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The prospective experience of a maxillofacial surgeon with the percutaneous endoscopic gastrostomy technique.

Insertion of a percutaneous endoscopic gastrostomy (PEG) was attempted on 225 occasions, mainly for oral malignancy. Seventy-five percent (169/225) were inserted at the time of definitive surgery. There were significant incidental findings during 5% (11/225). The rate of successful insertion was 97% (219/225). The incidence of minor complications was 12% (26/225) and major complications 3% (7/225). There was no procedure-related mortality. The 30-day mortality rate, including those with terminal malignant disease, was 6% (14/225). An increased risk of death was associated with age of 65 years

Helicobacter pylori eradication improves gastric histology and decreases serum gastrin, pepsinogen I and pepsinogen II levels in patients with duodenal ulcer.

BACKGROUND AND AIM: The aim of this study was to assess the gastric histopathology and serum gastrin-17 and pepsinogens profiles in patients with duodenal ulcer before and after Helicobacter pylori eradication in a population with a very high prevalence of H. pylori. At the same time we assessed the role of H. pylori density on these variables. METHODS: Eighty Caucasian patients with H. pylori-associated duodenal ulcer before treatment and 1 year after randomized eradication were studied. Among patients with unsuccessful eradication two groups were distinguished according to the data obtained

First-time endoscopy and use of antisecretory medication: a population-based cohort study.

OBJECTIVE: Endoscopy is the gold standard for diagnostic evaluation of upper gastrointestinal symptoms. The relation between endoscopy and use of antisecretory medication on a population level is unknown. The aim of this study was to describe development in the number of patients undergoing first-time endoscopies and their use of antisecretory medication. MATERIAL AND METHODS: Data on the use of endoscopies and antisecretory medication (H2 blockers and proton-pump inhibitors) were extracted from five population-based databases and included all citizens in Funen County (population 470,000) who

Evaluation of the effects of Helicobacter pylori eradication therapy on gastric antral epithelial hyperproliferation: a prospective six-month follow-up study.

BACKGROUND/AIMS: H. pylori-induced hyperproliferation of the gastric epithelium may have a critical role in gastric carcinogenesis. H. pylori-related hyperproliferation and reversibility of hyperproliferation after eradication therapy is still controversial. Therefore, we have evaluated the effects of H. pylori and its eradication on gastric antral epithelial proliferation. METHODOLOGY: A total of 32 H. pylori-positive and 22 H. pylori-negative subjects were enrolled into the study. Triple eradication therapy was given to the H. pylori-positive group. Upper endoscopy was repeated one month af

Concordance between noninvasive tests in detecting Helicobacter pylori and potential use of serology for monitoring eradication in gastric ulcer.

Our aim was to determine concordance between 13C-urea breath test and serology in detecting Helicobacter pylori and to study their potential use for monitoring eradication in patients with gastric ulcer. We prospectively studied 73 gastric ulcer patients. On endoscopy, biopsies were taken for hematoxylineosin staining and rapid urease testing. Blood samples were drawn for immunoglobulin G antibody determination by enzyme-linked immunosorbent assay (ELISA). A 13C-urea breath test was performed as well. Histology, serology, and urea breath tests were all repeated 1, 6, and 12 months after therap

Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori.

OBJECTIVES: In an attempt to increase the efficacy and simplicity of FDA-approved regimens for Helicobacter pylori, we studied (1) addition of an inexpensive antibiotic (amoxicillin) to twice-daily ranitidine bismuth citrate (RBC)-clarithromycin dual therapy, and (2) substitution of RBC for bismuth subsalicylate + H2-receptor antagonist in bismuth-based triple therapy. METHODS: Subjects with previously untreated Helicobacter pylori infection documented by 13C-urea breath test plus either endoscopic biopsy or serology were randomly assigned to a 2-wk course of (1) RBC 400 mg b.i.d., amoxicilli

Balloon-occluded retrograde transvenous obliteration for gastric varices with gastrorenal or gastrocaval collaterals.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of balloon-occluded retrograde transvenous obliteration for gastric varices with gastrorenal or gastrocaval collaterals. SUBJECTS AND METHODS: Thirty patients who had gastric varices with gastrorenal or gastrocaval collaterals underwent balloon-occluded retrograde transvenous obliteration. A 5-French balloon catheter was inserted in the gastrorenal collateral, gastrocaval collateral, or both, and a 5% solution of ethanolamine oleate iopamidole that contained equal amounts of ethanolamine oleate and iopamidole 300 was injected i

Pernicious Anemia: The Hematological Presentation of a Multifaceted Disorder Caused by Cobalamin Deficiency.

Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B12 deficiency may occur. The multifaceted nature of pernicious anemia is related to the important role of cobalamin, which, when deficient, may lead to several dysfunctions, and thus, the proteiform clinical presentations of pernicious anemia. Indeed, pernicious anemia may l

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… Gastroscopy and Histopathological Assessment: The Required Confirmation of the Diagnosis of Pernicious Anemia Patients with diagnosis of PA should undergo gastroscopy with biopsies to ascertain the presence of AAG, keeping in mind that PA patients are at increased gastric cancer risk. … The correct diagnosis of PA should always be confirmed by high-quality gastroscopy with biopsies. …

Case Report: Case of subacute combiled deгенерация спинного мозга в связи с хроническим атрофическим гастритом, макроцитической анемией и положительными антисульфатидом IgM и IgG антителами.

Антисульфатидные антитела являются автоантиорганизмами, связанными с различными неврологическими расстройствами. Они были выявлены в нескольких условиях, включая синдром Гильен-Барре, множественный склероз и хронический подстрекательский демиелинизирующий полинропат. Субакустическое комбинированное дегенерирование спинного мозга вызвано главным образом дефицитом витамина В12. Хроническая атрофическая гастритис — сложное состояние, характеризующееся атрофацией и воспалением желудочно-кишечной слизи. На сегодняшний день не было зарегистрировано ни одного случая, когда пациенты с субакутальным ко

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… Gastroscopy revealed atrophic gastritis in the gastric body and fundus, with mild congestion and exudative gastritis in the antrum ( Figure 2 ). The cardia showed focal, rough, congested, and eroded mucosa. … Although the patient’s VitB12 level was within the normal range, his long-term alcohol consumption and laboratory evidence of macrocytic anemia led us to conduct gastroscopy, which revealed CAG. …

Impact of antithrombotic medications on postprocedural outcomes of percutaneous endoscopic gastrostomy: a US Collaborative Network study.

BACKGROUND AND AIMS: Percutaneous endoscopic gastrostomy (PEG) is an essential procedure for patients who require long-term enteral nutrition but are unable to eat orally. However, it carries a risk of bleeding, particularly in patients on anticoagulation or dual antiplatelet therapy (DAPT). This study aimed to assess the bleeding risk associated with continuing anticoagulation or DAPT during PEG placement. METHODS: Using the TriNetX US Collaborative Network Database, we analyzed four cohorts: patients on anticoagulants, patients not on anticoagulants, patients on DAPT, and patients on aspiri

Value of upper gastrointestinal endoscopy for gastric cancer surveillance in patients with Lynch syndrome.

In our study, we evaluated the effectiveness of upper gastrointestinal (GI) endoscopy as an instrument for early gastric cancer (GC) detection in Lynch syndrome (LS) patients by analyzing data from the registry of the German Consortium for Familial Intestinal Cancer. In a prospective, multicenter cohort study, 1128 out of 2009 registered individuals with confirmed LS underwent 5176 upper GI endoscopies. Compliance was good since 77.6% of upper GI endoscopies were completed within the recommended interval of 1 to 3 years. Forty-nine GC events were observed in 47 patients. MLH1 (n = 21) and MSH2

Gastric bleeding risk following spleen preserving distal pancreatectomy with excision of the splenic vessels: a long-term follow-up.

BACKGROUND: Spleen-preserving distal pancreatectomy with resection of the splenic vessels (VR-SPDP) is an effective procedure. However, hemodynamic changes in splenogastric circulation may lead to the development of gastric varices (GV) with a risk of gastrointestinal (GI) bleeding. This retrospective study aimed to assess the long-term postoperative clinical follow-up of patients and review the late postoperative abdominal computed tomography (CT) or endoscopic examination. METHODS: From 1988 to 2015, 48 consecutive VR-SPDP for benign or low-grade malignant disease were included. Late postop

Endocytoscopic findings of lymphomas of the stomach.

