiota characterization and interpersonal variability make the construction of a core model of colonic biogeography challenging. In addition, how phylogenetic classification relates to immunogenicity and whether consistent alterations in the microbiota are associated with ulcerative colitis (UC) remain open questions. This addendum seeks to review the human colonic microbiota in health and UC as currently understood, in the broader context of the human microbiome.

  18. [How can leg ulcer pain be reduced?].

    Science.gov (United States)

    Stansal, A; Lazareth, I; D'Ussel, M; Priollet, P

    2016-09-01

    Chronic vascular wounds are often painful. Pain can develop whatever the cause of the ulceration. It is well known during wound care but can occur at any time. The pain is often a complex phenomenon involving nociceptive pain, neuropathic pain, anxiety and emotional suffering, all directly related to the chronic disease. Care for the patient suffering from pain must take into consideration all of these aspects of the disease. The therapeutic strategy should rely on the use of different pharmacological agents, well-adapted local care using the different available analgesic tools and include psycho-affective care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Role of Helicobacter pylori infection and lifestyle habits in the development of gastroduodenal diseases in a population from the Brazilian Amazon.

    Science.gov (United States)

    Vinagre, Ruth Maria Dias Ferreira; Vilar-e-Silva, Adenielson; Fecury, Amanda Alves; Martins, Luisa Caricio

    2013-01-01

    Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings. In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment. The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.

  20. ROLE OF HELICOBACTER PYLORI INFECTION AND LIFESTYLE HABITS IN THE DEVELOPMENT OF GASTRODUODENAL DISEASES IN A POPULATION FROM THE BRAZILIAN AMAZON

    Directory of Open Access Journals (Sweden)

    Ruth Maria Dias Ferreira VINAGRE

    2013-09-01

    Full Text Available Context Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. Objectives This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings. Methods In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR. Gastric biopsies were obtained for histological assessment. Results The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. Conclusion We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.

  1. Exclusão gastroduodenal e vagotomia troncular: repercussão no peso corporal e gastrinemia- estudo experimental em ratos

    Directory of Open Access Journals (Sweden)

    Pedro Luiz Squilacci Leme

    Full Text Available OBJETIVO: A obesidade mórbida é uma doença crônica que se acompanha de várias complicações médicas e de uma menor esperança de vida, prejudicando o aspecto físico, emocional, econômico e social. As pesquisas clínicas e experimentais são amplamente justificadas nesta doença, considerando-se que a opção de tratamento operatório é recente. As gastroplastias e as derivações gástricas são algumas das modalidades terapêuticas propostas e produzem uma grande câmara gástrica remanescente, que em algumas técnicas fica totalmente excluída do trânsito alimentar. As possíveis alterações deste segmento, transformado em apêndice do sistema digestório, representam um vasto campo para pesquisa. Tivemos como objetivo avaliar o peso e as alterações da dosagem de gastrina sérica do rato, após denervação vagal troncular subdiafragmática, com exclusão da câmara gástrica e duodeno do trânsito alimentar do animal. MÉTODO: Foi realizada vagotomia troncular e exclusão gastroduodenal em cem ratos, dos quais trinta puderam ser estudados. Eram ratos machos adultos (Rattus Norvegicus Albinus, da linhagem Wistar, com peso médio de 378,67 g. Este estudo foi complementado pela dosagem sérica de gastrina por radioimunoensaio com I125 e duplo anticorpo para gastrina. RESULTADOS: O peso de todos os ratos estudados diminuiu em média de 378,67 g para 285,83 g. Os trinta animais perderam em média 92,83 g (-24,52%. Houve diferenças significativas entre o peso inicial dos animais e o peso final (p< 0,001. A gastrina sérica também diminuiu em vinte e um dos trinta ratos operados, caindo de 59,68 pg/ml para 46,77 pg/ml em média, correspondendo a uma diminuição de 12,91 pg (-19,73% entre as duas médias (p< 0,001. A análise estatística teve como objetivo avaliar se houve diminuição nas médias das variáveis: peso e gastrina, medidas antes e depois da operação proposta. Para avaliar as diferenças entre as médias, utilizou

  2. Hyperplastic Polyps and Gastroduodenal Pseudomelanosis

    Directory of Open Access Journals (Sweden)

    Akanksha Agrawal

    2017-01-01

    Full Text Available Pseudomelanosis is a rare endoscopic finding of the upper gastrointestinal tract characterized by hemosiderin deposits in histiocytes of lamina propria. We report a case of 72-year-old lady on chronic oral iron supplementation diagnosed with gastric hyperplastic polyps with background pseudomelanosis of stomach and duodenum. Concomitant occurrence of gastric pseudomelanosis, duodenal pseudomelanosis, and gastric hyperplastic polyps has never been reported. Its presence in the absence of gastritis raises question if pseudomelanosis could be associated with hyperplastic polyp. With limited literature on its etiology and prognosis, these patients should be prospectively followed and reported to study the natural history of the disease.

  3. Risk factors and prevalence of diabetic foot ulcers at Kenyatta ...

    African Journals Online (AJOL)

    Risk factors and prevalence of diabetic foot ulcers at Kenyatta National Hospital, Nairobi. ... Design: Cross-sectional study. Setting: Kenyatta National Hospital, Kenya ... Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic. (East African ...

  4. Etiology and incidence of chronic ulcers in Blantyre, Malawi

    NARCIS (Netherlands)

    Zeegelaar, Jim E.; Stroïnk, Aimee C.; Steketee, Willemyn H.; Faber, William R.; van der Wal, Allard C.; Komolafe, Isaac O. O.; Dzamalala, Charles; Chibwana, Cecilia; Wendte, Johannes F.; Zijlstra, Eduard E.

