To see the other types of publications on this topic, follow the link: Dyspepsia.
Dissertations / Theses on the topic 'Dyspepsia'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Dyspepsia.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Jonsson, Bo H. "Psychophysiological study of functional dyspepsia /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3650-1/.
Full text
2
Jones, John I. W. "Characterisation of acid-sensitive dyspepsia." Thesis, Nottingham Trent University, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272811.
Full text
3
Koskenpato, Jari. "Helicobacter pylori and functional dyspepsia." Helsinki : University of Helsinki, 2001. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/koskenpato/.
Full text
4
Almeida, Rodrigues Isabel Maria Fragoso Carrelhas de. "Stress, personality factors and functional dyspepsia." Thesis, London South Bank University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414919.
Full text
5
Bolling-Sternevald, Elisabeth. "Functional Dyspepsia : Symptoms and Response to Omeprazole in the Short Term." Doctoral thesis, Linköping : Univ, 2003. http://www.ep.liu.se/diss/med/07/92/index.html.
Full text
6
Jones, Roger Hugh. "Self care and primary care of dyspepsia." Thesis, University of Southampton, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241615.
Full text
7
Watson, R. G. P. "A study of the pathogenesis of flatulent dyspepsia." Thesis, Queen's University Belfast, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.373008.
Full text
8
Piessevaux, Hubert. "Pathophysiological role of fundic tension receptors in functional dyspepsia." Université catholique de Louvain, 2004. http://edoc.bib.ucl.ac.be:81/ETD-db/collection/available/BelnUcetd-12232003-221959/.
Full textAbstract:
This work has tried to provide better insight in some pathophysiological factors involved in functional dyspepsia. We have identified several experimental evidences supporting the hypothesis that activation of transducers of wall tension at the level the proximal stomach might be the key to the genesis of at least some of the symptoms. One of the mechanisms by which this activation may be enhanced in patients is the presence of defective accommodation of the proximal stomach in response to a meal. This abnormality was present in a large subgroup of patients and was associated to the presence of early satiety. Pharmacological modulation of the gastric wall tension resulted in concomitant changes in symptom severity, both in health and in functional dyspepsia patients. Special attention has been given to provide the clinician with better tools to investigate his patient, in the perspective of the prescription of a treatment aimed at restoring a defective mechanism. / Ce travail a tenté d'améliorer la compréhension de certains mécanismes physiopathologiques de la dyspepsie fonctionnelle. Nous avons identifié plusieurs arguments expérimentaux soutenant l'hypothèse disant que c'est l'activation de mécanorécepteurs sensibles à la tension pariétale qui est reponsable d'au moins un des symptômes de l'affection. Un des mécanismes par lesquels cette activation peut accrue chez les patients est la présence d'un défaut de l'accommodation gastrique post-prandiale. Cette anomalie a été retrouvée dans une large proportion des patients et est associée à la présence de satiété précoce. Les modifications du tonus gastrique ont résulté dans de modifications concomitantes des symptômes aussi bien chez les volontaires que chez les patients atteints de dyspepsie fonctionnelle.Une attention particulière a été portée sur le développement de nouveaux outils permettant de caractériser les patients dans la perspective de la prescription d'un traitement visant à corriger un mécanisme défectueux.
9
Loffeld, Rudolf Johannes Louis Franciscus. "Dyspepsia and campylobacter associated gastritis clinical and pathological studies /." [Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1989. http://arno.unimaas.nl/show.cgi?fid=5556.
Full text
10
Mahadeva, Sanjiv. "Dyspepsia in a multi-racial South East Asian Population." Thesis, University of Leeds, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511136.
Full text
11
Fransen, Gerarda Adriana Johanna. "Dyspepsia in primary care: patient expectations, symptoms, and treatment adherence." Maastricht : Maastricht : Universiteit Maastricht ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=9280.
Full text
12
Pollock, Alexander Chapman. "From dyspepsia to Helicobacter : a history of peptic ulcer disease." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5114/.
Full textAbstract:
This thesis is a historical study of peptic ulcer disease from the sixth decade of the eighteenth century until the end of the twentieth. Symptoms of dyspepsia or indigestion have affected more than twenty percent of the British population for most of that period and attracted the involvement of many medical practitioners and others with the provision of health care. Within this group of symptomatic dyspeptic patients were to be found gastric and duodenal ulcers which were capable of causing serious health problems. However the prevalence of stomach and duodenal peptic ulcers has declined markedly during the time course of this thesis and now they are relatively uncommon. Although peptic ulcers may still have a fatal outcome, they now are considered to be curable conditions for the majority of patients who suffer from them in the developed world. This thematic history of gastric and duodenal ulcer examines how medical practitioners worked in a changing climate of novel ideas about disease, often aided or driven by technological developments, from the nineteenth century onwards. It begins with a humoural approach to the understanding of disease, which concentrated upon a patient’s personality, lifestyle choices and circumstances but this was gradually displaced from the end of the eighteenth century by the clinico-anatomical approach, which sought to identify a specific lesion as the ‘seat’ of the disease. In the nineteenth century, the discoveries of pathology, physiology, chemistry and bacteriology became incorporated in clinical medical practice, involving the laboratory in the investigation and treatment of many diseases. In the twentieth century, medical research became rooted in experimentation using scientific technology and engineering to equip investigators with new methods which changed the ways in which diseases were understood and treated. Although there were many innovations in theoretical concepts of disease aetiology and empirical treatments, many were subsequently rejected for reasons of ineffectiveness or possible harm to the patient, sometimes after long periods of use. In its first part, the thesis draws upon publications from 1769 until 1950, mostly in the form of scientific articles and books. In the second part, the oral testimonies of health care professionals involved with the management and treatment of gastric and duodenal ulcers are added. The recorded testimonies of 28 witnesses have been preserved in written form as a supplement to this dissertation. Peptic ulcer disease was initially perceived as a whole-body ailment which was centred on the stomach as its symptomatic location and its treatment was intended to alter humoural imbalance or relieve symptoms. However after post-mortem examinations were increasingly performed from the seventeen-nineties, medical practitioners could see its complications in death and combine their findings with the clinical presentations of what was becoming recognised as a relatively common disorder. In the nineteenth century, physiologists investigated the workings of the stomach using vivisection and chemistry to analyse the stomach contents. The acid produced by the stomach was seen to play a part in ulcer genesis but there was no agreement as to what its precise contribution was for many years thereafter. Bacteriologists who found micro-organisms in the stomach assumed that they were pathogenically involved and subsequent experiments confirmed this. As a result of effective anaesthesia and antisepsis in the last decades of the nineteenth century, surgeons intervened increasingly in life-threatening complications of gastric and duodenal ulcers and their observations changed their perceptions of the diseases. In the twentieth century, opaque meal X-ray techniques began to allow doctors to see lesions inside the living stomach, as did improved endoscopes. In 1952, research suggested that stomach bacteria played no part in causing ulcers and further bacteriological research in the stomach was abandoned. By this time, surgeons had designed operations to reduce stomach acid production which healed most gastric and duodenal ulcers. Good therapeutic results were also achieved using medication and dietetic regimens, but it was recognised that only the surgeon could help patients who had failed to respond to medical treatments. In 1962 it was noted that deaths rates for gastric and duodenal ulcer were falling and fewer people were suffering from them, but they remained a serious cause of morbidity and mortality. A new acid-reducing operation was devised in 1969 that offered the hope that surgery could adequately treat ulcers without causing iatrogenic damage, and in 1976, a new drug was marketed which healed them if continuously taken. Then in 1983 it was asserted that peptic ulcers were caused by a bacterium which was later called Helicobacter pylori. In time and in the face of much opposition, it was shown that if this organism was eradicated in the stomach by medication then gastric ulcers and duodenal ulcers could be cured for the first time. This account of the history of peptic ulcer disease shows how medical practitioners adapted the theoretical basis of their medical practice as its evolved under the influence of scientific or societal changes and later abandoned concepts and therapeutic regimens which no longer were in accord with current thinking. Important issues which have arisen out of the testimonies include: medical involvement with the pharmaceutical industry, how doctors co-operate in the care of patients and how they respond to new theories and equipment and techniques as they became available. The history of peptic ulcer disease over the past two hundred years as described in this thesis follows a broadly similar course to that of other diseases such as tuberculosis, syphilis and chronic renal disease which once dominated the lives of those who suffered from them and have largely become curable in recent years. This thesis is offered as an account of an equally fascinating and complex disease.
13
Usnato, Katherine Maria, Pierre palacios, and Alejandro Piscoya. "Comment on “prevalence of dyspeptic symptoms and heartburn of adults in belo horizonte, brazil." nstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades – IBEPEGE, 2017. http://hdl.handle.net/10757/622196.
Full text
14
Hungin, A. Pali S. "Open access gastroscopy." Thesis, University of Newcastle Upon Tyne, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295539.
Full text
15
MacIntosh, Donald Garth. "A symptom-based outcome measure for clinical trials in nonulcer dyspepsia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq25863.pdf.
Full text
16
Berglöv, Anna, and Tilda Holmberg. "Kostrelaterade egenvårdsmetoder och dess effekter för patienter med Irritable Bowel Syndrome & Funktionell Dyspepsi : En litteraturstudie." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-18008.
Full textAbstract:
Bakgrund: Irritable Bowel Syndrome (IBS) och Funktionell Dyspepsi (FD) är två syndrom som många personer lider av och som det inte finns någon botande behandling för. Då syndromen bara går att symptomlindra tar många av personerna som lider av dessa till egenvårdsmetoder som ofta är kostrelaterade. Att stötta och vägleda patienter i sin egenvård är en uppgift som sjuksköterskor i allmänhet har, och i synnerhet för dessa patienter eftersom ingen botande behandling finns. Syfte: Syftet med föreliggande litteraturstudie var att beskriva kostrelaterade egenvårdsmetoder för patienter med Irritable Bowel Syndrome och/eller Funktionell Dyspepsi där upplevda och/eller observerade effekter beskrivits. Syftet var även att beskriva de valda studiernas datainsamlingsmetoder. Metod: En litteraturstudie med beskrivande design. Datainsamlingen har skett från databaserna PubMed och CINAHL. Huvudresultat: Tretton studier har inkluderats. Utifrån dessa har det framkommit att patienter som lider av IBS och/eller FD kan ta till en mängd olika kostrelaterade egenvårdsmetoder. Effekter av dessa har visat sig förebygga och/eller lindra fysiska symptom från mag-tarmkanalen samt i och med detta ge förbättrad livskvalitet. De datainsamlingsmetoder som beskrivits har visat sig variera mellan frågeformulär och skattningsskalor, dagböcker, kroppsliga markörer samt gruppintervjuer. Slutsats: Patienter med IBS och/eller FD kan använda sig av ett flertal olika kostrelaterade egenvårdsmetoder i syfte att förebygga och/eller lindra sina symptom från mag-tarmkanalen. En mängd olika datainsamlingsmetoder kan användas för att identifiera olika kostrelaterade egenvårdsmetoder och dess påverkan på symptom från IBS och/eller FD.Background: Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) are two syndromes that many people suffers from and that has no curing treatment. Since the syndromes only has a symptomatic treatment many people that suffers from it uses self-care methodes that often includes diet. Support and guidance in patiens self-care are a main task for nurses in general and especially for these patients since no curing treatment is available. Aim: The aim of the present study was to describe dietary self-care practices for patients with Irritable Bowel Syndrome and/or Functional Dyspepsia where the perceived and/or observed effects was described. The aim was also to describe the selected studies data collection methods. Method: A literature review with descriptive design. Data has been collected from the databases PubMed and CINAHL. Main Results: Thirteen studies were included. From these, it has been found that patients suffering from IBS and/or FD may use a variety of dietary self-care methods. Effects of these have been shown to prevent and/or alleviate physical symptoms from the gastrointestinal tract and therefore provide better quality of life. The data collection methods described have been found to vary between questionnaires and rating scales, diaries, physical markers and group interviews. Conclusion: Patients with IBS and/or FD can make use of many diet related self-care methods to prevent and/or relieve their symptoms from the gastrointestinal tract. Many different data collection methods can be used to identify diet related self-care practices and its effect on the symptoms of IBS and/or FD.
