[Recurring duodenal ulcer. Evaluation of previous complications as a predictive factor of ulcer recurrence after eradication of Helicobacter pylori].

Duodenal ulcer is a chronic disease, punctuated by acute relapses. The pathogenic mechanism in 90-100% of cases is infection by Helicobacter pylori. Two major strains exist of this bacterium: I strain, which secretes a vacuolating cytotoxin (Vac-A), and another protein named cytotoxin-associated (Cag-A) and type II strain, unable to produce both proteins and unable to produce duodenal pathology.

Management of duodenal ulcer disease in the era of H. pylori.

Background: Today it is expected that the great majority of patients with duodenal ulcer (DU) respond to H. pylori eradication treatment without DU recurrence. The aim of the research is to identify patients who need a different therapeutic approach and the best management of their disease.

[Indications and limitations of 24-hour gastric pH-metry. Personal experience].

After a brief introduction regarding 24-hours gastric pH monitoring and a description of the instruments used, indications and the analysis of findings, the authors report their personal experience based on the study of 4 groups of subjects (healthy, hyersecretory, hyposecretory, dyspeptic). The analysis of pH-metries observed in these subjects show that 24-hour monitoring of gastric pH is a reliable method for assessing hypersecretion or hyposecretion of gastric acidity, whereas it is only of relative importance in essential dyspepsia. The authors therefore indicate the parameters to be taken into account in the evaluation of pH-metry findings in hypersecretory patients: 1) the percentage time of which pH is less than 1 (mean value 46.

Different effects of atropine and cimetropium bromide on gastric emptying of liquids and antroduodenal motor activity in man.

Atropine (1 mg intravenously) and a new antimuscarinic compound, cimetropium bromide (5 mg intravenously), as well as placebo (physiological saline) were tested for their effects on gastric emptying and antroduodenal motility in healthy humans. In a first single-blind cross-over study, the emptying rate was assessed in 12 subjects by measuring paracetamol absorption. In a second single-blind parallel-group study, antroduodenal motor activity was measured in 20 subjects through four perfused open tip catheters with orifices positioned in the antroduodenal region.

Biliary reflux after cholecystectomy: a prospective study.

The authors carried out a prospective study to ascertain whether cholecystectomy itself might be the cause of duodenogastric reflux. Patients with cholelithiasis were examined and underwent the following tests: hemanalysis, gastroscopy with biopsy, 24 hour pH-metry and acetaminophen test. Twelve patients were selected.

[Treatment of recurrences of duodenal ulcer: seasonal or long-term therapy?].

Many recently published papers have focused on the problem of the treatment of recurring duodenal ulcers and time trends, given the rate of late recurrences observed with long-term protocol. The results of trials with seasonal protocols are therefore presented. Given the seasonal trends in duodenal ulcer recurrence, a stable oscillatory behaviour with fluctuations of 6-month periodicity was demonstrated with the use of conventional statistical methods.

Monthly fluctuations of active duodenal ulcers.

In an attempt to verify whether the periodicity of ulcer-related symptoms would be confirmed by a spring and fall exacerbation of peptic ulcers, we have analyzed the monthly variation of active duodenal ulcers found at endoscopy of the upper gastrointestinal tract in the years 1979-1981. Control diagnoses were active gastric ulcers, gastric and rectal adenocarcinomas, and rheumatoid arthritis. Data were also available on hospital admission for perforated ulcers.