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Hospital de Órbigo, Spain

Dolz Abadia C.,Servicio de Aparato Digestivo
Gastroenterologia y Hepatologia

Obesity is highly prevalent in many developed and developing countries and is on the increase. The range of obese patients suitable for endoscopic treatment may be very broad. The most widely applied treatment in Spain and elsewhere in Europe is the Allergan intragastric balloon. The effectiveness of this technique is good in the short-term but suboptimal in the long term and its safety profile is high. However, severe complications may occur and consequently the indication and implantation of this technique should not be trivialized. In addition, there are distinct endoscopic devices that help patients lose weight, through distinct mechanisms of action, but these devices are currently under technological development and awaiting scientific validation. It is too soon to recommend these techniques and they should only be evaluated in the context of clinical trials. © 2012 Elsevier España, S.L. and AEEH y AEG. Source

Rivera Irigoin R.,Servicio de Aparato Digestivo
Gastroenterologia y Hepatologia

Given the liver's multiple synthetic, regulatory and detoxifying functions, one of the characteristics accompanying severe hepatocellular dysfunction is the presence of malnutrition. This disorder is highly frequent in liver cirrhosis, even in the relatively early stages of the disease. Independently of the cause of the cirrhosis, poor nutritional status is associated with a worse prognosis and therefore early intervention to correct nutrient deficiency can prolong life expectancy, improve quality of life, reduce complications and increase the probability of successful transplantation. The present article reviews current knowledge of the diagnosis and management of malnutrition in patients with cirrhosis. Special attention is paid to the concept of the late evening snack and its characteristics, composition and probable benefits in the course of the disease. © 2012 Elsevier España, S.L. and AEEH y AEG. Source

Introduction: Triple therapy, which remains the standard treatment for Helicobacter pylori infection, should be discouraged when its efficacy is lower than 80% or when clarithromycin resistance rates are above 15-20%. Aim: To update the available evidence on the effectiveness of triple therapy and clarithromycin resistance rates in adults in Spain over the last 6 years. Methods: A literature search (2007-2012) was conducted in Medline and the abstracts books of the annual meetings of several Spanish gastroenterological and microbiological congresses. The search terms were «Helicobacter pylori», «Spain» and «clarithromycin». Studies were selected if they included triple therapy consisting of a proton pump inhibitor with clarithromycin and amoxicillin or if they analyzed H. pylori clarithromycin susceptibility in treatment-naïve patients. Results: There were five articles and nine abstracts (3147 patients) on triple therapy, which showed a mean cure rate of 70.8% (95% CI = 66-76%). When stratified by the duration of therapy, the mean cure rates were 68.8% (60-76%) for 7-day regimens and 71.76% (68-78%) for 10-day regimens. For clarithromycin resistance rates, four articles and five abstracts (1709 patients) revealed a mean resistance rate of 18.3% (13-22%). Conclusions: The efficacy of triple therapy seems to be unacceptable in recent studies conducted in Spain, possibly associated with clarithromcyin resistance rates higher than previously reported. © 2013 Elsevier España, S.L. and AEEH y AEG. Source

Ber Nieto Y.,Servicio de Aparato Digestivo

Peptic ulcer disease (PUD) is a common problem, it consists in defects in the gastrointestinal mucosa that extend through the muscularis mucosae. Most ulcers occur when the normal mechanisms are disrupted by superimposed processes such as Helicobacter pylori infection and the ingestion of nonsteroidal anti-inflammatory (NSAI) drugs. Since the introduction of proton-pump inhibitors, cyclo-oxygenase-2-selective anti-inflammatory drugs and eradication of Helicobacter pylori infection, the incidence of PUD has decreased. This article reviews the etiology, clinical manifestations, diagnosis and treatment of peptic ulcer. Source

Peptic ulcer (PUD) is a defect in the gastrointestinal mucosa, and is an important cause of morbidity and health care costs. The natural history of PUD ranges from resolution without intervention to the development of complications such as bleeding, obstruction, perforation and penetration. The two principal factors to development PUD are the infection to Helicobacter pylori (HP) and the intake of nonsteroid-antiinflammatory drugs (NSAIDs). The principal treatment is the mucosal healing (treatment with proton pump inhibitors-PPI-) and to eliminate the risk factors (to erradicate HP and the interruption of NSAIDs). In case of complicated PUD, the stabilization of patient is the principal target, later depending of the complication choose to medical, endoscopy and/or surgical treatment. This protocol review the treatment of uncomplicated and complicated PUD. Source

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