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Sample records for buruli ulcer disease

  1. Wound care in Buruli ulcer disease in Ghana and Benin

    OpenAIRE

    Velding, Kristien; Klis, Sandor-Adrian; Abass, Kabiru M.; Tuah, Wilson; Stienstra, Ymkje; van der Werf, Tjip

    2014-01-01

    Buruli ulcer (BU) is a disease affecting the skin, subcutaneous fat, and bone tissues. Wound care is important in the prevention of disabilities. Awareness of current wound care practices in BU-endemic regions is necessary for future wound care interventions. Thirty-one health care workers in Ghana and Benin were interviewed with a semi-structured interview, complemented by structural observations. Quantitative data were analyzed through t tests and one-way analysis of variance, and qualitati...

  2. Experimental Infection of the Pig with Mycobacterium ulcerans: A Novel Model for Studying the Pathogenesis of Buruli Ulcer Disease

    OpenAIRE

    Bolz, Miriam; Ruggli, Nicolas; Ruf, Marie-Thérèse; Ricklin, Meret E.; Zimmer, Gert; Pluschke, Gerd

    2014-01-01

    BACKGROUND Buruli ulcer (BU) is a slowly progressing, necrotising disease of the skin caused by infection with Mycobacterium ulcerans. Non-ulcerative manifestations are nodules, plaques and oedema, which may progress to ulceration of large parts of the skin. Histopathologically, BU is characterized by coagulative necrosis, fat cell ghosts, epidermal hyperplasia, clusters of extracellular acid fast bacilli (AFB) in the subcutaneous tissue and lack of major inflammatory infiltration. The mo...

  3. Buruli ulcer: wound care and rehabilitation

    OpenAIRE

    Phillips, Richard

    2016-01-01

    Michael Frimpong,1 Fred Stephen Sarfo,2 Mabel Sarpong Duah,1 Mark Wansbrough-Jones,3 Richard O Phillips2 1Kumasi Centre for Collaborative Research in Tropical Medicine, 2Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 3Institute for Infection and Immunity, St George’s University of London, London, UK Abstract: Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive...

  4. Combined inflammatory and metabolic defects reflected by reduced serum protein levels in patients with Buruli ulcer disease.

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    Richard O Phillips

    2014-04-01

    Full Text Available Buruli ulcer is a skin disease caused by Mycobacterium ulcerans that is spreading in tropical countries, with major public health and economic implications in West Africa. Multi-analyte profiling of serum proteins in patients and endemic controls revealed that Buruli ulcer disease down-regulates the circulating levels of a large array of inflammatory mediators, without impacting on the leukocyte composition of peripheral blood. Notably, several proteins contributing to acute phase reaction, lipid metabolism, coagulation and tissue remodelling were also impacted. Their down-regulation was selective and persisted after the elimination of bacteria with antibiotic therapy. It involved proteins with various functions and origins, suggesting that M. ulcerans infection causes global and chronic defects in the host's protein metabolism. Accordingly, patients had reduced levels of total serum proteins and blood urea, in the absence of signs of malnutrition, or functional failure of liver or kidney. Interestingly, slow healers had deeper metabolic and coagulation defects at the start of antibiotic therapy. In addition to providing novel insight into Buruli ulcer pathogenesis, our study therefore identifies a unique proteomic signature for this disease.

  5. Environmental transmission of Mycobacterium ulcerans drives dynamics of Buruli ulcer in endemic regions of Cameroon

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    Garchitorena, Andrés; Ngonghala, Calistus N.; Texier, Gaëtan; Landier, Jordi; Eyangoh, Sara; Bonds, Matthew H.; Guégan, Jean-François; Roche, Benjamin

    2015-12-01

    Buruli Ulcer is a devastating skin disease caused by the pathogen Mycobacterium ulcerans. Emergence and distribution of Buruli ulcer cases is clearly linked to aquatic ecosystems, but the specific route of transmission of M. ulcerans to humans remains unclear. Relying on the most detailed field data in space and time on M. ulcerans and Buruli ulcer available today, we assess the relative contribution of two potential transmission routes -environmental and water bug transmission- to the dynamics of Buruli ulcer in two endemic regions of Cameroon. The temporal dynamics of Buruli ulcer incidence are explained by estimating rates of different routes of transmission in mathematical models. Independently, we also estimate statistical models of the different transmission pathways on the spatial distribution of Buruli ulcer. The results of these two independent approaches are corroborative and suggest that environmental transmission pathways explain the temporal and spatial patterns of Buruli ulcer in our endemic areas better than the water bug transmission.

  6. Landscape diversity related to Buruli ulcer disease in Cote d'Ivoire.

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    Télesphore Brou

    Full Text Available BACKGROUND: Buruli ulcer disease (BU, due to the bacteria Mycobacterium ulcerans, represents an important and emerging public health problem, especially in many African countries. Few elements are known nowadays about the routes of transmission of this environmental bacterium to the human population. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we have investigated the relationships between the incidence of BU in Côte d'Ivoire, western Africa, and a group of environmental variables. These environmental variables concern vegetation, crops (rice and banana, dams, and lakes. Using a geographical information system and multivariate analyses, we show a link between cases of BU and different environmental factors for the first time on a country-wide scale. As a result, irrigated rice field cultures areas, and, to a lesser extent, banana fields as well as areas in the vicinity of dams used for irrigation and aquaculture purposes, represent high-risk zones for the human population to contract BU in Côte d'Ivoire. This is much more relevant in the central part of the country. CONCLUSIONS/SIGNIFICANCE: As already suspected by several case-control studies in different African countries, we strengthen in this work the identification of high-risk areas of BU on a national spatial scale. This first study should now be followed by many others in other countries and at a multi-year temporal scale. This goal implies a strong improvement in data collection and sharing in order to achieve to a global picture of the environmental conditions that drive BU emergence and persistence in human populations.

  7. Clinical and Laboratory Diagnosis of Buruli Ulcer Disease: A Systematic Review

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    Aboagye, Samuel Y.

    2016-01-01

    Background. Buruli ulcer (BU) is a necrotizing cutaneous infection caused by Mycobacterium ulcerans. Early diagnosis is crucial to prevent morbid effects and misuse of drugs. We review developments in laboratory diagnosis of BU, discuss limitations of available diagnostic methods, and give a perspective on the potential of using aptamers as point-of-care. Methods. Information for this review was searched through PubMed, web of knowledge, and identified data up to December 2015. References from relevant articles and reports from WHO Annual Meeting of the Global Buruli Ulcer initiative were also used. Finally, 59 articles were used. Results. The main laboratory methods for BU diagnosis are microscopy, culture, PCR, and histopathology. Microscopy and PCR are used routinely for diagnosis. PCR targeting IS2404 is the gold standard for laboratory confirmation. Culture remains the only method that detects viable bacilli, used for diagnosing relapse and accrued isolates for epidemiological investigation as well as monitoring drug resistance. Laboratory confirmation is done at centers distant from endemic communities reducing confirmation to a quality assurance. Conclusions. Current efforts aimed at developing point-of-care diagnostics are saddled with major drawbacks; we, however, postulate that selection of aptamers against MU target can be used as point of care. PMID:27413382

  8. Genetic Diversity of Staphylococcus aureus in Buruli Ulcer

    NARCIS (Netherlands)

    Amissah, Nana Ama; Glasner, Corinna; Ablordey, Anthony; Tetteh, Caitlin S.; Kotey, Nana Konama; Prah, Isaac; van der Werf, Tjip; Rossen, John W.; van Dijl, Jan Maarten; Stienstra, Ymkje

    2015-01-01

    Background Buruli ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. Previous studies have shown that wounds of BU patients are colonized with M. ulcerans and several other microorganisms, including Staphylococcus aureus, which may interfere with wound healing. The present st

  9. Recent advances: role of mycolactone in the pathogenesis and monitoring of Mycobacterium ulcerans infection/Buruli ulcer disease.

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    Sarfo, Fred Stephen; Phillips, Richard; Wansbrough-Jones, Mark; Simmonds, Rachel E

    2016-01-01

    Infection of subcutaneous tissue with Mycobacterium ulcerans can lead to chronic skin ulceration known as Buruli ulcer. The pathogenesis of this neglected tropical disease is dependent on a lipid-like toxin, mycolactone, which diffuses through tissue away from the infecting organisms. Since its identification in 1999, this molecule has been intensely studied to elucidate its cytotoxic and immunosuppressive properties. Two recent major advances identifying the underlying molecular targets for mycolactone have been described. First, it can target scaffolding proteins (such as Wiskott Aldrich Syndrome Protein), which control actin dynamics in adherent cells and therefore lead to detachment and cell death by anoikis. Second, it prevents the co-translational translocation (and therefore production) of many proteins that pass through the endoplasmic reticulum for secretion or placement in cell membranes. These pleiotropic effects underpin the range of cell-specific functional defects in immune and other cells that contact mycolactone during infection. The dose and duration of mycolactone exposure for these different cells explains tissue necrosis and the paucity of immune cells in the ulcers. This review discusses recent advances in the field, revisits older findings in this context and highlights current developments in structure-function studies as well as methodology that make mycolactone a promising diagnostic biomarker. PMID:26572803

  10. Experimental infection of the pig with Mycobacterium ulcerans: a novel model for studying the pathogenesis of Buruli ulcer disease.

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    Miriam Bolz

    2014-07-01

    Full Text Available Buruli ulcer (BU is a slowly progressing, necrotising disease of the skin caused by infection with Mycobacterium ulcerans. Non-ulcerative manifestations are nodules, plaques and oedema, which may progress to ulceration of large parts of the skin. Histopathologically, BU is characterized by coagulative necrosis, fat cell ghosts, epidermal hyperplasia, clusters of extracellular acid fast bacilli (AFB in the subcutaneous tissue and lack of major inflammatory infiltration. The mode of transmission of BU is not clear and there is only limited information on the early pathogenesis of the disease available.For evaluating the potential of the pig as experimental infection model for BU, we infected pigs subcutaneously with different doses of M. ulcerans. The infected skin sites were excised 2.5 or 6.5 weeks after infection and processed for histopathological analysis. With doses of 2 × 10(7 and 2 × 10(6 colony forming units (CFU we observed the development of nodular lesions that subsequently progressed to ulcerative or plaque-like lesions. At lower inoculation doses signs of infection found after 2.5 weeks had spontaneously resolved at 6.5 weeks. The observed macroscopic and histopathological changes closely resembled those found in M. ulcerans disease in humans.Our results demonstrate that the pig can be infected with M. ulcerans. Productive infection leads to the development of lesions that closely resemble human BU lesions. The pig infection model therefore has great potential for studying the early pathogenesis of BU and for the development of new therapeutic and prophylactic interventions.

  11. Buruli Ulcer (Mycobacterium ulcerans Infection)

    Science.gov (United States)

    ... the older and elderly populations), diabetic ulcers, cutaneous leishmaniasis, extensive ulcerative yaws and ulcers caused by Haemophilus ... the support of the Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland, and Harvard University, field evaluation ...

  12. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

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    Kassi Komenan; Ecra J. Elidjé; Ildevert, Gbery P.; Yao, Kouassi I.; Kouame Kanga; Kouassi A. Kouamé; Sangaré Abdoulaye; Hamdam, Kourouma S.; Yoboué P. Yao; Kanga Jean-Marie

    2013-01-01

    Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune...

  13. Effects of Decontamination, DNA Extraction, and Amplification Procedures on the Molecular Diagnosis of Mycobacterium ulcerans Disease (Buruli Ulcer)

    OpenAIRE

    Affolabi, D.; Sanoussi, N.; Vandelannoote, K.; Odoun, M.; Faihun, F.; Sopoh, G.; Anagonou, S; Portaels, F.; Eddyani, M.

    2012-01-01

    We compared two DNA extraction methods (a semiautomated method using a Maxwell kit and a modified Boom method) and three amplification procedures (a single-step PCR, a nested PCR, and a real-time quantitative PCR) on 74 surgical tissue specimens from patients with clinically suspected Buruli ulcer. All of these procedures were compared before and after decontamination. We observed that, among the procedures tested, real-time PCR after the modified Boom extraction method or a single-run PCR as...

  14. Genetic Susceptibility and Predictors of Paradoxical Reactions in Buruli Ulcer

    OpenAIRE

    Barogui, Yves Thierry; Klis, Sandor-Adrian; Johnson, Roch Christian; Phillips, Richard O.; van der Veer, Eveline; Diemen, Cleo; van der Werf, Tjip S.; Stienstra, Ymkje

    2016-01-01

    Introduction Buruli ulcer (BU) is the third most frequent mycobacterial disease in immunocompetent persons after tuberculosis and leprosy. During the last decade, eight weeks of antimicrobial treatment has become the standard of care. This treatment may be accompanied by transient clinical deterioration, known as paradoxical reaction. We investigate the incidence and the risks factors associated with paradoxical reaction in BU. Methods The lesion size of participants was assessed by careful p...

  15. Survey of water bugs in bankim, a new buruli ulcer endemic area in cameroon.

    OpenAIRE

    Jean-François Guégan; Philippe Legall; Jordi Landier; Laurent Marsollier; Estelle Marion; Sara Eyangoh; Solange Meyin A Ebong

    2012-01-01

    Buruli ulcer is a debitliating human skin disease with an unknown transmission mode although epidemiological data link it with swampy areas. Data available suggest that aquatic insects play a role in the dissemination and/or transmission of this disease. However, their biodiversity and biology remain poorly documented. We conducted an entomological survey in Bankim, Cameroon, an area recently described as endemic for Buruli ulcer in order to identify the commonly occurring aquatic bugs and do...

  16. Recombinant BCG Expressing Mycobacterium ulcerans Ag85A Imparts Enhanced Protection against Experimental Buruli ulcer

    OpenAIRE

    Hart, Bryan E.; Hale, Laura P; Lee, Sunhee

    2015-01-01

    Buruli ulcer, an emerging tropical disease caused by Mycobacterium ulcerans (MU), is characterized by disfiguring skin necrosis and high morbidity. Relatively little is understood about the mode of transmission, pathogenesis, or host immune responses to MU infection. Due to significant reduction in quality of life for patients with extensive tissue scarring, and that a disproportionately high percentage of those affected are disadvantaged children, a Buruli ulcer vaccine would be greatly bene...

  17. Burden of Mycobacterium ulcerans disease (Buruli ulcer and the underreporting ratio in the territory of Songololo, Democratic Republic of Congo.

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    Delphin Mavinga Phanzu

    Full Text Available BACKGROUND: Cutaneous infection by Mycobacterium ulcerans, also known as Buruli ulcer (BU, represents the third most common mycobacterial disease in the world after tuberculosis and leprosy. Data on the burden of BU disease in the Democratic Republic of Congo are scanty. This study aimed to estimate the prevalence rate and the distribution of BU in the Songololo Territory, and to assess the coverage of the existing hospital-based reporting system. METHODS: We conducted a cross-sectional survey (July-August 2008 using the door-to-door method simultaneously in the two rural health zones (RHZ of the Songololo Territory (RHZ of Kimpese and Nsona-Mpangu, each containing twenty health areas. Cases were defined clinically as active BU and inactive BU in accordance with WHO-case definitions. RESULTS: We detected 775 BU patients (259 active and 516 inactive in a total population of 237,418 inhabitants. The overall prevalence of BU in Songololo Territory was 3.3/1000 inhabitants, varying from 0 to 27.5/1000 between health areas. Of the 259 patients with active BU, 18 (7% had been reported in the hospital-based reporting system at Kimpese in the 6-8 months prior to the survey. CONCLUSION: The survey demonstrated a huge variation of prevalence between health areas in Songololo Territory and gross underreporting of BU cases in the hospital-based reporting system. Data obtained may contribute to better targeted and improved BU control interventions, and serve as a baseline for future assessments of the control program.

  18. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

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    Komenan, Kassi; Elidjé, Ecra J.; Ildevert, Gbery P.; Yao, Kouassi I.; Kanga, Kouame; Kouamé, Kouassi A.; Abdoulaye, Sangaré; Hamdam, Kourouma S.; Yao, Yoboué P.; Jean-Marie, Kanga

    2013-01-01

    Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders. PMID:24454398

  19. Distribution of Mycobacterium ulcerans in buruli ulcer endemic and non-endemic aquatic sites in Ghana.

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    Heather R Williamson

    Full Text Available Mycobacterium ulcerans, the causative agent of Buruli ulcer, is an emerging environmental bacterium in Australia and West Africa. The primary risk factor associated with Buruli ulcer is proximity to slow moving water. Environmental constraints for disease are shown by the absence of infection in arid regions of infected countries. A particularly mysterious aspect of Buruli ulcer is the fact that endemic and non-endemic villages may be only a few kilometers apart within the same watershed. Recent studies suggest that aquatic invertebrate species may serve as reservoirs for M. ulcerans, although transmission pathways remain unknown. Systematic studies of the distribution of M. ulcerans in the environment using standard ecological methods have not been reported. Here we present results from the first study based on random sampling of endemic and non-endemic sites. In this study PCR-based methods, along with biofilm collections, have been used to map the presence of M. ulcerans within 26 aquatic sites in Ghana. Results suggest that M. ulcerans is present in both endemic and non-endemic sites and that variable number tandem repeat (VNTR profiling can be used to follow chains of transmission from the environment to humans. Our results suggesting that the distribution of M. ulcerans is far broader than the distribution of human disease is characteristic of environmental pathogens. These findings imply that focal demography, along with patterns of human water contact, may play a major role in transmission of Buruli ulcer.

  20. Survey of Water Bugs in Bankim, a New Buruli Ulcer Endemic Area in Cameroon

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    Solange Meyin A. Ebong

    2012-01-01

    Full Text Available Buruli ulcer is a debitliating human skin disease with an unknown transmission mode although epidemiological data link it with swampy areas. Data available suggest that aquatic insects play a role in the dissemination and/or transmission of this disease. However, their biodiversity and biology remain poorly documented. We conducted an entomological survey in Bankim, Cameroon, an area recently described as endemic for Buruli ulcer in order to identify the commonly occurring aquatic bugs and document their relative abundance, diversity, and spatial distribution. Collection of aquatic bugs was realized over a period of one month by daily direct capture in different aquatic environments (streams, ponds, and rivers and through light traps at night. Globally, the data obtained showed the presence of five families (Belostomatidae, Naucoridae, Nepidae, Notonectidae, and Gerridae, their abundance, distribution and diversity varying according to the type of aquatic environments and light attraction.

  1. Survey of water bugs in bankim, a new buruli ulcer endemic area in cameroon.

    Science.gov (United States)

    Ebong, Solange Meyin A; Eyangoh, Sara; Marion, Estelle; Landier, Jordi; Marsollier, Laurent; Guégan, Jean-François; Legall, Philippe

    2012-01-01

    Buruli ulcer is a debitliating human skin disease with an unknown transmission mode although epidemiological data link it with swampy areas. Data available suggest that aquatic insects play a role in the dissemination and/or transmission of this disease. However, their biodiversity and biology remain poorly documented. We conducted an entomological survey in Bankim, Cameroon, an area recently described as endemic for Buruli ulcer in order to identify the commonly occurring aquatic bugs and document their relative abundance, diversity, and spatial distribution. Collection of aquatic bugs was realized over a period of one month by daily direct capture in different aquatic environments (streams, ponds, and rivers) and through light traps at night. Globally, the data obtained showed the presence of five families (Belostomatidae, Naucoridae, Nepidae, Notonectidae, and Gerridae), their abundance, distribution and diversity varying according to the type of aquatic environments and light attraction. PMID:22666273

  2. Survey of Water Bugs in Bankim, a New Buruli Ulcer Endemic Area in Cameroon

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    Ebong, Solange Meyin A.; Eyangoh, Sara; Marion, Estelle; Landier, Jordi; Marsollier, Laurent; Guégan, Jean-François; Legall, Philippe

    2012-01-01

    Buruli ulcer is a debitliating human skin disease with an unknown transmission mode although epidemiological data link it with swampy areas. Data available suggest that aquatic insects play a role in the dissemination and/or transmission of this disease. However, their biodiversity and biology remain poorly documented. We conducted an entomological survey in Bankim, Cameroon, an area recently described as endemic for Buruli ulcer in order to identify the commonly occurring aquatic bugs and document their relative abundance, diversity, and spatial distribution. Collection of aquatic bugs was realized over a period of one month by daily direct capture in different aquatic environments (streams, ponds, and rivers) and through light traps at night. Globally, the data obtained showed the presence of five families (Belostomatidae, Naucoridae, Nepidae, Notonectidae, and Gerridae), their abundance, distribution and diversity varying according to the type of aquatic environments and light attraction. PMID:22666273

  3. What role do traditional beliefs play in treatment seeking and delay for Buruli ulcer disease?--insights from a mixed methods study in Cameroon.

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    Koen Peeters Grietens

    Full Text Available BACKGROUND: Victims of Buruli ulcer disease (BUD frequently report to specialized units at a late stage of the disease. This delay has been associated with local beliefs and a preference for traditional healing linked to a reportedly mystical origin of the disease. We assessed the role beliefs play in determining BUD sufferers' choice between traditional and biomedical treatments. METHODS: Anthropological fieldwork was conducted in community and clinical settings in the region of Ayos and Akonolinga in Central Cameroon. The research design consisted of a mixed methods study, triangulating a qualitative strand based on ethnographic research and quantitative data obtained through a survey presented to all patients at the Ayos and Akonolinga hospitals (N = 79 at the time of study and in four endemic communities (N = 73 belonging to the hospitals' catchment area. RESULTS: The analysis of BUD sufferers' health-seeking behaviour showed extremely complex therapeutic itineraries, including various attempts and failures both in the biomedical and traditional fields. Contrary to expectations, nearly half of all hospital patients attributed their illness to mystical causes, while traditional healers admitted patients they perceived to be infected by natural causes. Moreover, both patients in hospitals and in communities often combined elements of both types of treatments. Ultimately, perceptions regarding the effectiveness of the treatment, the option for local treatment as a cost prevention strategy and the characteristics of the doctor-patient relationship were more determinant for treatment choice than beliefs. DISCUSSION: The ascription of delay and treatment choice to beliefs constitutes an over-simplification of BUD health-seeking behaviour and places the responsibility directly on the shoulders of BUD sufferers while potentially neglecting other structural elements. While more efficacious treatment in the biomedical sector is likely to

  4. Recombinant BCG Expressing Mycobacterium ulcerans Ag85A Imparts Enhanced Protection against Experimental Buruli ulcer.

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    Hart, Bryan E; Hale, Laura P; Lee, Sunhee

    2015-09-01

    Buruli ulcer, an emerging tropical disease caused by Mycobacterium ulcerans (MU), is characterized by disfiguring skin necrosis and high morbidity. Relatively little is understood about the mode of transmission, pathogenesis, or host immune responses to MU infection. Due to significant reduction in quality of life for patients with extensive tissue scarring, and that a disproportionately high percentage of those affected are disadvantaged children, a Buruli ulcer vaccine would be greatly beneficial to the worldwide community. Previous studies have shown that mice inoculated with either M. bovis bacille Calmette-Guérin (BCG) or a DNA vaccine encoding the M. ulcerans mycolyl transferase, Ag85A (MU-Ag85A), are transiently protected against pathology caused by intradermal challenge with MU. Building upon this principle, we have generated quality-controlled, live-recombinant strains of BCG and M. smegmatis which express the immunodominant MU Ag85A. Priming with rBCG MU-Ag85A followed by an M. smegmatis MU-Ag85A boost strongly induced murine antigen-specific CD4+ T cells and elicited functional IFNγ-producing splenocytes which recognized MU-Ag85A peptide and whole M. ulcerans better than a BCG prime-boost vaccination. Strikingly, mice vaccinated with a single subcutaneous dose of BCG MU-Ag85A or prime-boost displayed significantly enhanced survival, reduced tissue pathology, and lower bacterial load compared to mice vaccinated with BCG. Importantly, this level of superior protection against experimental Buruli ulcer compared to BCG has not previously been achieved. These results suggest that use of BCG as a recombinant vehicle expressing MU antigens represents an effective Buruli ulcer vaccine strategy and warrants further antigen discovery to improve vaccine efficacy. PMID:26393347

  5. On the origin of Mycobacterium ulcerans, the causative agent of Buruli ulcer

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    Doig Kenneth D

    2012-06-01

    Full Text Available Abstract Background Mycobacterium ulcerans is an unusual bacterial pathogen with elusive origins. While closely related to the aquatic dwelling M. marinum, M. ulcerans has evolved the ability to produce the immunosuppressive polyketide toxin mycolactone and cause the neglected tropical disease Buruli ulcer. Other mycolactone-producing mycobacteria (MPM have been identified in fish and frogs and given distinct species designations (M. pseudoshottsii, M. shinshuense, M. liflandii and M. marinum, however the evolution of M. ulcerans and its relationship to other MPM has not been defined. Here we report the comparative analysis of whole genome sequences from 30 MPM and five M. marinum. Results A high-resolution phylogeny based on genome-wide single nucleotide polymorphisms (SNPs showed that M. ulcerans and all other MPM represent a single clonal group that evolved from a common M. marinum progenitor. The emergence of the MPM was driven by the acquisition of the pMUM plasmid encoding genes for the biosynthesis of mycolactones. This change was accompanied by the loss of at least 185 genes, with a significant overrepresentation of genes associated with cell wall functions. Cell wall associated genes also showed evidence of substantial adaptive selection, suggesting cell wall remodeling has been critical for the survival of MPM. Fine-grain analysis of the MPM complex revealed at least three distinct lineages, one of which comprised a highly clonal group, responsible for Buruli ulcer in Africa and Australia. This indicates relatively recent transfer of M. ulcerans between these continents, which represent the vast majority of the global Buruli ulcer burden. Our data provide SNPs and gene sequences that can differentiate M. ulcerans lineages, suitable for use in the diagnosis and surveillance of Buruli ulcer. Conclusions M. ulcerans and all mycolactone-producing mycobacteria are specialized variants of a common Mycobacterium marinum progenitor that have

  6. The incubation period of Buruli ulcer (Mycobacterium ulcerans infection.

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    Jason A Trubiano

    Full Text Available INTRODUCTION: Buruli Ulcer (BU is caused by the environmental microbe Mycobacterium ulcerans. Despite unclear transmission, contact with a BU endemic region is the key known risk factor. In Victoria, Australia, where endemic areas have been carefully mapped, we aimed to estimate the Incubation Period (IP of BU by interviewing patients who reported defined periods of contact with an endemic area prior to BU diagnosis. METHOD: A retrospective review was undertaken of 408 notifications of BU in Victoria from 2002 to 2012. Telephone interviews using a structured questionnaire and review of notification records were performed. Patients with a single visit exposure to a defined endemic area were included and the period from exposure to disease onset determined (IP. RESULTS: We identified 111 of 408 notified patients (27% who had a residential address outside a known endemic area, of whom 23 (6% reported a single visit exposure within the previous 24 months. The median age of included patients was 30 years (range: 6 to 73 and 65% were male. 61% had visited the Bellarine Peninsula, currently the most active endemic area. The median time from symptom onset to diagnosis was 71 days (range: 34-204 days. The midpoint of the reported IP range was utilized to calculate a point estimate of the IP for each case. Subsequently, the mean IP for the cohort was calculated at 135 days (IQR: 109-160; CI 95%: 113.9-156, corresponding to 4.5 months or 19.2 weeks. The shortest IP recorded was 32 days and longest 264 days (Figure 1 & 2. IP did not vary for variables investigated. CONCLUSIONS: The estimated mean IP of BU in Victoria is 135 days (IQR: 109-160 days, 4.5 months. The shortest recorded was IP 34 days and longest 264 days. A greater understanding of BU IP will aid clinical risk assessment and future research.

  7. The Application of Modern Dressings to Buruli Ulcers: Results from a Pilot Implementation Project in Ghana.

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    Velding, Kristien; Klis, Sandor-Adrian; Abass, K Mohammad; van der Werf, Tjip S; Stienstra, Ymkje

    2016-07-01

    Buruli ulcer (BU) is a tropical, infectious skin disease. The resulting ulcer can take a long time to heal, and a high standard of wound care is essential. Currently, the only dressing used for BU wound care is gauze, and its removal causes pain and bleeding. We performed a pilot implementation project using HydroTac(®) (HARTMANN, Heidenheim, Germany), a modern dressing combining foam with a hydrogel component. For future BU treatment, we recommend to use a more absorbent dressing than the HydroTac dressing used in the current project. However, we show that modern dressings can be applied to BUs and that HydroTac dressings yield clean, healing wounds, and prevent the pain and bleeding associated with gauze dressings. Wound care is a vital but to date neglected aspect of BU management. PMID:27162271

  8. A disseminated case of Buruli ulcer at Macenta in the forest region of Guinea in West Africa

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    Bafende Aombe Eric; Strahm Stefan; Loua Richard.; Beavogui Galada Daniel; Kolie Valentin; Guilavogui Raphael; Keita Samba

    2012-01-01

    The author report a confirmed case of Buruli ulcer at Macenta in the forest region of Guinea in West Africa. An 8 years old girl came to the general hospital of Macenta located in the forest region of Guinea at 800km south-west of Conakry. Her story reveals that she used to swim in the local river of Man region in Ivory Coast. There is no notion of trauma or insect bite .The disease started 2 years ago by a nodule of the skin in her right leg which had ulcerated; she received various traditional treatments.

  9. Situated knowledge of pathogenic landscapes in Ghana: Understanding the emergence of Buruli ulcer through qualitative analysis.

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    Tschakert, Petra; Ricciardi, Vincent; Smithwick, Erica; Machado, Mario; Ferring, David; Hausermann, Heidi; Bug, Leah

    2016-02-01

    Successfully addressing neglected tropical diseases requires nuanced understandings of pathogenic landscapes that incorporate situated, contexualized community knowledge. In the case of Buruli ulcer (BU), the role of social science is vital to investigate complex human-environment interactions and navigate different ways of knowing. We analyze a set of qualitative data from our interdisciplinary project on BU in Ghana, drawing from participatory mapping, focus group discussions, semi-structured interviews, and open-ended survey questions to explore how people in endemic and non-endemic areas see themselves embedded in changing environmental and social landscapes. We pay particular attention to landscape disturbance through logging and small-scale alluvial gold mining. The results from our participatory research underscore the holistic nature of BU emergence in landscapes, encapsulated in partial and incomplete local descriptions, the relevance of collective learning to distill complexity, and the potential of rich qualitative data to inform quantitative landscape-disease models. PMID:26761375

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

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    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

  11. Local Cellular Immune Responses and Pathogenesis of Buruli Ulcer Lesions in the Experimental Mycobacterium Ulcerans Pig Infection Model

    Science.gov (United States)

    Bolz, Miriam; Ruggli, Nicolas; Borel, Nicole; Pluschke, Gerd; Ruf, Marie-Thérèse

    2016-01-01

    Background Buruli ulcer is a neglected tropical disease of the skin that is caused by infection with Mycobacterium ulcerans. We recently established an experimental pig (Sus scrofa) infection model for Buruli ulcer to investigate host-pathogen interactions, the efficacy of candidate vaccines and of new treatment options. Methodology/Principal Findings Here we have used the model to study pathogenesis and early host-pathogen interactions in the affected porcine skin upon infection with mycolactone-producing and non-producing M. ulcerans strains. Histopathological analyses of nodular lesions in the porcine skin revealed that six weeks after infection with wild-type M. ulcerans bacteria extracellular acid fast bacilli were surrounded by distinct layers of neutrophils, macrophages and lymphocytes. Upon ulceration, the necrotic tissue containing the major bacterial burden was sloughing off, leading to the loss of most of the mycobacteria. Compared to wild-type M. ulcerans bacteria, toxin-deficient mutants caused an increased granulomatous cellular infiltration without massive tissue necrosis, and only smaller clusters of acid fast bacilli. Conclusions/Significance In summary, the present study shows that the pathogenesis and early immune response to M. ulcerans infection in the pig is very well reflecting BU disease in humans, making the pig infection model an excellent tool for the profiling of new therapeutic and prophylactic interventions. PMID:27128097

  12. Methods used in preclinical assessment of anti-Buruli ulcer agents: A global perspective.

    Science.gov (United States)

    Tsouh, Patrick Valere Fokou; Addo, Phyllis; Yeboah-Manu, Dorothy; Boyom, Fabrice Fekam

    2015-01-01

    Buruli ulcer (BU) caused by Mycobacterium ulcerans is the third most common chronic mycobacterial infection in humans. Approximately 5000 cases are reported annually from at least 33 countries around the globe, especially in rural African communities. Even though anti-mycobacterial therapy is often effective for early nodular or ulcerative lesions, surgery is sometimes employed for aiding wound healing and correction of deformities. The usefulness of the antibiotherapy nonetheless is challenged by huge restrictive factors such as high cost, surgical scars and loss of income due to loss of man-hours, and in some instances employment. For these reasons, more effective and safer drugs are urgently needed, and research programs into alternative therapeutics including investigation of natural products should be encouraged. There is the need for appropriate susceptibility testing methods for the evaluation of potency. A number of biological assay methodologies are in current use, ranging from the classical agar and broth dilution assay formats, to radiorespirometric, dye-based, and fluorescent/luminescence reporter assays. Mice, rats, armadillo, guinea pigs, monkeys, grass cutters and lizards have been suggested as animal models for Buruli ulcer. This review presents an overview of in vitro and in vivo susceptibility testing methods developed so far for the determination of anti-Buruli ulcer activity of natural products and derivatives. PMID:25792087

  13. Household cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality

    OpenAIRE

    Amoakoh, Hannah Brown; Aikins, Moses

    2013-01-01

    Background The economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources. Buruli ulcer (BU), a neglected but treatable tropical disease caused by Mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. However, most BU studies have tended to focused on its bacteriology, epidemiology, entomology and other social dete...

  14. Risk of Buruli ulcer and detection of Mycobacterium ulcerans in mosquitoes in southeastern Australia.

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    Caroline J Lavender

    2011-09-01

    Full Text Available BACKGROUND: Buruli ulcer (BU is a destructive skin condition caused by infection with the environmental bacterium, Mycobacterium ulcerans. The mode of transmission of M. ulcerans is not completely understood, but several studies have explored the role of biting insects. In this study, we tested for an association between the detection of M. ulcerans in mosquitoes and the risk of BU disease in humans in an endemic area of southeastern Australia. METHODOLOGY/PRINCIPAL FINDINGS: Adult mosquitoes were trapped in seven towns on the Bellarine Peninsula in Victoria, Australia, from December 2004 to December 2009 and screened for M. ulcerans by real-time PCR. The number of laboratory-confirmed cases of BU in permanent residents of these towns diagnosed during the same period was tallied to determine the average cumulative incidence of BU in each location. Pearson's correlation coefficient (r was calculated for the proportion of M. ulcerans-positive mosquitoes per town correlated with the incidence of BU per town. We found a strong dose-response relationship between the detection of M. ulcerans in mosquitoes and the risk of human disease (r, 0.99; 95% CI, 0.92-0.99; p < 0.001. CONCLUSIONS/SIGNIFICANCE: The results of this study strengthen the hypothesis that mosquitoes are involved in the transmission of M. ulcerans in southeastern Australia. This has implications for the development of intervention strategies to control and prevent BU.

  15. A Genomic Approach to Resolving Relapse versus Reinfection among Four Cases of Buruli Ulcer.

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    Miriam Eddyani

    2015-11-01

    Full Text Available Increased availability of Next Generation Sequencing (NGS techniques allows, for the first time, to distinguish relapses from reinfections in patients with multiple Buruli ulcer (BU episodes.We compared the number and location of single nucleotide polymorphisms (SNPs identified by genomic screening between four pairs of Mycobacterium ulcerans isolates collected at the time of first diagnosis and at recurrence, derived from a collection of almost 5000 well characterized clinical samples from one BU treatment center in Benin.The findings suggest that after surgical treatment-without antibiotics-the second episodes were due to relapse rather than reinfection. Since specific antibiotics were introduced for the treatment of BU, the one patient with a culture available from both disease episodes had M. ulcerans isolates with a genomic distance of 20 SNPs, suggesting the patient was most likely reinfected rather than having a relapse.To our knowledge, this study is the first to study recurrences in M. ulcerans using NGS, and to identify exogenous reinfection as causing a recurrence of BU. The occurrence of reinfection highlights the contribution of ongoing exposure to M. ulcerans to disease recurrence, and has implications for vaccine development.

  16. Pain Associated with Wound Care Treatment among Buruli Ulcer Patients from Ghana and Benin.

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    Marike Alferink

    Full Text Available Buruli ulcer (BU is a necrotizing skin disease caused by Mycobacterium ulcerans. People living in remote areas in tropical Sub Saharan Africa are mostly affected. Wound care is an important component of BU management; this often needs to be extended for months after the initial antibiotic treatment. BU is reported in the literature as being painless, however clinical observations revealed that some patients experienced pain during wound care. This was the first study on pain intensity during and after wound care in BU patients and factors associated with pain. In Ghana and Benin, 52 BU patients above 5 years of age and their relatives were included between December 2012 and May 2014. Information on pain intensity during and after wound care was obtained during two consecutive weeks using the Wong-Baker Pain Scale. Median pain intensity during wound care was in the lower range (Mdn = 2, CV = 1, but severe pain (score > 6 was reported in nearly 30% of the patients. Nevertheless, only one patient received pain medication. Pain declined over time to low scores 2 hours after treatment. Factors associated with higher self-reported pain scores were; male gender, fear prior to treatment, pain during the night prior to treatment, and pain caused by cleaning the wound. The general idea that BU is painless is incorrect for the wound care procedure. This procedural pain deserves attention and appropriate intervention.

  17. Health services for Buruli ulcer control: lessons from a field study in Ghana.

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    Mercy M Ackumey

    2011-06-01

    Full Text Available BACKGROUND: Buruli ulcer (BU, caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue. The first phase of a BU prevention and treatment programme (BUPaT was initiated from 2005-2008, in the Ga-West and Ga-South municipalities in Ghana to increase access to BU treatment and to improve early case detection and case management. This paper assesses achievements of the BUPaT programme and lessons learnt. It also considers the impact of the programme on broader interests of the health system. METHODS: A mixed-methods approach included patients' records review, review of programme reports, a stakeholder forum, key informant interviews, focus group discussions, clinic visits and observations. PRINCIPAL FINDINGS: Extensive collaboration existed across all levels, (national, municipality, and community, thus strengthening the health system. The programme enhanced capacities of all stakeholders in various aspects of health services delivery and demonstrated the importance of health education and community-based surveillance to create awareness and encourage early treatment. A patient database was also created using recommended World Health Organisation (WHO forms which showed that 297 patients were treated from 2005-2008. The proportion of patients requiring only antibiotic treatment, introduced in the course of the programme, was highest in the last year (35.4% in the first, 23.5% in the second and 42.5% in the third year. Early antibiotic treatment prevented recurrences which was consistent with programme aims. CONCLUSIONS: To improve early case management of BU, strengthening existing clinics to increase access to antibiotic therapy is critical. Intensifying health education and surveillance would ultimately increase early reporting and treatment for all cases. Further research is needed to explain the role of environmental factors for BU contagion. Programme strategies reported in our study: collaboration

  18. Amoebae as Potential Environmental Hosts for Mycobacterium ulcerans and Other Mycobacteria, but Doubtful Actors in Buruli Ulcer Epidemiology

    Science.gov (United States)

    Gryseels, Sophie; Amissah, Diana; Durnez, Lies; Vandelannoote, Koen; Leirs, Herwig; De Jonckheere, Johan; Portaels, Françoise; Ablordey, Anthony; Eddyani, Miriam

    2012-01-01

    Background The reservoir and mode of transmission of Mycobacterium ulcerans, the causative agent of Buruli ulcer, remain unknown. Ecological, genetic and epidemiological information nonetheless suggests that M. ulcerans may reside in aquatic protozoa. Methodology/Principal Findings We experimentally infected Acanthamoeba polyphaga with M. ulcerans and found that the bacilli were phagocytised, not digested and remained viable for the duration of the experiment. Furthermore, we collected 13 water, 90 biofilm and 45 detritus samples in both Buruli ulcer endemic and non-endemic communities in Ghana, from which we cultivated amoeboid protozoa and mycobacteria. M. ulcerans was not isolated, but other mycobacteria were as frequently isolated from intracellular as from extracellular sources, suggesting that they commonly infect amoebae in nature. We screened the samples as well as the amoeba cultures for the M. ulcerans markers IS2404, IS2606 and KR-B. IS2404 was detected in 2% of the environmental samples and in 4% of the amoeba cultures. The IS2404 positive amoeba cultures included up to 5 different protozoan species, and originated both from Buruli ulcer endemic and non-endemic communities. Conclusions/Significance This is the first report of experimental infection of amoebae with M. ulcerans and of the detection of the marker IS2404 in amoeba cultures isolated from the environment. We conclude that amoeba are potential natural hosts for M. ulcerans, yet remain sceptical about their implication in the transmission of M. ulcerans to humans and their importance in the epidemiology of Buruli ulcer. PMID:22880141

  19. Amoebae as potential environmental hosts for Mycobacterium ulcerans and other mycobacteria, but doubtful actors in Buruli ulcer epidemiology.

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    Sophie Gryseels

    Full Text Available BACKGROUND: The reservoir and mode of transmission of Mycobacterium ulcerans, the causative agent of Buruli ulcer, remain unknown. Ecological, genetic and epidemiological information nonetheless suggests that M. ulcerans may reside in aquatic protozoa. METHODOLOGY/PRINCIPAL FINDINGS: We experimentally infected Acanthamoeba polyphaga with M. ulcerans and found that the bacilli were phagocytised, not digested and remained viable for the duration of the experiment. Furthermore, we collected 13 water, 90 biofilm and 45 detritus samples in both Buruli ulcer endemic and non-endemic communities in Ghana, from which we cultivated amoeboid protozoa and mycobacteria. M. ulcerans was not isolated, but other mycobacteria were as frequently isolated from intracellular as from extracellular sources, suggesting that they commonly infect amoebae in nature. We screened the samples as well as the amoeba cultures for the M. ulcerans markers IS2404, IS2606 and KR-B. IS2404 was detected in 2% of the environmental samples and in 4% of the amoeba cultures. The IS2404 positive amoeba cultures included up to 5 different protozoan species, and originated both from Buruli ulcer endemic and non-endemic communities. CONCLUSIONS/SIGNIFICANCE: This is the first report of experimental infection of amoebae with M. ulcerans and of the detection of the marker IS2404 in amoeba cultures isolated from the environment. We conclude that amoeba are potential natural hosts for M. ulcerans, yet remain sceptical about their implication in the transmission of M. ulcerans to humans and their importance in the epidemiology of Buruli ulcer.

  20. Healthcare seeking behaviour for Buruli ulcer in Benin : a model to capture therapy choice of patients and healthy community members

    NARCIS (Netherlands)

    Mulder, Annelies A.; Boerma, Roelien P.; Barogui, Yves; Zinsou, Claude; Johnson, R. Christian; Gbovi, Jules; van der Werf, Tjip S.; Stienstra, Ymkje

    2008-01-01

    Buruli ulcer is a devastating condition emerging in West Africa. We investigated why patients often report late to the hospital. Health seeking behaviour determinants and stigma were studied by in-depth interviews in patients treated in hospital (n = 107), patients treated traditionally (n = 46) of

  1. Potential Wildlife Sentinels for Monitoring the Endemic Spread of Human Buruli Ulcer in South-East Australia

    OpenAIRE

    Carson, Connor; Lavender, Caroline J.; Handasyde, Kathrine A.; O'Brien, Carolyn R.; Hewitt, Nick; Johnson, Paul D.R.; Fyfe, Janet A. M.

    2014-01-01

    The last 20 years has seen a significant series of outbreaks of Buruli/Bairnsdale Ulcer (BU), caused by Mycobacterium ulcerans, in temperate south-eastern Australia (state of Victoria). Here, the prevailing view of M. ulcerans as an aquatic pathogen has been questioned by recent research identifying native wildlife as potential terrestrial reservoirs of infection; specifically, tree-dwelling common ringtail and brushtail possums. In that previous work, sampling of environmental possum faeces ...

  2. Amoebae as potential environmental hosts for Mycobacterium ulcerans and other mycobacteria, but doubtful actors in Buruli ulcer epidemiology

    OpenAIRE

    Gryseels, Sophie; Amissah, Diana; Durnez, Lies; Vandelannoote, Koen; Leirs, Herwig; De Jonckheere, Johan; Silva, Manuel T.; Portaels, Françoise; Ablordey, Anthony; Eddyani, Miriam

    2012-01-01

    BACKGROUND: The reservoir and mode of transmission of Mycobacterium ulcerans, the causative agent of Buruli ulcer, remain unknown. Ecological, genetic and epidemiological information nonetheless suggests that M. ulcerans may reside in aquatic protozoa. METHODOLOGY/PRINCIPAL FINDINGS: We experimentally infected Acanthamoeba polyphaga with M. ulcerans and found that the bacilli were phagocytised, not digested and remained viable for the duration of the experiment. Furthermore, we collected 13 ...

  3. Phase change material for thermotherapy of Buruli ulcer: a prospective observational single centre proof-of-principle trial.

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    Thomas Junghanss

    Full Text Available BACKGROUND: Buruli ulcer (BU is an infection of the subcutaneous tissue leading to chronic necrotizing skin ulcers. The causative pathogen, Mycobacterium ulcerans, grows best at 30 degrees C-33 degrees C and not above 37 degrees C. We explored the safety, tolerability and efficacy of phase change material (PCM, a novel heat application system for thermotherapy of BU. METHODOLOGY/PRINCIPAL FINDINGS: In a prospective observational single centre proof-of-principle trial in Ayos/Cameroon, six laboratory reconfirmed patients with ulcerative Buruli lesions received 28-31 (ulcers 2 cm days of thermotherapy with the PCM sodium acetate trihydrate as heat application system. This PCM is widely used in commercial pocket heat pads, it is easy to apply, rechargeable in hot water, non-toxic and non-hazardous to the environment. All patients enrolled in the trial completed treatment. Being completely mobile during the well-tolerated heat application, acceptability of the PCM bandages was very high. In patients with smaller ulcers, wounds healed completely without further intervention. Patients with large defects had skin grafting after successful heat treatment. Heat treatment was not associated with marked increases in local inflammation or the development of ectopic lymphoid tissue. One and a half years after completion of treatment, all patients are relapse-free. CONCLUSIONS/SIGNIFICANCE: Our reusable PCM-based heat application device appears perfectly suited to treat BU in endemic countries with limited resources and infrastructure. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN88392614.

  4. Mycobacterium ulcerans DNA not detected in faecal samples from Buruli ulcer patients: results of a pilot study.

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    Fred S Sarfo

    Full Text Available It has recently been shown that in a Buruli ulcer (BU endemic region of southeastern Australia, significant numbers of possums (native tree-dwelling marsupials have clinical BU disease. Furthermore, based on quantitative PCR (qPCR analysis, animals with BU lesions (and some without shed M. ulcerans DNA in their faeces, indicative of bacterial loads of up to 10(8 organisms/gram. These findings led us to propose that humans might also harbour M. ulcerans in their gastrointestinal tract and shed the bacterium in their faeces. We conducted a pilot study and collected faecal swabs from 26 patients with confirmed BU and 31 healthy household controls. Faecal samples were also collected from 10 healthy controls from non-endemic regions in Ghana. All 67 specimens were negative when tested by IS2404 PCR. The detection sensitivity of this method was ≥10(4 bacteria per gram (wet-weight of human faecal material. We conclude that the human gastrointestinal tract is unlikely to be a significant reservoir of M. ulcerans.

  5. Mycolactone-Dependent Depletion of Endothelial Cell Thrombomodulin Is Strongly Associated with Fibrin Deposition in Buruli Ulcer Lesions.

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    Joy Ogbechi

    2015-07-01

    Full Text Available A well-known histopathological feature of diseased skin in Buruli ulcer (BU is coagulative necrosis caused by the Mycobacterium ulcerans macrolide exotoxin mycolactone. Since the underlying mechanism is not known, we have investigated the effect of mycolactone on endothelial cells, focussing on the expression of surface anticoagulant molecules involved in the protein C anticoagulant pathway. Congenital deficiencies in this natural anticoagulant pathway are known to induce thrombotic complications such as purpura fulimans and spontaneous necrosis. Mycolactone profoundly decreased thrombomodulin (TM expression on the surface of human dermal microvascular endothelial cells (HDMVEC at doses as low as 2 ng/ml and as early as 8 hrs after exposure. TM activates protein C by altering thrombin's substrate specificity, and exposure of HDMVEC to mycolactone for 24 hours resulted in an almost complete loss of the cells' ability to produce activated protein C. Loss of TM was shown to be due to a previously described mechanism involving mycolactone-dependent blockade of Sec61 translocation that results in proteasome-dependent degradation of newly synthesised ER-transiting proteins. Indeed, depletion from cells determined by live-cell imaging of cells stably expressing a recombinant TM-GFP fusion protein occurred at the known turnover rate. In order to determine the relevance of these findings to BU disease, immunohistochemistry of punch biopsies from 40 BU lesions (31 ulcers, nine plaques was performed. TM abundance was profoundly reduced in the subcutis of 78% of biopsies. Furthermore, it was confirmed that fibrin deposition is a common feature of BU lesions, particularly in the necrotic areas. These findings indicate that there is decreased ability to control thrombin generation in BU skin. Mycolactone's effects on normal endothelial cell function, including its ability to activate the protein C anticoagulant pathway are strongly associated with this

  6. Buruli Ulcer in Cameroon: The Development and Impact of the National Control Programme.

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    Earnest Njih Tabah

    2016-01-01

    Full Text Available Cameroon is endemic for Buruli ulcer (BU and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP and to make suggestions for scaling up the programme.We analysed collated data on BU from 2001 to 2014 and reviewed activity reports NBUCP in Cameroon. Case-detection rates and key BU control indicators were calculated and plotted on a time scale to determine trends in performance. A linear regression analysis of BU detection rate from 2005-2014 was done. The regression coefficient was tested statistically for the significance in variation of BU detection rate.In 14 years of BU control, 3700 cases were notified. The BU detection rate dropped significantly from 3.89 to 1.45 per 100 000 inhabitants. The number of BU endemic health districts rose from two to 64. Five BU diagnostic and treatment centres are functional and two more are planned for 2015. The health system has been strengthened and BU research and education has gained more interest in Cameroon.Although institutional BU control Cameroon only began 30 years after the first cases were reported in 1969, a number of milestones have been attained. These would serve as stepping stones for charting the way forward and improving upon control activities in the country if the major challenge of resource allocation is dealt with.

  7. Cellular immunity confers transient protection in experimental Buruli ulcer following BCG or mycolactone-negative Mycobacterium ulcerans vaccination.

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    Alexandra G Fraga

    Full Text Available BACKGROUND: Buruli ulcer (BU is an emerging infectious disease caused by Mycobacterium ulcerans that can result in extensive necrotizing cutaneous lesions due to the cytotoxic exotoxin mycolactone. There is no specific vaccine against BU but reports show some degree of cross-reactive protection conferred by M. bovis BCG immunization. Alternatively, an M. ulcerans-specific immunization could be a better preventive strategy. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we used the mouse model to characterize the histological and cytokine profiles triggered by vaccination with either BCG or mycolactone-negative M. ulcerans, followed by footpad infection with virulent M. ulcerans. We observed that BCG vaccination significantly delayed the onset of M. ulcerans growth and footpad swelling through the induction of an earlier and sustained IFN-γ T cell response in the draining lymph node (DLN. BCG vaccination also resulted in cell-mediated immunity (CMI in M. ulcerans-infected footpads, given the predominance of a chronic mononuclear infiltrate positive for iNOS, as well as increased and sustained levels of IFN-γ and TNF. No significant IL-4, IL-17 or IL-10 responses were detected in the footpad or the DLN, in either infected or vaccinated mice. Despite this protective Th1 response, BCG vaccination did not avoid the later progression of M. ulcerans infection, regardless of challenge dose. Immunization with mycolactone-deficient M. ulcerans also significantly delayed the progression of footpad infection, swelling and ulceration, but ultimately M. ulcerans pathogenic mechanisms prevailed. CONCLUSIONS/SIGNIFICANCE: The delay in the emergence of pathology observed in vaccinated mice emphasizes the relevance of protective Th1 recall responses against M. ulcerans. In future studies it will be important to determine how the transient CMI induced by vaccination is compromised.

  8. "It is me who endures but my family that suffers": social isolation as a consequence of the household cost burden of Buruli ulcer free of charge hospital treatment.

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    Koen Peeters Grietens

    Full Text Available Despite free of charge biomedical treatment, the cost burden of Buruli ulcer disease (Bu hospitalisation in Central Cameroon accounts for 25% of households' yearly earnings, surpassing the threshold of 10%, which is generally considered catastrophic for the household economy, and calling into question the sustainability of current Bu programmes. The high non-medical costs and productivity loss for Bu patients and their households make household involvement in the healing process unsustainable. 63% of households cease providing social and financial support for patients as a coping strategy, resulting in the patient's isolation at the hospital. Social isolation itself was cited by in-patients as the principal cause for abandonment of biomedical treatment. These findings demonstrate that further research and investment in Bu are urgently needed to evaluate new intervention strategies that are socially acceptable and appropriate in the local context.

  9. Amoebae as Potential Environmental Hosts for Mycobacterium ulcerans and Other Mycobacteria, but Doubtful Actos in Buruli Ulcer Epidemiology

    DEFF Research Database (Denmark)

    Gryseels, Sophie; Amissah, Diana; Durnez, Lies; Vandelannoote, Koen; Leirs, Herwig; De Jonckheere, Johan; Silva, Manuel T.; Portaels, Francoise; Ablordey, Anthony; Eddyani, Miriam

    2012-01-01

    Ghana, from which we cultivated amoeboid protozoa and mycobacteria. M. ulcerans was not isolated, but other mycobacteria were as frequently isolated from intracellular as from extracellular sources, suggesting that they commonly infect amoebae in nature. We screened the samples as well as the amoeba...... cultures for the M. ulcerans markers IS2404, IS2606 and KR-B. IS2404 was detected in 2% of the environmental samples and in 4% of the amoeba cultures. The IS2404 positive amoeba cultures included up to 5 different protozoan species, and originated both from Buruli ulcer endemic and non-endemic communities....... Conclusions/Significance This is the first report of experimental infection of amoebae with M. ulcerans and of the detection of the marker IS2404 in amoeba cultures isolated from the environment. We conclude that amoeba are potential natural hosts for M. ulcerans, yet remain sceptical about their implication...

  10. Identification of the Mycobacterium ulcerans protein MUL_3720 as a promising target for the development of a diagnostic test for Buruli ulcer.