17
Hurenkamp, Gerardus Johannes Bernardus. "Chronic dyspepsia in general practice tapering the use of acid suppressant drugs /." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2001. http://dare.uva.nl/document/58324.
Full text
18
Carvalho, Roberta Villas Boas. "Avaliação da intolerancia alimentar e do padrão alimentar de pacientes com dispepsia funcional." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310800.
Full textAbstract:
Orientador: Maria Aparecida MesquitaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-10T16:18:34Z (GMT). No. of bitstreams: 1 Carvalho_RobertaVillasBoas_M.pdf: 798660 bytes, checksum: fd44d0259aeae156ed7a9e2381ccd7d7 (MD5) Previous issue date: 2007
Resumo: A dispepsia funcional (DF) é um diagnóstico bastante freqüente na prática clínica. A fisiopatologia deste distúrbio é provavelmente multifatorial, e ainda não foi completamente esclarecida. Como conseqüência, não existem medidas terapêuticas que sejam eficazes para todos os pacientes. Embora a maior parte dos pacientes relacione seus sintomas com a ingestão de vários tipos de alimentos, a influência dos fatores dietéticos no quadro clínico da dispepsia funcional foi muito pouco explorada na literatura, e os resultados dos estudos são muitas vezes controversos. Os objetivos deste estudo foram avaliar, em um grupo de pacientes com dispepsia funcional, o padrão alimentar, os hábitos dietéticos, o estado nutricional, e as queixas de intolerância alimentar, relacionando-as com os sintomas de dispepsia. Foram avaliados 41 pacientes com o diagnóstico de dispepsia funcional e 30 voluntários assintomáticos como grupo-controle. Inicialmente os participantes respondiam a um questionário geral padronizado, que abordava aspectos sócio-econômicos e a história médica e nutricional. Após essa entrevista, recebiam um recordatório alimentar de sete dias, que deveriam retornar preenchido na consulta seguinte. Nossos resultados demonstram que, de acordo com o IMC, 43,9% dos pacientes eram eutróficos e 56,1% apresentavam sobrepeso ou obesidade. Com relação ao consumo alimentar, não houve diferença significativa na ingestão calórica diária entre pacientes (1516 ± 424,5 kcal) e controles (1545 ± 365,1 kcal; p=0,73). Os pacientes apresentaram a mesma porcentagem de ingestão protéica que o grupo controle, e uma pequena, mas significativa, diminuição da porcentagem de lipídios (28,7±5,5% vs 32,7±4 %; p=0,001), acompanhada de um aumento na porcentagem de ingestão de carboidratos (55,7±4,5% vs 50,5±4,5%; p=0,001). Em relação à intolerância alimentar, os pacientes relacionaram seus sintomas com a ingestão de uma grande variedade de alimentos. A maior parte dos alimentos associados com o sintoma de plenitude gástrica foram aqueles ricos em lipídios e carboidratos. Os sintomas de queimação epigástrica e pirose foram mais relacionados com o consumo de queijo, cebola, pimenta e café. Apesar de associarem seus sintomas com a ingestão desses alimentos, os pacientes mantinham um consumo regular dos mesmos, semelhante ao relatado pelo grupo controle, com exceção da leve redução na ingestão de lipídios. Comparando-se os hábitos alimentares, os pacientes apresentam um período de jejum noturno maior em relação aos controles, relacionado com o hábito de jantar mais cedo. Houve também uma tendência estatística (p=0,07) para um menor número de refeições por dia no grupo de pacientes. Em conclusão, nossos dados sugerem que o padrão alimentar e os hábitos alimentares dos pacientes com dispepsia funcional são semelhantes aos do grupo controle. A intolerância alimentar não parece afetar o padrão alimentar e o estado nutricional desses pacientes
Abstrct: Functional dyspepsia is a common diagnosis in clinical practice. Its pathophysiology is still not completely understood. As a consequence, therapeutic strategies are not effective for all patients. Although most patients report that symptoms are related to food ingestion, the investigation on the role of diet in dyspeptic symptoms has been limited to a few studies, with controversial results. The aims of the present study were to assess in a group of functional dyspepsia patients the food and eating patterns, nutritional status, and the food intolerance and its relation with specific dyspeptic symptoms. Forty-one functional dyspepsia patients and thirty healthy volunteers were studied. First, they answered a standardized questionnaire comprising demographic characteristics, medical and nutritional history. Then, they were sent home with a seven-day alimentary diary. Our results showed that, according to BMI data, 56.1% of patients were overweight or obese. There was no significant difference in daily total caloric intake between patients (1516 ± 424.5 kcal) and controls (1545 ± 365.1 kcal; p=0.73). By percent of caloric intake, patients consumed the same proportion of proteins as controls. There was a small, but significant, reduction in the proportion of fat consumed by patients (28.7±5.5% vs 32.7±4%; p=0,001), and an increased proportion of carbohydrates (55.7±4.5% vs 50.5±4.5%; p=0,001). Patients reported the association of dyspeptic symptoms with ingestion of several foods. The sensation of fullness was related to fatty foods and carbohydrates. Epigastric burning and heartburn were related to ingestion of cheese, onion, pepper and coffee. Patients maintained a regular intake of foods associated with dyspeptic symptoms. Considering the eating patterns, nocturnal fasting was higher in dyspeptic patients, due to early dinner. There was a trend (p=0.07) for functional dyspepsia patients to eat less meals for day. In conclusion, our results suggest that food and eating patterns of functional patients are similar to the control group. It appears that food intolerance did not affect food pattern and nutritional status in these patients
Mestrado
Clinica Medica
Mestre em Clinica Medica
19
Carvalho, Mary de Assis. "Achados histopatológicos gástricos em crianças e adolescentes brasileiros com dispepsia e infecção por Helicobacter pylori /." Botucatu : [s.n.], 2011. http://hdl.handle.net/11449/104555.
Full textAbstract:
Orientador: Maria Aparecida Marchesan Rodrigues. -Banca: Carlos Antonio Caramori
Banca: Érika Veruska Paiva Ortolan
Banca: Francisco Agostinho Júnior
Banca: Gisele Alborghetti Nai
Resumo: Avaliar as características histopatológicas da mucosa gástrica, duodenal e esofágica de crianças e adolescentes brasileiros infectados por Helicobacter pylori (H. pylori) e submetidas à endoscopia digestiva alta para investigar dispepsia crônica. As correlações entre variáveis clínicas e histopatológicas também foram analisadas. Foi realizado estudo prospectivo de biópsias do trato gastrointestinal superior (mucosa gástrica, duodenal e esofágica) em crianças e adolescentes de 4 a 17 anos de idade. A análise histopatológica foi realizada com coloração por Hematoxilina & Eosina, as lesões gástricas e duodenais foram classificadas de acordo com o Sistema Sydney atualizado e a intensidade da esofagite foi graduada. O estudo incluiu um grupo de crianças infectadas por H. pylori (Hp+), com resultados positivos para dois testes (teste da urease e histologia) e um grupo de não infectadas (Hp-). Utilizou-se teste de Mann-Whitney, Qui-Quadrado, exato de Fisher e correlação de Spearman, sendo p<0,05 considerado significativo. Foram estudadas 185 crianças dispépticas (idade 9.5±2.7 anos), 63,2% (117/185) do sexo feminino, 96 (51,8%) H. pylori positivos (Hp+) e 89 (48,2%) H. pylori negativos (Hp-). O grupo Hp+ foi significativamente mais velho (9.9±2.8 anos) do que o grupo Hp- (9.0±2.6 anos) (p=0,02). Não houve diferença entre a proporção de sintomas entre os grupos Hp+ e Hp-. Não foram encontradas úlcera gástrica ou duodenal durante o procedimento endoscópico. Gastrite crônica ativa moderada/grave esteve presente em 70,5% das biópsias do antro e em 45,2% das biópsias do corpo no grupo Hp+, com intensidade significativamente maior no antro do que no corpo (p<0,05). A pontuação para densidade de H. pylori foi significativamente maior (p=0,005) nas biópsias do antro do que no corpo. Houve uma... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: To evaluate the histopathological features of the gastric, duodenal and esophageal mucosa from Brazilian children and adolescents infected with Helicobacter pylori (H. pylori), submitted to upper gastrointestinal endoscopy to investigate chronic dyspepsia. The correlations between clinical and histopathological variables were also analyzed. A prospective study of biopsies from the upper gastrointestinal tract (gastric, duodenal and esophageal mucosa) was performed on children and adolescents 4 to 17 years-old. The histopathological analysis was performed on Hematoxylin-and-Eosin-stained slides, the gastric and duodenal lesions were graded according to the updated Sydney System and the intensity of esophagitis was recorded. The study included one group of H. pylori infected children (Hp+), with positive results for two tests (rapid urease test and histology) and one uninfected group (Hp-). Mann-Whitney, Chi-square, Fisher exact test and Spearman rank correlation were performed and p<0.05 considered significant. We studied 185 dyspeptic children (age 9.5±2.7 years), 63.2% (117/185) female, 96 (51.8 %) H. pylori positive (Hp+) and 89 (48.2%) H. pylori negative (Hp-). H. pylori-positive were significantly older (9.9±2.8 years) than Hp- (9.0±2.6 years) (p=0.02). There was no difference among the proportion of symptoms between Hp+ and Hp- groups. Gastric or duodenal ulcers were not found during the endoscopic procedure. Moderate/severe chronic active gastritis was present in 70,5% of antrum biopsies and in 45,2% of corpus biopsies in the Hp+ group, with significantly higher grading in antrum than in corpus (p<0.05). The scores for H. pylori density were significantly higher (p=0.005) in the antrum biopsies than in the corpus. There was a significant positive association... (Complete abstract click electronic access below)
Doutor
20
McKenna, D. J. J. "An investigation into the incidence and causes of dyspepsia and vomiting in pregnancy." Thesis, Queen's University Belfast, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403244.
Full text
21
Reilly, Timothy Gilbert. "The diagnosis and management of dyspepsia and the relevance to it of Helicobacter pylori." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.262818.
Full text
22
Carvalho, Mary de Assis [UNESP]. "Achados histopatológicos gástricos em crianças e adolescentes brasileiros com dispepsia e infecção por Helicobacter pylori." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/104555.
Full textAbstract:
Made available in DSpace on 2014-06-11T19:33:24Z (GMT). No. of bitstreams: 0
Previous issue date: 2011-08-05Bitstream added on 2014-06-13T20:05:13Z : No. of bitstreams: 1
carvalho_ma_dr_botfm.pdf: 1115571 bytes, checksum: 83b322f65a0c84ce4930adccf88b2d28 (MD5)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Avaliar as características histopatológicas da mucosa gástrica, duodenal e esofágica de crianças e adolescentes brasileiros infectados por Helicobacter pylori (H. pylori) e submetidas à endoscopia digestiva alta para investigar dispepsia crônica. As correlações entre variáveis clínicas e histopatológicas também foram analisadas. Foi realizado estudo prospectivo de biópsias do trato gastrointestinal superior (mucosa gástrica, duodenal e esofágica) em crianças e adolescentes de 4 a 17 anos de idade. A análise histopatológica foi realizada com coloração por Hematoxilina & Eosina, as lesões gástricas e duodenais foram classificadas de acordo com o Sistema Sydney atualizado e a intensidade da esofagite foi graduada. O estudo incluiu um grupo de crianças infectadas por H. pylori (Hp+), com resultados positivos para dois testes (teste da urease e histologia) e um grupo de não infectadas (Hp-). Utilizou-se teste de Mann-Whitney, Qui-Quadrado, exato de Fisher e correlação de Spearman, sendo p<0,05 considerado significativo. Foram estudadas 185 crianças dispépticas (idade 9.5±2.7 anos), 63,2% (117/185) do sexo feminino, 96 (51,8%) H. pylori positivos (Hp+) e 89 (48,2%) H. pylori negativos (Hp-). O grupo Hp+ foi significativamente mais velho (9.9±2.8 anos) do que o grupo Hp- (9.0±2.6 anos) (p=0,02). Não houve diferença entre a proporção de sintomas entre os grupos Hp+ e Hp-. Não foram encontradas úlcera gástrica ou duodenal durante o procedimento endoscópico. Gastrite crônica ativa moderada/grave esteve presente em 70,5% das biópsias do antro e em 45,2% das biópsias do corpo no grupo Hp+, com intensidade significativamente maior no antro do que no corpo (p<0,05). A pontuação para densidade de H. pylori foi significativamente maior (p=0,005) nas biópsias do antro do que no corpo. Houve uma...
