scholarly journals Gastritis and dyspepsia: 2 names of one problem? Relations between predominant symptom and syndromal characteristics of upper GI disorders: results of a survey of physicians

2021 ◽  
pp. 30-39
Author(s):  
N. V. Bakulina ◽  
I. A. Oganesova ◽  
Yu. G. Topalova ◽  
I. G. Bakulin
Keyword(s):  
Empirical Therapy ◽  
Pain Syndrome ◽  
Computer Assisted ◽  
Interview Method ◽  
Predominant Symptom ◽  
Clinical Syndromes ◽  
Symptom Complex ◽  
H Pylori ◽  
First Time ◽  
Choice Of Therapy

Introduction. Chronic gastritis is one of the most common problems in gastroenterology and general medical practice. In this study, we tried to analyze the actions of therapists in relation to patients with symptoms of dyspepsia, to assess how different symptom complex affects the choice of therapy and the diagnostics.Aim. Identifying the process of a preliminary diagnosis by symptoms, determining the ability of physicians to differentiate clinical syndromes, and determining the approaches to empirical therapy at first visit and following the “test and treat” strategy aimed at identifying the H. pylori infection.Materials and methods. The study was conducted using the CAWI (Computer-assisted Web Interview) method. Each physician who agreed to participate in the study received a link to take the survey and independently entered the answers to the questions formulated by the researcher. The descriptions of three profiles of adult patients with suspected gastritis diagnosis who applied for the first time were suggested: 1) a patient with a pain syndrome and dyspepsia symptoms; 2) a patient with dyspepsia symptoms; 3) a patient with a pain syndrome.Results. The study involved 205 physicians from 33 cities of Russia. The most commonly assumed diagnosis was gastritis: 50% of responders suggested it for patient 1, 51% – for patient 2, and 40% – for patient 3. Despite the unambiguous description of the delayed motility symptoms in patients 1 and 2, the most commonly assumed diagnoses did not reflect the presence of a problem. At the same time, physicians did not conduct diagnostic tests for H. pylori infection in case of patients 1 and 3 with obvious symptoms of gastritis. In case of infection, physicians suggest prescribing eradication drugs to each patient, and the most popular pharmacological group suggested were PPIs (91%). However, every tenth physician suggested eradication without PPIs.Conclusion. The results of the survey indicate a lack of awareness among therapists about the symptoms of delayed motility. This leads to the symptomatic pharmacotherapy, which does not provide the rupture of pathogenetic mechanisms

scholarly journals The Computer-Assisted Web Interview Method as Used in the National Study of ICT Use in Primary Healthcare in Poland – Reflections on a Case Study

2015 ◽  
Vol 43 (1) ◽  
pp. 137-146 ◽  
Author(s):  
Paweł Sowa ◽  
Bartosz Pędziński ◽  
Michalina Krzyżak ◽  
Dominik Maślach ◽  
Sylwia Wójcik ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
National Study ◽  
Computer Assisted ◽  
Web Surveys ◽  
Technical Aspects ◽  
Interview Method ◽  
Advantages And Disadvantages ◽  
Ict Use ◽  
Aforementioned Study

Abstract The development and widespread use of ICT in society are reflected by the way research is designed and conducted. The Computer Assisted Web Interview method is becoming more attractive and is a frequently used method in health sciences. The National Study of ICT Use in Primary Healthcare in Poland was conducted using this method. The aim of this paper is to present the major advantages and disadvantages of web surveys. Technical aspects of methodology and important stages of the aforementioned study, as well as key elements for its procedure, are mentioned. The authors also provide reflections based on their analysis of this national study, conducted between January and April 2014.

scholarly journals Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Tsachi Tsadok Perets ◽  
Hemda Schmilovitz-Weiss ◽  
Rachel Gingold-Belfer ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Treatment Success ◽  
Population Based ◽  
Urea Breath Test ◽  
First Line Therapy ◽  
13C Urea Breath Test ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

scholarly journals Survival of Gastric and Enterohepatic Helicobacter spp. in Water: Implications for Transmission