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    Anita Dreyer

    2015-02-01

    Full Text Available Buruli ulcer (BU caused by Mycobacterium ulcerans is a devastating skin disease, occurring mainly in remote West African communities with poor access to health care. Early case detection and subsequent antibiotic treatment are essential to counteract the progression of the characteristic chronic ulcerative lesions. Since the accuracy of clinical BU diagnosis is limited, laboratory reconfirmation is crucial. However, currently available diagnostic techniques with sufficient sensitivity and specificity require infrastructure and resources only accessible at a few reference centres in the African endemic countries. Hence, the development of a simple, rapid, sensitive and specific point-of-care diagnostic tool is one of the major research priorities for BU. In this study, we have identified a previously unknown M. ulcerans protein, MUL_3720, as a promising target for antigen capture-based detection assays. We show that MUL_3720 is highly expressed by M. ulcerans and has no orthologs in other prevalent pathogenic mycobacteria. We generated a panel of anti-MUL_3720 antibodies and used them to confirm a cell wall location for MUL_3720. These antibodies could also specifically detect M. ulcerans in infected human tissue samples as well as in lysates of infected mouse footpads. A bacterial 2-hybrid screen suggested a potential role for MUL_3720 in cell wall biosynthesis pathways. Finally, we demonstrate that a combination of MUL_3720 specific antibody reagents in a sandwich-ELISA format has sufficient sensitivity to make them suitable for the development of antigen capture-based diagnostic tests for BU.

  11. Perceptions on the Effectiveness of Treatment and the Timeline of Buruli Ulcer Influence Pre-Hospital Delay Reported by Healthy Individuals

    OpenAIRE

    Alferink, Marike; van der Werf, Tjip S.; Sopoh, Ghislain E.; Agossadou, Didier C.; Barogui, Yves T.; Assouto, Frederic; Agossadou, Chantal; Stewart, Roy E.; Stienstra, Ymkje; Ranchor, Adelita V.

    2013-01-01

    Background Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to determine potential predictors for pre-hospital delay with Leventhal's commonsense model of illness representations, and to explore whether the type of available dominant treatment modality influenc...

  12. Clinical Epidemiology of Buruli Ulcer from Benin (2005-2013: Effect of Time-Delay to Diagnosis on Clinical Forms and Severe Phenotypes.

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    Carlos Capela

    Full Text Available Buruli Ulcer (BU is a neglected infectious disease caused by Mycobacterium ulcerans that is responsible for severe necrotizing cutaneous lesions that may be associated with bone involvement. Clinical presentations of BU lesions are classically classified as papules, nodules, plaques and edematous infiltration, ulcer or osteomyelitis. Within these different clinical forms, lesions can be further classified as severe forms based on focality (multiple lesions, lesions' size (>15 cm diameter or WHO Category (WHO Category 3 lesions. There are studies reporting an association between delay in seeking medical care and the development of ulcerative forms of BU or osteomyelitis, but the effect of time-delay on the emergence of lesions classified as severe has not been addressed. To address both issues, and in a cohort of laboratory-confirmed BU cases, 476 patients from a medical center in Allada, Benin, were studied. In this laboratory-confirmed cohort, we validated previous observations, demonstrating that time-delay is statistically related to the clinical form of BU. Indeed, for non-ulcerated forms (nodule, edema, and plaque the median time-delay was 32.5 days (IQR 30.0-67.5, while for ulcerated forms it was 60 days (IQR 20.0-120.0 (p = 0.009, and for bone lesions, 365 days (IQR 228.0-548.0. On the other hand, we show here that time-delay is not associated with the more severe phenotypes of BU, such as multi-focal lesions (median 90 days; IQR 56-217.5; p = 0.09, larger lesions (diameter >15 cm (median 60 days; IQR 30-120; p = 0.92 or category 3 WHO classification (median 60 days; IQR 30-150; p = 0.20, when compared with unifocal (median 60 days; IQR 30-90, small lesions (diameter ≤15 cm (median 60 days; IQR 30-90, or WHO category 1+2 lesions (median 60 days; IQR 30-90, respectively. Our results demonstrate that after an initial period of progression towards ulceration or bone involvement, BU lesions become stable regarding size and focal

  13. The “Buruli Score”: Development of a Multivariable Prediction Model for Diagnosis of Mycobacterium ulcerans Infection in Individuals with Ulcerative Skin Lesions, Akonolinga, Cameroon

    Science.gov (United States)

    Mueller, Yolanda K.; Bastard, Mathieu; Nkemenang, Patrick; Comte, Eric; Ehounou, Geneviève; Eyangoh, Sara; Rusch, Barbara; Tabah, Earnest Njih; Trellu, Laurence Toutous; Etard, Jean-Francois

    2016-01-01

    Background Access to laboratory diagnosis can be a challenge for individuals suspected of Buruli Ulcer (BU). Our objective was to develop a clinical score to assist clinicians working in resource-limited settings for BU diagnosis. Methododology/Principal Findings Between 2011 and 2013, individuals presenting at Akonolinga District Hospital, Cameroon, were enrolled consecutively. Clinical data were collected prospectively. Based on a latent class model using laboratory test results (ZN, PCR, culture), patients were categorized into high, or low BU likelihood. Variables associated with a high BU likelihood in a multivariate logistic model were included in the Buruli score. Score cut-offs were chosen based on calculated predictive values. Of 325 patients with an ulcerative lesion, 51 (15.7%) had a high BU likelihood. The variables identified for the Buruli score were: characteristic smell (+3 points), yellow color (+2), female gender (+2), undermining (+1), green color (+1), lesion hyposensitivity (+1), pain at rest (-1), size >5cm (-1), locoregional adenopathy (-2), age above 20 up to 40 years (-3), or above 40 (-5). This score had AUC of 0.86 (95%CI 0.82–0.89), indicating good discrimination between infected and non-infected individuals. The cut-off to reasonably exclude BU was set at scores <0 (NPV 96.5%; 95%CI 93.0–98.6). The treatment threshold was set at a cut-off ≥4 (PPV 69.0%; 95%CI 49.2–84.7). Patients with intermediate BU probability needed to be tested by PCR. Conclusions/Significance We developed a decisional algorithm based on a clinical score assessing BU probability. The Buruli score still requires further validation before it can be recommended for wide use. PMID:27045293

  14. Surgery for Crohn's Disease and Ulcerative Colitis

    Science.gov (United States)

    ... Crohn's Disease & Ulcerative Colitis Go Back Surgery for Crohn's Disease & Ulcerative Colitis Email Print + Share ( Disclaimer: Surgery information ... helps you to learn what to expect. About Crohn’s disease and ulcerative colitis Crohn’s disease and ulcerative colitis ...

  15. Epidemiology of peptic ulcer disease.

    Science.gov (United States)

    Kurata, J H; Haile, B M

    1984-05-01

    In the United States about four million people have active peptic ulcers and about 350,000 new cases are diagnosed each year. Four times as many duodenal ulcers as gastric ulcers are diagnosed. Approximately 3000 deaths per year in the United States are due to duodenal ulcer and 3000 to gastric ulcer. There has been a marked decrease in reported hospitalization and mortality rates for peptic ulcer in the United States. Changes in criteria for selecting the underlying cause of death might account for some of the apparent decrease in ulcer mortality rates. Hospitalization rates for duodenal ulcers decreased nearly 50 per cent from 1970 to 1978, but hospitalization rates for gastric ulcers did not decrease. Although this decrease in hospitalization rates may reflect a decrease in duodenal ulcer disease incidence, it appears that changes in coding practices, hospitalization criteria, and diagnostic procedures have contributed to the reported declines in peptic ulcer hospitalization and mortality rates. There is no good evidence to support the popular belief that peptic ulcer is most common in the spring and autumn. The most consistent pattern appears to be low ulcer rates in the summer. There is strong evidence that cigarette smoking, regular use of aspirin, and prolonged use of steroids are associated with the development of peptic ulcer. There is some evidence that coffee and aspirin substitutes may affect ulcers, but most studies do not implicate alcohol, food, or psychological stress as causes of ulcer disease. Genetic factors play a role in both duodenal and gastric ulcer. The first-degree relatives of patients with duodenal ulcer have a two- to threefold increase in risk of getting duodenal ulcer and relatives of gastric ulcer patients have a similarly increased risk of getting a gastric ulcer. About half of the patients with duodenal ulcer have elevated plasma pepsinogen I. A small increase in risk of duodenal ulcer is found in persons with blood group O and in

  16. Geographic distribution, age pattern and sites of lesions in a cohort of Buruli ulcer patients from the Mapé Basin of Cameroon.

    Science.gov (United States)

    Bratschi, Martin W; Bolz, Miriam; Minyem, Jacques C; Grize, Leticia; Wantong, Fidèle G; Kerber, Sarah; Njih Tabah, Earnest; Ruf, Marie-Thérèse; Mou, Ferdinand; Noumen, Djeunga; Um Boock, Alphonse; Pluschke, Gerd

    2013-01-01

    Buruli ulcer (BU), a neglected tropical disease of the skin, caused by Mycobacterium ulcerans, occurs most frequently in children in West Africa. Risk factors for BU include proximity to slow flowing water, poor wound care and not wearing protective clothing. Man-made alterations of the environment have been suggested to lead to increased BU incidence. M. ulcerans DNA has been detected in the environment, water bugs and recently also in mosquitoes. Despite these findings, the mode of transmission of BU remains poorly understood and both transmission by insects or direct inoculation from contaminated environment have been suggested. Here, we investigated the BU epidemiology in the Mapé basin of Cameroon where the damming of the Mapé River since 1988 is believed to have increased the incidence of BU. Through a house-by-house survey in spring 2010, which also examined the local population for leprosy and yaws, and continued surveillance thereafter, we identified, till June 2012, altogether 88 RT-PCR positive cases of BU. We found that the age adjusted cumulative incidence of BU was highest in young teenagers and in individuals above the age of 50 and that very young children (<5) were underrepresented among cases. BU lesions clustered around the ankles and at the back of the elbows. This pattern neither matches any of the published mosquito biting site patterns, nor the published distribution of small skin injuries in children, where lesions on the knees are much more frequent. The option of multiple modes of transmission should thus be considered. Analyzing the geographic distribution of cases in the Mapé Dam area revealed a closer association with the Mbam River than with the artificial lake. PMID:23785529

  17. Geographic distribution, age pattern and sites of lesions in a cohort of Buruli ulcer patients from the Mape Basin of Cameroon.

    Directory of Open Access Journals (Sweden)

    Martin W Bratschi

    Full Text Available Buruli ulcer (BU, a neglected tropical disease of the skin, caused by Mycobacterium ulcerans, occurs most frequently in children in West Africa. Risk factors for BU include proximity to slow flowing water, poor wound care and not wearing protective clothing. Man-made alterations of the environment have been suggested to lead to increased BU incidence. M. ulcerans DNA has been detected in the environment, water bugs and recently also in mosquitoes. Despite these findings, the mode of transmission of BU remains poorly understood and both transmission by insects or direct inoculation from contaminated environment have been suggested. Here, we investigated the BU epidemiology in the Mapé basin of Cameroon where the damming of the Mapé River since 1988 is believed to have increased the incidence of BU. Through a house-by-house survey in spring 2010, which also examined the local population for leprosy and yaws, and continued surveillance thereafter, we identified, till June 2012, altogether 88 RT-PCR positive cases of BU. We found that the age adjusted cumulative incidence of BU was highest in young teenagers and in individuals above the age of 50 and that very young children (<5 were underrepresented among cases. BU lesions clustered around the ankles and at the back of the elbows. This pattern neither matches any of the published mosquito biting site patterns, nor the published distribution of small skin injuries in children, where lesions on the knees are much more frequent. The option of multiple modes of transmission should thus be considered. Analyzing the geographic distribution of cases in the Mapé Dam area revealed a closer association with the Mbam River than with the artificial lake.

  18. [Peptic ulcer disease and stress].

    Science.gov (United States)

    Herszényi, László; Juhász, Márk; Mihály, Emese; Tulassay, Zsolt

    2015-08-30

    The discovery that Helicobacter pylori infection is the major cause of peptic ulcer disease revolutionised our views on the etiology and treatment of the disease. This discovery has tempted many experts to conclude that psychological factors and, specifically, stress are unimportant. However, Helicobacter pylori infection alone does not explain fully the incidence and prevalence of peptic ulcer disease. It has been demonstrated that stress can cause peptic ulcer disease even in the absence of Helicobacter pylori infection, supporting a multicausal model of peptic ulcer etiology. Psychological stress among other risk factors can function as a cofactor with Helicobacter pylori infection. PMID:26299834

  19. Crohn's Disease and Ulcerative Colitis: Emotional Factors

    Science.gov (United States)

    ... Ulcerative Colitis: Emotional Factors Q & A Go Back Crohn’s Disease and Ulcerative Colitis: Emotional Factors Q & A Email ... WHAT IS THE CAUSE OF ULCERATIVE COLITIS AND CROHN’S DISEASE? The origin of IBD is still unknown. It ...

  20. Socio-Environmental Factors Associated with the Risk of Contracting Buruli Ulcer in Tiassalé, South Côte d’Ivoire: A Case-Control Study

    Science.gov (United States)

    N’krumah, Raymond T. A. S.; Koné, Brama; Tiembre, Issaka; Cissé, Guéladio; Pluschke, Gerd; Tanner, Marcel; Utzinger, Jürg

    2016-01-01

    Background Buruli ulcer (BU) is a cutaneous infectious disease caused by Mycobacterium ulcerans. The exact mode of transmission remains elusive; yet, some studies identified environmental, socio-sanitary, and behavioral risk factors. The purpose of this study was to assess the association of such factors to contracting BU in Tiassalé, south Côte d’Ivoire. Methodology A case-control study was conducted in 2012. Cases were BU patients diagnosed according to clinical definition put forth by the World Health Organization, readily confirmed by IS2404 polymerase chain reaction (PCR) analysis prior to our study and recruited at one of the health centers of the district. Two controls were matched for each control, by age group (to the nearest 5 years), sex, and living community. Participants were interviewed after providing oral witnessed consent, assessing behavioral, environmental, and socio-sanitary factors. Principal Findings A total of 51 incident and prevalent cases and 102 controls were enrolled. Sex ratio (male:female) was 0.9. Median age was 25 years (range: 5–70 years). Regular contact with unprotected surface water (adjusted odds ratio (aOR) = 6.5; 95% confidence interval (CI) = 2.1–19.7) and absence of protective equipment during agricultural activities (aOR = 18.5, 95% CI = 5.2–66.7) were identified as the main factors associated with the risk of contracting BU. Etiologic fractions among exposed to both factors were 84.9% and 94.6%, respectively. Good knowledge about the risks that may result in BU (aOR = 0.3, 95% CI = 0.1–0.8) and perception about the disease causes (aOR = 0.1, 95% CI = 0.02–0.3) showed protection against BU with a respective preventive fraction of 70% and 90%. Conclusions/Significance Main risk factors identified in this study were the contact with unprotected water bodies through daily activities and the absence of protective equipment during agricultural activities. An effective strategy to reduce the incidence of BU should

  1. Socio-Environmental Factors Associated with the Risk of Contracting Buruli Ulcer in Tiassale, South Cote d'Ivoire: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Raymond T A S N'krumah

    2016-01-01

    Full Text Available Buruli ulcer (BU is a cutaneous infectious disease caused by Mycobacterium ulcerans. The exact mode of transmission remains elusive; yet, some studies identified environmental, socio-sanitary, and behavioral risk factors. The purpose of this study was to assess the association of such factors to contracting BU in Tiassalé, south Côte d'Ivoire.A case-control study was conducted in 2012. Cases were BU patients diagnosed according to clinical definition put forth by the World Health Organization, readily confirmed by IS2404 polymerase chain reaction (PCR analysis prior to our study and recruited at one of the health centers of the district. Two controls were matched for each control, by age group (to the nearest 5 years, sex, and living community. Participants were interviewed after providing oral witnessed consent, assessing behavioral, environmental, and socio-sanitary factors.A total of 51 incident and prevalent cases and 102 controls were enrolled. Sex ratio (male:female was 0.9. Median age was 25 years (range: 5-70 years. Regular contact with unprotected surface water (adjusted odds ratio (aOR = 6.5; 95% confidence interval (CI = 2.1-19.7 and absence of protective equipment during agricultural activities (aOR = 18.5, 95% CI = 5.2-66.7 were identified as the main factors associated with the risk of contracting BU. Etiologic fractions among exposed to both factors were 84.9% and 94.6%, respectively. Good knowledge about the risks that may result in BU (aOR = 0.3, 95% CI = 0.1-0.8 and perception about the disease causes (aOR = 0.1, 95% CI = 0.02-0.3 showed protection against BU with a respective preventive fraction of 70% and 90%.Main risk factors identified in this study were the contact with unprotected water bodies through daily activities and the absence of protective equipment during agricultural activities. An effective strategy to reduce the incidence of BU should involve compliance with protective equipment during agricultural

  2. Helicobacter pylori and peptic ulcer disease.

    OpenAIRE

    Feldman, M; Peterson, W. L.

    1993-01-01

    Medical therapy for duodenal or gastric ulcer disease has traditionally involved gastric acid antisecretory therapy for 4 to 8 weeks to promote initial healing and indefinitely to prevent recurrences of ulcer. The discovery of Helicobacter pylori in most patients with peptic ulcer disease has led to a change in this approach. Therapy designed to eradicate H pylori may facilitate ulcer healing with acid antisecretory agents and, more important, may greatly reduce the incidence of ulcer recurre...

  3. Perceptions on the effectiveness of treatment and the timeline of Buruli ulcer influence pre-hospital delay reported by healthy individuals.

    Directory of Open Access Journals (Sweden)

    Marike Alferink

    Full Text Available BACKGROUND: Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to determine potential predictors for pre-hospital delay with Leventhal's commonsense model of illness representations, and to explore whether the type of available dominant treatment modality influenced individuals' perceptions about BU, and therefore, influenced pre-hospital delay. METHODOLOGY: 130 healthy individuals aged >18 years, living in BU-endemic areas in Benin without any history of BU were included in this cross-sectional study. Sixty four participants from areas where surgery was the dominant treatment and sixty six participants from areas where antibiotic treatment was the dominant treatment modality were recruited. Using a semi-structured interview we measured illness perceptions (IPQ-R, knowledge about BU, background variables and estimated pre-hospital delay. PRINCIPAL FINDINGS: The individual characteristics 'effectiveness of treatment' and 'timeline acute-chronic' showed the strongest association with pre-hospital delay. No differences were found between regions where surgery was the dominant treatment and regions where antibiotics were the dominant treatment modality. CONCLUSIONS: Individual characteristics, not anticipated treatment modality appeared predictors of pre-hospital delay.

  4. Peptic Ulcer Disease

    Science.gov (United States)

    ... ACG on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos en Español What is a Gastroenterologist? Podcasts and Videos GI Health Centers Colorectal Cancer Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity © ...

  5. Computed tomography and complicated peptic ulcer disease

    International Nuclear Information System (INIS)

    Peptic ulcer disease (PUD) can present with many complications including inflammation, ulceration and perforation. Improvements in CT have enabled better imaging of the gastroduodenal area. Three cases of complicated PUD detected on CT are presented with a brief review of the current literature. Copyright (2004) Blackwell Science Pty Ltd

  6. 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....

  7. Large leg ulcers due to autoimmune diseases

    OpenAIRE

    Rozin, Alexander P; Egozi, Dana; Ramon, Yehuda; Toledano, Kohava; Braun-Moscovici, Yolanda; Markovits, Doron; Schapira, Daniel; Bergman, Reuven; Melamed, Yehuda; Ullman, Yehuda; Balbir-Gurman, Alexandra

    2011-01-01

    Summary Background Large leg ulcers (LLU) may complicate autoimmune diseases. They pose a therapeutic challenge and are often resistant to treatment. To report three cases of autoimmune diseases complicated with LLU. Case Report Case 1. A 55-year old woman presented with long-standing painful LLU due to mixed connective tissue disease (MCTD). Biopsy from the ulcer edge showed small vessel vasculitis. IV methylprednisolone (MethP) 1 G/day, prednisolone (PR) 1mg/kg, monthly IV cyclophosphamide ...

  8. [Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

    Science.gov (United States)

    Wirth, Hans-Peter

    2016-06-01

    Prevalence of H. pylori (HP) is declining, whereas reflux disease and the proportion of non-steroidal antiinflammatory drugs (NSAR) to HP-induced ulcers increase. Eradication heals HP-ulcer disease, interrupts cancerous progression and can improve dyspeptic symptoms. NSAR-ulcers heal under proton pump inhibitor (PPI) therapy but tend to recur after reexposition. Anticoagulants and antiplatlet agents increase the risk additionally. PPI reduces NSAR-ulcer recurrence. Reflux patients with severe inflammation and complications often need long-term therapy. Barrett’s esophagus patients are at risk of esophageal adenocarcinoma. PMID:27269775

  9. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan; Cucchiara, Salvatore; Sladek, Malgorzata; Murphy, M Stephen; Escher, Johanna C; Pærregaard, Anders

    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...... 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....

  10. Disease: H01042 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available and transmission of Buruli ulcer disease: a systematic review. PLoS Negl Trop Dis...on caused by Mycobacterium ulcerans that is related to the aquatic environment. Lesions heal with scarring, whic...s in understanding Mycobacterium ulcerans infection. Dermatol Clin 29:1-8 (2011) PMID:22004037 (description,...rium ulcerans disease (Buruli ulcer): from surgery to antibiotics, is the pill mightier than the knife? Future Microbiol 6:1185-98 (2011) ... ... env_factor) Converse PJ, Nuermberger EL, Almeida DV, Grosset JH Treating Mycobacte

  11. Age Features Of Peptic And Duodenal Ulcer Disease

    Directory of Open Access Journals (Sweden)

    Е.А. Islamova

    2009-12-01

    Full Text Available Peptic ulcer disease is one of the most widespread diseases. 6-10 % of adult population in Russia suffer from it. Demographic processes in the Russian Federation determine the increase of patients' number aged over 60 with peptic ulcer disease. It counts 10-35 % of all patients with this disease. The modern views on pathogenesis of peptic ulcer disease, including factor of Helicobacter pylori, in patients of different age groups have been highlighted in the article. Pathogenetic features and clinical morphological manifestations of peptic ulcer disease in young and aged patients have been considered

  12. Coronary heart disease after radiotherapy for peptic ulcer disease

    International Nuclear Information System (INIS)

    Purpose: To evaluate the risk of coronary heart disease (CHD) and cerebrovascular disease after radiotherapy (RT) for peptic ulcer disease. Methods and materials: Peptic ulcer disease patients treated with RT (n = 1859) or by other means (n = 1860) at the University of Chicago Medical Center between 1936 and 1965, were followed through 1997. The observed numbers of cause-specific deaths were compared with the expected numbers from the general population rates. During RT, 5% of the heart was in the treatment field and the remainder of the heart mostly received scattered radiation. A volume-weighted cardiac dose was computed to describe the average tissue dose to the entire organ. We used Cox proportional hazards regression analysis to analyze the CHD and cerebrovascular disease risk associated with RT, adjusting for confounding factors. Results: Greater than expected CHD mortality was observed among the irradiated patients. The irradiated patients received volume-weighted cardiac doses ranging from 1.6 to 3.9 Gy and the portion of the heart directly in the field received doses of 7.6-18.4 Gy. The CHD risk increased with the cardiac dose (p trend = 0.01). The cerebrovascular disease risk was not associated with the surrogate carotid dose. Conclusion: The excess CHD risk in patients undergoing RT for peptic ulcer disease decades previously indicates the need for long-term follow-up for cardiovascular disease after chest RT

  13. What I Need to Know about Peptic Ulcer Disease

    Science.gov (United States)

    ... a clean, safe source ● ● avoid drinking too much alcohol 16 To help prevent peptic ulcer disease caused by NSAIDs, ask your ... a clean, safe source • avoid drinking too much alcohol 18 ● ● To help prevent peptic ulcer disease caused by NSAIDs, ask your ...

  14. Case report 379: 'Ulcer osteoma' associated with sickle cell disease

    International Nuclear Information System (INIS)

    In summary, a 32-year-old black man with homozygous sickle cell anemia has been presented. The patient developed bilateral ulcers of the leg which never completely healed. In one leg he demonstrated a focal, fusiform, periosteal reaction which probably in time would become incorporated into the cortex, resulting in the formation of an ulcer osteoma of the tibia associated with sickle cell disease. The ulcer osteoma has the same radiological appearance as the ulcer osteoma in individuals in Africa without sickle cell disease. (orig./SHA)

  15. Surgical perspectives in peptic ulcer disease and gastritis

    OpenAIRE

    Lipof, Tamar; Shapiro, David; Kozol, Robert A

    2006-01-01

    For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery, patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understa...

  16. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Isene, Rune; Bernklev, Tomm; Høie, Ole;

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal...

  17. Crohn's disease and ulcerative colitis in the same patient.

    OpenAIRE

    White, C.L.; Hamilton, S R; Diamond, M. P.; Cameron, J. L.

    1983-01-01

    A well documented case of a patient with both Crohn's disease and ulcerative colitis is presented. A 29 year old woman underwent resection of her terminal ileum and ascending colon for typical Crohn's disease with ileocolitis. Eleven years later, an ileoproctocolectomy was performed for typical ulcerative colitis involving the left colon. The resection specimen also showed evidence of colonic Crohn's disease near the anastomotic site. This unusual case shows that Crohn's disease and ulcerativ...

  18. Current Medical Management of Peptic Ulcer Disease

    OpenAIRE

    Lukie, Bryan E.

    1989-01-01

    Peptic ulceration occurs when the digestive action of gastric secretions overcomes gastroduodenal mucosal defences. The therapeutic strategy used to correct this imbalance uses drugs that either reduce gastric secretion or increase mucosal resistance. Traditional therapies of dietary manipulation and antacid administration no longer play major roles in peptic ulcer therapy. Uncomplicated peptic ulcers respond quite well to drug treatment, although recurrences are common and may require long-t...

  19. Apthous ulcers - an early radiological sign of Crohn's disease

    International Nuclear Information System (INIS)

    Thirty-eight patients with histologically confirmed Crohn's disease are described. Eleven of these showed so-called aphthous ulcers. These were most common in the colon (five patients) and terminal ileum (four patients). Aphthous ulcers are small mucous membrane erosions on the surface of hypertrophic lymph follicles with surrounding oedema. From our material and from the literature we conclude that aphthous ulcers are occasional radiological signs and not invariable early signs of Crohn's disease. Their specificity has not been proved. Differentiation from gastric erosions in cases of gastro-duodenal involvement is discussed. (orig.)

  20. Inherited determinants of Crohn's disease and ulcerative colitis phenotypes

    DEFF Research Database (Denmark)

    Cleynen, Isabelle; Boucher, Gabrielle; Jostins, Luke;

    2016-01-01

    BACKGROUND: Crohn's disease and ulcerative colitis are the two major forms of inflammatory bowel disease; treatment strategies have historically been determined by this binary categorisation. Genetic studies have identified 163 susceptibility loci for inflammatory bowel disease, mostly shared...... between Crohn's disease and ulcerative colitis. We undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between diseases. METHODS: This study included patients from 49...... centres in 16 countries in Europe, North America, and Australasia. We applied the Montreal classification system of inflammatory bowel disease subphenotypes to 34,819 patients (19,713 with Crohn's disease, 14,683 with ulcerative colitis) genotyped on the Immunochip array. We tested for genotype...

  1. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    Science.gov (United States)

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis. PMID:2991089

  2. Management of NSAID-associated peptic ulcer disease.

    Science.gov (United States)

    Melcarne, Luigi; García-Iglesias, Pilar; Calvet, Xavier

    2016-06-01

    Non-steroidal anti-inflammatory drug (NSAID) use increases the risk of gastrointestinal complications such as ulcers or bleeding. The presence of factors like advanced age, history of peptic ulcer, Helicobacter pylori infection and the use of anticoagulants or antiplatelet agents increase this risk further. COX-2 inhibitors and antisecretory drugs, particularly proton pump inhibitors, help to minimize the risk of gastrointestinal complications in high-risk patients. This review presents a practical approach to the prevention and treatment of NSAID-associated peptic ulcer disease and examines the new advances in the rational use of NSAIDs. PMID:26775657

  3. Surgical perspectives in peptic ulcer disease and gastritis

    Institute of Scientific and Technical Information of China (English)

    Tamar Lipof; David Shapiro; Robert A Kozol

    2006-01-01

    For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery,patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understanding of the impact of H pylori has led to a trend towards minimalism in surgical therapy for complicated peptic ulcer disease. In addition to the changes in patient care, these developments have had an impact on the training of surgeons. This article outlines these trends and developments.

  4. Endoscopic Evaluation of Peptic Ulcer Disease During Ramadan Fasting

    Directory of Open Access Journals (Sweden)

    G. M. Malik

    1996-01-01

    Full Text Available The effects of fasting on peptic ulcer disease were evaluated in a prospective study, involving 23 fasting patients who underwent endoscopy before and after Ramadan. Eighteen patients took an H2-blocker (ranitidine, 150 mg twice daily regularly at “Suhur” and “Iftar” as prescribed, while 5 were drug defaulters. On the first endoscopy the diagnosis in 4 patients was active acute duodenal ulcer (AADU, in 8 patients was active chronic duodenal ulcer (ACDU in 8 patients was healed duodenal ulcer (HDU, in 2 patients was erosive duodenitis (ED, and in 1 patient was chronic gastric ulcer (CGU. All of the patients with AADU showed signs of healing on repeat endoscopy. None of the ACDU patients showed signs of healing on repeat endoscopy. Instead, 7 patients in this group bled during fasting. All of the 5 drug defaulters belonged to the ACDU group. One patient in the HDU group had developed an active ulcer near the previous scar, as which was seen on repeat endoscopy. The 2 patients with ED showed signs of healing, while the only patient with CGU had bled from the same ulcer as seen on repeat endoscopy. The results were compared with those of 15 nonfasting control subjects (6 patients with ACDU, 3 with HDU, and 6 with ED as diagnosed on the first endoscopy, who took an H2-blocker regularly. The repeat endoscopy did not show any change in these patients. In conclusion, we inferred that Ramadan fasting may prove hazardous in patients with peptic ulcer disease in general and with active chronic ulcers in particular, although the fact that only 23 patients volunteered for this study, of whom 5 were drug defaulters, is a limitation.

  5. Mucosal reactive oxygen metabolite production in duodenal ulcer disease.

    OpenAIRE

    Davies, G. R.; Simmonds, N J; Stevens, T R; Grandison, A; D. R. Blake; Rampton, D S

    1992-01-01

    To investigate the hypothesis that reactive oxygen metabolites are important in the pathophysiology of duodenal ulcer disease, their production by duodenal mucosal biopsy specimens was measured using luminol and lucigenin amplified chemiluminescence. Luminol chemiluminescence, expressed as background corrected median photon emission/mg/min x 10(3) (95% confidence intervals), was increased in duodenal inflammation as assessed macroscopically: ulcers 20.3 (4.8 to 51.3), n = 29; severe duodeniti...

  6. LEG ULCERS IN SICKLE CELL DISEASE: CURRENT PATTERNS AND PRACTICES

    OpenAIRE

    Delaney, Kara-Marie H.; Axelrod, Karen C.; Buscetta, Ashley; Hassell, Kathryn L.; Adams-Graves, Patricia E.; Seamon, Catherine; Kato, Gregory J.; Minniti, Caterina P.

    2013-01-01

    Leg ulcers are a debilitating complication of patients with sickle cell disease, and their frequency in North America was reported to be 2.5% by the Cooperative Study of Sickle Cell Disease more than 20 years ago. We sought to determine if the frequency of leg ulcers in sickle cell patients in the United States had declined and to assess which treatments providers use most commonly. We sent an e-mail survey to health professionals belonging to the national Sickle Cell Adult Provider Network. ...

  7. 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....... 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...

  8. Ulcerative colitis associated with chronic granulomatous disease: case report.

    Science.gov (United States)

    Imanzade, Farid; Sayarri, Aliakbar; Tajik, Pantea

    2015-01-01

    Chronic Granulomatous Disease (CGD) is an inherited primary immunodeficiency disease which increases the body's susceptibility to infections caused by certain bacteria and fungi. CGD is a rare disease, caused by four genes, one type is 1X linked and the other three are "autosomal recessive". Although clinical presentation is variable, but characteristic features are recurrent pneumonia, lymphadenitis, hepatic or other abscesses. Gastrointestinal tract symptoms are common in x-linked recessive form of CGD. These include gastric and esophageal obstruction and inflammatory bowel disease. GI involvement including small and large intestines, the findings of luminal narrowing and the presence of granuloma can make it difficult to distinguish from Crohn's disease. On the other hands according to the literature ulcerative colitis is rarely reported in patients with CGD. Our case presented with ulcerative colitis with CGD. PMID:26328046

  9. Epidemiology of peptic ulcer disease in Wuhan area of China from 1997 to 2002

    Institute of Scientific and Technical Information of China (English)

    Wei-Guo Dong; Chun-Sheng Cheng; Shao-Ping Liu; Jie-Ping Yu

    2004-01-01

    AIM: To describe the epidemiological features of peptic ulcer disease in Wuhan area during 1997-2002, to analyze the sex, age and occupation characteristics, as well as the geographic distribution of peptic ulcer disease, and to determine the effective methods of preventing and controlling peptic ulcer disease.METHODS: In the early 1980s, the peptic ulcer disease registry system was established to collect the data of peptic ulcer disease in Wuhan area. Here we performed a statistically detailed analysis of 4876 cases of peptic ulcer disease during 1997-2002.RESULTS: The morbidity of peptic ulcer disease between males and females was significantly different (x2 = 337.9,P<0.001). The majority of peptic ulcer diseases were found at the age of 20 to 50 years. Because of different occupations,the incidence of peptic ulcer disease was different in different areas.CONCLUSION: The incidence of peptic ulcer disease is highly associated with sex, age, occupation and geographic environmental factors. By analyzing the epidemiological features of peptic ulcer disease, we can provide the scientific data for prevention and control of peptic ulcer disease.

  10. Tobacco use as contributory factor in peptic ulcer disease

    International Nuclear Information System (INIS)

    Objective: To find out the association of tobacco as a contributory factor in patients presenting with peptic ulcer disease (PUD). Results: Fifty-six percent of all the patients with PUD used tobacco, 33% as cigarette, 18% took it as 'naswar' and 5% of patients used it in both the forms. Of these, 85.7% (48/56) patients had duodenal ulcer and 14.3% (8/56) patients had gastric ulcer. All these patients were male none of the female patients used tobacco in any form. Moreover, 40% of PUD patients reported long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Conclusion: This study supports the view that use of tobacco is associated with PUD in men. (author)

  11. An oral ulceration associated with Morgellons disease: a case report.

    Science.gov (United States)

    Grosskopf, Courtney; Desai, Bhavik; Stoopler, Eric T

    2011-08-01

    Morgellons disease is a psycho-dermatologic condition in which patients report fibers or filaments "growing" out of their skin. This case report highlights an oral ulceration in a young woman associated with Morgellons disease, a condition that has not been previously described in the dental literature. An increasing number of individuals are self-reporting this condition and oral health care providers must be familiar with this disorder. PMID:21749875

  12. Effect of Helicobacter pylori eradication on the natural history of duodenal ulcer disease

    OpenAIRE

    Goggin, N; Rowland, M; Imrie, C; Walsh, D.; Clyne, M.; Drumm, B

    1998-01-01

    BACKGROUND—Duodenal ulcer disease is strongly associated with Helicobacter pylori infection of the gastric mucosa. Eradication of H pylori from the gastric mucosa in adults is associated with long term healing of ulcers.
AIMS—To follow a cohort of children with duodenal ulcer disease for a minimum of two years after the eradication of H pylori.
PATIENTS AND METHODS—Over a three year period, all children diagnosed with duodenal ulcer disease had their symptoms documented a...

  13. [Diagnosis and Treatment of Peptic Ulcer Disease: Present and Future Perspective].

    Science.gov (United States)

    Kim, Byung Wook

    2016-06-25

    Peptic ulcer disease is one of the most commonly encountered diseases in gastroenterology clinics. After the discovery of Helicobacter pylori by Warren and Marshall, it has been identified as the most important cause of peptic ulcer. Eradication of H. pylori markedly reduces the post-treatment recurrence rate of peptic ulcer. However, as human populations age, the incidence of cardiovascular and musculoskeletal diseases increases and consequent use of aspirin and non-steroidal anti-in-flammatory drugs increases. Thus causes and presenting patterns of peptic ulcer have changed. In this review, I describe new diagnostic and therapeutic strategies for peptic ulcer disease and explore future perspectives. PMID:27312832

  14. The Association Between Peptic Ulcer Disease and Ischemic Stroke

    OpenAIRE

    Cheng, Tain-Junn; Guo, How-Ran; Chang, Chia-Yu; Weng, Shih-Feng; Li, Pi-I; Wang, Jhi-Joung; Wu, Wen-Shiann

    2016-01-01

    Abstract Stroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS. We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who receiv...

  15. Sarcomas arising after radiotherapy for peptic ulcer disease

    International Nuclear Information System (INIS)

    Therapeutic gastric irradiation has been used to reduce peptic juice secretion in patients with peptic ulcer disease. Between 1937 and 1968 a total of 2049 patients received such therapy at the University of Chicago. Three of these patients are known to have developed sarcomas in the field of radiation. Two gastric leiomyosarcomas of the stomach were diagnosed 26 and 14 years after treatment and a malignant fibrous histiocytoma of the anterior chest wall was removed six years after gastric irradiation. Of 743 peptic ulcer patients treated without irradiation and constituted as a control group for the study of therapeutic gastric radiation, none is known to have developed sarcoma. As the incidence of sarcoma in these patient groups is known only from the tumor registry of the University of Chicago, other cases of sarcoma may exist in the groups. While an increased incidence of sarcoma has not been proven to occur in patients who received therapeutic gastric irradiation for peptic ulcer disease, the possibility of such a risk should be borne in mind by physicians caring for such patients

  16. SOME EXPERIMENTALLY PROVED HERBS IN PEPTIC ULCER DISEASE

    Directory of Open Access Journals (Sweden)

    Javed Ahmad Khan et al

    2012-08-01

    Full Text Available Peptic ulcer is a worldwide health problem because of its high morbidity, mortality and enormous financial implication. An estimated 15,000 deaths per year occur as a consequence of complicated PUD. A large number of drugs for peptic ulcer disease are available in mainstream medicine but they are associated with numerous side effects like arrhythmias, impotence, gynaecomastia and haematopoietic changes and the recurrence is also very common. In recent times, focus on plant research has increased all over the world and a large body of evidence has been collected to show immense potential of medicinal plants used in various traditional systems. Here, an attempt is made to summarise experimentally proved herbs used in PUD during last decade.

  17. Pattern of 24 hour intragastric acidity in active duodenal ulcer disease and in healthy controls.

    OpenAIRE

    Merki, H S; Fimmel, C J; Walt, R P; Harre, K; Röhmel, J; Witzel, L

    1988-01-01

    Twenty four hour intragastric acidity was measured by continuous recording using intragastric combined glass electrodes in 46 duodenal ulcer patients within 48 hours of endoscopic confirmation of active ulceration. Acidity during predefined time periods was compared with that measured in 40 healthy controls without gastrointestinal disease: it was significantly higher in duodenal ulcer patients at all times, but 25% of ulcer patients had median 24 hour acidity within the interquartile range o...

  18. [Gastric ulcer, duodenal ulcer].

    Science.gov (United States)

    Matsui, Shigenaga; Kashida, Hiroshi; Asakuma, Yutaka; Sakurai, Toshiharu; Kudo, Masatoshi

    2015-07-01

    Recently, the acid secretion amount is increased by westernization of foods and Helicobacter pylori (H. pylori) infected patient's decrease in Japanese. Therefore, the recent tendencies are decrease of peptic ulcer diseases by H. pylori infection and increase of non-steroidal anti-inflammatory drugs(NSAIDs) ulcers. The endoscopic hemostasis should be performed for upper gastrointestinal bleeding from peptic ulcers in the first choice. A surgery or interventional radiology (IVR) should be performed in the unsuccessfulness of endoscopic hemostasis. H. pylori eradication therapy is effective for healing and prevention of recurrence from peptic ulcers. For prevention of recurrence of NSAIDs ulcers, therapy with proton pump inhibitor is effective. PMID:26165067

  19. Helicobacter Pylori Associated Antral Gastritis in Peptic Ulcer Disease Patients and Normal Healthy Population of Kashmir, India

    OpenAIRE

    Gh. Jeelani Romshoo; Malik, G. M.; M. Youssuf Bhat; Ab. Rashid rather; Javaid Ahmad Basu; Khursheed Ahmad Qureshi

    1998-01-01

    Aim: To study the association of Helicobacter pylori infection with chronic antral gastritis in peptic ulcer disease patients and healthy population of Kashmir. Methods: 50 peptic ulcer patients (duodenal ulcer = 46, gastric ulcer = 2 and combined duodenal and gastric ulcer = 2) and 30 asymptomatic healthy volunteers were included in this study. Peptic ulcer was diagnosed on endoscopic examination. 4–6 punch biopsies were taken from gastric antrum in all the individuals and in case of gastric...

  20. [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

  1. Fulminant ulcerative colitis associated with steroid-resistant minimal change disease and psoriasis: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A 43-year-old Chinese patient with a history of psoriasis developed fulminant ulcerative colitis after immunosuppressive therapy for steroid-resistant minimal change disease was stopped. Minimal change disease in association with inflammatory bowel disease is a rare condition. We here report a case showing an association between ulcerative colitis, minimal change disease,and psoriasis. The possible pathological link between 3 diseases is discussed.

  2. [Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease].

    Science.gov (United States)

    Chang, Young Woon

    2016-06-25

    Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat underlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen. PMID:27312831

  3. [Features of ulcer disease in elderly patients with ischemic heart disease].

    Science.gov (United States)

    Gorunovsiaia, I G

    2002-01-01

    The purpose of this research is to study the clinical current of stomach and duodenal ulcer disease in a combination with the ischemic heart disease (IHD). The group of 290 patients with IHD in a combination with SUD and DUD were examined. The clinical-laboratory researches, histological analysis of stomach mucosa bioptates (SMB) and duodenal mucosa bioptates (DMB) were spend. In persons with IHD the stomach ulcers are observed (56%) more often than duodenal ulcers. The lesser curvature and pillory part of stomach were affected more often. In male the ulcers were met 3.5 times more often than in female. It was marked the tendency to the painless current of ulcer disease (UD). There were no the seasonal prevalence of exacerbations. In 52% of the patients the first manifestations of the disease were the gastric bleedings. The UD current differed by often relapses and long exacerbations (76%), which have coincided with the IHD exacerbations. In 68% of the patients the UD exacerbations were marked at the first 10 days after the myocardial infarction or aortocoronary shunting. The role of Helicobacter pylori as a causative factor of UD is marked in 26% of the patients. In 62% of the patients the basic role in UD exacerbation played the microcirculatory disorders, lowering of bloodstream in stomach mucosa or duodenal mucosa, syndrome of hypocoagulation, dislipidemia. In stomach and duodenal mucosa bioptates the dystrophic changes were expressed. The formation of ulcers and erosions of mucosa of gastrointestinal path in IHD patients are probably connected with blood circulation disorders in SM. The main aggression factors are the hypoxia, accompanying trophic disorders of SM and DM, the changes in vascular system. PMID:12353380

  4. Peptic ulcer disease and other complications in patients receiving dexamethasone palliation for brain metastasis

    International Nuclear Information System (INIS)

    A retrospective analysis was done of 106 patients who received radiation therapy for brain metastasis. Dexamethasone therapy was instituted in 97 patients. Peptic ulcer disease developed in 5 of 89 patients (5.6 percent) who received a dosage of at least 12 mg a day, but did not occur in patients who received a lower dose or in those who did not receive steroids. The interval between institution of dexamethasone therapy and the development of peptic ulcer disease ranged from three to nine weeks. Two patients had perforated ulcers, one of whom required surgical resection. Peptic ulcer disease contributed to the general deterioration and death of three of the five patients. Overall, in 14 of the 89 patients (15.7 percent) a complication of steroid therapy developed in the form of peptic ulcer disease, steroid myopathy or diabetes mellitus (or a combination of these)

  5. Frequency of peptic ulcer disease in patients of dyspepsia an analysis of upper gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    To evaluate the frequency of peptic ulcer disease in patients of dyspepsia on upper gastrointestinal endoscopy. A convenient non probability sampling was done and one hundred patients were selected from out patient department presenting within six months of dyspeptic symptoms. They were all subjected to upper gastrointestinal endoscopy Of all patients 61% (n=61) were males and 39% (n=39) were females with age ranging between 20 - 45 years. Study revealed functional dyspepsia (76%), duodenal ulcer (11%), gastric ulcer (4%) and esophagitis including gastoesophageal reflux disease (9%). This showed an overall frequency of peptic ulcer disease to be 15% in the studied population.Conclusion: Peptic ulcer disease is a common structural cause of dyspepsia and was responsible for 15% of dyspepsia. (author)

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    L. A. Lyubskaya

    2014-11-01

    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.

  8. Chronic sole ulcerations associated with degenerative bone disease in two Asian elephants (Elephas maximus).

    Science.gov (United States)

    Luikart, Kimberly A; Stover, Susan M

    2005-12-01

    Chronic foot lesions and degenerative joint disease are common causes of morbidity in elephants. Lesions may become intractable and progressive despite intensive treatment regimens. The forelimbs of two Asian elephants (Elephas maximus) with chronic nonhealing sole ulcerations were examined using manual dissection and computed tomography. Both elephants had abnormal limb conformation that preceded the development of sole ulcerations. In both cases, sole ulcers were associated with remodeling and degeneration of underlying bones of the digits. Conformational abnormalities and altered weight distribution in these individuals may have induced compensatory bony degeneration and secondary ulcer formation. Sole ulcerations associated with digital abnormalities may have a guarded prognosis for resolution, even with aggressive treatment. Because limb conformational abnormalities could predispose to or result from chronic digital lesions, elephants with conformational abnormalities may have increased likelihood of having chronic sole ulcerations. PMID:17312727

  9. [Mixed-aetiology extensive ulcers of the crus: postthrombotic disease and gangrenous pyoderma].

    Science.gov (United States)

    Andreev, D Iu

    2011-01-01

    Gangrenous pyoderma (GP) is a rare infectious disease typically manifesting itself by utterly painful crural ulcers. Currently, the disease is considered to be most likely of an autoimmune origin. The author presents herein a case report describing key diagnostic and treatment decisions regarding a 30-year-old woman suffering from extensive crural ulcers. Of special interest was the finding that this patient's ultrasonographic duplex scanning showed the signs corresponding to postthrombotic disease. However, conventional treatment of venous trophic ulcers turned out inefficient. The woman was diagnosed as having GP. Topical therapy with corticosteroid drugs (combined with autodermoplasty and compression therapy) made it possible to achieve complete epithelisation of ulcers. Thus, should conventional treatment of venous trophic ulcers result in the patient's failure to respond properly, it is necessary to take into consideration the probability of gangrenous pyoderma. PMID:22616234

  10. Ulcerative colitis and Crohn's disease tissue cytotoxins

    Energy Technology Data Exchange (ETDEWEB)

    McLaren, L.C.; Gitnick, G.

    1982-06-01

    Bowel-wall tissue filtrates from patients with inflammatory bowel disease produce cytopathic effects in tissue culture. The cytopathic effects inducers have been reported to have the characteristics of a small RNA virus. Clostridium difficile toxin also produces cytopathic effects and has been found in the stools of patients with Crohn's disease and ulcerative colitis. The present study concerns the further characterization of the cytopathic inducers in tissues of inflammatory bowel disease patients. It was found that they are nonsedimentable at 148,000 g for 2 h and resistant to inactivation by UV light. They are proteins that are distinct from C. difficile toxin and are unique cytotoxins which are associated with the early cytopathic effects observed in Riff-free chick embryo and rabbit ileum cell cultures. These results suggest that the early cytopathic effects previously described are not produced by a virus. They do not explain the delayed cytopathic effects seen in rabbit ileum or WI-38 cells.

  11. Choledochoduodenal fistula complicating duodenal ulcer disease (a report of 3 cases.

    Directory of Open Access Journals (Sweden)

    Shah P

    1990-07-01

    Full Text Available Choledochoduodenal fistula complicating duodenal ulcer disease is a rare occurrence. The present paper describes 3 such cases which were incidentally picked up on upper gastro-intestinal (GI radiographic study and endoscopy done for ulcer like symptoms. The relevant literature is reviewed.

  12. Pathogenesis of aphthoid ulcers in Crohn's disease: correlative findings by magnifying colonoscopy, electron microscopy, and immunohistochemistry.

    OpenAIRE

    Fujimura, Y; Kamoi, R; Iida, M

    1996-01-01

    BACKGROUND--The mechanism of ulceration in Crohn's disease remains unknown. AIMS--To clarify the role of the follicle associated epithelium (FAE) of colonic lymphoid nodules in the formation of ulcers in Crohn's disease. METHODS--After identification of colonic lymphoid nodules and aphthoid lesions by magnifying colonoscopy, 76 biopsy specimens were obtained from 10 patients with Crohn's disease and three patients with colonic lymphoid hyperplasia. This study correlated magnifying colonoscopi...

  13. Radionuclide investigation of gastric evacuate function in ulcer disease

    International Nuclear Information System (INIS)

    The radionuclide method using labelled food was employed in 127 patients with gastric and duodenal ulcer to determine the gastric evacuate function. The method is physiologic and safe. The character of disorders of gastric evacuate rate was established in pyloroduodenal and mediogastral ulcers as well as the effect of gastric acid production on the rate of gastric evacuation

  14. Efficacy of Rifampin Plus Clofazimine in a Murine Model of Mycobacterium ulcerans Disease

    OpenAIRE

    Converse, Paul J.; Tyagi, Sandeep; Xing, Yalan; Li, Si-Yang; Kishi, Yoshito; Adamson, John; Nuermberger, Eric L.; Grosset, Jacques H.

    2015-01-01

    Treatment of Buruli ulcer, or Mycobacterium ulcerans disease, has shifted from surgical excision and skin grafting to antibiotic therapy usually with 8 weeks of daily rifampin (RIF) and streptomycin (STR). Although the results have been highly favorable, administration of STR requires intramuscular injection and carries the risk of side effects, such as hearing loss. Therefore, an all-oral, potentially less toxic, treatment regimen has been sought and encouraged by the World Health Organizati...

  15. The Association Between Peptic Ulcer Disease and Ischemic Stroke

    Science.gov (United States)

    Cheng, Tain-Junn; Guo, How-Ran; Chang, Chia-Yu; Weng, Shih-Feng; Li, Pi-I; Wang, Jhi-Joung; Wu, Wen-Shiann

    2016-01-01

    Abstract Stroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS. We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who received medications for PUD and had related diagnosis codes as the PUD group, and a reference group matched by age and sex was sampled from those who did not have PUD. We also collected data on medical history and monthly income. The events of IS occurred after enrollment were compared between the 2 groups. The data were analyzed using Cox proportional hazard models at the 2-tailed significant level of 0.05. The PUD group had higher income and prevalence of hypertension, diabetes mellitus (DM), heart disease, and hyperlipidemia. They also had a higher risk of developing IS with an adjusted hazard ratio of 1.31 (95% confidence interval: 1.20–1.41). Other independent risk factors included male sex, older age, lower income, and co-morbidity of hypertension, diabetes mellitus (DM), and heart disease. PUD is a risk factor for IS, independent of conventional risk factors such as male sex, older age, lower income, and co-morbidity of hypertension, DM, and heart disease. Prevention strategies taking into account PUD should be developed and evaluated. PMID:27258514

  16. Evidence-based clinical practice guidelines for peptic ulcer disease 2015.

    Science.gov (United States)

    Satoh, Kiichi; Yoshino, Junji; Akamatsu, Taiji; Itoh, Toshiyuki; Kato, Mototsugu; Kamada, Tomoari; Takagi, Atsushi; Chiba, Toshimi; Nomura, Sachiyo; Mizokami, Yuji; Murakami, Kazunari; Sakamoto, Choitsu; Hiraishi, Hideyuki; Ichinose, Masao; Uemura, Naomi; Goto, Hidemi; Joh, Takashi; Miwa, Hiroto; Sugano, Kentaro; Shimosegawa, Tooru

    2016-03-01

    The Japanese Society of Gastroenterology (JSGE) revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2014 and has created an English version. The revised guidelines consist of seven items: bleeding gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcer, non-H. pylori, non-nonsteroidal anti-inflammatory drug (NSAID) ulcer, surgical treatment, and conservative therapy for perforation and stenosis. Ninety clinical questions (CQs) were developed, and a literature search was performed for the CQs using the Medline, Cochrane, and Igaku Chuo Zasshi databases between 1983 and June 2012. The guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Therapy is initially provided for ulcer complications. Perforation or stenosis is treated with surgery or conservatively. Ulcer bleeding is first treated by endoscopic hemostasis. If it fails, surgery or interventional radiology is chosen. Second, medical therapy is provided. In cases of NSAID-related ulcers, use of NSAIDs is stopped, and anti-ulcer therapy is provided. If NSAID use must continue, the ulcer is treated with a proton pump inhibitor (PPI) or prostaglandin analog. In cases with no NSAID use, H. pylori-positive patients receive eradication and anti-ulcer therapy. If first-line eradication therapy fails, second-line therapy is given. In cases of non-H. pylori, non-NSAID ulcers or H. pylori-positive patients with no indication for eradication therapy, non-eradication therapy is provided. The first choice is PPI therapy, and the second choice is histamine 2-receptor antagonist therapy. After initial therapy, maintenance therapy is provided to prevent ulcer relapse. PMID:26879862

  17. How does disease location affect acute phase reactants in ulcerative colitis?

    Directory of Open Access Journals (Sweden)

    Serkan Ipek

    2015-07-01

    Conclusion: CRP, ESR, WBC, PLT counts and albumin levels are of limited value in determining disease activity in ulcerative colitis patients, especially in those with proctitis. [Int J Res Med Sci 2015; 3(7.000: 1589-1593

  18. The Helicobacter pylori theory and duodenal ulcer disease. A case study of the research process

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T

    1995-01-01

    OBJECTIVES: To describe the medical research process from the time of the generation of a new theory to its implementation in clinical practice. The Helicobacter pylori (H. pylori) theory, i.e. the theory that H. pylori plays a significant causal role in duodenal ulcer disease was chosen as a case...... therapeutic techniques. A total of 204 of the clinical studies addressed duodenal ulcer disease. Of these, 72% (147) were cross-sectional studies, 3% (7) were observational cohort studies and 25% (50) were therapeutic intervention studies. Thirty-one editorials and reviews concerning the etiological role of H....... pylori in duodenal ulcer disease had been published in some of the most widespread clinical journals. In half of the papers the authors were convinced of the causal role of H. pylori in duodenal ulcer disease, while in the remainder they were sceptical. In seven cases the authors stated which patients...

  19. Crohn's disease, ulcerative colitis, and measles vaccine in an English population, 1979–1998

    OpenAIRE

    Seagroatt, V; Goldacre, M.

