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Efecto del tratamiento erradicador para Helicobacter pylori en pacientes con dispepsia funcional Effect to Helicobacter pylori eradication on patients with functional dyspepsia  [cached]
T. de Artaza Varasa,J. Valle Mu?oz,M. J. Pérez-Grueso,A. García Vela
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract: Objetivo: este estudio ha tenido un doble objetivo: por un lado, evaluar el efecto del tratamiento erradicador para Helicobacter pylori en la respuesta sintomática de pacientes diagnosticados de dispepsia funcional y, por otro, determinar si los hallazgos histológicos podían servir como predictor de la efectividad de la terapia. En particular, se trató de averiguar si la presencia de gastritis antral (la que se asocia a la enfermedad ulcerosa péptica) podría predecir una mayor respuesta sintomática al tratamiento erradicador en los pacientes con dispepsia funcional e infección por Helicobacter pylori. Pacientes y métodos: estudio prospectivo, monocéntrico y aleatorizado, que incluyó a 48 pacientes con dispepsia funcional e infección por Helicobacter pylori (27 mujeres y 21 hombres, con edad media de 37 ± 13,5 a os). Veintisiete pacientes recibieron el tratamiento erradicador (rabeprazol, claritromicina y amoxicilina durante 10 días, seguido de 20 mg/día de rabeprazol 3 meses) y 21 el tratamiento control (20 mg/día de rabeprazol 3 meses). Los pacientes fueron seguidos durante un a o. Todos rellenaron el Cuestionario de calidad de vida asociada a dispepsia, que evalúa cuatro apartados: intensidad de los síntomas habituales, intensidad del dolor de estómago, incapacidad debida al dolor y satisfacción con la salud. Resultados: existió una mejoría significativa (p < 0,002) en los síntomas de los pacientes, tanto a los 6 como a los 12 meses tras el inicio del tratamiento, que además fue común a las dos pautas de tratamiento. En el análisis de regresión lineal múltiple, los efectos del tratamiento erradicador y de tener una sintomatología menos intensa antes de recibir el tratamiento, fueron los dos únicos factores independientes de forma significativa. La respuesta al tratamiento erradicador a los 6 meses fue significativamente mayor que con el tratamiento control (p = 0,01) en los pacientes con gastritis de predominio antral y en el apartado concreto de los síntomas habituales. Conclusiones: ambos tratamientos producen una mejoría sintomática significativa en los pacientes con dispepsia funcional. Se observa una tendencia hacia un beneficio sintomático mayor con el tratamiento erradicador respecto al control en pacientes con dispepsia funcional y en un medio con elevada prevalencia de infección por Helicobacter pylori. Existe una tendencia hacia la mejoría sintomática con el tratamiento erradicador en los pacientes que tienen una gastritis de predominio antral. Objective: this study evaluated Helicobacter pylori eradication therapy in terms of symptomatic res
Aloe gel viscoso en el tratamiento de pacientes con úlcera duodenal y Helicobacter pylori positivo Use of viscous gel Aloe in treatment of patients presenting duodenal ulcer and positive Helicobacter pylori
Myrna Quintero Díaz,Rosa Behar Hasday,Clara Elsa García Lima,Daymela Pupo Olivero
Revista Cubana de Plantas Medicinales , 2009,
Abstract: IINTRODUCCIóN: Aloe vera L. (sin. A. barbadensis L.) (aloe o sábila) es una planta con vastas propiedades medicinales. Los estudios preclínicos demostraron la acción antiulcerosa, sin efectos tóxicos, de extractos acuosos de hoja fresca. No se encontró ningún ensayo clínico en la literatura similar al del presente estudio. OBJETIVO: comparar el efecto de la formulación Aloe gel viscoso (Aloe) y amoxicilina administrados a pacientes ambulatorios con úlcera duodenal y Helicobacter pylori positivo, por la prueba de ureasa, sobre la evolución endoscópica de la úlcera y sobre el comportamiento del Helicobacter pylori frente a un grupo control. MéTODOS: los 2 grupos de Aloe recibieron 2 dosis diferentes (1,5 o 3,0 mg/kg de peso corporal) durante 6 semanas y amoxicilina (1 500 mg/d) durante10 d. Al grupo control se le administró ranitidina 300 mg/d por 6 semanas y amoxicilina de igual forma que a los grupos con Aloe. RESULTADOS: finalizaron el tratamiento 76 pacientes distribuidos en los 