To evaluate the histopathological features of the gastric, duodenal and esophageal mucosa from Brazilian children and adolescents infected with Helicobacter pylori (H. pylori), submitted to upper gastrointestinal endoscopy to investigate chronic dyspepsia. The correlations between clinical and histopathological variables were also analyzed. A prospective study of biopsies from the upper gastrointestinal tract (gastric, duodenal and esophageal mucosa) was performed on children and adolescents 4 to 17 years-old. The histopathological analysis was performed on Hematoxylin-and-Eosin-stained slides, the gastric and duodenal lesions were graded according to the updated Sydney System and the intensity of esophagitis was recorded. The study included one group of H. pylori infected children (Hp+), with positive results for two tests (rapid urease test and histology) and one uninfected group (Hp-). Mann-Whitney, Chi-square, Fisher exact test and Spearman rank correlation were performed and p<0.05 considered significant. We studied 185 dyspeptic children (age 9.5±2.7 years), 63.2% (117/185) female, 96 (51.8 %) H. pylori positive (Hp+) and 89 (48.2%) H. pylori negative (Hp-). H. pylori-positive were significantly older (9.9±2.8 years) than Hp- (9.0±2.6 years) (p=0.02). There was no difference among the proportion of symptoms between Hp+ and Hp- groups. Gastric or duodenal ulcers were not found during the endoscopic procedure. Moderate/severe chronic active gastritis was present in 70,5% of antrum biopsies and in 45,2% of corpus biopsies in the Hp+ group, with significantly higher grading in antrum than in corpus (p<0.05). The scores for H. pylori density were significantly higher (p=0.005) in the antrum biopsies than in the corpus. There was a significant positive association... (Complete abstract click electronic access below)
23
Sales, Kamila Maria Oliveira. "Estado nutricional, sintomas dispÃpticos e nÃveis de grelina em pacientes portadores de doenÃa de Crohn-correlaÃÃo com a atividade da doenÃa." Universidade Federal do CearÃ, 2013. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14116.
Full textAbstract:
nÃo hÃA perda de peso à uma queixa comum dos pacientes com doenÃa de Crohn, estando a desnutriÃÃo presente em 30-80% dos portadores dos casos. Foi demonstrado que pacientes com doenÃa de Crohn em inatividade apresentam sintomas dispÃpticos relacionados com alteraÃÃo no esvaziamento gÃstrico. No entanto, a correlaÃÃo da atividade da doenÃa com os parÃmetros antropomÃtricos, nutricionais e de saciedade ainda à objeto de investigaÃÃo. Portanto, o objetivo do nosso estudo foi correlacionar a atividade da doenÃa com o estado nutricional, sintomas dispÃpticos, esvaziamento gÃstrico, saciedade e nÃveis de grelina em pacientes com doenÃa de Crohn. Trata-se de um estudo transversal, analÃtico e quantitativo realizado em vinte pacientes com doenÃa de Crohn, classificados segundo um Ãndice de Atividade de DoenÃa de Crohn (Crohnâs Disease Activity Index â CDAI). Os pacientes foram submetidos a uma avaliaÃÃo nutricional, que se fundamentou na utilizaÃÃo de mÃtodos duplamente indiretos (Ãndice de massa corporal, dobra cutÃnea tricipital e circunferÃncia do braÃo). AlÃm disso, nos pacientes foi avaliado o consumo alimentar atravÃs de um recordatÃrio alimentar. Estes foram tambÃm submetidos a uma anÃlise do tempo de esvaziamento gÃstrico por teste respiratÃrio usando o 13C - Ãcido octanÃico ligado a uma refeiÃÃo sÃlida - e responderam a um questionÃrio validado (QuestionÃrio Porto Alegre de Sintomas DispÃpticos) para avaliar os sintomas dispÃpticos. Outro teste realizado foi o teste de saciedade(drinking test), no qual o paciente ingeriu 15 ml de uma bebida lÃquida padrÃo(Nutridrink), e era lhe perguntado o nÃvel de saciedade atravÃs de uma escala analÃgica. Durante o teste respiratÃrio, foram realizadas coletas de amostras de sangue para dosagem de grelina: basal( jejum) e pÃs-prandial. Os dados foram analisados estatisticamente pelos testes: t de Student, exato de Fisher, Mann-Whitney e correlaÃÃo de Spearman. Observou-se que os parÃmetros CDAI e IMC (p=0,0185) e CB (p=0,023) foram inversamente proporcionais, porÃm nÃo houve diferenÃa estatÃstica entre as correlaÃÃes do CDAI com prega cutÃnea tricipital( p=0,0543). Os pacientes nÃo apresentaram correlaÃÃo da atividade da doenÃa com o esvaziamento gÃstrico ( t Â- p=0,2533; t lag-p=0,3079). Entretanto, houve correlaÃÃo significativa do CDAI com todos os sintomas dispÃpticos (p=0,005). NÃo se verificou correlaÃÃo da atividade da doenÃa e o volume de lÃquido suportado. Entretanto, a atividade da doenÃa influenciou os nÃveis de grelina no pÃs-prandial (p=0,04). CONCLUSÃO: A atividade da doenÃa correlaciona-se com o estado nutricional, a presenÃa de sintomas dispÃpticos e nÃveis de grelina de pacientes portadores de doenÃa de Crohn. Entretanto nÃo existe correlaÃÃo com alteraÃÃes no esvaziamento gÃstrico e saciedade sugerindo que outros mecanismos possam estar envolvidos.
24
Leite, Carine. "Associação entre eosinofilia duodenal e dispepsia funcional." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/110200.
Full textAbstract:
Introdução: Dispepsia funcional é uma doença de alta prevalência e grande impacto econômico e social. Sua etiologia ainda é pouco conhecida, e a literatura tem sugerido a associação do aumento do número de eosinófilos em mucosa duodenal com os sintomas dispépticos. No entanto, o tema ainda é controverso. Objetivo: Avaliar se existe associação entre contagem de eosinófilos duodenais e sintomas dispépticos. Métodos: Foram incluídos pacientes dispépticos funcionais pelos critérios de Roma III (casos) e indivíduos assintomáticos do trato gastrointestinal (controles). Os dois grupos foram pareados por idade, sexo e infecção por Helicobacter pylori (H. pylori). Eosinófilos da segunda porção duodenal foram quantificados em 5 campos de maior aumento (CMA), selecionados randomicamente em fragmentos de biópsias endoscópicas, e o valor comparado entre os grupos. Resultados: Foram incluídos 42 dispépticos funcionais e 21 controles (idade média 39,6 e 38,7 anos respectivamente); 71,4% mulheres e 61,9% H. pylori positivos em cada grupo. Casos e controles apresentaram semelhante contagem de eosinófilos/CMA na biópsia duodenal, mediana 11,9 e 12,6 respectivamente (P=0,194). No grupo de casos a contagem de eosinófilos foi maior entre os portadores de H. pylori do que nos indivíduos não infectados (mediana 13,6 versus 6,1 P<0,001); no entanto foi semelhante no grupo de controles (mediana 12,6 versus 15,7 P=0,8). Conclusões: Não foi demonstrada diferença de contagem de eosinófilos duodenais entre dispépticos funcionais e controles. Entretanto, parece haver interação com infiltrado eosinofílico e sintomas no subgrupo de casos infectados pelo H. pylori.Introduction: Functional dyspepsia is a highly prevalent disease with major economic and social impact. Its etiology is still poorly understood, and it has been suggested the association of increased numbers of eosinophils in duodenal mucosa with dyspeptic symptoms. However, this issue is still controversial. Objective: To determine if there is association between duodenal eosinophilia and dyspeptic symptoms. Methods: Functional dyspeptic patients according to the Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were included. Groups were matched by age, sex and infection with Helicobacter pylori (H. pylori). Eosinophils in the second duodenal portion were counted in five high-power fields (HPF), randomly selected in endoscopic biopsies and the value was compared between groups. Results: 42 functional dyspeptic patients and 21 controls (mean age 39.6 and 38.7 years old, respectively) were included; 71.4% were women and 61.9% were positive for H. pylori in each group. Cases and controls had similar eosinophil counts/HPF in the duodenal biopsy: median 11.9 and 12.6 respectively (P = 0.194). In the case group the eosinophil count was higher in H. pylori carriers than in noncarriers (median 13,6 versus 6,1 P<0,001); however this count was similar in the control group (median 12,6 versus 15,7 P=0,8). Conclusions: No difference was found in duodenal eosinophil count between functional dyspeptic patients and controls. However, there seems to be an interaction between eosinophilic infiltrate and symptoms in the subgroup of H. pylori-infected cases.
25
Lee, In-Seon [Verfasser], and Paul [Akademischer Betreuer] Enck. "Interaction of psychological, physiological and neuronal processes in functional dyspepsia / In-Seon Lee ; Betreuer: Paul Enck." Tübingen : Universitätsbibliothek Tübingen, 2018. http://d-nb.info/1168804744/34.
Full text
26
Andersson, Stina. "Gastric electrical stimulation studies in patients with intractable nausea and comiting /." Göteborg : Dept. of Internal Medicine, Institute of Medicine at Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, 2010. http://hdl.handle.net/2077/21862.
Full text
27
Chan, David. "The evidence-based management of dyspepsia by a gastrointestinal specialist nurse in primary and secondary care settings." Thesis, University of Portsmouth, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430660.
Full text
28
Gibson, Margaret Agnes Ruth. "A study of the clinical interpretation of dyspepsia in general practice and the use of cimetidine in treatment." Thesis, Queen's University Belfast, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336207.
Full text
29
Pohjanen, V. M. (Vesa-Matti). "Toll-like receptor 4 and interleukin 6 gene polymorphisms in Helicobacter pylori related diseases." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526212555.