    2003-01-01

    Study objectives: To study the hospitalised incidence of Crohn's disease (CD) and ulcerative colitis (UC) from 1979 to 1998; and to determine whether the introduction of the measles vaccination programme was associated with an increase in the young.

  20. Disodium cromoglycate in the treatment of ulcerative colitis and Crohn's disease.

    OpenAIRE

    Binder, V; Elsborg, L.; Greibe, J; Hendriksen, C; Høj, L; Jensen, K. B.; Kristensen, E.; Madsen, J R; Marner, B; Riis, P; Willumsen, L

    1981-01-01

    A controlled clinical study on disodium cromoglycate (DSCG) at a dose of 800 mg per day versus placebo was carried out in 141 patients with ulcerative colitis and 25 patients with Crohn's disease. Those of the ulcerative colitis patients who had been on sulphasalazine treatment continued that treatment during the trial (101 patients). Forty patients were intolerant of sulphasalazine. No patient received steroids during the last month before the study. Patients with Crohn's disease had their p...

  1. Risk of ulcerative colitis and Crohn's disease among offspring of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Orholm, Marianne; Fonager, Kirsten; Sørensen, Henrik Toft

    1999-01-01

    ) and Crohn's disease (CD) among first-degree relatives of patients with these diseases. To give more precise risk estimates we conducted a nationwide study using population-based data from the Danish National Registry of Patients (NRP). METHODS: All patients from the entire Danish population (5......OBJECTIVE: The incidence of inflammatory bowel disease (IBD) varies among and within countries, but several studies have indicated that genetic factors may play an important role in the etiology of IBD. A Danish regional study has observed an almost 10-fold increased risk for ulcerative colitis (UC...

  2. Dietary Supplement Therapies for Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis.

    Science.gov (United States)

    Parian, Alyssa; Limketkai, Berkeley N

    2016-01-01

    Inflammatory bowel disease (IBD) including ulcerative colitis and Crohn's disease are chronic relapsing and remitting chronic diseases for which there is no cure. The treatment of IBD frequently requires immunosuppressive and biologic therapies which carry an increased risk of infections and possible malignancy. There is a continued search for safer and more natural therapies in the treatment of IBD. This review aims to summarize the most current literature on the use of dietary supplements for the treatment of IBD. Specifically, the efficacy and adverse effects of vitamin D, fish oil, probiotics, prebiotics, curcumin, Boswellia serrata, aloe vera and cannabis sativa are reviewed. PMID:26561079

  3. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease

    Science.gov (United States)

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-01-01

    Abstract To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531–534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19–142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03–1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events. PMID:27100415

  4. State of the liver, biliary tract and pancreas in ulcer disease

    International Nuclear Information System (INIS)

    A study is presented of 175 patients with uncomlicated gastric and duodenal ulcer associated with pathology of the hepato-chaledocho-pancreatic system. The dynamics of structural-functional indices in the course of treatment of ulcer disease as well as the bile biochemistry (cholesterol, phospholipids, bile acids, bilirubin) and scintiscanning of liver and pancreas may be used as criteria in determination of the ''dependent'' and ''independent'' variants of pathology of the hepato-choledocho-pancreatic system. Scarring of the ulcer in associated pathology was 48.5 days, without associated pathology - 36.6 days

  5. Molecular hydrogen in human breath: a new strategy for selectively diagnosing peptic ulcer disease, non-ulcerous dyspepsia and Helicobacter pylori infection.

    Science.gov (United States)

    Maity, Abhijit; Pal, Mithun; Maithani, Sanchi; Ghosh, Barnali; Chaudhuri, Sujit; Pradhan, Manik

    2016-01-01

    The gastric pathogen Helicobacter pylori utilizes molecular hydrogen (H2) as a respiratory substrate during colonization in the gastric mucosa. However, the link between molecular H2 and the pathogenesis of peptic-ulcer disease (PUD) and non-ulcerous dyspepsia (NUD) by the enzymatic activity of H. pylori still remains mostly unknown. Here we provide evidence that breath H2 excretion profiles are distinctly altered by the enzymatic activity of H. pylori for individuals with NUD and PUD. We subsequently unravelled the potential molecular mechanisms responsible for the alteration of H2 in exhaled breath in association with peptic ulcers, encompassing both gastric and duodenal ulcers, along with NUD. We also established that carbon-isotopic fractionations in the acid-mediated bacterial environment regulated by bacterial urease activity cannot discriminate the actual disease state i.e. whether it is peptic ulcer or NUD. However, our findings illuminate the unusual molecular H2 in breath that can track the precise evolution of PUD and NUD, even after the eradication of H. pylori infection. This deepens our understanding of the pathophysiology of PUD and NUD, reveals non-invasively the actual disease state in real-time and thus offers a novel and robust new-generation strategy for treating peptic-ulcer disease together with non-ulcer related complications even when the existing (13)C-urea breath test ((13)C-UBT) fails to diagnose. PMID:27448107

  6. Interobserver variation in the radiographic diagnosis of duodenal ulcer disease

    International Nuclear Information System (INIS)

    Interobserver variation was estimated in radiologists' detection of duodenal ulcer and deformity of the duodenal bulb. A consecutive series of 156 patients with upper abdominal pain had a double contrast barium examination. The films were first read by routine by a specialist in radiology. A second reading was performed by another specialist who did not know the result of the first reading. Overall agreement between the two readings in the detection of duodenal ulcer and deformity of the duodenal bulb was 0.91 and 0.94, respectively. The overall agreement was adjusted for the expected chance agreement and kappa values were calculated. Kappa was 0.63 for the detection of duodenal ulcer and 0.85 for the detection of deformity of the duodenal bulb. (orig.)

  7. A study of psychiatric morbidity in patients of peptic ulcer diseases

    Directory of Open Access Journals (Sweden)

    Jagpal Singh Klair

    2012-01-01

    Full Text Available Aims and Objectives: To study the prevalence of psychiatric morbidity among patients of peptic ulcer disease and to study the patients of peptic ulcer disease with psychiatric morbidity in comparison to patients of peptic ulcer disease without psychiatric morbidity on following variables: sociodemographic variables and attributes/risk factors of peptic ulcer disease. Materials and Methods: Fifty cases of clinically proven acid peptic diseases and 30 cases of the control group were screened in department of General Medicine, outdoor as well as indoor patients. Instruments applied for the purpose of the study were Personal Bio-data Performa (Appendix-I, (SCL- 80 (Appendix-II, Hamilton rating scale for anxiety and depression, (P.S.L.E.; clinical diagnosis of psychiatric disorders was made as per ICD- 10 criteria. Data collected shall be subjected to statistical analysis. Results and Findings: The psychiatric morbidity was significantly (P10 years, compared to 23.80% in patients without psychiatric morbidity. Lastly, 48.27% of patients with psychiatric morbidity had significantly (P<0.01 stronger family history of acid peptic disease compared to 9.52% in patients without psychiatric morbidity. Conclusions: There is a significant relationship between the peptic ulcer disease and the various psychiatric morbidity factors as illustrated from the findings of this study.

  8. Helicobacter pylori and peptic ulcer disease. Current evidence for management strategies.

    OpenAIRE

    Chiba, N; Lahaie, R; Fedorak, R N; Bailey, R.; Veldhuyzen van Zanten, S J; Bernucci, B.

    1998-01-01

    OBJECTIVE: To review current evidence for primary care physicians who manage Helicobacter pylori in peptic ulcer disease. QUALITY OF EVIDENCE: MEDLINE was searched to August 1997 for randomized controlled trials, systematic overviews, and consensus reports. High-quality recent reviews were often found. Randomized controlled trials presented as abstracts at recent meetings were reviewed. MAIN FINDINGS: Helicobacter pylori is found in most case of duodental and gastric ulcer, and eradication of...

  9. Stereomicroscopic examination of stained rectal biopsies in ulcerative colitis and Crohn's disease

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1980-01-01

    Rectal biopsy samples from 22 healthy control subjects, 54 patients with ulcerative colitis, and 34 with Crohn's disease with involvement of the colon or rectum were investigated in a stereomicroscopic study. Samples were stained as whole mounts with Alcian Green before the stereomicroscopic...... examination. In ulcerative colitis, biopsies almost constantly showed changes in the mucosal surface pattern, including irregular, enlarged crypt openings filled with exudate, granulated and bulging surface, and patchy localization of the goblet cells. There was a close correlation between the...

  10. Genital ulcerative pyoderma gangrenosum in Behçet′s disease: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pinar Ozuguz

    2015-01-01

    Full Text Available Behçet′s disease (BD, first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet′s ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD.

  11. Detection of longitudinal ulcer using roughness value for computer aided diagnosis of Crohn's disease

    Science.gov (United States)

    Oda, Masahiro; Kitasaka, Takayuki; Furukawa, Kazuhiro; Watanabe, Osamu; Ando, Takafumi; Goto, Hidemi; Mori, Kensaku

    2011-03-01

    The purpose of this paper is to present a new method to detect ulcers, which is one of the symptoms of Crohn's disease, from CT images. Crohn's disease is an inflammatory disease of the digestive tract. Crohn's disease commonly affects the small intestine. An optical or a capsule endoscope is used for small intestine examinations. However, these endoscopes cannot pass through intestinal stenosis parts in some cases. A CT image based diagnosis allows a physician to observe whole intestine even if intestinal stenosis exists. However, because of the complicated shape of the small and large intestines, understanding of shapes of the intestines and lesion positions are difficult in the CT image based diagnosis. Computer-aided diagnosis system for Crohn's disease having automated lesion detection is required for efficient diagnosis. We propose an automated method to detect ulcers from CT images. Longitudinal ulcers make rough surface of the small and large intestinal wall. The rough surface consists of combination of convex and concave parts on the intestinal wall. We detect convex and concave parts on the intestinal wall by a blob and an inverse-blob structure enhancement filters. A lot of convex and concave parts concentrate on roughed parts. We introduce a roughness value to differentiate convex and concave parts concentrated on the roughed parts from the other on the intestinal wall. The roughness value effectively reduces false positives of ulcer detection. Experimental results showed that the proposed method can detect convex and concave parts on the ulcers.

  12. Comparison of Behçet's Disease and Recurrent Aphthous Ulcer According to Characteristics of Gastrointestinal Symptoms

    OpenAIRE

    Rhee, Seung-Ho; Kim, Young-Bae; Lee, Eun-So

    2005-01-01

    Behçet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU f...

  13. Complete Response of Severe, Refractory, Gastric, Stomal and Sclerotherapy-Induced Esophageal Ulcer Disease to Omeprazole Therapy

    OpenAIRE

    Morgan, Earl P.; Williams, C. N.

    1989-01-01

    This report presents three unusual forms of resistant peptic ulcer disease, all healed completely with the use of a new class of anti-ulcer drug, a proton pump blocker, omeprazole. Each of these patients represents an unusual facet of acid-pepsin disease, namely, resistance to healing with current standard therapy, recurrence and rehealing with a second course of omcprazole, and a subsequent need for maintenance omeprazole to remain ulcer-free. The first patient had an unusual complication of...

  14. Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country.

    Science.gov (United States)

    Nag, Falguni; De, Abhishek; Hazra, Avijit; Chatterjee, Gobinda; Ghosh, Arghyaprasun; Surana, Trupti V

    2014-10-01

    Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries. PMID:23170845

  15. Duodenal prostaglandin synthesis and acid load in health and in duodenal ulcer disease

    International Nuclear Information System (INIS)

    We sought to test the hypothesis that duodenal ulcer disease results from an imbalance between duodenal acid load, an injurious force, and mucosal prostaglandin generation, a protective factor. Ten patients with duodenal ulcer and 8 healthy controls were studied. The duodenal acid load after an amino acid soup was quantified by a double-marker technique. Mucosal biopsy specimens were taken endoscopically from the duodenal bulb before and after the test meal. Prostaglandin synthesis activity was measured by incubating biopsy homogenates in excess [14C]arachidonic acid. Although mean duodenal acid load was higher in duodenal ulcer, ranges overlapped. Neither the qualitative nor quantitative profile of mucosal prostaglandin synthesis activities differed significantly between test groups. Prostaglandin synthesis activities, however, tended to increase post cibum in controls, but change little or decrease in duodenal ulcer. Only by comparing the responses with a meal of both parameters together (duodenal acid load and the change in prostaglandin synthesis activities) was there complete or nearly complete separation of duodenal ulcer from controls. Greatest discrimination was observed with prostacyclin (6-keto-PGF1 alpha). We conclude that in health, mucosal prostaglandin generation in the duodenum is induced post cibum in relation to duodenal acid load; this may be a physiologic example of adaptive cytoprotection. In duodenal ulcer there may be a defect in such a mechanism

  16. 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.

  17. Radioimmunoassay of gastrin level in duodenal ulcer, atrophic gostritis and Addison-Biermer's disease

    International Nuclear Information System (INIS)

    Radioimmunoassay of gastrin level in the blood was performed in 20 controls, 12 patients with duodenal ulcer, 13 patients with atrophic gastritis and 14 patients with Addison-Biermer's disease. Gastrin level in the serum of the patients with duodenal ulcer did not differ significantly from that of controls. In atrophic gastritis and particularly in Addison-Biermer's disease gastrin level was found to be several times higher. This is probably a result of chronic gastrin secretion stimulation which is normally inhibited by gastric juice. (author)

  18. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    OpenAIRE

    Kaija-Leena Kolho; Dan Turner

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000  μ g/g). The best cut-off value for calprotectin for predicting poor outcome was 800  μ g/g (sensitivity...

  19. The Etiology of Genital Ulcer Disease among Patients Attending Sexually Transmitted Disease Clinics in Guangzhou, China

    Institute of Scientific and Technical Information of China (English)

    GU Jin(谷进); ZENG Zhirong(曾志荣); CHEN Rongzhang(陈荣章); ZHU Huilan(朱慧兰); QIU Xiaoshan(邱晓珊)

    2002-01-01

    Objectives: To investigate the etiology of genital ulcerdisease (GUD) among patients attending sexuallytransmitted disease (STD) clinics in Guangzhou, China.Methods: Between September 8, 1998, and August 9,2001, 267 patients with a genital ulcer were clinicallyassessed. Clinical etiology of GUD was dependent onphysical appearance and microbiologic examination,including the following: dark field microscopy and serologyfor Treponema pallidum (TP), swabs of genital ulcer forHerpes simplex virus (HSV), processed quantitativefluorescent polymerase chain reaction (QF-PCR) forsimultaneous detection of HSV, TP, Haemophilus ducreyi(HD), Human papillomavirus (HPV), and serology for HIVinfection.Results: Two hundred thirty men and thirty-sevenwomen with a median age of 33.4 (range 16-74 years) wereanalyzed. The etiology of GUD was syphilis (26.59%)(71/267), genital herpes (17.60%) (47/267), condylomataacuminata (4.87%) (13/267), candidiasis (3.37%) (9/267),bacterial infection (3.75%) (10/267), and multiple infection(6.74%) (18/267). The seroprevalence of HIV was 0.75%(2/267). No etiology was identified in 50.56% (135/267).Conclusion: The etiology of GUD among STD patients inour area was multifactorial with a predominance of syphilisand genital herpes. Based on this limited data obtained atSTD clinics, HIV infection was not common.

  20. [Nonsteroidal Anti-inflammatory Drug and Aspirin-induced Peptic Ulcer Disease].

    Science.gov (United States)

    Shim, Young Kwang; Kim, Nayoung

    2016-06-25

    Despite decreasing Helicobacter pylori prevalence, the prevalence of peptic ulcer disease is increasing in the aged population, mainly due to increasing use of NSAIDs to manage pain and inflammation. In addition, low dose aspirin is employed as an anti-coagulant for those who have suffered or are at high risk of ischemic stroke and cardiovascular disease. However, NSAIDs and aspirin are injurious to mucosa of stomach and duodenum. NSAID-induced inhibition of mucosal prostaglandin synthesis is thought to be a major mechanism of gastrointestinal mucosal injury. The proportion of elderly has increased rapidly in Korea, with the proportion over 65 years old expected to be 24.3% in 2030. In this higher-risk population, the strategy to reduce the incidence of NSAID-related peptic ulcers and complications such as bleeding, obstruction and perforation is very important. Proton pump inhibitors (PPIs) with cyclooxygenase-2 inhibitor can be used for reducing the risk of NSAID-related ulcers and upper gastrointestinal (GI) complications. However, continuous use of PPI has several problems. In addition, NSAID-related problems in the lower GI tract have increased, in contrast to the decrease of NSAID-related upper GI disease. The aim of this review is to provide an evidence-based knowledge regarding the mechanism, complications of treatment, and prevention strategies for NSAID- or aspirin-related peptic ulcer disease in Korea. PMID:27312830

  1. The incidence of Crohn's disease and ulcerative colitis since 1995 in Danish children and adolescents

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Baldal, Mira Eggebrecht; Nielsen, Rasmus Gaardskær;

    2016-01-01

    OBJECTIVE: Worldwide the incidence of pediatric Crohn's disease (CD) and ulcerative colitis (UC) is suspected to be increasing. Based on unselected nationwide register data the aim of this study is to examine the change in incidence of CD and UC in children and adolescents in Denmark. MATERIALS AND...

  2. The incidence of ulcerative colitis (1995-2011) and Crohn's disease (1995-2012)

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz; Nielsen, Jan; Fonager, Kirsten;

    2014-01-01

    BACKGROUND AND AIMS: The incidence of ulcerative colitis (UC) and Crohn's disease (CD) has increased during the 20th century in North America and Western Europe. However, there are conflicting reports whether the incidence has declined, stabilized or even continued to increase. No nationwide Danish...

  3. X-ray examination of the stomach and duodenum in patients with ulcer disease after vagotomy

    International Nuclear Information System (INIS)

    A roentgenological and endoscopical study is presented of the stomach and duodenum in 66 patients during remission and in 22 patients during exacerbation of ulcer disease from 6 months up to 5 years after organsaving operations using vagotomy. In the majority of patients the stomach was characterized by a large gas bubble, cascade-like torsion, deformation of the antral portion and duodenal bulb. In some patients thickenings of the gastric antral mucosa were noted. An endoscopically confirmed ulcer was revealed roentgenologically only in 50% of patients

  4. HLA-DR expression and disease activity in ulcerative colitis

    DEFF Research Database (Denmark)

    Poulsen, L O; Elling, P; Sørensen, Flemming Brandt;

    1986-01-01

    In 12 patients with active ulcerative colitis (UC) the rectal epithelial cells were analyzed for HLA-DR antigens by an immunohistochemical technique. The clinical, rectoscopic, and histologic stages were also determined. The investigations were carried out at the beginning of the study and 2 weeks...... and 3 months later. The rectal epithelial cells were HLA-DR-positive in all patients at the first two examinations. After 3 months five patients had changed to an HLA-DR-negative stage, whereas the other seven patients remained HLA-DR-positive. Closer analyses showed that expression/nonexpression of...... HLA-DR antigens on rectal epithelial cells of patients with UC could not be predicted from the clinical, rectoscopic, or histologic findings. HLA-DR expression is normally restricted to immunocompetent cells. The presence of HLA-DR antigens on epithelial cells may be a consequence of immunological...

  5. Spontaneous pneumobilia revealing choledocho-duodenal fistula: A rare complication of peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Massimo Tonolini

    2013-01-01

    Full Text Available Spontaneous pneumobilia without previous surgery or interventional procedures indicates an abnormal biliary-enteric communication, most usually a cholelithiasis-related gallbladder perforation. Conversely, choledocho-duodenal fistulisation (CDF from duodenal bulb ulcer is currently exceptional, reflecting the low prevalence of peptic disease. Combination of clinical data (occurrence in middle-aged males, ulcer history, absent jaundice and cholangitis and CT findings including pneumobilia, normal gallbladder, adhesion with fistulous track between posterior duodenum and pancreatic head allow diagnosis of CDF, and differentiation from usual gallstone-related biliary fistulas requiring surgery. Conversely, ulcer-related CDF are effectively treated medically, whereas surgery is reserved for poorly controlled symptoms or major complications.

  6. [Environmental risk factors in Crohn's disease and ulcerative colitis (excluding tobacco and appendicectomy)].

    Science.gov (United States)

    Jantchou, Prévost; Monnet, Elisabeth; Carbonnel, Franck

    2006-01-01

    A rapid increase in the incidence of Crohn's disease and ulcerative colitis in developed countries, the occurrence of Crohn's disease in spouses, and a lack of complete concordance in monozygotic twins are strong arguments for the role of environmental factors in inflammatory bowel disease (IBD). Research in the field of environmental factors in IBD is based upon epidemiological (geographical and case-control), clinical and experimental studies. The role of two environmental factors has clearly been established in IBD. Smoking is a risk factor for Crohn's disease and a protective factor for ulcerative colitis; appendectomy is a protective factor for ulcerative colitis. Many other environmental factors for IBD have been investigated, including infectious agents, diet, drugs, stress and social status. They are detailed in the present review. Among them, atypical Mycobacteria, oral contraceptives and antibiotics could play a role in Crohn's disease. To date, three hypotheses associate environmental factors with the pathophysiology of IBD (loss of tolerance of intestinal immune system towards commensal bacterial flora): the hygiene, infection and cold chain hypotheses. Much work remains to be done to identify risk factors for IBD. Research identifying environmental factors that might cause a predisposition to IBD is useful. It may lead to disease prevention in subjects who are genetically predisposed and disease improvement in patients. PMID:16885870

  7. Raised serum activity of phospholipase A2 immunochemically related to group II enzyme in inflammatory bowel disease: its correlation with disease activity of Crohn's disease and ulcerative colitis.

    OpenAIRE

    Minami, T.; Tojo, H; Shinomura, Y; Tarui, S; Okamoto, M

    1992-01-01

    Calcium dependent phospholipase A2 activity in the mixed micelles of 1-palmitoyl-2-oleoyl-phosphatidylglycerol and cholate was measured in sera of 39 patients with Crohn's disease, 40 patients with ulcerative colitis, and 40 healthy controls. The phospholipase A2 activity was significantly raised in those sera of the patients with active Crohn's disease and those with moderate and severe ulcerative colitis. The major phospholipase A2 activity derived from the sera was separated into two peaks...

  8. Accuracy of abdominal ultrasound and MRI for detection of Crohn disease and ulcerative colitis in children

    Energy Technology Data Exchange (ETDEWEB)

    Ziech, Manon L.W.; Smets, Anne M.J.B.; Lavini, Cristina; Caan, Matthan W.A.; Nederveen, Aart J.; Bipat, Shandra; Stoker, Jaap [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Hummel, Thalia Z.; Benninga, Marc A.; Kindermann, Angelika [Emma Children' s Hospital, Academic Medical Center, Department of Pediatric Gastroenterology, Amsterdam (Netherlands); Nievelstein, Rutger A.J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Roelofs, Joris J.T.H. [Academic Medical Center, Department of Pathology, Amsterdam (Netherlands)

    2014-11-15

    Endoscopy is currently the primary diagnostic technique for inflammatory bowel disease (IBD) in children. To assess the accuracy of US and dynamic contrast-enhanced MRI for diagnosing inflammatory bowel disease and for distinguishing Crohn disease and ulcerative colitis in comparison to a reference standard. Consecutive children with suspected IBD underwent diagnostic workup including ileocolonoscopy and upper gastrointestinal endoscopy as the reference standard, abdominal US, and MR enterography and colonography at 3 T. The protocol included a dynamic contrast-enhanced 3-D sequence. Sensitivity, specificity and kappa values were calculated for one ultrasonographer and two MRI observers. We included 28 children (15 boys) with mean age 14 years (range 10-17 years). The diagnosis was IBD in 23 children (72%), including 12 with Crohn disease, 10 with ulcerative colitis and 1 with indeterminate colitis. For the diagnosis of inflammatory bowel disease the sensitivity was 55% for US and 57% (both observers) for MR entero- and colonography, and the specificity was 100% for US and 100% (observer 1) and 75% (observer 2) for MR entero- and colonography. Combined MRI and US had sensitivity and specificity of 70% and 100% (observer 1) and 74% and 80% (observer 2), respectively. With the addition of a dynamic contrast-enhanced MR sequence, the sensitivity increased to 83% and 87%. US and MRI could only distinguish between Crohn disease and ulcerative colitis when terminal ileum lesions were present. US and MR entero- and colonography have a high accuracy for diagnosing inflammatory bowel disease in children but cannot be used to distinguish Crohn disease and ulcerative colitis. (orig.)

  9. Risk factors for intestinal metaplasia in concomitant gastric and duodenal ulcer disease

    OpenAIRE

    Hong, Jun-Bo; Xia, Liang; Zuo, Wei; Wang, An-Jiang; Xu, Shan; Xiong, Hui-Fang; Chen, You-Xiang; ZHU, XUAN; LU, NONG-HUA

    2014-01-01

    The aim of this study was to estimate the prevalence and risk factors of intestinal metaplasia (IM) in concomitant gastric and duodenal ulcer (CGDU) disease by retrospectively reviewing consecutive patients who had undergone esophagogastroduodenal endoscopy. Patients who received the endoscopic diagnosis of CGDU disease were selected for analysis and the recorded demographic, endoscopic, clinical and outcome data, including data on the development of IM, were extracted. Associations of the va...

  10. Sexual behaviour in Zulu men and women with genital ulcer disease.

    OpenAIRE

    O'Farrell, N; Hoosen, A A; Coetzee, K D; van den Ende, J.

    1992-01-01

    OBJECTIVE--To investigate patterns of sexual behaviour in men and women with genital ulcer disease (GUD) and their relevance to HIV-1 transmission. METHODS--A sexual behaviour questionnaire was administered by the same interviewer to all participants who were also entered into a study of the microbial aetiology of GUD. SETTING--City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa. PARTICIPANTS--100 Zulu men and 100 Zulu women. RESULTS--36 (%) of me...

  11. Accuracy of abdominal ultrasound and MRI for detection of Crohn disease and ulcerative colitis in children

    International Nuclear Information System (INIS)

    Endoscopy is currently the primary diagnostic technique for inflammatory bowel disease (IBD) in children. To assess the accuracy of US and dynamic contrast-enhanced MRI for diagnosing inflammatory bowel disease and for distinguishing Crohn disease and ulcerative colitis in comparison to a reference standard. Consecutive children with suspected IBD underwent diagnostic workup including ileocolonoscopy and upper gastrointestinal endoscopy as the reference standard, abdominal US, and MR enterography and colonography at 3 T. The protocol included a dynamic contrast-enhanced 3-D sequence. Sensitivity, specificity and kappa values were calculated for one ultrasonographer and two MRI observers. We included 28 children (15 boys) with mean age 14 years (range 10-17 years). The diagnosis was IBD in 23 children (72%), including 12 with Crohn disease, 10 with ulcerative colitis and 1 with indeterminate colitis. For the diagnosis of inflammatory bowel disease the sensitivity was 55% for US and 57% (both observers) for MR entero- and colonography, and the specificity was 100% for US and 100% (observer 1) and 75% (observer 2) for MR entero- and colonography. Combined MRI and US had sensitivity and specificity of 70% and 100% (observer 1) and 74% and 80% (observer 2), respectively. With the addition of a dynamic contrast-enhanced MR sequence, the sensitivity increased to 83% and 87%. US and MRI could only distinguish between Crohn disease and ulcerative colitis when terminal ileum lesions were present. US and MR entero- and colonography have a high accuracy for diagnosing inflammatory bowel disease in children but cannot be used to distinguish Crohn disease and ulcerative colitis. (orig.)

  12. Fecal calprotectin level correlated with both endoscopic severity and disease extent in ulcerative colitis

    OpenAIRE

    Kawashima, Kousaku; Ishihara, Shunji; Yuki, Takafumi; Fukuba, Nobuhiko; Oshima, Naoki; Kazumori, Hideaki; Sonoyama, Hiroki; Yamashita, Noritsugu; Tada, Yasumasa; Kusunoki, Ryusaku; Oka, Akihiko; Mishima, Yoshiyuki; Moriyama, Ichiro; Kinoshita, Yoshikazu

    2016-01-01

    Background The relationship between fecal calprotectin (FC) and disease extent in ulcerative colitis (UC) has not been fully elucidated. The aim of this study was to clarify the correlation of FC with disease extent and severity in UC patients. Methods UC patients scheduled to undergo an ileocolonoscopy were enrolled and fecal samples for FC measurement were collected prior to the procedure. A Mayo endoscopic subscore (MES) was determined for each of 5 colonic segments. To evaluate the associ...

  13. Polymorphonuclear leucocytes in Crohn's disease and ulcerative proctocolitis: association between enhanced adherence to nylon fibre and disease variables.

    OpenAIRE

    Cason, J; Ainley, C C; Wolstencroft, R. A.; Thompson, R P

    1988-01-01

    The adherence of polymorphonuclear leucocytes (PMN) to nylon fibre was investigated in patients with Crohn's disease, ulcerative proctocolitis, and anorexia nervosa, and compared with changes of circulating PMNs, C reactive protein concentrations, erythrocyte sedimentation rates, and clinical assessment of disease activity. PMN adherence was in excess of the maximum value detected for healthy subjects in 14 of 25 patients with Crohn's disease and two of 10 with proctocolitis, but it was withi...

  14. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    Science.gov (United States)

    Kolho, Kaija-Leena; Turner, Dan

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000 μg/g). The best cut-off value for calprotectin for predicting poor outcome was 800 μg/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57–0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58–0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation. PMID:23533791

  15. Ulcerative colitis associated with chronic granulomatous disease: case report

    OpenAIRE

    Imanzade, Farid; Sayarri, Aliakbar; Tajik, Pantea

    2015-01-01

    Chronic Granulomatous Disease (CGD) is an inherited primary immunodeficiency disease which increases the body’s susceptibility to infections caused by certain bacteria and fungi. CGD is a rare disease, caused by four genes, one type is 1X linked and the other three are “autosomal recessive”. Although clinical presentation is variable, but characteristic features are recurrent pneumonia, lymphadenitis, hepatic or other abscesses. Gastrointestinal tract symptoms are common in x-linked recessive...

  16. The relationship between Helicobacter pylori-associated gastritis or ulcer disease and gastric emptying

    International Nuclear Information System (INIS)

    Forty-five patients with Helicobacter pylori (HP)-associated gastritis or ulcer disease were included in this study. Radionuclide-labelled solid meals were used to calculate gastric emptying times (GETs) and carbon-14 urea breath tests (14C UBTs) were used to measure the HP colonies quantitatively. The patients were assessed according to the following two criteria: (a) the HP colony number (i.e. high or low) and (b) the recorded duration of the GET (i.e. long or short). There was no statistically significant difference in the incidence of abnormal GET between high and low 14C UBT patients or in the incidence of abnormal 14C UBT between long and short GET cases. In conclusion, no significant relationship between HP-associated gastritis or ulcer disease and GET was found in this study. (orig.)

  17. A STUDY ON HEALTH SEEKING BEHAVIOR OF PATIENTS WITH GENITAL ULCER DISEASE

    OpenAIRE

    Meetesh; Swarupa

    2014-01-01

    BACKGROUND: In developing countries, the proportion with STDs who present with genital ulcers is high compared to developed nations. AIM: 1. To study reaction of the cases toward their disease. 2. To study communication of cases with their partners. 3. To study treatment of symptoms and starting treatment, selfmedication & completion of treatment. 4. To study approach of health care providers. STUDY SETTINGS: Present study was carried out in Department of skin and VD, Medical College and SSG ...

  18. Epizootic ulcerative syndrome: Exotic fish disease threatens Africa’s aquatic ecosystems

    Directory of Open Access Journals (Sweden)

    Karl D.A. Huchzermeyer

    2012-09-01

    Full Text Available In late 2006 an unusual ulcerative condition in wild fish was reported for the first time in Africa from the Chobe and upper Zambezi Rivers in Botswana and Namibia. Concern increased with subsistence fishermen reporting large numbers of ulcerated fish in their catches. In April 2007 the condition was confirmed as an outbreak of epizootic ulcerative syndrome (EUS. The causative agent, Aphanomyces invadans, is a pathogenic water mould of fish that shows little host specificity. Ulcers follow infection of tissues by oomycete zoospores, resulting in a granulomatous inflammation associated with invading oomycete hyphae. Granulomatous tracts surrounding oomycete hyphae within the necrotic tissues characterise the diagnostic histological picture. The upper Zambezi floodplain at the confluence with the Chobe River spans the four countries of Botswana, Namibia, Zambia and Zimbabwe, making disease control a challenge. The floodplain ecosystem supports a high fish diversity of around 80 species, and is an important breeding and nursery ground. The annual cycle of flooding brings about changes in water quality that are thought to favour the infectivity of A. invadans, with diseased fish appearing soon after the plains become flooded. Since 2006 the disease has spread rapidly upstream along the upper Zambezi and its tributaries. By 2010 the disease was reported from the Okavango Delta in Botswana and in 2011 from the Western Cape Province of South Africa. EUS has the potential to disrupt floodplain ecosystems elsewhere in Africa where high fish diversity forms the basis of subsistence fisheries and local economies, and is a direct threat to freshwater fish culture.

  19. Comparison of Behcet's disease and recurrent aphthous ulcer according to characteristics of gastrointestinal symptoms.

    Science.gov (United States)

    Rhee, Seung-Ho; Kim, Young-Bae; Lee, Eun-So

    2005-12-01

    Behcet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU from true BD with gastrointestinal involvement. Because pathognomonic clinical features and tools are absent, the differential diagnosis of these two diseases relies on the characteristic clinical features and the judgement of an experienced physician. Sixty-five out of a total 960 RAU patients and forty-four of 556 BD patients with gastrointestinal symptoms between January 1996 and December 2003 participated in this study. All were evaluated with esophagogastroduodenoscopy and colonoscopy. Clinical, endoscopic and histopathologic findings were analyzed and ELISA tests were conducted to detect serum levels of ASCA and pANCA. No significant difference was found between the two groups. Differential diagnosis between RAU with gastrointestinal symptoms and BD with gastrointestinal involvement requires further prospective, large-scale study. PMID:16361807

  20. Correlation between low bone density and disease activity in patients with ulcerative colitis.

    Science.gov (United States)

    Amiriani, Taghi; Besharat, Sima; Pourramezan, Zahra; Mirkarimi, Honey Sadat; Aghaei, Mehrdad; Joshaghani, Hamidreza; Roshandel, Gholamreza; Faghani, Maryam; Besharat, Mahsa

    2015-01-01

    BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov- Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index. PMID:25628850

  1. Correlation Between Low Bone Density and Disease Activity in Patients with Ulcerative Colitis

    Science.gov (United States)

    Amiriani, Taghi; Besharat, Sima; Pourramezan, Zahra; Mirkarimi, Honey Sadat; Aghaei, Mehrdad; Joshaghani, Hamidreza; Roshandel, Gholamreza; Faghani, Maryam; Besharat, Mahsa

    2015-01-01

    BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov– Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index. PMID:25628850

  2. Necrosante periodontal disease: ulcerative gengivitis necrosante – case report

    OpenAIRE

    Maurício Colin B. CORDEIRO

    2004-01-01

    This project proposes to discuss the clinical characteristics ofGUN and its differentiated diagnostics with the PUN under thenew optical classification of necrosante periodontal disease. Dealswith a clinical case of an 18 year old female patient, with symptomsof limited gingival necroses at the gingival vestibule edge and theinter-dental papilla in the upper back region, with painfulsymptoms, gum bleeding when touched, dental calculus, largequantity of visible bacterial plaque and bad breath ...

  3. Do clinicians accept the role of Helicobacter pylori in duodenal ulcer disease: a survey of European gastroenterologists and general practitioners

    DEFF Research Database (Denmark)

    Christensen, A H; Logan, R P; Noach, L A;

    1994-01-01

    OBJECTIVES. To examine to what extent clinicians in Europe accepted the theory of the casual role of Helicobacter pylori (H.pylori) in duodenal ulcer disease in the year 1992, and to what extent the theory had influenced their diagnostic and therapeutic habits in the management of duodenal ulcer...... significant cause of duodenal ulcer disease, use of diagnostic tests for detection of H. pylori and therapeutic regimens for eradicating H. pylori. RESULTS. Four hundred and forty-two doctors replied. Eighty-four per cent of the British doctors, 73% of the Dutch doctors, and 47% of the Danish doctors accepted...... the role of H. pylori in duodenal ulcer disease. The rates were higher among gastroenterologists than among general practitioners. Eighty-four per cent of the British doctors, 80% of the Dutch doctors, and 48% of the Danish doctors used diagnostic tests for H. pylori, most frequently histological...

  4. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B; Matzen, Peter

    1994-01-01

    The aim of the study was to investigate opinions among Danish patients and physicians on causes of peptic ulcer disease. Fifty-nine patients with an ulcer history and 77 physicians with a special interest in gastroenterology participated. They were given a questionnaire listing 16 possible causes...... of peptic ulcer and indicated for each whether they believed it was a contributory cause of the disease. The patients stated 0-10 causes each (median, 4), and the physicians 3-12 causes (median, 6) (p < 0.01). Younger physicians stated more causes than did the older ones (p < 0.01), and female...... physicians stated more causes than did their male colleagues (p < 0.01). Seventy-five per cent of the patients indicated that psychologic factors, such as grief, anxiety, and stress, were contributory causes of peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side...

  5. Necrosante periodontal disease: ulcerative gengivitis necrosante – case report

    Directory of Open Access Journals (Sweden)

    Maurício Colin B. CORDEIRO

    2004-11-01

    Full Text Available This project proposes to discuss the clinical characteristics ofGUN and its differentiated diagnostics with the PUN under thenew optical classification of necrosante periodontal disease. Dealswith a clinical case of an 18 year old female patient, with symptomsof limited gingival necroses at the gingival vestibule edge and theinter-dental papilla in the upper back region, with painfulsymptoms, gum bleeding when touched, dental calculus, largequantity of visible bacterial plaque and bad breath not significant,with the absence of linfoadenopathy, fever, pseudomembrane, andno discomfort. During the discussion of the patient’s medicalhistory she reports that she is healthy, except for the possibledevelopment of emotional stress. The treatment plan isconservative (educational orientation on health, coronary scraping,and smoothing out of the root on the entire oral cavity, prophylaxis,topical chemical treatment, of the bacterial plaque with hydrogenperoxide H2O2 and oral hygiene monitoring utilizing the visibleindex of plaque – IPV – and the edge gum bleeding – ISG. Antibiotictherapy was not used. The treatment is weekly. At the end of thisperiod there is a complete reestablishing of the periodontal healthso, her return for preventive periodontal maintenance wasscheduled, in 4 months. For this reason, this case agrees with thedecision of the committee responsible for the elaboration of thenew classification for the periodontal disease for it to be placed inthe same category “necrosante periodontal disease”.

  6. Genotyping of Helicobacter pylori Strains Isolated from Patients with Gastric Ulcer and Non Ulcer Disease using RFLP-PCR of ureAB, vacA , cagA Genes

    Directory of Open Access Journals (Sweden)

    Sh. Farshad

    2008-10-01

    Full Text Available Introduction & Objective: Different studies show that the reasons for clinically diverse outcomes of infections caused by H. pylori may include host and environmental factors as well as differences in the prevalence or expression of bacterial virulence factors. The aim of this study was to study the distribution of different genotypes of major virulence factors cagA, vacA and ureAB among H. pylori strains isolated from patients with gastric ulcer (ulcerative disease and patients with gastritis (non ulcerative disease.Materials & Methods: In this cross sectional study 65 H. pylori strains, 30 from patients with gastric ulcer and 35 from patients with non ulcerative gastritis disease were investigated by RFLP-PCR.Results: The prevalence of vacA-positive strains in ulcerative patients was significantly more than that in non ulcerative patients (P0.05.Conclusion: It seems that in the patients under our study the presence of cagA gene may not necessarily be a risk factor for ulcer disease, while a homologous genotype of vacA appears to be associated with an increase risk of ulcer development. Lastly, despite the existence of a high degree of genomic variability within ureAB, conserved DNA banding profiles are distributed in our areas.

  7. Concentrations of metals in gastric juice in health and peptic ulcer disease.

    OpenAIRE

    Powell, J J; S. M. Greenfield; Thompson, R P

    1992-01-01

    The concentrations of essential metal cations in gastric juice, collected at endoscopy from 17 normal patients and 11 with peptic ulcer disease, were determined by inductively coupled plasma emission spectrometry. Mean fasting levels in normal gastric juice were as follows: sodium 47.7 mM, potassium 14.6 mM, calcium 0.8 mM, magnesium 0.36 mM, zinc 13 microM, and copper 1.2 microM: these did not differ significantly in health or disease. Because samples were contaminated with iron, the concent...

  8. Metabonomics of human fecal extracts characterize ulcerative colitis, Crohn's disease and healthy individuals

    DEFF Research Database (Denmark)

    Bjerrum, Jacob Tveiten; Wang, Yulan; Hao, Fuhua;

    2015-01-01

    This study employs spectroscopy-based metabolic profiling of fecal extracts from healthy subjects and patients with active or inactive ulcerative colitis (UC) and Crohn's disease (CD) to substantiate the potential use of spectroscopy as a non-invasive diagnostic tool and to characterize the fecal...... metabolome in inflammatory bowel disease (IBD). Stool samples from 113 individuals (UC 48, CD 44, controls 21) were analyzed by (1)H nuclear magnetic resonance (NMR) spectroscopy (Bruker 600 MHz, Bruker BioSpin, Rheinstetten, Germany). Data were analyzed with principal component analysis and orthogonal...

  9. Management of leg ulcers

    OpenAIRE

    Sarkar, P; Ballantyne, S

    2000-01-01

    Leg ulcer is a leading cause of morbidity among older subjects, especially women in the Western world. About 400 years BC, Hippocrates wrote, "In case of an ulcer, it is not expedient to stand, especially if the ulcer be situated on the leg". Hippocrates himself had a leg ulcer. The best treatment of any leg ulcer depends upon the accurate diagnosis and the underlying aetiology. The majority of leg ulcers are due to venous disease and/or arterial disease, but the treatment of the underlying c...

  10. Case of pyoderma gangrenosum showing oral and genital ulcers, misdiagnosed as Behcet's disease at first medical examination.

    Science.gov (United States)

    Tsuboi, Hiromi

    2008-05-01

    It is occasionally difficult to distinguish between Behcet's disease (BD) and pyoderma gangrenous (PG). Our case showed ulcers of the oral, vaginal and perineal areas, and in the ileum, thus resulting in our initial diagnosis of BD. However, the patient showed a continued leukopenia, and she was subsequently diagnosed by bone marrow biopsy as having a myelodysplastic syndrome, which will sometimes accompany PG. In addition, following a hysterectomy, the ulcers of the stump in the vagina and the perineum showed the characteristic findings of a PG-like destructive ulceration. Based on these findings, we finally diagnosed our case to have PG. PMID:18477229

  11. Alteration in sample preparation to increase the yield of multiplex Polymerase Chain Reaction assay for diagnosis of genital ulcer disease

    OpenAIRE

    Rao, G.; A Das; Prabhakar, P.; V Nema; Risbud, A. R.

    2013-01-01

    Purpose: Genital Ulcer Disease (GUD) is common sexually transmitted infection (STI). Multiple studies have shown that GUDs are strongly associated with the transmission and the acquisition of HIV infection. An accurate diagnosis of common etiology of GUD namely Herpes, syphilis and Chancroid is possible using Multiplex PCR (M-PCR). However, frequent presence of Polymerase Chain Reaction inhibitors in the ulcer swab specimen limits the performance of the assay. In order to overcome this proble...

  12. Lung disease and ulcerative colitis--mesalazine-induced bronchiolitis obliterans with organizing pneumonia or pulmonary manifestation of inflammatory bowel disease?

    Science.gov (United States)

    Moeser, A; Pletz, M W; Hagel, S; Kroegel, C; Stallmach, A

    2015-09-01

    Ulcerative colitis can be associated with numerous extraintestinal organ manifestations. Pulmonary disease in inflammatory bowel disease (IBD) is supposed to be a rare entity and has to be distinguished from infectious complications and side-effects of medications used in the treatment of IBD. We present the case of a 20-year-old male patient with ulcerative colitis and a 4-week history of respiratory symptoms, malaise, fever and respiratory insufficiency under a medication with mesalazine. Computed tomography showed bilateral subpleural consolidations, bronchoscopy revealed signs of acute bronchitis. The diagnostic work-up ruled out an infectious cause. Under the tentative diagnosis of a mesalazine-induced bronchiolitis obliterans with organizing pneumonia (BOOP) the medication with mesalazine was withdrawn and the patient received a corticosteroid trial. The symptoms quickly improved and prednisone was tapered and stopped after 6 months. Unexpectedly, lung function after complete resolution of respiratory symptoms revealed a residual obstructive ventilatory defect that might be due to an asymptomatic pulmonary manifestation of ulcerative colitis. A review of the literature shows that pulmonary manifestations in IBD as well as pulmonary toxicity of mesalazine might not be as rare as expected and should be included as differential diagnoses in the work-up of respiratory symptoms in patients with IBD. A pragmatic therapeutic approach is reasonable in critically ill patients as it is not always easy to distinguish both entities. PMID:26367026

  13. Radionuclide angiography and blood pool imaging to assess skin ulcer healing prognosis in patients with peripheral vascular disease

    International Nuclear Information System (INIS)

    Several non-invasive diagnostic techniques including segmental limb blood pressures, skin fluoresence, and photo plethysmography, have been evaluated as predictors of skin ulcer healing in patients with peripheral vascular disease, but none are widely used. Using 20mCi of Tc-99m phosphate compounds, four phase bone scans were obtained, including (1) radionuclide angiogram (2) blood pool image (3) 2 hour and 4-6 hour static images and (4) 24 hour static delayed images. The first two phases were used to assess vacularity to the region of distal extremity ulceration; the last two phases evaluated presence or absence of osteomyelitis. Studies were performed in 30 patients with non-healing ulcers of the lower extremities. Perfusion to the regions of ulceration on images was graded as normal, increased, or reduced with respect to the opposite (presumed normal) limb or some other normal reference area. Hypervascular response was interpreted as good prognosis for healing unless osteomyelitis was present. Clinicians followed patients for 14 days to assess limb healing with optimum care. If there was no improvement, angiography and/or surgery (reconstructive surgery, sympathectomy, or amputation) was done. Results showed: sensitivity for predicting ulcer healing was 94%, specificity 89%. Patients who failed to heal their ulcers showed reduced perfusion, no hypervascular response, or osteomyelitis. Microcirculatory adequacy for ulcer healing appear predictable by this technique

  14. Polymorphonuclear leucocytes in Crohn's disease and ulcerative proctocolitis: association between enhanced adherence to nylon fibre and disease variables.

    Science.gov (United States)

    Cason, J; Ainley, C C; Wolstencroft, R A; Thompson, R P

    1988-03-01

    The adherence of polymorphonuclear leucocytes (PMN) to nylon fibre was investigated in patients with Crohn's disease, ulcerative proctocolitis, and anorexia nervosa, and compared with changes of circulating PMNs, C reactive protein concentrations, erythrocyte sedimentation rates, and clinical assessment of disease activity. PMN adherence was in excess of the maximum value detected for healthy subjects in 14 of 25 patients with Crohn's disease and two of 10 with proctocolitis, but it was within the normal range for all eight with anorexia nervosa. High adherence in Crohn's disease, however, was not associated with quantitative or qualitative changes of PMN populations, absolute concentrations of C reactive protein, erythrocyte sedimentation rates, disease severity, drug regimens, malnutrition, or zinc deficiency. High PMN adherence in Crohn's disease may therefore reflect the activation in vivo of normal PMN by humoral factors. PMID:3360954

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Noninfectious genital ulcers.

    Science.gov (United States)

    Kirshen, Carly; Edwards, Libby

    2015-12-01

    Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnosis to avoid undue testing, stress, and anxiety in patients experiencing genital ulcerations. PMID:26650697

  17. A study of endotoxemia in ulcerative colitis and Crohn's disease. I. Clinical study.

    Directory of Open Access Journals (Sweden)

    Aoki,Kunitake

    1978-06-01

    Full Text Available Endotoxin (lipopolysaccharide, LPS and LPS antibody in the blood were studied in 61 cases of ulcerative colitis (U.C. by radioimmunoassay. Lysozyme (LZM concentration was also studied by the turbidimetric method. As a result, it was found that the blood LPS value as well as serum LZM concentration reflects the clinical observations. The case of endotoxemia in the active phase group showed a positive correlation between the LPS value and LZM concentration. LPS antibody which could not be detected in many cases of the active phase, had a high titer in cases of remission with a long history of the disease. These results would suggest that in U.C. with damaged intestinal mucosal barrier, LPS originating from intestinal flora enters into the blood and aggravates the disease and further that this invading LPS releases LZM into the blood. The same studies were performed on 7 cases of Crohn's disease and the same result was obtained.

  18. Risk factors and therapeutic response in Chinese patients with peptic ulcer disease

    Institute of Scientific and Technical Information of China (English)

    Shou-Wu; Lee; Teng-Yu; Lee; Hong-Zen; Yeh; Chun-Fang; Tung; Yen-Chun; Peng

    2010-01-01

    AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December 2008.The differences were compared.RESULTS:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers respectively.Patients with gastric ulcers were younger than those with duodenal ulcers.Although more me...

  19. Selective biologics for ulcerative colitis and Crohn's disease – clinical utility of vedolizumab

    Directory of Open Access Journals (Sweden)

    Petkau JM

    2016-03-01

    Full Text Available Jill MV Petkau, Bertus Eksteen Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Abstract: Inflammatory bowel disease (IBD encompasses a cluster of different disease phenotypes which are broadly classified into ulcerative colitis and Crohn's disease. Disease pathogenesis is driven by abnormal host immune responses to their resident gut microbiome in genetically susceptible individuals. Clinical disease features and outcomes are heterogenous and not unexpected as over 163 genetic loci are associated with disease susceptibility, and there are great variability in environmental exposures. Despite this variability, there has been relatively few efficacious therapies for particularly moderate-to-severe IBD. Treatment has been dominated by antitumor necrosis alpha agents with significant success but equally potentially serious adverse events. Therapeutic targeting of leucocyte trafficking has emerged as a viable alternative therapy, with vedolizumab being the lead compound. This review focuses primarily on its biological function as a selective gut immunotherapy, its safety and efficacy, and its emerging role as a mainstream therapy in managing IBD. Keywords: adhesion molecule antagonist, anti-α4β7 integrin, inflammatory bowel disease, leukocyte trafficking, monoclonal antibody, selective gut immunotherapy, tumor necrosis factor alpha

  20. Importance of Helicobacter pylori eradcation for maintenance of remission of drug associated peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Dajani A

    2006-01-01

    Full Text Available Background: The role of Helicobacter pylori (H. pylori eradication in non-steroidal anti inflammatory drug (NSAID users with peptic ulcer disease is controversial especially in countries with a high prevalence of the infection. Furthermore the value of low dose omeprazole for maintenance of remission is not yet known. Patients and methods: 138 symptomatic out-patients receiving continuous COX 1 NSAID therapy, were treated with omeprazole 40mg/day upon endoscopic confirmation of gastro-duodenal ulceration or erosions while those infected with H. pylori received in addition clarithromycin 500 mg and amoxycillin 1000 mg twice daily during the first week of treatment. After endoscopic confirmation of healing at the end of week 5, the patients were randomized to receive omeprazole 10 mg (n=50 or 20 mg once daily (n=66 and endoscopy repeated after 20 weeks. Results: The overall healing rate (per protocol at five weeks (116/128 was 90.6% while in 85.5% (65/76 eradication was successful. The healing rate for the H. pylori eradicated patients (58/65 was 89.2%. For those who failed eradication (8/11 it was 72.7% (NS, while for patients not infected with H. pylori at entry to the study (50/52 it was 96.2% (NS. An intention to treat analysis showed that after 20 weeks of omeprazole prophylaxis with the 10mg dose 86% (43/50 had maintained healing while for the 20mg dose a similar figure was observed (87.9; 58/66. Only three patients in the two groups (pp had persistent H. pylori infection, all of whom relapsed. No patients discontinued treatment because of adverse effects of the drugs. Conclusion: H. pylori eradication was not associated with impaired ulcer healing in a Middle Eastern population with symptomatic NSAID induced gastro/duodenal lesions, when a high healing dose of omeprazole (40 mg was used. After eradication, omeprazole 10 or 20 mg per day were highly and equally effective for maintenance of gastroduodenal mucosal integrity during continued

  1. Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

    Science.gov (United States)

    Amin, Noha; Doupis, John

    2016-01-01

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

  2. Phenotypic and genotypic characterization of Helicobacter pylori from patients with and without peptic ulcer disease

    DEFF Research Database (Denmark)

    Petersen, A M; Fussing, V; Colding, H;

    2000-01-01

    divided into five groups on the basis of upper endoscopic findings: gastric ulcer, duodenal ulcer, gastritis, esophagitis, or normal. The ultrastructural adherence pattern in vivo, autoagglutination, hemagglutination, adhesion to human gastric adenocarcinoma (AGS) cells, and the lipopolysaccharide (LPS...

  3. An erosive/ulcerative alimentary disease of undetermined etiology in Swedish moose (AIces alces L.

    Directory of Open Access Journals (Sweden)

    Margareta Stéen

    1993-12-01

    Full Text Available During the years 1985 to 1987, 689 moose (Alces alces L. collected throughout Sweden were necrop-sied at the National Veterinary Institute in Uppsala, Sweden. Sixty-eight of those investigated had catarrhal to hemorrhagic enteritis, atrophied lymphoid organs, and/or numerous erosive, uclerative, necrotizing lesions of the digestive mucosa. Histopathology of the mucous membranes revealed marked inter- and intracellular oedema, erosions, ulcers and intracytoplasmic inclusion bodies. Neither Bovine Virus Diarrhoea/Mucosal Disease (BVD/MD or Infectious Bovine Rhinotracheitis (IBR virus could be isolated from the diseased animals. It is suggested that the syndrome resembling BVD/MD complex, may have been caused by an yet unidentified virus.

  4. Acute genital ulcers.

    Science.gov (United States)

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  5. Fecal Microbial Composition of Ulcerative Colitis and Crohn’s Disease Patients in Remission and Subsequent Exacerbation

    OpenAIRE

    Edgar S Wills; Jonkers, Daisy M. A. E.; Paul H Savelkoul; Masclee, Ad A.; Pierik, Marieke J.; John Penders

    2014-01-01

    BACKGROUND: Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. DESIGN: Fecal samples from 10 Crohn's disease (CD) and 9 ulcerative colitis (UC) patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion crit...

