Biomedical subjects

F Pakodi

Publications and source records attributed to F Pakodi.

6 recordsLinked to original sources

PubMed1996

Diagnostic interpretation of 24-hour intragastric pH-metry using a pattern recognition method.

BACKGROUND: Intragastric pH-metry is a widely used method in the evaluation of gastric acidity, but the interpretation of these data is not standardized. METHODS: The pH-metry data of 60 patients were sorted retrospectively into three groups according to the maximal acid output (MAO) values measured after stimulation by pentagastrin: hypoacid group (MAO < 5 mmol/h, n = 17), normacid group (MAO 10-15 mmol/h, n = 18) and superacid group (MAO > 25 mmol/h, n = 25). Statistical effectiveness of several descriptive statistical values and predefined time-intervals in differentiation between the study groups was analysed by the pattern recognition by independent multicategory analysis (PRIMA) method. RESULTS: The mean pH, the integrated pH and the time-interval of pH > or = 3 values were the most effective parameters for discriminating between each pair of groups. Hypoacid-normacid-superacid: mean pH 6.1 +/- 0.2-4.2 +/- 0.23-1.5 +/- 0.07; integrated pH 8898 +/- 208-5987 +/- 339-2224 +/- 98 pH.min; and pH > or = 3 1440 +/- 0-392 +/- 44-80 +/- 11 min, respectively (+/- SEM). More than a 99.9% separation of the study groups was achieved using these three parameters concomitantly by the PRIMA method, even when comparing 6-h daytime periods of measurements. A relative disagreement was found when reclassifying the hypoacid and normacid patients on the basis of pH records, compared with the primary classification based on the MAO data (11 out of 35 patients, 31%). CONCLUSIONS: The analysis of the mean pH data (instead of medians or [H+]), the AUC-pH and the pH > or = 3 duration, either separately or most beneficially concomitantly, are recommended for the diagnostic interpretation of intragastric pH-metry data. The duration of the diagnostic intragastric pH-metry measurements might be decreased to 6 h by using the PRIMA method.

Gastric Acid↗

PubMed1994

Dynamism of cytoprotective and antisecretory drugs in patients with unhealed gastric and duodenal ulcers.

A continuous multiclinical, randomized and prospective study has been carried out in our department to compare the efficacy of different cytoprotective (sucralfate, DE-NOL, Vitamin A) and antisecretory drugs (atropine, cimetidine, ranitidine, famotidine, pirenzepine) on ulcer healing in patients with chronic gastric ulcer (GU) and duodenal ulcer (DU). A total of 441 patients were randomized in different groups. The patients were treated with atropine (1 mg/day), cimetidine (1000 mg/day), ranitidine (300 mg/day), famotidine (80 mg/day), pirenzepine (50 mg/day), sucralfate (1000 mg/day), Vitamin A (3 x 50,000 IU/day) alone or in combination with cyproheptadinum (3 x 4 mg/day) DE-NOL (3 x 5 mL/day) and Tisacid (Al-Mg-hydroxycarbonicum; in different doses). Endoscopy (planimetric evaluation of ulcer sizes), measurements of clinical changes in patients' complaints, antacid consumption and laboratory tests (blood counts, urine, kidney and liver functions, electrolytes, pH status) were carried out at the beginning and 2, 4 and 6 weeks after treatment with different drugs. The incidence of ulcers, changes of ulcer sizes, subjective pain score and antacid consumption were noted at the abovementioned times. There were 20 or more patients in each group. The dynamism of ulcer healing rate was studied on the unhealed GU and DU. Our results showed that the ulcer size decreased significantly in all groups in GU and DU patients treated with cytoprotective and antisecretory drugs. Summed pain score (expressed as per cent of basic values) and antacid consumption decreased significantly in all groups. As well, some differences were found in the dynamism of ulcer healing at 2 weeks after the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Antacids↗

PubMed1984

Inhibition of hepatic drug metabolism by (+)-cyanidanol-3 (Catergen) in chronic alcoholic liver disease.

There are some controversies regarding the effect of (+)-cyanidanol-3 on hepatic drug metabolism. In the present study the effect of (+)-cyanidanol-3 was investigated on the microsomal and mitochondrial enzyme functions (hydroxylation, glucuronide production, D-glucaric acid excretion and acetylation) in alcoholic liver disease. Eight patients with biopsy-proven chronic alcoholic hepatitis were investigated before and after a 10-day, as well as after a further 30-day, treatment with (+)-cyanidanol-3 (Catergen), 3000 mg/day orally. Besides biochemical liver function tests (serum bilirubin levels, GOT, GGT), antipyrine metabolic clearance rate, mentholglucuronide production, urinary D-glucaric acid excretion and sulphadimidine kinetics were determined. Biochemical liver function tests improved markedly after the first period of treatment, at the same time antipyrine metabolic clearance rate decreased. Menthol-glucuronide production and D-glucaric acid excretion decreased significantly only after the second two course of Catergen administration. Sulphadimidine kinetics was not remarkably changed. Our findings suggest that (+)-cyanidanol-3 inhibits the hepatic microsomal drug metabolizing enzyme function in chronic alcoholic hepatitis.

Adult↗

PubMedDate not supplied

13C-Urea breath test is superior in sensitivity to detect Helicobacter pylori infection than either antral histology or rapid urease test.

