ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Studies done in the early 1970s came to the conclusion that antibiotic prophylaxis was not useful in the management of acute pancreatitis. However, these studies suffered from the drawback of using antibiotics that had poor penetration into the pancreas. In addition, the design of these trials were faulty. With the advent of new information and the availability of better antibiotics, the picture is changing. Recent studies have suggested that antibiotic prophylaxis is useful in decreasing the incidence of infection in patients with severe pancreatitis. Of the antibiotics that have been tested, imipenem appears to be the most promising.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

After resection of the head of the pancreas, the distal remnant is typically telescoped into the jejunum. Recently, pancreaticogastrostomy has re-emerged as a useful alternative, as the anastomosis is easy and without tension. The results of pancreaticogastrostomy in 10 consecutive patients is reviewed, as is the literature of both the technique and the physiology of the procedure. In the current series, mean ± SEM age was 65 ± 2.3 years. Extended pancreaticoduodenectomy was performed in two patients, pylorus-preserving in eight. Mean tumor size was 3.9 ± 1.1 cm (range, 1.5-7.5 cm), mean operative time was 6.5 ± 0.5 hours. Intraoperatively, 7.6 ± 0.8 L of fluid was given, only two patients were transfused. The mean length of stay was 9.4 ± 1.8 days. There were no anastomotic leaks, no deaths, and two patients developed temporary gastric ileus. There are now 841 pancreaticogastrostomies reported in the literature, with a leak rate of 3.1% and a death rate of 2.6%. Pancreaticogastrostomy is easy to perform, safe, and useful even after extended Whipple.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Our aim was to determine what parameters may be used to indicate an emergent endoscopy after foreign body (FB) ingestion and to ascertain how often FBs are found endoscopically. Demographic data, gastroesophageal antecedents, clinical and endoscopic data, and complications were obtained. We examined 122 patients endoscopically. The onset of symptoms was immediate after FB ingestion in 93% of patients. Dysphagia was the most frequent symptom (66%), with the pharynx the most frequent location of impaction (71%). Endoscopy confirmed the presence of FBs in 52% of patients. Extraction was performed in 78%. The immediate onset of symptoms, dysphagia, and the absence of pharynx localization of impaction were predictive indicators of a positive FB finding (p< 0.05), with diagnostic sensitivity of 86% and specificity of 63%. Upper endoscopy should be performed in all patients with FB ingestion, even though no FB was found in 48%.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A Sengstaken-Blakemore (SB) tube, when used approximately, still has a place in the management of acute variceal bleeding. Due to a number of reported complications from the misplacement of this tube, an x-ray localization before full inflation of the gastric balloon is recommended as the standard of care. Here, we report a new technique of SB tube placement with endoscopic confirmation in three patients. This technique is easy, accurate, and can be performed in any unit where a patient with variceal bleeding can be managed. Because it cuts down on the need for an x-ray or ultrasound confirmation, this technique may well become the "standard of care" among the practicing gastroenterologists.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Our aim was to assess the prevalence ofHelicobacter pylori(Hp) infection in Argentina, in the general population and by age groups, and to determine the value of various epidemiologic variables as predictors of Hp infection. The study comprised 754 subjects (443 women [58.7%], 311 men [41.3%]) from both genders, consecutively recruited from health centers where patients were undergoing routine medical analyses. Average age was 32 ± 22 years. The pediatric group included subjects ≤ 18 years of age (n = 261). Stratification was based primarily on climatic factors and secondarily on sanitary and demographic considerations. Hp infection status was assessed through a quick serologic test. The overall Hp infection prevalence in Argentina was 35.7 ± 3.8%. The age was statistically significant using a multiple regression test (p< 0.01). Furthermore, the socioeconomic (p< 0.05) and educational level (p< 0.01) in the adults and the water sources (p< 0.01) in the pediatric group were all statistically significant according the multiple regression test. The overall Hp infection prevalence in Argentina was 35.7 ± 3.8%. Age was a predictor of Hp infection status. There is evidence of low infection prevalence in children, a higher prevalence in adolescents, and a more noticeable increase at 40 years of age. Furthermore, the socioeconomic and educational level in adults and the water sources in the pediatric group explained, in part, the occurrence of Hp infection.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Factors influencingHelicobacter pyloriinfection recurrence still have not been fully clarified. The aim of this study was to determine whether, after eradication ofH. pylori,any clinical or histologic features could yield information on infection relapse. We enrolled in the study 72 patients successfully treated forH. pyloriinfection by either dual (n = 49) or triple (n = 23) therapy.H. pylorieradication was defined as a negative bacterial finding by rapid urease test and histologic assessment at least 4 weeks after cessation of therapy. Upon eradication, gastritis grading was performed and patients were asked to return for an endoscopic control 6-8 months later. The recurrence ofH. pyloriinfection was observed in 12 of 72 (16.7%) patients. The infection recurrence rate resulted significantly higher in nonulcer dyspepsia patients (p= 0.01) and in women (p= 0.03), whereas infection relapse did not differ between patients treated with dual or triple therapy. There was a strong (p= 0.0001) relationship between the persistence of chronic active gastritis afterH. pylorieradication and recurrence of infection, whereas gastritis grade and metaplasia were not related to recurrence. In conclusion, this study found thatH. pyloriinfection recurrence after successful dual or triple therapy is fairly high and that gastroduodenal disease, gender, and gastritis activity seem to affect infection relapse.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Peptic ulcer disease (PUD) has been described in the absence ofHelicobacter pylori(Hp) infection, suggesting that different factors are involved in its etiopathogenesis. We investigated prevalence and characteristics of Hp-negative (Hp-) PUD in an area of Northern Italy and calculated the rate of Hp-positive (Hp+) patients with PUD in whom Hp might be coincidental and not causal. Four hundred nine consecutive patients with endoscopically diagnosed PUD were enrolled in seven hospitals. Hp infection was assessed by rapid urease test and histologic examination. The attributable risk percentages in different age groups were calculated by appropriate formulas. Of 409 patients, 31 (7.6%) were Hp− (gastric, 8.3%; duodenal, 7.6%). Age, nonsteriodal antiinflammatory drug (NSAID) consumption, and complication rates were significantly higher in Hp− than Hp+ patients with duodenal ulcers (DUs). Of the Hp− patients with DU, 58% did not use NSAIDs. In patients with Hp+ DU, the attributable risk percentage for Hp infection in patients aged <40 years, 40-60 years, or >60 years was 98%, 88%, and 66%, respectively. The prevalence of Hp− PUD was about 8%, mainly unrelated to any known etiologic factor. In about one-third of Hp+ patients with PUD aged over 60 years, Hp infection might be coincidental and not causal.

ISSN:0192-0790    

出版商:OVID    

年代:2000

数据来源: OVID