  6. Herpes simplex virus type 1 in peptic ulcer disease: An inverse association with Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Klisthenis Tsamakidis; Efstathia Panotopoulou; Dimitrios Dimitroulopoulos; Dimitrios Xinopoulos; Maria Christodoulou; Alexandra Papadokostopoulou; Ioannis Karagiannis; Elias Kouroumalis; Emmanuel Paraskevas

    2005-01-01

    AIM: To assess the frequency of herpes simplex virus type Ⅰ in upper gastrointestinal tract ulcers and normal mucosa with the modern and better assays and also with a larger number of well characterized patients and controls and its relationship to Helicobacter pylori(H pylori).METHODS: Biopsy specimens from 90 patients (34 with gastric ulcer of the prepyloric area and 56 with duodenal ulcer) were evaluated. Biopsies from 50 patients with endoscopically healthy mucosa were considered as the control group. The method used to identify herpes simplex virus-1 (HSV-1) was polymerase chain reaction.H pylori was detected by the CLO-test and by histological method.RESULTS: Herpes simplex virus-1 was detected in 28 of 90 patients with peptic ulcer (31%) [11 of 34 patients with gastric ulcer (32.4%) and 17 of 56 with duodenal ulcer (30.4%)] exclusively close to the ulcerous lesion.All control group samples were negative for HSV-1.The likelihood of H pylori negativity among peptic ulcer patients was significantly higher in HSV-1 positive cases than in HSV-1 negative cases (P = 0.009). Gastric ulcer patients with HSV-1 positivity were Strongly associated with an increased possibility of Helicobacter pylori negativity compared to duodenal ulcer patients (P= 0.010).CONCLUSION: HSV-1 is frequent in upper gastrointestinal tract ulcers but not in normal gastric and duodenal mucosa. There is an inverse association between HSV-1 and H pylori infection.

  7. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B;

    1994-01-01

    physicians stated more causes than did their male colleagues (p < 0.01). Seventy-five per cent of the patients indicated that psychologic factors, such as grief, anxiety, and stress, were contributory causes of peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side...

  8. Antibacterial activity of extracts from Zostera marina against pathogens of Apostichopus japonicus skin ulceration disease

    Science.gov (United States)

    Liu, Yang; Jiang, Guoliang; Wu, Zhiqiang

    2010-03-01

    The purpose of this study was to investigate the antibacterial activity of extracts from Zostera marina against the pathogens of Apostichopus japonicus skin ulceration disease. When 95% ethanol (v/v) solvent was used to extract Zostera marina at 50°C, aqueous extract (ZA) showed obvious bacteriostatic effects on the tested bacterial strains (inhibition halo diameters between 8.23 mm and 13.62 mm), whereas the ethyl acetate extract (ZE) was almost inactive. The minimal inhibitory concentration (MIC) of ZA against four pathogens were homogeneous at 12.8 g L-1. ZA components were analyzed by thin layer chromatography (TLC) assay and six fractions were obtained. In another study, the six fractions showed inhibitory effects against the tested bacteria while their functions seemed to counteract the ZA activity.

  9. Crohn's disease but not chronic ulcerative colitis induces the expression of PAI-1 in enteric neurons

    DEFF Research Database (Denmark)

    Laerum, O.D.; Illemann, M.; Skarstein, A.;

    2008-01-01

    wall. The PAI-1 was seen in the perikarya of the neurons and a few proximal axons, whereas nerves were negative. uPAR was seen in nerves in all types of lesion varying from 21% to 88% of the cases, most frequent in colon adenocarcinomas. No uPAR-positive nerves were detected in normal colon......OBJECTIVES: Chronic inflammation of the intestinal wall is the common characteristic of Crohn's disease and ulcerative colitis; disorders, which in some cases can be difficult to distinguish. The inflammation also affects the local neuronal plexuses of the enteric nervous system. It is known that...... plasminogen activator inhibitor-1 (PAI-1) and urokinase receptor (uPAR) are upregulated in neurons after experimental peripheral nerve injury and have been linked to nerve regeneration. METHODS: The expression of PAI-1 and uPAR in neuronal cells in lesions of the gastrointestinal tract was analyzed by...

  10. Different risk factors influence peptic ulcer disease development in a Brazilian population

    Institute of Scientific and Technical Information of China (English)

    Rodrigo Buzinaro Suzuki; Rodrigo Faria Cola; Larissa Tranquilino Bardela Cola; Camila Garcia Ferrari; Fred Ellinger; Altino Luiz Therezo; Luis Carlos da Silva

    2012-01-01

    AIM:To investigate age,sex,histopathology and Helicobacter pylori (H.pylori) status,as risk factors for gastroduodenal disease outcome in Brazilian dyspeptic patients.METHODS:From all 1466 consecutive dyspeptic patients submitted to upper gastroscopy at Hospital das Clinicas of Marilia,antral biopsy specimens were obtained and subjected to histopathology and H.pylori diagnosis.All patients presenting chronic gastritis (CG)and peptic ulcer (PU) disease localized in the stomach,gastric ulcer (GU) and/or duodenal ulcer (DU) were included in the study.Gastric biopsies (n =668) positive for H.pylori by rapid urease test were investigated for vacuolating cytotoxin A (vacA) medium (m) region mosaicism by polymerase chain reaction.Logistic regression analysis was performed to verify the association of age,sex,histopathologic alterations,H.pylori diagnosis and vacA m region mosaicism with the incidence of DU,GU and CG in patients.RESULTS:Of 1466 patients submitted to endoscopy,1060 (72.3%) presented CG [male/female =506/554;mean age (year) ± SD =51.2 ± 17.81],88 (6.0%)presented DU [male/female =54/34; mean age (year)± SD =51.4 ± 17.14],and 75 (5.1%) presented GU[male/female =54/21; mean age (year) ± SD =51.3± 17.12] and were included in the comparative analysis.Sex and age showed no detectable effect on CG incidence (overall x2 =2.1,P =0.3423).Sex [Odds ratios (OR) =1.8631,P =0.0058] but not age (OR =0.9929,P =0.2699) was associated with DU and both parameters had a highly significant effect on GU (overall x2 =30.5,P < 0.0001).The histopathological results showed a significant contribution of ageing for both atrophy (OR =1.0297,P < 0.0001) and intestinal metaplasia (OR =1.0520,P < 0.0001).Presence of H.pylori was significantly associated with decreasing age (OR =0.9827,P < 0.0001) and with the incidence of DU (OR =3.6077,P < 0.0001).The prevalence of ml in DU was statistically significant (OR =2.3563,P =0.0018) but not in CG (OR =2.678,P =0.0863) and

  11. Dynamic observation of transforming growth factor-alpha content in plasma of pediatric patients with peptic ulcer disease

    International Nuclear Information System (INIS)

    Objective: To elicit the relationship between transforming growth factor alpha (TGF-α) and the pathogenesis as well as healing process of peptic ulcer disease (PUD) in pediatric patients. Methods: The levels of TGF-α in plasma were measured by radioimmunoassay in 57 Children with PUD. Results: TGF-α levels of plasma at active stage of peptic ulcer were significantly lower than those at healing stage as well as in controls (P 0.05). Conclusion: There is an abnormal secretion of TGF-α in PUD patients. Changes of TGF-α release might play a role in the pathogenesis of PUD

  12. Acute genital ulcers

    OpenAIRE

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on...

  13. Sweet's syndrome: an unusual cutaneous feature of Crohn's disease or ulcerative colitis. The South West Gastroenterology Group.

    Science.gov (United States)

    Travis, S; Innes, N; Davies, M G; Daneshmend, T; Hughes, S

    1997-07-01

    Sweet's syndrome is characterized by tender, red inflammatory nodules or papules, usually affecting the upper limbs, face or neck. It is part of the group of acute neutrophilic dermatoses that includes pyoderma gangrenosum, but can be distinguished by its appearance, distribution and histological features. Four patients with Sweet's syndrome and Crohn's disease are reported. A total of 30 cases from the literature suggest that Sweet's syndrome is an unusual extraintestinal manifestation of either Crohn's disease or ulcerative colitis. There is a strong predilection for women (87%), patients with colonic disease (100%) and those with other extraintestinal features (77%). The rash is associated with active disease in 67-80%, but may precede the onset of intestinal symptoms in 21% and has been reported 3 months after proctocolectomy for ulcerative colitis. PMID:9262983

  14. Refractory duodenal ulcer

    Directory of Open Access Journals (Sweden)

    Al Freihi Hussein

    1995-01-01

    Full Text Available Refractory or intractable ulcer is defined as an ulcer that fails to heal completely after eight to twelve weeks, despite appropriate treatment with a modern antiulcer therapy in a compliant patient. Refractory ulcer should be suspected in individuals diagnosed to have peptic ulcer if their symptoms persist longer than usual: occurrence of complications or simply their ulcers fail to heal, since up to 25% of such patients remain asymptomatic. Conditions associated with refractory ulcer include noncompliance, continuous consumption of nonsteroidal anti-inflam-matory drugs, acid hypersecretion, smoking. male gender and other factors with questionable role like advanced age, large ulcer size, prolonged duration of symptoms and the presence of complication like bleeding. Nonpeptic ulcers like tuberculosis, malignancy, Crohn′s disease and primary intestinal lymphoma should always be considered in the differential diagnosis. Colonization with H. pylori which is well-known as a cause of frequent recurrences, has not been linked with refractoriness. Patients with refractory ulcers must undergo thorough re-evaluation including repeated endoscopies, obtaining biopsies for microbiology and histology and determination of serum-gastrin level. Once diseases with identifiable etiologies have been ruled out, aggressive medical management with single or multiple antiulcer drugs should be instituted. Such treatments will virtually heal all refractory ulcers. Surgery should be reserved for patients whose ulcers fail to respond to optimal medical therapy or those who develop com-plications necessitating surgical intervention.

  15. Technetium-99m colloidal bismuth subcitrate: A novel method for the evaluation of peptic ulcer disease

    International Nuclear Information System (INIS)

    The therapeutic agent colloidal bismuth subcitrate (CBS) selectively binds to peptic ulcers. The authors have developed a method for labeling this agent with Tc-99m. Chromatographic quality control studies of the agent on silica gel coated strips (ITLC-SG) showed that more than 97% of Tc-99m was bound to CBS. During in-vitro stability testing, the radio-label was stable for a minimum of 6 hours. The chromatographic findings are in agreement with the in-vivo distribution of the agent which showed no significant radioactivity in thyroid, kidneys, liver, or bladder. The resulting Tc-99m-CBS solution is administered orally in drinking water. Preliminary animal studies have been conducted on 5 adult 3 kg New Zealand rabbits sedated with 50 mg Ketamine I.M. The rabbits were intubated with I.V. tubing advanced to the stomach. They were given a gastric erosive suspension of 600-1000 mg/kg of pulverized ASA in 10 cc tap water. Four hours later they were given 3-4 mCi of the radiotracer in a 5 cc volume of water. Serial in-vivo images were obtained for 2 hours which included thyroid, abdomen, and urinary bladder. Next the stomachs were excised, opened along the greater curvature, imaged, vigorously washed and reimaged. All 5 rabbits showed avid localized binding of radiotracer which remained fixed even with vigorous washing. Areas of normal appearing mucosa were relatively devoid of radiotracer. This new compound may have significant clinical usefulness in the detection of peptic ulcer disease. In addition, such a non-invasive technique, carrying none of the risks or discomfort of endoscopy could also find application in the evaluation of the response to therapy

  16. Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review

    Institute of Scientific and Technical Information of China (English)

    Jia-Qing Huang; Ge-Fan Zheng; Richard H Hunt; Wai-Man Wong; Shiu-Kum Lam; Johan Karlberg; Benjamin Chun-Yu Wong

    2005-01-01

    AIM: It is controversial whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H pylori) eradication treatment than those with peptic ulcer disease (PUD). To review the evidence for any difference in H pylori eradication rates between PUD and NUD patients. METHODS: A literature search for full articles and meeting abstracts to July 2004 was conducted. We included studies evaluating the efficacy of a proton pump inhibitor (P) or ranitidine bismuth citrate (RBC) plus two antibiotics of clarithromycin (C), amoxicillin (A), metronidazole (M), or P-based quadruple therapies for eradicating theinfection.RESULTS: Twenty-two studies met the criteria. No significant difference in eradication rates was found between PUD and NUD patients when treated with 7-d RBCCA, 10-d PCA or P-based quadruple therapies. When the 7-d PCA was used, the pooled H pylori eradication rate was 82.1% (431/525) and 72.6% (448/617) for PUD and NUD patients, respectively, yielding a RR of 1.15(95%CI 1.01-1.29). However, the statistically significant difference was seen only in meeting abstracts, but not in full publications.CONCLUSION: There is no convincing evidence to suggest that NUD patients respond to H pylori eradication treatments differently from those with PUD, although a trend exists with the 7-d PCA therapy.

  17. A Real World, Observational Registry of Chronic Wounds and Ulcers

    Science.gov (United States)

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  18. Fecal microbial composition of ulcerative colitis and Crohn's disease patients in remission and subsequent exacerbation.

    Directory of Open Access Journals (Sweden)

    Edgar S Wills

    Full Text Available BACKGROUND: Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. DESIGN: Fecal samples from 10 Crohn's disease (CD and 9 ulcerative colitis (UC patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion criteria were pregnancy, antibiotic use, enema use and/or medication changes between consecutive samples. The microbial composition was assessed by 16S rDNA pyrosequencing. RESULTS: After quality control, 6,194-11,030 sequences per sample were available for analysis. Patient-specific shifts in bacterial composition and diversity were observed during exacerbation compared to remission, but overarching shifts within UC or CD were not observed. Changes in the bacterial community composition between remission and exacerbation as assessed by Bray-Curtis dissimilarity, were significantly larger in CD versus UC patients (0.59 vs. 0.42, respectively; p = 0.025. Thiopurine use was found to be a significant cause of clustering as shown by Principal Coordinate Analysis and was associated with decreases in bacterial richness (Choa1 501.2 vs. 847.6 in non-users; p<0.001 and diversity (Shannon index: 5.13 vs. 6.78, respectively; p<0.01. CONCLUSION: Shifts in microbial composition in IBD patients with changing disease activity over time seem to be patient-specific, and are more pronounced in CD than in UC patients. Furthermore, thiopurine use was found to be associated with the microbial composition and diversity, and should be considered when studying the intestinal microbiota in relation to disease course.

  19. Systemic lupus erythematosus in association with ulcerative colitis: related autoimmune diseases.

    Science.gov (United States)

    Stevens, H P; Ostlere, L S; Rustin, M H

    1994-03-01

    We report a patient who developed urticaria, angio-oedema and polyarthropathy secondary to the hypocomplementaemic urticarial vasculitis syndrome, a year prior to the onset of ulcerative colitis. Ten years later, primary sclerosing cholangitis and the antiphospholipid syndrome developed concomitantly. We believe this patient represents only the second reported case of idiopathic systemic lupus erythematosus (SLE) occurring in association with ulcerative colitis. PMID:8148283

  20. Adult hypertrophic pyloric stenosis due to peptic ulcer disease: a rare presentation

    Directory of Open Access Journals (Sweden)

    Shameer Deen

    2016-05-01

    Full Text Available Primary adult hypertrophic stenosis is uncommon with an uncertain etiopathogenesis and associated gastric outlet obstruction mimics gastric carcinoma. We present a case of AHPS as sequel of peptic ulcer disease in a 72 year old male. With the advent of proton pump inhibitors as a mainstay of medical therapy, complication into gastric outlet obstruction is a rare disease today. Upper GI endoscopy revealed a distended stomach, residual food and a hyperemic bulky pylorus not accommodating the endoscope. Barium meal follow-through revealed a dilated stomach and minimal barium passing through the pylorus. Histological analysis revealed mild dysplasia at the focus with dense inflammatory infiltrates composed of lymphocytes and eosinophils in the lamina propria. No evidence of malignancy was noted, favouring chronic gastritis. The condition mimics other forms of proliferative disorders like carcinoma, gastrointestinal stromal tumors. We present the clinical findings, imaging analysis and discuss etiopathogenesis and management. [Int J Res Med Sci 2016; 4(5.000: 1730-1732

  1. Bacterial colonization of colonic crypt mucous gel and disease activity in ulcerative colitis.

    LENUS (Irish Health Repository)

    Rowan, Fiachra

    2012-02-01

    OBJECTIVE: To optimize total bacterial 16S rRNA quantification in microdissected colonic crypts in healthy controls and patients with ulcerative colitis (UC) and to characterize the findings with disease activity. BACKGROUND: Microscopic and molecular techniques have recently converged to allow bacterial enumeration in remote anatomic locations [eg, crypt-associated mucous gel (CAMG)]. The aims of this study were to combine laser capture microdissection (LCM) and 16S rRNA-based quantitative polymerase chain reaction (qPCR) to determine total bacterial copy number in CAMG both in health and in UC and to characterize the findings with disease activity. METHODS: LCM was used to microdissect CAMG from colonic mucosal biopsies from controls (n = 20) and patients with acute (n = 10) or subacute (n = 10) UC. Pan-bacterial 16S rRNA copy number per millimeter square in samples from 6 locations across the large bowel was obtained by qPCR using Desulfovibrio desulfuricans as a reference strain. Copy numbers were correlated with the UC disease activity index (UCDAI) and the simple clinical colitis activity index (SCCAI). RESULTS: Bacterial colonization of CAMG was detectable in all groups. Copy numbers were significantly reduced in acute UC. In subacute colitis, there was a positive correlation between copy number and UCDAI and SCCAI in the ascending, transverse and sigmoid colon. CONCLUSIONS: This study describes a sensitive method of quantitatively assessing bacterial colonization of the colonic CAMG. A positive correlation was found between CAMG bacterial load and subacute disease activity in UC, whereas detectable bacterial load was reduced in acute UC.

  2. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jun-Ying Xiang; Qin Ouyang; Guo-Dong Li; Nan-Ping Xiao

    2008-01-01

    AIM:To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC).METHODS: The enzyme-linked immunosorbent assay(ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria.RESULTS: The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls (402.16±48.0 μg/g vs 35.93±3.39 μg/g, 11.5±3.42 μg/g, P < 0.01). The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group (P < 0.05). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUCROC) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP,respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001).CONCLUSION: Calprotectin in the patient's feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonly-used markers such as CRP, ESR and AGR.

  3. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

    Science.gov (United States)

    Xiang, Jun-Ying; Ouyang, Qin; Li, Guo-Dong; Xiao, Nan-Ping

    2008-01-01

    AIM: To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC). METHODS: The enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS: The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls (402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P < 0.01). The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group (P < 0.05). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUCROC) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001). CONCLUSION: Calprotectin in the patient’s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonly-used markers such as CRP, ESR and AGP. PMID:18176961

  4. A STUDY ON HEALTH SEEKING BEHAVIOR OF PATIENTS WITH GENITAL ULCER DISEASE

    Directory of Open Access Journals (Sweden)

    Meetesh

    2014-03-01

    Full Text Available BACKGROUND: In developing countries, the proportion with STDs who present with genital ulcers is high compared to developed nations. AIM: 1. To study reaction of the cases toward their disease. 2. To study communication of cases with their partners. 3. To study treatment of symptoms and starting treatment, selfmedication & completion of treatment. 4. To study approach of health care providers. STUDY SETTINGS: Present study was carried out in Department of skin and VD, Medical College and SSG Hospital Baroda between June 2001 to Feb. 2003. MATERIAL AND METHODS: A cross sectional study was conducted. Sexually active male or female having genital ulcer with history of exposure in patient or partner. Total 216 cases were included in the study. Detailed history was taken and was recorded. An attempt was made to study health care seeking behavior in 60 cases. These cases were questioned about their reaction towards the disease treatment seeking including completion of treatment and time gap between appearance of symptoms and treatment taken were asked. They were also asked about the approach of the health care providers from whom they took treatment before coming to our clinic. RESULTS: It was observed that 57% of the cases among males were frightened after having GUD. They were likely to come to STD clinics at the earliest for treatment. Spousal communication was only 45% in male cases. Only 1/3rd cases came directly to STD clinic and the other visited other practitioners. Among these, only 60% took treatment from MBBS doctors or STD specialist. Rest of them went to unqualified health. Awareness about protective value of condom, as for as STI prevention is concerned, was 70% but consistent use was seen only in 2% cases. Twenty one percent cases did not know how to use condom, and 7% did not know about condoms at all. As many as 89% cases didn’t feel it necessary to use condoms during sexual relations with wife. CONCLUSION: Creating awareness

  5. Trends in peptic ulcer disease and the identification of Helicobacter Pylori as a causative organism: Population-based estimates from the US nationwide inpatient sample

    Directory of Open Access Journals (Sweden)

    Bronislava Bashinskaya

    2011-01-01

    Full Text Available Background: Peptic ulcer disease can lead to serious complications including massive hemorrhage or bowel perforation. The modern treatment of peptic ulcer disease has transitioned from the control of gastric acid secretion to include antibiotic therapy in light of the identification of Helicobacter pylori as a causative infectious organism. We sought to determine trends related to this discovery by using a national database. Materials and Methods: Patient discharges with peptic ulcer disease and associated sequelae were queried from the Nationwide Inpatient Sample, 1993 to 2007, under the auspices of a data user agreement. To account for the Nationwide Inpatient Sample weighting schema, design-adjusted analyses were used. Standard error was calculated using SUDAAN software (Research Triangle International, NC, USA. Results: Decreases in the incidences of gastrointestinal perforation, gastrointestinal hemorrhage, and surgical procedures most specific to peptic ulcer disease were statistically significant over the study period [range of P value (two tailed = 0.000 - 0.00353; significant at P < 0.001 to < 0.01]. The incidence of H. pylori rose dramatically, peaking at an estimated 97,823 cases in 1998 [SE = 3155; 95% CI = 6,184]. Since that time it has decreased and then stabilized. Conclusions: The identification of H. pylori as the causative agent in the majority of peptic ulcer disease has revolutionized the understanding and management of the disease. Medical conditions and surgical procedures associated with end-stage peptic ulcer disease have significantly decreased according to analysis of selected index categories. Resident physician education objectives may need to be modified in light of these trends. Review Criteria: We reviewed patients with peptic ulcer disease. The database used was the Nationwide Inpatient Sample, 1993 to 2007. Message for the Clinic: Medical therapy has resulted in decreased morbidity from H. pylori infection as it

  6. Ulcer disease prophylaxis in koi carp by bath immersion with chicken egg yolk containing anti-Aeromonas salmonicida IgY.

    Science.gov (United States)

    Gan, Hongjian; He, Haiwen; Sato, Atsushi; Hatta, Hajime; Nakao, Miki; Somamoto, Tomonori

    2015-04-01

    Ulcer disease, caused by atypical Aeromonas salmonicida, is a serious concern in ornamental koi carp, because it induces skin ulceration, disfiguring ornamental fish and causing economic loses. The present study aimed to establish a novel prophylaxis with chicken egg yolk immunoglobulin, IgY, against ulcer disease and to assess its feasibility in the ornamental fish industry. Addition of egg yolk powder containing anti-A. salmonicida IgY to rearing water provided significant protection against an A. salmonicida bath infection, whereas administration of non-specific IgY did not. Consecutive immersion of fish into rearing water containing specific IgY completely prevented ulcer disease resulting from cohabitation infection, indicating that this prophylaxis could prevent infection from such type of contact. Thus, passive immunization induced by immersing fish into aquarium water containing specific IgY is a prospective prophylaxis against diseases caused by pathogens that invade the skin and gills. PMID:25687817

  7. Pregnancy, fertility, and disease course in patients with Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Munkholm, NN

    2000-01-01

    Pattern recognition of the long-term disease course before, during, and after pregnancy can provide us with data about the influence of pregnancy on IBD, and vice versa. Determinants that predict an indolent versus an aggressive disease course are currently being sought. Our intention is to analyze...... the disease course during pregnancy in an EU-IBD inception cohort of 1200 patients diagnosed from 1991 to 1993 and followed up for 10 years. We also attempt to evaluate such factors as smoking and medication and to predict pregnancy course and fertility in IBD as well as in a cross-sectional study of...

  8. Stress ulcers - Cushing ulcers: diagnosis, treatment, prevention

    Directory of Open Access Journals (Sweden)

    R. Şcerbina

    2012-11-01

    Full Text Available BACKGROUND: Cushing ulcers appear at the 3rd to 5th day after stress situations accompanied with hemorrhage in 5-10%, perforations in 4%. METHODS: Between 2007-2011 in the National Scientific and Practical Center for Emergency Medicine Kishinev, 1917 patients with superior gastric hemorrhages were treated, from which 139 in ICU. RESULTS: In 45 cases were diagnosed Cushing ulcers: men – 30, women – 15 with age between 21 years and 87 years. The disease causes were: cerebral vascular diseases 13(28.8%; fractures with hip replacement – 16 (35.5%; chronic renal insufficiency and septic states - 3 (12.32%; severe head trauma – 10 (22.2%. The mortality rate was 22.2% (10 patients. Gastroscopy revealed hemorrhages followed by endoscopic hemostasis. For the prophylaxis of hemorrhage relapse all patients underwent repeated endoscopic hemostasis 2 to 3 times. One patient was operated for a perforated bulbar Cushing ulcer and another one due to Forrest IA hemorrhage that didn’t respond to endoscopic hemostasis – Bilroth I antrum resection. Both patients died due to multiple organ dysfunction syndrome (MODS. Patients with Cushing ulcers received anti-ulcer treatment: PPI, H2 blockers in maximum dosages, hemostatic and repeated blood plasma transfusions. CONCLUSIONS: Gastroscopy is obligatory in all patients with severe head trauma, septic states, chronic renal insufficiency and severe cerebral vascular diseases. Anti-ulcer and hemostatic treatment insures ulcer healing and scarring in most of the cases.

  9. Foot & Mouth Disease & Ulcerative/Vesicular Rule-outs: Challenges Encountered in Recent Outbreaks

    Energy Technology Data Exchange (ETDEWEB)

    Hullinger, P

    2008-01-28

    development and subsequent rupturing of vesicles at the coronary band and in the oral cavity. Vesicles and ulcerations can also occur on the mammary gland. Recovery in adult animals usually occurs in 8-15 days. Clinical signs for most serotypes are less dramatic in sheep and goats. Swine can develop very severe coronary band lesions and high mortality in piglets has been observed. One of the challenges of diagnosing FMD is that it may be clinically similar to several other vesicular or ulcerative diseases. FMD is clinically indistinguishable from Vesicular stomatitis, Swine vesicular disease and Vesicular exanthema of swine. It may also resemble Bovine viral diarrhea, Mucosal disease, Infectious bovine rhinotracheitis, Bluetongue, Bovine papular stomatitis, Bovine mammillitis and Rinderpest.

  10. Application of fecal calprotectin and myeloperoxidase in evaluation of disease activity of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    柏明见

    2013-01-01

    Objective To explore the clinical value of fecal calprotectin and myeloperoxidase in evaluation of ulcerative colitis(UC) activity.Methods Specimens of serum and feces over the same period were collected from

  11. Computed tomography of Crohn`s disease and ulcerative colitis; Computertomographische Morphologie von Morbus Crohn und Colitis ulcerosa

    Energy Technology Data Exchange (ETDEWEB)

    Klein, H.M. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Wein, B. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Adam, G. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Ruppert, D. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany)

    1995-07-01

    We analysed the CT examinations of 109 patients with 197 involved bowel locations. 81 patients suffered from Crohn`s disease, 28 from ulcerative colitis. Diagnosis was based on the combination of clinical, endoscopic and histopathologic findings. Three radiologists evaluated the CT series concerning the presence of morphologic changes analogous to conventional radiographic findings. In Crohn`s disease, we found irregular outer contours in 26% of cases. The bowel wall was thickened in 82%. In acute phases, the bowel wall was thickened in 100%. Abscess and fistula as complications of inflammatory disease were present in 26 and 14% respectively. In ulcerative colitis, a target sign of the bowel wall was present in 40%, whereas in Crohn`s disease a homogeneous wall density was present in all but two cases. Reduced attenuation due to submucosal fat deposits was found in 16% and mucosal tunneling in 27% of cases with ulcerative colitis. Even if severe mucosal destructions were found, the outer contour of the gut was smooth and regular in 95% of the ulcerative colitis cases. CT can provide additional information on acuity, extent and complications in inflammatory bowel disease. In combination with conventional radiographic findings a three-step classification for Crohn`s disease and ulcerative colitis (early changes, acute and chronic phase) can be proposed. (orig./MG) [Deutsch] Wir untersuchten computertomographisch 109 Patienten mit 197 erkrankten Darmsegmenten. 81 Patienten litten an M. Crohn und 28 an Colitis ulcerosa. Die Diagnose wurde durch Kombination klinischer, endoskopischer, radiologischer und bioptischer Befunde gesichert. Drei Radiologen bewerteten die Computertomographien und verglichen die Ergebnisse mit den konventionell-radiologischen Befunden. Bei den Patienten mit M. Crohn fanden wir in 26% der Faelle eine irregulaere aeussere Darmwand. Eine Darmwandverdickung lag in 82% vor und fand sich regelmaessig in Darmabschnitten mit floriden Veraenderungen

  12. Measurement of the healing ability of ischemic ulcers in the lower limbs in chronic arterial obstructive disease using 201Tl-Cl

    International Nuclear Information System (INIS)

    Evaluation of the healing ability of ischemic ulcers by a method involving measurement of the ulcer index (U. I.) and mean ulcer index of toes (mU. I.) using 201Tl-Cl before and after the treatment of chronic arterial obstructive disease accompanied by ischemic ulcer was studied. The lesions consisted of 56 ulcers in 41 limbs. Reactive hyperemia following avascularization stress was used for measurement, and U. I. was determined according to the method of Siegel et al. For cases with toe ulcers, the mU. I. was measured from plantar scintigrams, twice under stress and upon redistribution after 3 hours' rest. The following results were obtained. 1) The healing ability of the cases with a U. I. value of more than 1.4 was good, but even among cases with a pretreatment U. I. of 0.9 - 1.4, ulcer healing was also good in cases in which the U. I. was maintained above 1.4 as a result of various treatments. 2) Significant increases in U. I. were observed in the arterial reconstruction group after treatment, compared to the conservative treatment group and the lumbar sympathectomy group. 3) The healing ability was good in cases with an mU. I. of more than 1.2 at stress except for 2 ASO cases complicated by diabetes. 4) Although it was difficult to prognosticate the healing ability of cases with an mU. I. of less than 1.2 before treatment, healing ability could be evaluated after treatment on the basis of the appearance of significant increase in blood flow on stress in the ulcerated toes. 5) A stress index seemed to reflect the ischemic conditions in ulcerated toes in relation to stress. 6) U. I. and mU. I. measured using 201Tl-Cl were significantly correlated with the degree of inflammatory and reactive hyperemia in the floor of ulcers and in the ulcerated toes. (J.P.N.)

  13. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease: A Nationwide Population-Based Study.

    Science.gov (United States)

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-04-01

    To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset.This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531-534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model.During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19-142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03-1.34) compared to PUD patients without PPIs use.This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events. PMID:27100415

  14. Quantification of Helicobacter pylori infection in gastritis and ulcer disease using a simple and rapid carbon-14-urea breath test

    Energy Technology Data Exchange (ETDEWEB)

    Debongnie, J.C.; Pauwels, S.; Raat, A.; de Meeus, Y.; Haot, J.; Mainguet, P. (Department of Nuclear Medicine, University of Louvain Medical School, Brussels (Belgium))

    1991-06-01

    Gastric urease was studied isotopically in 230 patients with biopsy-proven normal mucosa or chronic gastritis, including 59 patients with ulcer disease. Carbon-14-urea was given in 25 ml of water without substrate carrier or nutrient-dense meal, and breath samples were collected over a 60-min period. The amount of 14CO2 excreted at 10 min was independent of the rate of gastric emptying and was not quantitatively influenced by the buccal urease activity. The 10-min 14CO2 values discriminated well between Helicobacter pylori positive and negative patients (94% sensitivity, 89% specificity) and correlated with the number of organisms assessed by histology. The test was a good predictor of chronic gastritis (95% sensitivity and 96% specificity), and a quantitative relationship was observed between 14CO2 values and the severity and activity of the gastritis. In H. pylori positive patients, breath 14CO2 was found to be similar in patients with and without ulcer disease, suggesting that the number of bacteria is not a determining factor for the onset of ulceration.

  15. Quantification of Helicobacter pylori infection in gastritis and ulcer disease using a simple and rapid carbon-14-urea breath test

    International Nuclear Information System (INIS)

    Gastric urease was studied isotopically in 230 patients with biopsy-proven normal mucosa or chronic gastritis, including 59 patients with ulcer disease. Carbon-14-urea was given in 25 ml of water without substrate carrier or nutrient-dense meal, and breath samples were collected over a 60-min period. The amount of 14CO2 excreted at 10 min was independent of the rate of gastric emptying and was not quantitatively influenced by the buccal urease activity. The 10-min 14CO2 values discriminated well between Helicobacter pylori positive and negative patients (94% sensitivity, 89% specificity) and correlated with the number of organisms assessed by histology. The test was a good predictor of chronic gastritis (95% sensitivity and 96% specificity), and a quantitative relationship was observed between 14CO2 values and the severity and activity of the gastritis. In H. pylori positive patients, breath 14CO2 was found to be similar in patients with and without ulcer disease, suggesting that the number of bacteria is not a determining factor for the onset of ulceration

  16. Birth outcome in women with ulcerative colitis and Crohn's disease, and pharmacoepidemiological aspects of anti-inflammatory drug therapy

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz

    2011-01-01

    conception, iii) the risk of adverse birth outcome in women with Crohn's disease according to type of anti-inflammatory drug treatment in pregnancy (sulfasalazine/5-aminosalicylic acid, steroids or azathioprine/6-mercaptopurine), and iv) the impact of disease activity in women with Crohn's disease on adverse......, including patients with ulcerative colitis and Crohn's disease. The third part (and the latest publications) includes birth outcome in women with Crohn's disease; and the methods of cohort establishment in these studies are developed and improved due to the knowledge gathered from conducting the earlier...... increased risk of preterm birth when women give birth 0-6 months after establishment of the diagnosis. It is considered whether the increased risk may be influenced by disease activity around the time of establishing the diagnosis. 2) No increased risk of giving birth to children with low birth weight...

  17. Sulphation of colonic and rectal mucin in inflammatory bowel disease: reduced sulphation of rectal mucus in ulcerative colitis.

    Science.gov (United States)

    Raouf, A H; Tsai, H H; Parker, N; Hoffman, J; Walker, R J; Rhodes, J M

    1992-11-01

    1. Normal colonic mucin is heavily sulphated and this increases its resistance to degradation by bacterial enzymes. Any defect in mucus sulphation could therefore be important in the pathogenesis of ulcerative colitis. 2. Rectal biopsies taken at colonoscopy from patients with ulcerative colitis (n = 9), patients with Crohn's disease (n = 6) and control subjects (n = 16) were cultured for 24 h in the presence of N-[3H]acetylglucosamine and [35S]sulphate. Mucin was then extracted and purified, and the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into pure mucin was assessed. 3. The ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was significantly reduced in rectal biopsies taken from patients with ulcerative colitis (0.463, 0.305-0.703, geometric mean and 95% confidence intervals) compared with control subjects (0.857, 0.959-1.111, P < 0.01). In patients with Crohn's disease the reduction in this ratio (0.559, 0.378-0.829) did not quite reach statistical significance (P = 0.06). There was no difference between the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin in Crohn's disease and that in ulcerative colitis (P = 0.26). 4. In control subjects the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was higher in the rectal biopsies (0.882, 0.618-1.022) than in their paired proximal colonic biopsies (0.602, 0.421-0.861; P < 0.01), but this regional variation was not observed in either ulcerative colitis (rectum: 0.450, 0.262-0.773; right colon: 0.470, 0.321-0.690, P = 0.3) or Crohn's disease (rectum: 0.459, 0.260-0.815; right colon: 0.492, 0.260-0.929, P = 0.8).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1335401

  18. Does Helicobacter pylori Eradication Reduce the Risk of Open Angle Glaucoma in Patients With Peptic Ulcer Disease?

    Science.gov (United States)

    Chen, Hsin-Yi; Lin, Cheng-Li; Chen, Wen-Chi; Kao, Chia-Hung

    2015-09-01

    To investigate whether Helicobacter pylori (H pylori) eradication would influence the risk of primary open angle glaucoma (POAG) in patients with peptic ulcer disease. From the Longitudinal Health Insurance Database 2000, 6061 patients with peptic ulcer and receiving H pylori eradication therapy were recruited. The study cohort was subdivided into early (within 1 year) and late (after 1 year) eradication cohorts. The 24,244 control cohort subjects were those who without peptic ulcer and without receiving H pylori eradication therapy and were frequency-matched with the H pylori eradication cohort by age, sex, and the year of receiving H pylori eradication therapy. The higher incidence of POAG was observed in late H pylori eradication cohort and in early H pylori eradication cohort than in control cohort (1.57, 1.32, and 0.95, per 1000 person-year, respectively). However, overall risk of glaucoma was not significantly higher in the late eradication than in the early eradication (adjusted hazard ratio = 0.85, 95% confidence interval = 0.48-1.53). The POAG incidence was greater in the late H pylori eradication cohort when follow-up duration ≤ 5 years (1.59, per 1000 person-years). However, when follow-up duration >5 years, the incidence of POAG was greater in the early H pylori eradication cohort (1.68, per 1000 person-years). These relationships were not associated with a significantly increased or decreased risk of POAG in multivariable analyses. Either early or late H pylori eradication does not significantly reduce the risk of glaucoma in patients with peptic ulcer disease compared with normal control. PMID:26426633

  19. Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Rahul S Mhaskar

    2013-01-01

    Full Text Available Background: Helicobacter pylori (H. pylori infection is a risk factor for peptic ulcer. There have been no studies addressing environmental and dietary risk factors in western India. We conducted a case control study enrolling peptic ulcer patients in Pune, India. Materials and Methods: Risk factors for peptic ulcer and H. pylori infection were assessed in a participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. Results: We enrolled 190 peptic ulcer, 35 stomach cancer patients, and 125 controls. Fifty-one percent (180/350 of the participants were infected with H. pylori. Lower socioeconomic status (SES [odds ratio (OR: 1.10, 95% confidence interval (CI: 1.02-1.39], meat consumption (OR: 2.35, 95% CI: 1.30-4.23, smoking (OR: 2.23, 95% CI: 1.24-4.02, eating restaurant food (OR: 3.77, 95% CI: 1.39-10.23, and drinking nonfiltered or nonboiled water (OR: 1.05, 95% CI: 1.01-1.23 were risk factors for H. pylori infection. H. pylori infection (OR: 1.70, 95% CI: 1.03-2.89, meat (OR: 1.10, 95% CI: 1.02-1.75, fish (OR: 1.05, 95% CI: 1.02-1.89 consumption, and a family history of ulcer (OR: 1.20, 95% CI: 1.08-1.60 were risk factors for peptic ulcer. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10-0.37 and parasite infestation (OR: 0.44, 95% CI: 0.24-0.80 were protective against H. pylori infection. Conclusion: H. pylori infection is associated with peptic ulcer. Lower SES, consumption of restaurant food, meat, nonfiltered water, and smoking are risk factors for H. pylori. Consumption of meat, fish, and a family history of peptic ulcer are risk factors for peptic ulcer. Consumption of chili peppers and concurrent parasite infestation appear to be protective against H. pylori.

  20. Is there a role for vedolizumab in the treatment of ulcerative colitis and Crohn’s disease?

    Directory of Open Access Journals (Sweden)

    Gilroy L

    2014-05-01

    Full Text Available Leah Gilroy, Patrick B Allen Department of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland Abstract: Inflammatory bowel disease (IBD is an important cause of morbidity and mortality for millions of patients worldwide. Current treatment options include corticosteroids, 5-aminosalicylates, immunosuppressants, and TNFα antagonists. However, these are frequently ineffective in achieving sustained response and remission over time. At present, gastroenterologists lack safe and effective treatments if patients fail anti-TNF therapy. Vedolizumab is a promising new agent for IBD patients refractory to anti-TNF therapy. Vedolizumab is an integrin antagonist which is thought to act by reducing inflammation by selectively inhibiting leukocyte migration in the gut. Emerging evidence from clinical trials suggests a potential role for vedolizumab in both ulcerative colitis (UC and Crohn’s disease (CD, particularly in patients who have previously failed biological therapy. The safety profile of vedolizumab appears reasonable, possibly because it has a “gut-selective” mode of action, with no reported cases of progressive multifocal leukoencephalopathy, a condition which has been linked to another integrin antagonist, natalizumab. This review discusses the available evidence for integrin antagonists and their potential role in the management of IBD. Keywords: vedolizumab, ulcerative colitis, Crohn’s disease, inflammatory bowel disease

  1. Update on the role of modified release mesalamine in the management of ulcerative colitis and Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Glen A Doherty

    2009-12-01

    Full Text Available Glen A Doherty, Mark A PeppercornCenter for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA, USAAbstract: 5-aminosalicyclates (5-ASA remain a key first-line therapy for patients with ulcerative colitis (UC. A range of 5-ASA preparations is available and Eudragit-S® coated modified release formulations of mesalamine, such as Asacol®, remain among the most popular choices. We here review the current understanding of the mechanism of action of 5-ASA in inflammatory bowel disease. We evaluate evidence supporting the efficacy and safety of modified release mesalamine for both induction and remission maintenance in UC, including a review of the data from the recent ASCEND studies. We also examine the controversial issue of the role of mesalamine in treatment of Crohn’s disease (CD and highlight data supporting its use following surgically induced remission of CD. Evidence supporting the use of mesalamine as prophylaxis for colorectal cancer and dysplasia will be considered. Finally, recent developments in our understanding of how to use modified release mesalamine in a safe and cost-effective manner are evaluated, including discussion of the importance of studying patient non-adherence as a key component of future studies in this area.Keywords: mesalamine (mesalazine, 5-aminosalicyclate, ulcerative colitis, Crohn’s disease, modified release

  2. Peripheral Ulcerative Keratitis

    Science.gov (United States)

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... unless they are treated. Rheumatoid arthritis is what causes peripheral ulcerative keratitis and death due to a ...

  3. Is Childhood Physical Abuse Associated with Peptic Ulcer Disease? Findings from a Population-Based Study

    Science.gov (United States)

    Fuller-Thomson, Esme; Bottoms, Jennifer; Brennenstuhl, Sarah; Hurd, Marion

    2011-01-01

    This study investigated childhood physical abuse and ulcers in a regionally representative community sample. Age, race and sex were controlled for in addition to five clusters of potentially confounding factors: adverse childhood conditions, adult socioeconomic status, current health behaviors, current stress and marital status, and history of…

  4. 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.

  5. Pressure ulcers.

    Science.gov (United States)

    O'Byrne, Deborah

    2016-04-13

    My nursing experience is in acute care. Acute medical nurses are well placed to assess skin integrity, identify patients at risk of pressure ulcer development, and commence appropriate interventions to prevent or treat pressure ulcers. PMID:27073966

  6. Isocitrate dehydrogenase of Helicobacter pylori potentially induces humoral immune response in subjects with peptic ulcer disease and gastritis.

    Directory of Open Access Journals (Sweden)

    M Abid Hussain

    Full Text Available BACKGROUND: H. pylori causes gastritis and peptic ulcers and is a risk factor for the development of gastric carcinoma. Many of the proteins such as urease, porins, flagellins and toxins such as lipo-polysaccharides have been identified as potential virulence factors which induce proinflammatory reaction. We report immunogenic potentials of isocitrate dehydrogenase (ICD, an important house keeping protein of H. pylori. METHODOLOGY/PRINCIPAL FINDINGS: Amino acid sequences of H. pylori ICD were subjected to in silico analysis for regions with predictably high antigenic indexes. Also, computational modelling of the H. pylori ICD as juxtaposed to the E. coli ICD was carried out to determine levels of structure similarity and the availability of surface exposed motifs, if any. The icd gene was cloned, expressed and purified to a very high homogeneity. Humoral response directed against H. pylori ICD was detected through an enzyme linked immunosorbent assay (ELISA in 82 human subjects comprising of 58 patients with H. pylori associated gastritis or ulcer disease and 24 asymptomatic healthy controls. The H. pylori ICD elicited potentially high humoral immune response and revealed high antibody titers in sera corresponding to endoscopically-confirmed gastritis and ulcer disease subjects. However, urea-breath-test negative healthy control samples and asymptomatic control samples did not reveal any detectable immune responses. The ELISA for proinflammatory cytokine IL-8 did not exhibit any significant proinflammatory activity of ICD. CONCLUSIONS/SIGNIFICANCE: ICD of H. pylori is an immunogen which interacts with the host immune system subsequent to a possible autolytic-release and thereby significantly elicits humoral responses in individuals with invasive H. pylori infection. However, ICD could not significantly stimulate IL8 induction in a cultured macrophage cell line (THP1 and therefore, may not be a notable proinflammatory agent.

  7. Genetic analysis of innate immunity in Crohn's disease and ulcerative colitis identifies two susceptibility loci harboring CARD9 and IL18RAP

    NARCIS (Netherlands)

    Zhernakova, Alexandra; Festen, Eleanora M; Franke, Lude; Trynka, Gosia; van Diemen, Cleo C; Monsuur, Alienke J; Bevova, Marianna; Nijmeijer, Rian M; van 't Slot, Ruben; Heijmans, Roel; Boezen, Hendrika; van Heel, David A; van Bodegraven, Adriaan A; Stokkers, Pieter C F; Wijmenga, Cisca; Crusius, J Bart A; Weersma, Rinse K

    2008-01-01

    The two main phenotypes of inflammatory bowel disease (IBD)--Crohn's disease (CD) and ulcerative colitis (UC)--are chronic intestinal inflammatory disorders with a complex genetic background. Using a three-stage design, we performed a functional candidate-gene analysis of innate immune pathway in IB

  8. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    (SPPH) as measured with a photocell. Thirty-two patients (35 feet with ulcerations) had diabetes mellitus. The treatment was conservative. In 42 feet the ulcers healed after an average period of 5.8 months; in 24 feet major amputation became necessary after an average of 4.3 months. The frequency of...... cases (9%) healed. Of the 11 cases with SDBP of 20 to 29 mmHg seven cases (64%) healed and of the 33 cases with SDBP of30 mmHg or above all cases (100%) healed. There was no significant difference between the 35 diabetic feet and the 31 non-diabetic feet as regards the healing rates, although infection...... and peripheral neuropathy were frequent in the diabetic group. The data show that the systolic digital blood pressure is a particularly valuable prognostic parameter....

  9. Microbial diversity of genital ulcer disease in men enrolled in a randomized trial of male circumcision in Kisumu, Kenya.

    Directory of Open Access Journals (Sweden)

    Supriya D Mehta

    Full Text Available BACKGROUND: Medical male circumcision (MMC reduces the risk of genital ulcer disease (GUD in men by 50%. In Ugandan and Kenyan trials, a sexually transmissible agent was not identified in 50-60% of GUD specimens by polymerase chain reaction (PCR assay. We sought to better define the etiology of GUD in men participating in the Kenyan trial and examine how MMC affects GUD etiology. METHODS: We defined GUD of unknown etiology as negative for HSV (type 1 and type 2, T. pallidum, and H. ducreyi by PCR, and negative for HSV-2 and T. pallidum by serology. We identified bacterial microbiota in a subset of 59 GUD specimens using multitag pyrosequencing of the 16S rRNA gene, and compared results by unknown vs. STI-associated etiology. Statistical analysis employed Bray-Curtis similarity measure of bacterial community by etiology, hierarchical clustering and logistic regression. RESULTS: In 59 GUD specimens from 59 men, 23 (39% had unknown etiology. Bacterial diversity was greater in GUD of unknown than STI etiology (p = 0.01. Fusobacteria (Fusobacterium spp. and Sneathia spp. were more commonly detected in men with GUD of unknown etiology [adjusted OR = 5.67; 95% CI: 1.63-19.8] as were Oxobacter spp. and Anaerovorax spp. [adjusted OR = 3.12; 95% CI: 0.83-11.7]. Sequences from these four anaerobic bacterial taxa were more often detected in uncircumcised men than circumcised men (p<0.05. CONCLUSIONS: Anaerobic bacteria are more common in genital ulcers of uncircumcised men. The specific anaerobic bacteria associated with GUD of unknown etiology have cytotoxic properties that can exacerbate epithelial disruptions leading to ulcer-like appearance. MMC may reduce GUD through a reduction in these anaerobic bacteria.

  10. Receptor binding sites for substance P in surgical specimens obtained from patients with ulcerative colitis and Crohn disease

    Energy Technology Data Exchange (ETDEWEB)

    Mantyh, C.R.; Gates, T.S.; Zimmerman, R.P.; Welton, M.L.; Passaro, E.P. Jr.; Vigna, S.R.; Maggio, J.E.; Kruger, L.; Mantyh, P.W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides (substance P (SP), substance K (SK), and neuromedin K (NK)) play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. In all cases, specimens were processed for quantitative receptor autoradiography by using /sup 125/I-labeled Bolton-Hunter conjugates of NK, SK, and SP. In colon tissue obtained from ulcerative colitis and Crohn disease patients, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscalairs mucosa, external circular muscle, external longitudinal muscle, and serosa, in contrast to control patients. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations by cells involved in mediating inflammatory and immune responses. These data suggest that SP may be involved in the pathophysiology of inflammatory bowel disease and might provide some insight into the interaction between the nervous system and the regulation of inflammation and the immune response in human inflammatory disease.

  11. Associations between diet and disease activity in ulcerative colitis patients using a novel method of data analysis

    Directory of Open Access Journals (Sweden)

    Curno Richard

    2005-02-01

    Full Text Available Abstract Background The relapsing nature and varying geographical prevalence of ulcerative colitis (UC implicates environmental factors such as diet in its aetiology. Methods In order to determine which foods might be related to disease activity in UC a new method of dietary analysis was developed and applied. Eighty-one UC patients were recruited at all stages of the disease process. Following completion of a 7 d diet diary, clinical assessment including a sigmoidoscopic examination (scale 0 (normal mucosa to 6 (very active disease was conducted. Food weights for each person were adjusted (divided by the person's calorific intake for the week. Each food consumed was given a food sigmoidoscopy score (FSS calculated by summing the products of the (adjusted weight of food consumed and sigmoidoscopy score for each patient and occurrence of food and dividing by the total (adjusted weight of the food consumed by all 81 patients. Thus, foods eaten in large quantities by patients with very active disease have high FSSs and vice versa. Foods consumed by Results High FSS foods were characterized by high levels of the anti-thiamin additive sulfite (Mann-Whitney, p Conclusions The dietary analysis method described provides a new tool for establishing relationships between diet and disease and indicates a potentially therapeutic diet for UC.

  12. Attempt to validate breakpoint MIC values estimated from pharmacokinetic data obtained during oxolinic acid therapy of winter ulcer disease in Atlantic salmon ( Salmo salar )

    DEFF Research Database (Denmark)

    Coyne, R.; Bergh, Ø.; Samuelsen, O.;

    2004-01-01

    Concentrations of oxolinic acid (OXA) were measured in the plasma, muscle, liver, and kidney of 48 Atlantic salmons (Salmo salar) 1 day after the end of an oral administration. OXA was administered over a period of 13 days to control an outbreak of winter ulcer disease in a commercial marine farm...

  13. Leg ulcers due to hyperhomocysteinemia

    OpenAIRE

    Krupa Shankar D; Akhib Syed

    2006-01-01

    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. Admin...

  14. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study

    DEFF Research Database (Denmark)

    Prompers, L.; Schaper, N.; Apelqvist, J.;

    2008-01-01

    such predictors differ between patients with and without PAD. Methods Analyses were conducted within the EURODIALE Study, a prospective cohort study of 1,088 diabetic foot ulcer patients across 14 centres in Europe. Multiple logistic regression modelling was used to identify independent predictors of...... outcome (i.e. non-healing of the foot ulcer). Results After 1 year of follow-up, 23% of the patients had not healed. Independent baseline predictors of non-healing in the whole study population were older age, male sex, heart failure, the inability to stand or walk without help, end-stage renal disease...

  15. Psychological status in Iranian patients with ulcerative colitis and its relation to disease activity and quality of life

    Directory of Open Access Journals (Sweden)

    Mahshid Tabatabaeian

    2015-01-01

    Full Text Available Background: Psychological profile of inflammatory bowel disease patients is not well studied in Iran. We investigated the psychological status of Iranian patients with ulcerative colitis (UC and its relationship with disease activity and quality of life (QOL. Materials and Methods: A cross-sectional study was conducted on adult UC patients. The Lichtiger Colitis Activity Index, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, and WHOQOL-BREF, were completed by the patients. Results: From 120 studied patients, 35 (29.2%, 48 (40.0%, and 46 (38.3% had significant anxiety, depression, and psychological distress, respectively. Anxiety, depression, and psychological distress were strongly correlated with disease activity (r = 0.357 to 0.439, P < 0.01. Disease activity was negatively correlated with all QOL dimensions (r = −0.245 to −0.550, P < 0.01. Anxiety, depression, and psychological distress were also negatively correlated with all QOL domains (r = −0.356 to −0.789, P < 0.01. In the regression models, anxiety was independently associated with active disease (β = 4.150, P = 0.049. Furthermore, disease activity was associated with the physical health (β = −0.371, P < 0.001. For almost all of the QOL domains, depression and psychological distress were independent predictors (β = −0.296 to −0.453, P < 0.001. Conclusion: Anxiety, depression, and psychological distress are highly frequent in UC patients of our society and are strongly associated with disease activity. Depression and psychological distress are important predictors of poor QOL in these patients. Further prospective studies, as well as clinical trials, are warranted in this regard.

  16. Alteration in sample preparation to increase the yield of multiplex Polymerase Chain Reaction assay for diagnosis of genital ulcer disease

    Directory of Open Access Journals (Sweden)

    G Rao

    2013-01-01

    Full Text Available Purpose: Genital Ulcer Disease (GUD is common sexually transmitted infection (STI. Multiple studies have shown that GUDs are strongly associated with the transmission and the acquisition of HIV infection. An accurate diagnosis of common etiology of GUD namely Herpes, syphilis and Chancroid is possible using Multiplex PCR (M-PCR. However, frequent presence of Polymerase Chain Reaction inhibitors in the ulcer swab specimen limits the performance of the assay. In order to overcome this problem, alternative specimen preparation method was used. Materials and Methods: To determine the common etiology, GUD specimens obtained under an STI operations research study were tested with M-PCR after the samples were prepared using Roche Amplicor specimen preparation kit. PCR inhibiting samples were identified from that, which showed negative results. These samples were subjected to phenol-chloroform extraction and ethanol precipitation before the conduct of M-PCR on them. Results: Of the 237 GUD specimens tested, in 145 etiologies could be detected, whereas 92 samples were found negative. Further spiking with one of the target DNA, 128 of the negative samples were found to contain the inhibitors. These 126 samples were then subjected to phenol chloroform extraction and ethanol precipitation followed by M-PCR. Using this method for sample preparation, etiology could be determined in 46 (23% additional samples. This success rate of altered sample preparation method has been lower than that has reported. Conclusion: The results indicate that sample preparation using phenol chloroform extraction and ethanol precipitation, prior to M-PCR helps to eliminate the inhibitors and increase the yield of the assay. However, being a laborious procedure, it may be used for samples giving negative results after the screening by Roche Amplicor specimen preparation kit.