2008 ◽  
Vol 74 (6) ◽  
pp. 1805-1811 ◽  
Author(s):  
N. F. Azevedo ◽  
C. Almeida ◽  
I. Fernandes ◽  
L. Cerqueira ◽  
S. Dias ◽  
...  
Keyword(s):  
Membrane Integrity ◽  
Hierarchical Cluster ◽  
Culture Method ◽  
Oral Route ◽  
Human Stomach ◽  
Aquatic Environments ◽  
Integrity Assessment ◽  
Environmental Reservoir ◽  
H Pylori ◽  
First Time

ABSTRACT Part of the reason for rejecting aquatic environments as possible vectors for the transmission of Helicobacter pylori has been the preference of this microorganism to inhabit the human stomach and hence use a direct oral-oral route for transmission. On the other hand, most enteric bacterial pathogens are well known for being able to use water as an environmental reservoir. In this work, we have exposed 13 strains of seven different Helicobacter spp. (both gastric and enterohepatic) to water and tracked their survival by standard plating methods and membrane integrity assessment. The influence of different plating media and temperatures and the presence of light on recovery was also assessed. There was good correlation between cultivability and membrane integrity results (Pearson's correlation coefficient = 0.916), confirming that the culture method could reliably estimate differences in survival among different Helicobacter spp. The species that survived the longest in water was H. pylori (>96 h in the dark at 25°C), whereas H. felis appeared to be the most sensitive to water (<6 h). A hierarchical cluster analysis demonstrated that there was no relationship between the enterohepatic nature of Helicobacter spp. and an increased time of survival in water. This work assesses for the first time the survival of multiple Helicobacter spp., such has H. mustelae, H. muridarum, H. felis, H. canadensis, H. pullorum, and H. canis, in water under several conditions and concludes that the roles of water in transmission between hosts are likely to be similar for all these species, whether enterohepatic or not.

Infrared Thermography – A Tool for Computer Assisted Research in Rehabilitation Medicine

2015 ◽  
Vol 772 ◽  
pp. 603-607
Author(s):  
Marius Cristian Cojocaru ◽  
Ioana Maria Cojocaru ◽  
Nida Alexandra Cojan Carlea ◽  
Delia Cinteza ◽  
Mihai Berteanu
Keyword(s):  
Infrared Thermography ◽  
Muscle Pain ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Rehabilitation Medicine ◽  
Clinical Findings ◽  
Computer Assisted ◽  
The Central Nervous System

Muscle pain can be elicited by any irritation of the nociceptors in the muscle or central sensitization in the central nervous system and represent a challenge for medical as well as for neurological rehabilitation. The most frequently described muscle pain syndromes are myofascial pain syndrome (MPS) and fibromyalgia syndrome (FMS). The use of infrared thermography in rehabilitation medicine for assessment of musculoskeletal disorders is not well documented in the current literature. This study is focused around MPS due to the more localized manifestations of this syndrome and it’s objective is to asses a correlation between the clinical findings, ultrasound examination and the thermal pattern of trigger points.

CRPS: what’s in a name? Taxonomy, epidemiology, neurologic, immune and autoimmune considerations

2019 ◽  
Vol 44 (3) ◽  
pp. 376-387 ◽  
Author(s):  
Michael d‘A Stanton-Hicks
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Complex Regional Pain Syndrome ◽  
Severity Score ◽  
Clinical Management ◽  
Pain Syndrome ◽  
Clinical Syndromes ◽  
Shed Light ◽  
Historical Origins

This account of the condition now termed complex regional pain syndrome (CRPS) spans approximately 462 years since a description embodying similar clinical features was described by Ambroise Paré in 1557. While reviewing its historical origins, the text describes why it became necessary to change the taxonomies of two clinical syndromes with similar pathophysiologies to one which acknowledges this aspect but does not introduce any mechanistic overtones. Discussed at length is the role of the sympathetic component of the autonomic nervous system (ANS) and why its dysfunction has both directly and indirectly influenced our understanding of the inflammatory aspects of CRPS. As the following article will show, our knowledge has expanded in an exponential fashion to include musculoskeletal, immune, autoimmune, central and peripheral nervous system and ANS dysfunction, all of which increase the complexity of its clinical management. A burgeoning literature is beginning to shed light on the mechanistic aspects of these syndromes and the increasing evidence of a genetic influence on such factors as autoimmunity, and its importance is also discussed at length. An important aspect that has been missing from the diagnostic criteria is a measure of disease severity. The recent validation of a CRPS Severity Score is also included.