    2006-01-01

    BACKGROUND: Little information is available on the incidence and etiology of chronic ulcers in the tropics. Therefore, the incidence and etiology of chronic skin ulcers were assessed in out-patients at the Department of Dermatology and in in-patients at the Departments of Dermatology, Surgery,

  5. In-patient management of leg ulcers | Ohanaka | East African ...

    African Journals Online (AJOL)

    Objective: To review in-patient management of leg ulcers and to compare our experiences with those from other similar centres. Design: A retrospective study. Setting: University of Benin Teaching Hospital, Nigeria. Patients: Forty five patients hospitalisad with leg ulcers. Results: There were 27 male and 18 females (MF 3:2) ...

  6. Establishing Baseline Data for Pressure Ulcers in a Rwandan ...

    African Journals Online (AJOL)

    The objective of this study was to establish baseline data and compare prevalence, incidence, and severity of pressure ulcers in this ICU before and after educational classes. Methods. Educational classes on pressure ulcer assessment and classification were held for all ICU nurses. After train- ing, data collection was ...

  7. Colloidal bismuth subcitrate in peptic ulcer--a review

    NARCIS (Netherlands)

    Tytgat, G. N.

    1987-01-01

    De-Nol (colloidal bismuth subcitrate, CBS) precipitates in an acid environment and adheres to the exudate layer covering an ulcer crater; moreover, CBS blocks pepsin activity, retards hydrogen-ion back-diffusion and stimulates prostaglandin synthesis. The average healing rate in duodenal ulcer (DU)

  8. An audit of peptic ulcer surgery in Ibadan, Nigeria

    African Journals Online (AJOL)

    An audit of peptic ulcer surgery in Ibadan, Nigeria. D. O. Irabor. Department of Surgery, University College ... individual and possibly environmental variables influence which procedure is chosen. Some of these procedures ... This paper gives an audit of the treatment of peptic ulcer disease in this institution. Materials and ...

  9. Perforated Duodenal Ulcer: A Review Of Fourteen Consecutive ...

    African Journals Online (AJOL)

    Context: Due to the dire nature of perforated peptic ulcer, fatality could occur if prompt surgical intervention is not employed. Poor prognostic factors include delay in presentation, co-morbid medical factors and preoperative shock. Objective: To review patients of perforated peptic ulcer seen over a four-year period (2008 ...

  10. Secondary hyperparathyroidism: Uncommon cause of a leg ulcer

    NARCIS (Netherlands)

    van Rijssen, L. B.; Brenninkmeijer, E. E. A.; Nieveen van Dijkum, E. J. M.

    2012-01-01

    Most leg ulcers are vascular based. Only if vascular therapy fails other causes are considered. We report the case of a female with incapacitating leg ulcers caused by a rare condition which was only diagnosed after failing treatment. PRESENTATION OF CASE: The female had an extensive previous

  11. Leg ulcers: a review of their impact on daily life.

    NARCIS (Netherlands)

    Persoon, A.; Heinen, M.M.; Vleuten, C.J.M. van der; Rooij, M.J.M. de; Kerkhof, P.C.M. van de; Achterberg, T. van

    2004-01-01

    BACKGROUND: Current nursing care for leg ulcer patients often focuses on wound care and providing compression therapy. Nurses perceive leg ulcer patients as 'under-served' with regard to problems patients experience in daily life. An overview of patient problems is a first and essential step in the

  12. The recalcitrant venous leg ulcer - A never ending story?

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)

    2013-01-01

    textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is

  13. Nurses' knowledge about venous leg ulcer care: a literature review.

    Science.gov (United States)

    Ylönen, M; Stolt, M; Leino-Kilpi, H; Suhonen, R

    2014-06-01

    There is an increasing prevalence of venous leg ulcers coinciding with increasing older people populations. They are therefore important health problems, which restrict daily activities and incur high costs. Efficient and comprehensive nursing care for people with venous leg ulcers requires knowledge of causes, presentations and characteristics, the effects that venous leg ulcers have on individuals and nursing care with evidence-based treatment. To identify the gaps between nurses' demonstrated knowledge of venous leg ulcers and the related nursing care treatment with evidence-based nursing care. A computerized search using MEDLINE, CINAHL the COCHRANE LIBRARY was conducted. The initial search yielded 174 citations from which 16 relevant articles were included in this review. Four themes in venous leg ulcer nursing care emerged demonstrating nurses' knowledge gaps: assessment, physiology and the healing process, nursing care and dressings, and compression treatment. This review suggests that there is a lack of knowledge related to venous leg ulcer physiology, the healing process and how this influences care and treatment. Nurses may not be using the evidence base sufficiently well to support ulcer healing and patient well-being. There is a need for a positive work culture development and ongoing educational programmes aimed at improving nurses' knowledge of venous leg ulcer treatment and care, which address the themes within the results of this review. © 2014 International Council of Nurses.

  14. Venous leg ulcer in the context of chronic venous disease.

    Science.gov (United States)

    Lozano Sánchez, F S; Marinel lo Roura, J; Carrasco Carrasco, E; González-Porras, J R; Escudero Rodríguez, J R; Sánchez Nevarez, I; Díaz Sánchez, S

    2014-05-01

    Chronic venous disease (CVD) is a frequent disorder with a high socioeconomic impact. Little is known about the possible differences between healed ulcer (C5 group) and active ulcer (C6 group) in terms of disease severity and quality of life (QoL). Our aim was to determine the possible differences in severity disease and QoL between the C5-C6 and C1 (control) group. Data from a national, multicentre, observational and cross-sectional study (n = 1598) were used to compare three groups of CVD: C1 (n = 243), C5 (n = 136) and C6 (n = 70). CVD severity was assessed with the Venous Clinical Severity Score (VCSS) and QoL with the Short Form 12 Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Patients with active ulcers had a higher mean total VCSS than patients with healed ulcers (P ulcers than in those with C1 (P ulcers (C6) had lower QoL scores, but the differences were not statistically significant. Patients with venous leg ulcers (C5-C6) are associated with high severity and poor QoL. However, the healing of a leg ulcer did not contribute to improvement of QoL.

