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  • 1
    ISSN: 1523-5378
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: BackgroundInfection with Helicobacter pylori causes active chronic gastritis. Once the infection is acquired, gastritis will persist for almost the rest of one's life. To date, very few data are available on H. pylori gastritis in relation to age. Therefore, we attempted to inestigate whether H. pylori gastritis in children exhibits features different from H. pylori gastritis in adults of two different age groups. Materials and Methods.Fifty consecutive children with a median age of 11 years (range, 3–18 years) were compared with two groups of 50 adult patients, one group with a median age of 43 (range, 19–56 years) and another group with a median age of 70 years (range, 59–86 years). All patients had H. pylori gastritis unrelated to active peptic ulcer disease. Two biopsy specimens were taken from the antrum and two from the corpus, and the following gastritis parameters were evaluated: degree and activity of gastritis, H. pylori colonization, replacement of foveolar epithelium by regenerative epithelium, mucous depletion, presence of atrophic gastritis with intestinal metaplasia, and presence of lymphoid follicles. Results.Degree and activity of gastritis, extent of H. pylori colonization, degree of replacement by regenerative epithelium, extent of mucous depletion, degree of atrophic gastritis with intestinal metaplasia, and the presence of lymphoid follicles in the antrum, as well as the presence of lymphoid follicles in the corpus differed significantly (chi-square test: p 〈 .05). All these differences—except the once frequent occurrence of atrophic gastritis with intestinal metaplasia in adults—were attributable to a higher expression of these gastritis parameters in children. Conclusions.We conclude that H. pylori gastritis, particularly in the antrum, is more severely expressed in childhood. One reason for this might be a child-specific immune response to an infection with H. pylori. Alternatively, infection may represent a pediatric disease characterized by a nonatrophic, highly expressed form of gastritis, which changes its appearance once the host becomes adapted over time.
    Materialart: Digitale Medien
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  • 2
    ISSN: 1523-5378
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background. It has been reported that treatment with proton pump inhibitors (PPI) leads to partial elimination and suppression of Helicobacter pylori. In theory, since acid is known to denature immunoglobulins, this antibacterial activity of PPI may be due to a reduction in the acid output favouring humoral immunity.Materials and methods. We analysed prospectively fasting gastric juice in 54 consecutive patients attending upper endoscopy for pH and levels of IgG, IgA and IgM. In addition, two antral and two corpus biopsies were obtained and histologically examined for the presence of H. pylori.Results. 41/54 patients were infected with H. pylori. Immunoglobulines in the gastric juice of these patients were found in 25/41 (IgG), 27/41 (IgA), and 29/41 (IgM) patients. There was a highly significant difference in the gastric pH when H. pylori infected patients with measurable IgG, IgA, or IgM were compared with those in whom no immunoglobulines were found (median pH: 6 vs. 2 in each group; p 〈 .001)Conclusions. There is a close correlation between a high gastric pH and the presence of IgG, IgA, and IgM antibodies. Hence, it may be speculated that the efficacy of humoral immunity following H. pylori infection depends on a high pH such as resulting from PPI treatment.
    Materialart: Digitale Medien
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  • 3
    Digitale Medien
    Digitale Medien
    Cambridge, MA, USA : Blackwell Science, Inc.
    Helicobacter 2 (1997), S. 0 
    ISSN: 1523-5378
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Although considerable evidence suggests that Helicobacter pylori infection plays a crucial role in the pathogenesis of gastric carcinoma, a striking difference exists between the number of infected individuals and the proportion of those developing gastric carcinoma. The purpose of this article is to review the available evidence supporting the existence of identifiable risk factors for the development of gastric carcinoma.〈section xml:id="abs1-2"〉〈title type="main"〉Methods.We performed a critical review of the pertinent literature, which forms the basis for this study.〈section xml:id="abs1-3"〉〈title type="main"〉Results.In terms of treatment strategies for prevention of gastric carcinoma, cure of H. pylori infection in all infected patients seems unfeasible, mainly for economic reasons. However, the final and definite step to prove that infection with H. pylori is a preneoplastic condition for the development of gastric cancer would be the observation that cure of the infection leads to a significant reduction in gastric cancer incidence rates in comparison with an untreated population. Therefore, in 1997 a multicenter preventive interventional study on gastric carcinoma will be started in Germany. The target group in this study includes patients with a specific pattern of H. pylori gastritis who will be summarized by a “gastric cancer risk index.”〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions.It is hoped that long-term follow-up of these patients will reveal whether preventive treatment of H. pylori infection is capable of reducing the risk for development of gastric cancer.