Full textAbstract:
Abstract Helicobacter pylori is a Gram-negative bacterium, which infects the stomach of more than 50% of the population worldwide. In addition to being the most important risk factor for gastric cancer and peptic ulcers, H. pylori infection is a risk factor for several extra-digestive diseases including dyslipidemia. The consequences of having an H. pylori infection are significantly influenced by the inflammatory response of the host. The pattern recognition receptor Toll-like receptor 4 (TLR4) and the cytokine interleukin 6 (IL6) are important mediators of inflammation in H. pylori related diseases. We have analyzed a series of control subjects and patients with dyspepsia, peptic ulcers or gastric cancer for frequent genetic polymorphisms of the TLR4 and IL6 genes. The prevalence of H. pylori infection, the histologic features of gastritis and cancer and serum endocrine markers and lipid concentrations were also analyzed. Furthermore, the expression of TLR4 was analyzed in specific cell types of gastric mucosa by immunohistochemistry. The TLR4 wild type genotypes of polymorphisms +896 and +1196 were associated with an increased risk of peptic ulcers. The same genotypes also associated with higher serum gastrin levels, but not with atrophy or other features of gastritis. The TLR4 expression was seen in the gastrin and somatostatin secreting cells of gastric mucosa. These results suggest a regulatory link between TLR4 and gastrin secretion. Such a link indicates the presence of a novel effector mechanism for innate immunity in modifying the host endocrine function. The IL6 -174 polymorphism associated significantly with a risk of the diffuse type of gastric carcinoma but not with the intestinal type or its precursor conditions. Finally, we demonstrated that H. pylori infections modify HDL serum levels significantly only in IL6 -174 CC genotype patients, which suggests that the detrimental effects of H. pylori infections on HDL levels are transmitted through IL6. These results clarify the mechanisms of H. pylori related diseases and open new possibilities for research on peptic ulcer disease, gastric cancer and dyslipidemiaTiivistelmä Helicobacter pylori on yleinen ihmisen mahalaukussa esiintyvä Gram-negatiivinen bakteeri. Helikobakteeri on tärkein mahasyövän ja maha- ja pohjukaissuolihaavan riskitekijä ja se on myös muun muassa rasva-aineenvaihdunnan häiriöiden riskitekijä. Ihmisen tulehdusvaste vaikuttaa merkittävästi helikobakteeri-infektion seurauksiin. Tollin kaltainen reseptori 4 (TLR4), joka on hahmontunnistusreseptori ja tulehduksenvälittäjäaine interleukiini 6 (IL6) ovat tärkeitä ihmisen tulehdusvasteeseen osallistuvia proteiineja. Olemme tutkineet dyspepsiaa, maha- ja pohjukaissuolihaavaa ja mahasyöpää sairastavilta potilailta sekä kontrollihenkilöiltä TLR4:n ja IL6:n geenien yleisiä emäsjärjestyksen polymorfioita. Tutkimme myös helikobakteeri-infektion yleisyyttä ja histologisia piirteitä, mahasyövän histologisia piirteitä ja seerumin merkkiaineita ja lipidipitoisuuksia. Lisäksi tutkimme TLR4:n ilmenemistä mahan limakalvolla immunohistokemiallisesti. TLR4:n polymorfismien +896 ja +1196 villin tyypin genotyypit liittyivät kohonneeseen maha- ja pohjukaissuolihaavan riskiin. Samat genotyypit liittyivät myös korkeampiin gastriinitasoihin. TLR4:ä esiintyi mahalaukun limakalvolla gastriinia tai somatostatiinia ilmentävissä soluissa. Täten TLR4:n ja maha- pohjukaissuolihaavariskin yhteys näyttää välittyvän gastriinin erityksen kautta, mikä viittaa uuteen säätely-yhteyteen luontaisen immuniteetin ja mahalaukun umpieritysjärjestelmän välillä. IL6 -174 -polymorfismi yhdistyi diffuusin tyypin mahakarsinooman riskiin mutta ei intestinaalisen tyypin karsinooman riskiin. Helikobakteeri-infektio yhdistyi pienentyneisiin HDL-kolesterolipitoisuuksiin vain potilailla, joilla oli IL6 -174 CC genotyyppi, mikä viittaa helikobakteerin kolesterolitasoille haitallisen vaikutuksen välittyvän IL6:n kautta. Nämä tulokset antavat lisätietoa helikobakteerin aiheuttamien sairauksien mekanismeista ja avaavat uusia tutkimuspolkuja myös mahahaavan, mahasyövän ja rasva-aineenvaihdunnan häiriöiden kliiniseen tutkimukseen
30
Jančiauskas, Dainius. "Funkcine dispepsija sergančių pacientų skrandžio gleivinės histomorfologiniai pakitimai bei jų dinamika vartojant augalinės kilmės antioksidantą astaksantiną." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100906_104114-57126.
Full textAbstract:
Darbo tikslas - įvertinti sergančiųjų funkcine dispepsija skrandžio gleivinės morfologinius pakitimus bei jų pokyčius gydant skirtingomis augalinės kilmės antioksidanto astaksantino dozėmis. Tikslui pasiekti buvo nustatyti ir išspręsti šie uždaviniai: įvertinti infekuotumą Helicobacter pylori mikroorganizmais bei skrandžio gleivinės histomorfologinius pakitimus pagal Sidnėjaus ir OLGA klasifikacijas sergantiesiems funkcine dispepsija; ištirti funkcine dispepsija sergančių ligonių uždegimo žymenų IL-4, IL-6, IL-8, IL-10, IFN-γ bei lastelių žymenų CD4, CD8, CD14, CD19, CD25, CD30 raišką skrandžio gleivinėje; palyginti funkcine dispepsija sergančių ligonių, gydytų augalinės kilmės antioksidanto astaksantino skirtingomis dozėmis ir placebu, skrandžio gleivinės morfologinius pokyčius; palyginti funkcine dispepsija sergančių ligonių, gydytų augalinės kilmės antioksidantu astaksantinu ir placebu, uždegimo žymenų IL-4, IL-6, IL-8, IL-10, IFN-γ bei lastelių žymenų CD4, CD8, CD14, CD19, CD25, CD30 raišką skrandžio gleivinėje.The aim of the study was to evaluate histomorphological changes of the gastric mucosa in functional dyspepsia patients and their dynamics after treatment with the natural antioxidant astaxanthin. The following objectives were established and reached: to determine the presence of Helicobacter pylori infection and evaluate the histomorphological changes of gastric mucosa in functional dyspepsia patients; to evaluate interleukins IL-4, IL-6, IL-8, IL-10 and interferon-γ as well as the cell markers CD4, CD8, CD14, CD19, CD25 and CD30 in functional dyspepsia patients; to evaluate histomorphological changes of the gastric mucosa in functional dyspepsia patients after treatment with the natural antioxidant astaxanthin; to evaluate interleukins IL-4, IL-6, IL-8, IL-10 and interferon-γ as well as the cell markers CD4, CD8, CD14, CD19, CD25 and CD30 in functional dyspepsia patients and their dynamics after treatment with the natural antioxidant astaxanthin.
31
Vargas, Mariela, Ulfe Lincolth Talledo, Reimer O. Samaniego, Paula Heredia, Christian A. S. Rodríguez, César A. Mogollón, Walter F. Enriquez, and Christian R. Mejia. "Dispepsia funcional en estudiantes de ocho facultades de medicina peruanas. Influencia de los hábitos." Sociedad Argentina de Gastroenterología (SAGE), 2016. http://hdl.handle.net/10757/617222.
Full textAbstract:
Functional dyspepsia impacts on quality of life. Due to its multifactorial etiology its characterization proves difficult, especially in populations at risk such as medical students. Objetives. To determine if behavioral and harmful habits of medical students from eight universities of Peru were associated to functional dyspepsia. Methods. Multicentric, cross-sectional study. A self-administered questionnaire was taken among students enrolled in eight medical faculties in Peru. Functional dyspepsia was measured using a validated test; diet characteristics, alcohol, tobacco, coffee or energy drinks consumption were considered behavioral habits. Furthermore, others from the social and educational sphere were measured. Bivariate and multivariate statistical analyses were made. Results. From a total of 1.923 students, the median of the ages was 20, 55% were women and 24% suffered from functional dyspepsia. Factors which diminished the frequency of functional dyspepsia were masculine gender (aPR:0,75; 95%CI:0.64-0.87; p < 0,001), hours spent studying (aPR:0,97; 95%CI:0,96-0,99; p < 0,001) and eating following a fixed schedule (aPR:0,80; 95%CI:0,67- 0,95; p = 0,013); however, having failed a course increases the frequency of functional dyspepsia (aPR:1.24; 95%CI:1.13-1.37; p < 0,001)adjusted for age, as well as difficulties to fall asleep and depression. Conclusion. Many medical students suffered from functional dyspepsia, this being related to several behavioral variables; therefore further studies as well as educational institutions’ intervention is required, due to the short and long term problems that may arise from this situation.Revisión por pares
32
Reisswitz, Pâmela Schitz von. "Validação do questionário diagnóstico de roma III para dispepsia funcional em língua portuguesa." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/24660.
Full textAbstract:
Introdução: Define-se dispepsia funcional (DF) por dor ou desconforto centrado no abdômen superior, na ausência de lesões estruturais que expliquem os sintomas. Apesar de muito prevalente, a DF permanece sendo uma entidade de difícil estudo, pela falta de ferramentas adequadas para mensuração de desfechos significativos. Isto acontece porque a DF não possui um substrato anatômico ou fisiopatológico mensurável, e, portanto, torna-se obrigatória a valorização de aspectos subjetivos para se quantificar benefícios de intervenções terapêuticas. Objetivo: Validar o Questionário Diagnóstico de Roma III para Dispepsia Funcional na língua portuguesa. Métodos: O questionário foi traduzido seguindo as recomendações do Grupo de Roma. O grupo de casos foi formado por 109 pacientes consecutivos com DF, que responderam o questionário em 4 momentos diferentes. Já o grupo de controles, foi composto por 100 doadores de sangue consecutivos, sem relato de sintomas digestivos. As seguintes propriedades clinimétricas foram avaliadas: consistência interna (através do alfa de Cronbach), reprodutibilidade, responsividade (através do X² de McNemar), validade discriminante (através do X² de Pearson), validade de conteúdo. Resultados: O Coeficiente alfa de Cronbach foi de 0,92. O questionário mostrou-se reprodutível, indicando que os pacientes responderam de maneira parecida nos dois momentos em que o questionário foi aplicado, a discordância entre as respostas não foi significativa (p=1,00). O questionário foi capaz de identificar alterações quando elas ocorreram, de maneira significativa (p<0,01). Os dois gastroenterologistas “cegos” concordaram que o questionário avalia DF. Quando comparamos as respostas dos casos com os controles (pareados por sexo e idade) o questionário indicou que 5,3% dos controles tinha DF, contra 91,2% dos pacientes, uma diferença significativa (p<0,01). Conclusão: O Questionário Diagnóstico de Roma III para Dispepsia Funcional está pronto para ser utilizado em estudos na língua portuguesa, tendo sido validado com sucesso.Background: Validated questionnaires are essential tools to be utilized in epidemiological research. At the moment there are no Rome III diagnostic questionnaires translated to Portuguese. Aim: To validate the Portuguese version of the Rome III Diagnostic Questionnaire for Functional Dyspepsia (FD). Methods: The questionnaire has been translated following the Rome III recommendations. A hundred and nine consecutive patients with FD answered the questionnaire. The control group comprised 100 healthy consecutive blood donors, without digestive symptoms. Internal consistency, reproducibility, responsiveness, discriminant validity and content analysis were evaluated. Results: Cronbach‟s α coefficient was 0.92. The questionnaire showed reliability: the patients answered it in a similar way on two distinct occasions and their responses were substantially very similar (p=1.00). The questionnaire was able to demonstrate changes when they occur (p<0,01). Two “blinded” gastroenterologists agreed that the questionnaire adequately evaluated FD. When we compared the answers between patients and controls, the questionnaire showed that 5,3% of controls had FD symptoms compared with 91,2% of the patients (p<0,01). Conclusion: The Rome III Diagnostic Questionnaire for FD is ready to be used in clinical researches in Portuguese, as it has been successfully validated in Portuguese.
33
Westbrook, Johanna. "The epidemiology, management and outcomes of dyspepsia in New South Wales with particular reference to the use of upper gastrointestinal endoscopy." Thesis, The University of Sydney, 2000. https://hdl.handle.net/2123/27760.
Full text
34
Mazzoleni, Felipe. "Eosinófilos duodenais : potencial associação com a infecção pelo Helicobacter pylori e com os sintomas da dispepsia funcional." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/174772.
