Stress Control Training In The Treatment Of The Irritable Bowel Syndrome [treino De Controle De Estresse No Tratamento Da Síndrome Do Intestino Irritável]

The objective was to evaluate the role of stress control training (SCT) in the treatment of irritable bowel syndrome (IBS). Sixteen IBS patients were studied, 15 of them female and one male, ages ranging from 22 to 72 years old, all coming from two university hospitals in the State of São Paulo. The patients were divided into two groups, experimental and control. The experimental group was submitted to the SCT and psychological evaluation was made with the application of Lipp's Inventory of Stress Symptoms for Adults, of the Anxiety and Depression Scale (ADS), and the levels of assertiveness and irrational beliefs were surveyed. Results showed that SCT achieved a partial, though not statistically significant reduction of the variables under study: stress level, irrational beliefs, lack of assertiveness, and anxiety and depression levels. Conclusion was that SCT was not effective as an adjuvant treatment for the disease.255135139Drossman, D.A., Corazziari, E., Talley, N.J., Thompson, W.C., Whitehead, W.E., (2000) Rome II: The Functional Gastrointestinal Disorders. 2 nd Ed., , Mc Lean VA: Degmon AssociatesQuilici, F.A., André, S.B., (2000) Síndrome Do Intestino Irritável, , São Paulo: LemosPrado, F.C., Ramos, J., Valle, J.R., Retocolite ulcerativa inespecífica (1991) Atualização Terapêutica: Manual Prático de Diagnóstico e Tratamento. 15 a Ed., pp. 264-265. , Prado FC, Ramos J, Valle JR. Artes MédicasFolks, D.G., The interface of psychiatry and irritable bowel syndrome (2004) Curr Psychiatry Rep, 6 (3), pp. 210-215Talley, N.J., Spiller, R., Irritable bowel syndrome: A little understood organic bowel disease? (2002) Lancet, 360 (9332), pp. 555-564Ross, C.A., Childhood sexual abuse and psychosomatic symptoms in irritable bowel syndrome (2005) J Child Sex Abus, 14 (1), pp. 27-38Cornejo, Z.C., Vilarreal, M.J., Relación entre síntomas de síndrome de intestino irritable y síntomas depresivos em pacientes hospitalizados (2005) Rev G Peru, 25 (2), pp. 156-160Creed, F., Ratcliffe, J., Fernandes, L., Palmer, S., Rigby, C., Tomenson, B., Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders (2005) Br J Psychiatry, 186, pp. 507-515Whithead, W.E., Shabin, Psychological characteristics of patients with gastrointestinal disorders (1991) Handbook of Clinical Psychology in Medical Settings, pp. 517-537. , Sweet JJ, Rosensky RH, Tovian SM. New York and London: Plenuns PressCrane, C., Martin, M., Social learning, affective state and passive coping in irritable bowel syndrome and inflammatory bowel disease (2004) Gen Hosp Psychiatry, 26 (1), pp. 50-58Magalhães, K.C., (1995) Estudos de Aspectos Psicossociais Em Pacientes Com Retocolite Ulcerativa Inespecífica e Síndrome Do Intestino Irritável, , [Dissertação de mestrado]. UNICAMP: CampinasPosserud, I., Agerforz, P., Ekman, R., Björnsson, E.S., Abrahamsson, H., Simrén, M., Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress (2004) Gut, 53 (8), pp. 1102-1108Brasio, K.M., (2000) Eficácia Do Treino de Controle de Stress Na Retocolite Ulcerativa Inespecífica, , [Tese de doutorado]. PUC-CampinasMagalhães, A.F.N., Brasio, K.M., Relação entre stress e doenças gástricas (2003) Mecanismos Neuropsicológicos Do Stress: Teoria e Aplicações Clínicas, , Lipp MEN, editor. Campinas: PapirusHeaton, K.W., Thompson, W.G., (2000) Síndrome Do Cólon Irritável, , J&C Ediciones Médicas, S.LLipp, M.E.N., Malagris, L.N., Manejo de estresse (1995) Psicoterapia Comportamental e Cognitiva: Pesquisa, Prática, Aplicação e Problemas, pp. 279-292. , Range B, editor. Campinas: Editorial Psy IIDias, R.R., (1998) Stress e Psoríase: Assertividade e Crenças Irracionais, , [Dissertação de mestrado]. PUC-CampinasTorrezan, E.A., (1999) O Efeito Do Controle de Stress No Resultado Da Gravidez, , [Tese de doutorado]. PUC-CampinasMiller, V., Hopkins, L., Whorweel, P.J., Suicidal ideation in patients with irritable bowel syndrome (2004) Clin Gastroenterol Hepatol, 2 (12), pp. 1064-1068Robert, J.J., Orr, W.C., Eisenbruch, S., Modulation of sleep quality and autonomic functioning by symptoms of depression in women with irritable bowel syndrome (2004) Dig Dis Sci., 49 (7-8), pp. 1250-1258Brasio, K.M., Laloni, D.T., Fernandes, Q.P., Bezerra, T.L., Comparação entre três técnicas de intervenção psicológica para o tratamento da fibromialgia: Treino de controle de stress, relaxamento progressivo e reestruturaç ão cognitiva (2003) Revista de Ciências Médicas, 12 (4), pp. 307-318Lipp, M.E.N., Nogueira, J.C., Nery, M.J.S., (1991) Estudo Experimental de Duas Condições de Tratamento Médico-psicológico a Pessoas Portadoras de Psoríase, , Campinas: UNICAMP, NE