3 grupos; los síntomas principales (dolor y acidez) de los pacientes desaparecieron antes de las 2 semanas de tratamiento en 94 % de estos. Aunque en el grupo control tratado con ranitidina + amoxicilina, las úlceras duodenales cicatrizaron en mayor número y se obtuvo un mayor porcentaje de negativización de H. pylori, no resultó significativo respecto al grupo con mayor dosis de Aloe. CONCLUSIONES: los efectos obtenidos con el Aloe a mayor dosis más la amoxicilina, dado que es un producto de origen vegetal, el cual se utiliza por primera vez, se consideró aceptable y se sugiere hacer un ensayo controlado de este producto unido a 2 antibióticos y en un mayor número de pacientes. INTRODUCTION: Aloe vera (sin. A. barbadensis) (aloe or sábila) is a plant with numerous medicinal properties. Preclinical studies have showed the antiulcerous action without toxic effects of the aqueous extracts from fresh leaves. In literature there was not a clinical trial similar to present study. OBJECTIVE: to compare the effect of viscous gel Aloe formulation and amoxicillin administered to ambulatory patients presenting with duodenal ulcer and positive Helicobacter pylori, according to urease test on ulcer endoscopic course and on behavior of Helicobacter pylori in a control group. METHODS: the two Aloe groups received two different dose (1.5 or 3.0 mg/kg of body weight) during six weeks and amoxicillin (1 500 mg/d) during 10 days. Control group received ranitidine (300 mg/d) for sis weeks and amoxillin in similar way that Aloe groups. RESULTS: seventy six patients completed the treatment distr
Helicobacter pylori: Tratamiento actual. Un importante reto en gastroenterología Helicobacter pylori: Current treatment An important challenge for gastroenterology  [cached]
William Otero Regino,Alba Alicia Trespalacios,Elder Otero
Revista Colombiana de Gastroenterologia , 2009,
Abstract: Desde cuando se descubrió Helicobacter pylori, su erradicación ha constituido uno de los más importantes retos en gastroenterología. En muchas partes se desconocen las prevalencias de resistencia primaria del microorganismo a los diferentes antibióticos que empíricamente utilizan y por no realizar de rutina pruebas para verificar la erradicación, en la práctica diaria, se ignora la efectividad de los esquemas prescritos. Conocer estos dos factores, permite, no solo identificar los que aún persisten infectados, sino también elegir la próxima terapia de rescate de una manera más racional. El no disponer de la información sobre resistencia pretratamiento es un inconveniente que impide evaluar el impacto de la resistencia con el fracaso terapéutico. A nivel mundial, la triple terapia estándar ha perdido la eficacia que tenía en el pasado y la terapia secuencial no es igualmente eficaz en todos los sitios, en especial en regiones en donde existe alta resistencia a claritromicina y metronidazol. Los esquemas con levofloxacina han demostrado eficacia en triples terapias de primera línea o como terapia de rescate, pero es necesario que cada región adopte sus propios esquemas de tratamiento fundamentados en pruebas de susceptibilidad y en estudios farmacogenómicos. Since when Helicobacter pylori was discovered, the eradication has been one of the most important challenges in gastroenterology. In many places, the prevalence of primary resistance of microorganism to the different antibiotics is not known, and these are used empirically. In daily practice, no routine test is used to verify the eradication, and therefore do not know the effectiveness of the schemes. Knowing these two factors is possible identify those still infected and choose the next rescue therapy in a rational form. The absence of information on pre-treatment resistance is a problem that cannot measure the impact of resistance to therapeutic failure. A global level, the standard triple therapy has lost the effectiveness that it had in the past and sequential therapy is not equally effective everywhere, especially in regions where there is high resistance to clarithromycin and metronidazole. The schemes have proved effective with levofloxacin triple therapies as first line therapy or rescue, but it is necessary that each region takes its own schemes of treatment based on susceptibility tests and pharmacogenomic studies.