Full textAbstract:
Introdução e objetivos: Eosinofilia duodenal está associada com parasitoses intestinais e com alergias alimentares, e tem sido sugerida como possível fator etiológico da dispepsia funcional, pela capacidade de causar alterações na motilidade e na sensibilidade do aparelho digestivo. Sua relação com o Helicobacter pylori é pouco conhecida, tendo sido avaliada apenas como achado secundário em alguns estudos, com resultados controversos. Esse estudo tem como objetivos avaliar o papel da infecção gástrica pelo H. pylori no número de eosinófilos duodenais e avaliar a relação dos eosinófilos duodenais com os sintomas da dispepsia funcional. Métodos: foram avaliados 100 pacientes dispépticos funcionais, de acordo com os critérios de Roma III, dos quais 50 foram H. pylori positivos e 50 negativos. Os pacientes foram submetidos à endoscopia digestiva alta com biópsias gástricas e duodenais. A positividade do H. pylori foi avaliada pelo teste de urease e pelo exame histológico (Hematoxilina-eosina e Giemsa). As biópsias duodenais foram avaliadas com hematoxilina-eosina e a número de eosinófilos duodenais foi quantificada pela média de eosinófilos por 5 campos de grande aumento (CGA) aleatórios e não sobrepostos. Eosinofilia duodenal foi definida pela presença de >22 eosinófilos/CGA. As medianas das médias aritméticas dos eosinófilos duodenais por cinco CGA foram comparadas entre os pacientes H. pylori positivos e negativos. Também foi avaliada a relação do número de eosinófilos duodenais com a intensidade e tipo de sintomas dispépticos, determinados por questionário validado (PADYQ). Os eosinófilos duodenais foram avaliados para variáveis demográficas e endoscópicas. Resultados: Pacientes do sexo feminino representaram 88% da amostra e a idade média foi de 41,7 anos As características basais dos pacientes H. pylori positivos e H. pylori negativos foram semelhantes. Apenas um paciente, no grupo H. pylori positivo, apresentou eosinofilia duodenal. As medianas dos eosinófilos duodenais/CGA foram 4,6 [P25-75: 2,8-7,2] nos pacientes H. pylori negativos e 4,7 [P25-75: 3,4-8,4] nos H. pylori positivos (p= 0,403). O número de eosinófilos 8 duodenais foi significativamente maior em pacientes com sintomas mais intensos: pacientes com escore do PADYQ >22 (>50% da pontuação máxima) apresentaram mediana de eosinófilos duodenais/CGA de 5,4 [P25-75: 3,4–7,6] e pacientes com escore ≤22 de 3,4 [P25-75: 2,2–6,0] (p= 0,018). Os pacientes foram divididos em tercis, de acordo com a intensidade dos sintomas: grupo 1 com 31 pacientes (sintomas leves); grupo 2 com 30 pacientes (sintomas moderados); e grupo 3 com 31 pacientes (sintomas acentuados). A mediana dos eosinófilos duodenais/CGA no grupo 1 foi de 3,4 [P25-75: 2,2 -6,0]; no grupo 2 de 4,7 [P25-75: 3,2-6,4]; e o grupo 3 de 5,8 [P25-75: 3,6-8,2] (P=0,033). Houve diferença estatisticamente significativa no número de eosinófilos duodenais entre fumantes e não fumantes (p= 0,030) e entre pacientes com índice de massa corporal (IMC) <25 kg/m2 e IMC ≥ 25 kg/m2 (p= 0,035). Na análise multivariada por regressão linear, os fatores que tiveram influência sobre o número de eosinófilos duodenais foram o tabagismo (p= 0,026) e a intensidade dos sintomas dispépticos (p= 0,039). Conclusões: Esse estudo não mostrou associação entre a infecção pelo H. pylori e a contagem de eosinófilos duodenais, nessa população de pacientes dispépticos funcionais. Entretanto, foi demonstrada uma relação diretamente proporcional e estatisticamente significativa entre o número de eosinófilos duodenais e a intensidade dos sintomas dispépticos.Background and Aims: Duodenal eosinophilia is associated with intestinal parasitosis and food allergies. It has also been implicated as a potential factor on the etiology of functional dyspepsia, probably by causing changes in digestive tract motility and sensitivity. The association with Helicobacter pylori is poorly understood, and has been only evaluated as a secondary finding in 9 previous studies, with conflicting results. This study aims to evaluate the potential role of gastric H. pylori infection in the duodenal eosinophil count, and the influence of duodenal eosinophils on symptoms in functional dyspeptic subjects. Methods: One hundred functional dyspeptic subjects, according to Rome III criteria, were evaluated, and 50 were H. pylori positive and 50 H. pylori negative. Patients were submitted to upper gastrointestinal endoscopy with gastric and duodenal biopsies. H. pylori positivity was evaluated by urease test and gastric histology (Hematoxylin-eosin and Giemsa). Duodenal biopsies were evaluated with Hematoxylin-Eosin staining, and the duodenal eosinophil count was determined by the mean of eosinophil by 5 random nonoverlapping high power fields (HPF). Duodenal eosinophilia was defined as >22 eosinophils/HPF. The median of the arithmetic means of the duodenal eosinophils counts per high power field were compared between H. pylori positive and H. pylori negative subjects. The relationship between the number of duodenal eosinophils and the intensity and type of dyspeptic symptoms was determined by validated questionnaire (PADYQ). Duodenal eosinophils counts were also evaluated by demographic variables and endoscopic findings. Results: 88% of the subjects were female and the mean age was 41.7 years. Baseline characteristics were similar between H. pylori positive and H. pylori negative subjects. Only one patient, in the H. pylori positive group, had duodenal eosinophilia. The median duodenal eosinophils/HPF were 4.6 [Percentiles 25-75(P25-75): 2.8-7.2] in H. pylori negative and 4.7 [P25-75: 3.4-8.4] in H. pylori positive subjects (p= 0.403). The duodenal eosinophil count was greater in subjects with higher symptoms severity: patients with PADYQ score more than 22 (>50% of the maximum score) had median duodenal eosinophil/HPF of 5.4 [P25-75: 3,4–7,6] and subjects with PADYQ score ≤22 of 3.4 [P25-75: 2.2–6.0] (p= 0.018). The patients were divided into terciles, according to symptoms severity: group 1 with 31 subjects (mild symptoms); group 2 with 30 subjects (moderate symptoms); and group 3 with 31 subjects (severe symptoms). 10 The median duodenal eosinophils/HPF was 3.4 [P25-75: 2.2-6.0] in group 1; 4.7 [P25-75: 3.2-6.4] in group 2; and 5.8 [P25-75: 3.6-8.2] in group 3 (p=0.033). There was a higher duodenal eosinophils count in smokers (current or former) (p=0.030), and subjects with BMI ≥ 25 kg/m2 (p=0.035). In the multivariate analysis by linear regression, the duodenal eosinophil count were influenced by smoking (p = 0.026) and dyspeptic symptoms severity (p= 0.039). Conclusion: This study did not show an association between H. pylori infection and the number of duodenal eosinophils, in this population of functional dyspeptic patients. However, a directly proportional and statistically significant relationship between the number of duodenal eosinophils and the intensity of dyspeptic symptoms has been demonstrated.
35
Lauffer, Adriana. "Tradução e validação para o português do Brasil do questionário “Patient Assessment Of Upper Gastrointestinal Disorders-Quality Of Life (PAGI-QOL)” em pacientes dispépticos funcionais." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/30935.
Full textAbstract:
Não existem instrumentos validados para o português do Brasil que avaliem a qualidade de vida relacionada à saúde (QVRS) em dispepsia funcional (DF). Esse tipo de avaliação tem se tornado cada vez mais importante para análise do desfecho de ensaios clínicos e para o desenvolvimento de pesquisas transculturais em pacientes dispépticos funcionais. Objetivo: traduzir e validar o questionário doença-específico de QVRS “Patient Assessment of Upper Gastrointestinal Disorders – Quality of Life (PAGI-QOL)” em DF. Metodologia: estudo transversal para validação. Após adequado processo de tradução, 5 testes psicométricos foram realizados. Para cada teste um número variável de pessoas foi avaliado, considerando cálculo amostral: consistência interna (n=150 casos e 150 controles), reprodutibilidade (n=44 casos), a validade de conteúdo contou com a participação de 3 gastroenterologistas experientes em distúrbios funcionais “cegos” para o estudo; validade de critério (n=113 casos) e validade discriminante (n=86 casos e 86 controles). Grupo de casos: pacientes dispépticos funcionais diagnosticados segundo Critério de Roma III. Grupo controle: doadores de sangue que não apresentavam sintomas gastrointestinais e outras co-morbidades clinicamente relevantes. Amostras foram coletadas por conveniência e consecutivamente e completaram os questionários PAGI-QOL e SF-36 versão 2. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Consentimento informado foi assinado por todos os indivíduos. Resultados: consistência interna: 0,976 (α de Cronbach); reprodutibilidade dos escores totais: 0,841 (coeficiente de correlação intra-classe); e valor p = 0,331 para diferença entre as duas observações; validade de critério entre o escore total do PAGI-QOL e os escores dos componentes físicos e mentais do SF-36 versão 2: rs = -0,289 (p = 0,002) e rs = -0,437 (p <0,001), respectivamente; validade discriminante para todos os domínios: p<0,0001 (Mann-Whitney). Validade de conteúdo foi adequada. Conclusão: O PAGI-QOL em português do Brasil é um questionário válido e confiável para avaliar a QVRS em DF.There are no validated instruments to Brazilian Portuguese to assess health related quality of life (HRQoL) in functional dyspepsia (FD). This type of assessment has become increasingly important with the objective of evaluating outcomes in clinical trials and development of cross-cultural research in FD patients. Objective: To translate and validate the HRQOL disease-specific questionnaire "Patient Assessment of Upper Gastrointestinal Disorders - Quality of Life (PAGI-QoL)" in FD. Methodology: cross sectional study for validation. After an adequate the translation process, 5 psychometric tests were performed. For each of them a variable number of individuals were assessed, considering sample size calculation: internal consistency (n = 150 patients and 150 controls), reproducibility (n = 44 patients), content validity with the participation of 3 gastroenterologists experienced in functional gastrointestinal disorders, blinded to the study; concurrent validity = n = 113 patients and discriminant validity = 86 patients and 86 controls. FD patients: diagnosed according to Rome III criteria. Control group: blood donors who had no gastrointestinal symptoms and no other clinically relevant co-morbidities. Both samples were collected by convenience and consecutively, and completed questionnaires PAGI-QoL and SF-36 version 2. The study was approved by the Institutional Research Ethics Committee. Informed consent form was signed by all individuals. Results: Internal consistency: 0.976 (Cronbach's α), reproducibility of total scores: 0.841 (correlation coefficient of intra-class) and p value = 0.331 for differences between the two observations; concurrent validity between the total score of the PAGI-QOL and the scores of physical and mental components of SF-36 version 2: rs = -0,289 (p = 0.002) and rs = -0,437 (p <0.001), respectively; discriminant validity for all domains: p <0.0001 (Mann-Whitney). Content validity was adequate. Conclusion: The PAGI-QoL in Brazilian Portuguese language is a valid and reliable questionnaire to assess HRQoL in FD.
36
Aguiar, Marise dos Santos. "Níveis séricos de vitamina B12, folato e homocisteína em pacientes dispépticos funcionais após um ano da erradicação do Helicobacter Pylori." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/118629.