Helicobacter Pylori' Gastritis Must Be Classified As A Disease [gastrite Por 'helicobacter Pylori' Deve Ser Classificada Como Doenca]

Helicobacter pylori gastritis is considered a disease by the authors, and is excluded from the diagnosis of functional dyspepsia. They emphasize that, although not associated to specific clinical features, this gastritis type has an etiologic agent and defined hisotpathological alterations. These characteristics are similar to those of other infectious diseases, such as chronic B and C virus hepatitis.16624724

Isoniazid Acetylation In Hepatic Cirrhosis [a Acetilacao Da Isoniazida Na Cirrose Hepatica]

[No abstract available]103627627

Treatment Of Duodenal Ulcer With Pirenzepine. A Double-blind Study [tratamento Da Ulcera Duodenal Com Pirenzepina. Estudo Duplo-cego]

[No abstract available]401039339

Antireflux Surgery Followed By Bipolar Electrocoagulation In The Treatment Of Barrett's Esophagus

Background: Management of Barrett's esophagus requires reduction of gastric acid secretion and screening for the development of adenocarcinoma. However, the current therapeutic options are inneffective in reducing the Barrett's mucosa. The aim of this study was to evaluate the effectiveness of endoscopic thermal coagulation of Barrett's mucosa as an alternative therapeutic approach and the recurrence of the disease in the long term. Methods: Fourteen patients (11 men, 3 women; mean age 45.7 years) with Barrett's esophagus participated in the study. They underwent laparoscopic fundoplication and were symptom free with no defective fundoplication wraps before therapeutic endoscopy. Endoscopic thermocoagulation was performed with a flexible videoendoscope and a bipolar probe. Mucosal areas were treated once a month until the Barrett's mucosa disappeared. Endoscopy was performed 1 and 7 months after completion of the treatments and once a year thereafter. Results: The mean follow-up period was 21.6 months (range 18 to 30 months). The mean length of Barrett's esophagus was 4.8 cm. Successful ablation of the columnar epithelium was achieved in 3.7 sessions, as defined by demonstration of normal squamous epithelium at histologic examination of biopsy samples collected after completion of the treatments and at follow-up evaluations. Three patients experienced short-term (10 days) odynophagia or dysphagia. All patients were symptom free with no evidence of Barrett's esophagus at the end of the study. Conclusions: Bipolar electrocoagulation after antireflux operations is effective in promoting regression of Barrett's esophagus and has few complications. Endoscopic thermal coagulation might reduce risk for adenocarcinoma among these patients.50217317