Helicobacter pylori: Tratamiento actual. Un importante reto en gastroenterología
Otero Regino,William; Trespalacios,Alba Alicia; Otero,Elder;
Revista Colombiana de Gastroenterologia , 2009,
Abstract: since when helicobacter pylori was discovered, the eradication has been one of the most important challenges in gastroenterology. in many places, the prevalence of primary resistance of microorganism to the different antibiotics is not known, and these are used empirically. in daily practice, no routine test is used to verify the eradication, and therefore do not know the effectiveness of the schemes. knowing these two factors is possible identify those still infected and choose the next rescue therapy in a rational form. the absence of information on pre-treatment resistance is a problem that cannot measure the impact of resistance to therapeutic failure. a global level, the standard triple therapy has lost the effectiveness that it had in the past and sequential therapy is not equally effective everywhere, especially in regions where there is high resistance to clarithromycin and metronidazole. the schemes have proved effective with levofloxacin triple therapies as first line therapy or rescue, but it is necessary that each region takes its own schemes of treatment based on susceptibility tests and pharmacogenomic studies.
Effect of Helicobacter pylori eradication therapy in rosacea patients Efecto del tratamiento erradicador frente a Helicobacter pylori en la rosácea  [cached]
D. Boixeda de Miquel,M. Vázquez Romero,E. Vázquez Sequeiros,J. R. Foruny Olcina
Revista Espa?ola de Enfermedades Digestivas , 2006,
Abstract: Objective: the causal relation between rosacea and Helicobacter pylori infection is discussed. We evaluated the clinical evolution of rosacea after infection eradication. Patients and methods: we have prospectively studied 44 patients diagnosed with rosacea. Helicobacter pylori infection was determined, and infected patients were treated with eradication therapy. The evolution of dermatological symptoms in a subgroup of 29 infected patients in whom eradication had been achieved was followed during 16.8 (± 17.8) months. Median age was 50.6 (± 14.1) years for 22 women (75.9%) and 7 men (24.1%). Clinical response according to gender and clinical subtype of rosacea was evaluated. Results: complete improvement was observed in 10 patients (34.5%; 95% CI: 18.6-54.3%), relevant improvement in 9 (31.1%; 95% CI: 16-51%), poor improvement in 5 (17.2%; 95% CI: 6.5-36.4%), and absence of improvement in 5 cases (17.2%; 95% CI: 6.5-36.4%). No significant differences in dermatological evolution according to sex were observed. Regarding subtype of rosacea there was a relevant improvement in 83.3% (95% CI: 64.1-93.8%) of cases with papulopustular type as opposed to 36.5% (95% CI: 20-56.1%) of cases with erythematous predominance, p = 0.02. Conclusions: based on these results, the relation between Helicobacter pylori and rosacea is supported, and infection should be investigated in these patients because an appreciable percentage of patients diagnosed with rosacea and Helicobacter pylori infection can benefit from eradication therapy, mainly in the papulopustular subtype.