  15. RISK FACTORS AND PREVALENCE OF DIABETIC FOOT ULCERS ...

    African Journals Online (AJOL)

    hi-tech

    2003-01-01

    Jan 1, 2003 ... RISK FACTORS AND PREVALENCE OF DIABETIC FOOT ULCERS AT KENYATTA NATIONAL HOSPITAL, NAIROBI. P.N. Nyamu, MBChB, MMed, ... Subjects: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers .... patients in fasted state of about 10 hours, 5 mls of venous blood was ...

  16. studies on diabetic foot ulcers in patients at

    African Journals Online (AJOL)

    An epidemioloigcal and microbiological studies of diabetic foot ulcers were- carried out in our hospital, with a view to reducing the amputation and mortality rate associated with the disease. Wound swabs from 38 Diabetes Mellitus (DM) foot ulcer patients were investigated using culture methods for both strict aerobes and ...

  17. Risk factors, ulcer grade and management outcome of diabetic foot ...

    African Journals Online (AJOL)

    Background: The objective was to determine the risk factors, ulcer grade, and management outcome of patients with diabetic foot ulcers (DFU) managed in a tropical tertiary hospital. Materials and Methods: This is a prospective observational study of all consecutive diabetes mellitus (DM) patients with DFU admitted in the ...

  18. Histological confirmation of epizootic ulcerative syndrome in two ...

    African Journals Online (AJOL)

    Epizootic ulcerative syndrome (EUS) is a fish disease caused by an infection of the oomycete, Aphanomyces invadans. During a fish biodiversity assessment of Lake Liambezi, Zambezi Region, Namibia, in August 2011, two Barbus haasianus and three Barbus unitaeniatus with circular ulcerative skin lesions were collected ...

  19. Chronic foot ulcer complicating a traumatic arteriovenous fistula ...

    African Journals Online (AJOL)

    Background: Chronic foot ulcers could be a complication of traumatic arteriovenous (A-V) fistulation. We report a rare case of chronic foot ulcer and deformity resulting from arteriovenous fistula of the anterior tibial artery. Method: The clinical presentation and the outcome of treatment in a patient treated at the University of ...

  20. Case Series: Cost effective management of duodenal ulcers in ...

    African Journals Online (AJOL)

    Results: These patients were initially treated in upcountry clinics for acute gastritis from either alcohol consumption or suspected food poisoning. There was no duodenal ulcer history. As a result, they came to specialist surgical clinic more than 72 hours after perforation. Diagnosis of perforated duodenal ulcer was made and ...

  1. Placebo effect in the treatment of duodenal ulcer

    NARCIS (Netherlands)

    de Craen, A. J.; Moerman, D. E.; Heisterkamp, S. H.; Tytgat, G. N.; Tijssen, J. G.; Kleijnen, J.

    1999-01-01

    AIMS: To assess whether frequency of placebo administration is associated with duodenal ulcer healing. METHODS: A systematic literature review of randomized clinical trials was undertaken. 79 of 80 trials that met the inclusion criteria. The pooled 4 week placebo healing rate of all duodenal ulcer

  2. Patient education for preventing diabetic foot ulceration (Review)

    NARCIS (Netherlands)

    Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.J.; Valk, G.D.

    2012-01-01

    BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS:

  3. The management of pelvic pressure ulcers by myocutaneous flaps ...

    African Journals Online (AJOL)

    The sex ratio was 5 men for 4 women 10 sacral ulcers were treated by gluteus maximus myocutaneous flaps, 10 trochanteric and 4 ischiatic ulcers were covered by tensor fascia lata myocutaneous flaps. The cure rate was 100%. The main complications were: infection (63.5%), serous fluid discharge (21.05%), and flap ...

  4. fungal infections among diabetic foot ulcer- patients attending ...

    African Journals Online (AJOL)

    2011-01-01

    Jan 1, 2011 ... FUNGAL INFECTIONS AMONG DIABETIC FOOT ULCER- PATIENTS ATTENDING DIABETIC CLINIC IN KENYATTA. NATIONAL HOSPITAL ... in diabetic patients and identify the spectrum of yeasts colonising diabetic foot ulcers at Kenyatta ..... action of antibiotic favours the growth and replication of yeasts ...

  5. Marjolin's Ulcers: A Review | Opara | Nigerian Health Journal

    African Journals Online (AJOL)

    Method: Literatures on marjolin's ulcers were sourced from available journals and internet based searches using Pubmed, Medline and Google search. Results: The incidence of Marjolin's ulcers appears higher in developing countries. First recognized in the first century AD, a lot is yet to be understood about the evolution ...

  6. Coexistent duodenal ulcer among patients with gastric carcinoma ...

    African Journals Online (AJOL)

    To examine the prevalence of coexistent duodenal ulcers among patients with gastric carcinoma in an otherwise intact stomach, we surveyed 604 endoscopically and pathologically diagnosed gastric carcinoma patients and thoroughly inspected their duodenums. Twenty-two (3,6%) of them had either active ulcers or scars ...