Peptic Ulcer [Úlcera Péptica]

Peptic ulcer is a common disease. The Helicobacter pylori infection and the use of anti-inflammatory drugs are the main risk factors. There is no characteristic clinical finding and some patients have no symptom. Epigastric pain is a common finding and is associated with food. The diagnosis is done by upper gastrointestinal endoscopy and endoscopic biopsies can identificate H.pylori. Eradication of the organism is the therapy of choice in infected patients. Drugs that inhibit acid gastric secretion can promote ulcer healing in almost all patients. The protom pump inhibitors are the most effective. They can be used in prevention of ulcer in high risk patients that use anti-inflammatory, as in elderly, patients with severe comorbid conditions and patients taking corticosteroids or anticoagulants.60SPEC. ISS.2532Kurata, J.H., Epidemiology of peptic ulcer disease (1984) Clin Gastroenterol, 13, p. 289Munnangi, S., Time trends of physician visits and treatment patterns of peptic ulcer disease in the United States (1997) Arch Intern Med, 157, pp. 1489-1494Higham, J., Kang, J.Y., Majeed, A., Recent trends in admissions and mortality due to peptic ulcer in England: Increasing frequency of haemorrhage among older subjects (2002) Gut, 50, pp. 460-464Marshall, B.J., Warren, J.R., Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulcerations (1984) Lancet, 1, pp. 1311-1315Cohen, H., Peptic ulcer and Helicobacter pylori (2000) Gastroenterol Clin North Am, 29, p. 775El-Omar, E.M., Penman, I.D., Ardill, J.E., Chittajallu, R.S., Howie, C., McColl, K.E., Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease (1995) Gastroenterology, 109, pp. 681-691Beales, I., Calam, J., Post, L., Effect of transforming growth factor alpha and interleukin 8 on somatostatin release from canine fundic D cells (1997) Gastroenterology, 112, pp. 136-143Hogan, D.L., Rapier, R.C., Dreilinger, A., Duodenal bicarbonate secretion: Eradication of Helicobacter pylori and duodenal structure and function in humans (1996) Gastroenterology, 110, pp. 705-716Segal, E.D., Cha, J., Lo, J., Falkow, S., Tompkins, L.S., Altered states: Involvement of phosphorylated CagA in the induction of host cellular growth changes by Helicobacter pylori (1999) Proc Natl Acad Sci USA, 96, pp. 14559-14564Uemura, N., Okamoto, S., Yamamoto, S., Helicobacter infection and the development of gastric cancer (2001) N Engl J Med, 345, pp. 784-789Wolfe, M.M., Lichtenstein, D.R., Singh, G., Gastrointestinal toxicity of non-steroidal anti-inflammatory drugs (1999) N Engl J Med, 340, p. 1888Wallace, J.L., Keenan, C.M., Granger, D.N., Gastric ulceration induced by nonsteroidal anti-inflammatory drugs is a neutrophil-dependent process (1990) Am J Physiol, 259, pp. 462-467Silverstein, F.E., Faich, G., Goldstein, J.L., Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflamamatory drugs for osteoarthritis and rheumatoid arthritis (2000) JAMA, 284, pp. 1247-1255Wallace, J.L., McKnight, W., Reuter, B.K., Vergnolle, N., NSAID-induced gastric damage in rats: Requirement for inhibition of both cyclooxygenase 1 and 2 (2000) Gastroenterology, 119, pp. 706-714Huang, J.Q., Sridhar, S., Hunt, R.H., Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: A meta-analysis (2002) Lancet, 359, pp. 14-22Zeitune, J.M.R., Monici, L.T., Nishimura, N.F., Diagnóstico da infecção pelo Helicobacter pylori (2000) Gastroenterologia III/Farid Nader, , Pelotas: Editora UniversitáriaBorody, T.J., Cole, P., Noonan, S., Recurrence of duodenal ulcer and Campylobacter pylori infection after eradication (1989) Med J Aust, 151, pp. 431-435Porro, G.B., Parente, F., Antacids for duodenal ulcer: Current role (1990) Scand J Gastroenterol, 25, p. 48Deakin, M., Williams, J.G., Histamine H2-receptor antagonists in peptic ulcer disease. Efficacy in healing peptic ulcers (1992) Drugs, 44, p. 709Lee, F.I., Collin-Jones, D.G., Golding, P.L., Double-blind comparative study of omeprazole and ranitidine in patients with duodenal or gastric ulcer: A multicentre trial (1991) Gut, 26, p. 137Malfertheiner, P., Megraud, F., O'Morain, C., Current concepts in the management of Helicobacter pylori infection: The Maastricht 2-2000 Consensus Report (2002) Aliment Pharmacol Ther, 16, pp. 167-180Vaira, D., Vakil, N., Menegatti, M., The stool antigen test for detection of Helicobacter pylori after eradication therapy (2002) Ann Intern Med, 136, pp. 280-287Yeomans, N.D., Tulassay, Z., Juhasz, L., Omeprazole compared with ranitidine for ulcers associated with nonsteroidal antiinflamatory drugs (1998) N Engl J Med, 338, pp. 719-726Rich, M., Scheiman, J., Nonsteroidal anti-inflammatory drug gastropathy at the new millennium: Mechanisms and prevention (2000) Sem Arthritis Rheum, 30, p. 167Norton, J., Surgery to cure Zollinger-Ellison syndrome (1999) N Engl J Med, 341, p. 63