  17. Association of Helicobacter pylori Ig A antibodies with the risk of peptic ulcer disease and gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Timo U Kosunen; Kari Sepp(a)l(a); Seppo Sarna; Arpo Aromaa; Paul Knekt; Jarmo Virtamo; Anniina Salomaa-R(a)s(a)nen; Hilpi Rautelin

    2005-01-01

    AIM: To compare the prevalence of Helicobacter pylori (Hpylori) IgG and IgA antibodies between adult subjects,with defined gastric diseases, nondefined gastric disorders and those representing the population.METHODS: Data on H pylori IgG and IgA antibodies,determined by enzyme immunoassay, were analyzed in 3 252 subjects with DGD including 482 patients with gastric ulcer, 882 patients with duodenal ulcer, 1 525patients with chronic gastritis only and 363 subjects with subsequent gastric cancer, 19 145 patients with NoDg and4 854 POPUL subjects. The age-adjusted prevalences were calculated for 1- and 20-year age cohorts.RESULTS: The prevalences of IgG antibodies were equally high (89-96%) in all 20-year age cohorts of the DGD groups, whereas the prevalences of IgG antibodies were lower and increased by age in the POPUL and NoDg groups. The prevalences of IgA antibodies were also higher in the DGD groups; among them CA (84-89%) and GU groups (78-91%) showed significantly higher prevalences than DU (68-77%) and CG patients (59-74%) (OR 2.49, 95%CI 1.86-3.34 between the GU and DU groups). In the CA, GU, and DU groups, the IgA prevalences showed only minor variation according to age, while they increased by age in the CG, POPUL, and NoDg groups (P≤0.0001). The IgA response, but not the IgG response, was associated with an increased risk of CA (OR 2.41, 95%CI 1.79-3.53) and GU (OR 2.57,95%CI 1.95-3.39) in comparison with CG patients.CONCLUSION: An IgA antibody response during H pylori infection is significantly more common in CA and GU patients as compared with CG patients.

  18. Low Level Laser Therapy to Reduce Recurrent Oral Ulcers in Behçet’s Disease

    Directory of Open Access Journals (Sweden)

    D. B. Gandhi Babu

    2016-01-01

    Full Text Available Behçet’s disease (BD is a chronic, relapsing multisystemic vascular condition. Behçet’s disease was described by Hulusi Behçet in 1937. This rare multisystem relapsing-remitting inflammatory disease is poorly understood but is thought to be an autoimmune inflammatory vasculitic process in a genetically predisposed population. Diagnosis of Behçet’s disease is based on International Criteria of Behçet’s Disease (ICBD. The present paper describes a case report of Behçet’s syndrome where aphthous stomatitis was treated with low level laser therapy.

  19. Low Level Laser Therapy to Reduce Recurrent Oral Ulcers in Behçet's Disease

    Science.gov (United States)

    Babu, D. B. Gandhi; Chavva, Sunanda; Waghray, Shefali

    2016-01-01

    Behçet's disease (BD) is a chronic, relapsing multisystemic vascular condition. Behçet's disease was described by Hulusi Behçet in 1937. This rare multisystem relapsing-remitting inflammatory disease is poorly understood but is thought to be an autoimmune inflammatory vasculitic process in a genetically predisposed population. Diagnosis of Behçet's disease is based on International Criteria of Behçet's Disease (ICBD). The present paper describes a case report of Behçet's syndrome where aphthous stomatitis was treated with low level laser therapy. PMID:27555969

  20. Integrating analysis reveals microRNA-mediated pathway crosstalk among Crohn's disease, ulcerative colitis and colorectal cancer.

    Science.gov (United States)

    Bai, Jing; Li, Yongsheng; Shao, Tingting; Zhao, Zheng; Wang, Yuan; Wu, Aiwei; Chen, Hong; Li, Shengli; Jiang, Chunjie; Xu, Juan; Li, Xia

    2014-07-29

    Inflammatory bowel disease (IBD), which can increase the risk of colorectal cancer (CRC), includes two primary subtypes, ulcerative colitis (UC) and Crohn's disease (CD). Although several individual genes involved in inflammation or cancer characterization have been identified, it is still difficult to elucidate functional relationship details between the molecules underlying pathogenesis at the system level. The global effect of miRNAs on genes or their involved functions is also poorly understood. We first integrated genome-wide gene expression profiles and biological pathway information to explore the underlying associations among UC, CD and CRC at the function and gene level. After identifying the pathways regulated by miRNAs, a global map of miRNA-mediated pathway crosstalk shared by the three diseases was further constructed to vertically explain the links of three level alterations. The three types of diseases have close associations with each other at the levels of function, gene and miRNA regulation. Several key biological pathways are involved in the three diseases, related to the immune system and inflammation, metabolism, or cell proliferation and apoptosis etc. Moreover, miRNAs exhibit dominant effects on multiple pathways. It is worth noting that UC shows relatively close associations with CD and CRC at the three levels. Finally, the miRNAs could mediate the crosstalk within or between pathways. For example, hsa-miR-125b, hsa-miR-335 and hsa-miR-155 mediated the crosstalk between three metabolic pathways. The crosstalk within the Toll-like receptor signaling pathway could be mediated by hsa-miR-124, hsa-miR-146a and hsa-mir-221/222. Our results make sense for the prevention and treatment of intestinal-related chronic inflammation or cancer. PMID:24949825

  1. Fecal Microbial Composition of Ulcerative Colitis and Crohn’s Disease Patients in Remission and Subsequent Exacerbation

    Science.gov (United States)

    Wills, Edgar S.; Jonkers, Daisy M. A. E.; Savelkoul, Paul H.; Masclee, Ad A.; Pierik, Marieke J.; Penders, John

    2014-01-01

    Background Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. Design Fecal samples from 10 Crohn’s disease (CD) and 9 ulcerative colitis (UC) patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion criteria were pregnancy, antibiotic use, enema use and/or medication changes between consecutive samples. The microbial composition was assessed by 16S rDNA pyrosequencing. Results After quality control, 6,194–11,030 sequences per sample were available for analysis. Patient-specific shifts in bacterial composition and diversity were observed during exacerbation compared to remission, but overarching shifts within UC or CD were not observed. Changes in the bacterial community composition between remission and exacerbation as assessed by Bray-Curtis dissimilarity, were significantly larger in CD versus UC patients (0.59 vs. 0.42, respectively; p = 0.025). Thiopurine use was found to be a significant cause of clustering as shown by Principal Coordinate Analysis and was associated with decreases in bacterial richness (Choa1 501.2 vs. 847.6 in non-users; p<0.001) and diversity (Shannon index: 5.13 vs. 6.78, respectively; p<0.01). Conclusion Shifts in microbial composition in IBD patients with changing disease activity over time seem to be patient-specific, and are more pronounced in CD than in UC patients. Furthermore, thiopurine use was found to be associated with the microbial composition and diversity, and should be considered when studying the intestinal microbiota in relation to disease course. PMID:24608638

  2. Infliximab therapy for moderately severe Crohn’s disease and ulcerative colitis: a retrospective comparison over 6 years

    Directory of Open Access Journals (Sweden)

    Raed Alzafiri

    2011-01-01

    Full Text Available Raed Alzafiri1, Christina A Holcroft2, Paula Malolepszy1, Albert Cohen1, Andrew Szilagyi11Jewish General Hospital, Division of Gastroenterology, Department of Medicine, McGill University School of Medicine, Montreal, Quebec, Canada; 2Centre for Clinical Epidemiology and Community Studies, McGill University School of Medicine, Montreal, Quebec, CanadaBackground: Infliximab has shown benefit in Crohn’s disease (CD and ulcerative colitis (UC.Objective: Evaluation of long-term outcome of therapy for both diseases.Methods: We analyzed retrospectively patients treated at infusion centers from one institution. Demographic, laboratory parameters leading up to biologic therapy and the subsequent pattern of outcomes in either disease were established as a database. Initial failure, subsequent need to change therapy, or need to adjust therapy were evaluated. Kruskal–Wallis (nonparametric tests to compare two groups and Kaplan–Meier survival curve analysis were used to compare outcomes.Results: Over approximately 6 years, 71 CD and 26 UC patients received 999 and 215 infusions, respectively, for a median of 62 months. Of these, 17% for CD and 19% for UC patients were primary failures. Following the start of infliximab, 18% of CD and 11% of UC patients required stoppage and switching to another type of therapy. In either CD or UC patients, 54% or 62%, respectively, continued therapy without the need to change to other treatments. Few serious side effects were noted. No important statistically significant differences in treatment patterns or outcome were observed between the groups.Discussion: Long-term treatment of both inflammatory bowel diseases reflects outcomes of clinical trials.Conclusions: This study emphasizes similarities between CD and UC and reports therapeutic success for an extended time.Keywords: infliximab, inflammatory bowel diseases

  3. Computed tomographic findings in penetrating peptic ulcer

    International Nuclear Information System (INIS)

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease

  4. Quality of Life Is Related to Fecal Calprotectin Concentrations in Colonic Crohn Disease and Ulcerative Colitis, but not in Ileal Crohn Disease.

    Science.gov (United States)

    Gauss, Annika; Geib, Thomas; Hinz, Ulf; Schaefert, Rainer; Zwickel, Philipp; Zawierucha, Anna; Stremmel, Wolfgang; Klute, Lukas

    2016-04-01

    To formulate therapy goals, we aimed to define the relationship between fecal calprotectin and health-related quality of life in inflammatory bowel diseases (IBDs). This retrospective single-center cross-sectional study included ambulatory IBD patients who had completed standardized questionnaires comprising items of health-related quality of life (Short Inflammatory Bowel Disease Questionnaire) and clinical disease activity scores, and who had provided stool samples for calprotectin determination within 30 days of questionnaire completion. Correlation analyses were performed between the indicated parameters. Post hoc analysis was conducted, taking into account only data from patients with fecal calprotectin concentrations measured within 3 days of questionnaire completion. One hundred ninety-seven patients with Crohn disease and 111 patients with ulcerative colitis were enrolled in the study. Lower fecal calprotectin concentrations were associated with better health-related quality of life. The correlations were weak, but stronger if only fecal calprotectin concentrations measured within 3 days of questionnaire completion were included (results for 3 days; Crohn disease: n = 86, rS = -0.419, P care should be taken to keep the time between clinical evaluation of IBD patients and the determination of fecal calprotectin concentrations as short as possible. PMID:27100452

  5. Genetics Home Reference: ulcerative colitis

    Science.gov (United States)

    ... my area? Other Names for This Condition colitis gravis idiopathic proctocolitis inflammatory bowel disease, ulcerative colitis type ... for professional medical care or advice. Users with questions about a personal health condition should consult with ...

  6. Tuberculous ulcer of the penis

    OpenAIRE

    Venkataramaiah, N. R.; van Raalte, J. A.; Dutta, S. N.

    1982-01-01

    Two cases of tuberculosis of the penis are presented because of the rarity of the disease. Stress is laid on the histopathological confirmation of the diagnosis of all penile ulcers before contemplating the line of treatment.

  7. Differences in Visceral Fat and Fat Bacterial Colonization between Ulcerative Colitis and Crohn’s Disease. An In Vivo and In Vitro Study

    OpenAIRE

    Zulian, Alessandra; Cancello, Raffaella; Ruocco, Chiara; Gentilini, Davide; Di Blasio, Anna Maria; Danelli, Piergiorgio; Micheletto, Giancarlo; Cesana, Elisabetta; Invitti, Cecilia

    2013-01-01

    Crohn’s disease (CD) is notably characterized by the expansion of visceral fat with small adipocytes expressing a high proportion of anti-inflammatory genes. Conversely, visceral fat depots in ulcerative colitis (UC) patients have never been characterized. Our study aims were a) to compare adipocyte morphology and gene expression profile and bacterial translocation in omental (OM) and mesenteric (MES) adipose tissue of patients with UC and CD, and b) to investigate the effect of bacterial inf...

  8. Differences in Visceral Fat and Fat Bacterial Colonization between Ulcerative Colitis and Crohn’s Disease. An In Vivo and In Vitro Study

    OpenAIRE

    Alessandra Zulian; Raffaella Cancello; Chiara Ruocco; Davide Gentilini; Anna Maria Di Blasio; Piergiorgio Danelli; Giancarlo Micheletto; Elisabetta Cesana; Cecilia Invitti

    2013-01-01

    Crohn's disease (CD) is notably characterized by the expansion of visceral fat with small adipocytes expressing a high proportion of anti-inflammatory genes. Conversely, visceral fat depots in ulcerative colitis (UC) patients have never been characterized. Our study aims were a) to compare adipocyte morphology and gene expression profile and bacterial translocation in omental (OM) and mesenteric (MES) adipose tissue of patients with UC and CD, and b) to investigate the effect of bacterial inf...

  9. Deposits of terminal complement complex (TCC) in muscularis mucosae and submucosal vessels in ulcerative colitis and Crohn's disease of the colon.

    OpenAIRE

    Halstensen, T S; Mollnes, T.E.; O. Fausa; Brandtzaeg, P

    1989-01-01

    Extensively washed, ethanol fixed and paraffin embedded colonic specimens from 15 patients with ulcerative colitis (UC) and nine patients with Crohn's disease (CD) of the colon, ileal specimens from six patients with CD of the ileum, and histologically normal control specimens obtained from 10 patients operated for colonic carcinoma, were examined by immunohistochemistry with a monoclonal antibody specific for a neoepitope in the C9 part of the terminal complement complex (TCC). The submucosa...

  10. 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

  11. Leisure-time physical activity in Canadians living with Crohn disease and ulcerative colitis: population-based estimates.

    Science.gov (United States)

    Mack, Diane E; Wilson, Philip M; Gilmore, Jennica C; Gunnell, Katie E

    2011-01-01

    The purpose of this study was to provide population-based estimates of leisure-time physical activity (LTPA) in Canadians diagnosed with Crohn disease (CD) or ulcerative colitis (UC). Data were derived from the Canadian Community Health Survey Cycle 3.1 (2005). Those diagnosed with CD (n = 474; 61.60% female) or UC (n = 637; 65.10% female) were compared with those not reporting CD/UC (n = 113,685; 53.60% female). The most prevalent forms of LTPA reported were walking and gardening/yard work. Individuals with CD were more likely to be classified as "inactive" (OR = 1.34; 95% CI [1.12, 1.61]) and less likely to be "active" (OR = 0.69; 95% CI [0.55, 0.87]) than those not reporting CD/UC. These trends were mirrored for those living with UC, although statistical significance was not attained. Despite claims advocating the benefits of LTPA for ameliorating complications associated with CD/UC, prevalence estimates from a population-based sample of Canadians living with CD/UC suggest that the majority do not meet current public health guidelines. Results offer benchmarks for prevalence of LTPA in those diagnosed with CD/UC. Findings suggest that many living with this condition will not benefit from the protective role of LTPA on complications associated with CD/UC. PMID:21814062

  12. Histopathologic features of Mycobacterium ulcerans infection

    NARCIS (Netherlands)

    Guarner, J; Bartlett, J; Whitney, EAS; Raghunathan, PL; Stienstra, Y; Asamoa, K; Etuaful, S; Klutse, E; Quarshie, E; van der Werf, TS; van der Graaf, WTA; King, CH; Ashford, DA

    2003-01-01

    Because of the emergence of Buruli ulcer disease, the World Health Organization launched a Global Buruli Ulcer Initiative in 1998. This indolent skin infection is caused by Mycobacterium ulcerans. During a study of risk factors for the disease in Ghana, adequate excisional skin-biopsy specimens were

  13. 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.

  14. Pharmacotherapy of recurrent aphthous ulcers

    Directory of Open Access Journals (Sweden)

    J P Angeline Archana

    2011-01-01

    Full Text Available Aphthous ulcer is the most common type of ulcer affecting the oral cavity and is considered to be one of the most painful conditions. Treatment is often unsatisfactory. Newer treatment modalities are therefore being tried. Amlexanox and rebamipide are the approved drugs for painful aphthous ulcers and have been used in painful symptoms of acid peptic disease as prostaglandin enhancers. Safety and efficacy of the drugs used in the treatment of recurrent aphthous ulcers were evaluated and being used widely by most of the treating physicians choosing a modality of treatment of their experience. There is no proper treatment modality available till date. Various drugs and their efficacy with least adverse drug effects while treating the various aphthous ulcers are discussed.

  15. A study of psychiatric morbidity in patients of peptic ulcer diseases

    OpenAIRE

    Sidhu, B. S.; Jagpal Singh Klair

    2012-01-01

    Background: A stressful life event or situation-internal or external, acute or chronic-generates challengesto which the organism cannot adequately respond some times. Recent studies have found that the peoplewho face general stresses pessimistically are apt to experience psychosomatic disorders. Psychologicalfactors like stress are important in development of initiation, progression, aggravation, predisposition orreaction to disease. For example, a stressful event might lead to exacerbation o...

  16. Effects of Moringa oleifera, A Plant Extract Coded OBAYOKOU on Ulcers Caused by Mycobacterium ulcerans In Children under 15 Years in Côte d'Ivoire

    OpenAIRE

    Kodia M; Trébissou Jonhson Noel D; Crezoit Yapo A; Eyangoh S; Asse H

    2014-01-01

    The aqueous extract of a plant coded OBAYOKOU (Moringa oleifera ) has been tested on the healing of ulcers in children under 15 years, two lots of 15 children each were made all presenting clinical forms of Buruli ulcer. The aqueous plant extract of Moringa oleifera was added to the food supply given to Lot B (lot of experimental subjects) at a rate of 330 ml per meal per child for six weeks. Children of Lot A (control Lot) received normal diet without Moringa oleifera. The results of this st...

  17. Subtotal Gastrectomy With Billroth II Anastomosis Is Associated With a Low Risk of Ischemic Stroke in Peptic Ulcer Disease Patients

    Science.gov (United States)

    Chen, Chien-Hua; Lin, Cheng-Li; Kao, Chia-Hung

    2016-01-01

    Abstract Duodenal diversion can ameliorate lipid and glucose metabolism. We assessed the risk of stroke after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) in peptic ulcer disease (PUD). We identified 6425 patients who received SGBIIA for PUD between 1998 and 2010 from the Taiwan National Health Insurance Research Database as the study cohort; we frequency-matched them with 25,602 randomly selected controls from the PUD population who did not receive SGBIIA according to age, sex, index year, and comorbidities including hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease (COPD), and obesity. All patients were followed until the end of 2011 to determine the incidence of stroke. The incidence of stroke was lower in patients in the SGBIIA cohort than in those in the non-SGBIIA cohort (18.9 vs 22.9 per 1000 person-years, adjusted hazard ratio [aHR] 0.80, 95% confidence interval [CI] 0.72–0.89, P < 0.001). The risk of ischemic stroke (aHR 0.77, 95% CI 0.69–0.86, P < 0.001), rather than hemorrhagic stroke (aHR 1.00, 95% CI 0.78–1.28), was lower for the SGBIIA cohort than for the non-SGBIIA cohort according to the multivariable Cox proportional hazard regression analysis. The relative risk of ischemic stroke after SGBIIA was lower in men (aHR 0.77, 95% CI 0.69–0.86) than in women (aHR 0.80, 95% CI 0.65–0.99) and in patients aged ≥65 years (aHR 0.72, 95% CI 0.63–0.81) than in those of other age groups (≤49 years, aHR 0.82, 95% CI 0.48–1.39; 50–64 years, aHR 1.01, 95% CI 0.79–1.28). The relative risk of ischemic stroke after SGBIIA was also reduced in patients with comorbidities (aHR 0.84, 5% CI 0.75–0.95) rather than in those without comorbidities (aHR 0.81, 95% CI 0.59–1.12). SGBIIA is associated with a low risk of ischemic stroke for PUD patients, and its protective effect is prominent in men, patients aged ≥65

  18. ULCERATED ACROCHORDON IN VULVA

    Directory of Open Access Journals (Sweden)

    Borré-Arrieta Orlando

    2015-01-01

    Full Text Available Introduction: the acrochordon, also known as soft fibromas, is a dermatological disease of common location in the cutaneous folds. Its appearance in external genitalia is weird, but it generates negative consequences regarding the quality of life of the patients. Due to the typical characteristics of the genital area in women, it increases the risk of ulceration and superinfection. Case record: patient in the third decade of life with lesion of slow growth in the vulvar area, who attended late to the emergency service because of the presence of laceration and infection signs in the genital lesion. Conclusions: the acrochordon in vulva or vulvar fibroma is a vulvar benign and uncommon disease, however it always merits opportune treatment by esthetic reason as for the ulceration risk. Revista ciencias biomédicas. 2015;6(1:138-141 KEYWORDS Vulva; Vulvar diseases; Vulvar neoplasms.

  19. Peripheral Blood Based Discrimination of Ulcerative Colitis and Crohn’s Disease from Non-IBD Colitis by Genome-Wide Gene Expression Profiling

    OpenAIRE

    Ferenc Sipos; Orsolya Galamb; Barnabás Wichmann; Tibor Krenács; Kinga Tóth; Katalin Leiszter; Györgyi Műzes; Tamás Zágoni; Zsolt Tulassay; Béla Molnár

    2011-01-01

    A molecular diagnostic assay using easily accessible peripheral blood would greatly assist in the screening and diagnosis of ulcerative colitis (UC) and Crohn’s disease (CD). Transcriptional profiles in blood/biopsy samples from 12 UC (6/12), 9 CD (5/9), 6 non-inflammatory bowel disease (non-IBD) colitis (6/0), and 11 healthy (11/11) patients were assessed by Affymetrix HGU133Plus2.0 microarrays. Prediction analysis of microarrays, discriminant and ROC analyses were performed, the results wer...

  20. Genetic Analysis of Innate Immunity in Crohn's Disease and Ulcerative Colitis Identifies Two Susceptibility Loci Harboring CARD9 and IL18RAP

    OpenAIRE

    Zhernakova, Alexandra; Festen, Eleanora M.; Franke, Lude; Trynka, Gosia; Diemen, Cleo C van; Monsuur, Alienke J.; Bevova, Marianna; Nijmeijer, Rian M.; van ‘t Slot, Ruben; Heijmans, Roel; Boezen, H. Marike; van Heel, David A; van Bodegraven, Adriaan A.; Stokkers, Pieter C. F.; Wijmenga, Cisca

    2008-01-01

    The two main phenotypes of inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—are chronic intestinal inflammatory disorders with a complex genetic background. Using a three-stage design, we performed a functional candidate-gene analysis of innate immune pathway in IBD. In phase I, we typed 354 SNPs from 85 innate immunity genes in 520 Dutch IBD patients (284 CD, 236 UC) and 808 controls. In phase II, ten autosomal SNPs showing association at p < 0.006 in phase I...

  1. Studies on the pathogenic bacterium of ulcer disease in Epinephelus awoara

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Studies were conducted to determine the cause of the acute mortality of cage-cultured Epinephelus awoara in the Tong'an Bay of Xiamen, China during the summer of 2002. Predominant bacteria strain TS-628 was isolated from the diseased grouper. The virulence test confirmed that TS-628 was the pathogenic bacterium. Biochemical characteristics of the isolates were determined using the automatic bacterial identification system and standard tube tests. To further confirm the identification, a 1 121 bp 16S rRNA gene sequence of the isolate was amplified by PCR, which had been deposited into Genbank (accession number: AY747308). According to the biochemical characteristics and by comparing the 16S rRNA gene homology of the isolate, the pathogenic bacterium was identified as Vibrio harveyi. Drug sensitivity tests showed that this pathogenic bacterium was sensitive to 16 antibacterials, especially to chloramphenicol and actinospectacin, but completely resistant to antibacterials likes vancomycin, penicillin, lincomycin, and so on.

  2. Indirect health costs in ulcerative colitis and Crohn's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2015-04-01

    The aim of this systematic review was to collect all current data on indirect costs related to inflammatory bowel disease as well as assessing homogeneity and comparability, and conducting a meta-analysis. Costs were collected using databases from Medline, Embase and Centre for Reviews and Dissemination databases, then average annual cost per patient was calculated and expressed in 2013-rate USD using the consumer price index and purchasing power parity (scenario 1) and then adjusted to specific gross domestic product (scenario 2) to make them comparable. The studies were then included in quantitative synthesis using the meta-analysis and bootstrap methods. This systematic review was carried out and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 18 publications, overall annual indirect costs per patient as a result of the quantitative synthesis among all studies eligible for meta-analysis ranged from US$2425.01-US$9622.15 depending on the scenario and model used for analysis. The cost of presenteeism was assessed in only two studies. Considering heterogeneity among all identified studies random-effect model presented the most accurate results of meta-analysis equal to US$7189.27 and US$9622.15 per patient per year for scenario 1 and scenario 2, respectively. This systematic review revealed the existence of a relatively small number of studies that reported on the great economic burden of the disease upon society. A great variety of methodologies and cost components resulted in a very large discrepancy in indirect costs and made meta-analysis difficult to perform, so two scenarios were considered and meta-analysis conducted in subgroups to make data more comparable. PMID:25656310

  3. Long-term Compliance with Oral 5-aminosalicylic Acid Therapy and Risk of Disease Recurrence in Patients with Ulcerative Colitis

    DEFF Research Database (Denmark)

    Prosberg, Michelle V; Vester-Andersen, Marianne K; Andersson, Mikael; Jess, Tine; Andersen, Jon T; Vind, Ida; Bendtsen, Flemming

    2016-01-01

    BACKGROUND: Noncompliance to long-term medical therapy is a well-known problem among patients treated for ulcerative colitis, but studies of long-term consequences in unselected patients are lacking. The authors aimed to determine the risk of recurrence according to long-term compliance with oral 5......-aminosalicylic acid among unselected patients with ulcerative colitis. METHODS: The authors conducted a 7-year follow-up study of a population-based inception cohort of 243 Danish patients with ulcerative colitis diagnosed from 2003 to 2004. Compliance was defined as consumption of ≥80% of prescribed oral 5...... treatment, or colectomy) in compliant versus noncompliant patients. RESULTS: In total, 182 patients(75%) experienced at least 1 recurrence during follow-up. For the first year after diagnosis, risk of recurrence did not differ significantly between compliant and noncompliant patients. For 1 to 3 years...

  4. Omeprazole, Furazolidone, and Tetracycline: an eradication treatment for resistant H. pylori in Brazilian patients with peptic ulcer disease Omeprazol, Tetraciclina e Furazolidona, um tratamento para erradicação do H. pylori resistente em pacientes ulcerosos do Brasil

    OpenAIRE

    Fernando Marcuz Silva; Jaime Natan Eisig; Ethel Zimberg Chehter; Júlio Jovino da Silva; Antonio Atílio Laudanna

    2002-01-01

    OBJECTIVES: To determine the efficacy of a simple, short-term and low-cost eradication treatment for Helicobacter pylori (H. pylori) using omeprazole, tetracycline, and furazolidone in a Brazilian peptic ulcer population, divided into 2 subgroups: untreated and previously treated for the infection. PATIENTS AND METHODS: Patients with peptic ulcer disease diagnosed by endoscopic examination and infected by H. pylori diagnosed by the rapid urease test (RUT) and histological examination, untreat...

  5. Mucosa-associated but not luminal Escherichia coli is augmented in Crohn’s disease and ulcerative colitis

    Directory of Open Access Journals (Sweden)

    de Souza Helton Luis

    2012-12-01

    Full Text Available Abstract Background Escherichia coli is believed to participate in the etiology of Crohn’s disease (CD and possibly of ulcerative colitis (UC, due at least in part to the observed rise in the number of these bacteria in the gut microbiota of CD and UC patients. Nevertheless, it is not fully understood whether this quantitative variation occurs equally throughout the mucosal and luminal spaces of the gut. To assess this question, stools and mucosa biopsies from distinct intestinal sites were cultured aiming at determining their E. coli concentration. The cultures were additionally screened for the presence of some virulence genes of pathogenic E. coli. Results Analyses of clinical materials from 14 controls (38 biopsies and 14 stools samples, 11 CD (25 biopsies and 11 stools samples and 7 UC patients (18 biopsies and 7 stools samples indicated no significant variation in the number of E. coli present in stools, but a rise of at least one log10 CFU/mg in biopsies from the ileum of CD patients and the sigmoid and rectum of CD and UC patients. The cultures were screened for the presence of E. coli attaching and effacing (eae, invasion plasmid antigen H (ipaH, aggregative adherence transcriptional activator (aggR, Shiga cytotoxins (stx, and heat labile enterotoxin (elt and the following serine proteases autotransporters of Enterobacteriaceae (SPATE genes: plasmid encoded toxin (pet, secreted autotransporter toxin (sat, Shigella extracellular protein (sepA, protein involved in intestinal colonization (pic and Shigella IgA-like protease homolog (sigA. Six of the 10 genes screened were detected in the total of samples investigated: aggR, eae, pet, sat, sepA and sigA. No difference in the prevalence of any of these markers was observed in cultures from different clinical materials or groups of patients. Methods Bacterial quantitation was carried out following cultures of diluted samples suspensions in MacConkey agar, Wilkins Chalgren agar for anaerobes

  6. ULCERATED ACROCHORDON IN VULVA

    OpenAIRE

    Borré-Arrieta Orlando; Monsalve-Montoya Rosa

    2015-01-01

    Introduction: the acrochordon, also known as soft fibromas, is a dermatological disease of common location in the cutaneous folds. Its appearance in external genitalia is weird, but it generates negative consequences regarding the quality of life of the patients. Due to the typical characteristics of the genital area in women, it increases the risk of ulceration and superinfection. Case record: patient in the third decade of life with lesion of slow growth in the vulvar area...

  7. Epidemiology of appendicectomy in primary sclerosing cholangitis and ulcerative colitis: its influence on the clinical behaviour of these diseases

    OpenAIRE

    Florin, T H J; Pandeya, N; Radford-Smith, G. L.

    2004-01-01

    Background and aims: Appendicectomy and smoking are environmental factors that are known to influence ulcerative colitis (UC). The phenotype of UC is different in patients with coexistent primary sclerosing cholangitis (PSC). This study investigates the interaction of appendicectomy and PSC on the epidemiology and clinical behaviour of colitis.

  8. Accuracy of a rapid 10-minute carbon-14 urea breath test for the diagnosis of Helicobacter pylori-associated peptic ulcer disease

    International Nuclear Information System (INIS)

    Urease in the human gastric mucosa is a marker for infection with Helicobacter pylori (HP), an organism which is associated with peptic ulcer disease. To detect gastric urease, we examined 184 patients (144 males, 40 females; mean age: 49.8±15.6 years) with suspected peptic ulcer disease. Fasting patients were given orally 5 μCi of carbon-14 labelled urea. For each patient only one breath sample was collected in hyamine at 10 min. The amount of 14C collected at 10 min was expressed as follows: [(DPM/mmol CO2 collected)/(DPM administered)]x100xbody weight (kg). The presence of HP colonization was determined by examination of multiple endoscopic prepyloric antral biopsy specimens subjected to culture or a rapid urease test. For the purpose of this study, HP-positive patients were defined as those with characteristic bacteria as indicated by a positive result of either the culture or the rapid urease test; HP-negative patients were defined as those with negative findings on both the culture and the rapid urease test. Of the 184 cases, 99 (53.8%) were positive for HP infection, and 85 (46.2%), negative. The sensitivity and specificity of the rapid 10 min 14C-urea breath test for the diagnosis of HP-associated peptic ulcer disease were evaluated by a receiver operating characteristic (ROC) curve with a variable cut-off value from 1.5 to 4.5. When a cut-off value of 1.5 was selected, the sensitivity was 100% and the specificity, 83.5%; when a cut-off value of 4.5 was selected, the sensitivity was 54.5% and the specificity, 97.6%. (orig.)

  9. Accuracy of a rapid 10-minute carbon-14 urea breath test for the diagnosis of Helicobacter pylori-associated peptic ulcer disease

    Energy Technology Data Exchange (ETDEWEB)

    Kao Chiahung (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Wang Shyhjen (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Hsu Chungyuan (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Lin Wanyu (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Huang Chihkua (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Gastroenterology); Chen Granhum (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Gastroenterology)

    1993-08-01

    Urease in the human gastric mucosa is a marker for infection with Helicobacter pylori (HP), an organism which is associated with peptic ulcer disease. To detect gastric urease, we examined 184 patients (144 males, 40 females; mean age: 49.8[+-]15.6 years) with suspected peptic ulcer disease. Fasting patients were given orally 5 [mu]Ci of carbon-14 labelled urea. For each patient only one breath sample was collected in hyamine at 10 min. The amount of [sup 14]C collected at 10 min was expressed as follows: (DPM/mmol CO[sub 2] collected)/(DPM administered)x100xbody weight (kg). The presence of HP colonization was determined by examination of multiple endoscopic prepyloric antral biopsy specimens subjected to culture or a rapid urease test. For the purpose of this study, HP-positive patients were defined as those with characteristic bacteria as indicated by a positive result of either the culture or the rapid urease test; HP-negative patients were defined as those with negative findings on both the culture and the rapid urease test. Of the 184 cases, 99 (53.8%) were positive for HP infection, and 85 (46.2%), negative. The sensitivity and specificity of the rapid 10 min [sup 14]C-urea breath test for the diagnosis of HP-associated peptic ulcer disease were evaluated by a receiver operating characteristic (ROC) curve with a variable cut-off value from 1.5 to 4.5. When a cut-off value of 1.5 was selected, the sensitivity was 100% and the specificity, 83.5%; when a cut-off value of 4.5 was selected, the sensitivity was 54.5% and the specificity, 97.6%. (orig.)

  10. Steroid unresponsive case of ulcerative Mucha-habermann disease (Febrile Ulcernecrotic Mucha-Habermann disease treated with methotrexate

    Directory of Open Access Journals (Sweden)

    Deepam J Shah

    2014-01-01

    Full Text Available A 20 year old male presented with fever associated with eruption of papules, plaques and vesiculobullous lesions on the chest, back, extremities, palms, soles, and genital mucosa of 20 days duration. Histopathological examination revealed epidermal clefts, edema and vacuolar degeneration of keratinocytes, basal cell degeneration, and dermal perivascular lymphocytic infiltrate. On the basis of clinical features and histology, a diagnosis of febrile ulceronecrotic Mucha-Habermann disease (FUMHD was made. Treatment with doxycycline (100 mg BD for 4 weeks and oral prednisolone 60 mg/day tapered to 25 mg in 4 weeks led to initial response that was followed by a relapse on tapering steroid. Addition of methotrexate (7.5 mg increased to 15 mg in 2 weeks led to a dramatic response.

  11. The Use of Hyperbaric Oxygen Therapy in the Treatment of Non-healing Ulcers Secondary to Graft-versus-host Disease

    OpenAIRE

    Heyboer, Marvin; Taylor, Justin; Morgan, Monica; Mariani, Peter; Jennings, Shane

    2014-01-01

    We present the case of a 69 year-old gentleman with non-healing ulcers of the bilateral medial malleoli as a result of graft-versus-host disease (GvHD). The patient discussed was diagnosed with stage IV mantle cell lymphoma. Over the course of 4 years the patient was treated with autologous stem cell transplant, later reduced-intensity allogeneic stem cell transplant, and finally donor lymphocyte infusion due to recurrence. Following these therapies, the patient developed extensive GvHD that ...

  12. Does physical activity reduce the risk of developing peptic ulcers?

    OpenAIRE

    Cheng, Y.; Macera, C.; Davis, D; Blair, S.

    2000-01-01

    Background—Although Helicobacter pylori has been identified as a major cause of chronic gastritis, not all infected patients develop ulcers, suggesting that other factors such as lifestyle may be critical to the development of ulcer disease.

  13. Peptic ulcer disease - discharge

    Science.gov (United States)

    ... stress level and learn ways to better manage stress. Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. Take all medicines with plenty of water.

  14. Bedsores (Pressure Ulcers)

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Bedsores (Pressure Ulcers) Information for adults A A A A well-defined superficial pressure ulcer. Overview Bedsores (pressure ulcers), also known as pressure ...

  15. Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patients by Markov analysis

    DEFF Research Database (Denmark)

    Odes, S.; Vardi, H.; Friger, M.;

    2010-01-01

    P>Background Forecasting clinical and economic outcomes in ulcerative colitis (UC) and Crohn's disease (CD) patients is complex, but necessary. Aims To determine: the frequency of treatment-classified clinical states; the probability of transition between states; and the economic outcomes. Methods....../surgical remission (medication-free) and mild disease (on 5-aminosalicylates, antibiotics, topical corticosteroids), comprising 28% and 62% of UC cycles and 24% and 51% of CD cycles respectively. The probability of drug-response in patients receiving systemic corticosteroids/immunomodulators was 0.74 in UC, 0.66 in...... CD. Both diseases had similar likelihood of persistent drug-dependency or drug-refractoriness. Surgery was more probable in CD, 0.20, than UC, 0.08. In terms of economic outcomes, surgery was costlier in UC per cycle, but the outlay over 10 years was greater in CD. Drug-refractory UC and CD cases...

  16. High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis

    DEFF Research Database (Denmark)

    Goyette, Philippe; Boucher, Gabrielle; Mallon, Dermot;

    2015-01-01

    Genome-wide association studies of the related chronic inflammatory bowel diseases (IBD) known as Crohn's disease and ulcerative colitis have shown strong evidence of association to the major histocompatibility complex (MHC). This region encodes a large number of immunological candidates, includi...

  17. Laparoscopic highly selective vagotomy: technical considerations and preliminary results in 119 patients with duodenal ulcer or gastroesophageal reflux disease.

    Science.gov (United States)

    Awad, W; Csendes, A; Braghetto, I; Yarmuch, J; Loehnert, R; Burdiles, P; Diaz, J C; Schutte, H; Maluenda, F

    1997-01-01

    The technical considerations and preliminary results of 119 patients submitted to laparoscopic highly selective vagotomy are presented. There were 33 with duodenal ulcers, 31 with duodenal ulcers plus gastroesophageal reflux, and 55 with gastroesophageal reflux. Operating time varied from 120 to 160 minutes. Six complications occurred: four perforations of the gastric fundus and two bleeding episodes. Conversion to open surgery was done in four cases and reoperation in one case. No deaths occurred, and the mean hospital stay was 3 days. The mean follow-up was 16 months, being 94% of the cases with Visick I or II and 6% with Visick III or IV. This technique is completely feasible by laparoscopic procedure and reproduces exactly what has been done with the laparotomy approach. PMID:9015168

  18. Non-ulcer dyspepsia and peptic ulcer: the distribution in a population and their relation to risk factors.

    OpenAIRE

    Bernersen, B; Johnsen, R; Straume, B

    1996-01-01

    BACKGROUND: The aetiology of non-ulcer dyspepsia and a possible connection to peptic ulcer disease is debated. This paper discusses this problem in a population based study. AIMS: The relation between non-ulcer dyspepsia and peptic ulcer disease was explored by the distribution in the general population and their associations to demographic, lifestyle, and psychological factors. METHODS: All inhabitants of a community aged 20-69 years received a questionnaire concerning abdominal complaints, ...

  19. Marjolin's Ulcer

    Directory of Open Access Journals (Sweden)

    Niloofar Mehrolhasani

    2014-10-01

    Full Text Available A 45 years old man who had sustained a burn injury to his right hand 20 years ago come to our dermatology clinic with complaint of a rapidly growing fungating mass in burn scar from 4 months ago (Fig. 1. A biopsy of the mass revealed invasive squamous cell carcinoma consistent with Marjolin Ulcer (Fig. 2. The patinet underwent wide local excision and placement of a split thickness skin graft.No evidence of tumor was identified in the sentinel lymph nodes.

  20. PARASYMPATHETIC DENERAVATION OF GASTRIUM AS A TREATMENT OF PEPTIC ULCER DISEASE PRECIPITATE MOTILITY DISORDER OF GALLBLADDER : A STUDY

    OpenAIRE

    Purujit

    2015-01-01

    A prospective clinical study on choleakinesia following total vagectomy (Bilateral truncal vagotomy) was carried out during the period from April 2005 to December 2010.Total 55 cases were studied who was suffering from chronic duodenal ulcer. Out of these total 55 cases fifteen cases had gastric outlet obstruction with hugely dilated stomach which was considered as control group in this study. Other 40 cases were considered as study group. Truncal vagotomy with retr ocoli...

  1. Effects of Cichorium Intybus L. Root Extract on Secretory Activity of the Stomach in Health and Ulcer Disease.

    Science.gov (United States)

    Krylova, S G; Vymyatnina, Z K; Zueva, E P; Amosova, E N; Razina, T G; Litvinenko, V I

    2015-09-01

    Gastroprotective effect of Cichorium intybus L. root extract is demonstrated on H. Shay's model of experimental ulcer in rats. The effect is attributed to the antisecretory activity of the plant and stimulation of defense barrier function of the gastric mucosa. The regulatory effect of the phytocomplex on seasonal characteristics of the gastric secretory and defense functions in dogs with Basov's fistula is detected. PMID:26468023

  2. Isocitrate Dehydrogenase of Helicobacter pylori Potentially Induces Humoral Immune Response in Subjects with Peptic Ulcer Disease and Gastritis

    OpenAIRE

    M Abid Hussain; Naveed, Shaik A.; Sechi, Leonardo A; Sarita Ranjan; Ayesha Alvi; Irshad Ahmed; Akash Ranjan; Sangita Mukhopadhyay; Niyaz Ahmed

    2008-01-01

    BACKGROUND: H. pylori causes gastritis and peptic ulcers and is a risk factor for the development of gastric carcinoma. Many of the proteins such as urease, porins, flagellins and toxins such as lipo-polysaccharides have been identified as potential virulence factors which induce proinflammatory reaction. We report immunogenic potentials of isocitrate dehydrogenase (ICD), an important house keeping protein of H. pylori. METHODOLOGY/PRINCIPAL FINDINGS: Amino acid sequences of H. pylori ICD wer...

  3. NURSING CARE OF PATIENTS WITH DUODENAL ULCER

    OpenAIRE

    SZCZEPAŃSKA, URSZULA; GARCZYŃSKI, WOJCIECH; Zukow, Walery

    2011-01-01

    Peptic ulcer disease is one of the most common gastrointestinal disease worldwide. The prevalence of peptic ulcer disease is now so large that it has entailed the development of diagnostic and treatment methods improve. Currently used drug combination may produce effects even at 80% of cases, which is virtually unheard of in any other disease entity. Over 60% of peptic ulcers are located in the duodenum (3-4 times more than in the stomach). Estimates suggest that 5-10% of adults are affected ...

  4. Effects of Moringa oleifera, A Plant Extract Coded OBAYOKOU on Ulcers Caused by Mycobacterium ulcerans In Children under 15 Years in Côte d'Ivoire

    Directory of Open Access Journals (Sweden)

    Kodia M

    2014-04-01

    Full Text Available The aqueous extract of a plant coded OBAYOKOU (Moringa oleifera has been tested on the healing of ulcers in children under 15 years, two lots of 15 children each were made all presenting clinical forms of Buruli ulcer. The aqueous plant extract of Moringa oleifera was added to the food supply given to Lot B (lot of experimental subjects at a rate of 330 ml per meal per child for six weeks. Children of Lot A (control Lot received normal diet without Moringa oleifera. The results of this study have shown that children in (lot B in addition to the normal diet received 330 ml of Moringa oleifera per meal, had a higher rate of healing than Lot A (Witness Lot who received only normal diet. Thus, the rate of healing of ulcers with M. oleifera (24 mm is superior to healing without M. oleifera (10 mm after six weeks. This study shows that we can overcome Buruli ulcer with medicinal plants that is abundantly available in Africa. It also shows that it is necessary to conduct research on a wider range of fractions of Moringa oleifera to improve the activity of antimycobacteriennes molecules in the aqueous extract of Moringa oleifera.

  5. Ulcerative Colitis

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  6. Roentgenologic image of penetrating duodenal bulb ulcer

    International Nuclear Information System (INIS)

    When studying a series of aimed roentgenograms in patients with peptic ulcer a gas bubble of irregular spherical configuration or two-layer niche were determined near the bulb medial contour. Gas bubble was from 0.5-0.7 to 3.5 cm in diameter. In such cases penetrating ulcers were determined in operations. Along with other signs gas bubble symptom, sometimes two-layer signs may be used for timely and exact roentgenological diagnosis of penetrating duodenal bulb ulcer in peptic ulcer disease

  7. Cholangiographic findings in ulcerative colitis

    International Nuclear Information System (INIS)

    Endoscopic retrograde cholangiography (ERC) was performed in 28 patients with hepatobiliary disease associated with ulcerative colitis. The films were reviewed and correlated with diagnoses at liver biopsy. Thirteen patients with extrahepatic as well as intrahepatic bile duct abnormalities had characteristic cholangiographic findings compatible with sclerosing cholangitis, together with cholangiocarcinoma in one patient. Six patients had intrahepatic bile duct involvement only, and the cholangiographic abnormalities differed from those of sclerosing cholangitis. In 5 of these patients cirrhosis of the liver was found at biopsy or clinically. The result indicates that in patients with hepatobiliary disease suggested in association with ulcerative colitis, ERC gives valuable information. (Auth.)

  8. Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patients by Markov analysis

    DEFF Research Database (Denmark)

    Odes, S.; Vardi, H.; Friger, M.;

    2010-01-01

    P>Background Forecasting clinical and economic outcomes in ulcerative colitis (UC) and Crohn's disease (CD) patients is complex, but necessary. Aims To determine: the frequency of treatment-classified clinical states; the probability of transition between states; and the economic outcomes. Methods...... CD. Both diseases had similar likelihood of persistent drug-dependency or drug-refractoriness. Surgery was more probable in CD, 0.20, than UC, 0.08. In terms of economic outcomes, surgery was costlier in UC per cycle, but the outlay over 10 years was greater in CD. Drug-refractory UC and CD cases...... engendered high costs in the cohort. Conclusions Most patients on 5-aminosalicylates, corticosteroids and immunomodulators had favourable clinical and economic outcomes over 10 years. Drug-refractory and surgical patients exhibited greater long-term expenses...

  9. TO COMPARE THE SAFETY AND EFFICACY OF THREE DIFFERENT, PROTON PUMP INHIBITORS OMEPRAZOLE, ESO M EPRAZOLE AND RABEPRAZOLE IN A TRIPLE DRUG REGIMEN IN PATIENTS WITH PEPTIC ULCER DISEASE IN THE ERADICATION OF H. PYLORI INFECTION

    Directory of Open Access Journals (Sweden)

    Margaret Viola

    2015-03-01

    Full Text Available Peptic ulcer disease continues to be issue especially due to its high prevalence in the developing world. Helicobacter pylori ( H. pylori infection associated duodenal ulcers should undergo eradication therapy. There are many regimens offered for H. pylori eradication which include triple , quadruple , or sequential therapy regimens. In our study we planned to see whether these differences in pharmacokinetic properties show any difference in t he efficacy and safety parameters between treatment with omeprazole rabeprazole and esomeprazole in the triple drug regimen for eradication of H.pylori infection in peptic ulcer patients in our hospital Osmania General Hospital / Osmania Medical College , Hyderabad. MATERIALS AND METHODS: A total number of 45 patients were enrolled in the study. Patients with either sex suffering from peptic ulcer defined as ulcer crater of >2.5mm in size by endoscopy. Study Design : It was a randomized double blind , paralle l and comparative study. CONCLUSION: Two weeks after triple drug treatment , H.pylori was negative in 66.7% , 73% and 80% and Rapid urease test was negative in 53% , 60% and 66% in group A , B and C respectively. Endoscopy findings showed significant reduction in size and healing of ulcers in group A , B and C. There was improvement in signs and symptoms by 53 to 80% , after 2 weeks. Hence after therapy with triple drug regimen H.pylori eradication was 66 - 80% and healing of ulcers was 83 – 100% which was higher in Rabeprazole group. At 6 weeks , there was complete relief of signs and symptoms. At the follow up of 10 weeks there was no ulcer recurrence. No adverse effects were noted in all the groups. In conclusion , Triple drug regimen had shown to eradicate H.pylori infection in the treatment of Peptic ulcer. There was healing of ulcers in all the groups which was highly significant. There was no recurrence of peptic ulcer with these regimens in all the groups. However Rabeprazole group patients

  10. 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...... 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 a...... substantial note in the precipitation of active duodenal ulcer....

  11. 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.

  12. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. PMID:26358306

  13. Update on peripheral ulcerative keratitis

    Directory of Open Access Journals (Sweden)

    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

  14. The stress ulcer syndrome

    OpenAIRE

    Essen, H.A.

    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 system disorders (Cushing's ulcers) appear to have a different pathophysiology and a different pathology to the real stress ulcers. Peptic ulcers and gastric lesions following use of non-steroidal ant...

  15. Pressure ulcers: Back to the basics

    Directory of Open Access Journals (Sweden)

    Karoon Agrawal

    2012-01-01

    Full Text Available Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

  16. 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 a...

  17. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    Institute of Scientific and Technical Information of China (English)

    Ertugrul Kayacetin; Serra Kayacetin

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base.

  18. A rare complication of ulcerative colitis: Pyoderma gangrenosum

    OpenAIRE

    AKIN, Hatice Şule; Coşkun, Adil; KARATAY, Pınar; SAVK, Ekin; Yaşa, Mehmet Hadi

    2011-01-01

    Pyoderma gangrenosum is a rare inflammatory skin illness characterized by ulcers. It can be seen with unknown etiology or with some systemic disorders such as ulcerative colitis, Crohn's disease and monoclonal gammopathy. Ulcers may be seen as single or multiple. We present in this article a pyoderma gangrenosum case that occurred with the activation of ulcerative colitis. A 21-year-old male was admitted to our hospital with a one-month history of symptoms of bloody and mucoid defecation with...

  19. Duodeno gastric reflux in peptic ulcer disease: gall bladder emptying provoked by cholecystokinin or a fatty meal

    International Nuclear Information System (INIS)

    A wide range of incidence of diodeno-gastric bile reflux has been reported in patients with duodenal ulcer (DU) or gastric ulcer (GU). Using either 100 units of CCK i/v or a fatty meal of 320 Cal containing 20 g fat to contract the gall bladder, we have investigated the incidence of reflux in 170 subjects: CCK (Control: 20; DU: 60; GU: 19), Meal (Control: 19; DU: 37; GU: 15). The CCK or meal was given in the supine subject 30 minutes after injection of 75 MBq sup(99m)Tc diethyl Hida. Reflux was considered present if labelled bile was seen in the stomach on 3 successive 2 minute gamma camera pictures. The percentage of patients showing reflux was as follows: CCK (Control: 45%; DU: 53%; GU: 58%), Meal (Control: 11%; DU: 24%; GU: 40%). These results have been compared using the Chi-squared test. There was no significant difference in the incidence of reflux between control, DU or GU patients either in the group of patients given CCK or a meal. However, reflux was more common after CCK than the meal in control subjects (p<0.05) and in those with DU (p<0.01) but not in those with GU. We conclude that the stimulus given to contract the gall bladder affects the incidence of reflux, and that any significant difference in reflux incidence of DU or GU patients may become apparent when more patients are studied. (Author)

  20. Turner Syndrome with Ulcerative Colitis

    OpenAIRE

    Hyodo, Hiromi; TOMITA, Yuichiro; Hirai, Kohta; HIRAKAWA, Hitoshi; Ueno, Shigeru; Ishiguro, Hiroyuki

    2009-01-01

    Turner syndrome is a chromosomal disease frequently associated with autoimmune disorders including diabetes mellitus, thyroid disease and inflammatory bowel disease (IBD). Although the etiology of IBD has not been fully elucidated, genetic analysis has recently revealed several susceptibility genes. Recently, cases with Turner syndrome associated with IBD have been reported. We report here a 13-yr-old girl with Turner syndrome associated with ulcerative colitis. The patient was undergoing gro...

  1. Radiographical evaluation of ulcerative colitis

    OpenAIRE

    Deepak, Parakkal; Bruining, David H.

    2014-01-01

    Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography ...

  2. Gastric emptying abnormal in duodenal ulcer

    International Nuclear Information System (INIS)

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease

  3. Management of pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Turner, Dan; Levine, Arie; Escher, Johanna C; Griffiths, Anne M; Russell, Richard K; Dignass, Axel; Dias, Jorge Amil; Bronsky, Jiri; Braegger, Christian P; Cucchiara, Salvatore; de Ridder, Lissy; Fagerberg, Ulrika L; Hussey, Séamus; Hugot, Jean-Pierre; Kolacek, Sanja; Kolho, Kaija Leena; Lionetti, Paolo; Paerregaard, Anders; Potapov, Alexander; Rintala, Risto; Serban, Daniela E; Staiano, Annamaria; Sweeny, Brian; Veerman, Gigi; Veres, Gabor; Wilson, David C; Ruemmele, Frank M

    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...

  4. The relationship between the Five-Factor Model personality traits and peptic ulcer disease in a large population-based adult sample.

    Science.gov (United States)

    Realo, Anu; Teras, Andero; Kööts-Ausmees, Liisi; Esko, Tõnu; Metspalu, Andres; Allik, Jüri

    2015-12-01

    The current study examined the relationship between the Five-Factor Model personality traits and physician-confirmed peptic ulcer disease (PUD) diagnosis in a large population-based adult sample, controlling for the relevant behavioral and sociodemographic factors. Personality traits were assessed by participants themselves and by knowledgeable informants using the NEO Personality Inventory-3 (NEO PI-3). When controlling for age, sex, education, and cigarette smoking, only one of the five NEO PI-3 domain scales - higher Neuroticism - and two facet scales - lower A1: Trust and higher C1: Competence - made a small, yet significant contribution (p personality traits that are associated with the diagnosis of PUD at a particular point in time. Further prospective studies with a longitudinal design and multiple assessments would be needed to fully understand if the FFM personality traits serve as risk factors for the development of PUD. PMID:26437682

  5. Complement activation capacity in plasma before and during high-dose prednisolone treatment and tapering in exacerbations of Crohn's disease and ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Baatrup Gunnar

    2005-09-01

    Full Text Available Abstract Background Ulcerative colitis (UC and Crohn's disease (CD are characterized by intestinal inflammation mainly caused by a disturbance in the balance between cytokines and increased complement (C activation. Our aim was to evaluate possible associations between C activation capacity and prednisolone treatment. Methods Plasma from patients with exacerbations of UC (n = 18 or CD (n = 18 were collected before and during high dose prednisolone treatment (1 mg/kg body weight and tapering. Friedman's two way analysis of variance, Mann-Whitney U test and Wilcoxon signed-rank sum test were used Results Before treatment, plasma from CD patients showed significant elevations in all C-mediated analyses compared to the values obtained from 38 healthy controls (p Conclusion Our findings indicate that C activation capacity is up-regulated significantly in plasma from CD patients. The decreases observed after prednisolone treatment reflect a general down-regulation in immune activation.