  7. Perforated peptic ulcer disease at Kenyatta National Hospital, Nairobi

    African Journals Online (AJOL)

    Background: Published reports on perforated peptic ulcers indicate increasing rates for the elderly, those chronically ill and females. Our local observations are at variance. This study analysed patients treated for peptic ulcer perforations at the Kenyatta National Hospital between January 2005 and December 2006.

  8. The role of surgery for peptic ulcer in eastern Ethiopia

    African Journals Online (AJOL)

    rrgical Resident. I:aculty of Med~cine, University of Addis Ababa. Key words: peptic ulcer, Ethiopia. This was a retrospective study of 90 patients operated on for peptic ulcer disease (PUD) in. Karamara Hospital, Ethiopia, between 1st April.

  9. Anti-Ulcer Effect of Risperidone in Rats | Onwuchekwa | African ...

    African Journals Online (AJOL)

    induced and indomethacin-induced ulcers in the rats. Rats were treated with risperidone (0.1mg/kg, 0.3mg/kg and 0.5mg/kg) orally once daily for 21 days before assessing for ulcer using water immersion restraint stress (WIRS), starvation and ...

  10. Association of Helicobacter pylori infection with peptic ulcer disease ...

    African Journals Online (AJOL)

    Background: Helicobacter pylori infection has been identified as an important risk factor for the development of peptic ulcer disease and is probably the most important cause of relapse in those previously treated for peptic ulcer disease. The aim of this study was to determine the association of Helicobacter pylori infection as ...

  11. Acute Perforated Peptic Ulcer at El Obeid Hospital, Western Sudan ...

    African Journals Online (AJOL)

    Background: The pattern of peptic ulcer disease and its complications has changed during the last two to three decades. Objectives: To state the frequency of acute peptic ulcer perforations and outcomes of their management at El Obeid Hospital, Western Sudan. Materials and Methods: This is an audit of patients with acute ...

  12. Case Report Meleney's Ulcer; A Rare but Fatal Abdominal Wall ...

    African Journals Online (AJOL)

    KIGZ

    Case Report. Meleney's Ulcer; A Rare but Fatal Abdominal Wall Disease Complicating Laparatomy. Waweru JM. Nyeri Provincial General Hospital. Correspondence to: Dr Waweru, P.O. Box 36153-00200, Nairobi. Email: mayshno@gmail.com. Summary. Meleney's ulcer or post operative synergistic bacterial gangrene is a ...

  13. STUDIES ON DIABETIC FOOT ULCERS IN PATIENTS AT JOS ...

    African Journals Online (AJOL)

    An epidemiologcal and microbiological studies of diabetic foot ulcers were carried out in our hospital, with a view to reducing the amputation and mortality rate associated with the disease. Wound swabs from 38 Diabetes Mellitus (DM) foot ulcer patients were investigated using culture methods for both strict aerobes and ...

  14. Campylobacter pylori as possible factor in peptic ulcer recurrence

    NARCIS (Netherlands)

    Rauws, E. A.

    1989-01-01

    The author reviews the literature up to 1988 about the close association of Campylobacter pylori with chronic active gastritis, duodenitis and peptic ulcer disease. No firm data however demonstrate that Campylobacter pylori causes duodenal ulcer but long term eradication of this bacterium prevents

  15. Peptic ulcer perforation: University of Benin Teaching Hospital ...

    African Journals Online (AJOL)

    Peptic ulcer perforation is one of the surgical complications of peptic ulcer disease. Treatment can be operative or non-operative followed by proton pump inhibitor and eradication of Helicobacter pylori.The study was aimed at analyzing the clinical features, operative findings and outcome of patients who had operative ...

  16. Umbilical cord ulceration and jejunal atresia | Mackay | South ...

    African Journals Online (AJOL)

    The association between umbilical cord ulceration and congenital intestinal atresia is being increasingly reported and carries a high mortality. We report on a case of jejunal atresia associated with massive fetal haemorrhage from an umbilical cord ulcer. Fetal distress noted on continuous fetal heart monitoring allowed for ...

  17. The Demographic and Clinical Presentation of Ulcerative Keratitis in ...

    African Journals Online (AJOL)

    Patients with ulcerative keratitis consecutively underwent ocular history, examination, corneal scrapping and HIV screening. Treatment was initiated based on clinical appearance of the ulcer and was changed accordingly after laboratory results. Patients were followed up until complete healing occurred. The demographic ...

  18. Prevalence of corneal ulcer among contact lens wearers in Nigeria ...

    African Journals Online (AJOL)

    Corneal Ulceration has been described as the most serious complication of contact lens wear worldwide. The incidence of corneal ulceration in contact lens wearers in Nigeria was determined retrospectively. 1759 case notes of patients who had worn contact lenses for at least one year were obtained from eye clinics in ...

  19. Conjunctival ulcers in Behçet's disease.

    Science.gov (United States)

    Zamir, Ehud; Bodaghi, Bahram; Tugal-Tutkun, Ilknur; See, Robert F; Charlotte, Frederic; Wang, Robert C; Wechsler, Bertrand; LeHoang, Phuc; Anteby, Irene; Rao, Narsing A

    2003-06-01

    To describe the occurrence of conjunctival ulcers as a manifestation of Behçet's disease. Retrospective, noncomparative, interventional case series with histopathologic correlation. Six patients who fulfilled the diagnostic criteria for Behçet's disease and presented with painful conjunctival ulcers were included in the study. Three of these ulcers were biopsied and studied histologically and immunohistochemically. The lesions were treated with topical or subconjunctival injection of corticosteroids and, in one case, with oral indomethacin. Although all six patients fulfilled the diagnostic criteria for Behçet's disease, two developed uveitis and other signs of Behçet's disease only months to years after the appearance of the conjunctival ulcers. The 3- to 5-mm, round to oval ulcers were located in the limbal and/or bulbar conjunctiva. Histopathology revealed disrupted epithelium, infiltration of both acute and chronic inflammatory cells, and high endothelial venules. Immunohistochemical analysis of the infiltrating lymphocytes revealed primarily T-cell populations admixed with several B cells and CD68-positive histiocytes. After treatment, the conjunctival lesions invariably healed without scarring. In addition to the oral and genital ulceration, ulcers can also be found in the conjunctiva of patients with Behçet's disease. Although this is a rare clinical sign, when accompanied by uveitis or orogenital ulcers, it may suggest a diagnosis of Behçet's disease.