There is no single technique which fulfils the criterion for a reference method to detect Helicobacter pylori (Hp) infection. The aim was to compare the results of antral histology (H), rapid urease test (U) and urea breath test (UBT) from antral biopsy samples in patients having gastric or duodenal lesions during upper GI endoscopy. We used the following methods: 1) biopsy specimens for histology (Warthin-Starry staining); 2) rapid urease test; and 3) 13C-urea breath test with infrared spectrometry. The total number of patients was 166 examined by H, U, and UBT. H, U and UBT were negative (-) in 64 patients and positive (+) in 51. The true positivity and false negativity (%, number of patients in parentheses) of each method based upon the positivity of the other two tests were: H+, U+ (54): UBT+, 94.4% (51) and UBT-, 5.6% (3); H+, UBT+ (57): U+, 89.5% (51) and U-, 10.5% (6); U+, UBT+ (65): H+, 78.5% (51) and H-, 21.5% (14). If Hp infection is considered to be positive when at least two tests detect the presence of Hp, UBT shows the highest sensitivity in comparison to histology of biopsy specimens and urease test. UBT is highly recommended as a screening test for Hp infection in patients presenting upper GI endoscopic alterations.

Breath Tests↗

PubMedDate not supplied

Helicobacter pylori. One bacterium and a broad spectrum of human disease! An overview.

Since the historical rediscovery of gastric spiral Helicobacter pylori in the gastric mucosa of patients with chronic gastritis by Warren and Marshall in 1983, peptic ulcer disease has been largely viewed as being of infectious aetiology. Indeed, there is a strong association between the presence of H. pylori and chronic active gastritis in histology. The bacterium can be isolated in not less than 70% of gastric and in over 90% of duodenal ulcer patients. Eradication of the organism has been associated with histologic improvement of gastritis, lower relapse rate and less risk of bleeding from duodenal ulcer. The bacterium possesses several virulence factors enabling it to survive the strong acid milieu inside the stomach and possibly damaging host tissues. The sequence of events by which the bacterium might cause gastric or duodenal ulcer is still not fully elucidated and Koch's postulates have never been fulfilled. In the majority of individuals, H. pylori infection is largely or entirely asymptomatic and there is no convincing data to suggest an increase in the prevalence of peptic ulcer disease among these subjects. An increasingly growing body of literature suggests an association between colonization by H. pylori in the stomach and a risk for developing gastric mucosa-associated lymphoid tissue (MALT), MALT lymphoma, gastric adenocarcinoma and even pancreatic adenocarcinoma. The bacterium has been implicated also in a number of extra-gastrointestinal disorders such as ischaemic heart disease, ischaemic cerebrovascular disease, atherosclerosis, and skin diseases such as rosacea, but a causal role for the bacterium is missing. Eradication of H. pylori thus seems to be a beneficial impact on human health. Various drug regimens are in use to eradicate H. pylori involving the administration of three or four drugs including bismuth compounds, metronidazole, clarithromycin, tetracyclines, amoxycillin, ranitidine, omeprazole for 1-2 weeks. The financial burden, side effects and emergence of drug resistant strains due to an increase in the use in antibiotics for H. pylori eradication therapy need further reconsideration.

Adenocarcinoma↗

PubMedDate not supplied

One year follow-up of patients after successful helicobacter pylori eradication therapy.

UNLABELLED: The aim of this study was to investigate the Helicobacter pylori (Hp) status of patients who underwent successful eradication therapy 1 year prior to the study and to evaluate their current symptoms. METHODS: all of the patients were initially evaluated by oesophago-gastro-bulboscopy and the Hp status was determined by at least two different methods [rapid urease test, histology or urea breath test (UBT)]. The Hp infection was treated with a 1-week triple therapy protocol, and the UBT was repeated 4-6 weeks later. We invited back 110 patients who had negative post-eradication UBT results 12+/-3 months prior to the study period. UBT was repeated and a questionnaire was completed about the previous and present complaints and medication. RESULTS: 80 of the 110 patients (73%) came back for the follow-up. Twenty five patients had peptic ulcer disease, 36 patients had gastritis or duodenitis without erosive lesions, and 19 patients had erosive form of gastritis or duodenitis initially. All of the patients except one in the erosive gastritis group had negative control UBT 1 year after the eradication, which means 1.25% recurrence rate within 1 year. The eradication therapy completely revealed the symptoms of 16 patients in the ulcer group (64%), 13 patients in the gastroduodenitis group (36%, P=0.03 vs. ulcer patients), 10 patients with erosive gastroduodenitis (52%), but this was only temporary. One year after the eradication therapy seven of the ulcer patients (28%), 11 patients with gastroduodenitis (31%) and seven patients with erosive gastroduodenitis (37%) were symptom-free. Most of the patients had epigastric pain (44%), heartburn (43%) and/or abdominal distension (33%). Nine ulcer patients (36%), 10 patients with gastroduodenitis (28%) and five patients with erosive gastroduodenitis (26%) were taking H(2)-blockers regularly. CONCLUSION: the 1-month post-eradication UBT was probable true negative in all of the evaluated cases, since 79 patients (98.75%) were also negative after 1 year. The Hp recurrence rate is very low (1.25%) in a 1-year period. The symptoms were relieved shortly after eradication therapy in the majority of patients with ulcer disease or erosive lesions. However, significantly smaller portion of the patients with gastroduodenitis became symptom-free. Only about one third of the treated patients remained symptom-free 1 year after the eradication.

Adult↗