Volume 79 - 2016 - Fasc.1 - Original articles
Does the urea breath test predict eradication of Helicobacter pylori infection ?
Background/Aim: Helicobacter pylori infection is common worldwide and has been linked to development of gastric and duo- denal ulcers, gastric adenocarcinoma, and gastric lymphoma. However, antimicrobial resistance has decreased H. pylori eradica- tion rates worldwide. This study aimed to evaluate the effect of bacterial load on eradication rate.
Method : This prospective study included 237 consecutive pa- tients who presented to our institution with dyspeptic symptoms and underwent both upper endoscopy and urea breath tests (UBT). The patients were divided into three equal sized groups according to their UBT values. All subjects received a standard triple eradica- tion regimen, followed by a bismuth- based quadruple eradication regimen if triple eradication was not successful. The three groups were compared with respect to age, endoscopic findings, sex, and eradication rates.
The Effect of the iNOS Inhibitor S-Methylisothiourea and Hyperbaric Oxygen Treatment on Radiation Colitis in Rats
Introduction : External radiotherapy is one of the main treat- ment modalities for a variety of malignancies. However, the lower gastrointestinal tract is sensitive to the ionizing radiation. Hyper- baric oxygen treatment (HOT) has been suggested as a viable treat- ment for refractory radiation colitis, but the effect of S-Methyliso- thiourea (SMT) in the radiation colitis have not reported.
Aim : To investigate the effect of SMT, HOT and the combina- tion of both in an acute radiation-induced enterocolitis model.
Methods : Sixty Sprague-Dawley rats were divided randomly into five equal groups. A single dose of gamma irradiation (25 Gy) was administered through the colorectal region to anesthetized rats. In the control group, we applied 2 ml of saline solution intra- peritoneally for five days. In the HOT group, 100-per-cent oxygen at 2.5 atm pressure was applied for five days. In the SMT group, 10 mg/kg/day of SMT was applied intraperitoneally for five days. In the HOT+SMT group, HOT and SMT were both applied in the same dosages as in the preceding two groups. At the end of five days, the rats were sacrificed and colon samples were collected for histological grading. Blood samples were collected to test for : tu- mor necrosis factor-a (TNF-a), interleukin-10 (IL-10), IL-1ss, transforming growth factor-ss (TGF-ss) and intercellular adhesion molecule-1 (ICAM-1) mRNA.
Clinical scores for the prediction of esophageal varices in patients with liver cirrhosis
Introduction : Esophageal bleeding is one of the most important and dramatic complications of liver cirrhosis in our everyday practice. Considering the costs of repeated upper endoscopy (UE) there is an increasing number of studies focusing on noninvasive parameters for the assessment of esophageal varices (EV).
Patients and methods : Retrospective study included 74 patients with alcoholic and viral liver cirrhosis treated at Clinic of Gastro-enterology and Hepatology, Clinical Center of Serbia. The data were obtained from patients medical records including history, biochemical, ultrasonography and UE findings.
Results : The average value of the RLLD/INR for patients who showed evidence of EV during UE and in those who didn't was 10.46±3.09 and 12.24±3.43, respectively (p=0.019, p<0.05). Cutoff value (11.5) of RLLD/INR showed a sensitivity of 64.15% and specificity of 66.67% (1.92LR+, and 0.54 LR-, AUROC 0.639) for the detection of EV. The average value of PC/SBD for patients who showed evidence of EV during UE and in those who didn't was 619.79 ± 492.96 and 1423.1 ± 908.2, respectively (p = 0.0, p < 0.05). The average value of RLLD/SA was 5.5 ± 0.17 and 4.57 ± 0.17 (p = 0.015, p < 0.05) for patients who showed evidence of EV during UE and in those who didn't, respectively.
Retreatment of Chronic Hepatitis C Infection with Telaprevir : Turkey Experience
Background/Aims : Patients with genotype 1 chronic hepatitis C virus (HCV) who do not have a sustained virologic response to therapy with peginterferon alfa and ribavirin have a low likelihood of success with retreatment.
Materials and Methods : Voluntary patients aged 18 and older with genotype-1 chronic HCV and with no exclusion criteria were included. Treatment was organized as following : telaprevir was administered at a dose of 750 mg every 8 hours ; Peg-IFN a-2a was administered at a dose of 180 mcg per week and ribavirin was administered at a dose of 1000-1200 mg per day. HCV-RNA levels were measured before treatment, at 4, 12, 24 weeks of treatment, after treatment and after 24 weeks of treatment. Sustained viro- logic response was defined as undetectable HCV-RNA after 24 weeks of treatment.
Results : Sustained virologic response was obtained in 37 pa- tients (74%). Breakthrough (BT) or early relapse was seen in 6 pa- tients (12%) in total. Treatment had to be discontinued because of treatment related adverse events in 7 patients (14%).
Conclusion : Triple combination therapy including telaprevir is significantly better than classical Peg-IFN a and ribavirin therapy in patients with chronic hepatitis-C infection. (Acta gastroenterol. belg., 2016, 79, 18-22).
Evaluation of oxidant - anti-oxidants status in patients with mild acute pancreatitis
Background and aim : Acute pancreatitis (AP), an inflammatory disorder of the pancreas, is associated with significant morbidity and mortality. The pathogenesis of AP has been suggested to involve high oxidative stress (OS), combined with inadequate anti- oxidant status.
We aimed to investigate the levels of serum total anti-oxidant status (TAS), total oxidant status (TOS) and ischemia-modified al- bumin (IMA) in patients with mild AP.
Methods : Thirty subjects with mild AP and 29 healthy controls were enrolled into the study. The levels of TAS, TOS and IMA, C- reactive protein (CRP), high sensitivity CRP (hs-CRP) and fibrino- gen were measured in both groups.
Results : TAS levels were significantly lower (p = 0.037), while IMA levels were significantly higher (p < 0.001) in patients, com- pared to controls. TOS levels were similar between two groups. Fibrinogen, CRP and hs-CRP levels were significantly higher in patients than those of controls (p < 0.001 for all parameters). IMA levels were positively correlated with amylase and lipase levels (r = 0.448, p = 0.001 and r = 0.469, p < 0.001, respectively). There was a negative correlation between TAS levels, and amylase and lipase levels (r = -0.277, p = 0.035 and r = -0.278, p = 0.034, respec- tively).