  20. gastric acid secretion, mucus concentration and ulceration following ...

    African Journals Online (AJOL)

    Physiology

    and in high dose group (P<0.001) respectively when compared with control group. The ulceration in high dose ... Cannabis sativa causes decrease in adherent gastric mucus, increase acid secretion and increase in gastric ulceration in a dose ... important cannabis sativa products in food and drug trade are whole hemp.

  1. Early detection of foot ulcers through asymmetry analysis

    Science.gov (United States)

    Kaabouch, Naima; Chen, Yi; Hu, Wen-Chen; Anderson, Julie; Ames, Forrest; Paulson, Rolf

    2009-02-01

    Foot ulcers affect millions of Americans annually. Areas that are likely to ulcerate have been associated with increased local skin temperatures due to inflammation and enzymatic autolysis of tissue. Conventional methods to assess skin, including inspection and palpation, may be valuable approaches, but usually they do not detect changes in skin integrity until an ulcer has already developed. Conversely, infrared imaging is a technology able to assess the integrity of the skin and its many layers, thus having the potential to index the cascade of physiological events in the prevention, assessment, and management of foot ulcers. In this paper, we propose a technique, asymmetry analysis, to automatically analyze the infrared images in order to detect inflammation. Preliminary results show that the proposed technique can be reliable and efficient to detect inflammation and, hence, predict potential ulceration.

  2. [Intratracheal lymphotropic ozone therapy in erosive-ulcerous tracheitis].

    Science.gov (United States)

    Chernekhovskaia, N E; Iarema, I V; Shishlo, V K; Andreev, V G; Khodos, D V

    2001-01-01

    Under observation there were 452 patients with chronic stenosis of hollow organs of the neck having cannulas during the period from 3 months to several years. During the tracheobronchoscopic examination it was found that 35 patients had trachea ulcers, 46 patients had erosive tracheobronchitis. The ulcers were localized on the anterior wall of the thoracic part of the trachea. Their diameter was from 1 to 2.5 cm. The ulcers were accompanied by diffuse bilateral bronchitis of the II-III degree of the inflammation intensity. 2-3 ml of ozonated sodium chloride solution with the concentration of ozone in it 5 mg/l were introduced into the ulcer edges, i.e. lymphotropically, into the submucous membrane. The same solution (40-60 ml) was used for daily sanitation of the tracheobronchial tree. Complete epithelization of the ulcers and cleansing of the bronchial tree took 3-4 curative bronchoscopies.

  3. Malignant melanoma misdiagnosed as diabetic foot ulcer: A case report.

    Science.gov (United States)

    Gao, Wei; Chen, Dawei; Ran, Xingwu

    2017-07-01

    Acral lentiginous melanoma (AML) does not exhibit the classic signs of malignant melanoma. ALM is frequently misdiagnosed because of its unusual sites and atypical clinical morphologies, which lead to poor prognosis. A female patient aged 78 years was presented to our center with two ulcers on her right foot. Diabetic foot ulcer was considered as the primary diagnosis. The ulcers failed to improve after 2 weeks' therapy. An incisional biopsy of the lesion revealed malignant melanoma. The patient received wide excision, skin grafting as well as biotherapy. The lesion was healed and no other metastasis has been founded until now. Clinicians must maintain a high level of suspicion in distinguishing malignant melanoma from other more benign skin lesions of the foot. The need for early biopsy of ulcer, even when clinical suspicion is low, can not be overemphasized. Only in this way can we reduce misdiagnosis rate and improve survival rate in patients with foot ulcer.

  4. A Case of Peripheral Ulcerative Keratitis Associated with Autoimmune Hepatitis

    Directory of Open Access Journals (Sweden)

    Hamoon Eshraghi

    2017-01-01

    Full Text Available Purpose. To describe a case of peripheral ulcerative keratitis in the setting of autoimmune hepatitis and possible overlap syndrome with primary sclerosing cholangitis. Case Report. A 48-year-old African American female with autoimmune hepatitis with possible overlap syndrome with primary sclerosing cholangitis presented with tearing, irritation, and injection of the left eye that was determined to be peripheral ulcerative keratitis. The patient was treated with topical and systemic steroids, immunosuppressant drugs (azathioprine and mycophenolate mofetil, a biologic (rituximab, and surgery (conjunctival resection, and the peripheral ulcerative keratitis epithelialized but ultimately led to corneal perforation. Conclusion. In this unique case, a patient with peripheral ulcerative keratitis who underwent treatment ultimately had a corneal perforation. This case may suggest a possible relationship between autoimmune hepatitis and peripheral ulcerative keratitis.