scholarly journals Results from the Survey of Antibiotic Resistance (SOAR) 2015–17 in Turkey: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints

2020 ◽  
Vol 75 (Supplement_1) ◽  
pp. i88-i99
Author(s):  
D Torumkuney ◽  
A Tunger ◽  
B Sancak ◽  
A Bıçakçıgil ◽  
B Altun ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Antibiotic Susceptibility ◽  
Low Dose ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
High Dose ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
First Time ◽  
Higher Doses

Abstract Objectives To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015–17 from Turkey. Methods MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results A total of 179 S. pneumoniae and 239 H. influenzae isolates were collected. Few (27.9%) pneumococci were penicillin susceptible by CLSI oral or EUCAST low-dose breakpoints, but by EUCAST high-dose or CLSI IV breakpoints 84.4% were susceptible. The most active antibiotics (excluding penicillin IV) by CLSI breakpoints were fluoroquinolones (98.9% of isolates susceptible), ceftriaxone (83.2%), amoxicillin (78.8%) and amoxicillin/clavulanic acid (78.8%). Pneumococcal susceptibility to amoxicillin and amoxicillin/clavulanic acid was lower using EUCAST low-dose breakpoints (49.7%), although susceptibility increased when using EUCAST high-dose (57.0%–58.1%) and PK/PD (78.8%–87.7%) breakpoints. Twenty-three H. influenzae isolates were β-lactamase positive, with 11 characterized as β-lactamase negative and ampicillin resistant following EUCAST criteria and 5 by CLSI criteria. Generally antibiotic susceptibility was high using CLSI breakpoints: ≥92.9% for all antibiotics except ampicillin (87% by CLSI and EUCAST breakpoints) and trimethoprim/sulfamethoxazole (67.4% and 72% by CLSI and EUCAST breakpoints, respectively). Susceptibility using EUCAST breakpoints (where these are published) was similar, except for cefuroxime (oral) with 3.8% of isolates susceptible. PK/PD breakpoints indicated low susceptibility to macrolides (5.9%–10%) and cefaclor (13%). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. Conclusions Antibiotic susceptibility of S. pneumoniae was generally low, which is in keeping with evidence of inappropriate and high antibiotic use in Turkey. H. influenzae susceptibility was high. These data are important for empirical therapy of CA-RTIs.

Role of gut-brain axis in persistent abnormal feeding behavior in mice following eradication of Helicobacter pylori infection

2009 ◽  
Vol 296 (3) ◽  
pp. R587-R594 ◽  
Author(s):  
Premysl Bercik ◽  
Elena F. Verdú ◽  
Jane A. Foster ◽  
Jun Lu ◽  
Angela Scharringa ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Feeding Behavior ◽  
Computer Assisted ◽  
Bacterial Eradication ◽  
Cell Counts ◽  
Tnf Α ◽  
Gastric Sensitivity ◽  
H Pylori ◽  
The Brain