  6. Mice lacking myosin IXb, an inflammatory bowel disease susceptibility gene, have impaired intestinal barrier function and superficial ulceration in the ileum.

    Science.gov (United States)

    Hegan, Peter S; Chandhoke, Surjit K; Barone, Christina; Egan, Marie; Bähler, Martin; Mooseker, Mark S

    2016-04-01

    Genetic studies have implicated MYO9B, which encodes myosin IXb (Myo9b), a motor protein with a Rho GTPase activating domain (RhoGAP), as a susceptibility gene for inflammatory bowel disease (IBD). Moreover, we have recently shown that knockdown of Myo9b in an intestinal epithelial cell line impairs wound healing and barrier function. Here, we investigated whether mice lacking Myo9b have impaired intestinal barrier function and features of IBD. Myo9b knock out (KO) mice exhibit impaired weight gain and fecal occult blood (indicator of gastrointestinal bleeding), and increased intestinal epithelial cell apoptosis could be detected along the entire intestinal axis. Histologic analysis revealed intestinal mucosal damage, most consistently observed in the ileum, which included superficial ulceration and neutrophil infiltration. Focal lesions contained neutrophils and ultrastructural examination confirmed epithelial discontinuity and the deposition of extracellular matrix. We also observed impaired mucosal barrier function in KO mice. Transepithelial electrical resistance of KO ileum is >3 fold less than WT ileum. The intestinal mucosa is also permeable to high molecular weight dextran, presumably due to the presence of mucosal surface ulcerations. There is loss of tight junction-associated ZO-1, decreased lateral membrane associated E-cadherin, and loss of terminal web associated cytokeratin filaments. Consistent with increased Rho activity in the KO, there is increased subapical expression of activated myosin II (Myo2) based on localization of phosphorylated Myo2 regulatory light chain. Except for a delay in disease onset in the KO, no difference in dextran sulfate sodium-induced colitis and lethality was observed between wild-type and Myo9b KO mice. © 2016 Wiley Periodicals, Inc. PMID:26972322

  7. Glycoaminoglycan (GAG) deficiency in protective barrier as an underlying, primary cause of ulcerative colitis, Crohn's disease interstitial cystitis and possibly Reiter's syndrome.

    Science.gov (United States)

    Russell, A L

    1999-04-01

    Ulcerative colitis, Crohn's disease and interstitial cystitis share many common features, the most important of which is a defect in the glycoaminoglycan (GAG) defensive barrier. This defect allows penetration of toxins causing localized inflammatory response, followed by fibrosis and distant pathological changes, together with a myriad of biochemical and immunological changes. The latter has caused confusion as to etiology of the aforementioned disorders. This hypothesis is somewhat supported by the fact that agents such as glucosamine and pentosan polysulphate (Elmiron) that replace the GAG layer, improve the conditions. The potential for extrapolation of this hypothesis to atherosclerosis and arthropathies exists. There is a great danger in modern medical research that if one misses the wood for the trees, one becomes hopelessly lost in the minutiae of research. At present, it is embarrassing that ulcerative colitis (UC), Crohn's (CR) and interstitial cystitis (IC) are the cause of a great deal of morbidity and occasionally mortality, yet after intensive research, the etiology and effective treatment eludes us. The research in the past has focused extensively on inflammatory response in the mucosal lining, and biochemical, infective and immunological changes in the serum. This has led to a vast array of research pathways that seem at the present time to be totally lost and, might I say, aimless in direction, as a cause for these conditions, that remain amongst the most imperically treated in modern medicine. Another possible syndrome in this class would be Reiter's, which has many features in common with the above. The basic tenet of a GAG deficiency hypothesis is that, as shown in Figure 1A, an intact GAG layer provides, firstly, a mechanical and electrostatic defence against penetration of infective agents, toxins, antigenic protein moieties, etc. and, secondly, the prevention of extravasation of body fluid components. A degraded GAG layer is the start of the

  8. [Mixed leg ulcers].

    Science.gov (United States)

    Willenberg, Torsten

    2011-03-01

    Coexisting peripheral arterial disease is not uncommon (15 - 21 %) in patients with ulcera cruris primarily based on a venous etiology. Patient's history, clinical examination and detection of ABI as well as duplex scan will establish diagnosis of mixed arterial-venous ulcera. Clinical significance of coexisting arterial disease is often difficult to define and should be evaluated by a vascular specialist. The concept of treatment of mixed ulcers should always include the arterial component. Frequently peripheral arterial perfusion and healing can be improved by minimal invasive, endovascular revascularization. Compression therapy is the corner stone in treatment of venous disease and should be complemented by contemporary two piece graduated compression systems if ulcera are present. According to circumstances ablation of varicose veins must be considered. PMID:21360460

  9. DIFFERENTIAL DIAGNOSIS OF LONG TERM TONGUE ULCERS

    Directory of Open Access Journals (Sweden)

    Hegde Nidarsh D.

    2012-08-01

    Full Text Available Oral ulcers is a very common disorder of the oral mucosa. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease, some with a chronic non- healing ulcer are advised biopsy. Indeed, a spectrum of disorders can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. Lesions of the tongue have a broad differential diagnosis ranging from benign idiopathic processes to infections, cancers, and infiltrative disorders. This article will focus on common ulcerative disorders of the tongue in aspects of their clinical features and differential diagnosis, two case reports with the diagnosis and conservative management for long-term chronic ulcers. The two cases which are reported in this article had a differential diagnosis of Squamous cell carcinoma of the tongue. The clinical picture was craterlike lesion, having a velvety-red base and a rolled, indurated border and most important painless in both cases. Removal of the irritant which was the tooth, rehabilitation of the oral mucosa by lubrication with Cocus Nucifera resulted in the healing of the ulcers. Functional components of Cocus Nucifera are Squaline, tocopherol, phytosterols and other sterols which are all plant steroids.

  10. Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa Articular manifestations in patients with Crohn's disease and ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Cristina Costa Duarte Lanna

    2006-06-01

    Full Text Available Os sintomas articulares constituem a manifestação extra-intestinal mais comum em pacientes com doença de Crohn e com retocolite ulcerativa. Reconhecida como artrite colítica, e mais recentemente, artrite enteropática, está classificada como uma das doenças do grupo das espondiloartropatias. Reconhecidamente, há dois padrões de acometimento articular: 1 periférico, habitualmente, associado aos períodos de atividade da doença intestinal e sem associação com o antígeno HLA B27, e 2 axial, caracterizado por espondilite e sacroiliíte, com curso clínico e radiográfico independente da doença intestinal e associado ao HLA B27.Joint involvement is the most commom extraintestinal manifestation in patients with Crohn's disease and ulcerative colitis. The colitic arthritis, lately called enteropathic arthritis, is classified as one of the diseases of the spondyloarthropathies group. There are two patterns of joint involvement: 1 peripheral arthritis, usually coincides with exacerbations of the inflammatory bowel disease and is not associated with the HLA B27 antigen; and 2 axial involvement, characterized by spondylitis and sacroiliitis, which the clinical course is independent of the intestinal disease, and has an association with HLA B27.

  11. Intestinal microecology in rats with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    韩晓霞

    2013-01-01

    Objective To study the abundance and diversity ofthe gut flora in rats with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)to provide new knowledge about the pathogenesis of this disease.Methods Twenty-six

  12. Update in the treatment of paediatric ulcerative colitis.

    Science.gov (United States)

    Greifer, Melanie K; Markowitz, James F

    2006-10-01

    Ulcerative colitis is an important disease in the paediatric population. Ulcerative colitis is one of the chronic inflammatory bowel diseases, and is medically incurable. However, the arsenal of medications has grown as knowledge of the pathogenesis of this disease advances. This review looks at the classical treatments for children with ulcerative colitis, including the 5-aminosalicylates, corticosteroids and imunomodulators, as well as biological therapy and other, newer modalities. PMID:17020417

  13. Evaluation of dairy allergy among ulcerative colitis patients

    OpenAIRE

    judaki, Arezo; Hafeziahmadi, Mohamadreza; Yousefi, Atefe; Havasian, Mohamad Reza; Panahi, Jafar; Sayehmiri, Koroush; Alizadeh, Sajjad

    2014-01-01

    The intestine is the largest mucosal organ of the body and also the first line immune homeostasis. Inflammatory bowel disease or IBD is divided into ulcerative colitis and Crohn's disease. One of the problems that can occur with UC is dietary allergy to some foods. This study aimed to evaluated the dairy allergy among patients with ulcerative colitis. This study is a Case - control study, that studied 72 patients with Ulcerative Colitis, after recording history of the disease, colonoscopy and...

  14. 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.

  15. Sunitinib induced pyoderma gangrenosum-like ulcerations

    OpenAIRE

    Akanay-Diesel S; Hoff NP; Kürle S; Haes J; Erhardt A; Häussinger D; Schulte KW; Bölke E; Matuschek C; Budach W.; Gerber PA; Homey B

    2011-01-01

    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 ...

  16. Receptor binding sites for substance P, but not substance K or neuromedin K, are expressed in high concentrations by arterioles, venules, and lymph nodules in surgical specimens obtained from patients with ulcerative colitis and Crohn disease.

    OpenAIRE

    Mantyh, C R; Gates, T S; Zimmerman, R P; Welton, M L; Passaro, E P; Vigna, S R; Maggio, J E; Kruger, L.; Mantyh, P W

    1988-01-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative ...

  17. [Sick or made sick? Recurrent episodes of cutaneous and subcutaneous ulcers, colitis, arthralgia and hair loss... a systemic disease or iatrogenic?].

    Science.gov (United States)

    Woitzek, Katja; Dusemund, Frank; Müller, Beat

    2010-12-01

    Recurrent episodes of cutaneous and subcutaneous ulcers, especially in the oral cavity, represent a high psychological and painful burden for the patient. If there in addition are symptoms of arthralgia and/or colitis, an autoimmune disease with vasculitis, particularly a Morbus Behçet has to be considered as a possible differential diagnosis. The therapy therefore would be an immunosuppressive one. Also a wide immunologic diagnostic process has to be started. Furthermore, a chronic inflammatory bowel disease has to be excluded by colonoscopic biopsy. An infectious etiology of the symptoms (viral/bacterial/parasitic) should be investigated by microbiological and laboratory tests. A thrush or a herpes-infection caused by immunosuppression (toxic or due to illness) has to be considered as a further differential diagnosis. Also a precise medical and drug history is very important because of possible toxic adverse effects. Until confirmation of a final diagnosis, only a symptomatic analgetic or antifungal or antiviral therapy in case of a positive thrush or herpes culture respectively should be initiated with respect to the very different kinds of treatment of the diseases included in the differential diagnosis. PMID:21108189

  18. Preventing pressure ulcers

    Science.gov (United States)

    Pressure ulcers are also called bedsores, or pressure sores. They can form when your skin and soft tissue ... become damaged or die. When this happens, a pressure ulcer may form. You have a risk of developing ...

  19. How to Diagnose and Treat Peptic Ulcer?

    Institute of Scientific and Technical Information of China (English)

    HU Xian-guo

    2009-01-01

    @@ Ulcer of the stomach and duodenum,also called ulcerative disease,is a sharply circumscribed loss of the tissue lining those parts of the digestive tract exposed to gastric juice containing acid and pepsin. Because its formation and development are closely related to the digestive effect of acidic gastric juice and pepsase,the disease is called peptic ulcer. It is a common disease,belonging to epigastric pain in TCM,mainly caused by cold attacking the stomach,stagnated liver-qi affecting the stomach,or spleen and stomach deficiency with deficiency and cold of the middle-jiao. Regulating qi to stop pain is the principle for its treatment. Peptic ulcer is usually differentiated as the following TCM syndromes.

  20. Surgical treatment of perforated gastric ulcer

    Directory of Open Access Journals (Sweden)

    Korica Milan

    2002-01-01

    Full Text Available Introduction Peptic ulcer perforation is a complication of ulcer disease which requires urgent surgical treatment. The aim of this paper was to point out our experience in surgical treatment of perforated peptic ulcer. Material and methods This retrospective study analyzes results of surgical treatment in 365 patients with perforated peptic ulcer during the period January 1996 to December 2000. Results During the last 5-year period 365 patients were treated following peptic ulcer perforation. The average age was 43.53±8.26, with the span from 18 to 86. The most frequent surgical procedures in treatment of peptic ulcer perforation were: simple closure with biopsy (55.88%, excision of the ulcer with a pyloroplasty and vagotomy (35.29% as nonresection surgical procedures and stomach resection after Billroth II (8.83%. The postoperative mortality was 4.41%. Conclusions The methods of choice in surgical treatment of gastric ulcer perforation are nonresection surgical procedures with drug therapy and eradication of Helicobacter pylori, if present.

  1. In Vitro Activity of Selected West African Medicinal Plants against Mycobacterium ulcerans Disease

    OpenAIRE

    Patrick Valere Tsouh Fokou; Abena Adomah Kissi-Twum; Dorothy Yeboah-Manu; Regina Appiah-Opong; Phyllis Addo; Lauve Rachel Tchokouaha Yamthe; Alvine Ngoutane Mfopa; Fabrice Fekam Boyom; Alexander Kwadwo Nyarko

    2016-01-01

    Buruli ulcer (BU) is the third most prevalent mycobacteriosis, after tuberculosis and leprosy. The currently recommended combination of rifampicin-streptomycin suffers from side effects and poor compliance, which leads to reliance on local herbal remedies. The objective of this study was to investigate the antimycobacterial properties and toxicity of selected medicinal plants. Sixty-five extracts from 27 plant species were screened against Mycobacterium ulcerans and Mycobacterium smegmatis, u...

  2. Highly selective vagotomy in the treatment of peptic ulcer diathesis.

    Science.gov (United States)

    Kaushik, S P; Kohli, P; Kumar, P; Pradeep, R; Saxena, R; Choudhary, S R; Suresh, A

    1990-09-01

    The results of highly selective vagotomy in 174 Indian patients have been analysed. Compared to other procedures on the stomach, HSV has a definite advantage both on long term as well as on short term basis. HSV has therefore become the procedure of choice in the treatment of duodenal ulcer disease provided the expertise is available locally. HSV has also been used now in the treatment of ulcer complications and benign gastric ulcer disease. PMID:2092027

  3. Quality of life in patients with ulcerative colitis treated surgically

    OpenAIRE

    Kozłowska, Katarzyna A.; Bączyk, Grażyna; Krokowicz, Piotr

    2014-01-01

    Introduction Ulcerative colitis belongs to the group of inflammatory bowel diseases. The specific symptoms and chronic nature of the disease significantly affect the quality of patients’ lives. Quality-of-life assessment helps to define its determining factors as well as the efficiency of surgical procedures. Aim Quality-of-life evaluation of patients with ulcerative colitis treated surgically. Material and methods A retrospective review was carried out on 35 patients with ulcerative colitis,...

  4. A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers

    OpenAIRE

    Chung, Chen-Shuan; Chiang, Tsung-Hsien; Lee, Yi-Chia

    2015-01-01

    An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk f...

  5. Laparoscopic Repair for Perforated Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    A. Cotirleţ

    2015-01-01

    Full Text Available Perforated peptic ulcer (PPU, despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies but there is no consensus on whether the benefits of laparoscopic closure of perforated peptic ulcer outweigh the disadvantages such as prolonged surgery time and greater expense. However we can say that laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered with the necessary expertise available.

  6. Gastroprotective and Anti-ulcer activity of Aloe vera juice, Papaya fruit juice and Aloe vera and Papaya fruit combined juice in Ethanol induced Ulcerated Rats

    OpenAIRE

    Mr. S. Gopinathan; D. Naveenraj

    2013-01-01

    Peptic ulcer is the most prevalent gastrointestinal disease. Even though a wide range of drugs are available for the treatment of peptic ulcer, but many of these do not fulfill all the requirements and have side effects. These factors have attracted researchers to investigate the natural products which have more efficacy, less side effects and less expensive for the treatment of peptic ulcer disease. In the present study the anti ulcer activity of (1) Aloe vera juice, (2) papaya fruit juice (...

  7. Selective proximal vagotomy in the treatment of patients with duodenal ulcer

    International Nuclear Information System (INIS)

    An analysis of immediate and long-term results of 600 vagotomies indicates that the best results with isolated selective proximal vagotomy (SPV) are observed in uncomplicated ulcer disease, in patients with small ulcers (under 1 cm). Isolated SPV should be primarily used when there exists a hazard of development of complicated ulcer disease. Differential approach to the use of SPV improves treatment results of ulcer disease

  8. Current treatment of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Johannes Meier; Andreas Sturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring recurrent inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complications of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice- orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  9. PARASYMPATHETIC DENERAVATION OF GASTRIUM AS A TREATMENT OF PEPTIC ULCER DISEASE PRECIPITATE MOTILITY DISORDER OF GALLBLADDER : A STUDY

    Directory of Open Access Journals (Sweden)

    Purujit

    2015-07-01

    Full Text Available A prospective clinical study on choleakinesia following total vagectomy (Bilateral truncal vagotomy was carried out during the period from April 2005 to December 2010.Total 55 cases were studied who was suffering from chronic duodenal ulcer. Out of these total 55 cases fifteen cases had gastric outlet obstruction with hugely dilated stomach which was considered as control group in this study. Other 40 cases were considered as study group. Truncal vagotomy with retr ocolic isoperistaltic GJA done in study group and only retrocolic isoperistaltic GJA operation done in control group. Two patients had incomplete vagotomy. All the patients were male and average age was 38.1 years. 32.7% cases were belonging to the age gro up between 26 - 35 years which was the highest. Though the cases were operated till September 2010, they were followed up till December 2013. Gastric acidity, oral cholecystography and ultrasonography of upper abdomen was done in both pre and post - operative period. All cases were meticulously examined to exclude other associated pathology. Cases were diagnosed by Barium meal and clinical analysis.14days post - operatively gastric acid analysis and three months post - operatively oral cholecystography was done. In the post - operative follow up period ultrasonography upper abdomen was done. 39(71% patients were turned up for checkup in post - operative period out of which 29 patients belong to complete vagotomy group. In conclusion it was seen that following total vag otomy the contraction of gall bladder was definitely reduced with decrease % loss of bile results stasis of bile. There was more than double dilatation of the gall bladder as detected three months post - operatively [1] after complete section of vagus. 7.5% o f patients of complete vagotomy group developed gall stones till three to four years post - operatively and 20% patients developed minimal gall bladder sludge and 5% patients developed dense peripheral sludge

  10. [Weight loss and healing of ulcers - case report].

    Science.gov (United States)

    Seremet, Jasmina; Laginja, Stanislava; Marinović, Marin

    2013-10-01

    Diabetes mellitus type 2 is one of the most common diseases with a prevalence increasing with age. If blood sugar is not controlled, complications arise and diabetic foot ulcer occurs. Depending on the blood vessels involved, we distinguish venous and arterial ulcers. Venous ulcers respond very well to modern methods of treatment such as compression therapy and hydrocolloid dressings, but for arterial ulcer prevention is most significant, e.g. weight loss, dietary modification, etc. The aim of this study was to show that despite all the available therapeutic options, we cannot cure ulcers completely because the patient's readiness to change his lifestyle plays a decisive role. Therefore, we present a patient having suffered from venous ulcers for several years and arterial ulcer that healed only after the patient had lost about 20 pounds. PMID:24371990

  11. Ulcerative colitis in infancy

    Directory of Open Access Journals (Sweden)

    Md Rukunuzzaman

    2011-01-01

    Full Text Available Ulcerative colitis (UC is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter started with immunosuppressive drugs. After initial induction therapy with parenteral steroid and infliximab, the patient is now on remission with azathioprine and mesalamine. UC is rare in Bangladesh, especially in children, and it is rarer during infancy. Several conditions like infective colitis, allergic colitis, Meckel′s diverticulitis, Crohn′s disease, etc. may mimic the features of UC. So, if a child presents with recurrent bloody diarrhea, UC should be considered as differential diagnosis.

  12. Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

    OpenAIRE

    Adrián Imbernón-Moya; Elena Vargas-Laguna; Antonio Aguilar; Miguel Ángel Gallego; Claudia Vergara; María Fernanda Nistal

    2015-01-01

    Pyoderma gangrenosum is an unusual necrotizing noninfective and ulcerative skin disease whose cause is unknown. Ophthalmic involvement in pyoderma gangrenosum is an unusual event. Only a few cases have been reported, from which we can highlight scleral, corneal, and orbital cases. Peripheral ulcerative keratitis is a process which destroys the peripheral cornea. Its cause is still unknown although it is often associated with autoimmune conditions. Pyoderma gangrenosum should be included in th...

  13. Management of BU-HIV co-infection

    OpenAIRE

    O'Brien, D P; Ford, N.; Vitoria, M; Christinet, V; Comte, E; Calmy, A; Stienstra, Y; Eholie, S.; Asiedu, K

    2014-01-01

    Buruli Ulcer (BU)-HIV co-infection is an important emerging management challenge for BU disease. Limited by paucity of scientific studies, guidance for management of this co-infection has been lacking.

  14. Assessment of Disease-Related Therapeutic Protein Drug-Drug Interaction for Etrolizumab in Patients With Moderately to Severely Active Ulcerative Colitis.

    Science.gov (United States)

    Wei, Xiaohui; Kenny, Jane R; Dickmann, Leslie; Maciuca, Romeo; Looney, Caroline; Tang, Meina T

    2016-06-01

    The efficacy and safety of etrolizumab, a humanized IgG1 mAb, were evaluated in patients with ulcerative colitis (UC) in a phase 2 study (EUCALYPTUS). The current study assessed the risk of therapeutic protein drug-drug interaction (TP-DDI) of etrolizumab on CYP3A activity in patients with UC. Literature review was performed to compare serum proinflammatory cytokine levels and pharmacokinetic (PK) parameters of CYP3A substrate drugs between patients with inflammatory bowel disease (IBD) and healthy subjects. Treatment effect of etrolizumab on CYP3A activity was evaluated by measuring colonic CYP3A4 mRNA expression and serum C-reactive protein (CRP) in EUCALYPTUS patients. Literature data suggested similar levels between IBD patients and healthy subjects for serum proinflammatory cytokines and PK parameters of CYP3A substrate drugs. Additionally, treatment with etrolizumab did not change colonic CYP3A4 mRNA expression or serum CRP levels in UC patients. In conclusion, our results indicate a low TP-DDI risk for etrolizumab in UC patients, particularly on medications metabolized by CYP3A. PMID:26412221

  15. Risk factors influencing the outcome of peptic ulcer bleeding in chronic kidney disease after initial endoscopic hemostasis: A nationwide cohort study.

    Science.gov (United States)

    Liang, Chih-Ming; Hsu, Chien-Ning; Tai, Wei-Chen; Yang, Shih-Cheng; Wu, Cheng-Kun; Shih, Chih-Wei; Ku, Ming-Kun; Yuan, Lan-Ting; Wang, Jiunn-Wei; Tseng, Kuo-Lun; Sun, Wei-Chih; Hung, Tsung-Hsing; Nguang, Seng-Howe; Hsu, Pin-I; Wu, Deng-Chyang; Chuah, Seng-Kee

    2016-09-01

    Patients with chronic kidney disease (CKD) who had peptic ulcer bleeding (PUB) may have more adverse outcomes. This population-based cohort study aimed to identify risk factors that may influence the outcomes of patients with CKD and PUB after initial endoscopic hemostasis. Data from 1997 to 2008 were extracted from the National Health Insurance Research Database in Taiwan. We included a cohort dataset of 1 million randomly selected individuals and a dataset of patients with CKD who were alive in 2008. A total of 18,646 patients with PUB were screened, and 1229 patients admitted for PUB after endoscopic hemostasis were recruited. The subjects were divided into non-CKD (n = 1045) and CKD groups (n = 184). We analyzed the risks of peptic ulcer rebleeding, sepsis events, and mortality among in-hospital patients, and after discharge. Results showed that the rebleeding rates associated with repeat endoscopic therapy (11.96% vs 6.32%, P = 0.0062), death rates (8.7%, vs 2.3%, P < 0.0001), hospitalization cost (US$ 5595±7200 vs US$2408 ± 4703, P < 0.0001), and length of hospital stay (19.6 ± 18.3 vs 11.2 ± 13.1, P < 0.0001) in the CKD group were higher than those in the non-CKD group. The death rate in the CKD group was also higher than that in the non-CKD group after discharge. The independent risk factor for rebleeding during hospitalization was age (odds ratio [OR], 1.02; P = 0.0063), whereas risk factors for death were CKD (OR, 2.37; P = 0.0222), shock (OR, 2.99; P = 0.0098), and endotracheal intubation (OR, 5.31; P < 0.0001). The hazard ratio of rebleeding risk for aspirin users after discharge over a 10-year follow-up period was 0.68 (95% confidence interval [CI]: 0.45-0.95, P = 0.0223). On the other hand, old age (P < 0.0001), CKD (P = 0.0090), diabetes (P = 0.0470), and congestive heart failure (P = 0.0013) were the independent risk factors for death after discharge. In-hospital patients with CKD and PUB after endoscopic therapy

  16. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule

    OpenAIRE

    Li, Xin; Chandra, Subhash

    2014-01-01

    Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis.Keywords: ulcerative colitis; pyoderma gangrenosum...

  17. Overload of iron in the skin of patients with varicose ulcers. Possible contributing role of iron accumulation in progression of the disease

    International Nuclear Information System (INIS)

    The brown pigmentation of the skin associated with venous ulceration is caused by increased local iron deposition. Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for the noninvasive determination of iron levels in the skin of patients with venous ulceration. The mean (+/- SEM) iron concentration in the skin around the venous ulcer was elevated, compared with control values of nonulcerated skin (250 +/- 54 vs 128 +/- 39 micrograms) and compared with normal skin from the forearm (250 +/- 54 vs 14 +/- 2.5 micrograms). These data suggest that dermal iron deposition may not be an incidental by-product of increased venous pressure, but may actively perpetuate tissue damage in venous ulcerations

  18. Overload of iron in the skin of patients with varicose ulcers. Possible contributing role of iron accumulation in progression of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Ackerman, Z.; Seidenbaum, M.; Loewenthal, E.; Rubinow, A.

    1988-09-01

    The brown pigmentation of the skin associated with venous ulceration is caused by increased local iron deposition. Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for the noninvasive determination of iron levels in the skin of patients with venous ulceration. The mean (+/- SEM) iron concentration in the skin around the venous ulcer was elevated, compared with control values of nonulcerated skin (250 +/- 54 vs 128 +/- 39 micrograms) and compared with normal skin from the forearm (250 +/- 54 vs 14 +/- 2.5 micrograms). These data suggest that dermal iron deposition may not be an incidental by-product of increased venous pressure, but may actively perpetuate tissue damage in venous ulcerations.

  19. Evaluation of multiplex real-time PCR for detection of Haemophilus ducreyi, Treponema pallidum, herpes simplex virus type 1 and 2 in the diagnosis of genital ulcer disease in the Rakai District, Uganda

    Science.gov (United States)

    Suntoke, T R; Hardick, A; Tobian, A A R; Mpoza, B; Laeyendecker, O; Serwadda, D; Opendi, P; Gaydos, C A; Gray, R H; Wawer, M J; Quinn, T C; Reynolds, S J

    2009-01-01

    Objective: To develop a real-time PCR assay that reliably and accurately detects the predominant sexually transmitted aetiological agents of genital ulcer disease (GUD) (Haemophilus ducreyi, Treponema pallidum and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)) and to assess the use of real-time PCR diagnostic testing in a rural African field site. Methods: Two multiplex real-time PCR reactions were used to detect H ducreyi/and HSV-1/HSV-2 in ulcer swabs from 100 people with symptomatic genital ulcers in rural Rakai, Uganda. Results were compared with syphilis, HSV-1 and HSV-2 serology. Results: Of 100 GUD samples analysed from 43 HIV positive and 57 HIV negative individuals, 71% were positive for one or more sexually transmitted infection (STI) pathogens by real-time PCR (61% for HSV-2, 5% for T pallidum, 3% for HSV-1, 1% for H ducreyi and 1% for dual H ducreyi/HSV-2). The frequency of HSV in genital ulcers was 56% (32/57) in HIV negative individuals and 77% (33/43) in HIV positive individuals (p=0.037). Assay reproducibility was evaluated by repeat PCR testing in the USA with 96% agreement (κ=0.85). Conclusions: STI pathogens were detected in the majority of GUD swab samples from symptomatic patients in Rakai, Uganda, by real-time PCR. HSV-2 was the predominant cause of genital ulcers. Real-time PCR technology can provide sensitive, rapid and reproducible evaluation of GUD aetiology in a resource-limited setting. PMID:19066198

  20. Gastrin releasing peptide receptor expression is decreased in patients with Crohn’s disease but not in ulcerative colitis

    OpenAIRE

    ter Beek, W P; Muller, E S M; van Hogezand, R A; Biemond, I; Lamers, C B H W

    2004-01-01

    Background: Gastrin releasing peptide (GRP) and neuromedin B are bombesin (BN)-like peptides involved in regulating motility and inflammation in the gastrointestinal tract, which may be useful in treating inflammatory bowel disease (IBD). Three bombesin-like peptide receptors have been reported, but no studies have investigated their localisation in normal and inflamed human intestine.

  1. Alpha-1 antitrypsin and granulocyte colony-stimulating factor as serum biomarkers of disease severity in ulcerative colitis

    DEFF Research Database (Denmark)

    Soendergaard, Christoffer; Nielsen, Ole Haagen; Seidelin, Jakob Benedict; Kvist, Peter Helding; Bjerrum, Jacob Tveiten

    2015-01-01

    (Mayo score) and from 40 healthy controls were analyzed by multiplex enzyme-linked immunosorbent assay for 78 potential disease biomarkers. Using the statistical software SIMCA-P+ and GraphPad Prism, multivariate statistical analyses were conducted to identify a limited number of biomarkers to assess...

  2. Aphthous ulcers (recurrent)

    OpenAIRE

    Porter, Stephen R; Scully CBE, Crispian

    2007-01-01

    Most people with recurrent aphthous ulcers develop a few ulcers less than 1 cm in diameter, that heal after 5 to 14 days without scarring. The causes are unknown, but risks of recurrence may decrease if the person gives up smoking.Local physical trauma may trigger ulcers in susceptible people.In 10% of sufferers, lesions are more than 1 cm in diameter and can cause scarring.

  3. Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

    Science.gov (United States)

    Imbernón-Moya, Adrián; Vargas-Laguna, Elena; Aguilar, Antonio; Gallego, Miguel Ángel; Vergara, Claudia; Nistal, María Fernanda

    2015-01-01

    Pyoderma gangrenosum is an unusual necrotizing noninfective and ulcerative skin disease whose cause is unknown. Ophthalmic involvement in pyoderma gangrenosum is an unusual event. Only a few cases have been reported, from which we can highlight scleral, corneal, and orbital cases. Peripheral ulcerative keratitis is a process which destroys the peripheral cornea. Its cause is still unknown although it is often associated with autoimmune conditions. Pyoderma gangrenosum should be included in the differential diagnosis of peripheral ulcerative keratitis. Early recognition of these manifestations can vary the prognosis by applying the appropriate treatment. We introduce a 70-year-old woman who suffered pyoderma gangrenosum associated with peripheral ulcerative keratitis in her left eye. The patient's skin lesions and peripheral keratitis responded successfully to systemic steroids and cyclosporine A. PMID:26527531

  4. Characterization of Helicobacter Pylori Infection in Patients with Gastric Ulcer

    OpenAIRE

    Marcos Félix Osorio Pagola; Magalys Blanca Olivert Cruz; Juan Luís de Pasos Carrazana; Alfredo Basilio Quiñones Ceballos; Mabel Vega Galindo; Anagalys Ortega Alvelay

    2009-01-01

    Background: Nowadays, infection due to Helicobacter Pylori is recognized as a medical problem worldwide. It causes chronic gastritis, peptic ulcer disease, lymphatic proliferative disorders and it is a risk factor for gastric cancer. Objective: To characterize Helicobacter Pylori infection in patients with gastric ulcer and to relate this infection to gastric histological diagnoses. Methods: An observational, descriptive, correlational retrospective study in patients with gastric ulcers at ...

  5. Pyoderma Gangrenosum: A Rare Cause of Breast Ulceration

    OpenAIRE

    Duke, Georgina; Samaraee, Ahmad Al; Husain, Akhtar; Meggitt, Simon; Fasih, Tarannum

    2012-01-01

    Breast ulceration is an alarming sign for clinicians and places a significant physical and psychological burden on the patient. We report a rare presentation of pyoderma gangrenosum of the breast in a patient known to have ulcerative colitis but no active underlying disease process and no history of breast tissue trauma. This case report with literature review highlights the importance of considering pyoderma gangrenosum as a differential diagnosis in breast ulcers.

  6. ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

    Directory of Open Access Journals (Sweden)

    Mariana Barbosa ARAÚJO

    2014-04-01

    Full Text Available Objectives To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori. Methods A search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries. Results It was observed that the prevalence of H. pylori infection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylori shows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries. Discussion The observations might be suggestive of H. pylori being only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

  7. Subtotal Gastrectomy With Billroth II Anastomosis Is Associated With a Low Risk of Ischemic Stroke in Peptic Ulcer Disease Patients: A Nationwide Population-Based Study.

    Science.gov (United States)

    Chen, Chien-Hua; Lin, Cheng-Li; Kao, Chia-Hung

    2016-04-01

    Duodenal diversion can ameliorate lipid and glucose metabolism. We assessed the risk of stroke after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) in peptic ulcer disease (PUD).We identified 6425 patients who received SGBIIA for PUD between 1998 and 2010 from the Taiwan National Health Insurance Research Database as the study cohort; we frequency-matched them with 25,602 randomly selected controls from the PUD population who did not receive SGBIIA according to age, sex, index year, and comorbidities including hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease (COPD), and obesity. All patients were followed until the end of 2011 to determine the incidence of stroke.The incidence of stroke was lower in patients in the SGBIIA cohort than in those in the non-SGBIIA cohort (18.9 vs 22.9 per 1000 person-years, adjusted hazard ratio [aHR] 0.80, 95% confidence interval [CI] 0.72-0.89, P < 0.001). The risk of ischemic stroke (aHR 0.77, 95% CI 0.69-0.86, P < 0.001), rather than hemorrhagic stroke (aHR 1.00, 95% CI 0.78-1.28), was lower for the SGBIIA cohort than for the non-SGBIIA cohort according to the multivariable Cox proportional hazard regression analysis. The relative risk of ischemic stroke after SGBIIA was lower in men (aHR 0.77, 95% CI 0.69-0.86) than in women (aHR 0.80, 95% CI 0.65-0.99) and in patients aged ≥65 years (aHR 0.72, 95% CI 0.63-0.81) than in those of other age groups (≤49 years, aHR 0.82, 95% CI 0.48-1.39; 50-64 years, aHR 1.01, 95% CI 0.79-1.28). The relative risk of ischemic stroke after SGBIIA was also reduced in patients with comorbidities (aHR 0.84, 5% CI 0.75-0.95) rather than in those without comorbidities (aHR 0.81, 95% CI 0.59-1.12).SGBIIA is associated with a low risk of ischemic stroke for PUD patients, and its protective effect is prominent in men, patients aged ≥65 years, and those with comorbidities

  8. 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. .

  9. Health-related biotechnologies for infectious disease control in Africa: Ethical, Legal and Social Implications (ELSI) of transfer and development.

    Science.gov (United States)

    Sommerfeld, J; Oduola, A M J

    2007-01-01

    The African continent is disproportionately affected by infectious diseases. Malaria, HIV/AIDS, tuberculosis, and more "neglected" diseases including African trypanosomiasis, Buruli ulcer, leishmaniasis, onchocerciasis and trachoma continue to dramatically impact social and economic development on the continent. Health biotechnologies provide potential to develop effective strategies for the fight against the vicious circle of poverty and infections by helping in the development and improvement of novel affordable drugs, diagnostics and vaccines against these diseases. As the prospects of this emerging biotechnology research and deployment of its products become a reality in Africa, there is a need to consider the ethical, legal and social implications of both the scientific and technological advances and their use in the communities. The article provides a short overview of the potential values of biotechnology, issues involved in its transfer and presents the rationale, design and recommendations of the international workshop/symposium held in April 2005 at the International Institute for Tropical Agriculture (IITA) in Ibadan, Nigeria. PMID:17703556

  10. Neonatal Pressure Ulcer Prevention.

    Science.gov (United States)

    Scheans, Patricia

    2015-01-01

    The incidence of pressure ulcers in acutely ill infants and children ranges up to 27 percent in intensive care units, with a range of 16-19 percent in NICUs. Anatomic, physiologic, and developmental factors place ill and preterm newborns at risk for skin breakdown. Two case studies illustrate these factors, and best practices for pressure ulcer prevention are described. PMID:26803094

  11. Differences in visceral fat and fat bacterial colonization between ulcerative colitis and Crohn's disease. An in vivo and in vitro study.

    Directory of Open Access Journals (Sweden)

    Alessandra Zulian

    Full Text Available Crohn's disease (CD is notably characterized by the expansion of visceral fat with small adipocytes expressing a high proportion of anti-inflammatory genes. Conversely, visceral fat depots in ulcerative colitis (UC patients have never been characterized. Our study aims were a to compare adipocyte morphology and gene expression profile and bacterial translocation in omental (OM and mesenteric (MES adipose tissue of patients with UC and CD, and b to investigate the effect of bacterial infection on adipocyte proliferation in vitro. Specimens of OM and MES were collected from 11 UC and 11 CD patients, processed and examined by light microscopy. Gene expression profiles were evaluated in adipocytes isolated from visceral adipose tissue using microarray and RTqPCR validations. Bacteria within adipose tissue were immuno-detected by confocal scanning laser microscopy. Adipocytes were incubated with Enterococcus faecalis and cells counted after 24 h. Morphology and molecular profile of OM and MES revealed that UC adipose tissue is less inflamed than CD adipose tissue. Genes linked to inflammation, bacterial response, chemotaxis and angiogenesis were down-regulated in adipocytes from UC compared to CD, whereas genes related to metallothioneins, apoptosis pathways and growth factor binding were up-regulated. A dense perinuclear positivity for Enterococcus faecalis was detected in visceral adipocytes from CD, whereas positivity was weak in UC. In vitro bacterial infection was associated with a five-fold increase in the proliferation rate of OM preadipocytes. Compared to UC, visceral adipose tissue from CD is more inflamed and more colonized by intestinal bacteria, which increase adipocyte proliferation. The influence of bacteria stored within adipocytes on the clinical course of IBD warrants further investigations.

  12. Altered colonic mucosal Polyunsaturated Fatty Acid (PUFA derived lipid mediators in ulcerative colitis: new insight into relationship with disease activity and pathophysiology.

    Directory of Open Access Journals (Sweden)

    Mojgan Masoodi

    Full Text Available OBJECTIVES: Ulcerative colitis (UC is a relapsing inflammatory disorder of unconfirmed aetiology, variable severity and clinical course, characterised by progressive histological inflammation and with elevation of eicosanoids which have a known pathophysiological role in inflammation. Therapeutic interventions targetting eicosanoids (5-aminosalicylates (ASA are effective first line and adjunctive treatments in mild-moderate UC for achieving and sustaining clinical remission. However, the variable clinical response to 5-ASA and frequent deterioration in response to cyclo-oxygenase (COX inhibitors, has prompted an in depth simultaneous evaluation of multiple lipid mediators (including eicosanoids within the inflammatory milieu in UC. We hypothesised that severity of inflammation is associated with alteration of lipid mediators, in relapsing UC. DESIGN: Study was case-control design. Mucosal lipid mediators were determined by LC-MS/MS lipidomics analysis on mucosal biopsies taken from patients attending outpatients with relapsing UC. Univariate and multivariate statistical analyses were used to investigate the association of mucosal lipid mediators, with the disease state and severity graded histologically. RESULTS: Levels of PGE2, PGD2, TXB2, 5-HETE, 11-HETE, 12-HETE and 15-HETE are significantly elevated in inflamed mucosa and correlate with severity of inflammation, determined using validated histological scoring systems. CONCLUSIONS: Our approach of capturing inflammatory mediator signature at different stages of UC by combining comprehensive lipidomics analysis and computational modelling could be used to classify and predict mild-moderate inflammation; however, predictive index is diminished in severe inflammation. This new technical approach could be developed to tailor drug treatments to patients with active UC, based on the mucosal lipid mediator profile.

  13. Quality of Life Is Related to Fecal Calprotectin Concentrations in Colonic Crohn Disease and Ulcerative Colitis, but not in Ileal Crohn Disease

    OpenAIRE

    Gauss, Annika; Geib, Thomas; Hinz, Ulf; Schaefert, Rainer; Zwickel, Philipp; Zawierucha, Anna; Stremmel, Wolfgang; Klute, Lukas

    2016-01-01

    Abstract To formulate therapy goals, we aimed to define the relationship between fecal calprotectin and health-related quality of life in inflammatory bowel diseases (IBDs). This retrospective single-center cross-sectional study included ambulatory IBD patients who had completed standardized questionnaires comprising items of health-related quality of life (Short Inflammatory Bowel Disease Questionnaire) and clinical disease activity scores, and who had provided stool samples for calprotectin...

  14. Histamine and duodenal ulcer: effect of omeprazole on gastric histamine in patients with duodenal ulcer.

    OpenAIRE

    Man, W K; Thompson, J. N.; Baron, J. H.; Spencer, J

    1986-01-01

    Gastric mucosal concentrations of histamine and of its metabolic enzyme, histamine methyltransferase activity, were measured in patients with duodenal ulcer disease and patients with an apparently normal stomach and duodenum. Patients with duodenal ulcer had significantly less (p less than 0.05) mucosal histamine (median 204 nmol/g) than control subjects (median 252 nmol/g). There was no significant difference between the two groups in their histamine methyltransferase activity values. Omepra...

  15. 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.

  16. 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...

  17. [Ulcerated duodenitis revealing Henoch-Schönlein purpura].

    Science.gov (United States)

    Marting, A; Defrance, P; Wain, E; Van Severen, M; Deflandre, J

    2015-01-01

    Inflammation and duodenal ulcers can meet many etiologies. We report the case of a young adult with an ulcerated duodenitis revealing Henoch-Schönlein purpura. The abdominal symptoms preceded the emergence of the classical cutaneous signs of the disease. PMID:26376566

  18. Bactericidal activity does not predict sterilizing activity: the case of rifapentine in the murine model of Mycobacterium ulcerans disease.

    Directory of Open Access Journals (Sweden)

    Deepak V Almeida

    Full Text Available BACKGROUND: Since 2004, treatment of Mycobacterium ulcerans disease, or Buruli ulcer, has shifted from surgery to daily treatment with streptomycin (STR + rifampin (RIF for 8 weeks. For shortening treatment duration, we tested the potential of daily rifapentine (RPT, a long-acting rifamycin derivative, as a substitute for RIF. METHODOLOGY/PRINCIPAL FINDINGS: BALB/c mice were infected with M. ulcerans in the right hind footpad and treated either daily (7/7 with STR+RIF or five days/week (5/7 with STR+RIF or STR+RPT for 4 weeks, beginning 28 days after infection when CFU counts were 4.88±0.51. The relative efficacy of the drug treatments was compared by footpad CFU counts during treatment and median time to footpad swelling after treatment cessation as measure of sterilizing activity. All drug treatments were bactericidal. After 1 week of treatment, the decline in CFU counts was significantly greater in treated mice but not different between the three treated groups. After 2 weeks of treatment, the decline in CFU was greater in mice treated with STR+RPT 5/7 than in mice treated with STR+RIF 7/7 and STR+RIF 5/7. After 3 and 4 weeks of treatment, CFU counts were nil in mice treated with STR+RPT and reduced by more than 3 and 4 logs in mice treated with STR+RIF 5/7 and STR+RIF 7/7, respectively. In sharp contrast to the bactericidal activity, the sterilizing activity was not different between all drug regimens although it was in proportion to the treatment duration. CONCLUSIONS/SIGNIFICANCE: The better bactericidal activity of daily STR+RIF and especially of STR+RPT did not translate into better prevention of relapse, possibly because relapse-freecure after treatment of Buruli ulcer is more related to the reversal of mycolactone-induced local immunodeficiency by drug treatment rather than to the bactericidal potency of drugs.

  19. A case series to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis.

    Science.gov (United States)

    Siddle, Heidi J; Firth, Jill; Waxman, Robin; Nelson, E Andrea; Helliwell, Philip S

    2012-03-01

    The aim of this study was to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis (RA). Adults with RA and current foot ulceration but without diabetes were recruited. Clinical examination included assessment of RA disease activity, foot deformity, peripheral vascular disease, neuropathy and plantar pressures. Location, wound characteristics and time to healing were recorded for each ulcer. Participants completed the Health Assessment Questionnaire and Leeds Foot Impact Scale. Thirty-two cases with 52 current ulcers were recruited. Thirteen patients (41%) experienced more than one current ulcer: 5 (16%) had bilateral ulceration, 15 (47%) had previous ulceration at a current ulcer site. The majority (n = 33) of open ulcers were located over the dorsal aspect of the interphalangeal joints (n = 12), plantar aspect of the metatarsophalangeal joints (MTPJs) (n = 12) and medial aspect of first MTPJs (n = 9). In ulcerated limbs (n = 37), ankle brachial pressure index (ABPI) was 6 kg/cm(2) in 6 (16%). Mean ulcer size was 4.84 by 3.29 mm. Most ulcers (n = 42, 81%) were superficial; five (9.6%) were infected. Time to healing was available for 41 ulcers: mean duration was 28 weeks. Three ulcers remained open. In conclusion, foot ulceration in RA is recurrent and multiple ulcers are common. Whilst ulcers are small and shallow, time to achieve healing is slow, posing infection risk. Reduced protective sensation is common in affected patients. The prevalence of arterial disease is low but may be under estimated due to high intolerance of ABPI. PMID:22052587

  20. Amyloid Goiter Secondary to Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Bunyamin Aydin

    2016-01-01

    Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.

  1. Amyloid Goiter Secondary to Ulcerative Colitis.

    Science.gov (United States)

    Aydin, Bunyamin; Koca, Yavuz Savas; Koca, Tugba; Yildiz, Ihsan; Gerek Celikden, Sevda; Ciris, Metin

    2016-01-01

    Diffuse amyloid goiter (AG) is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn's disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis. PMID:27051538

  2. Perforated peptic ulcer and short-term mortality among tramadol users

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Riis, Anders; Christensen, Steffen;

    2007-01-01

    AIM: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown...

  3. Aetiopathology of ulcers of oral cavity and oropharynx: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Thimmappa T.D.

    2013-08-01

    Full Text Available Background: Oral ulcers are common diseases for which patient seeks medical advice. Till date the clinical profile to diagnose the oral ulcers, management and risk of malignancy is not well established. Hence, the study has been taken up to investigate the aetiopathology of ulcers of oral cavity and oropharynx. Methods: 60 cases of ulcers of oral cavity and oropharynx were included in the study. The aetiopathology of ulcers of oral cavity and oropharynx were investigated on the basis of age, sex, duration, etiological factors, symptom Index, socioeconomic status and anatomical distribution. Values are expressed as percentages. Results: The highest incidence was found in low socioeconomic status. The lesions studied in this study were 50% of Non Specific ulcers [Short term (3 wks 10-33%], 15% of Aphthous ulcers, 8.3% of Traumatic Ulcers, 6.5% of Malignant ulcers, 6.5% of Dental ulcers, 3.2% of HIV infection & AIDS, 3.2% of ulcer due to T.B and 6.5% of ulcers. The majority of the cases were between the age 21-30 years constituting 35% followed by 11-12 years constituting 26.6%.d 62% of the short term ulcers, Female 38%. Conclusions: Low socioeconomic status, lack of education, bad oral hygiene, bad habits cultivated in early childhood is predisposing factors. Hence early diagnosis and prompt treatment is advised in all cases of ulcers. [Int J Res Med Sci 2013; 1(4.000: 496-500

  4. Role of testosterone in resistance to development of stress-related vascular diseases in male and female organisms: models of hypertension and ulcer bleeding

    Science.gov (United States)

    Semyachkina-Glushkovskaya, O.; Pavlov, A.; Semyachkin-Glushkovskiy, I.; Zinchenko, E.; Kassim, M.; Al-Fatle, F.; Al Hassani, L.; Ulanova, M.; Gekaluk, A.

    2015-03-01

    In this paper, we discuss a relationship between stress-induced formation of hypertension and ulcer bleeding and the level of serum testosterone in female and male rats. We show that the secretion of testosterone is an important sign of severity of stress-induced damages of vascular homeostasis in males but not in females.

  5. Crohn's disease and ulcerative colitis. Occurrence, course and prognosis during the first year of disease in a European population-based inception cohort

    DEFF Research Database (Denmark)

    Burisch, Johan

    2014-01-01

    European countries. The reasons for these changes remain unknown but could include an increasing awareness of the diseases, better access to diagnostic procedures, methodological bias in previous studies from Eastern Europe, or real differences in environmental factors, lifestyle and genetic susceptibility...... subsequent to diagnosis in terms of clinical presentation, disease outcome, treatment choices, frequency of environmental risk factors, as well as patient-reported health-related quality of life (HRQoL) and quality of care (QoC). Finally, we assessed resource utilization during the initial year of disease...... differences in environmental factors prior to IBD diagnosis. In fact, Eastern European patients had higher frequencies of dietary risk factors than Western European patients, while the remaining risk factors occurred just as frequently. Furthermore, the availability of diagnostic tools and the diagnostic...

  6. PERFORATED PEPTIC ULCER: A CLINICAL ANALYSIS AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Bijit

    2016-03-01

    Full Text Available BACKGROUND The incidence of perforated peptic ulcer is approximately 7-10 cases per one lakh population per year. Perforation is seen in about 7% of patients hospitalized for peptic ulcer disease. Peptic ulcer perforation, which can be gastric/duodenal perforation can be a serious life-threatening condition if not detected early and treated urgently. Peptic ulcer disease has decreased considerably worldwide with the advent of potent anti-ulcer medicines, but its complication like peptic ulcer perforation has not. Our study is to analyse the clinical, radiological and management related findings in influencing the outcome of patients of peptic ulcer perforation after surgery. MATERIALS AND METHODS A series of 47 patients of peptic ulcer perforation were evaluated. Patients expiring within six hours of admission were not included in this study. RESULTS Age of the patients ranged from 17-80 years. The incidence of perforation was highest in the age group of 41-50 years (31.9%. Out of 47 patients, 41 (87.2% survived. CONCLUSION The incidence of perforation was highest in the age group of 41-50 years. Prognosis becomes poor with age, delayed treatment, shock at admission and concomitant diseases. Direct repair of the perforation with pedicled omentum gave excellent results.

  7. An eHealth System for Pressure Ulcer Risk Assessment Based on Accelerometer and Pressure Data

    OpenAIRE

    Dieter Hayn; Markus Falgenhauer; Jürgen Morak; Karin Wipfler; Viktoria Willner; Walter Liebhart; Günter Schreier

    2015-01-01

    Pressure ulcers are a common skin disease which is associated with pain, reduced autonomy, social isolation, and reduced quality of life. There are several systems for monitoring of pressure ulcer-related risk factors on the market, but up to now no satisfactory solution is available, especially for people with medium pressure ulcer risk. We present a novel pressure ulcer risk assessment and prevention system, which combines the advantages of accelerometer and pressure sensors for monitoring ...

  8. Diabetic foot ulcer treatment by activated platelet rich plasma: a clinical study

    OpenAIRE

    Tung Dang-Xuan Tran; Phuong Thi-Bich Le and Phuc Van Pham

    2014-01-01

    Diabetic foot ulcer is a major complication of diabetes mellitus. It occurred in about 15% of all diabetic patients. To date, the outcome of management of diabetic foot ulcer is poor and low sufficient. Some new therapies were suggested to manage and treat this disease. In almost therapies, management of diabetic foot ulcer relates to debridement of the wound, revascularization, off-loading of the ulcer, antibacterial actions, stimulating granulation, epidermization and angiogenesis. This stu...

  9. Bidirectional Crosstalk between Stress-Induced Gastric Ulcer and Depression under Chronic Stress

    OpenAIRE

    Shuang Zhang; Zhiwei Xu; Yan Gao; Yonghong Wu; Zhihui Li; Haifeng Liu; Chenggang Zhang

    2012-01-01

    Stress contributes to a variety of diseases and disorders such as depression and peptic ulcer. The present study aimed to investigate the correlation between stress ulcer and depression in pathogenesis and treatment by using chronic stress depression (CSD), chronic psychological stress ulcer (CPSU) and water immersion restrain stress models in rats. Our data showed that the ulcer index of the animals after CSD exposure was significantly higher than that of controls. Depression-like behaviors ...

  10. Treatment of a Non-Healing Diabetic Foot Ulcer With Platelet-Rich Plasma

    OpenAIRE

    Suresh, Deepak H; Shwetha Suryanarayan; Sacchidanand Sarvajnamurthy; Srikanth Puvvadi

    2014-01-01

    Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Among diabetes mellitus-related complications, foot ulceration is the most common, affecting approximately 15% of diabetic patients during their lifetime. The pathogenesis of diabetic ulcer is peripheral sensory neuropathy, calluses, oedema and peripheral vascular disease. Diabetic ulcer is managed by adequate control of infections and blood sugar levels, surgical debridement with various dressin...

  11. The effect of a minor constituent of essential oil from Citrus aurantium: the role of β-myrcene in preventing peptic ulcer disease.