  5. Acyclovir in the prevention of duodenal ulcer recurrence

    DEFF Research Database (Denmark)

    Rune, S J; Linde, J; Bonnevie, O

    1990-01-01

    This study tests the hypothesis that reactivation of a latent herpes simplex virus infection may be a cause of recurrent duodenal ulceration. Patients with recently healed duodenal ulcer were entered into a double blind, randomised study of maintenance treatment with the antiviral drug acyclovir...... (400 mg bid) versus placebo, to determine if suppression of herpes virus infection would influence the natural history of the ulcer disease. One hundred and fifteen patients entered the trial and 76 patients completed it according to the protocol. Endoscopy was performed when ulcer symptoms recurred...... and at the end of the 25 week trial period. In the acyclovir group the cumulated relapse rate was 63% compared with 56% in the placebo group (NS). This result suggests that reactivation of herpes simplex virus is not a cause of recurrent duodenal ulcer....

  6. [A case of acquired immunodeficiency syndrome with ileocecal ulcer].

    Science.gov (United States)

    Iwasaki, Tetsuyoshi; Saruta, Masayuki; Sawada, Ryoichi; Ide, Daisuke; Arihiro, Seiji; Matsuoka, Mika; Katoh, Tomohiro; Tajiri, Hisao

    2015-10-01

    We report a case of a patient with acquired immunodeficiency syndrome (AIDS) and ileocecal ulcer. A 31-year-old man was admitted with chief complaints of decreased body weight and abdominal pain. Colonoscopy revealed a round punched-out ulcer on the ileocecal valve. Initially, we suspected entero-Behçet's disease and simple ulcer as the cause of the ileocecal ulcer. However, after histologic examination of tissue biopsies obtained during colonoscopy, we diagnosed the patient as having cytomegalovirus (CMV) enteritis. Based on the patient's white blood cell depletion and CMV enteritis, we performed a human immunodeficiency virus (HIV) antibody test. The test was positive, and the diagnosis of AIDS was established. The number of patients with AIDS has been increasing in Japan; thus, we should consider the possibility of CMV enteritis and AIDS in young adult patients affected by ileocecal ulcer with no notable history.

  7. Peptic ulcer pathophysiology: acid, bicarbonate, and mucosal function

    DEFF Research Database (Denmark)

    Højgaard, L; Mertz Nielsen, A; Rune, S J

    1996-01-01

    The previously accepted role of gastric acid hypersecretion in peptic ulcer disease has been modified by studies showing no correlation between acid output and clinical outcome of ulcer disease, or between ulcer recurrence rate after vagotomy and preoperative acid secretion. At the same time......, studies have been unable to demonstrate increased acidity in the duodenal bulb in patients with duodenal ulcer, and consequently more emphasis has been given to the mucosal protecting mechanisms. The existence of an active gastric and duodenal mucosal bicarbonate secretion creates a pH gradient from...... cell removal and repair regulated by epidermal growth factor. Sufficient mucosal blood flow, including a normal acid/base balance, is important for subepithelial protection. In today's model of ulcer pathogenesis, gastric acid and H. pylori work in concert as aggressive factors, with the open question...

  8. Treatment of right dorsal ulcerative colitis in a horse.

    Science.gov (United States)

    Simmons, T R; Gaughan, E M; Ducharme, N G; Dill, S G; King, J M; Anderson, W I

    1990-02-01

    Excessive administration of phenylbutazone was associated with development of right dorsal ulcerative colitis. The clinical signs of right dorsal colitis include chronic colic and weight loss. The laboratory abnormalities include panhypoproteinemia and a high WBC count in the abdominal fluid. Medical management of the chronic colic and protein-losing enteropathy associated with the ulcerative lesions in the right dorsal colon and surgical bypass of the right dorsal colon did not result in long-term resolution of clinical signs. Resection of the ulcerated right dorsal colon through a right lateral approach at the 16th rib resulted in resolution of intestinal protein loss and colic. The results of this case suggest that surgical resection of the ulcerated right dorsal colon may be the recommended treatment for right dorsal ulcerative colitis.

  9. Repositioning for pressure ulcer prevention in adults.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy P; McInnes, Elizabeth; Kent, Bridie; Whitty, Jennifer A; Thalib, Lukman

    2014-04-03

    A pressure ulcer (PU), also referred to as a 'pressure injury', 'pressure sore', or 'bedsore' is defined as an area of localised tissue damage that is caused by unrelieved pressure, friction or shearing forces on any part of the body. PUs commonly occur in patients who are elderly and less mobile, and carry significant human and economic impacts. Immobility and physical inactivity are considered to be major risk factors for PU development and the manual repositioning of patients in hospital or long-term care is a common pressure ulcer prevention strategy. The objectives of this review were to:1) assess the effects of repositioning on the prevention of PUs in adults, regardless of risk or in-patient setting;2) ascertain the most effective repositioning schedules for preventing PUs in adults; and3) ascertain the incremental resource consequences and costs associated with implementing different repositioning regimens compared with alternate schedules or standard practice. We searched the following electronic databases to identify reports of the relevant randomised controlled trials: the Cochrane Wounds Group Specialised Register (searched 06 September 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 8); Ovid MEDLINE (1948 to August, Week 4, 2013); Ovid EMBASE (1974 to 2013, Week 35); EBESCO CINAHL (1982 to 30 August 2013); and the reference sections of studies that were included in the review. Randomised controlled trials (RCTs), published or unpublished, that assessed the effects of any repositioning schedule or different patient positions and measured PU incidence in adults in any setting. Two review authors independently performed study selection, risk of bias assessment and data extraction. We included three RCTs and one economic study representing a total of 502 randomised participants from acute and long-term care settings. Two trials compared the 30º and 90º tilt positions using similar repositioning frequencies (there was a