Bacterial infection can trigger the development of functional GI disease. Here, we investigate the role of the gut-brain axis in gastric dysfunction during and after chronic H. pylori infection. Control and chronically H. pylori-infected Balb/c mice were studied before and 2 mo after bacterial eradication. Gastric motility and emptying were investigated using videofluoroscopy image analysis. Gastric mechanical viscerosensitivity was assessed by cardioautonomic responses to distension. Feeding patterns were recorded by a computer-assisted system. Plasma leptin, ghrelin, and CCK levels were measured using ELISA. IL-1β, TNF-α, proopiomelanocortin (POMC), and neuropeptide Y mRNAs were assessed by in situ hybridizations on frozen brain sections. Gastric inflammation was assessed by histology and immunohistochemistry. As shown previously, H. pylori-infected mice ate more frequently than controls but consumed less food per bout, maintaining normal body weight. Abnormal feeding behavior was accompanied by elevated plasma ghrelin and postprandial CCK, higher TNF-α (median eminence), and lower POMC (arcuate nucleus) mRNA. Infected mice displayed delayed gastric emptying and visceral hypersensitivity. Eradication therapy normalized gastric emptying and improved gastric sensitivity but had no effect on eating behavior. This was accompanied by persistently increased TNF-α in the brain and gastric CD3+ T-cell counts. In conclusion, chronic H. pylori infection in mice alters gastric emptying and mechanosensitivity, which improve after bacterial eradication. A feeding pattern reminiscent of early satiety persists after H. pylori eradication and is accompanied by increased TNF-α in the brain. The results support a role for altered gut-brain pathways in the maintenance of postinfective gut dysfunction.

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

2019 ◽  
Vol 23 (03) ◽  
pp. 227-251 ◽  
Author(s):  
Florian Schmaranzer ◽  
Luis Cerezal ◽  
Eva Llopis
Keyword(s):  
Magnetic Resonance ◽  
Sports Injuries ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Pain Syndrome ◽  
Volumetric Analysis ◽  
Computer Assisted ◽  
Current Standard ◽  
Increasing Demand ◽  
Magnetic Resonance Imaging Mri

AbstractOver the last 2 decades, the definition of pathomechanical concepts that link osseous deformities to chondrolabral damage and expose young and active patients to the risk of early osteoarthritis has led to a tremendous increase in the number of joint-preserving surgeries performed. The rise in arthroscopic procedures has led to an increasing demand for comprehensive preoperative magnetic resonance imaging (MRI) assessment of the hip joint. This includes conventional MRI for the assessment of extra-articular and periarticular pathologies such as greater trochanteric pain, deep gluteal pain syndrome, and sports injuries. Magnetic resonance arthrography with or without traction is reserved for the accurate evaluation of deformities associated with impingement and hip instability and for detecting the resulting intra-articular lesions. This article summarizes the current standard imaging techniques that the radiologist should know. It also explores the potential of computer-assisted analysis of three-dimensional MRI for virtual impingement simulation and volumetric analysis of cartilage composition and geometry.

scholarly journals RESISTANCE TO AMOXICILLIN, CLARITHROMYCIN AND CIPROFLOXACIN OF Helicobacter pylori ISOLATED FROM SOUTHERN BRAZIL PATIENTS

2014 ◽  
Vol 56 (3) ◽  
pp. 197-200 ◽  
Author(s):  
Simone Ulrich Picoli ◽  
Luiz Edmundo Mazzoleni ◽  
Heriberto Fernández ◽  
Laura Renata De Bona ◽  
Erli Neuhauss ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Empirical Therapy ◽  
British Society ◽  
World Population ◽  
Southern Brazil ◽  
First Line ◽  
The World ◽  
Antibiotics Susceptibility ◽  
H Pylori

Introduction: Helicobacter pylori is a bacteria which infects half the world population and is an important cause of gastric cancer. The eradication therapy is not always effective because resistance to antimicrobials may occur. The aim of this study was to determine the susceptibility profile of H. pylori to amoxicillin, clarithromycin and ciprofloxacin in the population of Southern Brazil. Material and methods: Fifty four samples of H. pylori were evaluated. The antibiotics susceptibility was determined according to the guidelines of the British Society for Antimicrobial Chemotherapy and the Comité de l'Antibiogramme de la Société Française de Microbiologie. Results: Six (11.1%) H. pylori isolates were resistant to clarithromycin, one (1.9%) to amoxicillin and three (5.5%) to ciprofloxacin. These indices of resistance are considered satisfactory and show that all of these antibiotics can be used in the empirical therapy. Conclusion: The antibiotics amoxicillin and clarithromycin are still a good option for first line anti-H. pylori treatment in the population of Southern Brazil.

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