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BMC Pediatrics Jul 2023Gastric non-Helicobacter pylori helicobacters (NHPH) naturally colonize the stomach of animals. In humans, infection with these bacteria is associated with chronic...
BACKGROUND
Gastric non-Helicobacter pylori helicobacters (NHPH) naturally colonize the stomach of animals. In humans, infection with these bacteria is associated with chronic active gastritis, peptic ulceration and MALT-lymphoma. H. bizzozeronii belongs to these NHPH and its prevalence in children is unknown.
CASE PRESENTATION
This case report describes for the first time a NHPH infection in a 20-month-old girl with severe gastric disorders in Mexico. The patient suffered from melena, epigastric pain, and bloating. Gastroscopy showed presence of a Hiatus Hill grade I, a hemorrhagic gastropathy in the fundus and gastric body, and a Forrest class III ulcer in the fundus. Histopathologic examination revealed a chronic active gastritis with presence of long, spiral-shaped bacilli in the glandular lumen. Biopsies from antrum, body and incisure were negative for presence of H. pylori by culture and PCR, while all biopsies were positive for presence of H. bizzozeronii by PCR. Most likely, infection occurred through intense contact with the family dog. The patient received a triple therapy consisting of a proton pump inhibitor, clarithromycin, and amoxicillin for 14 days, completed with sucralfate for 6 weeks, resulting in the disappearance of her complaints.
CONCLUSION
The eradication could not be confirmed, although it was suggested by clear improvement of symptoms. This case report further emphasizes the zoonotic importance of NHPH. It can be advised to routinely check for presence of both H. pylori and NHPH in human patients with gastric complains.
Topics: Child; Female; Humans; Animals; Dogs; Infant; Mexico; Helicobacter; Helicobacter Infections; Stomach Diseases; Gastritis; Helicobacter pylori
PubMed: 37454059
DOI: 10.1186/s12887-023-04142-7 -
Laryngoscope Investigative... Oct 2023To study the effectiveness of Sucralfate suspension oral rinse compared to normal saline alone for pain reduction and wound healing promotion in open oral surgical...
OBJECTIVES
To study the effectiveness of Sucralfate suspension oral rinse compared to normal saline alone for pain reduction and wound healing promotion in open oral surgical wounds. The primary outcome of this study was postoperative pain VAS score reduction. The secondary outcome was wound healing promotion based on wound grade and maximal wound length reduction.
MATERIALS AND METHODS
A total of 30 patients with secondary healing intraoral surgical wounds were enrolled in this study. Sucralfate suspension (1 g/5 mL) was prescribed to a randomized experimental group as an oral rinse every 6 h for 14 days in addition to standard postoperative care. Postoperative pain VAS score, wound grade, and wound length were collected and compared with baseline from initial to final visit during 2 weeks.
RESULTS
The mean change of VAS score was significantly lower from baseline in the Sucralfate group on day 3 (-0.77 in control and -2.15 in Sucralfate, < .05) and day 7 (-2.15 in control and -3.62 in Sucralfate, < .05). Wound grade distribution over time was the same in both Sucralfate and control groups. The mean change in wound length was not significantly different between the two groups. No adverse reaction to Sucralfate was reported during the study participation.
CONCLUSIONS
Sucralfate suspension oral rinse can be recommended as an effective topical analgesic solution in postoperative secondary healing of intraoral wounds with no significant interference. The benefits of wound healing promotion have yet to be proven.
LEVEL OF EVIDENCE
1b.
PubMed: 37899873
DOI: 10.1002/lio2.1146 -
Inflammopharmacology Dec 2022Gastroprotective is an effect caused by the compounds that have the capability of protecting the gastric mucosa. Peperomia pellucida L. plants contain alkaloids,...
