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Biomedical subjects

G Börsch

Publications and source records attributed to G Börsch.

At least 73 records · Page 4Linked to original sources
PubMed1992

Two weeks treatment with amoxicillin/omeprazole for eradication of Helicobacter pylori.

In an open study, 62 patients with Helicobacter pylori-associated ulcer disease or functional dyspepsia were treated for two weeks with 2 x 20 mg omeprazole preprandially and 4 x 500 mg amoxicillin suspension one hour before meals and at night. 57 patients (active ulcer disease: n = 53, functional dyspepsia: n = 4) completed the study without contravening the protocol. The rate of eradication of the bacteria at least 4 weeks after cessation of study medication was 82.5% (47/57 patients). Three patients experienced side effects during the treatment period (stomatitis, self-limiting diarrhea, allergic exanthema). In one case allergic exanthema led to discontinuation of therapy. 11 patients with H. pylori-associated ulcer disease received 2 x 20 mg omeprazole for two weeks. In this group no eradication of bacteria was observed.

Amoxicillin↗
PubMed1991

[Diagnosis of Helicobacter pylori colonization of the gastric mucosa. A prospective comparative study of direct test methods and validation of a new urease test].

A prospective study including 119 patients submitted for routine endoscopy of the upper gastrointestinal tract was initiated to compare three commercial biopsy urease tests with regard to sensitivity and specificity in detecting Helicobacter pylori colonization of the gastric mucosa and their reaction velocity. Specific culture, microscopy after staining with methylene-blue, histologic search after modified Giemsa staining and the combined results of culture and histology ("true standard") served as reference methods. The sensitivity and specificity of all three tests were high: Angass urease test 92.0%/97.7%, Telen-Quick test 94.7%/100%, CLO-test 94.7%/100% (analysis of one antrum and one body biopsy in a single test kit). Telen-Quick and CLO-tests reacted faster than the Angass urease test, but a period of 24 hours was necessary for all three tests to detect "true negatives". Histology and microscopy were reliable reference methods concerning sensitivity and specificity, while culture was characterized by inferior sensitivity (78.6%) and high specificity (100%).

Adolescent↗
PubMed1991

[Endoscopic laser therapy. Indications, effectiveness and cost analysis in a medical department].

Between June 1985 and December 1988, 297 endoscopic laser procedures were performed in 130 patients. The indications comprised hemostasis, coagulation of potentially bleeding lesions, palliative tumor therapy in the upper and lower gastrointestinal tract and in the tracheobronchial tree, eradication of adenomas after incomplete snare resection, and recanalization of benign esophageal/cardiac strictures and postoperative colonic stenoses. In addition, an endoscopically introduced biliary endoprosthesis was shortened. Treatment was highly effective, and the complication rate less than 1%. The average operating cost of the laser equipment was DM 80 per application, increasing to 430 DM when account was taken of the high purchasing price of the laser.

Cost-Benefit Analysis↗
PubMed1991

Chronic active gastritis after eradication of Campylobacter (now: Helicobacter) pylori. Results of a medium term follow-up study.

11 patients with C.p.-associated chronic gastritis underwent a triple therapy with bismuth-subsalicylate, amoxicillin susp. and metronidazole. The C.p.-status and the inflammation parameters "polymorphonuclear leucocytes in the epithelium". "polymorphonuclear leucocytes in the lamina propria", "lympho-plasmacellular infiltrate in the lamina propria", "congestion and edema of the lamina propria" and "inflammatory alteration of the epithelium" were determined semi-quantitatively in semi-thin-sections by light microscopy in the same sections. The C.p.-status was verified further by means of the CLO-test and cultures. The biopsy probes were taken before treatment, immediately after treatment, 1 month following treatment and in differing time intervals up to 9 months following treatment. Eradication of C.p. could not be attained in 2 of the patients. Spherical forms and vibrioforms of C.p. exhibiting degenerative alterations could be demonstrated by electron microscopy. Throughout the study the inflammatory parameters "intraepithelial polymorphonuclear leucocytes", "polymorphonuclear leucocytes in the lamina propria", "inflammatory alterations of the epithelium" showed concordance in their reactions. They were closely correlated with the light microscopical demonstration of C.p.-organisms in the biopsy specimens. The regression of the lympho-plasmacellular infiltrate was still incomplete after 5 months of eradication. The time relationship between the end of treatment and complete remission differed. The results of our studies suggest that C.p. was the sole etiological factor for the development of chronic active gastritis in at least 4 of the 11 patients.

Chronic Disease↗
PubMed1991

[Ciprofloxacin-omeprazole combination therapy for eradication of Helicobacter pylori].

20 H. pylori-positive patients with gastric or duodenal ulcer disease (n = 16, one with proof of gastric cancer obtained by histology) or severe non-ulcer dyspepsia (n = 4) were entered in a pilot study to examine the effect of a combination of omeprazole (40 mg) before breakfast and ciprofloxacin (2 x 500 mg) 1 hour after meals for 1 week to treat Helicobacter pylori (Hp). The eradication rate was 15% (3 out of 20 patients) 4 weeks after therapy. Ulcer healing occurred in 2 of 3 patients having eradication and 9 of 11 control patients with positive H. pylori urease test and/or culture 4 weeks after treatment. Despite some good theoretical background, this drug combination is inefficient to eradicate H. pylori and cannot be recommended for routine clinical practice. No major side effects of the therapy-regimen were observed.