  10. Radiologic changes of ulcerated foot in leprosy

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jung Hyun; Ahn, Eun Joo; Chung, Eun Chul; Rhee, Chung Sik [Ewha Woman' s University College of Medicine, Seoul (Korea, Republic of); Choi, Sung Jun [Institute for Leprosy Research, KLCA, Uiwang (Korea, Republic of)

    1990-12-15

    There are radiologically characteristic bone changes on the foot and tarsus in leprosy. The bone changes are primarily due to Mycobacterium leprae infection and secondarily to the injurious effect, such as trauma, and infection on the denervated tissue. 117 bone changes of 100 leprosy patients with plantar ulcerations from Jan. 1984 to Oct. 1989 in the Korean Leprosy Control Center were analyzed. Male to female ratio was about 2 : 1 and the most prevalent age was 41 to 60 years, and according to Ridley-Jopling's classification. L-type was most common (46%). One hundred and eleven cases (94.9%) showed bone changes, suggesting high incidence of bone changes in patients with plantar ulcers. Specific findings were observed in two cases(1.7%). One hundred and nine cases showed nonspecific bone changes, which were osteomyelitis(23.1%), neurotrophic changes(39.3%), periostitis(5.1%) and arthritis(12.8%). Extensive bone involvement was seen in neurotrophic changes involving forefoot and metatarsal in 22 of 46 cases, and in secondary changes involving metatarsal bone in 23, tarsus in 20 of 49 cases.

  11. Assessing Ulcerative Pododermatitis of Breeding Rabbits.

    Science.gov (United States)

    Rosell, Joan M; de la Fuente, L Fernando

    2013-04-17

    Rabbits in conventional farms are housed in wire net cages with mesh floors to separate them from droppings. In time, lacerations appear on the legs of adult rabbits causing ulcerative pododermatitis or sore hocks, a severe health and welfare problem. Pain causes behavioral changes; productivity is reduced and the most seriously affected animals die or are culled. In this study we evaluated the attention producers have given to this problem and its prevention by installing footrests in cages. We made 2,331 visits to 664 commercial farms in Spain and Portugal between 2001 and 2012, and evaluated morbidity by examining 105,009 females and 10,722 males. The study highlights that the rate of farms with footrests increased from 27.8% in 2001 to 75.2% in 2012. Prevalence of sore hocks in does in 2001 was 11.4%, decreasing to 6.3% in 2012; prevention of ulcerative pododermatitis was associated (P < 0.001) with the presence of footrests. Overall, prevalence was 4.87 ± 0.26 on farms with footrests and 13.71 ± 0.32 without (P < 0.01).

  12. Assessing Ulcerative Pododermatitis of Breeding Rabbits

    Directory of Open Access Journals (Sweden)

    Joan M. Rosell

    2013-04-01

    Full Text Available Rabbits in conventional farms are housed in wire net cages with mesh floors to separate them from droppings. In time, lacerations appear on the legs of adult rabbits causing ulcerative pododermatitis or sore hocks, a severe health and welfare problem. Pain causes behavioral changes; productivity is reduced and the most seriously affected animals die or are culled. In this study we evaluated the attention producers have given to this problem and its prevention by installing footrests in cages. We made 2,331 visits to 664 commercial farms in Spain and Portugal between 2001 and 2012, and evaluated morbidity by examining 105,009 females and 10,722 males. The study highlights that the rate of farms with footrests increased from 27.8% in 2001 to 75.2% in 2012. Prevalence of sore hocks in does in 2001 was 11.4%, decreasing to 6.3% in 2012; prevention of ulcerative pododermatitis was associated (P < 0.001 with the presence of footrests. Overall, prevalence was 4.87 ± 0.26 on farms with footrests and 13.71 ± 0.32 without (P < 0.01.

  13. Golimumab for the treatment of ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Löwenberg M

    2014-03-01

    Full Text Available Mark Löwenberg,1 Nanne KH de Boer,2 Frank Hoentjen3 1Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, the Netherlands; 3Inflammatory Bowel Disease Center, Radboud University Medical Center, Nijmegen, the Netherlands Abstract: The introduction of therapeutic antibodies against tumor necrosis factor (TNF had a major impact on the treatment of ulcerative colitis (UC. Infliximab and adalimumab are powerful agents that are used for remission induction and maintenance therapy in UC and have an acceptable safety profile. However, a proportion of UC patients for whom therapy with anti-TNF agents is indicated fail or become intolerant to treatment with infliximab or adalimumab. Hence, there remains an unmet need for novel anti-TNF agents. Golimumab (Simponi®, a human anti-TNF antibody that is administered by monthly subcutaneous injections, is the most recently introduced TNF blocker for the treatment of UC. Here, we will discuss recent literature on clinical efficacy and safety of golimumab induction and maintenance treatment in patients with UC. Furthermore, we will discuss the positioning of golimumab for UC in current treatment algorithms. Keywords: ulcerative colitis, UC, antitumor necrosis factor, TNF, antibodies, golimumab

  14. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  15. Ulcerating Ileocolitis in Severe Amatoxin Poisoning

    Directory of Open Access Journals (Sweden)

    Matthias Peter Hilty

    2015-01-01

    Full Text Available Amatoxin poisoning is still associated with a great potential for complications and a high mortality. While the occurrence of acute gastroenteritis within the first 24 hours after amatoxin ingestion is well described, only very few descriptions of late gastrointestinal complications of amatoxin poisoning exist worldwide. We present the case of a 57-year-old female patient with severe amatoxin poisoning causing fulminant but reversible hepatic failure that on day 8 after mushroom ingestion developed severe abdominal pain and watery diarrhea. Ulcerating ileocolitis was identified by computed tomography identifying a thickening of the bowel wall of the entire ileum and biopsies taken from the ileum and large bowel revealing distinct ileitis and proximally accentuated colitis. The absence of discernible alternative etiologies such as infectious agents makes a causal relationship between the ulcerating ileocolitis and the amatoxin poisoning likely. Diarrhea and varying abdominal pain persisted over several weeks and clinical follow-up after six months showed a completely symptom-free patient. The case presented highlights the importance to consider the possibility of rare complications of Amanita intoxication in order to be able to respond to them early and adequately.