Full textAbstract:
Introdução: Dispepsia funcional é uma doença que possui critérios diagnósticos definidos por reuniões de consenso, conhecidos por critérios de Roma. Apresenta alta prevalência mundial, grande impacto social e redução na qualidade de vida do indivíduo. Helicobacter pylori está envolvida na patogênese da dispepsia funcional, sendo indicada sua detecção e erradicação no tratamento dos pacientes dispépticos funcionais. H. pylori também tem sido sugerida como um importante agente na etiologia de níveis baixos de Vitamina B12 no soro. A hiperhomocisteinemia secundária à deficiência de Vitamina B12 e folato podem constituir um risco para as doenças cardiovasculares. Objetivo: investigar a relação entre os níveis séricos de Vitamina B12, folato e homocisteína e infecção pelo H. pylori em pacientes dispépticos funcionais. Métodos: Foram incluídos pacientes dispépticos funcionais, pelos critérios de Roma III do estudo HEROES (Helicobacter Eradication Relief of Dyspeptic Symptoms) - ClinicalTrials.gov número NCT00404534. Os pacientes dispépticos que apresentaram positividade para H. pylori foram randomizados para erradicação da bactéria com antibiticoterapia oral ou placebo. Após doze meses realizaram o segundo exame endoscópico com mesma metodologia. Da amostra total, 77 continuaram positivos para a infecação por H. pylori e 77 tiveram como resultado a erradicação da bactéria H. pylori, ou seja, negativaram. O material biológico foi previamente coletado e armazenado, além dos respectivos dados demográficos e clínicos. As amostras foram armazenadas a -80◦C em ependorf e realizadas medidas em soro dos níveis de vitamina B12 e folato e homocisteína. Resultados: Da amostra total, 77 pacientes eram H. pylori positivo (15 homens e 62 mulheres) e 77 eram H.pylori erradicados (21 homens e 56 mulheres). A média de idade foi de 47,8±11,5, em relação à idade e gênero não houve diferença significativa entre os grupos (p > 0,05). Quanto aos resultados reunidos em categorias (níveis de vitamina B12, folato e homocisteína), conforme os pontos de corte usados na literatura, não foi observada diferença estatisticamente significativa entre os dois grupos de pacientes (p > 0,6). Não houve correlação entre idade e níveis de vitamina B12 (p = 0,924). Houve diferença entre gêneros para homocisteína (p = 0,035), porém não houve significância para vitamina B12 (p = 0,584) e folato (p = 0,312). Não houve diferença entre níveis de homocisteína de pacientes H. pylori positivos e H. pylori erradicados para ambos os gêneros (p > 0,5). Conclusões: O presente estudo demonstrou que não houve relação significativa entre os níveis séricos de Vitamina B12, folato e homocisteína e infecção por H. pylori em relação aos H. pylori erradicados nos dispépticos funcionais. E quanto aos níveis de homocisteína comparados entre gêneros, os valores foram mais altos em homens.Introduction: Functional dyspepsia a disease which has diagnosis criteria defined by consensus gatherings, known as the Rome criteria. It is highly prevalent worldwide, has great social impact, and reduces the quality of life of individuals. Helicobacter pylori is involved in the pathogenesis of functional dyspepsia, and its detection and eradication are indicated in the treatment of functional dyspepsia patients. H. pylori has also been suggested as an important agent in the etiology of low levels of vitamin B12 in serum. A hyperhomocysteinemia secondary to vitamin B12 and folate deficiencies could pose a risk for cardiovascular diseases. Objective: To investigate the relationship among the serum levels of Vitamin B12, folate and homocysteine, and the H. pylori infection in functional dyspeptic patients. Methodology: A group of patients with functional dyspepsia was included, following the Rome III criteria from the study HEROES (Helicobacter Eradication Relief of Dyspeptic Symptoms) – ClinicalTrials.gov number NCT00404534. The dyspeptic patients who were positive for H. pylori in tissue biopsy were randomized to eradication of the bacteria with oral antibiotic therapy or placebo. After twelve months, a second endoscopy was performed with the same methodology. Of the total sample, 77 patients remained positive for H. pylori and 77 patients had as a result the eradication of H. pylori bacteria, that is, they became negative. The biological material was previously collected and stored, besides its demographic and clinical data. The samples were stored at -80◦C in Eppendorf, they were measured in the serum of vitamin B12 folate and homocysteine levels. Results: Of the total sample, 77 patients were positive for H. pylori (15 men, 62 women) and 77 patients had the eradication of H. pylori (21 men, 56 women). The average age of the sample was about 47,8±11,5,regarding age and gender, it was not observed significant difference between the groups (p > 0,05). Concerning the results gathered into categories (the levels of vitamin B12, folate, and homocysteine), as the cut off points used in the literature, it was not observed statistically significant difference between the two groups of patients (p > 0,6). There was no correlation between age and vitamin B12 levels (p = 0,924). There was difference between genders for homocysteine (p = 0,035), but there was no significant difference for vitamin B12 (p = 0,584) and folate (p = 0,312). There was no difference between homocysteine levels of positive patients for H. pylori and H. pylori eradication in both genders (p > 0.5). Conclusions: The study showed no significant relationship between the serum levels of vitamin B12, folate, and homocysteine and the H. pylori infection in relation to H. pylori eradication in functional dyspeptic patients. Regarding homocysteine levels compared between genders, the values were higher in men.
37
Кулинич, О. В. "Порівняння частоти виявлення функціональної диспепсії у військових та цивільних." Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/55455.
Full textAbstract:
Актуальність. Функціональні розлади є однією з найбільш актуальних проблем сучасної гастроентерології. Особливою групою хворих, які піддаються підвищеному ризику виникнення функціональної диспепсії (ФД) є військові. Правильне розуміння лікарями етіологічних чинників залишається надзвичайно важливим для вироблення тактики обстеження та лікування таких хворих.
38
Taborda, Aline Gamarra. "Fatores alimentares envolvidos no desenvolvimento de metaplasia intestinal em dispépticos funcionais." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/52954.
Full textAbstract:
Introdução: A metaplasia intestinal (MI) do estômago é uma lesão onde ocorre a metaplasia das células epiteliais gástricas para um fenótipo intestinal. A MI gástrica é considerada uma lesão preneoplásica associada a um aumento do risco de desenvolvimento de carcinoma gástrico. Estudos epidemiológicos indicam uma relação entre hábitos alimentares e o risco de desenvolvimento de câncer de estômago: tanto podendo ter um efeito carcinogênico gástrico, como um fator protetor, sugerindo que os antioxidantes como as vitaminas A, C e E, diminuem o risco desse tipo de câncer Material e métodos: Trata-se de um estudo caso-controle, observacional, para o qual foram avaliados 320 pacientes portadores de dispepsia funcional, que separados em dois grupos, um grupo de casos I (indivíduos com metaplasia intestinal) tiveram seus hábitos alimentares comparado aos do grupo de casos controle (sem metaplasia intestinal), através de um questionário de frequência de consumo alimentar (QFCA). Resultados: Ao analisarmos o padrão alimentar dos pacientes dispépticos funcionais portadores de metaplasia intestinal e compará-lo com o padrão daqueles que não possuem MI constatou-se que os pacientes portadores de MI consomem mais alimentos como os enlatados e defumados, enquanto que os pacientes sem metaplasia intestinal apresentam um consumo expressivamente maior de frutas em geral e vegetais. Diferença no padrão de consumo de sal não foi identificada. Conclusões: Através dos resultados obtidos no presente estudo podemos supor que a modificação da dieta, por meio de uma diminuição na ingestão de alimentos como defumados e enlatados e um acréscimo na ingestão de frutas e vegetais, pode levar a uma diminuição de casos de metaplasia intestinal.Introduction: Intestinal metaplasia (IM) of the stomach is a lesion in which metaplasia of gastric epithelial cells occurs for an intestinal phenotype. Gastric IM is considered a preneoplastic lesion associated with an increase in the risk of gastric carcinoma development. Epidemiologic studies indicate a relation between dietary habits and stomach cancer development, some habits increasing the risk for it, and others have a protective effect, suggesting that antioxidants, such as vitamins A, C, and E, decrease the risk of this type of cancer. Materials and methods: It is a case-control, observational study in which 320 patients with functional dyspepsia, divided in two groups, were assessed. The case I group (individuals with intestinal metaplasia) had their dietary pattern compared to that of the control group, constituted of individuals similar to those in the case group but without intestinal metaplasia, through a food frequency questionnaire (FFQ). Results: The analysis of the dietary pattern of functional dyspeptic patients with intestinal metaplasia, and its comparison with those without IM, showed a higher frequency of canned and smoked foods consumption in the first group, and, on the other hand, a higher consumption of fruits and vegetables in patients without IM. No effect of salt consumption was detected. Conclusions: The results obtained in this study suggest changes in the diet, with a decrease in the consumption of smoked and canned foods, and an increase in the consumption of fruits and vegetables, can lead to a diminution of intestinal metaplasia cases.
39
Andreolla, Huander Felipe. "Associação entre infecção por Helicobacter pylori, proteína C reativa e virulência bacteriana na dispepsia funcional." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/129668.
Full textAbstract:
Introdução: Recentemente, vários estudos têm investigado e até mesmo sugerindo a bactéria Helicobacter pylori como um importante componente no desenvolvimento de eventos restritos ou não ao trato gastrintestinal. A relação já bastante elucidada acerca da relação entre os fatores bacterianos de virulência e o risco aumentado para úlcera péptica e adenocarcinoma gástrico parece não estar muito definida em se tratando de alterações em marcadores de inflamação aguda, como a proteína C reativa (PCR), em indivíduos infectados pelas cepas mais virulentas do microrganismo. Neste trabalho, nós avaliamos a presença de H. pylori, virulência bacteriana e níveis séricos de PCR em pacientes dispépticos funcionais. Materiais e métodos: Estudo transversal que incluiu 489 indivíduos saudáveis com diagnóstico de dispepsia funcional firmado através de critérios do Consenso de Roma III. Após avaliação clínica e endoscópica, os pacientes foram incluídos por não apresentarem qualquer causa orgânica que pudesse estar relacionada aos sintomas de dispepsia. A presença da bactéria foi diagnosticada através de análise histológica e teste rápido da urease dos fragmentos biopsiados. Os níveis séricos de PCR foram obtidos por imunonefelometria e o status para o fator de virulência CagA foi determinado através de ensaio comercial imunoenzimático. Resultados: A prevalência de H. pylori foi de 66,3% e a presença de anticorpos anti-CagA foi detectada em aproximadamente 43% das amostras positivas. Houve uma associação estatisticamente significativa entre o consumo de chimarrão e a presença da bactéria. Observou-se um efeito importante da infecção por H. pylori na inflamação local, estimada através da atividade inflamatória e grau de inflamação do epitélio gástrico. Não foi constatada resposta inflamatória sistêmica ao patógeno através da dosagem de PCR, independente do status de virulência bacteriana. Conclusão: Na população de indivíduos disépticos funcionais avaliada, a bactéria parece não desencadear qualquer resposta inflamatória sistêmica, estando a virulência bacteriana associada a um maior grau e atividade inflamatória do epitélio gástrico.Background: Recently, a great variety of studies aimed to investigate and even suggest Helicobacter pylori as an important key factor in gastrointestinal and non-gastrointestinal events development. The well-established relationship between bacterial virulence and increased risk for peptic ulcer or gastric carcinoma is not so clear when comparing inflammation markers alterations, such C reactive protein (CRP), with the pathogen. We evaluated the presence of H. pylori, bacterial virulence and CRP serum levels in individuals diagnosed with functional dyspepsia. Materials and Methods: Transversal study that evaluated 489 healthy individuals well characterized according to Rome III Consensus for the diagnosis of functional dyspepsia. The study population underwent to an endoscopic investigation and did not present any organic explanation for their symptoms. The bacterial infection was established by histology and urease rapid test. The levels of serum CRP were obtained by immunonefelometry and CagA status of H. pylori positive individuals was determined trough a commercial imunoenzimatic assay. Results: Prevalence rate of H. pylori was 66.3% and virulence factor CagA was detected in nearly 43% of positive samples. We found a statistically significant relationship between yerba mate tea consumption and positive H. pylori status. An important effect of bacterial infection on inflammation was only observed in gastric epithelium. No systemic response to the pathogen, measured through CRP levels, was observed, regardless of CagA status. Conclusion: In our study population, the presence of H. pylori seems not to be related with any important systemic inflammatory response. Bacterial virulence was related to a higher inflammation and inflammatory activity in gastric epithelium.
40
McWilliams, Tracy. "Proteome comparison of helicobacter pylori isolates associated with four disease groups." Thesis, Curtin University, 2006. http://hdl.handle.net/20.500.11937/1114.
Full textAbstract:
The Gram-negative bacterium Helicobacter pylori is found in human gastric mucosa. H. pylori, one of the most common chronic bacterial infections of humans, is present in almost half of the world population. It is associated with chronic gastritis, non-ulcer dyspepsia, gastric and duodenal ulcers, and malignant neoplasms. The aim of this study was to detect microbial candidate protein markers whose presence might be correlated with the development of four different clinical consequences of H. pylori infection, gastric ulceration [GU], duodenal ulceration [DU], non-ulcer dyspepsia [NUD] and gastritis [GI]. Eleven H. pylori isolates associated with these outcomes were analysed. The total complement of protein from these H. pylori isolates were resolved by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and compared using PDQUEST pattern analysis software. Relationships between the isolates associated with specific disease outcomes were determined by cluster analysis.Fifty six disease specific proteins were then characterised by tryptic peptide-mass fingerprinting using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Up to 1165 protein species were resolved from each H. pylori strain. Proteome analysis revealed that only 470 (40%) of the proteins detected were common to all eleven isolates. Twenty six of the 56 disease specific proteins that were selected for identification consisted of spots whose expression is altered in response to stress conditions or those that can affect H. pylori cell division and the cell membrane. The remaining 30 proteins had no known function. This study has provided further confirmation of the extensive variation that the bacterium H. pylori exhibits at the proteome level. Most significantly this study has found, through the application of cluster analysis and protein matching, that isolates do form disease groups. Comparative proteome analysis is a useful method for highlighting the extensive strain variation that H. pylori exhibits and to determine if any disease specific proteins exist.