    Materialart: Digitale Medien
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  • 4
    ISSN: 1432-2307
    Schlagwort(e): Key words Gastritis ; Cancer ; Helicobacter pylori ; Cancer risk
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Epidemiological data show an association between Helicobacter pylori gastritis and gastric carcinoma. However, most people infected with H. pylori do not develop gastric cancer. We have therefore evaluated histological criteria indicating an increased risk for gastric cancer. H. pylori gastritis was investigated in 117 patients with small (∅〈2 cm) early gastric carcinomas and in 117 age-matched duodenal ulcer patients infected with H. pylori, who are known to have a low risk for developing gastric carcinoma. The results showed that infiltration with lymphocytes/plasma cells and infiltration with neutrophils predominating in the corpus, and intestinal metaplasia in antrum and corpus were associated with both types of gastric carcinoma (intestinal and diffuse, P〈 0.0001). If an index is computed by giving one point to each of these features, the predictive value for the presence of gastric carcinoma was 0.79 with a score of 2, and 0.94 with a score of 3 (all points on the index used). Application of this index might be a simple method of identifying patients infected with H. pylori and carrying a higher risk for gastric carcinoma.
    Materialart: Digitale Medien
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  • 5
    ISSN: 1432-2307
    Schlagwort(e): Key words Atrophy ; Gastritis ; Helicobacter pylori ; Proton pump inhibitors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Long-term treatment with proton pump inhibitors in patients with Helicobacter pylori gastritis can lead to atrophic changes in the corpus mucosa. What is still unclear, however, is whether this atrophy can regress in response to Helicobacter pylori eradication. We report on a male patient with Helicobacter pylori gastritis receiving long-term treatment (4 years) with omeprazole for gastro-oesophageal reflux disease, who developed autoaggressive gastritis with progressive atrophy, hypochlorhydria, hypergastrinaemia and nodular ECL-cell hyperplasia. To determine whether these changes might be induced to regress, Helicobacter pylori eradication therapy was administered. Ten months after Helicobacter pylori eradication autoaggressive lymphocytic infiltrates were no longer detectable, and the glands in the corpus mucosa had normalised despite continued treatment with omeprazole – a finding that was confirmed at two further follow-up surveys performed at 6-month intervals. This case report shows that atrophy of the corpus mucosa developing under long-term treatment with a proton pump inhibitor can be cured by eradicating Helicobacter pylori.
    Materialart: Digitale Medien
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  • 6
    ISSN: 1432-2307
    Schlagwort(e): Key words Gastritis ; Helicobacter pylori ; Peptic ulcer ; Gastric cancer ; MALT lymphoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Infection with Helicobacter pylori (H. pylori) causes gastritis, and may be associated with gastric and duodenal ulcers and also with such malignant diseases as MALT lymphoma and gastric carcinoma. In order to determine whether there are differences in the degree and distribution of gastritis, each patient with H. pylori gastritis only (n = 50) was matched for sex and age with four patients, one each with H. pylori-associated duodenal ulcer, gastric ulcer, gastric carcinoma or MALT lymphoma. From each patient, two biopsies were taken from the antrum and two from the corpus for histopathological examination of H. pylori gastritis. The median summed gastritis score decreases in the following order: antrum: gastric ulcer 〉 duodenal ulcer 〉 gastritis alone 〉 carcinoma 〉 MALT lymphoma, and corpus: gastric ulcer 〉 carcinoma 〉 MALT lymphoma 〉 gastritis alone and duodenal ulcer. We conclude that the degree and distribution of H. pylori gastritis differs significantly among H. pylori-associated diseases. These differences may explain some of the underlying pathomechanisms associated with H. pylori infection.
    Materialart: Digitale Medien
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