  16. Adjuvant Biological Therapies in Chronic Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Natalia Burgos-Alonso

    2017-11-01

    Full Text Available Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers.

  17. Potential of Jatropha multifida sap against traumatic ulcer

    Directory of Open Access Journals (Sweden)

    Basri A. Gani

    2015-09-01

    Full Text Available Background: Traumatic ulcer is a lesion in oral mucosa as a result of physical and mechanical trauma, as well as changes in salivary pH. Jatropha multifida sap can act as antimicrobial, anti-inflammatory and re-epithelialization, and can also trigger the healing process of ulcers. Purpose: Research was aimed to determine the potential of Jatropha multifida sap against traumatic ulcer base on clinical and histopathological healing process. Method: This research was conducted laboratory experimental model, with rats (Rattus norvegicus as the subject as well as Jatropha multifida sap for ulcer healing. Those subjects were divided into four groups: two treatment groups administrated with pellet and Jatropha multifida sap, one group as the positive control group administrated with 0.1% triamcinolone acetonide, and one group as the negative control group administrated with 0.9% NaCl. Ulcer manipulation was used 30% H2O2, and evaluation of ulcer healing was used clinical and histopathological approach. Result: Clinically, the healing process of ulcers in the treatment group with Jatropha multifida sap was faster than that in the positive control group with 0.1% triamcinolone acetonide, indicated with the reduction of the ulcer size until the missing of the ulcers started from the third day to the seventh one (p≤0.05. Histopathologically inflammatory cells (lymphocytes, and plasma cells declined started from the third day, and the formation of collagen and re-epithelialization then occurred. On the seventh day, the epithelial cells thickened, and the inflammatory cells infiltrated. Statistically, those groups were significant (p≤0.05. Conclusion: Jatropha multifida sap has a significant potential to cure traumatic ulcers on oral mucosa clinically and histopathologically.

  18. Nurses' attitudes towards pressure ulcer prevention in Turkey.

    Science.gov (United States)

    Aslan, Arzu; Yavuz van Giersbergen, Meryem

    2016-02-01

    Pressure ulcers remain a major problem in healthcare system. Pressure ulcer incidence is widely accepted as an indicator for the quality of care. Positive attitudes towards pressure ulcer prevention have positive impacts on preventive care. The aim of this study was to identify nurses' attitude towards pressure ulcer prevention. The study design was descriptive. The study was carried out in a university hospital in Izmir, Turkey. The study population consisted of 660 nurses who work in medical and surgical clinics and intensive care units. The study sample consisted of 426 nurses who agreed to participate. Attitude towards Pressure Ulcer Prevention Instrument was used in order to evaluate nurses' attitudes. Written permissions for ethical considerations and Attitude towards Pressure Ulcer Prevention Instrument permission were obtained. Data were collected between June and July 2014. The statistics program SPSS 18 packaged software was used in the analyses of data. The average age of the nurses who took part in the study was 31.86 ± 7.09 years and the average work experience was 8.88 ± 7.41 years; 36.9% (n: 157) were working in intensive care units. The nurses' average score on the Attitude towards Pressure Ulcer Prevention Instrument was 43.74 ± 4.29 (84.12%). It was seen that the attitudes of the nurses towards the prevention of pressure ulcers was positive. To read guidelines and training time about pressure ulcer prevention affect positively attitudes towards the prevention of pressure ulcers. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  19. Longitudinal study of influence of Helicobacter pylori on current risk of duodenal ulcer relapse. The Hvidovre Ulcer Project Group

    DEFF Research Database (Denmark)

    Clausen, M R; Franzmann, M B; Holst, C

    1992-01-01

    Seventy-four patients with duodenal ulcer were followed up longitudinally for 2 years after initial ulcer healing. Endoscopy including biopsy of the antral mucosa was performed every 3rd month and whenever clinical symptoms of relapse occurred. The presence of Helicobacter pylori in the biopsy sp...

  20. Indication for endoscopic treatment of ulcerative early gastric cancer according to depth of ulcer and morphological change.

    Science.gov (United States)

    Lee, Jae Ik; Kim, Ji Hyun; Kim, Jong Han; Choi, Byoung Jin; Song, Young Jin; Choi, Sang Bun; Bae, Young Seok; Lee, Sang Heon; Jee, Sam Ryong; Kang, Mi Seon; Seol, Sang Young

    2012-11-01

    This study was conducted to determine the clinicopathologic factors affecting the stage of ulcerative early gastric cancer (EGC), focusing on the relationships between cancer stage and degree of endoscopic ulcer depth and morphologic changes. Medical records of 183 cases of ulcerative EGC who had received endoscopic examination two or more times with a minimum interval of one week, and who underwent either curative surgery or endoscopic treatment were retrospectively reviewed. Change in ulcer morphology at follow-up endoscopy was observed in 84 cases (45.9%) with improvement and exacerbation of ulcer in 65 (35.5%) and 19 (13.8%) cases, respectively. The presence of type III ulcer (P depth of ulcer at follow-up endoscopy, and which are not accompanied with deep ulcer more than the thickness of adjacent mucosal surface and prominent surrounding mucosal fold change. In addition, histologic criteria should meet the conditions of differentiated intramucosal cancer without lymphovascular invasion. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.