41
Lima, Flávia Altaf da Rocha. "Avaliação da eficácia da acupuntura como forma complementar ao tratamento medicamentoso em pacientes com dispepsia funcional." Universidade Federal de Juiz de Fora, 2012. https://repositorio.ufjf.br/jspui/handle/ufjf/1607.
Full textAbstract:
Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-20T12:20:13Z
No. of bitstreams: 1
flaviaaltafdarochalima.pdf: 1162345 bytes, checksum: 18a62c489991ceea8aa434e2b2a63f89 (MD5)Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-02T11:21:12Z (GMT) No. of bitstreams: 1 flaviaaltafdarochalima.pdf: 1162345 bytes, checksum: 18a62c489991ceea8aa434e2b2a63f89 (MD5)
Made available in DSpace on 2016-07-02T11:21:12Z (GMT). No. of bitstreams: 1 flaviaaltafdarochalima.pdf: 1162345 bytes, checksum: 18a62c489991ceea8aa434e2b2a63f89 (MD5) Previous issue date: 2012-08-14
FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais
Introdução: A dispepsia funcional (DF) representa um transtorno gastrointestinal frequente na prática clínica. Por apresentar mecanismos etiopatogênicos diversos, a terapia medicamentosa não se mostra totalmente eficaz, razão pela qual a busca por terapias complementares como a acupuntura é fundamental. Objetivo: avaliar a eficácia da acupuntura como terapia complementar ao tratamento medicamentoso convencional em pacientes com DF. Método: ensaio clínico randomizado, com portadores de dispepsia funcional, segundo os critérios de Roma III. Dois grupos foram formados: Grupo I (terapia medicamentosa e acupuntura específica) e Grupo II (terapia medicamentosa e acupuntura não específica). Foram avaliados o índice de sintomas gastrointestinais (Gastrointestinal Scale Related Symptoms – GSRS), a presença de transtornos psíquicos (Escala Hospitalar de Ansiedade e Depressão) e a qualidade de vida (Short-form Health Survey – SF 36) no início, no fim e três meses após o tratamento. Resultados: após 4 semanas de tratamento houve melhora dos sintomas gastrointestinais no Grupo I (55 ± 12 vs. 29 ± 8,8; p = 0,001) e Grupo II (50,3 ± 10,2 vs. 46 ± 10,5; p = 0,001). A qualidade de vida foi significativamente melhor no Grupo I (93,4 ± 7,3 vs. 102,4 ± 5,1; p = 0,001). Transtornos de ansiedade (93,3% vs. 0%; p = 0,001) e depressão (46,7% vs. 0%; p = 0,004) foram significativamente menores no Grupo I. Na comparação intergrupos os sintomas gastrointestinais (29 ± 8,8 vs. 46 ± 10,5; p < 0,001) e a qualidade de vida (102,4 ± 5,1 vs. 96 ± 6,1; p = 0,021) foram significativamente melhores no Grupo I. Três meses após o tratamento, os sintomas gastrointestinais permaneceram melhores no Grupo I quando comparados aos valores pré-tratamento (38 ± 11,3 vs. 55 ± 12; p = 0,001). Conclusão: em portadores de dispepsia funcional o tratamento complementar com acupuntura foi superior ao tratamento convencional. A acupuntura pode ser uma terapia complementar eficaz no tratamento de pacientes com DF.
Introduction: Functional dyspepsia (FD) represents a frequent gastrointestinal disorder in clinical practice. By presenting various etiopathogenic mechanisms, often the drug therapy is not entirely effective. Therefore, the search for complementary therapies such as acupuncture is essential. Objective: Evaluate the effectiveness of acupuncture as a complement to conventional treatment in functional dyspepsia patients. Methods: randomized clinical trial with functional dyspepsia patients in according with ROME III criteria. Two groups were created: Group I (drug therapy and specific acupuncture) and Group II (drug therapy and non-specific acupuncture). The gastrointestinal symptoms (Gastrointestinal Scale Related Symptoms – GSRS), presence of psychiatric disorders (Hospital Anxiety and Depression Scale – HADS) and quality of life (Short-form Health Survey – SF 36) were evaluated, at the end and three months after treatment. Results: After 4 weeks of treatment there was significantly improvement of gastrointestinal symptoms in Group I (55 ± 12 vs. 29 ± 8,8; p = 0,001) and Group II (50 ± 10 vs. 46 ± 10,5; p = 0,001). Quality of life was significantly better in Group I (93,4 ± 7,3 vs. 102,4 ± 5,1; p = 0,001). Anxiety and depression disorders were significantly lower in Group I (93% vs. 0%; p = 0,001 and 46% vs. 0%; p = 0,004; respectively). Inter-group, gastrointestinal symptoms comparison and quality of life were significantly better in Group I (29 ± 8,8 vs. 46 ± 10,5; p < 0,001 and 102,4 ± 5,1 vs. 96,4 ± 6,1; p = 0,021; respectively). Three months after the treatment, gastrointestinal symptoms remained best in Group I, when compared to the pre-treatment values (38 ± 11,3 vs. 55 ± 12; p = 0,001). Conclusion: In patients with functional dyspepsia the complementary acupuncture treatment was superior to conventional treatment. Acupuncture as a complementary treatment can be effective in treating patients with FD.
42
Aguiar, Vanessa de Paula e. Silva Rossi. "Pesquisa da cepa de Helicobacter pylori na cavidade bucal." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5147/tde-02062009-102749/.
Full textAbstract:
No Brasil, cerca de 65% da população é infectada por H. pylori, bactéria associada à patogênese de gastrite, úlcera péptica e considerada fator de risco de câncer gástrico. A transmissão da bactéria parece ocorrer de pessoa para pessoa, nas formas oral-oral, gástrica-oral e fecal-oral, e a cavidade bucal pode ser importante neste processo de transmissão. Os objetivos deste estudo foram: pesquisar a presença de H. pylori na cavidade bucal de pacientes dispépticos e identificar as possíveis cepas existentes. Para tanto, 43 pacientes com dispepsia funcional do Ambulatório de Estômago do Departamento de Gastroenterologia, Disciplina de Gastroenterologia Clínica FMUSP foram selecionados para o estudo. Todos realizaram exame de endoscopia digestiva alta e coleta de fragmento da mucosa gástrica para pesquisa de H. pylori através de teste da urease. A presença de H. pylori no estômago foi também evidenciada pelo teste respiratório com 14C ou sorologia, e em 30 pacientes foi identificado H. pylori no estômago. Foram coletadas 144 amostras da cavidade bucal: 43 de saliva, 43 de dorso de língua, 43 de placa supra-gengival e 15 de placa sub-gengival. A detecção de H. pylori das amostras bucais realizou-se através de PCR utilizando os primers espécie-específicos: P1/P2, Urease A/B e primers para investigar os genótipos cagA e vacA (m1, m2, s1a, s1b, s2). Não foi possível detectar o microorganismo em nenhuma amostra da cavidade bucal. Esse estudo mostrou que a cavidade bucal de pacientes dispépticos não representa reservatório para a bactéria.Helicobacter pylori (H. pylori) infection is very prevalent in Brazil, infecting almost 65% of our population, being associated with peptic ulcer disease, gastric cancer, lymphoma and functional dyspepsia. The aim of this study was to evaluate the presence of this bacterium in the oral cavity of epigastric pain syndrome (functional dyspepsia) patients and assess the frequency of cagA and vacA genotypes of oral H. pylori. All 43 epigastric pain syndrome outpatients, who entered the study, were submitted to upper gastrointestinal endoscopy to rule out organic diseases. H. pylori infection was confirmed by rapid urease test, urea breath test and sorology, and thirty patients harbored H. pylori in the stomach. 144 samples of the oral cavity were collected: 43 samples of saliva, 43 of the tongue dorsum and 43 of supragingival dental plaque and 15 of sub-gingival dental plaque which were collected from the patients with periodontitis; H. pylori infection was verified by polymerase chain reaction (PCR) using primers (P1 and P2) that amplify the DNA sequence of a species-specific antigen present in all H. pylori strains, primers Urease A/B and primers for cagA and vacA (m1, m2, s1a, s1b, s2) genotyping. It was not possible to detect H. pylori in any oral samples using P1/P2 and Urease A/B. The genotype cagA was also negative in all samples and vacA genotype could not be characterized (s-m-). In this study, the oral cavity seemed not to be a reservoir for H. pylori in patients with epigastric pain syndrome being detected exclusively in the stomach.
43
Menezes, Valfredo da Mota [UNIFESP]. "Avaliação do uso terapêutico do extrato de Lafoensia pacari St. Hil. Mangava-Brava na erradicação do Helicobacter pylori: Ensaio Clínico Randomizado Duplo Cego." Universidade Federal de São Paulo (UNIFESP), 2006. http://repositorio.unifesp.br/handle/11600/8984.
Full textAbstract:
Made available in DSpace on 2015-07-22T20:49:27Z (GMT). No. of bitstreams: 0
Previous issue date: 2006-04-03Avaliação do uso terapêutico do extrato de Lafoensia pacari St. Hil. Mangava brava na erradicação do Helicobacter pylori: Ensaio Clínico Randomizado Duplo Cego. Objetivo: Avaliar a ação de uma planta usada popularmente como fitoterápico, conhecida cientificamente como Lafoensia pacari, na erradicação do Helicobacter pylori e verificar se a mesma é mais efetiva que o placebo para alívio da sintomatologia dispéptica. Analisar também sua ação sobre os processos inflamatórios e seus possíveis efeitos adversos. Método: Pacientes dispépticos, maiores de 18 anos, H. pylori positivos (teste rápido da urease), foram randomizados para receber 500mg do extrato metanólico de L. pacari duas vezes por dia (Grupo Intervenção) ou placebo (Grupo Controle), por duas semanas. A variável (“Erradicação do H.pylori”) foi analisada oito semanas após o fim da medicação por nova endoscopia com biópsia e realização do teste rápido da urease e histologia. As outras variáveis (“Melhora”, “Alívio completo dos sintomas” e “Efeitos adversos”) foram analisadas no fim da medicação (duas semanas). Resultados: Cem pacientes com idades entre 18 e 79 anos foram randomizados e alocados nos grupos Intervenção (n=55) e Controle (n=45). Os resultados dos exames (urease e histologia) mostraram que a situação relativa à positividade para o H. pylori se manteve inalterada em 100% dos participantes. Melhora da sintomatologia foi observada em 74% no grupo-intervenção (IC 95%: 62,4 a 85,8) e em 48% do controle (IC 95%: 33,9 a 63,8) com p= 0,007. Alívio completo de sintomatologia foi observado em 42,5% (IC 95%: 29,4 a 55,8) no grupo-intervenção e em 21%(I C 95%. 8,8 a 33,1) do grupo-controle, com p=0,020 (qui quadrado). Os efeitos colaterais foram mínimos e similares nos dois grupos. Conclusões: O extrato de L. pacari, como agente único, na dose e no tempo de uso estabelecidos neste ensaio, foi ineficaz para a erradicação do H. pylori na população analisada. Foi, porém, bem tolerado e conseguiu resolução sintomatológica significativa em grande parte dos participantes que dele fez uso. Futuros estudos poderão testá-lo, com a utilização de doses e períodos maiores, tanto em tratamento sintomatológico, como em associação com antibióticos no combate ao H. pylori.
