Calcium imbalance in comorbid gastroduodenal ulcers

Purpose of the study. To study the level of blood calcium, reflecting the functional state of the calcium-regulating system (CRS), in the comorbid course of gastroduodenal ulcers (GDU) with chronic erosive gastritis / chronic erosive duodenitis (CEG/CED), arterial hypertension (AH), their symptomatic nature when taking non-steroidal drugs (NSAIDs) and find out its effect on the activity of the ulcerous process, the state of regional microcirculation and the secretory function of the stomach.Materials and methods. 132 patients with GDU were examined. All patients were divided into groups: the first (39 people) – patients with recurrent peptic ulcer (PU) and CEG/CED, the second – 23 people with recurrent peptic ulcer and hypertension, the third – 20 patients with symptomatic gastroduodenal ulcers (SGDU) when taking NSAIDs. The fourth (control) group included 56 patients with PU without associated pathology.Results and discussion. Recurrence of PUr, comorbid to its course with CEG/CED, AH, SGDU, when taking NSAIDs, occurs with an increase in the level of calcium in the blood, which contributes to the activation of the acid-peptic factor, impaired microcirculation and repair processes in the mucous of the gastroduodenal zone, the development and maintaining the ulcerous process.Conclusion. Gastroduodenal ulcers are accompanied by dysfunction of the calcium regulatory system, which is characterized by an increase in blood calcium, which supports the formation of the main ulcerous mechanisms. In the treatment of comorbid and symptomatic gastroduodenal ulcers, it is necessary to include drugs for correcting the calcium-regulating system, which will increase the activity of sanogenic mechanisms.

Rebamipid in real clinical practice: quality of life and safety of use

The aim of the study was to assess the tolerability and impact on the quality of life of pharmacotherapy for gastric ulcer, erosive gastritis using regimens including rebamipide. The quality of life of patients was assessed using the SF-36 questionnaire. Pharmacotherapy of gastric ulcer with the inclusion of rebamipide as part of the conventional treatment regimen provides data comparable to the healthy group on the scales of physical functioning, role functioning due to physical condition, pain intensity, general health, and vital activity. The results of our own research and data from literary sources indicate that rebamipide is a drug with a confident evidence base, good tolerance and safety of use.

The effect of eradication therapy on the quality of life of patients with chronic erosive gastritis induced with Helicobacter pylori

The aim of the study was to evaluate the effect of eradication therapy on the quality of life of patients with chronic erosive gastritis induced with Helicobacter pylori. The quality of life was assessed according to the GIQLI questionnaire before treatment during incomplete remission, remission, and during the year. It was found that the exacerbation of the disease significantly changes the level of quality of life of patients, and the complex treatment, eradication of Helicobacter pylori, which stopped the exacerbation of the disease, gradually increases and brings this indicator closer to the control group. The gastrointestinal quality of life index can be used as an additional criterion for diagnosing the stages of chronic erosive gastritis, for evaluating the effectiveness of therapy, determining the timing of treatment, rehabilitation and prevention in the dispensary management of patients at the therapeutic site.

Analysis of Risk Factors and Establishment of a Prediction Model for Endoscopic Primary Bile Reflux: A Single-Center Retrospective Study

Background: Endoscopic primary bile reflux is one of the main diagnostic criteria for bile reflux gastritis (BRG). Presently, the risk factors and prediction models of endoscopic primary bile reflux (EPBR) in gastropathy patients who cannot or will not undergo endoscopy due to contraindications are not clear. Thus, this study aimed to evaluate the risk factors of EPBR and to establish and verify a prediction model.Methods: A series of 844 patients (564 subjects with EPBR and 280 control subjects) were retrospectively selected for this study and divided into a training set (n = 591) and a validation set (n = 253) according to the usual ratio of 70:30% for the subsequent internal validation of the logistic regression model for EPBR. Fifteen parameters that might affect the occurrence of EPBR were collected. Subsequently, univariate and stepwise logistic regression analyses were introduced to reveal the risk factors and the multivariate prediction model. An R package was dedicated to the corresponding internal validation of the EPBR model.Results: The univariate analysis showed that gender, age, smoking, Helicobacter pylori (H. pylori) infection status, metabolic syndrome (MS), non-steroidal anti-inflammatory drugs (NSAIDs) use history, and previous medical histories of chronic liver diseases, cholelithiasis, and erosive gastritis were statistically significant between the two groups (P < 0.05). Multivariate regression described that being a male [OR (95%confidence interval (CI)) = 2.29 (1.50–3.50), P < 0.001], age≥45 years old [OR (95% CI) = 4.24 (2.59–6.96), P < 0.001], H. pylori infection status [OR (95% CI) = 2.34 (1.37–4.01), P = 0.002], MS [OR (95% CI) = 3.14 (1.77–5.54), P < 0.001], NSAIDs use history [OR (95% CI) = 1.87 (1.03–3.40), P = 0.04], cholelithiasis history [OR (95% CI) = 3.95 (2.18–7.18), P < 0.001] and erosive gastritis history [OR (95% CI) = 6.77 (3.73–12.29), P < 0.001] were the risk factors for the occurrence of EPBR. Based on the results of these risk factors, an EPBR prediction model with an adequate calibration and excellent discrimination was established [area under the curve (AUC): 0.839, 95% CI = 0.806–0.872].Conclusions: Being a male, age ≥ 45 years old, H. pylori infection, histories of MS, NSAIDs use, cholelithiasis, and erosive gastritis appear to be the risk factors for EPBR, and our favorable prediction model might be an option for the prediction of EPBR.

