Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Nov 1998
Recurrence of Helicobacter pylori infection after eradication: incidence and variables influencing it.
Our aim was to study the incidence of Helicobacter pylori recurrence in our country and to assess the different variables that might influence it. ⋯ Risk of post-eradication H. pylori recurrence is higher during the first 6 months, which suggests that most recurrences during this period are recrudescences and not true reinfections. Patients who have H. pylori recurrence tend to be younger and have higher delta 13C-urea breath test values after therapy, which suggests that a 'negative' value between 3 per thousand and 5 per thousand needs to be confirmed. Recurrence of H. pylori is more frequent in patients treated with low-efficacy therapies but is exceptional when high-efficacy therapies are used, in which case post-therapy eradication can be safely confirmed at 4 weeks. Finally, recurrence of H. pylori is clinically relevant, as ulcer recurrence is observed in a considerable proportion of these patients.
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Scand. J. Gastroenterol. · Sep 1998
Serum pancreatic enzymes in human immunodeficiency virus-infected children. A collaborative study of the Italian Society of Pediatric Gastroenterology and Hepatology.
Numerous studies have shown pancreatic disease in adult human immunodeficiency virus (HIV)-infected patients, but there are very few reports on pediatric patients. Our aim was to determine the prevalence of increased serum pancreatic enzyme levels and their relationship to clinical manifestations of acute pancreatitis in HIV-infected children. ⋯ Fifteen per cent of HIV-infected children had biochemical evidence of pancreatic involvement; however, this condition was unrelated to clinical signs of pancreatitis. Neither drug administration nor opportunistic infections seem to determine the increased serum pancreatic enzyme levels.
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Scand. J. Gastroenterol. · May 1998
Clinical TrialValue of early blood Th-1 cytokine determination in predicting severity of acute pancreatitis.
Early evaluation of the severity of acute pancreatitis (AP) requires measurement of many variables within 48 h after admission. Septic complications (SC) are frequent, and preliminary studies have highlighted the value of prophylactic antibiotherapy; however, single and reliable predictive markers of sepsis are not yet available. The aim of this study was to assess the value of determining early blood Th-1 cytokines and their natural antagonists (interleukin-6 (IL-6), IL-1, IL-1ra, and the soluble form of tumor necrosis factor (sTNF) receptors RI and RII) to predict the severity and SC during AP. ⋯ Besides severity markers, IL-1, IL-1-ra, and sTNF RI and RII should be considered in base-line AP assays and, if confirmed by larger studies, could help to screen patients at risk for SC and candidates for prophylactic antibiotherapy with a good negative predictive value.
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Scand. J. Gastroenterol. · Mar 1998
Randomized Controlled Trial Clinical Trial13C-urea breath test for the diagnosis of Helicobacter pylori infection. A further simplification for clinical practice.
The 13C-urea breath test is the most accurate noninvasive method for the diagnosis of Helicobacter pylori infection. The oral administration of citric acid solution as test drink 10 min before administration of 13C-urea appears to be the most valuable test procedure hitherto reported. To simplify the test for clinical routine, we evaluated in a prospective, randomized, crossover study the accuracy of a new modification that consists in giving the 13C-urea dissolved in the test drink. ⋯ The 13C-urea breath test for the diagnosis of H. pylori infection can be simplified by giving the substrate dissolved in the test drink. This modification is not associated with a loss of diagnostic accuracy.
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Scand. J. Gastroenterol. · Jul 1997
Unhealed duodenal ulcers despite Helicobacter pylori eradication.
Our aims were 1) to study the influence of several factors (age, sex, smoking, previous ulcer disease, ulcer size, chronic gastritis, serum gastrin and pepsinogen I levels, therapy regimen and, especially, eradication of Helicobacter pylori) on duodenal ulcer healing; 2) to evaluate the frequency of duodenal ulcer healing failure despite eradication of H. pylori, to study why this failure occurs, and to verify its evolution without antisecretory therapy; and 3) to confirm whether a week's prescription of omeprazole is sufficient to obtain ulcer healing. ⋯ Eradication of H. pylori favours ulcer healing, which is achieved in most patients in whom the organism is eradicated. Just 1 week of omeprazole therapy (that is, the antibiotic administration period in the new triple therapies) is enough to obtain a high ulcer healing rate. Most duodenal ulcers that do not heal initially despite H. pylori eradication will ultimately do so after several weeks without additional therapy.