Tratamiento en pacientes operados de estómago con ácidos biliares elevados y Helicobacter pylori positivo Treatment in patients operated on of the stomach with elevated biliary acids and positive Helicobacter pylori
Héctor Rubén Hernández Garcés,Felipe Pi?ol Jiménez,Manuel Paniagua Estévez
Revista Cubana de Farmacia , 2008,
Abstract: Se realizó un estudio del tipo experimental, no ciego y aleatorizado, constituido por 30 pacientes adultos de uno y otro sexos con diagnóstico de gastritis crónica alcalina por reflujo duodenogástrico, en resecados de estómago (Billroth I, Billroth II), mediante endoscopia superior, con ácidos biliares totales elevados y Helicobacter pylori positivo. Estos pacientes se distribuyeron en 2 grupos de tratamiento durante 8 semanas. El grupo A, de 15 pacientes, recibió tratamiento con: subcitrato de bismuto coloidal (Q-ulcer), metronidazol y tetraciclina, más ranitidina como antihistamínico H2. El grupo B, de 15 pacientes, se le administró celulosa microcristalina (Microcel). Ambos grupos recibieron metoclopramida como fármaco procinético durante todo el tratamiento. Los índices de erradicación de la infección por H. pylori fueron del 46,7 % para el grupo A y del 42,9 % para el grupo B. La concentración de ácidos biliares totales al final del tratamiento disminuyó en el 53,3% de los pacientes del grupo A y en el 71,4% de los pacientes del grupo B. La concentración de ácidos biliares totales en el remanente gástrico al final del tratamiento, no influyó en la evaluación clínica, endoscópica e histológica de los pacientes en ambos esquemas de tratamiento. No se presentaron efectos adversos secundarios en los pacientes del grupo A y 1 paciente (6,6 %) del grupo B abandonó el estudio al empeorar su cuadro clínico, el cual fue intervenido quirúrgicamente, por lo que se considera fracaso del tratamiento. Se concluye que estos esquemas terapéuticos no fueron eficaces A non-blind randomized experimental study was undertaken. It included 30 adults of both sexes with diagnosis of alkaline chronic gastritis due to duodenogastric reflux, in stomach resections (Billroth I, Billroth II), by upper endoscopy, with elevated total biliary acids and positive Helicobacter pylori. These patients were divided into 2 groups of treatment during 8 weeks. The group A was composed of 15 patients and received treatment with colloidal bismuth subcitrate (Q-ulcer), metronidazole and tetracycline, plus ranitidine as H2 antihistaminic. The group B was made up of 15 patients and it was administered microcrystalline cellulose (Microcel). Metoclopramide was given to both groups as a prokinetic drug during the whole treatment. The indexes for the eradication of H. pylori infection were 46.7 % for group A, and 42.9 % for group B. The concentration of total biliary acids at the end of the treatment decreased in 53.3 % of the patients from group A and in 71.4 % in group B. The concentration of tot
Tratamiento de la infección por Helicobacter pylori asociada con gastritis en ni os
Carlos Alberto Velasco
Colombia Médica , 2005,
Abstract: Management of Helicobacter pylori-induced gastritis in children Helicobacter pylori-induced gastritis causing mucosal ulceration either in the stomach or the proximal duodenum is a relatively uncommon event in children compared with adults. Recurrences of H. pylori-associated peptic ulceration are markedly reduced by treatment directed at eradicating the gastric infection. This intervention therefore results in reduced global health care costs. Increasing knowledge of the natural history of the infection, routes of transmission in human populations, and potential environmental reservoirs will help to clearly define why, when, and in whom to treat H. pylori.
úlcera duodenal no complicada y complicada con sangrado: cuál es la importancia del tratamiento contra Helicobacter pylori? What is the importance of treatment for Helicobacter pylori in cases of uncomplicated duodenal ulcers and cases of duodenal ulcers complicated by bleeding?  [cached]
Javier Leonardo Galindo Pedraza,William Otero Regino,Martín Gómez Zuleta
Revista Colombiana de Gastroenterologia , 2010,
Abstract: Helicobacter pylori es la principal etiología de la úlcera péptica a nivel mundial, no obstante la disminución progresiva de la infección. La úlcera duodenal es una complicación frecuente de la infección, y por la magnitud y la consistencia de esta asociación, la necesidad de erradicar a Helicobacter pylori en estos casos está claramente establecida por las guía del American College of Gastroenterology y el consenso Maastricht III. Con el tratamiento de erradicación se obtiene curación y se evitan las complicaciones derivadas de la úlcera (Ej. sangrado). Es de importancia establecer un manejo antibiótico adecuado al perfil de resistencia de la población y verificar la erradicación de la infección para eliminar el riesgo de recaída y complicación de la úlcera. Worldwide Helicobacter pylori remains the main etiology for peptic ulcer disease despite progressively decreasing prevalence of the infection. Duodenal ulcers are frequent complications of H. pylori infections. Because of the magnitude and consistency of this association, the need for eradication of Helicobacter pylori in these cases has been clearly established by the American College of Gastroenterology guidelines and by the Maastricht III consensus. With the eradication treatment healing can be achieved and complications of ulcers such as bleeding can be avoided. It is important to establish an antibiotic treatment appropriate to the population’s resistance profile and to confirm eradication of infection in order to eliminate the risk of relapse and complications due to ulcers.