Gastroprotective is an effect caused by the compounds that have the capability of protecting the gastric mucosa. Peperomia pellucida L. plants contain alkaloids, flavonoids, saponins, tannins, and terpenoids, while Pachyrhizus erosus L. contains flavonoids, alkaloids, tannins, and saponins. Peperomia pellucida L. reportedly contains dillapiole compounds with a gastroprotective effect. Moreover, its isolation result from Pachyrhizus erosus L. indicates the presence of dulcitol, gentisic acid, and formononetin, which has antioxidant activity. This study aims to determine the gastroprotective effect of the combination of Peperomia pellucida L. and Pachyrhizus erosus L. extract on rats with gastric ulcer models by looking at the ulcer index, percentage of inhibition, and histopathology. The research method used in this study was by making a combination of Peperomia pellucida L. and Pachyrhizus erosus L. extract. The combined extract was then given to five treatment groups. Group I as a negative control, group II as a positive control was given sucralfate, groups III, IV, and V were given a combination of Peperomia pellucida L. and Pachyrhizus erosus L. extract of 100, 200, and 400 mg/kg BW. The treatment was given orally for 14 days, after 1 h of treatment on the 14th day, 96% ethanol induction was given orally at a dose of 5 mg/kg BW. The animal dissection was performed 24 h after the induction. The results from observations showed an increase in body weight before and after the treatment. The ulcer index produced by negative control, positive control in the treatment with doses of 100, 200, and 400 were 4.18; 2.98; 2.42; 2.04; and 1.07. This study showed that the combination of Peperomia pellucida L. and Pachyrhizus erosus L. extract has a gastroprotective effect.
Topics: Rats; Animals; Peperomia; Pachyrhizus; Ethanol; Ulcer; Plant Extracts; Tannins; Flavonoids; Saponins; Anti-Ulcer Agents
PubMed: 35467241
DOI: 10.1007/s10787-022-00982-4 -
Annali Italiani Di Chirurgia 2022Black esophagus, or acute esophageal necrosis, is a rare entity with multifactorial aetiology. Modern theories suggest a combination of ischemia, compromised mucosa... (Review)
Review
AIM
Black esophagus, or acute esophageal necrosis, is a rare entity with multifactorial aetiology. Modern theories suggest a combination of ischemia, compromised mucosa defences and corrosive agent's injury.
MATERIAL AND METHODS
We investigated black esophagus by means of a retrospective review of 26 cases in literature. A Medline overview is performed until May 2021 by considering the Italian results. The search terms were "black esophageal syndrome in Italy", "black esophagus in Italy", "black esophageal necrosis in Italy", and "Gurvits syndrome in Italy". To complete these case reports, we illustrate our first experience of the syndrome successfully treated with esophagectomy, cervical diversion and gastrostomy.
RESULTS
Black esophagus is common in adult males (M/F: 21/5) (Range: 47-89 years; Average: 70.6 year-old). The most common symptoms are hematemesis, epigastric pain and dysphagia. Endoscopically, diffuse involvement of acute esophageal necrosis is diagnosed in 42.3% of cases. The treatment consisted on red blood cell transfusions, sucralfate administration, proton pump-inhibition, enteral nutrition and antimicrobial agents. Overall mortality was 38.4% and only one case underwent surgery for acute bleeding.
CONCLUSIONS
Black esophagus is often reversible both anatomically and functionally. Its treatment is based on supported therapies and hemodynamic resuscitation. This syndrome shows high mortality related to the coexisted medical conditions rather than acute esophageal necrosis. Only in selected cases, surgical treatment is indicated.
KEY WORDS
Acute necrotizing esophagitis, Black esophagus, Ischemia.
Topics: Adult; Aged; Humans; Male; Acute Disease; Esophageal Diseases; Esophagitis; Ischemia; Necrosis
PubMed: 36625078
DOI: No ID Found -
Pediatric Critical Care Medicine : a... Feb 2020To describe current stress ulcer prophylaxis practice in Canadian PICUs. (Observational Study)
Observational Study
OBJECTIVE
To describe current stress ulcer prophylaxis practice in Canadian PICUs.
DESIGN
Multicenter cohort study. We defined stress ulcer prophylaxis as the use of a proton-pump inhibitor, histamine-2 receptor antagonist, or sucralfate within the first 2 PICU days among children who had not been on these medications at home and had no evidence of gastrointestinal bleeding.
SETTING
Seven PICUs in Canada.