    Science.gov (United States)

    Bonamin, Flavia; Moraes, Thiago M; Dos Santos, Raquel C; Kushima, Hélio; Faria, Felipe M; Silva, Marcos A; Junior, Ivan V; Nogueira, Leonardo; Bauab, Tais M; Souza Brito, Alba R M; da Rocha, Lucia R M; Hiruma-Lima, Clélia A

    2014-04-01

    The monoterpene β-myrcene has been widely used in cosmetics, food and beverages, and it is normally found in essential oil from citrus fruit. The aim of this study was to investigate the anti-ulcer effects of β-myrcene on experimental models of ulcers that are induced by ethanol, NSAIDs (non-steroidal anti-inflammatory drugs), stress, Helicobacter pylori, ischaemia-reperfusion injury (I/R) and cysteamine in order to compare with the essential oil of Citrus aurantium and its major compound limonene. The results indicate that the oral administration of β-myrcene at a dose of 7.50mg/kg has important anti-ulcer activity with significantly decreased gastric and duodenal lesions as well as increased gastric mucus production. The results showed treatment with β-myrcene caused a significant increase in mucosal malondialdehyde level (MDA), an important index of oxidative tissue damage. The β-myrcene was also endowed with marked enhancement of antioxidant enzyme activity from GR system as evidenced by the decreased activity of superoxide dismutase (SOD) and increased levels of glutathione peroxidase (GPx), glutathione reductase (GR), and total glutathione in gastric tissue. Our results also shown that treatment with β-myrcene is not involved with thioredoxin reductase (TrxR) activity. Our results reveal, for the first time, the importance of β-myrcene as an inhibitor of gastric and duodenal ulcers and demonstrate that an increase in the levels of gastric mucosa defence factors is involved in the anti-ulcer activity of β-myrcene. PMID:24480520

  12. Current management of peptic ulcer perforations

    International Nuclear Information System (INIS)

    Perforation is a life-threatening complication of peptic ulcer disease. Smoking and use of non-steroidal anti-inflammatory drugs are important risk factors for perforation. Diagnosis is made clinically and confirmed by the presence of pneumoperitoneum on radiographs. Nonoperative management is successful in patients identified to have a spontaneously sealed perforation proven by water-soluble contrast gastroduodenogram. Operative management consists of the time-honoured practice of mental patch closure, but now this can be done by laparoscopic methods. The practice of addition of acid-reducing procedures is currently being debated though it continues to be recommended in good-risk patients. Laparoscopic approaches to closure of duodenal perforation are now being applied widely and may become the gold standard in the future especially in patients with < 10 mm perforation size presenting within the first 24 hours of onset of pain. The role of Helicobacter pylori in duodenal ulcer perforation is controversial and more studies are needed to answer this question though recent indirect evidence suggests that eradicating H pylori may reduce the necessity for adding acid reducing procedures and the associated morbidity. Perforation is a life-threatening complication of peptic ulcer disease. The management of peptic ulcer disease has evolved over the decades, due to advances in operative techniques, bacteriology and pharmacology. While the recognition of the role of Helicobacter pylori (H. pylori) in peptic ulceration has resulted in a paradigm shift in the management of uncomplicated peptic ulcers, debate continues about the appropriate management of perforated duodenal bulb and prepyloric ulcers. A new dimension has been added to this controversy by the advent of laparoscopic techniques for closing the perforation. A Medline search of all articles dealing with the management of peptic ulcer perforation published after 1985 was undertaken. The short listed articles were

  13. Stasis dermatitis and ulcers

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000834.htm Stasis dermatitis and ulcers To use the sharing features on this page, please enable JavaScript. Stasis dermatitis is a change in the skin that occurs ...

  14. Giant duodenal ulcers

    Institute of Scientific and Technical Information of China (English)

    Eric Benjamin Newton; Mark R Versland; Thomas E Sepe

    2008-01-01

    Giant duodenal ulcers (GDUs) are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently,few cases had been successfully treated with medical therapy. However, the widespread use of endoscopy,the introduction of H-2 receptor blockers and proton pump inhibitors, and the improvement in surgical techniques all have revolutionized the diagnosis,treatment and outcome of this condition. Nevertheless,GDUs are still associated with high rates of morbidity,mortality and complications. Thus, surgical evaluation of a patient with a GDU should remain an integral part of patient care. These giant variants, while usually benign, can frequently harbor malignancy. A careful review of the literature highlights the important differences when comparing GDUs to classical peptic ulcers and why they must be thought of differently than their more common counterpart.

  15. Diabetes - foot ulcers

    Science.gov (United States)

    ... of the ulcer area. This will help speed healing. Be sure to wear shoes that do not ... American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37:S14-S80. PMID: 24357209 www. ...

  16. Canker Sore (Aphthous Ulcer)

    Science.gov (United States)

    ... are the most common cause of periodic (recurring) ulcers inside the mouth and genital linings (mucous membrane surfaces). Their cause is unknown, but stress, lack of sleep, trauma, and perhaps some vitamin ...

  17. 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 the...... 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...

  18. A Maximum Likelihood Estimator of a Markov Model for Disease Activity in Crohn's Disease and Ulcerative Colitis for Annually Aggregated Partial Observations

    DEFF Research Database (Denmark)

    Borg, Søren; Persson, U.; Jess, T.; Thomsen, Ole Østergaard; Ljung, T.; Riis, L.; Munkholm, P.

    2010-01-01

    Hospital, Copenhagen, Denmark, during 1991 to 1993. The data were aggregated over calendar years; for each year, the number of relapses and the number of surgical operations were recorded. Our aim was to estimate Markov models for disease activity in CD and UC, in terms of relapse and remission, with a...

  19. Trigeminal Neurotrophic Ulceration

    OpenAIRE

    El-Daly, Ahmed; Snyderman, Carl H.

    1997-01-01

    A 74 year-old female developed a trigeminal neurotrophic ulcer (TNU) 20 years following surgical ablation of the trigeminal nerve. The diagnosis of this unusual disorder is suggested when an ulcerative lesion develops. In the ala nasi in a patient with trigeminal sensory loss. A history of self-induced trauma to that area and some form of mental impairment further support the diagnosis.

  20. A Maximum Likelihood Estimator of a Markov Model for Disease Activity in Crohn's Disease and Ulcerative Colitis for Annually Aggregated Partial Observations

    DEFF Research Database (Denmark)

    Borg, Søren; Persson, U.; Jess, T.;

    2010-01-01

    cycle length of 1 month. The purpose of these models was to enable evaluation of interventions that would shorten relapses or postpone future relapses. An exact maximum likelihood estimator was developed that disaggregates the yearly observations into monthly transition probabilities between remission...... observed data and has good face validity. The disease activity model is less suitable for UC due to its transient nature through the presence of curative surgery...... Hospital, Copenhagen, Denmark, during 1991 to 1993. The data were aggregated over calendar years; for each year, the number of relapses and the number of surgical operations were recorded. Our aim was to estimate Markov models for disease activity in CD and UC, in terms of relapse and remission, with a...

  1. Barrett's ulcer: cause of spontaneous oesophageal perforation.

    OpenAIRE

    Limburg, A. J.; Hesselink, E. J.; Kleibeuker, J H

    1989-01-01

    We report two patients, who presented within six months with the classic clinical picture of 'spontaneous' oesophageal perforation, which was caused by a perforated Barrett's ulcer. These two cases underline the importance of postoperative endoscopy in ruling out intrinsic oesophageal disease as the cause of the rupture in every patient, who survives this life threatening condition.

  2. Manipulation of enteric flora in ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Mario Guslandi

    2005-01-01

    @@ TO THE EDITOR Reviewing the available therapeutic options in the medical treatment of ulcerative colitis, Xu et al.[1], have omitted to mention an important aspect in the pharmacological management of the disease, namely the possibility to promote clinical and endoscopic improvement by manipulating the enteric flora.

  3. 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.

  4. A community survey on the knowledge of neglected tropical diseases in Cameroon

    Directory of Open Access Journals (Sweden)

    Kamga HLF

    2012-01-01

    Full Text Available Background: The neglected tropical diseases are a group of 13 infections that affect more than one billion people worldwide, especially those who live in extreme poverty. Aim: This study was conducted to determine community knowledge of these neglected tropical diseases (NTD in Cameroon. Materials and Methods: A random sampling method was used to administer questionnaires to 3345 adults. Results: 2566 (76.7% of people approached responded to the questionnaire. This comprised 1313 (51.2% females and 1253 (48.8% males. There was a significant level of association between the opinion of the respondents and their region of residence (P<0.05. Globally the percentage of persons with good knowledge of one of the neglected tropical diseases was low (ranging from 23.1% to 80.9%. Diseases for which the population had the highest percentages of knowledge were leprosy (80.9%, soil-transmitted helminth infections (75.3%, lymphatic filariosis (70.3%, onchocerciasis (66.2% and human African trypanosomiasis (57.8%. Diseases for which people had the least percentages of knowledge were leishmaniosis (18.0%, dracunculiasis (23.1%, buruli ulcer (23.8%, trachoma (38.2%, endemic treponematosis (41.5% and schistosomiasis (49.1%. Populations living in urban areas had a greater knowledge of the neglected tropical diseases than those living in rural and peri-urban areas (P<0.05 and males exhibited a greater knowledge than females (P<0.05. Conclusion: There was low community knowledge pattern of neglected tropical diseases, mostly among the female populations and people living in rural areas. We advocate mass media health education to be adopted as one of the strategies for the national control policy of NTDs.

  5. 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)

  6. Changing trend in emergency surgery for perforated duodenal ulcer

    International Nuclear Information System (INIS)

    Objective: To evaluate changes in the emergency surgery of the duodenal ulcer. Subjects and Methods: Hospital records of 523 surgically treated patients, with duodenal ulcer perforation, during the period of 25 years 91975-1999) in the same surgical department, was retrospectively analysed. Changing aspects of emergency surgery of peptic ulcer disease, in the recent period, were determined in respect to number of operations per year and in the choice of operative methods. Results: The average number of patients and emergency operations per year was 21. No significant change was observed during the study period. Elective operations gradually decreased in the last ten years, and none was performed in the last 4 years. On the other hand, 226 emergency interventions for duodenal ulcer perforation were performed in the last ten years and 84 interventions in the last 4 years. Definitive anti-ulcer surgery was performed in 42% of patients between 1985 and 1994. Simple closure of the perforation plus treatment with proton pump inhibitors and with anti-Helicobacter pylori medication was the method in 80% during the last year. Conclusion: Emergency surgery for perforated duodenal ulcer preserves its steady rate despite disappearance of elective operations after tremendous progress in medical control of peptic ulcer disease. There is an obvious return from definitive anti-ulcer surgery to simple closure of the perforation followed by antisecretory and antibacterial medications in the recent years. (author)

  7. [Decubitus ulcer and nutritional status: literature review].

    Science.gov (United States)

    Castilho, Lillian Dias; Caliri, Maria Helena Larcher

    2005-01-01

    In order to better understand aspects related to the nutritional assessment of patients in risk for pressure ulcers, we reviewed the national and international literature indexed on Medline and LILACS bibliographic databases, from 1987 to 2001. The aim of this research was to investigate the knowledge production on pressure ulcers and nutritional status, as well as to learn about the authors and the publication focus. We concluded that patients in risk for pressure ulcers can be early identified based on nutritional assessment, including biochemical data, anthropometric evaluation, clinical data, diet history and energetic consumption. The alterations are frequent in elderly patients, hospitalized patients, patients with a chronic disease such as a vascular cerebral accident, cancer and spinal cord injury. PMID:16613396

  8. Gastric emptying in patients with gastric ulcer

    International Nuclear Information System (INIS)

    The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera. (U.K.)

  9. BLEEDING DUODENAL ULCER-TREATMENT OPTIONS

    Directory of Open Access Journals (Sweden)

    V. Poroch

    2009-11-01

    Full Text Available Actual treatment of bleeding duodenal ulcer is most frequently medical but also surgical. The aim of this study is to assess the factors that influence the outcomes for a group of 67 patients suffering of bleeding duodenal ulcer. Out of 67 patients considered in this study, 53 were men (79.1% and 14 were women (20.9%. The average age was 52 years for men and 53 years for women (range 19-86 years. 59 (88% were patients with known medical history of peptic ulcer disease. Endoscopy has been performed for 64 patients (95.6%. Specific medical treatment was started immediately for all patients. For 47 patients (70.1% the hemorrhage stopped with conservative treatment, 8 patients (12% benefit by endoscopic treatment and 12 patients (17.9% underwent surgery. The postoperative morbidity rate was 16.7%. Comorbidities were present in 43 patients (64.2%. Failure of medical conservative treatment has been observed in 7 cases (13%, and failure of endoscopic procedures in 2 cases (20%. The risk factors involved in therapy outcomes of bleeding duodenal ulcer are: age, the severity of hemorrhage confirmed by endoscopy, the hemorrhagic episodes in medical history and the time of surgery. Conclusion: The prognosis of bleeding duodenal ulcer after bleeding is highly correlated with the time that the treatment starts, the severity of hemorrhage, comorbid conditions and age.

  10. Ulcerative colitis Presenting as leukocytoclastic vasculitis of skin

    Institute of Scientific and Technical Information of China (English)

    Sabiye Akbulut; Ersan Ozaslan; Firdevs Topal; Levent Albayrak; Burcak Kayhan; Cumali Efe

    2008-01-01

    A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD),including pyoderma gangrenosum, erythema nodosum,perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

  11. Effect of cimetidine on the amounts of histamine in the gastric mucosa of patients with gastric or duodenal ulcers.

    OpenAIRE

    Man, W K; Saunders, J H; Ingoldby, C; Spencer, J

    1981-01-01

    Measurements were made of the amounts of histamine extracted from patients with peptic ulcer disease and control subjects suffering from various gastrointestinal diseases. Patients with duodenal ulcer, gastric ulcer, or recurrent duodenal ulcer after proximal gastric vagotomy often had less gastric mucosal histamine than did normal controls. Cimetidine therapy increased the amounts of the histamine to above control levels, presumably by suppression of output. It is concluded that endogenous a...

  12. Management of parastomal ulcers

    Institute of Scientific and Technical Information of China (English)

    Heather Yeo; Farshad Abir; Walter E Longo

    2006-01-01

    Management of surgically placed ostomies is an important aspect of any general surgical or colon and rectal surgery practice. Complications with surgically placed ostomies are common and their causes are multifactorial. Parastomal ulceration, although rare, is a particularly difficult management problem. We conducted a literature search using MD Consult, Science Direct,OVID, Medline, and Cochrane Databases to review the causes and management options of parastomal ulceration. Both the etiology and treatments are varied.Different physicians and ostomy specialists have used a large array of methods to manage parastomal ulcers;these including local wound care; steroid creams;systemic steroids; and, when conservative measures fail, surgery. Most patients with parastomal ulcers who do not have associated IBD or peristomal pyoderma gangrenosum (PPG) often respond quickly to local wound care and conservative management. Patients with PPG,IBD,or other systemic causes of their ulceration need both systemic and local care and are more likely to need long term treatment and possibly surgical revision of the ostomy. The treatment is complicated, but improved with the help of ostomy specialists.

  13. ANIMAL MODELS TO EVALUATE THE CAUSE BEHIND GASTRIC ULCERS

    Directory of Open Access Journals (Sweden)

    Saini Amita

    2012-08-01

    Full Text Available Peptic ulcer is the major cause of mortality and morbidity in developing countries, characterised by imbalance between aggressive gastric luminal factor and defensive mucosal barrier. This disease is mainly associated with increase in gastric acid secretion. Numerous factors like diet, smoking, drugs like aspirin and infection are responsible for augmentation of ulcers. Still, no therapeutic intervention has been found successful. So, this review has been designed to explore various animal models to find out a suitable medication. Various synthetic Omeprazole, cemitidine and herbal drugs like tulsi, Areca catechu are employed in the management of the ulcers but still no curative treatment is available due to unknown mechanism behind ulceration. So this review has been designed to explore various animal models that depict the signalling pathway involved in ulcers and have open vista for the development of the new drugs.

  14. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

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

    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...

  15. Understanding non ulcer dyspepsia.

    Science.gov (United States)

    Loh, K Y; Siang, T K

    2008-06-01

    Non ulcer dyspepsia is one of the most common problems encountered in primary care practice. The underlying pathophysiology of non ulcer dyspepsia is not fully understood, but it is known that this condition is associated with H. pylori infection and motility disorder. The presenting abdominal symptoms are non specific: they include bloating, belching, flatulence, excessive fullness after eating and nausea. Psychological condition such as anxiety, depression and stress do play a role in the recurrence of symptoms. Upper GI endoscopy is necessary in patients who presents with alarm symptoms suggestive of possible underlying organic condition before one makes the diagnosis of non ulcer dyspepsia. Pharmacological therapy using H2 receptor antagonist and proton pump inhibitors are effective for symptom relief. Patient's education and supportive care should be part of the management strategy in recurrent chronic dyspepsia. PMID:18942314

  16. 养殖日本鳗鲡腐皮病真菌性病原的分离与鉴定%ISOLATION AND IDENTIFICATION OF FUNGAL PATHOGEN FROM DERMAL ULCERATION DISEASE ON CULTURED ANGUILLA JAPONICA

    Institute of Scientific and Technical Information of China (English)

    曾占壮; 樊海平; 卓玉琛; 吴斌; 张新艳; 陈灵

    2011-01-01

    In recent years, dermal ulceration disease is one of the most serious diseases on cultured Japanese eels (An-guilla japonica), which occurs widely, spreads quickly and has caused great expense through the winter. In the beginning, the grume of the diseased eels are hyperplastic and then broken off. Following the evolvement of the illness, the derma is bareness and the muscle is necrotic. Eventually, the derma and the muscle are rotted.The isolation and identification of the fungal pathogen of this disease was studied. The fungal strain Js80122 was isolated from diseased eels by cultured on kernels of wheat. Strain Js80122 was confirmed as the causative pathogen of the dermal ulceration disease by artificial infection tests, which lasted for 2 weeks. In these tests, healthy eels were infected with four kinds of different methods, namely, injected with spores (0.3 mL/ind.) on dorsal muscle, marinated with 3 dish of culture after ravaged, daubed with spores(1.0x108 cell/mL)on wound and injected with spores and bacteria (0.3 mL/ind.) on dorsal muscle. The results showed that dermal ulceration disease could be recurred well on the experimental eels by any infection method; the symptom and process were similar to the naturally diseased eels. During the course of the artificial infection tests, the mortality were up to 100% in the group injected with spores (5.0x107 cell/mL) and bacteria (5.0x107CFU/mL) on dorsal muscle, 80% in the group injected with spores (l.OxlO8 cell/mL) on dorsal muscle, 60% in the group daubed with spores on wound, 20% in the group marinated with culture after ravaged, respectively. Observation on the morphology and life history of strain Js80122 cultured on slide and cover glass showed that strain Js80122 was the filamentous fungi and could grow well at 15℃, 20℃ and 25℃. Its hyphae were non-aseptate with plentiful branches, the reproductive modes were asexual and sexual. The asexual structure of Js80122 could be well produced at 20℃ or 25

  17. 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.

  18. ANTI-ULCER ACTIVITY OF LEGUMINOSAE PLANTS

    Directory of Open Access Journals (Sweden)

    Noemi D. PAGUIGAN

    2014-03-01

    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.

  19. Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds.

    Science.gov (United States)

    Hulkko, A; Holopainen, Y V; Orava, S; Kangas, J; Kuusisto, P; Hyvärinen, E; Ervasti, E; Silvennoinen, E

    1981-01-01

    The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase. PMID:6172073

  20. Frequency of nonsteroidal anti-inflammatory drug-associated ulcers.

    Science.gov (United States)

    Hiraishi, Hideyuki; Oki, Ryo; Tsuchida, Kohei; Yoshitake, Naoto; Tominaga, Keiichi; Kusano, Koji; Hashimoto, Takashi; Maeda, Mitsunori; Sasai, Takako; Shimada, Tadahito

    2012-06-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treatment of orthopedic diseases, inflammatory diseases, etc., and low-dose aspirin is a common antiplatelet therapy given mainly for secondary prevention of atherothrombosis (e.g., myocardial infarction and cerebral infarction). As to the history of NSAID-induced gastric mucosal injury in Japan, the first case of an aspirin-induced gastric ulcer was reported as early as 1934. Based on a meta-analysis of risk factors for peptic ulcers, Helicobacter pylori infection and NSAIDs are the main etiologies of peptic ulcers. NSAIDs alone increase the odds ratio for ulcer development to 19.4 and that for ulcer bleeding to 4.85. In fact, the Japan Rheumatism Foundation reported in 1991 that active gastric ulcers and active duodenal ulcers were detected in 15.5 and 1.9 % of 1008 patients, respectively, taking oral NSAIDs for 3 months or longer. In Japan, which is becoming an increasingly aged society, the numbers of patients taking NSAIDs and low-dose aspirin are expected to increase dramatically in the future. It is hoped that accumulation of evidence on gastrointestinal risk will allow many patients to rationally avoid gastrointestinal complications while receiving the benefits of NSAIDs and low-dose aspirin. PMID:26182316

  1. PEPTIC ULCER: A REVIEW ON ETIOLOGY AND PATHOGENESIS

    Directory of Open Access Journals (Sweden)

    Kaur Amandeep

    2012-06-01

    Full Text Available A peptic ulcer is a sore on the lining of the stomach or duodenum. The two most common types of peptic ulcer are called “gastric ulcers” and “duodenal ulcers”. Peptic ulcers are found to be due to an imbalance between aggressive factors such as hydrochloric acid (HCL, pepsin, refluxed bile, leukotrienes (LTs, reactive oxygen species (ROS and defensive factors, which include the function of the mucus-bicarbonate barrier, prostaglandins (PGs, mucosal blood flow, cell renewal and migration, nonenzymatic and enzymatic antioxidants and some growth factors. H. pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs are the predominant causes of peptic ulcer disease. Also, a numbers of factors are implicated in the pathogenesis of gastric ulcer, among which major factors involved are bacterial infection (Helicobacter pylori, certain medications (NSAID, chemicals (Hcl/ethanol ,gastric cancer and minor factors are stress, smoking, spicy food and nutritional deficiencies. The idea behind treating ulcers is to lower the amount of acid that your stomach makes, to neutralize the acid that is made and to protect the injured area so it can have time to heal. The main aim of this review article has to summarize the ulcerogenic mechanisms of various mediators involved in Peptic ulcer disease.

  2. The Incidence of Gastric Metaplasia in Patients with Duodenal Ulcer *

    OpenAIRE

    Min, Young II; LEE, BYOUNG WOOK; Chang, Young Woon; Chi, Hyun Sook; Lee, Jung Kook

    1987-01-01

    To investigate the incidence of duodenal gastric metaplasia and its underlying gastric or duodenal diseases, the authors obtained endoscopic biopsy specimens from the duodenal bulb at random sites during endoscopy from 19 normal subjects, 11 patients with gastric ulcer, 18 with duodenal and/or prepyloric ulcer (s), 7 with duodenitis and 8 with gastric erosions. The biopsy specimens were assessed with PAS staining to confirm gastric metaplasia. The incidence of duodenal gastric metaplasia was ...

  3. Risk factors of recurrent aphthous ulceration among university students

    OpenAIRE

    Shi, Liuxia; Wan, Kuan; Tan, Mengmeng; Yin, Guifang; Ge, Mengkai; Rao, Xiaoqian; He, Lianping; Jin, Yuelong; Yao, Yingshui

    2015-01-01

    Recurrent aphthous ulceration (RAU) is a common oral mucosal disease. The etiological involves in genetics, vitamin deficiencies, trauma, immune dysfunction and stress. This study was to explore the related risk factors of recurrent aphthous ulceration (RAU) among college students, and provide basis for further research. We conducted a questionnaire survey among students from three colleges in Wuhu by stratified cluster sampling. The information collected includes general demographic characte...

  4. Randomised controlled trial of azathioprine withdrawal in ulcerative colitis.

    OpenAIRE

    Hawthorne, A. B.; Logan, R. F.; Hawkey, C. J.; Foster, P. N.; Axon, A T; Swarbrick, E T; Scott, B B; Lennard-Jones, J E

    1992-01-01

    OBJECTIVE--To determine whether azathioprine can prevent relapse in ulcerative colitis. DESIGN--One year placebo controlled double blind trial of withdrawal or continuation of azathioprine. SETTING--Outpatient clinics of five hospitals. SUBJECTS--79 patients with ulcerative colitis who had been taking azathioprine for six months or more. Patients in full remission for two months or more (67), and patients with chronic low grade or corticosteroid dependent disease (12) were randomised separate...

  5. Duodenal ulcer course in patients participated in Chernobyl accident response

    International Nuclear Information System (INIS)

    80 participants of Chernobyl accident response having duodenal ulcer exacerbation were examined. Their disease was the result of internal irradiation (due to ingestion of short-living radioisotopes) as well as other emergency factors. Data characterizing the specific course of duodenal ulcer in patients were presented. Conclusion was made on the expediency of microbiological and cytogenetic investigations with simultaneous assessment of the indices of somatic mutagenesis

  6. ANIMAL MODELS TO EVALUATE THE CAUSE BEHIND GASTRIC ULCERS

    OpenAIRE

    Saini Amita; Sharma Nidhi; Sharma Ramica

    2012-01-01

    Peptic ulcer is the major cause of mortality and morbidity in developing countries, characterised by imbalance between aggressive gastric luminal factor and defensive mucosal barrier. This disease is mainly associated with increase in gastric acid secretion. Numerous factors like diet, smoking, drugs like aspirin and infection are responsible for augmentation of ulcers. Still, no therapeutic intervention has been found successful. So, this review has been designed to explore various animal mo...

  7. SPONTANEOUS DUODENO-BILIARY FISTULA CAUSED BY DUODENAL PEPTIC ULCER

    Directory of Open Access Journals (Sweden)

    N. Danila

    2005-07-01

    Full Text Available Spontaneous duodeno-biliary fistula represents a rare complication of chronic duodenal peptic ulcer. The authors present two cases with this pathology and also the particularities of surgical approach. Spontaneous duodeno-biliary fistula caused by chronic peptic ulcer is often a surprising diagnostic in the era of H2 blockers. The difficulties and the complexity of the diagnosis associated with the particularities of surgical technique represent the key of this rare disease.

  8. Receptor Binding Sites for Substance P, but not Substance K or Neuromedin K, are Expressed in High Concentrations by Arterioles, Venules, and Lymph Nodules in Surgical Specimens Obtained from Patients with Ulcerative Colitis and Crohn Disease

    Science.gov (United States)

    Mantyh, Christopher R.; Gates, Troy S.; Zimmerman, Robert P.; Welton, Mark L.; Passaro, Edward P.; Vigna, Steven R.; Maggio, John E.; Kruger, Lawrence; Mantyh, Patrick W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative colitis (n = 4) and Crohn disease (n = 4). Normal tissue was obtained from uninvolved areas of extensive resections for carcinoma (n = 6). In all cases, specimens were obtained <5 min after removal to minimize influences associated with degradation artifacts and were processed for quantitative receptor autoradiography by using 125I-labeled Bolton--Hunter conjugates of NK, SK, and SP. In the normal colon a low concentration of SP receptor binding sites is expressed by submucosal arterioles and venules and a moderate concentration is expressed by the external circular muscle, whereas SK receptor binding sites are expressed in low concentrations by the external circular and longitudinal muscle. In contrast, specific NK binding sites were not observed in any area of the human colon. In colon tissue obtained from ulcerative colitis and Crohn disease patients, however, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscularis mucosa, external circular muscle, external longitudinal muscle, and serosa. In addition, very high concentrations of SP receptor binding sites are expressed within the germinal center of lymph nodules, whereas the concentrations of SP and SK binding sites expressed by the external muscle layers are not altered significantly. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations (1000-2000 times normal) by cells

  9. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule

    Directory of Open Access Journals (Sweden)

    Xin Li

    2014-02-01

    Full Text Available Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis.

  10. Doença veno-linfática: alterações linfocintilográficas nas úlceras venosas Venous-lymphatic disease: lymphoscintigraphic abnormalities in venous ulcers

    Directory of Open Access Journals (Sweden)

    José Humberto Silva

    2009-03-01

    Full Text Available Contexto: O sistema linfático tem papel relevante em qualquer tipo de edema periférico. Atualmente, a linfocintilografia é considerada o principal exame para diagnóstico da doença linfática das extremidades. Embora haja associação entre edema linfático e úlcera de estase venosa crônica, a fisiopatologia dessas alterações permanece indefinida. Objetivo: Verificar as alterações linfocintilográficas qualitativas que ocorrem em pacientes portadores de úlceras de estase dos membros inferiores. Métodos: Quarenta pacientes portadores de úlcera de estase venosa crônica ou cicatriz unilateral foram submetidos a linfocintilografia de ambos os membros inferiores. Foram estudados 25 mulheres e 15 homens, com média de idade de 53,7 anos (28 a 79 anos e tempo médio de úlcera de 71,5 meses (3 a 240 meses. Foram comparados qualitativamente os parâmetros linfocintilográficos dos membros inferiores, previamente classificados em três grupos de acordo com a classificação clínica, etiológica, anatômica e patológica (CEAP: I, membros sem sinais clínicos de doença venosa ou com telangiectasias e veias reticulares (classes 0 e 1; II, membros inferiores com veias varicosas, edema e/ou alterações de pele e subcutâneo (classes 2, 3 e 4; III, membros inferiores com úlcera e/ou cicatriz (classes 5 e 6. Resultados: Quando foi comparada a presença de alterações linfocintilográficas dos membros com úlcera ou cicatriz (grupo III - classes 5 e 6 com as dos membros sem úlcera (grupos I e II - classes 0, 1, 2, 3 e 4, houve diferença significativa (p Background: The lymphatic system plays a relevant role in any type of peripheral edema. Lymphoscintigraphy is currently considered the primary test in the diagnosis of lymphatic disease of the lower limbs. Although there is an association between lymphatic edema and chronic venous ulcers, the physiopathology of such changes remains uncertain. Objective: To assess qualitative

  11. 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

  12. Radiography of pressure ulcers

    International Nuclear Information System (INIS)

    In patients with longstanding and/or deep pressure ulcers radiology is usually consulted. Survey radiography and sinography in 14 patients with pressure ulcers (6 over the tuber ischii and 8 over the femoral trochanter) were evaluated. Osteomyelitic involvement of adjacent bone was revealed in 9 patients on survey radiography. However, it was usually impossible to assess whether or not bony involvement represents healed or active osteomyelitis. Sinography did not contribute to the assessment of whether or not adjacent cortical bone was involved. However, when a fistulation to an adjacent joint was revealed this contributed substantially to the preoperative planning of resection. We therefore recommend that survey radiography and sinography should be included in the evaluation of these patients but that the results from such examinations are critically evaluated. Joint involvement should be taken seriously as progression of septic arthritis usually occurs rapidly. (orig.)

  13. Solitary penile ulcer associated with infections mononucleosis.

    OpenAIRE

    Lawee, D.; Shafir, M. S.

    1983-01-01

    Determining the cause of genital ulcers requires extensive laboratory investigation, particularly if there is no history of sexually transmitted disease. In a patient with a solitary penile erosion who was tired, weak, sweaty and febrile, hematologic and serologic tests suggested infectious mononucleosis, and bacteriologic and serologic studies, along with attempts at virus culture, ruled out syphilis and herpes simplex. The erosion healed soon after the other signs and symptoms resolved. It ...

  14. Fecal calprotectin and ulcerative colitis endoscopic activity index as indicators of mucosal healing in ulcerative colitis.

    Science.gov (United States)

    Taghvaei, Tarang; Maleki, Iradj; Nagshvar, Farshad; Fakheri, Hafez; Hosseini, Vahid; Valizadeh, Seyed Mohammad; Neishaboori, Hassan

    2015-04-01

    Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory large bowel disease with recurrent variable periods of exacerbation. The aim of the current study is to evaluate the correlation of UCEIS with fecal calprotectin (FC) level to assess disease activity in UC patients in order to determine whether FC can prognosticate clinical outcome and disease activity of UC instead of colonoscopic evaluation. Our endoscopic investigations revealed the extension of UC as the following: proctitis (11.6%), procto-sigmoiditis (18.5%), left-sided colitis (15.8%), extensive colitis (11.7%), and normal endoscopy (42.4%). Conclusively, we suggest that FC can be used as a reliable tool to evaluate disease activity in ulcerative colitis patients. Moreover, our findings indicate a significant correlation between FC level and mucosal healing. PMID:25366383

  15. Ulcerative Colitis in Infancy

    OpenAIRE

    Md Rukunuzzaman; A. S. M. Bazlul Karim

    2011-01-01

    Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter ...

  16. Contact Lens Related Corneal Ulcer

    OpenAIRE

    Loh, KY; P Agarwal

    2010-01-01

    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. Th...

  17. [PPI treatment for gastric ulcer patients in the elderly].

    Science.gov (United States)

    Itoh, Toshiyuki; Minami, Maya; Naito, Chisako; Chiba, Tsutomu

    2010-11-01

    Proton pump inhibitor (PPI) is an effective and safe medication for the elderly people for the treatment of peptic ulcer disease. However, some PPIs have been reported that they have metabolic interactions with some drugs. Therefore, drug-interactions should be considered when the PPI is prescribed to the elderly people. The number of NSAIDs ulcer patients is thought to increase along with the increase of those who take NSAIDs in the elderly. Although PPI is indispensable for the prevention of the NSAIDs ulcer, PPI has not obtained authorization for the purpose of prevention in Japan. PPIs are strongly expected to be approved for prevention of NSAIDs ulcer by the Japanese government in the near future. PMID:21061533

  18. Update on Peptic Ulcers in the Pediatric Age

    Directory of Open Access Journals (Sweden)

    Graziella Guariso

    2012-01-01

    Full Text Available Background. Peptic ulcer disease (PUD in children is reported worldwide, although it is relatively rare as compared with adults. Helicobacter pylori (HP infection is a common cause of PUD in the pediatric age. Other risk factors include the use of nonsteroidal anti-inflammatory agents (NSAIDs, steroids, immunosuppressive drugs, and stressful events. Aim. To critically review the evidence on epidemiology, diagnostic management, and available treatments for PUD in the pediatric age. Methods. A MEDLINE search was performed indicating keywords as “Peptic Ulcer Disease,” “Epidemiology,” “Pediatric,” “Helicobacter pylori,” “Gastric ulcer,” “Bulbar Ulcer,” and “Upper Gastrointestinal Bleeding.” A selection of clinical trials, systematic reviews, and meta-analyses within the time period 2002–2012 was performed. Results. PUD in children is reported worldwide with an estimated frequency of 8.1% in Europe and of 17.4% in the US. When the underlying cause of PUD is addressed, the prognosis is excellent. Standard triple therapy, bismuth-based quadruple therapy, and the sequential therapy represent the current recommended treatments for HP related ulcers. NSAIDs related ulcers are treated by stopping the causative medications and by administration of proton-pump inhibitors or antisecretory drugs. Conclusions. PUD still represents a major concern in the paediatric age. A careful differential diagnosis and an adequate treatment constitute an excellent prognosis.

  19. The Diminished Expression of Proangiogenic Growth Factors and Their Receptors in Gastric Ulcers of Cirrhotic Patients

    OpenAIRE

    Jiing-Chyuan Luo; Yen-Ling Peng; Ming-Chih Hou; Kuang-Wei Huang; Hui-Chun Huang; Ying-Wen Wang; Han-Chieh Lin; Fa-Yauh Lee; Ching-Liang Lu

    2013-01-01

    OBJECTIVES: The pathogenesis of the higher occurrence of peptic ulcer disease in cirrhotic patients is complex. Platelets can stimulate angiogenesis and promote gastric ulcer healing. We compared the expressions of proangiogenic growth factors and their receptors in the gastric ulcer margin between cirrhotic patients with thrombocytopenia and those of non-cirrhotic patients to elucidate possible mechanisms. METHODS: Eligible cirrhotic patients (n = 55) and non-cirrhotic patients (n = 55) who ...

  20. EFFECT OF OCIMUM SANCTUM LINN. IN STRESS INDUCED GASTRIC ULCERS IN RATS

    OpenAIRE

    Ayesha Vaseem, Ghulam Subhani, Khuteja Afshan, Mazher Ali, Md. Mohiuddin A Khan, Mujtaba T Rumana

    2015-01-01

    Aims & Objectives: Ocimum sanctum L. popularly known as Tulsi is a medicinal plant that has been used for curing various diseases since ages. In the present study we used leaf extract of Ocimum sanctum for its anti-ulcer property by inducing stress ulcers on rats. Materials and Method: Albino rats were randomly allocated to different experimental groups and aqueous leaf extract of Ocimum sanctum was given for 7 days. Stress ulcers were induced by restraint and ethanol administered methods and...

  1. Incidence of lactase deficiency (LD) in gastroduodenal ulcer and gastric carcinoma

    International Nuclear Information System (INIS)

    Lactase deficiency (LD) has been described in associated with peptic ulcer disease of the upper gastrointestinal tract, but little has been known as to the incidence of LD in the patients with ulcer disease of the upper GI tract or with gastric carcinoma. The purpose of the present study is to investigate the incidence of LD in gastric and/or duodenal ulcer disease and in gastric carcinoma, and to hypothesize the possible effect of these diseases on LD. Clinical materials consisted of 40 cases of active duodenal ulcer disease, 19 cases of benign gastric ulcer, 5 cases of multiple ulcers both in the stomach and duodenum, and 32 cases of gastric carcinoma. We used the lactose-barium test in diagnosing LD. X-ray findings were assessed according to the criteria described by Laws et al. and Preger and Amberg in the small-bowel film obtained at 30 minutes after the ingestion of some 200 ml of lactose-barium meal which contained 50 gm of lactose. Our clinical study revealed that the incidence of LD in duodenal ulcer was 50%, in gastric ulcer 57.9%, in gastric and duodenal ulcer 60%, and in gastric carcinoma 46.9%. The difference of incidence between each disease were statistically not significant, but the difference between the disease group and normal control was highly significant. The incidence of LD in disease group was nearly twice as high as that of normal control (27.7%). It is speculated that high incidence of LD in peptic ulcer disease of upper GI tract in particular may be associated with high acidity, the analog of which is found in Zollinger-Ellison syndrome. But high acidity is not a prominent feature in gastric carcinoma which is attended by almost equally high incidence of LD. It is therefore likely that the intolerability to lactose is caused by much complicated mechanism of versatile factors

  2. Venous ulcers of the lower limb: Where do we stand?

    Science.gov (United States)

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein. PMID:23162226

  3. Venous ulcers of the lower limb: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Chatterjee S Sasanka

    2012-01-01

    Full Text Available Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  4. Tofacitinib in ulcerative colitis.

    Science.gov (United States)

    Archer, Thomas P; Moran, Gordon W; Ghosh, Subrata

    2016-05-01

    Cytokines orchestrate immune and inflammatory responses involved in the pathogenesis of ulcerative colitis (UC). Protein kinases are essential for signal transduction in eukaryotic cells. Janus kinases (JAKs) are a family of protein tyrosine kinases that play a pivotal role in cytokine receptor signaling. Indeed, a major subgroup of cytokines use Type I and II cytokine receptors which signal via the activation of JAKs. Tofacitinib is an oral JAK inhibitor that has been studied in autoimmune pathologies, including UC and rheumatoid arthritis with good overall efficacy and acceptable safety profile. This literature review was performed with the goal of summarizing the knowledge on JAK inhibitors in UC treatment. PMID:27140405

  5. Cellular and Molecular Immunopathogenesis of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    Suzhen Zhang; Xuhui Zhao; Dechun Zhang

    2006-01-01

    Ulcerative colitis (UC) is an inflammatory disease of the rectal and colonic mucosa and seems to result from a complex series of interactions between susceptibility genes, the environment and the immune system. Various components of the mucosal immune system are implicated in the immunopathogenesis of UC. Evidence from animal models also suggests that an altered immune response to the commensal microflora of the host plays a central role in the development of UC. So in this review, we elucidate the cells and molecules which are implicated in the immunopathogenesis of the disease from four aspects: antigens in the intestine, dendritic cells, toll like receptors and NF-κB in the UC.

  6. Marjolin ulcer with multifocal origin

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    Das Sudip

    2009-01-01

    Full Text Available Marjolin ulcer developed from a twenty years old post burn scar. The patient presented with chronic ulceration followed by multifocal development of squamous cell carcinoma with different growth pattern. One nodular lesion grew rapidly to produce a large lesion with history of a little bleeding after trauma but without any pain. Excision followed by skin grafting resulted in good cosmetic scar.

  7. A comparison of DNA extraction procedures for the detection of Mycobacterium ulcerans, the causative agent of Buruli ulcer, in clinical and environmental specimens

    DEFF Research Database (Denmark)

    Durnez, Lies; Stragier, Pieter; Roebben, Karen;

    2008-01-01

    the moment, research is based on the detection by PCR of the insertion sequence IS2404 present in M. ulcerans and some closely related mycobacteria. In the present study, we compared four DNA extraction methods for detection of M. ulcerans DNA, namely the one tube cell lysis and DNA extraction...... purity of the extracted DNA and the time and effort needed were compared as well. All methods were performed on environmental specimens and the two best methods (MB and M16) were tested on clinical specimens for detection of M. ulcerans DNA. When comparing the DLs of the DNA extraction methods, the MB...... and M16 had a significantly lower DL than the OT and FP. For the different PCR targets, IS2404 showed a significantly lower DL than mlsA, MIRU1, MIRU5 and VNTR6. The FP and M16 were considerably faster than the MB and OT, while the purity of the DNA extracted with the MB was significantly higher than...

  8. A brief analysis of patients suffering from stomach or duodenal ulcers in Almaty hospital №1

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    Aryzbekova Aliya

    2015-12-01

    Full Text Available Peptic ulcers are a serious problem worldwide, and affect about 4 million people each year. Their etiology is connected with the presence of Helicobacter pylori, the act of smoking, drinking alcohol, being stress, and taking excessively nonsteroidal anti-inflammatory drugs, as well as steroids. The most common symptoms are abdominal pain, nausea, chest pain and fatigue, while less frequent symptoms include vomiting and weight loss. Helicobacter pylori is responsible for about 80% of gastric and 90% of duodenal ulcer cases. In this work, an analysis is made of a correlation between stomach or duodenal ulcer and gender, residence and number of patients hospitalized in the Almaty hospital №1, from 2009-2012, in order to learn about trends in the incidence of these diseases in Kazakhstan. A total number of 950 patients with stomach and duodenal ulcers, in 2009-2012, were questioned. The patient’s residence, gender and stomach or duodenal ulcer problem were taken into account in the study. The result of this work reveals that the largest amount of hospitalized patients suffering from stomach or duodenal ulcers came from urban areas. Moreover, more women than men suffered from peptic ulcers. Furthermore, the number of patients admitted to the hospital due to duodenal ulcers did not show any variation throughout the study. However, the least number of patients suffering from gastric ulcers was noticed in December 2009, and the greatest was in October and November 2011. The obtained data show that ulcers are a serious problem in Kazakhstan.

  9. Desulfovibrio bacterial species are increased in ulcerative colitis.

    LENUS (Irish Health Repository)

    Rowan, Fiachra

    2012-02-01

    BACKGROUND: Debate persists regarding the role of Desulfovibrio subspecies in ulcerative colitis. Combined microscopic and molecular techniques enable this issue to be investigated by allowing precise enumeration of specific bacterial species within the colonic mucous gel. The aim of this study was to combine laser capture microdissection and quantitative polymerase chain reaction to determine Desulfovibrio copy number in crypt-associated mucous gel in health and in acute and chronic ulcerative colitis. METHODS: Colonic mucosal biopsies were harvested from healthy controls (n = 19) and patients with acute (n = 10) or chronic (n = 10) ulcerative colitis. Crypt-associated mucous gel was obtained by laser capture microdissection throughout the colon. Pan-bacterial 16S rRNA and Desulfovibrio copy number\\/mm were obtained by polymerase chain reaction at each locus. Bacterial copy numbers were interrogated for correlation with location and disease activity. Data were evaluated using a combination of ordinary linear methods and linear mixed-effects models to cater for multiple interactions. RESULTS: Desulfovibrio positivity was significantly increased in acute and chronic ulcerative colitis at multiple levels within the colon, and after normalization with total bacterial signal, the relative Desulfovibrio load was increased in acute colitis compared with controls. Desulfovibrio counts did not significantly correlate with age, disease duration, or disease activity but interlevel correlations were found in adjacent colonic segments in the healthy control and chronic ulcerative colitis groups. CONCLUSION: The presence of Desulfovibrio subspecies is increased in ulcerative colitis and the data presented suggest that these bacteria represent an increased percentage of the colonic microbiome in acute ulcerative colitis.

  10. 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...... stressful life events before entrance to the study (P less than 0.05) and, like the neurotic patients, they had lowerego-strength to cope with such events (P less than 0.05). The results indicate that personality assessments make it possible to distinguish between subgroups of duodenal ulcer patients with...

  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...... stressful life events before entrance to the study (P less than 0.05) and, like the neurotic patients, they had lower ego-strength to cope with such events (P less than 0.05). The results indicate that personality assessments make it possible to distinguish between subgroups of duodenal ulcer patients with...

  12. Treatment of a non-healing diabetic foot ulcer with platelet-rich plasma

    Directory of Open Access Journals (Sweden)

    Deepak H Suresh

    2014-01-01

    Full Text Available Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Among diabetes mellitus-related complications, foot ulceration is the most common, affecting approximately 15% of diabetic patients during their lifetime. The pathogenesis of diabetic ulcer is peripheral sensory neuropathy, calluses, oedema and peripheral vascular disease. Diabetic ulcer is managed by adequate control of infections and blood sugar levels, surgical debridement with various dressings and off loading of the foot from pressure. In spite of these standard measures, some recalcitrant non-healing ulcers need additional growth factors for healing. Autologous platelet-rich plasma is easy and cost-effective method in treating diabetic ulcers as it provides necessary growth factors which enhance healing.

  13. [Neutrophilic dermatosis in ulcerative colitis occurring in advanced age].

    Science.gov (United States)

    López Maldonado, M D; Calvo Catalá, J; Ronda Gasulla, A; Hortelano Martínez, E; Herrera Ballester, A; Febrer Bosch, I

    1994-08-01

    The Neutrophilic dermatosis (ND) is considered as an independent entity with diverse clinical manifestations among which there are: gangrenous pyoderma, nodous erythema, Sweets Syndrome, vesiculopustula eruptions associated to ulcerous colitis and intestinal short circuit syndrome with or without short circuit. Histologically, they are characterized by infiltration of polymorphonuclear neutrophils, generally at the dermic level, but also at the epidermic. They are usually associated to systemic diseases, especially to chronic intestinal inflammatory disease. Our aim was to describe two forms of clinical presentation of neutrophilic dermatosis: gangrenous pyoderma and vesiculopustula eruption, associated to ulcerous colitis starting at advances ages. PMID:7772690

  14. [Pyoderma gangrenosum, an etiology of chronic ulcer disregarded?].

    Science.gov (United States)

    Zaugg, Patrice; Koch, Nathalie; Erba, Paolo; Raffoul, Wassim

    2016-02-10

    We report the case of a 65years old patient followed for more than 4 years for a leg ulcer in whom a rare combination of pyoderma gangrenosum with breast cancer was diagnosed. This is a rare skin disease, usually associated with systemic disease: digestive, rheumatological or malignant. The diagnosis is mainly clinical. Taking patient diagnostic management has two objectives: to eliminate other causes of skin ulcer and determine whether there is a concomitant illness that can be treated. Bacteriological swab and a biopsy should always be performed. The treatment consists of topical corticosteroids and systemic therapy with corticosteroids or immunosuppressive agents. PMID:27039446

  15. Ulcerative Colitis associated with Sclerosing Cholangitis and Autoimmune Hepatitis

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    Hoduț Andrei

    2013-04-01

    Full Text Available Introduction: Ulcerative colitis is a chronic intestinal inflammation, part of inflammatory bowel disease, which also includes Crohn’s disease. Both have extraintestinal manifestations, but those that tend to occur more commonly with ulcerative colitis include chronic active hepatitis, pyoderma gangrenosum and ankylosing spondylitis. Many individuals present with overlapping non-diagnostic features of more than one of these conditions that is referred to in the literature as autoimmune overlap syndrome. Sclerosing cholangitis associated with IBD is often referred to as overlap syndrome.

  16. 940 nm diode laser therapy in management of recurrent apthous ulcer

    OpenAIRE

    Misra, Neeta; Maiti, Debasmita; Misra, Pradyumna; Singh, Ashish Kumar

    2013-01-01

    Recurrent apthous stomatitis (RAS) is one of the most common oral inflammatory diseases characterised by painful recurrent ulcerations of the orofacial region. The ulcers occur in three clinical forms: minor, major and herpetiform. Several therapies have been advocated to manage these lesions such as topical corticosteroids (triamcinolone acetonide, hydrocortisone acetate and clobetasol propionate), chlorhexidine mouth rinses, tetracycline oral rinses, thalidomide, fluocinonide, colchicines a...

  17. Diabetes Foot Ulcers: A novel Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Golnaz Namazi

    2008-05-01

    Full Text Available Foot ulcers are common in 12-25 percent of diabetic patients. Preventing, controlling and treating of these kind chronic wounds are of the major clinical challenges.Evidence based documents revealed that DFU (Diabetic Foot ulcer is a chronic wound type originating from disturbed cellular and molecular mechanisms that have to be in its functional form to overcome its problem. In diabetes and some other chronic based diseases, harmonized acting machine causes chronic phases that result in conditions as foot ulceration and related complications seen commonly in diabetes.DFU needs to be transformed into acute phase in order to be healed in a physiological manner. Disturbed mechanisms have to be corrected reversely and to achieve such a goal it is essential to better understanding of disturbing factors responsible for biological abnormalities. Factors associated with DFU are as cellular and molecular recruitment and function impairments and there is need to repair these mechanisms. For this, we believe that the activated Th-1 cells (T helper-1 Cells might have a critical role in regulation of the several effector functions of the cellular and molecular mechanisms essential to the body to act the best. Evidences and our successful results urge us to suggest this regulatory role for effector cells and molecules generated through activation of Th-1 cells as a treatment strategy.

  18. Prevalence of non- Helicobacter pylori duodenal ulcer in Karachi,Pakistan

    Institute of Scientific and Technical Information of China (English)

    Javed Yakoob; Wasim Jafri; Nadim Jafri; Muhammad Islam; Shahab Abid; Saeed Hamid; Hasnain AliShah; Hizbullah Shaikh

    2005-01-01

    AIM: To determine the prevalence of non-Helicobacter pylori (H pylori)-related duodenal ulcer in patients with acid-peptic diseases.METHODS: Medical records of patients who attended the Gastroenterology Department at Aga Khan University Hospital from 1999 to 2001 and had endoscopic diagnosis of duodenal ulcers were reviewed. Duodenal ulcer associated with H pylori was diagnosed on the basis of endoscopy,rapid urease test and histopathology whereas histories of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) related duodenal ulcers. Non-H pylori, non-NSAID duodenal ulcers were those without H pylori infection and history of NSAID intake. Co-morbid conditions associated were noted.RESULTS: Of 2 260 patients, 10% (217/2 260) had duodenal ulcer. Duodenal ulcer related to H pylori infectionaccounted for 53% (116/217), NSAID-related 10% (22/217),non-H pylori non-NSAID 29% (62/217), and 8% (17/217) had both Hpyloriinfection and histories of NSAID intake. Fifteen percent (18/116)_patients had past histories of peptic ulcer disease in Hpyloriinfection, while 8% (5/62) in non-Hpylorinon-NSAID ulcer. Co-morbid conditions in H pylori infection were seen in 23% (27/116) and 34%(21/62) in non-H pylori non-NSAID ulcer.CONCLUSION: Incidence of H pylori infection related with duodenal ulcer is common. In the presence of co-morbids, non-Hpyloriand non-NSAID duodenal ulcer is likely to be present.

  19. The predictors of foot ulceration in patients with rheumatoid arthritis.

    Science.gov (United States)

    Firth, Jill; Waxman, Robin; Law, Graham; Nelson, E Andrea; Helliwell, Philip; Siddle, Heidi; Otter, Simon; Butters, Violet; Baker, Lesley; Hryniw, Rosemary; Bradley, Sarah; Loughrey, Lorraine; Alcacer-Pitarch, Begonya; Davies, Samantha; Tranter, Jennifer

    2014-05-01

    This study was conducted to determine the predictors of foot ulceration occurring in patients with rheumatoid arthritis (RA) without diabetes. A multi-centre case control study was undertaken; participants were recruited from eight sites (UK). Cases were adults diagnosed with RA (without diabetes) and the presence of a validated foot ulcer, defined as a full thickness skin defect occurring in isolation on / below the midline of the malleoli and requiring > 14 days to heal. Controls met the same criteria but were ulcer naive. Clinical examination included loss of sensation (10g monofilament); ankle-brachial pressure index (ABPI); forefoot deformity (Platto); plantar pressures (PressureStat); RA disease activity (36 swollen/tender joint counts) and the presence of vasculitis. History taking included past ulceration/foot surgery; current medication and smoking status. Participants completed the Health Assessment Questionnaire (HAQ) and Foot Impact Scale. A total of 83 cases with 112 current ulcers and 190 ulcer naïve controls participated. Cases were significantly older (mean age 71 years; 95 % confidence interval [CI], 69-73 vs. 62 years, 60-64) and had longer RA disease duration (mean 22 years; 19-25 vs. 15, 13-17). Univariate analysis showed that risk of ulceration increases with loss of sensation; abnormality of ABPI and foot deformity. Plantar pressures and joint counts were not significant predictors. HAQ score and history of foot surgery were strongly associated with ulceration (odds ratio [OR] = 1.704, 95 % CI 1.274-2.280 and OR = 2.256, 95 % CI 1.294-3.932). Three cases and two controls presented with suspected cutaneous vasculitis. In logistic regression modelling, ABPI (OR = 0.04; 95 % CI, 0.01-0.28) forefoot deformity (OR = 1.14; 95 % CI, 1.08-1.21) and loss of sensation (OR = 1.22; 95 % CI, 1.10-1.36) predicted risk of ulceration. In patients with RA, ABPI, forefoot deformity and loss of sensation predict risk of ulceration

  20. A CLINICAL STUDY ON PATIENTS WITH DUODENAL ULCER PERFORATION

    Directory of Open Access Journals (Sweden)

    Kishore Babu

    2016-03-01

    Full Text Available INTRODUCTION Perforated duodenal ulcer, the most catastrophic complication was Associated with high mortality in the past due to late presentation of the patients, delay in surgery and lack of antibiotics. Various authors state that the incidence of peptic ulcer disease and perforation has been declining for the past 3 decades. Because of advances in the medical therapy of peptic ulcer with a wide range of drugs the management of peptic ulcer disease has been changing and the role of surgery has been declining. Perforation is usually seen in 3rd and 4th decades with a male preponderance and the epidemiological trend is not the same worldwide. Incidence is slightly declining in western countries. The present study has been done during the period between 2013 and 2014 in S. V. R. R. Government general hospital Tirupati. AIMS AND OBJECTIVES The aim of the present study is to analyze the probable factors for increase in incidence of duodenal ulcer perforation, with particular emphasis on assessment of impact of H2 receptor antagonists and Proton Pump inhibitors on the incidence of perforation. STUDY SETTING S. V. Medical College, Department of General Surgery, Tirupati. STUDY PERIOD Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2013 to October 2014. INCLUSION CRITERIA Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have peritonitis due to duodenal ulcer perforation. EXCLUSION CRITERIA Patients with peritonitis due causes other than duodenal ulcer. STUDY METHOD Prospective Observational study among the selected patients. Total numbers of peptic ulcer cases that were admitted in this hospital and treated either medically or surgically were noted. The details of their clinical history and findings, investigation reports, operative findings, post-operative complications were recorded. Simple closure was performed for all the

  1. Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Sara Tomczyk

    Full Text Available The control of neglected tropical diseases (NTDs has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs.We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM, leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR estimates and corresponding 95% confidence intervals (CIs were calculated as a measure of intervention effect, using random effects meta-analyses.Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29, CLM (OR=0.24; 95% CI: 0.06-0.96, tungiasis (OR=0.42; 95% CI: 0.26-0.70, hookworm infection (OR=0.48; 95

  2. Clinical management of pressure ulcers.

    Science.gov (United States)

    Thomas, David R

    2013-05-01

    Pressure ulcers are chronic and difficult to heal. Pressure-reducing devices are clearly superior to a standard hospital mattress in preventing pressure ulcers, but only limited evidence and clinical intuition supports pressure-reducing devices in improving the healing rate of pressure ulcers. Local wound treatment should aim at maintaining a moist wound environment. The choice of a particular dressing depends on wound characteristics, such as the amount of exudate, dead space, or wound location. Nutritional status should be addressed as a process of good care. Debridement may improve time to a clean wound bed, but no clearly superior approach has been demonstrated. PMID:23571035

  3. A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers.

    Science.gov (United States)

    Chung, Chen-Shuan; Chiang, Tsung-Hsien; Lee, Yi-Chia

    2015-09-01

    An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis. PMID:26354049

  4. The Prevalence of Anemia of Chronic Disease in Patients With Spinal Cord Injuries and Pressure Ulcers and the Impact of Erythropoietin Supplementation on Wound Healing: A Descriptive Pilot Study.