Background: The eradication of Helicobacter pylori is easily achieved by combining antisecretory agents and antibiotics; however, the cost of these associations is very high for the population of Third World countries, where the prevalence of the infection is even higher and leads to markedly reduced treatment effectiveness. We tested a plant (Lafoensia pacari) that is used in the central region of Brazil. According to previous studies, this plant has high concentrations of ellagic acid, which presents gastric antisecretory and antibacterial actions. Material and Methods: 100 dyspeptic, urease-positive patients were randomized to receive 500mg of methanolic extract of L. pacari (n= 55) or placebo (n= 45), for 14 days, in a double-blind clinical trial. The main variables assessed were the eradication of H. pylori eight weeks after the intervention and complete symptom relief at the end of the treatment. Results: The exams (urease and histology) showed persistence of H. pylori in 100% of participants. Complete symptom relief was experienced by 42.5% of patients (95% CI: 29.4-55.8) in the intervention group and by 21% (95% CI: 8.8-33.1) in the control group, p=0.020. The side effects were minimum and similar in both groups. Conclusions: The extract of L. pacari as a single agent was not effective to eradicate H. pylori. However, it was well tolerated and many participants reported relief of symptoms. Future studies may test the agent using larger doses and longer periods, in monotherapy or in combination with antibiotics.
TEDE
BV UNIFESP: Teses e dissertações
44
Kalopothakès, Marie Hooper Blackler. "Troubles et lésions gastriques dans la dyspepsie gastro-intestinale chronique des nourrissons thèse pour le doctorat en médecine présentée et soutenue le 24 juillet 1894 /." Paris : BIUM, 2003. http://www.bium.univ-paris5.fr/histmed/medica/cote?TPAR1894x473.
Full text
45
Rímoli, Fábia. "INTERVENÇÃO LÚDICO-SIMBÓLICA JUNTO A PORTADORES DE DISPEPSIA FUNCIONAL." Universidade Metodista de São Paulo, 2010. http://tede.metodista.br/jspui/handle/tede/1446.
Full textAbstract:
Made available in DSpace on 2016-08-03T16:34:50Z (GMT). No. of bitstreams: 1
INTERVENCAO LUDICO SIMBOLICA JUNTO A PORTADORES DE DISPEPSIA FUNCIONAL.pdf: 3915367 bytes, checksum: a67792e79857c0f3571ce6fd8acb19a6 (MD5)
Previous issue date: 2010-03-30This study focuses on ludic-symbolic group intervention involving patients with functional dyspepsia (FD), a gastrointestinal disorder characterized by pain or discomfort on the upper abdomen area without identifiable cause by conventional diagnostic means. The present study aims to analyze the stress level of FD patients and connect it to the ludic-symbolic group intervention data. This is an exploratory-descriptive qualitative research.The group intervention uses active imagination techniques and the subjects stress level is evaluated with LIPP Adults Stress Symptoms Inventory (ISSL). The group consists of twelve members, mostly women; half of the participants are aged between 20 and 50 and the rest is older. Analysis of interview data shows that all group members have associated the beginning of their symptoms to emotional conflicts, focalizing scenes and situations as stressing factors that have triggered their FD. The symbolic analysis of the group interventions is based on Carl Gustav Jung s analytical psychology. Results show that the participants presented reduction of FD symptoms and of stress levels: initially, eight subjects were at the resistance stage, one at the alert stage and three of them presented no stress; by the end of the ludic-symbolic group intervention, three subjects were at the resistance stage, one remained at the alert stage and eight presented no stress. This transformation occurred after the symptoms regarded as symbols of emotions and feelings through symbolic play-action, and after having them integrated into consciousness by making psychic connections between mind and body to recognize actions taken or to be taken to avoid confrontations accelerate and crystallize symptoms of functional dyspepsia, from the standpoint of analytical psychology.
O presente estudo aborda uma intervenção grupal lúdico-simbólica junto a portadores de dispepsia funcional (DF), um distúrbio gastrointestinal caracterizado por sintomas como dor ou desconforto na região superior do abdômen, sem causa orgânica. Tem como objetivo intervir de forma grupal lúdicosimbólica junto ao portador de DF; analisar o nível de estresse dessa população e relacionar os dados da intervenção frente o nível de estresse. Trata-se de pesquisa exploratório-descritiva de caráter qualitativo. A intervenção grupal utiliza-se de técnicas de imaginação e pensamento dirigido; o nível de stress é avaliado através do Inventário de Sintomas de Stress para adultos de LIPP (ISSL). Os participantes do grupo são 12, predominantemente do sexo feminino, sendo a metade entre 20 e 50 anos e os demais, acima. Através da análise de conteúdo dos dados da entrevista dirigida pôde-se observar que todos fizeram uma associação do aparecimento dos sintomas a conflitos emocionais, focalizando cenas e situações como fatores estressores e desencadeadores da dispepsia funcional. A análise simbólica das intervenções grupais tem como base teórica a psicologia analítica de Carl Gustav Jung. Os resultados demonstraram que os participantes da intervenção grupal apresentaram redução dos sintomas da dispepsia funcional e do nível de estresse, sendo que, no início oito participantes encontravam-se na fase de resistência; um na de alerta e três sem estresse e, ao final, três se encontram na fase de resistência, um permanece na fase alerta e oito sem estresse. Essa transformação ocorreu após terem considerado os sintomas como símbolos de emoções e sentimentos através das intervenções lúdico-simbólicas, e após tê-los integrados à consciência ao fazerem conexões psíquicas entre mente e corpo para reconhecerem atitudes tomadas ou a tomar e agilizar enfrentamentos para não cristalizar sintomas da dispepsia funcional, do ponto de vista da psicologia analítica.
46
Machado, Dialina da Conceicao Martins. "Prevalência de doença celíaca em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia Digestiva do Hospital Universitário Pedro Ernesto da UERJ." Universidade do Estado do Rio de Janeiro, 2011. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=3999.
Full textAbstract:
A Doença Celíaca (DC) é uma doença autoimune que afeta o intestino delgado de indivíduos geneticamente susceptíveis após contato com o glúten. Diversos estudos têm relatado aumento da prevalência ao longo dos anos. Objetivo: Determinar a prevalência de DC em pacientes adultos sem diarreia encaminhados à Disciplina de Gastroenterologia do HUPE da UERJ para serem submetidos a Endoscopia Digestiva Alta (EDA).Comparar os resultados do histopatológico das biópsias duodenais com os resultados sorológicos, utilizando o anticorpo antitransglutaminase tecidual IgA (ATGt IgA). Métodos: Pacientes que foram encaminhados ao nosso serviço para serem submetidos a EDA entre Julho de 2008 e Julho de 2010, com idade entre 18 e 85 anos foram aceitos no estudo. Critérios de exclusão foram cirrose, neoplasias do trato gastrointestinal, HIV, uso de imunossupressores e anticoagulantes, diarreia, hemorragia digestiva e DC. Coleta de sangue para pesquisa do anticorpo ATGt IgA (utilizando KIT ORGENTEC - Alemanha), avaliação endoscópica e exame histopatológico das biópsias de segunda porção duodenal foram feitos para cada paciente. Biópsias foram avaliadas de acordo com o critério de Marsh modificado. Resultados: Trezentos e noventa e nove pacientes consecutivos (112 homens, 287 mulheres), média de idade 49,616,4 anos, variando de 18-85 anos, sem diarreia, foram prospectivamente aceitos. Os sintomas clínicos mais prevalentes foram dor abdominal em 99,5%, pirose em 41,1%, plenitude pós prandial em 30,6%, náuseas e vômitos em 21,3%. Os achados endoscópicos foram: normais em 41,6%, lesões pépticas (esofagite, gastrite, duodenite e úlceras) em 41,6%, hérnia hiatal em 5,5%, pólipos gástricos em 3%, neoplasias em 1,3% e miscelânea em 7%. DC foi endoscopicamente diagnosticada em 13 pacientes (3,3%) com mucosa duodenal exibindo serrilhamento das pregas em 8 (2%), diminuição do pregueado em 2 (0,5%) e mucosa exibindo padrão nodular e mosaico em 3 (0,75%). Os achados histopatológicos de duodeno foram normais em 96,7%, duodenites inespecíficas em 2,7% e 3 pacientes (0,75%) confirmaram DC pelos critérios de Marsh modificado (IIIa, IIIb e IIIc). O anticorpo ATGt IgA foi positivo (>10 U/ml) em 1,3% (5/399). Conclusão: Este estudo mostrou que a prevalência de DC em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia do HUPE/UERJ foi de 0,75% (1:133). A acurácia diagnóstica do anticorpo ATGt IgA é boa para pacientes com Marsh III e achados endoscópicos sugestivos. Nenhum dos pacientes tinha alterações Marsh I ou II. A EDA se mostrou um excelente método de triagem para definir os pacientes com graus mais acentuados de atrofia e que se beneficiariam de biópsia e sorologia para confirmação diagnóstica. Os resultados obtidos neste trabalho não justificam uma triagem rotineira de DC.Celiac Disease (CD) is an autoimmune disease that affects the small intestine in genetically susceptible individuals after contact with gluten. Several studies have reported increased prevalence over the years. Objective:To determine the prevalence of CD in adult dyspeptic patients without diarrhea referred to the Gastroenterology Division at Pedro Ernesto University Hospital in Rio de Janeiro (HUPE- UERJ) to undergo esophago-gastro-duodenoscopy (EGD). Compare the results of histopathology of duodenal biopsies with the serological results using IgA anti-tissue transglutaminase antibody (IgA anti-tTG). Methods: Patients with dyspepsia referred to our clinic to undergo EGD between July 2008 and July 2010, aged 18 and 85 years were enrolled into the study. Exclusion criteria were cirrhosis, gastrointestinal neoplasms, HIV, use of immunosuppressive drugs and anticoagulants, diarrhea, gastrointestinal bleeding and CD. Samples for IgA anti-tTG antibody (using ORGENTEC KIT -Germany), endoscopic evaluation and histological examination of biopsies of the second duodenal portion were made for each patient. Biopsies were evaluated according to the modified Marsh criteria. Results: Three hundred and ninety-nine consecutive patients (112 men, 287 women), mean age 49.6 16.4 years, ranging from 18-85 years, without diarrhea, were prospectively accepted. The most prevalent clinical symptoms were abdominal pain in 99.5%, heartburn in 41.1%, postprandial fullness in 30.6%, nausea and vomiting in 21.3%. Endoscopic findings were normal in 41.6%, peptic lesions (esophagitis, gastritis, duodenitis and ulcers) in 41.6%, hiatal hernia in 5.5%, gastric polyps in 3%, cancer by 1.3% and miscellaneous 7%. CD was diagnosed endoscopically in 13 patients (3.3%) with duodenal mucosa exhibiting scalloped folds in 8 (2%), decreased in the number of folds in 2 (0.5%), nodular mucosa and mosaic pattern in 3 (0.75%).The histopathological findings of duodenum were normal in 96.7%, nonspecific duodenitis in 2.7% and 3 patients (0.75%) confirmed by the CD modified Marsh criteria (IIIa, IIIb and IIIc). IgA anti-tTG antibody was positive (>10U/ml) in 1.3% (5/399). Conclusion: This study showed that the prevalence of CD in patients without diarrhea seen at the Division of Gastroenterology and Endoscopy, Pedro Ernesto University Hospital was 0.75% (1:133). The diagnostic accuracy of IgA anti-tTG is good for patients with Marsh III and suggestive endoscopic findings. None of the patients had Marsh I or II changes. The EGD has proved an excellent screening method to define patients with more marked degrees of atrophy and could benefit from biopsy and serology for diagnosis confirmation. The results of this study do not justify routine screening of CD.
47
Adang, Robert Peter René. "The discriminative value of patient characteristics and dyspeptic symptoms for upper gastrointestinal endoscopic diagnoses." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1995. http://arno.unimaas.nl/show.cgi?fid=5764.
Full text
48
Renou-Piton, Béatrice. "Prévalence de l'infection à Helicobacter pylori dans une population de 249 patients souffrant de dyspepsie fonctionnelle." Bordeaux 2, 1999. http://www.theses.fr/1999BOR23107.
Full text
49
Friis, Lennart. "Health of municipal sewage workers : Studies of cancer incidence, biomarkers of carcinogenicity and genotoxicity, and self reported symptoms." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4980-8/.
Full text
50
Lartigue, Sylvie. "Scintigraphie gastrique : reproductibilite et resultats dans les syndromes dyspeptiques." Nantes, 1991. http://www.theses.fr/1991NANT131M.
Full text