RESUMEN
Prediction of outcome is difficult in patients with acute upper gastrointestinal bleeding (AUGIB). Some factors have been proposed in this regard with varying accuracy. This study aimed to investigate probable predictors of in-hospital outcome in patients with AUGIB. One hundred sixty four patients with AUGIB were studied prospectively in Tabriz Imam Reza Teaching Centre. All these patients were evaluated endoscopically by an expert. Patients' age, gender, presenting complains, transfusion, clinical findings and previous medical history were compared between survived vs. expired, re-bled vs. non re-bled and operated vs. non operated patients. There were 117 males and 47 females with the mean age of 57.12 +/- 17.32 (range: 32-78) years in this study. Hematemesis was the sole independent predictor of in-hospital mortality (82.1 vs. 100%; p < 0.001). In univariate analysis, however, female gender, major hemorrhage and previous neurological disease were associated with higher rate of expiration. Comparing two re-bled and non re-bled groups, hematemesis (76.5 vs. 95.9%; p = 0.003) and need of transfusion > 2U (36.1 vs. 71.4%; p = 0.006) were independent predictors of re-bleeding. In univariate analysis, hematocrit < 30%, major hemorrhage and previous history of hepatic disease or hypertension were predictive of re-bleeding. In comparison between operated and non operated groups no significant predictor was detected. In conclusion, this study showed that presence of hematemesis at the time of admission and need of transfusion > 2U were independent predictors of poor outcome in patients with AUGIB.
Asunto(s)
Hemorragia Gastrointestinal/mortalidad , Hemorragia Gastrointestinal/prevención & control , Hemorragia Gastrointestinal/cirugía , Enfermedad Aguda , Adulto , Anciano , Femenino , Hematemesis/mortalidad , Mortalidad Hospitalaria , Hospitalización , Humanos , Irán , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Recurrencia , Factores de Riesgo , Resultado del TratamientoRESUMEN
Helicobacterpylori (HP) is a common cause of gastric infection with serious consequences which is detected by different methods. This study aimed at comparing the diagnostic value of Rapid Urease Test (RUT), Touch Cytology (TC) and histopathologic assessment in outpatients setting. In this cross-sectional study, 51 candidates for upper gastrointestinal endoscopy were recruited in Tabriz Imam Khomeini Teaching Centre in a 24 month period of time. Three biopsy specimens were obtained from gastric antrum during endoscopic intervention. The RUT, TC and histopathologic assessment were performed on each biopsy specimen in each patient. Definite infection by HP was considered when at least 2 out of 3 tests indicated presence of infection. Fifty one patients, 29 females and 22 males with a mean age of 40.10 +/- 12.54 (range: 18-72) years enrolled in this study. Infection by HP was definite in 41 cases (80.4%). The infection rates by RUT, TC and histopathologic examination were 82.4, 82.4 and 76.5%, respectively. The sensitivity, specificity and accuracy of RUT, TC and histopathologic assessment were 92.7, 60 and 66.75%; 100, 90 and 98% and 95.1, 100 and 96.1%, respectively. There were significant agreements between outcomes of the three methods in diagnosis of infection by HP. In conclusion, TC was the most sensitive and histopathologic assessment was the most specific method in diagnosis of infection by HP in outpatient setting. The diagnostic value of RUT was rather low in this regard.
Asunto(s)
Pruebas Respiratorias/métodos , Técnicas Citológicas/métodos , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/enzimología , Infecciones por Helicobacter/patología , Ureasa , Adulto , Biopsia , Estudios Transversales , Endoscopía del Sistema Digestivo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes AmbulatoriosRESUMEN
Thirty human tooth samples were collected from smoker and non-smoker groups with different ages and different sexes from north of Iran. The samples were analysed by a radiochemical procedure, and the prepared source by spontaneous electrolysis was measured by an alpha spectrometry to determine activity concentrations of (210)Po in teeth. The results indicated that the average (210)Po concentration in Iranian human teeth is 3.94 +/- 2.38 mBq g(-1.) The measured mean activity concentrations of (210)Po in smokers' and non-smokers' teeth were 5.89 +/- 3.59 and 2.55 +/- 1.00 mBq g(-1), respectively. The detailed analysis of 30 tooth samples of Iranian population revealed that smoking habits and age may have some influence on (210)Po content in teeth, although this is not the case of difference in sex.