PATIENTS
Three hundred seventy-eight children requiring mechanical ventilation.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
Children were ventilated for a median (interquartile range) of 2 days (1-6 d) and stayed in the PICU for a median (interquartile range) of 4 days (2-10 d). The median (interquartile range) age was 1.3 years (0.3-6.7 yr). Seventy percent of all children received acid suppression during their PICU stay. One hundred sixty-seven (54%) of the 309 children eligible for stress ulcer prophylaxis received it. Histamine-2 receptor antagonists were the most frequently used class (66%), followed by proton-pump inhibitors (47%) and sucralfate (4%), and 20% received more than one class. Stress ulcer prophylaxis was continued on the PICU transfer orders for 34% of these children. Children who received prophylaxis were older and had a higher Pediatric Risk of Mortality III score, more often received nonsteroidal anti-inflammatory drugs and systemic corticosteroids and received less enteral nutrition. In multivariate analysis, age and invasive mechanical ventilation were independently associated with an increased likelihood of receiving stress ulcer prophylaxis and receiving feeds was independently associated with a decreased likelihood of receiving stress ulcer prophylaxis. Gastrointestinal bleeding was reported in 21 (6%) of 378 children; three (0.8%) were clinically important. Eighteen percent were treated for a new respiratory tract infection, and 1% developed Clostridium difficile-associated diarrhea.
CONCLUSIONS
Stress ulcer prophylaxis is common in Canadian PICUs. Clinically important gastrointestinal bleeding and C. difficile-associated diarrhea are rare, and the utility of routine prophylaxis should be examined.
Topics: Anti-Ulcer Agents; Canada; Child; Child, Preschool; Cohort Studies; Critical Illness; Diarrhea; Enteral Nutrition; Female; Gastrointestinal Hemorrhage; Histamine H2 Antagonists; Humans; Infant; Intensive Care Units, Pediatric; Male; Peptic Ulcer; Proton Pump Inhibitors; Respiration, Artificial; Stress, Physiological; Sucralfate
PubMed: 31821206
DOI: 10.1097/PCC.0000000000002202 -
Turk Gogus Kalp Damar Cerrahisi Dergisi Jan 2023This study aims to compare methylprednisolone frequently used in the therapeutic practices of corrosive esophagus burns, sucralfate, a protective material of mucosal...
BACKGROUND
This study aims to compare methylprednisolone frequently used in the therapeutic practices of corrosive esophagus burns, sucralfate, a protective material of mucosal surfaces, and alpha lipoic acid, the most potent antioxidant in a rat model.
METHODS
A total of 40 female Sprague-Dawley rats were used in this study. The rats were equally divided into control, alpha lipoic acid, methylprednisolone, and sucralfate groups (n=10). A corrosive esophagus burn was created by using 10% pH:12 sodium hydroxide. No treatment was applied to the control group, and each group was given their own treatment. The treatment was continued regularly until the eighth day, when they were sacrificed. The corrosive esophagus burn lines were removed and tissue sections were stained with hematoxylin and eosin.
RESULTS
The difference in ulceration in the group treated with alpha lipoic acid was significant, compared to the other groups. The most excellent complete epithelialization and complete re-epithelialization were observed in the alpha lipoic acid group. The difference between the groups was significant, with complete re-epithelialization being the lowest in the control and methylprednisolone groups (42.9% and 12.5%, respectively) and the highest in the alpha lipoic acid group (77.8%). In terms of ulceration and re-epithelialization, comparable values were found in the alpha lipoic acid group. The main difference was that the inflammation levels in the sucralfate group were lower and more favorable than the other groups in this period. The glutathione level was significantly higher in the alpha lipoic acid group and decreased the tissue hydroxyproline level.
CONCLUSION
Alpha lipoic acid reduces esophageal ulceration, severity and prevalence of inflammation, severity and prevalence of fibrosis, decreases tissue damage by increasing blood glutathione level, and also reduces stricture in corrosive esophagus burns in rats.