Efecto del tratamiento erradicador para Helicobacter pylori en pacientes con dispepsia funcional
Artaza Varasa,T. de; Valle Mu?oz,J.; Pérez-Grueso,M. J.; García Vela,A.; Martín Escobedo,R.; Rodríguez Merlo,R.; Cuena Boy,R.; Carrobles Jiménez,J. M.;
Revista Espa?ola de Enfermedades Digestivas , 2008, DOI: 10.4321/S1130-01082008000900002
Abstract: objective: this study evaluated helicobacter pylori eradication therapy in terms of symptomatic response in patients with functional dyspepsia. on the other hand, we analyzed the importance of histologic findings as a predictor of treatment response. in particular, we studied whether antral gastritis (which is associated with peptic ulcer) may predict a greater symptomatic response to helicobacter pylori eradication in functional dyspepsia. patients and methods: this prospective, randomized, single-center trial included 48 patients with functional dyspepsia and helicobacter pylori infection (27 women and 21 men, mean age 37 ± 13.5 years). twenty-seven patients received a 10-day course of rabeprazole, amoxicillin, and clarithromycin (eradication group), followed by 20 mg of rabeprazole for 3 months. twenty-one patients received 20 mg of rabeprazole for 3 months (control group). patients were followed up over a 1-year period. all patients completed the dyspepsia-related health scale questionnaire, which studies four dimensions: pain intensity, pain disability, non-pain symptoms, and satisfaction with dyspepsia-related health. results: there was significant symptomatic improvement (p < 0.002) after 6 and 12 months, which was similar with both treatments. in the multivariate analyses, eradication therapy and less severe symptoms before treatment were the only independent factors. the symptomatic response to helicobacter pylori eradication after 6 months was significantly greater as compared to control therapy (p = 0.01) in patients with antral gastritis and in the non-pain symptoms dimension of the questionnaire. conclusions: both treatments proved to be clinically beneficial in patients with functional dyspepsia. we observed a tendency to greater symptomatic benefit with helicobacter pylori eradication therapy when compared to control treatment in patients with functional dyspepsia and in a population with a high prevalence of his infection. there is a tendency to symp
Aloe gel viscoso? en el tratamiento de pacientes con úlcera duodenal y Helicobacter pylori positivo
Quintero Díaz,Myrna; Behar Hasday,Rosa; García Lima,Clara Elsa; Pupo Olivero,Daymela; Hernández Domínguez,Maité; Díaz Elías,Javier; Pérez Suárez,Frank;
Revista Cubana de Plantas Medicinales , 2009,
Abstract: introduction: aloe vera (sin. a. barbadensis) (aloe or sábila) is a plant with numerous medicinal properties. preclinical studies have showed the antiulcerous action without toxic effects of the aqueous extracts from fresh leaves. in literature there was not a clinical trial similar to present study. objective: to compare the effect of viscous gel aloe? formulation and amoxicillin administered to ambulatory patients presenting with duodenal ulcer and positive helicobacter pylori, according to urease test on ulcer endoscopic course and on behavior of helicobacter pylori in a control group. methods: the two aloe groups received two different dose (1.5 or 3.0 mg/kg of body weight) during six weeks and amoxicillin (1 500 mg/d) during 10 days. control group received ranitidine (300 mg/d) for sis weeks and amoxillin in similar way that aloe groups. results: seventy six patients completed the treatment distributed into three groups; leading symptoms (pain and heartburn) in patients disappearing before two weeks of treatment in the 94 %. although in control group treated with ranitidine + amoxicillin, duodenal ulcers healed in a higher proportion and there was a higher percentage of negativity of h. pylori, it was not significant regarding the group with higher dose of aloe. conclusions: effects obtained with aloe use at a higher dose plus the amoxicillin, since it is a product of vegetal origin, which is used for the first time, it was considered as acceptable. authors propose a controlled trial of this product combined with two antibiotics in a greater number of patients.
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