BACKGROUND: The gastric lesions of various lymphomas were observed at the cellular level using endocytoscopy. METHODS: Endocytoscopy and magnifying endoscopy with narrow band imaging (NBI) were performed in 17 patients with lymphomas of the stomach. The lesions consisted of 7 with low-grade mucosa-associated lymphoid tissue (MALT), 5 with gastric involvement by adult T-cell leukemia/lymphoma (ATLL), 4 with diffuse large B-cell lymphoma (DLBCL), and 1 with peripheral T-cell lymphoma. RESULTS: On conventional endoscopy, 9 were classified as having superficial spreading type, 7 were mass-formin

Nutritional support teams increase percutaneous endoscopic gastrostomy uptake in motor neuron disease.

AIM: To examine factors influencing percutaneous endoscopic gastrostomy (PEG) uptake and outcomes in motor neuron disease (MND) in a tertiary care centre. METHODS: Case notes from all patients with a confirmed diagnosis of MND who had attended the clinic at the Repatriation General Hospital between January 2007 and January 2011 and who had since died, were audited. Data were extracted for demographics (age and gender), disease characteristics (date of onset, bulbar or peripheral predominance, complications), date and nature of discussion of gastrostomy insertion, nutritional status [weight me

Current management of upper gastrointestinal bleeding.

Despite the introduction of proton pump inhibitors and modern flexible endoscopy techniques, upper gastrointestinal bleeding is still a common and serious condition. Once considered the domain of surgery, it is now uncommon to treat endoscopically controllable bleeding surgically. Therefore, most surgically treated cases are complicated and associated with a high mortality rate. This article presents the current management of upper gastrointestinal bleeding. Besides the description of current endoscopic treatment, medical prophylaxis and treatment, as well as radiological intervention, the art

Natural history of chronic gastritis in a population-based cohort.

OBJECTIVE: To describe and explore the natural history of Helicobacter pylori infection and chronic gastritis in terms of gastric mucosal atrophy and ulcer development over time in a population-based cohort. MATERIAL AND METHODS: A population-based cohort of 314 volunteers was re-screened (median follow-up interval of 8.4 years) with gastroduodenoscopy with biopsy, assessment of H. pylori status, analysis of pepsinogens, and monitoring of a nonsteroidal anti-inflammatory drug (NSAID) use and alcohol and smoking habits. RESULTS: The incidence of duodenal or prepyloric ulcer was 0.45 per 100 p

[Applications of noninvasive mechanical ventilation in anesthesiology and postanesthesia recovery care].

Noninvasive ventilation (NIV) can be useful to anesthesiologists working in critical care units, postanesthesia recovery units, operating theaters, or other settings. NIV can help in situations of acute respiratory failure or serve as a preventive measure in patients undergoing interventions under local-regional anesthesia or diagnostic or therapeutic procedures requiring sedation. Successful NIV depends on adequately trained health personnel and the proper choice of material (interfaces, respirators, etc.) for each setting where this modality is used.

Prospective clinical trial of magnetic-anchor-guided endoscopic submucosal dissection for large early gastric cancer (with videos).

BACKGROUND: The treatment of early gastric cancer (EGC) by endoscopic submucosal dissection (ESD) has been rapidly gaining popularity in Japan. However, the procedure needs a high quality of skill. To facilitate complicated ESD by using a single working-channel gastroscope ("one-hand surgery method"), the magnetic-anchor-guided ESD (MAG-ESD) controlled by an extracorporeal electromagnet was reported to be successful in a porcine model. OBJECTIVES: The purpose of this prospective clinical trial was to evaluate the feasibility of MAG-ESD for large EGC located on the gastric body in human beings

Successful treatment of Helicobacter pylori-negative gastric MALT lymphoma with rituximab.

Helicobacter pylori infection is strongly associated with low-grade gastric lymphoma, commonly known as mucosa-associated lymphoid tissue (MALT) lymphoma. H. pylori eradication leads to complete remission in 80% of early stage MALT lymphomas. The treatment for early stage H. pylori-negative gastric MALT lymphoma is evolving. Rituximab, a chimeric anti-CD20 antibody, has shown response rates of approximately 50% with minimal toxicity in patients with B-cell non-Hodgkin lymphoma. We describe herein the clinical, endoscopic, and histologic features of a patient with H. pylori-negative gastric MAL