    Science.gov (United States)

    Vair, Audra; Keast, David; LeMesurier, Anne

    2015-06-01

    Anemia of chronic disease (ACD) is thought to impair the responsiveness of erythroid progenitor cells, but research has shown treatment with recombinant human erythropoietin (rhuEPO) can improve patient hemoglobin levels and, subsequently, overall patient health status and quality of life. A prospective pilot study was designed to estimate the prevalence of ACD in outpatients with spinal cord injury (SCI) and chronic pressure ulcers (PUs) and examine the impact of rhuEPO on PU healing in this population. The charts of 49 SCI patients with PUs were reviewed; of those, 17 had anemia (hemoglobin nutritional status and treatment response. No statistically significant changes were observed with treatment. Wound surface area and depth had mean decreases of 1.35 cm(2) and 0.58 cm, respectively, immediately post-treatment. Participants' elevated C-reactive protein levels (91.1-14.2 mg/L) decreased with rhuEPO treatment, but returned to baseline levels post-treatment (83.2-14.3 mg/L). Prealbumin levels were consistently low (range of 0.1-0.21 g/L). This research indicates rhuEPO treatment may improve some outcomes for ACD-SCI PU patients, but larger randomized controlled trials are required. The results of this study suggest the prevalence of ACD in the SCI outpatient population with PUs is at least 35%, and increased vigilance of patient nutrition is recommended. PMID:26061404

  5. Natural Herbal Medicines Used As Anti-Ulcer Agents: A Pharmacological Review

    OpenAIRE

    Shruti Srivastava; Jatin Jaiswal; Hemendra Gautam; Surabhi Sharma

    2013-01-01

    Herbal drugs are traditional method of treating the disease in the world wide, the plant having ability to treat the disease is known as medicinal plants. Several types of medicinal plants are exists in the nature and effective in different type of disease. Peptic ulcers are a broad term that includes ulcers of digestive tract in the stomach or the duodenum. The formation of peptic ulcers depends on the presence of acid and peptic activity in gastric juice plus a breakdown in mucosal defenses...

  6. The treatment of skin ulcers in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    M. Matucci- Cerinic

    2011-09-01

    Full Text Available Systemic Sclerosis (Ssc is a complex disease of the connective tissue, characterized by progressive thickening and fibrosis of the skin and the internal organs and by diffused damage of the microvascular system. The fibrosis ones of the skin associated to the characteristic vascular alterations lead to the genesis of ulcers, more or less extended, often multiple, peripheral localization, chronic course, painful, able to influence patient’s quality of life. Indeed, immunity reactivity, the thinning and the loss of elasticity of the skin, the peripheral neurological damage and the eventual drug assumption that can reduce regenerative/reparative abilities, can easy chronicizzate an ulcer and become infected complicating still more the patient disease, rendering more difficult the cure often, ulcer evolves to gangrene, and in some cases, in amputation too. For all these reasons, we have begun to study ulcers therapy (local and systemic, considering this activity it leave integrating of the charitable distance of the sclerodermico patient, putting to point on strategy both diagnostic and therapeutic, but above all with the primary scope, if possible, is to prevent ulcers, in contrary case, to alleviate the pain and to render the quality of the life of the patient better.

  7. Omeprazole, Furazolidone, and Tetracycline: an eradication treatment for resistant H. pylori in Brazilian patients with peptic ulcer disease Omeprazol, Tetraciclina e Furazolidona, um tratamento para erradicação do H. pylori resistente em pacientes ulcerosos do Brasil

    Directory of Open Access Journals (Sweden)

    Fernando Marcuz Silva

    2002-09-01

    Full Text Available OBJECTIVES: To determine the efficacy of a simple, short-term and low-cost eradication treatment for Helicobacter pylori (H. pylori using omeprazole, tetracycline, and furazolidone in a Brazilian peptic ulcer population, divided into 2 subgroups: untreated and previously treated for the infection. PATIENTS AND METHODS: Patients with peptic ulcer disease diagnosed by endoscopic examination and infected by H. pylori diagnosed by the rapid urease test (RUT and histological examination, untreated and previously unsuccessfully treated by macrolides and nitroimidazole, were medicated with omeprazole 20 mg daily dose and tetracycline 500 mg and furazolidone 200 mg given 3 times a day for 7 days. Another endoscopy or a breath test was performed 12 weeks after the end of treatment. Patients were considered cured of the infection if a RUT and histologic examination proved negative or a breath test was negative for the bacterium. RESULTS: Sixty-four patients were included in the study. The women were the predominant sex (58%; the mean age was 46 years. Thirty-three percent of the patients were tobacco users, and duodenal ulcer was identified in 80% of patients. For the 59 patients that underwent follow-up examinations, eradication was verified in 44 (75%. The eradication rate for the intention-to-treat group was 69%. The incidence of severe adverse effects was 15%. CONCLUSION: The treatment provides good efficacy for H. pylori eradication in patients who were previously treated without success, but it causes severe adverse effects that prevented adequate use of the medications in 15% of the patients.OBJETIVO: Testar a eficácia de um esquema simplificado e de baixo custo para erradicação do H. pylori utilizando omeprazol, tetraciclina e furazolidona, em uma população de ulcerosos do Brasil, já tratados e não tratados previamente para a infecção. PACIENTES E MÉTODOS: Pacientes portadores de úlcera péptica, documentada por exame endoscópico e

  8. Avaliação da analgesia de opioide tópico em úlcera de perna de paciente falcêmico Evaluation of the topical application of opioid analgesia for a leg ulcer of a sickle cell disease patient

    Directory of Open Access Journals (Sweden)

    Alexandre F. Neves

    2010-01-01

    Full Text Available A doença falciforme é caracterizada por apresentar várias alterações clinicas e fisiopatológicas nos pacientes que por ela são acometidos. Uma dessas alterações é presença de úlceras de perna dolorosas e de difícil cicatrização, sendo necessário o apoio de equipe multiprofissional no seu manejo e tratamento. Com o objetivo de reduzir a dor associada a úlcera de perna, o paciente falcêmico faz uso de opioides parenterais e enterais que normalmente estão associados a efeitos colaterais indesejados. Com o objetivo de reduzir o uso desses opioides sistêmicos, avaliamos um gel de morfina, de fácil manipulação e baixo custo, que foi utilizado antes e após o processo de troca de curativo das úlceras de perna dos pacientes falcêmicos atendidos em nossa instituição. Baseados na escala analógica da dor foi avaliado o efeito analgésico do gel em 28 pacientes. Todos apresentavam dor grau 7 ou 8 antes da aplicação do gel. Vinte e quatro pacientes (85,7% apresentaram total ausência de dor por um período de 24 horas, não sendo necessário o uso de analgésicos sistêmicos. Em três pacientes (10,7% a ausência de dor durou um periodo de 12horas. Somente um paciente (3,6% não relatou analgesia apos o uso do gel. Os resultados demonstraram que o gel é altamente eficaz no controle da dor das úlceras de perna de pacientes falcêmicos.Sickle cell disease is characterized by several clinical and pathophysiological changes including painful leg ulcers. These are difficult to heal and require the support of a multidisciplinary team in their management. The treatment of pain in these patients usually involves the use of opioids. In order to reduce the use of systemic opioids, we evaluated an easy-to-use low-cost morphine gel (0.12% that was applied before and after changing leg ulcer dressings of sickle cell patients treated in Hemorio hospital. Based on the Analogue Pain Scale (APS we evaluated the analgesic effect of the gel with

  9. Is Helicobacter pylori Infection the Primary Cause of Duodenal Ulceration or a Secondary Factor? A Review of the Evidence

    Directory of Open Access Journals (Sweden)

    Vikram Kate

    2013-01-01

    Full Text Available Helicobacter pylori (H. pylori has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. Against this concept there are issues that need explanation such as the reason why only a minority of infected persons develop duodenal ulceration when infection with H. pylori is widespread. There is evidence that H. pylori infection has been prevalent for several centuries, yet duodenal ulceration became common at the beginning of the twentieth century. The prevalence of duodenal ulceration is not higher in countries with a high prevalence of H. pylori infection. This paper debate puts forth the point of view of two groups of workers in this field whether H. pylori infection is the primary cause of duodenal ulcer disease or a secondary factor.

  10. Gastroprotective and Anti-ulcer activity of Aloe vera juice, Papaya fruit juice and Aloe vera and Papaya fruit combined juice in Ethanol induced Ulcerated Rats

    Directory of Open Access Journals (Sweden)

    S. Gopinathan

    2013-12-01

    Full Text Available Peptic ulcer is the most prevalent gastrointestinal disease. Even though a wide range of drugs are available for the treatment of peptic ulcer, but many of these do not fulfill all the requirements and have side effects. These factors have attracted researchers to investigate the natural products which have more efficacy, less side effects and less expensive for the treatment of peptic ulcer disease. In the present study the anti ulcer activity of (1 Aloe vera juice, (2 papaya fruit juice (3 Aloe vera and papaya fruit combined juice were investigated in the ethanol induced ulcerated rats. The administration of plant juices decreased the offensive factors like ulcer index and acid secretion and also reduced the amount of protein and carbohydrates in the stomach fluid. Further, plant juices increased the defensive factors like activity of oxidative enzymes such as superoxide dismutase and reduced glutathione. Activities of alkaline phosphatase and lipid peroxide were higher in the diseased condition and same were reduced after the treatment with plant juices. Content of haemoglobin and RBC and WBC counts were brought back to normalcy after the treatment with plant juices. The efficacy of plant juices was comparable with the reference drug- Ranitidine. The results of the present study reveal that the plant juices are having efficiency in the gastroprotective activity. It is recommended that the above said plant juices can be further studied for their anti ulcer efficacy in human subjects.

  11. Use of anti tumor necrosis factor-alpha monoclonal antibody for ulcerative jejunoileitis

    Institute of Scientific and Technical Information of China (English)

    Gulseren Seven; Adel Assaad; Thomas Biehl; Richard A Kozarek

    2012-01-01

    Ulcerative jejunoileitis is an uncommon clinical syndrome consisting of abdominal pain,weight loss associated with diarrhea,and multiple inflammatory ulcerations and strictures of the small bowel.Ulcerative jejunoileitis can complicate established celiac disease or develop in patients de novo.Increased levels of tumor necrosis factor-alpha (TNF-α) in the small intestine of patients with untreated celiac disease are associated with a role in the immune pathogenesis of this disorder.No specific therapy has been shown to change the course of ulcerative jejunoileitis.We report a case of severe ulcerative jejunoileitis previously unresponsive to traditional therapies,including high dose corticosteroids and cyclosporine.The patient had a dramatic resolution of symptoms and a complete normalization of endoscopic findings after anti-TNF-α monoclonal antibody,infliximab (Remicade(R)).

  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. PMID:11915640

  13. Survey of stress ulcer prophylaxis

    OpenAIRE

    Erstad, Brian L; Barletta, Jeffrey F; Jacobi, Judith; Killian, Aaron D; Kramer, Katherine M; Martin, Steven J.

    1999-01-01

    Background: No surveys of stress ulcer prophylaxis prescribing in the USA have been conducted since 1995. Since that time, the most comprehensive meta-analysis and largest randomized study to date concerning stress ulcer prophylaxis have been published. Results: Three hundred sixty-eight surveys were sent to all members of the Section of Pharmacy and Pharmacology of the Society of Critical Care Medicine. One hundred fifty-three (42%) surveys were returned. Representatives from 86% of institut...

  14. In Vitro Activity of Selected West African Medicinal Plants against Mycobacterium ulcerans Disease.

    Science.gov (United States)

    Tsouh Fokou, Patrick Valere; Kissi-Twum, Abena Adomah; Yeboah-Manu, Dorothy; Appiah-Opong, Regina; Addo, Phyllis; Tchokouaha Yamthe, Lauve Rachel; Ngoutane Mfopa, Alvine; Fekam Boyom, Fabrice; Nyarko, Alexander Kwadwo

    2016-01-01

    Buruli ulcer (BU) is the third most prevalent mycobacteriosis, after tuberculosis and leprosy. The currently recommended combination of rifampicin-streptomycin suffers from side effects and poor compliance, which leads to reliance on local herbal remedies. The objective of this study was to investigate the antimycobacterial properties and toxicity of selected medicinal plants. Sixty-five extracts from 27 plant species were screened against Mycobacterium ulcerans and Mycobacterium smegmatis, using the Resazurin Microtiter Assay (REMA). The cytotoxicity of promising extracts was assayed on normal Chang liver cells by an MTT assay. Twenty five extracts showed activity with minimal inhibitory concentration (MIC) values ranging from 16 µg/mL to 250 µg/mL against M. smegmatis, while 17 showed activity against M. ulcerans with MIC values ranging from 125 µg/mL to 250 µg/mL. In most of the cases, plant extracts with antimycobacterial activity showed no cytotoxicity on normal human liver cells. Exception were Carica papaya, Cleistopholis patens, and Polyalthia suaveolens with 50% cell cytotoxic concentrations (CC50) ranging from 3.8 to 223 µg/mL. These preliminary results support the use of some West African plants in the treatment of Buruli ulcer. Meanwhile, further studies are required to isolate and characterize the active ingredients in the extracts. PMID:27089314

  15. In Vitro Activity of Selected West African Medicinal Plants against Mycobacterium ulcerans Disease

    Directory of Open Access Journals (Sweden)

    Patrick Valere Tsouh Fokou

    2016-04-01

    Full Text Available Buruli ulcer (BU is the third most prevalent mycobacteriosis, after tuberculosis and leprosy. The currently recommended combination of rifampicin-streptomycin suffers from side effects and poor compliance, which leads to reliance on local herbal remedies. The objective of this study was to investigate the antimycobacterial properties and toxicity of selected medicinal plants. Sixty-five extracts from 27 plant species were screened against Mycobacterium ulcerans and Mycobacterium smegmatis, using the Resazurin Microtiter Assay (REMA. The cytotoxicity of promising extracts was assayed on normal Chang liver cells by an MTT assay. Twenty five extracts showed activity with minimal inhibitory concentration (MIC values ranging from 16 µg/mL to 250 µg/mL against M. smegmatis, while 17 showed activity against M. ulcerans with MIC values ranging from 125 µg/mL to 250 µg/mL. In most of the cases, plant extracts with antimycobacterial activity showed no cytotoxicity on normal human liver cells. Exception were Carica papaya, Cleistopholis patens, and Polyalthia suaveolens with 50% cell cytotoxic concentrations (CC50 ranging from 3.8 to 223 µg/mL. These preliminary results support the use of some West African plants in the treatment of Buruli ulcer. Meanwhile, further studies are required to isolate and characterize the active ingredients in the extracts.

  16. 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.

  17. PYODERMA GANGRENOSUM WITH INFLAMATORY BOWEL DISEASE

    OpenAIRE

    Guru Prasad; Jhansi Lakshmi; Krishna Rao; Parvathi; Durga Bhavani

    2015-01-01

    Pyoderma gangrenosum (PG) is a chronic , painful ulcerated skin disease of unknown etiology. Its association with inflammatory bowel disease like ulcerative colitis is common . The lesions generally appear dur ing the course of active bowel disease , frequently concur with exacerbations of colitis , sometimes with inactive ulcerative colitis. 15 to 20 % of patients with Pyoderma gangrenosum have ulcerative colitis and 0.5 to 5 % of patients w...

  18. Tubercular Ulcer: Mimicking Squamous Cell Carcinoma of Buccal Mucosa

    OpenAIRE

    Ram, Hari; Kumar, Santosh; Mehrotra, Sanjay; Mohommad, Shadab

    2011-01-01

    Tuberculosis is a chronic granulomatous disease that rarely affects oral cavity. Tuberculous lesions of the oral cavity are frequently overlooked in the differential diagnosis of oral lesions. The oral clinical presentation of tuberculosis may take many forms as ulcers, nodules, tubercular fissure, tubercular papilloma and tuberculomas. Diagnosis is confirmed by histopathology.

  19. Arteriovenous shunt graft ulceration with sinus and graft epithelialization

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2015-03-01

    Full Text Available Arteriovenous fistula and grafts are used as access sites for patients with chronic kidney disease and are prone for complications. Stent grafts are used to treat access site complications. We report a rare and unusual finding of epithelialization of the sinus tract and the lumen of a polytetrafluoroethylene graft, following ulceration of the overlying skin.

  20. Chronic eosinophilic pancreatitis and ulcerative colitis in a horse.

    Science.gov (United States)

    Breider, M A; Kiely, R G; Edwards, J F

    1985-04-15

    A generalized debilitating disease in a horse was believed to be related to hypersensitivity to migrating strongyle larvae. The clinical signs included weight loss, diarrhea, and ulcers on all 4 coronary bands. The mare's condition deteriorated rapidly, so the mare was euthanatized and necropsied. The major histopathologic findings were chronic multifocal eosinophilic pancreatitis, hepatic portal fibrosis, biliary hyperplasia, and chronic ulcerative eosinophilic colitis. This case was similar to previously reported cases of chronic eosinophilic gastroenteritis in horses. Although the etiologic agent was not evident, the distribution and character of the lesions were consistent with a hypersensitivity response to migrating parasitic larvae, most probably Strongylus equinus. PMID:3997643

  1. Simultaneous genital ulcer and meningitis: a case of EBV infection.

    Science.gov (United States)

    Rahhal, Hassan; Nunes, Jairo Tavares; Lopes, Leonardo da Costa; Prokopowitsch, Aleksander Snioka

    2016-01-01

    The Epstein-Barr virus (EBV) is associated with a broad spectrum of diseases, mainly because of its genomic characteristics, which result in different latency patterns in immune cells and infective mechanisms. The patient described in this report is a previously healthy young man who presented to the emergency department with clinical features consistent with meningitis and genital ulcers, which raised concern that the herpes simplex virus was the causative agent. However, the polymerase chain reaction of cerebral spinal fluid was positive for EBV. The authors highlight the importance of this infection among the differential diagnosis of central nervous system involvement and genital ulceration. PMID:27547743

  2. Refractory ulcerative colitis and iatrogenic colorectal Kaposi's sarcoma.

    Science.gov (United States)

    Girelli, C M; Serio, G; Rocca, E; Rocca, F

    2009-02-01

    Colorectal Kaposi's sarcoma, a human herpes virus-8 associated mesenchymal tumour, is exceedingly rare in human immunodeficiency virus-negative subjects and almost always reported in association with severe, refractory, inflammatory bowel disease. In this paper we report a case--the second from Italy--of a colorectal Kaposi's sarcoma in a human immunodeficiency virus-negative, heterosexual man with severe refractory ulcerative colitis. Kaposi's sarcoma developed after starting glucocorticosteroid therapy, supporting the theory that colorectal Kaposi's sarcoma associated with ulcerative colitis is iatrogenic. PMID:18054849

  3. Health-related quality of life in diabetic patients with foot ulcers: literature review.

    Science.gov (United States)

    Goodridge, Donna; Trepman, Elly; Embil, John M

    2005-01-01

    Foot ulcers are a common, serious, and costly complication of diabetes, preceding 84% of lower extremity amputations in diabetic patients and increasing the risk of death by 2.4-fold over diabetic patients without ulcers. Health-related quality of life (HRQOL) is worse among individuals with diabetes than individuals without diabetes, and complications of diabetes, including foot ulcers, have a major negative effect on HRQOL. Diabetic foot ulcers are associated with reduced mobility and deficits related to activities of daily living that adversely affect HRQOL. Qualitative studies have confirmed clinical observations that diabetic foot ulcers have a huge negative psychological and social effect, including reduction in social activities, increased family tensions for patients and their caregivers (spouses or partners), limited employment, and financial hardship. Quantitative studies confirm the findings of qualitative studies that diabetic foot ulcers exert a negative effect on physical functioning, psychological status, and social situation. Recent advances include the development and validation of disease-specific HRQOL surveys for diabetic patients with foot ulcers. Disease-specific surveys may improve the evaluation of HRQOL as a function of ulcer healing, the effect of different treatment methods on HRQOL, and the relationship between treatment-specific HRQOL, patient compliance, and treatment efficacy. PMID:16301902

  4. Leishmaniasis Disease

    Science.gov (United States)

    ... please visit this page: About CDC.gov . Parasites - Leishmaniasis Parasites Home Share Compartir Disease Ulcerative skin lesion, ... border, on a Guatemalan patient who has cutaneous leishmaniasis. (Credit: B. Arana, MERTU, Guatemala) Marked splenomegaly (enlargement/ ...

  5. Density of Helicobacter pylorimay affect the efficacy of eradication therapy and ulcer healing in patients with active duodenal ulcers

    Institute of Scientific and Technical Information of China (English)

    Yung-Chih Lai; Teh-Hong Wang; Shih-Hung Huang; Sien-Sing Yang; Chi-Hwa Wu; Tzen-Kwan Chen; Chia-Long Lee

    2003-01-01

    AIM: To evaluate the association of pre-treatment Helicobacter pylori (H. pylori) density with bacterial eradication and ulcer healing rates in patients with active duodenal ulcer.METHODS: One hundred and four consecutive duodenal ulcer outpatients with H, pylori infection ascertained by gastric histopathology and 13C-urea breath test (UBT) were enrolled in this study. H. pylori density was graded histologically according to the Sydney system (normal, mild,moderate, and marked). In each patient, lansoprazole (30rng b.i.d.), clarithromycin (500 mg b.i.d.) and amoxicillin (1g b.i.d.) were used for 1 week, then 30 mg lansoprazole once daily was continued for an additional 3 weeks. Followup endoscopy was performed at 4 weeks after completion of the therapy, and UBT was done at 4 and 8 weeks after completion of the therapy.RESULTS: The H. pylorieradication rates were 88.9 %/100.0 %, 94.3 %/100.0 %, and 69.7 %/85.2 %; and the ulcer healing rates were 88.9 %/100.0 %, 94.3 %/100.0 %,and 63.6 %/77.8 % (intention-to-treat/per protocol analysis)in the mild, moderate, and marked H. pyloridensity groups,respectively. The association of pretreatment H. pyloridensity with the eradication rate and ulcer healing rate was both statistically significant (P=0.013/0.006 and 0.002/<0.001,respectively; using results of intention-to-treat/per protocol analysis).CONCLUSION: Intragastric bacterial load may affect both the outcome of eradication treatment and ulcer healing in patients with active duodenal ulcer disease.

  6. Photoletter to the editor: Oral ulceration in pyoderma gangrenosum.

    LENUS (Irish Health Repository)

    Verma, Saroj

    2012-02-01

    A 65-year-old woman presented with widespread necrotising cutaneous ulceration and oral involvement. Past history included rheumatoid arthritis, and a left nephrectomy.Examination revealed multiple violaceous undermined ulcers. Blood investigations showed an acute inflammatory response. Skin histopathology showed epidermal ulceration with acute and chronic inflammation. Direct immunofluorescence was negative. A diagnosis of pyoderma gangrenosum with oral involvement was made. Mycophenolate mofetil therapy resulted in complete resolution of her pyoderma gangrenosum. Her treatment was complicated by a left proteus mirabilis psoas abscess. This resolved following four weeks of antibiotics.Pyoderma gangrenosum with oral involvement is rare but has been linked with inflammatory bowel disease and hematological disorders. Oral pyoderma gangrenosum has not previously been described in rheumatoid arthritis. Primary psoas abscess is rare but can develop in immunocompromised patients. Proteus mirabilis has been reported in patients years after nephrectomy. This is a rare case of pyoderma gangrenosum with oral involvement.

  7. Diagnosis and management of long-standing benign oral ulceration.

    Science.gov (United States)

    Birt, D; From, L; Main, J

    1980-05-01

    The authors formed a Mouth Clinic at Sunnybrook Hospital in 1973 since when there have been 3025 patient visits. Those patients with chronic ulceration present a challenge, the diagnosis sometimes being difficult and therapy not rapidly effective. The differential diagnosis includes lichen planus, pemphigus vulgaris, benign mucous membrane pemphigoid, discoid lupus erythematosus, erythema multiforme, aphthous ulcers, Behcets disease, periadenitis mucosa necrotica recurrens, specific infections and iatrogenic causes. It is possible to reach a definite diagnosis in virtually every case by means of a good history and careful clinical examination supplemented by biopsies and in some cases direct and indirect immunofluorescent studies. Treatment emphasizes scrupulous attention to oral hygiene with baking soda mouthwashes and careful teeth cleaning to minimize the accumulation of dental plaque. Specific therapy includes topical steroids in lichen planus, intra muscular gold in benign mucous membrane pemphigoid, a previously unreported treatment which considerably improved seven out of ten patients, and tetracycline mouthwashes in aphthous ulcers. PMID:6990140

  8. Risk factors of recurrent aphthous ulceration among university students.

    Science.gov (United States)

    Shi, Liuxia; Wan, Kuan; Tan, Mengmeng; Yin, Guifang; Ge, Mengkai; Rao, Xiaoqian; He, Lianping; Jin, Yuelong; Yao, Yingshui

    2015-01-01

    Recurrent aphthous ulceration (RAU) is a common oral mucosal disease. The etiological involves in genetics, vitamin deficiencies, trauma, immune dysfunction and stress. This study was to explore the related risk factors of recurrent aphthous ulceration (RAU) among college students, and provide basis for further research. We conducted a questionnaire survey among students from three colleges in Wuhu by stratified cluster sampling. The information collected includes general demographic characteristics, dietary habits and so on. The overall prevalence of RAU is 23.30% among college students (23.23% in male and 23.39% in female). There are statistical significance in prevalence of RAU between subjects with RAU and without RAU (Pdental ulcer, which consist of promoting a correct way of living habits, paying attention to the health conscious diet, strengthen physical exercise, self-decompression and keeping good mentality. PMID:26131228

  9. Perforated duodenal ulcer: A rare complication of deferasirox in children

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Yadav

    2013-01-01

    Full Text Available Duodenal ulcer perforation in pediatric age group is an uncommon entity; hence, it is not usually considered in the differential diagnosis of acute abdomen in these patients. It is important for the emergency physician to consider perforated peptic ulcer in the differential diagnosis of children presenting with acute abdominal pain, gastrointestinal bleeding, or shock. We report a 6½-year-old male child with thalassemia major who presented to emergency room with an acute abdomen and shock, who was subsequently found to have a perforated duodenal ulcer, probably related to use of oral chelating agent, deferasirox. Although, gastrointestinal symptoms like nausea, vomiting, and abdominal pain has been mentioned as infrequent adverse event in the scientific product information of deferasirox, in our current knowledge this is the first case report of perforated duodenal ulcer after oral deferasirox. The severity of this event justifies the reporting of this case. This patient had an atypical presentation in that there were no signs or symptoms of peptic ulcer disease before perforation and shock he was successfully managed with open surgery after initial resuscitation and stabilization of his general condition.

  10. Seronegative Herpes simplex Associated Esophagogastric Ulcer after Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Edouard Matevossian

    2008-03-01

    Full Text Available Herpes simplex infection is characterized by acute or subacute infection, often followed by a chronic carrier state. Consecutive recurrences may flare up if immunocompromise occurs. Herpes simplex associated esophagitis or duodenal ulcer have been reported in immunocompromised patients due to neoplasm, HIV/AIDS or therapeutically induced immune deficiency. Here we report the case of an HSV-DNA seronegative patient who developed grade III dysphagia 13 days after allogeneic liver transplantation. Endoscopy revealed an esophageal-gastric ulcer, and biopsy histopathology showed a distinct fibroplastic and capillary ulcer pattern highly suspicious for viral infection. Immunohistochemistry staining revealed a distinct nuclear positive anti-HSV reaction. Antiviral therapy with acyclovir and high-dose PPI led to a complete revision of clinical symptoms within 48 h. Repeat control endoscopy after 7 days showed complete healing of the former ulcer site at the gastroesophageal junction. Although the incidence of post-transplantation Herpes simplex induced gastroesophageal disease is low, the viral HSV ulcer may be included into a differential diagnosis if dysphagia occurs after transplantation even if HSV-DNA PCR is negative.

  11. Miniaturized oligonucleotide arrays: a new tool for discriminating colonization from infection due to Staphylococcus aureus in diabetic foot ulcers.

    OpenAIRE

    Sotto, Albert; Richard, Jean-Louis; Jourdan, Nathalie; Combescure, Christophe; Bouziges, Nicole; Lavigne, Jean-Philippe

    2007-01-01

    OBJECTIVE: We sought to evaluate the use of oligonucleotide arrays to discriminate colonization from infection due to Staphylococcus aureus in diabetic foot ulcers. RESEARCH DESIGN AND METHODS: We included diabetic patients hospitalized in a diabetic foot department for an episode of foot ulcer. Only patients who had no antibiotic treatment during the previous 6 months were included. At admission, ulcers were classified on clinical examination, according to the Infectious Diseases Society of ...

  12. Protective Effect of Flos Lonicerae against Experimental Gastric Ulcers in Rats: Mechanisms of Antioxidant and Anti-Inflammatory Action

    OpenAIRE

    Kang, Jung-Woo; Yun, Nari; Han, Hae-Jung; Kim, Jeom-Yong; Kim, Joo-Young; Lee, Sun-Mee

    2014-01-01

    Flos Lonicerae is one of the oldest and most commonly prescribed herbs in Eastern traditional medicine to treat various inflammatory diseases. In the present study, we investigated the effects of ethyl acetate fraction of Flos Lonicerae (GC-7101) on experimental gastric ulcer models and its mechanisms of action in gastric ulcer healing. The pharmacological activity of GC-7101 was investigated in rats on HCl/EtOH, indomethacin, water immersion restraint stress induced acute gastric ulcer, and ...

  13. EXPERIMENTAL EVALUATION OF THE ANTI-ULCER ACTIVITY OF GRAPE (VITIS VINIFERA) SEED EXTRACT IN WISTAR ALBINO RATS

    OpenAIRE

    Anand M. Ingale; Vijaya Rajendran; Venkata BharatKumar Pinnelli

    2014-01-01

    Background: Peptic ulcer disease is a common condition of present day life, and its incidence is markedly increasing. The available drugs for the treatment are associated with adverse effects. Hence, there is a need for newer and better treatment for the same. Objectives: To evaluate the anti-ulcer activity of ethanolic extract of Vitis Vinifera (seed) by Water Immersion stress induced gastric ulcer model in Wistar albino rats using two doses (100, 200mg/kg body weight.) Methods: The antiu...

  14. Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection and without exposure to non-steroidal anti-inflammatory drugs

    OpenAIRE

    Smolović Brigita; Stanisavljević Dejana; Golubović Mileta; Vučković Ljiljana; Miličić Biljana; Đuranović Srđan

    2014-01-01

    Background/Aim. A high risk of bleeding in Helicobacter pylori (H.pylori)-negative, non-steroidal anti-inflammatory drugs (NSAID)-negative ulcers highlights the clinical importance of analysis of the changing trends of peptic ulcer disease. The aim of the study was to investigate the risk factors for ulcer bleeding in patients with non-H. pylori infection, and with no NSAIDs use. Methods. A prospective study included patients with endoscopically diagnosed u...

  15. Cushing's ulcer in traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Biteghe-bi-Nzeng Alain; WANG Yun-jie

    2008-01-01

    Traumatic brain injury(TBI)remains a complicated and urgent disease in our modernized cities. It becomes now a public health disease. We have got more and more patients in Neurosurgery Intensive Care Unit following motor vehicle accidents and others causes. TBI brings multiple disorders,from the primary injury to secondary injury. The body received the disturbances in the brain,in the hypothalamo-pituitary-adrenocortical(HPA)axis,in the gastric mucosa,in the immune and neuroendocrine systems.The mortality of TBI is more than 50 000 deaths/year, the third of the mortality of all iniuries. Cushing ulcer is one of the severe complications of TBI and its mortality rate is more than 50%. Many studies have improved the management of TBI and the associated complications to give patients a better outcome. Furthers studies need to be done based on the similar methodology to clarify the different steps of the HPA axis and the neuroendocrine change associated. The aim of the present review is to assess the clinical and endocrinal features of hypopituitarism and stress ulcer following TBI.

  16. Bosentan and sildenafil: successful treatment in a sclerodermic patient with refractory ulcers

    OpenAIRE

    E. Catarsi; Doveri, M.; Tavoni, A

    2013-01-01

    Systemic sclerosis is an inflammatory disease of the connective tissue characterized by vasculopathy and accumulation of collagen and other components of the connective matrix, affecting the skin and internal organs. The appearance of skin ulcers as a result of vascular damage is very common in the history of the disease. Skin ulcers, painful and slow healing due to atrophy and local ischemia, get worse the quality of life of patients. Often, the use of conventional therapies (such as calcium...

  17. Celiac disease (CD, ulcerative colitis (UC, and primary sclerosing cholangitis (PSC in one patient: a family study Enfermedad celiaca (EC, colitis ulcerosa (CU y colangitis esclerosante primaria (CEP asociadas en el mismo paciente: estudio familiar

    Directory of Open Access Journals (Sweden)

    V. Cadahía

    2005-12-01

    Full Text Available We discuss the case of a 17-year-old male who at the age of 7 was diagnosed with celiac disease (CD together with ulcerative colitis (UC and primary sclerosing cholangitis (PSC. The patient was treated with gluten-free diet and immunosuppressive drugs (azathioprine, and currently remains asymptomatic. The patient's younger, 12-year-old sister was diagnosed with CD when she was 1.5 years old, and at 7 years she developed type-I diabetes mellitus, which was difficult to control. A family study was made, and both parents were found to be affected with silent CD. All were DQ2 (+. In relation to the case and family study, we provide a series of comments related to CD and its complications.Presentamos el caso de un varón de 17 años, que a la edad de 7 años fue diagnosticado de enfermedad celiaca (EC junto con una colitis ulcerosa (CU y una colangitis esclerosante primaria (CEP asociadas. Fue tratado con DSG e inmuno-supresores tipo azatioprina y se encuentra asintomático en la actualidad. Su hermana menor de 12 años, fue diagnosticada de EC cuando tenía 1,5 años y a los 7 años desarrolló una DM tipo 1 de difícil control. Se realizó un estudio familiar y ambos padres están afectos de una EC silente. Todos ellos son DQ2 (+. A propósito del caso y estudio familiar, se hacen una serie de consideraciones sobre la enfermedad celiaca y el desarrollo de complicaciones.

  18. Technetium-99m hexamethyl propylene amine oxime-labeled leukocyte scintigraphy at three different times in active ulcerative colitis. Comparison with colonoscopy and clinico-biochemical parameters in the assessment of disease extension and severity

    International Nuclear Information System (INIS)

    In this study, our objective was to define the usefulness of technetium-99m hexamethyl propylene amine oxime (Tc-99m HMPAO)-labeled leukocyte scintigraphy at three different time points in the assessment of disease extension and severity in patients with active ulcerative colitis (UC). Twenty-one consecutive patients (10 women, 11 men; mean age 42.4±12 years) with active UC were prospectively studied. All patients were diagnosed by colonoscopy and histopathology prior to inclusion. Scintigraphy was performed at 1 h, 2 h, and 4 h after Tc-99m HMPAO-labeled leukocyte injection. Clinic-biochemical activity score, total colonoscopic activity score, and total scintigraphic activity score at 1 h, 2 h, and 4 h were calculated for each patient. Sensitivity, specificity, and accuracy values of Tc-99m HMPAO-labeled leukocyte scintigraphy were calculated as follows, respectively: 1 h imaging 86%, 73%, and 83%; 2 h imaging 89%, 74%, and 86%; 4 h imaging 90%, 58%, and 83% in the detection of active inflammatory segments. Even though no statistically significant difference was found between 1 h, 2 h, and 4 h imaging with respect to the sensitivity, specificity of labeled leukocyte scintigraphy, the largest area under the curve value was found for 2 h imaging. Tc-99m HMPAO-labeled leukocyte scintigraphy has been found to be correlated well with colonoscopy in the assessment of both the extension and severity of UC. We recommend 2 h scintigraphic imaging because it provides the largest area under the curve value and decreases the number of false-positive results. (author)

  19. A RETROSPECTIVE STUDY ON DUODENAL ULCER PERFORATION AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Parameshwara Chaldiganahalli

    2016-02-01

    Full Text Available INTRODUCTION Duodenal ulcer disease which was once so common 3-4 decades ago has drastically decreased in its incidence due to invent of PPIs and anti H. Pylori therapy. But percentage of patients with complications of duodenal ulcer has not shown a similar decline. In spite of understanding the disease effective resuscitation and prompt surgery there is still High incidence of morbidity and mortality. Hence in this study an attempt is made to analyse the various factors which effect the morbidity, mortality of patients with duodenal ulcer perforation and management of the same. AIMS The objective is to study, 1. The factors responsible for duodenal ulcer perforation. 2. The factors that affect the post-operative outcome. 3. Morbidity, mortality after surgery. MATERIALS AND METHODS Fifty patient’s case sheets were selected retrospectively who were diagnosed as duodenal ulcer perforation, admitted in MIMS Hospital, Mandya. Between 2012 to 2014 patients underwent Graham's omentoplasty. All the data related to the objectives of the study were collected. RESULTS Majority of patients belong to the. Age group of 30-50 years and commonly males Most of the perforations occur in first part of duodenum low socio-economic group, O+ve blood group with maximum seasonal incidence in October-January All cases were managed by Graham's omentoplasty. Four per cent of mortality noted. CONCLUSION Duodenal ulcer perforation is one of the common acute abdominal emergencies. The peak incidence between 30 and 50 years, majority cases males, common in lower socio–economic group, unskilled workers, maximum incidence period October-January, increased morbidity and mortality when perforation time period >24 hours, maximum in patient with blood group o+, early diagnosis and septicaemia management necessary for patients better prognosis, emergency procedure is Graham’s omentoplasty (perforations<2cm with H. pylori eradication treatment. Mortality noticed in longer

  20. Spontaneous Healing of Mycobacterium ulcerans Lesions in the Guinea Pig Model

    OpenAIRE

    Gomes, Rita Silva; Marcq, Elly; Trigo, Gabriela; Gonçalves, Carine M.; Longatto Filho, Adhemar; Castro, António G.; Pedrosa, Jorge; Fraga, Alexandra G.

    2015-01-01

    Buruli Ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans infection. BU is characterized by a wide range of clinical forms, including non-ulcerative cutaneous lesions that can evolve into severe ulcers if left untreated. Nevertheless, spontaneous healing has been reported to occur, although knowledge on this process is scarce both in naturally infected humans and experimental models of infection. Animal models are useful since they mimic different spectrums of human BU ...

  1. Rabbit gastric ulcer models: comparison and evaluation of acetic acid-induced ulcer and mucosectomy-induced ulcer

    OpenAIRE

    Maeng, Jin Hee; Lee, Eunhye; Lee, Don Haeng; YANG, SU-GEUN

    2013-01-01

    In this study, we examined rabbit gastric ulcer models that can serve as more clinically relevant models. Two types of ulcer model were studied: acetic acid-induced ulcers (AAU) and mucosal resection-induced ulcers (MRU). For AAU, rabbit gastric mucosa was exposed by median laparotomy and treated with bottled acetic acid. MRU was examined as a model for endoscopic mucosal resection (EMR). Normal saline was injected into the submucosal layer and the swollen mucosa was resected with scissors. E...

  2. A FUZZY INFERENCE SYSTEM FOR ASSESSMENT OF THE SEVERITY OF THE PEPTIC ULCERS

    Directory of Open Access Journals (Sweden)

    Kianaz Rezaei

    2014-05-01

    Full Text Available Peptic ulcer disease is the most common ulcer of an area of the gastro- intestinal tract. The aim of this study is to utilize soft computing techniques to manage uncertainty and imprecision in measurements related to the size, shape of the abnormality. For this, we designed a fuzzy inference system (FIS which emulates the process of human experts in detection and analysis of the peptic ulcer. The proposed approach models the vagueness and uncertainty associated to measurements of small objects in low resolution images In this study, for the first time, we applied soft computing technique based upon fuzzy inference system (FIS for assessment of the severity of the peptic ulcer. Performance results reveal the FIS with maximum accuracy of 98.1%, which reveals superiority of the approach. The intelligent FIS system can help medical experts as a second reader for detection of the peptic ulcer in the decision making process and consequently, improves the treatment process.

  3. Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity

    Institute of Scientific and Technical Information of China (English)

    Frank I Tovey; Michael Hobsley; John Holton

    2006-01-01

    Reports from countries with a high prevalence of Helicobacter pylori (H pylori) infection do not show a proportionately high prevalence of duodenal ulceration,suggesting the possibility that H pylori cannot be a primary cause of duodenal ulceration. It has been mooted that this discrepancy might be explained by variations in the prevalence of virulence factors in different populations. The aim of this paper is to determine whether the published literature gives support to this possibility. The relevant literature was reviewed and analyzed separately for countries with a high and low prevalence of H pylori infection and virulence factors. Although virulent strains of H pylori were significantly more often present in patients with duodenal ulcer than without the disease in countries with a low prevalence of H pyloriinfection in the population, there was no difference in the prevalence of virulence factors between duodenal ulcer, non- ulcer dyspepsia or normal subjects in many countries, where the prevalence of both H pylori infection and of virulence factors was high.In these countries, the presence of virulence factors was not predictive the clinical outcome. To explain the association between virulence factors and duodenal ulcer in countries where H pylori prevalence is low,only two papers were found that give little support to the usual model proposed, namely that organisms with the virulence factors are more likely than those without them to initiate a duodenal ulcer. We offer an alternative hypothesis that suggests virulence factors are more likely to interfere with the healing of a previously produced ulcer. The presence of virulence factors only correlates with the prevalence of duodenal ulcer in countries where the prevalence of H pylori is low. There is very little evidence that virulence factors initiate duodenal ulceration, but they may be related to failure of the ulcer to heal.

  4. Ulcerative Colitis Associated with Aplastic Anemia; A Case Report

    OpenAIRE

    Ghavidel, Ali

    2013-01-01

    Anemia is the most common hematologic disorder in patients with ulcerative colitis (UC). In some cases, normochromic anemia results from the presence of chronic disease; however blood loss or malabsorption may lead to an iron deficiency anemia with hypochromic appearance. Other rare hematologic manifestations associated with UC include myelodysplastic syndromes and leukemia. Several investigators have suggested a clinical association between inflammatory bowel disease and myelodysplastic synd...

  5. Controlled trial of azathioprine in chronic ulcerative colitis.

    OpenAIRE

    Kirk, A P; Lennard-Jones, J E

    1982-01-01

    A double-blind controlled trial of azathioprine in a dose of 2-2.5 mg/kg body weight over six months was conducted among 44 patients with active chronic ulcerative colitis. Three patients treated with placebo did not complete the trial because their disease became so severe that colectomy was performed. Among patients who completed the trial the mean dose of prednisolone necessary to control the disease decreased in those treated with azathioprine and those treated with placebo; the reduction...

  6. The Role of Fecal Calprotectin in Investigating Pediatric Ulcerative Colitis

    OpenAIRE

    Fatih Ünal; Evren Semizel; Muhittin Serdar; Çiğdem Ömür Ecevit; Yılmaz Karaca; Emine Mert Yılmaz; Hasan Kocaefe; Hasan Erhun Kasırga

    2012-01-01

    Introduction: Fecal calprotectin (FCP) can be found in high concentrations in inflammatory bowel disease due to the increase in leucocyte turnover in intestinal wall or increase of migration of neutrophils into the lumen. In this study, we aimed to determine the FCP values of the ulcerative colitis (UC) patients at the time of diagnosis and to investigate the applicability and effectiveness of this non-invasive method in the diagnosis of the disease, routinely.Materials and Methods: A total o...

  7. Venous Ulcers: New Options in Treatment: Minimally Invasive Vein Surgery

    OpenAIRE

    Poblete, Honesto; Elias, Steven

    2009-01-01

    Venous disease has a spectrum of presentations. The most advanced state of chronic venous insufficiency (CVI) managed by wound care specialists being ulceration of the lower extremity. The goal of all treatments for advanced venous disease is to decrease ambulatory venous hypertension. Treatment can be divided into exogenous and endogenous methods. Exogenous methods include those applied externally such as compression, elevation, debridement and wound dressings. Endogenous methods treat the u...

  8. Steroid ulcers:Any news?

    Institute of Scientific and Technical Information of China (English)

    Mario; Guslandi

    2013-01-01

    Steroid ulcers,although a common feature in experimental studies,seldom develop in clinical practice,as observed by the meta-analyses carried out in the 90s.Corticosteroids alone become ulcerogenic only if treatment lasts longer than one month and the total administered dose exceeds 1000 mg.On the other hand concomitant intake of non-steroidal anti-inflammatory drugs results in a synergistic,highly damaging effect on the gastroduodenal mucosa.Thus,despite the survival of the steroid ulcer myth in the medical culture,pharmacological protection against steroid-induced peptic ulcers is a rare necessity while the best prophylactic strategy still remains to be determined.

  9. Ulcerative Lichen Planus in Childhood

    Directory of Open Access Journals (Sweden)

    Chiyadu Padmini

    2013-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory mucocutaneous condition which is relatively common in adults but rarely affects children. The present study is a report on an unusual case of ulcerative oral LP involving the dorsum of tongue in a 12-year-old boy. Patient complained of painful oral lesion on the tongue which was burning in nature and obstructing talking and eating spicy foods. On intraoral examination, a white ulcerative lesion on the dorsum of tongue was observed. Diagnosis was made based on clinical examination and histopathological features. We instituted local treatment and patient responded well to the treatment. Although rarely reported in childhood, lichen planus should be considered in a differential diagnosis of hyperkeratotic, reticular, and ulcerative lesions of the oral mucosa in children.

  10. Indigenous anti-ulcer activity of Musa sapientum on peptic ulcer

    Directory of Open Access Journals (Sweden)

    P Prabha

    2011-01-01

    Full Text Available Background: Peptic ulcer disease (PUD, encompassing gastric and duodenal ulcers is the most prevalent gastrointestinal disorder. The pathophysiology of PUD involves an imbalance between offensive factors like acid, pepsin and defensive factors like nitric oxide and growth factors. The clinical evaluation of antiulcer drugs showed tolerance, incidence of relapses and side-effects that make their efficacy arguable. An indigenous drug like Musa sapientum possessing fewer side-effects is the major thrust area of present day research, aiming at a better and safer approach for the management of PUD. Material and Methods: The unripe plantain bananas (Musa sapientum were shade-dried, powdered and used for phytochemical analysis and as antiulcer drug. In our present study Group I rats served as control and were treated with saline, Group II was indomethacin-induced ulcerated rats, Group III received aqueous extract of Musa sapientum along with indomethacin and Group IV received esomeprazole along with indomethacin for 21 days. The anti-ulcerogenic activity was investigated by performing hematological, mucosal, antioxidant profile in comparison with the standard drug esomeprazole. Results: Our findings from High - Performance Thin Layer Chromatography (HPTLC analysis showed that Musa sapientum has an active compound a monomeric flavonoid (leucocyanidin with anti-ulcerogenic activity. Results were expressed as mean ± SD. All our results are in congruous with the results of standard drug esomeprazole. Conclusion: It could be clearly concluded that administration of the aqueous extract of Musa sapientum at the dose used in this study tends to ameliorate ulcers. Its use in indigenous medicine should be scientifically scrutinized with further research.

  11. Probiotics in the Management of Ulcerative Colitis.

    Science.gov (United States)

    Chibbar, Richa; Dieleman, Levinus A

    2015-01-01

    Rapid progress has been made to understand the pathophysiology of inflammatory bowel diseases and to identify new treatments. Interaction of the gut microbiota on the host inflammatory response has suggested that alternative therapies, such as probiotics, might have a complementary role in treating and preventing disease flares. Multiple probiotics and their formulations have been studied for both the induction and maintenance of remission of ulcerative colitis (UC); however, mainly Escherichia coli Nissle 1917 and VSL#3 have been shown to provide significant benefits for the prevention and treatment of mild to moderate UC. Although these data are promising, there is still a paucity of robust, randomized-controlled trials to suggest that probiotics be utilized as part of a standard treatment regimen. With continued research and a movement toward carefully selected, individualized management based on an individual's specific microbiota composition and function, probiotics may become an integral part of tailored therapy for UC. PMID:26447965

  12. Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

    OpenAIRE

    Bowering, C. K.

    2001-01-01

    OBJECTIVE: To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers. QUALITY OF EVIDENCE: A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled trials. MAIN MESSAGE: Foot ulcers in diabetic patients are common and frequently lead to lower limb...

  13. Management of patients with pressure ulcers

    OpenAIRE

    Bora Ozel

    2014-01-01

    A pressure ulcer is an area of localized damage to the skin and underlying tissue caused by pressure or shear. Although these ulcers can occur anywhere on the body, they are often located in the ischial, trochanteric, sacral areas and. heel. These ulcers are primarily the products of a combination of pressure and decreased angiogenic response. Early intervention and comprehensive treatment should result in complete healing of ulcers. In this review, we tried to create a general perspective ab...

  14. Diabetic foot ulcer treatment by activated platelet rich plasma: a clinical study

    Directory of Open Access Journals (Sweden)

    Tung Dang-Xuan Tran

    2014-02-01

    Full Text Available Diabetic foot ulcer is a major complication of diabetes mellitus. It occurred in about 15% of all diabetic patients. To date, the outcome of management of diabetic foot ulcer is poor and low sufficient. Some new therapies were suggested to manage and treat this disease. In almost therapies, management of diabetic foot ulcer relates to debridement of the wound, revascularization, off-loading of the ulcer, antibacterial actions, stimulating granulation, epidermization and angiogenesis. This study aimed to evaluate the effects of activated platelet rich plasma (aPRP on diabetic foot ulcer healing on volunteer patients. There were 6 patients enrolled in this study. All patients have non-healing foot ulcers. aPRP was isolated from peripheral blood and activated with calcium chloride. Patients were injected with aPRP two times with 14-day interval. All patients were monitored during 12 weeks. The results showed that 100% (6/6 ulcers completely closed after about 7 weeks. This result initially suggests that aPRP injection is efficient method to treat the non-healing foot ulcers. Level of evidence: IV [Biomed Res Ther 2014; 1(2.000: 37-42

  15. Diagnostic value of determination of serum pepsinogen and gastrin levels in patients with peptic ulcer

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical significance of changes of serum pepsinogen and gastrin levels in patients with gastric/duodenal ulcer. Methods: Serum pepsinogen I (PG I), pepsinogen II (PGII), gastrin levels and PG I/PG II ratio were determined with RIA in 100 controls, 61 patients with duodenal ulcer, 46 patients with gastric ulcer, 66 patients with gastric cancer and 101 patients with chronic gastritis. Results: In patients with peptic ulcer (gastric/duodenal), the serum levels of PG I, PG II and PG I/PG II ratio were significantly higher than those in controls (P<0.001); the serum gastrin levels were also significantly higher than those in controls and patients with chronic gastritis (P<0.001), but lower than those in patients with gastric cancer (P<0.001). Among patients with peptic ulcer, the serum PG I level and PG I/PG II ratio were significantly higher in patients with duodenal ulcer than those in patients with gastric ulcer (P<0.001). Conclusion: Excessive high serum levels of PG I, PG II, gastrin and PG I/PG II ratio were some of the high risk factors for peptic ulcer. Those were useful serum markers for diagnosis and follow-up of the disease. (authors)

  16. The diminished expression of proangiogenic growth factors and their receptors in gastric ulcers of cirrhotic patients.

    Directory of Open Access Journals (Sweden)

    Jiing-Chyuan Luo

    Full Text Available OBJECTIVES: The pathogenesis of the higher occurrence of peptic ulcer disease in cirrhotic patients is complex. Platelets can stimulate angiogenesis and promote gastric ulcer healing. We compared the expressions of proangiogenic growth factors and their receptors in the gastric ulcer margin between cirrhotic patients with thrombocytopenia and those of non-cirrhotic patients to elucidate possible mechanisms. METHODS: Eligible cirrhotic patients (n = 55 and non-cirrhotic patients (n = 55 who had gastric ulcers were enrolled. Mucosa from the gastric ulcer margin and non-ulcer areas were sampled and the mRNA expressions of the proangiogenic growth factors (vascular endothelial growth factor [VEGF], platelet derived growth factor [PDGF], basic fibroblast growth factor [bFGF] and their receptors (VEGFR1, VEGFR2, PDGFRA, PDGFRB, FGFR1, FGFR2 were measured and compared. Platelet count and the expressions of these growth factors and their receptors were correlated with each other. RESULTS: The two groups were comparable in terms of gender, ulcer size and infection rate of Helicobacter pylori. However, the cirrhotic group were younger in age, had a lower platelet count than those in the non-cirrhotic group (p0.5, p<0.001. CONCLUSIONS: Our findings implied that diminished activity of proangiogenic factors and their receptors may contribute to the pathogenesis of gastric ulcers in cirrhotic patients.

  17. Risk factors for healing of duodenal ulcer under antacid treatment: do ulcer patients need individual treatment?

    OpenAIRE

    Massarrat, S; Müller, H. G.; Schmitz-Moormann, P

    1988-01-01

    In order to identify the risk factors affecting the healing of duodenal ulcer, a clinical trial with effective dose of antacid was carried out in 53 patients. Duration of ulcer history, number of relapses, duration of the last and present relapse, number, duration and severity of pain attacks in the present ulcer relapse, pain radiation to back, vomiting, appetite, smoking habit, intake of analgesics and previous haemorrhage were registered. Number of ulcers, ulcer depth, bublar narrowing, er...

  18. 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

  19. Treatment of experimental ulcerative colitis.

    Science.gov (United States)

    Lazebnik, L B; Lychkova, A E; Knyazev, O V

    2012-10-01

    The effects of infliximab, an anticytokine drug, on the course of inflammatory process was studied on the model of ulcerative colitis induced by injection of picrylsulfonic acid. Infliximab prevented the development of toxic dilatation and a drop of bioelectric activity of smooth muscles via maintenance of activity of the intramural nervous system neurons. PMID:23113311

  20. 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...