Cross-sectional association between long working hours and endoscopic gastritis: the Kangbuk Samsung Health Study

ObjectivesThis study aimed to determine the cross-sectional association between long working hours and gastritis diagnosed by endoscopy.DesignCross-sectional study.SettingLarge university hospitals in Seoul and Suwon, South Korea.ParticipantsWorkers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 168 391 full-time day workers met the inclusion criteria and were included in the analysis.Primary outcome measureEndoscopic gastritis.ResultsThe participants were predominantly college graduates or above (88.9%), male (71.2%) and in their 30s (51.1%), and the median age was 36 (IQR 31–42). Approximately 93.2% of participants had positive endoscopic gastritis, and there was a significant association between working hours and positive findings of endoscopic gastritis. The multivariate fully adjusted prevalence ratio (PR) of endoscopic gastritis for participants working >55 hours per week compared with 35–40 hours per week was 1.011 (95% CI 1.007 to 1.015). Furthermore, endoscopic findings were classified into nine subtypes of gastritis, including superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis increased with longer working hours (p for trends <0.05). Their PRs for participants working >55 hours per week compared with 35–40 hours per week were 1.019 (95% CI 1.012 to 1.026), 1.025 (95% CI 1.011 to 1.040), 1.017 (95% CI 1.008 to 1.027), 1.066 (95% CI 1.028 to 1.105) and 1.177 (95% CI 1.007 to 1.375), respectively.ConclusionsWorking over 55 hours per week was cross-sectionally associated with positive findings of endoscopic gastritis. The study findings indicated potentially increased risks of superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis among workers with long working hours (>55 hours per week), supporting the need for further exploration via longitudinal studies.

Saliva as new analytical object for D-dimer level determination

The amount of D-dimer in the mixed saliva of healthy individuals and patients with comorbidities has been investigated. It has been established that the level of D-dimer in saliva increases with age regardless of pathology. The highest values were found in patients with erosive gastritis.

Prevalence, clinical course and treatment of chronic gastritis at the present stage

Background. The importance of the problem of chronic gastritis (CG) is determined by its high proportion in the structure of gastrointestinal pathology, reduced quality of life of patients, and possible complications. The study aimed at the investigation of the incidence and features of the clinical course of CG in servicemen at the present stage and pharmacoeconomic efficacy of bismuth and triple anti-helicobacter therapy (AHBT) in H. pylori (HP) — associated erosive gastritis with the use of domestic drugs. Materials and methods. At the first stage, the indicators of the admission rate of servicemen with CG and the peculiarities of the endoscopic picture of the gastric mucosa were analyzed. At the second stage, the features of the clinical course were studied and a pharmacoeconomic analysis of treatment regimens in servicemen with HP-associated erosive gastritis with proton pump inhibitors of different generations and domestic bismuth subcitrate, used in triple and bismuth-containing regimens, was performed. Results. An epidemiological, clinical, and pharmacoeconomic analysis of HP-associated CG in servicemen at the present stage has been conducted. It is reasonable to treat servicemen with HP-associated erosive gastritis with domestic drugs using bismuth-containing anti-helicobacter therapy, which will improve the efficiency and quality of treatment and avoid unjustified budget costs. Conclusions. Among the servicemen of the Armed Forces of Ukraine, starting from 2013, there is a tendency to increase the number of erosive gastroduodenal lesions with a predominant lesion of the antrum of the stomach. Pharmacoeconomic analysis of the treatment of HP-associated erosive gastritis showed the feasibility of switching to bismuth-containing AHBT with the use of domestic rabeprazole and bismuth subcitrate. This is justified by a higher anti-Helicobacter activity by 1.2 times (20 %), 1.6 times better (60 %) cost-effectiveness, and 1.4 times higher (40 %) cost-utility.

Intoksikasi Alkohol Akibat Minuman Keras Oplosan

The incidence of alcoholic liquor poisoning (alcoholic liquor) in Indonesia shows a high number. One of the causes of alcohol poisoning is methanol. Methanol poisoning in Indonesia usually occurs as a result of drinking mixed alcohol liquor. It has been reported a male 23 years old with decreased consciousness after drinking oplosan alcohol suspected to contain methanol. The examination reveals that patients has metabolic acidosis, toxic optic neuropathy (TON) and erosive gastritis. Treatment was acidosis correction, prevent formation of metabolites, hemodialysis with supportive and symptomatic teraphy .Keywords: methanol, poisoning, alcohol mixed liquor

Ménétrier Disease; 2-Year-Old Boy Presenting With Prolonged Emesis, Generalized Edema and Chance Histopathological Finding of Cytomegalovirus Gastritis: A Case Report

Ménétrier disease (MD) is characterized by enlarged gastric folds with associated protein losing gastropathy. In children it is a rare and self-limited cause of protein losing gastropathy. We report a case of a 2-year-old male who presented with prolonged, refractory emesis and peripheral edema. Workup revealed severe hypoalbuminemia, hypoproteinemia, iron deficiency anemia, and high stool alpha-1 antitrypsin. Hepatic protein synthesis was normal with no urinary protein loss. Endoscopy showed antrum sparing, severe erosive gastritis in body and fundus, characteristic of MD. Histologic examination displayed inflammation with eosinophilia, foveolar hyperplasia, atrophic oxyntic epithelium, and rare CMV inclusions. Patient received antiviral therapy, intravenous albumin, diuretic and was discharged on high protein diet. Follow-up revealed clinical recovery, with endoscopy and histology showing normal gastric mucosa throughout the stomach. It is important to remain vigilant of this condition in pediatric population and to include it in the differential diagnosis in cases of protein losing gastroenteropathy.