Clinical Study Of The Efficacy And Tolerability Of Lansoprazole In The Management Of Duodenal Ulcer [estudo Clinico Sobre A Eficacia E A Tolerabilidade De Lansoprazol No Tratamento Da Ulcera Duodenal]

The present study aimed to evaluate the efficacy and tolerability of lansoprazole 30 mg once daily in healing duodenal ulcer in two Brazilian centers. Patients were evaluated on the basis of clinical and endoscopic criteria before treatment and two weeks after the beginning of treatment. The patients who were not healed (red or white scar: S1 or S2 according Sakitas's classification) were reevaluated 4 weeks after the beginning of treatment. Fifthy-eight patients completed the study. Endoscopic examination revealed that duodenal ulcer was healed (S1 or S2 according Sakitas's classification) 2 weeks after the beginning of treatment in 51 patients (87,9%). In the remaining seven patients (12,1%) the ulcer was healed at the end of treatment (4 weeks). Clinical symptoms (daytime epigastric pain, nocturnal epigastric pain, daytime heartburn, nocturnal heartburn, nausea, vomiting, post-prandial distention, anorexia, and dysphagia) were dramatically reduced two weeks after the beginning of treatment in terms of the number of patients presenting the symptom and the severity. The present study confirms the efficacy of lansoprazole in the treatment of duodenal ulcer. All patients who completed the study were healed. The adverse events reported were mild nature and were not considered related to the medication under study, not requiring discontinuation of treatment. With a marked efficacy lansoprazole is also safe.553156160Black, J.W., Duncan, W.A.M., Durant, C.J., Definition and antagonism of histamine H2-receptors (1972) Nature, 236, pp. 385-390Brimblecombe, R.W., Duncan, W.A.M., Durant, C.J., Cimetidine - A non-thiourea H-receptors antagonist (1975) J Int Med Res, 3, pp. 86-92Andersen, B.N., Medical treatment of peptic ulcer disease (1988) Acta Chir Scand Suppl, 547, pp. 88-92Dammann, H.G., Dreyer, M., Kangah, R., First-choice treatment in uncomplicated ulcer disease: A case for acid inhibitors (1988) Scand J Gastroenterol, 23 (153 SUPPL.), pp. 62-70Burland, W.L., Hawkins, B.W., Beresford, J., Cimetidine treatment for the prevention of duodenal ulcer: An international collaborative study (1980) Postgr Med J, 56, pp. 173-176Lindberg, P., Brändström, A., Wallmark, B., Structure-activity relationships of omeprazole analogues and their mechanism of action (1987) Trends in Pharmacol Sci, 8, pp. 399-402Lindberg, P., Brändström, A., Wallmark, B., Omeprazole: The first proton pump inhibitor (1990) Med Res Rev, 10 (1), pp. 1-54Dahlgren, S., Domellöf, L., Hradsky, M., The effects