Epidemiology and treatment of perforated duodenal ulcer in Kemerovo Region

Aim. To estimate the frequency of ulcerative bleeding, pyloric stenosis, need for pyloroplasty and the justification of vagotomy for perforated duodenal ulcer.Materials and Methods. We analyzed the surgical treatment of patients with perforated duodenal ulcer admitted to Podgorbunskiy Regional Clinical Emergency Hospital during 1999-2019.Results. In 2018, the number of surgical interventions due to perforated duodenal ulcer decreased by 56.4% in comparison with 1998. In 8.6% and 2.1% of patients, perforated duodenal ulcer was combined with pyloric stenosis and bleeding, respectively, requiring Judd pyloroplasty (diamond- shaped transverse excision) or gastroduodenotomy followed by Heineke-Mikulicz pyloroplasty (transversely closed longitudinal incision across the pylorus) and vagotomy. Distal gastric resection by Billroth’s operation II was required in 2.8% of patients. Repeated admission of patients with duodenal ulcer complications has been observed after isolated suturing of perforated duodenal ulcer.Conclusion. Over the last 20 years, the amount of surgical interventions because of perforated duodenal ulcer in Kemerovo Region decreased more than twofold. In > 10% patients, pyloric stenosis and bleeding require a gastric drainage. In > 8% patients, perforated duodenal ulcer is combined with pyloric stenosis; in these cases, Heineke-Mikulicz pyloroplasty may be a treatment of choice. In > 2% patients, perforated duodenal ulcer is combined with ulcerative bleeding requiring excision of the ulcer and optional distal gastric resection. Pyloroplasty may be combined with vagotomy to normalise the proteolytic activity of gastric acid.

Peptic Ulcer: Chapter Closed?

The incidence of peptic ulcer disease (PUD) peaked in the late 19th century while transiting into the 20th century. With entry in the new millennium a significant decrease of PUD has occurred. However, demographic changes with an increasing elderly population associated with multiple comorbidities and polypharmacy became responsible for a persistent high rate of peptic ulcer complications. The acid driven concept of PUD has directed the development of surgical procedures and drugs with an increasing potency in acid suppression. High speed of symptom resolution and rapid ulcer healing was obtained with the introduction of proton pump inhibitors, but cure of PUD has failed. The arrival of Helicobacter pylori has revolutionized the history of PUD which has become a curable disease by successful cure of the infection. However, new challenges have emerged with an increase of treatment failures due to increasing antibiotic resistance of H. pylori. The changing pattern in the prevalence of etiologies other than H. pylori demands for accurate identification of the ulcerogenic cause in the individual patient to allow for proper selection of therapy. Management of peptic ulcer bleeding remains a critical clinical challenge. The chapter of PUD is reduced in size and has become more heterogeneous – but is not closed!

Faktor-Faktor Yang Berhubungan Dengan Perilaku Pencegahan Ulkus Diabetikum Pada Penderita Diabetes Mellitus

<span>DM sufferers continue to increase every year. Diabetic ulcers are a common complication that often occurs in DM patients. complications prevention behavior that must be performed by DM patients in order to prevent complications. This study aims to determine the factors related to the behavior of prevention of diabetic ulcers in patients with diabetes mellitus at Achmad Mochtar Bukittinggi Hospital in 2019<br />This type of research is analytic descriptive with cross sectional study approach. The population in this study was 334 people. Sampling using accidental sampling technique with a sample size of 35 people. Data collection in this study used a questionnaire sheet. Data analysis included univariate and bivariate analyzes using the chi-square test.<br />The results showed that 62.9% of respondents had low knowledge, 88.6% had no ulcers, 51.4% were low socioeconomic. The results of bivariate analysis showed that there was a relationship between knowledge (p = 0.038, OR = 6) and socioeconomic status (p = 0.028, OR = 6.417) with the prevention behavior of diabetic ulcer complications, whereas the ulcer experience variable was not related to the prevention behavior of diabetic ulcer complications (p = 0.619).<br />It was concluded that knowledge and socioeconomic status were significantly related to the prevention of diabetic ulcers in DM patients. It is expected that all parties, especially health workers, will maximize education and counseling for DM patients, especially in the low knowledge group and with low socioeconomic status.</span>

Morbidity and Mortality Rates from Digestive Diseases in the RF Northwestern Federal District (NWFD) and Measures to Reduce Them

Aim: to analyze the dynamics of morbidity and mortality from digestive diseases, as well as their causes, in the RF Northwestern Federal District (NWFD).Materials and methods. A statistical analysis was carried out on the basis of the 2007–2017 annual reports of the Medical Information and Analytical Center (MIAC) in St. Petersburg and the reports of the chief gastroenterologists of the Northwestern Federal District subjects.Results. In the RF Northwestern Federal District, an increase in both morbidity and mortality from digestive diseases is observed. The main non-oncological reasons for the development of these disorders include alcoholic liver disease, chronic alcoholic pancreatitis, peptic ulcer complications and NSAID-associated gastropathies. Along with a decrease in the incidence of gastric cancer, an increase in the incidence of colorectal cancer, as well as pancreatic cancer, is observed. A decrease in mortality from all the aforementioned cancer localizations is revealed.Conclusions. The main reasons for the increase in morbidity and mortality due to gastroenterological diseases in the RF Northwestern Federal District include alcohol abuse among the population, inadequate prevention of gastric helicobacteriosis, insufficient expertise of physicians in terms of Helicobacter pylorieradication and cancer prevention.

Morphological substantiation of the use of laser and led irradiation in emergent treatment of ulcer complications

The structural basis of ulcer perforation and bleeding was determined, based on morphological evaluation of gastroduodenal ulcers. The effects of low-intensive laser irradiation LILI and LED irradiation on pathomorphosis of ulcers were studied. It was found that the local phototherapy with LILI and LED increases the relative fraction volume — RFV of fibroblasts and connective tissue fibers, reduces RFV of cell-free zones, which contributes to “strengthening” of the ulcer walls and prevents their perforation. These same photo-infllead to an increase of RFV of blood vessels, indicating inappropriateness of their use for local phototherapy in bleeding ulcers.

In silico Pharmacokinetic, Bioactivity and Toxicity Evaluation of Some Selected Anti-Ulcer Agents

Peptic ulcer is a major health burden that recognized as a group of upper gastro-intestinal tract disorders. The aim of the therapy is to provide relieve from pain and prevent ulcer complications. Therefore, it is essential to evaluate the drug-likeness and toxicity profile of existing drugs for developing new potent anti-ulcer agents. In this research work, we study the pharmacokinetic, toxicity and bioactivity profile of few selected anti-ulcer agents by In silico method. These research investigations provide the lead for the development of new anti-ulcer agents with lesser toxicity and more effectiveness.