Administration, Oral↗
PubMed1990

[Bowel cleansing prior to colonoscopy. A prospective, randomized, blind comparative study].

A randomized, prospective, single blind study was performed in 90 hospital inpatients to compare the effect of three different bowel preparatory regimens prior to total colonoscopy. The extend of bowel cleansing, acceptance by the patients, side effects as well as body weight, blood pressure, pulse rate and various laboratory parameters served as major assessment criteria. Peroral colonic lavage was superior to a senna preparation and a combined laxative agent with regard to the extend of bowel cleansing (p less than 0.001). The study failed to detect significant differences in terms of acceptance by the patients between the three study groups. Minor deviations were found after the combination laxative (slight decrease of serum potassium levels by 0.32 mmol/l), after the senna preparation (minimal decrease of the heart rate), and after peroral lavage (slightly less weight reduction) as compared with the other study groups, respectively. We conclude that peroral lavage is significantly more effective with regard to the extend of bowel cleansing, when compared with two other bowel preparatory regimens, which use a senna preparation or a laxative combination, respectively. Likewise, this study failed to detect significant differences in terms of acceptance by the patients.

Adult↗
PubMed1990

[Vascular anomalies as the cause of recurrent intestinal hemorrhages].

A 24-year-old patient suffered from acute intestinal haemorrhage three times within 10 years. After the last bleeding coloscopy demonstrated mesenterial varices in the terminal ileum and in the colon between the caecum and the left flexure. There were no signs of portal hypertension or obstruction of the superior mesenteric vein either by sonography or by angiography. Arteriovenous malformations of the vascular ectasia type were identified as other potential causes of haemorrhage when selective digital subtraction angiography of the superior mesenteric artery was performed segmentally in the proximal jejunum. Since the bleeding stopped spontaneously, no curative therapeutic consequences resulted from the combined vascular disorder. The patient was advised to submit to treatment immediately if bleeding recurred, to enable an angiography to be performed in the acute stage.

Acute Disease↗
PubMed1990

Gastrointestinal transit disorders in patients with insulin-treated diabetes mellitus.

Gastric emptying, mouth-to-cecum transit and whole gut transit of a solid-liquid meal were measured in 43 insulin-treated diabetics and in 30 control subjects by using scintigraphic techniques, the hydrogen breath test and stool markers. In the diabetics various parameters including duration of diabetes, gastrointestinal symptoms and complications such as autonomic neuropathy, peripheral neuropathy and proteinuria were determined and related to gastrointestinal transit times. Gastric emptying was significantly prolonged in diabetics as compared to the control group (p less than 0.05) with 35% of the diabetics disclosing abnormally delayed gastric emptying, whereas no significant overall differences were observed between diabetics and controls concerning mouth-to-cecum transit and whole gut transit time. However, abnormally prolonged mouth-to-cecum transit was detected in 23% and delayed whole gut transit in 26% of the diabetics (p less than 0.02 as compared to the control group). There was a significant correlation of dyspeptic symptoms and diarrhea with prolonged gastric emptying (p less than 0.001). Gastric emptying, but not mouth-to-cecum transit or whole gut transit was significantly related to autonomic nerve dysfunction (p less than 0.001) and peripheral neuropathy (p less than 0.02). Furthermore, gastric emptying and WGT were significantly correlated to proteinuria (p less than 0.03). Using a linear regression model, autonomic neuropathy, diarrhea and dyspeptic symptoms were the major parameters in predicting delayed gastric emptying. It is concluded that in diabetics different compartments of the gut are affected by gastrointestinal motor abnormalities and that these segments are probably regulated by independent or different control mechanisms.

Adult↗
PubMed1989

[Laser therapy of the lower gastrointestinal tract. A report of experiences].

In the years 1985 to 1988, 15 patients with advanced rectal or rectosigmoidal tumors causing stenosis or bleeding were submitted to palliative Neodymium-YAG laser therapy. In addition, twelve patients with remnant adenomas after endoscopic polypectomy and three patients with benign strictures were treated to attempt cure. Stenosis and bleeding could be effectively treated in all cases. Three patients developed unmanageable tumor recurrences and eventually had to undergo colostomy after a mean lag period of seven months (1.6 to 8.8 months). Mean survival time presently is 6.3 months. Of the tumor patients, five are still alive. Ten out of twelve remnant colorectal adenomas could be eradicated by additional laser treatment. There was one recurrence. Two patients did not attend to follow-ups. All three anastomotic strictures could be recanalized by laser treatment. Two of these three patients later developed recurrences, which could likewise be effectively managed by repeated laser application. There were no treatment-associated complications in these patients. Our results give additional confirmation, that ND-YAG lasers are effective for the palliative treatment of tumor stenoses and tumor bleeding of the rectal and rectosigmoidal area and also may be a valuable therapeutic modality for benign strictures and remnant adenomas in selected patients.

Adult↗
PubMed1989

[Serous (microcystic) pancreatic adenoma].

Microcystic pancreatic adenoma is an extremely rare tumor, arising in exocrine pancreatic tissue, which may lead to severe abdominal pain. To date malignant transformation has not been reported. There is a conspicuous, statistically significant, association of microcystic pancreatic adenoma with various other diseases. This report describes a 57 year-old woman with associated clinical signs of scleroderma. Therapeutic modalities are primarily aimed at complete removal of the tumor, which may--depending on the localisation--require major pancreatic resections.

Adenoma↗