of omeprazole and cimetidine on duodenal ulcer healing and the relief of symptoms (1988) Aliment Pharmacol Ther, 2 (6), pp. 483-492Walan, A., Bader, J.P., Classen, M., Effect of omeprazole and ranitidine on ulcer healing and relapse rates in patients with benign gastric ulcer (1989) N Engl J Med, 320 (2), pp. 69-75Maton, P.N., Omeprazole (1991) N Engl J Med, 324 (14), pp. 965-975Lauritsen, K., Andersen, B.N., Laursen, L.S., Omeprazole 20 mg three days a week and 10 mg daily in prevention of duodenal ulcer relapse. Double-blind comparative trial (1991) Gastroenterology, 100 (3), pp. 663-669Bianchi Porro, G., Corinaldesi, R., Lazzaroni, M., Long term treatment with omeprazole 20mg three days a week or 10mg daily in the prevention of duodenal ulcer relapse (1994) Aliment Pharmacol Ther, 8 (5), pp. 541-548Goh, K.L., Boonyapisit, S., Lai, K.H., Prevention of duodenal ulcer relapse with omeprazole 20mg daily, a randomized double-blind, placebo-controlled study (1995) J Gastroenterol Hepatol, 10 (1), pp. 92-97Pilotto, A., Di Mario, F., Battaglia, G., The efficacy of two doses of omeprazole for short- and long-term peptic ulcer treatment in the elderly (1994) Clin Ther, 16 (6), pp. 935-941Festen, H.P., Prevention of duodenal ulcer relapse by long-term treatment with omeprazole (1994) Scand J Gastroenterol, 29 (201 SUPPL.), pp. 39-41Licht, H., Andrieu, J., Bognel, J.C., Lansoprazole versus ranitidine dans le traitement des ulcères duodenaux: Resultats d'un essai multicentrique controlé, randomisé en double insu sur groupes paralleles (1990) MCD, 19, pp. 251-255Petite, J.P., Slama, J.L., Licht, H., Comparaison du lansoprazole (30mg) et de l'oméprazole (20mg) dans le traitement de l'ulcère duodenaux. Essai thérapeutique multicentrique comparatif en double aveugle (1993) Gastroenterol Clin Biol, 17 (5), pp. 334-340Bader, J.P., Delchier, J.C., Clinical efficacy of pantoprazole compared with ranitidine (1994) Aliment Pharmacol Ther, 8 (1 SUPPL.), pp. 47-52Judmater, G., Koeltz, H.R., Comparison of pantoprazole and ranitidine in the treatment of acute duodenal ulcer (1994) Aliment Pharmacol Ther, 8 (1), pp. 81-86. , Pantoprazole-Duodenal Ulcer-Study GroupZaterka, S., Massuda, H., Chinzon, D., Treatment of duodenal ulcer with omeprazole or ranitidine in a Brazilian population: A multicenter double-blind, parallel group study (1993) Am J Gastroenterol, 88 (3), pp. 397-401Meneghelli, U.G., Zaterka, S., Castro, L.P., (1998) Pantoprazole Versus Ranitidine in the Treatment of Duodenal Ulcer. A Multicenter Study in Brazil, , Enviado para publica̧ãoMarks, I.N., Winter, T.A., Lucke, W., Omeprazole and ranitidine in duodenal ulcer healing (1988) S Afr Med J, 74 (SUPPL.), pp. 54-5