RESUMO
Helicobacter pylori is the most common chronic bacterial infection in humans. In less developed nations, e.g., most South American countries, the prevalence of H pylori infection ranges from 70% to 90% of the population. In these countries there is rapid acquisition of the infection in early life, due to poor sanitation, low standards of living conditions and an increased rate of H pylori infection. The management of H pylori infection in South America is outlined.
Assuntos
Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , América do SulAssuntos
Gastrite , Doença Aguda , Alcoolismo/complicações , Anti-Inflamatórios não Esteroides/efeitos adversos , Doença Crônica , Doença de Crohn/complicações , Diagnóstico Diferencial , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Gastrite/classificação , Gastrite/etiologia , Gastrite/terapia , Infecções por Helicobacter , Helicobacter pylori , Humanos , Sarcoidose/complicações , Estresse Fisiológico/complicações , Sífilis/complicações , Tuberculose/complicaçõesAssuntos
Gastrite/classificação , Gastrite/etiologia , Gastrite/história , Gastrite/terapia , Doença Aguda , Doença Crônica , Infecções por Helicobacter , Helicobacter pylori/patogenicidade , Estresse Fisiológico/complicações , Alcoolismo/complicações , Tratamento Farmacológico/efeitos adversos , /efeitos adversos , Doença de Crohn/complicações , Sarcoidose/complicações , Doenças do Sistema Digestório , Tuberculose/complicaçõesAssuntos
Gastrite/classificação , Doença Aguda , Alcoolismo/complicações , Anti-Inflamatórios não Esteroides/efeitos adversos , Doença Crônica , Doenças do Sistema Digestório , Doença de Crohn/complicações , Tratamento Farmacológico/efeitos adversos , Gastrite/etiologia , Gastrite/história , Gastrite/terapia , Infecções por Helicobacter , Helicobacter pylori/patogenicidade , Sarcoidose/complicações , Estresse Fisiológico/complicações , Tuberculose/complicaçõesRESUMO
Previous studies have demonstrated that the eradication of Helicobacter pylori (H. pylori) is associated with a significant reduction of the rate of duodenal ulcer (DU) relapse. The aim of this study was to assess the long-term effect of a bismuth-free triple therapy on the eradication of H. pylori and reduction of DU relapse. After informed consent, 61 patients with endoscopically proven DU and H. pylori infection detected on 14C-urea breath test (BT) were included in the study. All patients received a combination of furazolidone, amoxicillin, and metronidazole, three times a day, for 5 days, in addition to eventual classical antiulcer agents prescribed by their attending physicians. BT was repeated after an interval of at least 60 days to evaluate H. pylori eradication. Endoscopy and another BT were performed again at 6.5 months after therapy to detect possible recurrences. Forty-eight patients completed the trial: 26 (54%) patients were negative for H. pylori at 6.5 months after the end of treatment, and 22 (46%) persisted H. pylori positive. Ninety-two percent of the patients in whom the bacteria were eradicated showed endoscopically healed ulcers and were asymptomatic, and two that were symptomatic presented only occasional pain not requiring therapy. Among the 22 patients who persisted H. pylori positive, six (27%) showed endoscopically active ulcers (p = 0.012) and eight (36%) patients continued to be symptomatic (p less than 0.01), and were still using antiulcer drugs (p = 0.002) 6.5 months after treatment. It is concluded that combined treatment with furazolidone, amoxicillin, and metronidazole for 5 days represents a well-tolerated, inexpensive, and effective therapeutic regime for the eradication of H. pylori and abolition of DU relapse in more than 50% of the patients during a follow-up period of 6.5 months.
Assuntos
Amoxicilina/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Furazolidona/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Metronidazol/uso terapêutico , Adulto , Testes Respiratórios , Radioisótopos de Carbono , Esquema de Medicação , Quimioterapia Combinada , Úlcera Duodenal/complicações , Duodenoscopia , Feminino , Seguimentos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Humanos , Masculino , Recidiva , UreiaRESUMO
In order to assess the effect of furazolidone on duodenal ulcer disease and Helicobacter pylori (Hp), a double-blind, double-dummy, randomized, prospective pilot study comparing furazolidone and cimetidine was carried out in 31 antral Hp positive patients with endoscopically proven active duodenal ulcer. Clinical, endoscopical, bacteriological and histological studies were done before and at four weeks of the study in all patients. If the ulcer was not healed, the treatment was extended for a further four weeks and all the procedures repeated. The healed ulcer patients were followed-up and re-endoscoped, regardless the presence of symptomatology, at least at 3 and 6mo after the end of treatment. It was observed that furazolidone cleared Hp (18% x 0%), healed the ulcer (91% x 87%) and reduced the relapse rate (30% x 92%; p < 0.025).
