5 research outputs found
Endoscopic mucosal resection of flat and sessile colorectal adenomas: Our experience with long-term follow-ups
Bacground/Aim. Endoscopic mucosal resection (EMR) or mucosectomy is a
removing method of flat or sessile lesions, laterally spreading tumors and
carcinoma of the colon or the rectum limited to mucosa or the surface part of
the submucosa. The aim of the study was to estimate the efficacy and safety
of EMR in removing flat and sessile colorectal adenomas. Methods. This
prospective study involved 140 patients during the period of 8 years. A total
of 187 colorectal adenomas were removed using the EMR method āinject and cut
with snareā. Results. The approximate size of mucosectomised adenomas was
13.6 mm (from 8 mm to 60 mm). There was a total of 48 (25.7%) flat adenomas
and 139 (74.3%) sessile adenomas, (p < 0.01). Using āen blocā and āpiecemealā
resection, 173 (92.5%) and 14 (7.5%) of colorectal adenomas were removed,
respectively. In all the cases, a complete removal of colorectal adenomas was
achieved. Two (1.4%) patients had adenoma removal with intramucosal carcinoma
each. In the average follow-up period of 21.2 Ā± 17.8 months, 2 (1.4%)
patients had adenoma relapse after EMR. Considering complications, there was
bleeding in 1 (0.7%) patient with a big rectum adenoma removed with EMR.
Furthermore, one (0.7%) patient had a postcoagulation syndrome after cecal
adenoma was removed by EMR. Conclusion. EMR is an efficient, safe and
minimally invasive technique of removing flat and sessile adenomas in the
colon and the rectum, with a very low percentage of adenoma recurrence over a
long period of monitoring
Comparison of biohumoral and morphological parameters in acute pancreatitis
Introduction. Acute pancreatitis occurs as a result of autodigestive
activation of pancreatic proenzymes, within the parenchyma of the glands.
Objective. The goal of the work was to establish possible connection of
etiology and severity of the acute pancreatitis and biohumoral parameters,
ultrasound and CT. Methods. The study included 273 patients with
pancreatitis, classified by Ransonās score, according to degree of severity
and etiology, whose biohumoral parameters were correlated with each other,
and with the ultrasound and CT findings. Results. The values of amylase and
ALT were significantly higher in the severe form of pancreatitis and biliary
etiology compared to etilic (p<0.05). The ratio of AST/ALT was significantly
higher in the group of etilic compared to biliary etiology (p<0.05). LDH was
significantly higher in the severe form group compared to moderate form of
pancreatitis (p<0.01). Cholesterol was significantly higher in the group of
biliary compared to the group of etilic pancreatitis (p<0.05). There was a
negative low correlation between the value of calcium ions in the plasma and
CT analysis (p=0.05). Low degree negative correlation between the value of
calcium ions and ultrasound analysis was established (p=0.0001). Conclusion.
There was a negative correlation between the level of ionized calcium in the
blood and the degree of the acute pancreatitis by the Balthazar score. Mean
value of alpha amylase, total value of cholesterol and ALT were significantly
higher in the group of biliary compared to the group of etilic acute
pancreatitis. The average values of the alpha amylase, LDH and ALT were
significantly higher in the group of severe form of the acute pancreatitis
compared to the group of moderate form. The ratio AST/ALT was significantly
higher in the group of etilic than in the group of biliary pancreatitis
Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study
Background/Aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 Ć 30 mg half an hour before the meal, amoxicillin 2 Ć 1.000 mg per 12 hours and clarithromycin 2 Ć 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics
Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication
Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)
of the stomach usually occurs as a consequence of Helicobacter pylori (H.
pylori) infection. The aim of this study was to investigate the long-term
effect of treatment of low-grade gastric MALT lymphoma with the H. pylori
eradication method. Methods. In the period 2002-2012 in 20 patients with
dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of
gastric MALT lymphoma in the early stages were made. Histological
preparations of endoscopic biopsy specimens were stained with
hematoxyllineosin (HE), histochemical and immunohistochemical methods.
Results. Endoscopic findings of gastritis were documented in 25% of the
patients, and 75% of the patients had hypertrophic folds, severe mucosal
hyperemia, fragility, nodularity, exulcerations and rigidity.
Histopathologically, pathognomonic diagnostic criterion were infiltration and
destruction of glandular epithelium with neoplastic lymphoid cells, the
so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified
by rapid urease test and Giemsa stain. After the triple eradication therapy
complete remission of MALT lymphoma was achieved in 85% of the patients, with
no recurrence of lymphoma and H. pylori infection in the average follow-up
period of 48 months. In 3 (15%) of the patients, there was no remission of
MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2
had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion.
Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in
a high percentage after eradication of H. pylori infection, thus preventing
the formation of diffuse large-cell lymphoma and gastric adenocarcinoma
Amlodipine as an antiischemic drug is superior to long acting nitrates
European Society of Cardiology Guidelines cite
results of meta-analysis that the use of calcium channel
blockers results in fewer angina episodes per week vs.
long-acting nitrates. Moreover, we listed 12 reasons more
to prefer amlodipine over long-acting nitrates, especially
in stable angina pectoris patients with arterial hypertension.
It may be the way to decrease polypharmacy without
loosing efficacy. Some important advantages of amlodipine
versus long-acting nitrate(s) are: amlodipine also
treats hypertension, it helps reducing hypertensive target organ damages (e.g. left ventricular hypertrophy) and prevents
morning blood pressure surge. Moreover, amlodipine
can be given once daily (which improves adherence),
it produces neither tolerance nor rebound, it has less side
effects