Assuntos
Cimetidina/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Furazolidona/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Adolescente , Adulto , Método Duplo-Cego , Úlcera Duodenal/microbiologia , Duodenoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Antro Pilórico/microbiologia , RecidivaRESUMO
This prospective multicentric randomized open trial was designed to evaluate the efficacy of ranitidine 150 mg bid vs 300 mg nocte in the short-term (4 weeks) treatment of duodenal ulcer in 15 Brazilian centers. On the basis of a randomization table 190 patients with endoscopically confirmed duodenal ulcer were allocated to receive either ranitidine 150 mg bid (94 pts) or 300 mg nocte (96 pts). The 2 treatment groups were well matched for age, sex, duration of ulcer disease, number and size of ulcers, duration of current episode, intensity of ulcer pain, alcohol and coffee intake and smoking habits. They were endoscopically controlled at the end of the 4 weeks. At 4 weeks 78 of 94 patients (83.0%) had their ulcers healed with the 150 mg bid regimen as opposed to 79 of 96 patients (82.3%) allocated to the 300 mg nocte dosage. This difference was not statistically significant. Ulcer symptoms diminished with treatment in both groups. The tolerability and compliance was excellent in both groups. The results show that ranitidine 300 mg nocte is as effective in the short-term treatment of duodenal ulcer as ranitidine 150 mg bid. Considering the greater simplicity of administration enhancing patient compliance, the treatment with 300 mg nocte is preferable.
Assuntos
Úlcera Duodenal/tratamento farmacológico , Ranitidina/administração & dosagem , Adolescente , Adulto , Brasil , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ranitidina/efeitos adversos , Ranitidina/uso terapêuticoAssuntos
Cobaias , Animais , Fezes/microbiologia , Genes Virais , Intestinos/microbiologia , RNA Viral , Rotavirus/genética , Rotavirus/ultraestruturaRESUMO
Evidência sorológica de infecçäo por rotavírus em uma colônia de cobaios - Anticorpos reagindo com rotavírus símio SA11 foram demonstrados por ensaio imuno-enzimático (EIE) e por "Western blot assay" (WBA) em soros de cobaios mantidos para fins experimentais na Fundaçäo Oswaldo Cruz, Rio de Janeiro, Brasil. A proporçäo de animais soro-positivos e os níveis de anticorpos subiram rapidametne em 1985, mantiveram-se altos em 1986 e baixaram em 1987. Näo foram observados sinais de doença coincidente com a elevaçäo de anticorpos. Resultados de WBA sugerem que o rotavírus responsável pela resposta sorológica pertence ao subgrupo do grupo A
Assuntos
Cobaias , Animais , Anticorpos Antivirais/análise , Rotavirus/imunologia , Suscetibilidade a Doenças , Técnicas ImunoenzimáticasRESUMO
The successful isolation of C. pyloridis from human gastric mucosa has renewed interest in these bacteria and their role as a causative agent for gastritis, and possible causal relationship between chronic gastritis and peptic ulceration. To determine the incidence of C. pyloridis in gastric biopsies we studied 51 consecutive Brazilian patients with a wide range of alimentary disorders presenting for endoscopy. At least three biopsies were taken from each site: antrum, any ulcer or cancer. Microbiological and histological studies were performed to identify the bacteria. The organism was found in 40/51 (78%) of patients. These was a close correlation between culture (100%), Gram (90%) and Gimenez staining (80%) in identifying the bacteria. All C. pyloridis positive patients had histological evidence of antral chronic gastritis (active or quiescent) even if the endoscopic appearance looked normal. All peptic ulcer patients (n = 17) showed C. pyloridis in the antrum. In the duodenum the bacteria were mainly seen in gastric type of mucosa. Our findings support the hypothesis that C. pyloridis is etiologically related to gastritis and possibly peptic ulceration.
Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter/isolamento & purificação , Gastrite/microbiologia , Úlcera Péptica/microbiologia , Antro Pilórico/microbiologia , Adolescente , Adulto , Idoso , Brasil , Úlcera Duodenal/patologia , Feminino , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Gástrica/patologiaRESUMO
Foram estudados 1006 funcionários de um hospital geral militar, com idades de 18 a 65 anos, sendo 737 civis e 269 militares. A prevalência da hipertensäo arterial (PAD > 90mmHg) foi 8,15%. O porcentual de hipertensos foi maior no sexo masculino, nos indivíduos de raça negra, nos de faixa etária mais elevada e naqueles com história familiar de hipertensäo arterial. Independentemente do sexo e da idade, observou-se prevalência maior de hipertensos entre os funcionários militares, (10,04%) do que nos civis (7,76%). Em relaçäo ao diagnóstico prévio de hipertensäo, 63,16% sabiam ser hipertensos e 35,53% desconheciam o diagnóstico. Quanto ao tratamento, 68% dos hipertensos näo estavam fazendo uso de anti-hipertensivos
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Recursos Humanos em Hospital , Hipertensão/epidemiologia , Determinação da Pressão Arterial , Brasil , Hospitais MilitaresAssuntos
Antiulcerosos/uso terapêutico , Úlcera Péptica/economia , Antiácidos/administração & dosagem , Antiácidos/uso terapêutico , Antiulcerosos/administração & dosagem , Brasil , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Úlcera Péptica/tratamento farmacológicoRESUMO
In eight fasting men with duodenal ulcer disease, oral administration of therapeutic dose of 49,5 mEq of neutralizing potency of either sodium bicarbonate or a preparation of calcium hidroxogluconaluminate did not produce significant increase in gastric acid secretion above basal levels for 90 minutes. This data support the conclusion that this specific antacid-containing calcium preparation does not stimulate the gastric secretion of acid.
Assuntos
Antiácidos/farmacologia , Bicarbonatos/farmacologia , Cálcio/farmacologia , Úlcera Duodenal/metabolismo , Ácido Gástrico/metabolismo , Humanos , Bicarbonato de SódioRESUMO
A prospective study of the effects of maximal doses of betazol hydrochloride ( Histalog ) on the endoscopic and histologic findings of the gastric mucosa of volunteers was made. Of the 11 patients examined, no alteration was seen on gastroscopic examination after Histalog in three, slight to moderate congestion of the mucosa in six and scattered oozing bleeding points in two. The study of the histologic findings revealed no statistical significant difference in the recurrence of erosion, hemorrhage and edema in the antrum and body gastric mucosa, before and after the administration of Histalog . It was concluded that maximal doses of Histalog cause no significant hemorrhage in the mucosa of the stomach and that the brown colour frequently seen in the gastric secretions of the final portions of a Histalog test is to be attributed to trauma to the mucosa by the nasogastric tube and to Histalog induced congestion of the mucosa.
Assuntos
Betazol , Ácido Gástrico/metabolismo , Mucosa Gástrica/patologia , Pirazóis , Adolescente , Adulto , Betazol/farmacologia , Biópsia por Agulha , Feminino , Mucosa Gástrica/efeitos dos fármacos , Gastroscopia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Antiácidos/uso terapêutico , Cimetidina/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Consumo de Bebidas Alcoólicas , Aspirina/efeitos adversos , Benzodiazepinonas/uso terapêutico , Carbenoxolona/uso terapêutico , Quimioterapia Combinada , Ácido Gástrico/metabolismo , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Úlcera Péptica/terapia , Pirenzepina , Prostaglandinas/uso terapêutico , FumarRESUMO
Ten subjects were studied for two periods of six days each during which they were fed respectively a regular diet (control diet) followed by a fiber-supplemented diet (experimental diet). The experimental diet consisted of a regular diet in which some foods where substracted and some bran biscuits, specially produced for this investigation, were added. The experimental diet produced a significant increase in daily stool weight, dried stool weight, water contents of the stools and intestinal transit time. The study has shown that special bran biscuits is effective in promoting a increase in bowel transit time, and therefore should be submitted to therapeutic trial in patients with constipation.