PubMed: 36926144
DOI: 10.5606/tgkdc.dergisi.2023.22694 -
Annals of Emergency Medicine Sep 2021We hypothesized that sucralfate along with oral analgesics (acetaminophen or ibuprofen) administered in the emergency department leads to a clinically significant... (Randomized Controlled Trial)
Randomized Controlled Trial
STUDY HYPOTHESIS
We hypothesized that sucralfate along with oral analgesics (acetaminophen or ibuprofen) administered in the emergency department leads to a clinically significant improvement in oral intake in children with acute infectious oral ulcers.
METHODS
This was a randomized, double-blind, placebo-controlled trial of sucralfate versus placebo conducted between 2017 and 2018 in an urban pediatric emergency department. Children aged 6 months to 5 years with acute, infectious oral ulcers and poor oral intake received either acetaminophen at 15 mg/kg or ibuprofen at 10 mg/kg and were then randomized to receive sucralfate at 20 mg/kg per dose up to 1 g or a placebo solution. The primary outcome was oral fluid intake within 60 minutes of medication administration. The secondary outcomes were repeat ED visits, length of stay in ED, intravenous hydration rate, admission rate, adverse event rate, and emergency physician's determination of the adequacy of oral intake.
RESULTS
One hundred subjects with mild dehydration (clinical dehydration score of 1) and a median age of 1.38 years were enrolled and analyzed (49 in the sucralfate group and 51 in the placebo group). Oral intake 1 hour after drug administration was similar in both the groups: the median intake in the sucralfate group was 9.7 mL/kg and 10.7 mL/kg in the placebo group (difference -1 mL/kg; 95% confidence interval [CI] -2.0 to 4.8). According to the emergency physician's report, the secondary outcomes were significant only for adequate oral intake: 71% in the sucralfate group versus 88% in the placebo group (difference -16.8%; 95% CI -32.2 to -1.4).
CONCLUSION
Sucralfate as an adjunct to oral analgesics was not superior to placebo in improving oral intake in children with acute oral infectious ulcers.
Topics: Administration, Oral; Analgesics, Non-Narcotic; Anti-Ulcer Agents; Child, Preschool; Dehydration; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Infant; Male; Oral Ulcer; Sucralfate
PubMed: 33867179
DOI: 10.1016/j.annemergmed.2021.01.019 -
Annali Italiani Di Chirurgia 2020Chronic radiation proctitis is a frequent complication after radiotherapy for pelvic malignancies. It is reported that 1 to 5% of patients develop chronic radiation... (Review)
Review
Chronic radiation proctitis is a frequent complication after radiotherapy for pelvic malignancies. It is reported that 1 to 5% of patients develop chronic radiation proctitis even with recent advances in external radiotherapy. Hematochezia, mucus discharge, urgency and tenesmus are common symptoms and they can vary in severity but bleeding is often the most debilitating to the patient. Different options are reported for treatment of this condition that always should keep in differential diagnosis in patients with history of pelvic radiotherapy. Treatments range from easy, with topic administration of formalina, to expensive and requiring specialized equipment such as hyperbaric oxygen therapy. Surgery is reserved to patients with failure of conservative treatments due to the high risk of leakage and high morbidity up to 60%. KEY WORDS: Argon beam, Bleeding, Formalin, Radiation, Proctitis, Sucralfate enema.
Topics: Enema; Gastrointestinal Hemorrhage; Humans; Pelvic Neoplasms; Proctitis; Radiation Injuries; Sucralfate; Treatment Outcome
PubMed: 33554948
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Oct 2022Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disorder. Typically, young adults are affected and it is rare in children. Straining during...
Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disorder. Typically, young adults are affected and it is rare in children. Straining during defecation, self-induced trauma and paradoxical contraction of puborectalis muscle are the major contributing factors of this condition. Clinical features of SRUS are rectal bleeding, mucorrhoea, excessive straining during defecation, tenesmus, feeling of incomplete defecation and constipation. A complete and thorough history is most important for diagnosis of SRUS. Rectal bleeding may be misinterpreted as originating from an anal fissure caused by constipation or as other causes of rectal bleeding such as a juvenile polyp. The best and most accurate diagnostic method of SRUS is rectal biopsy. The major histological feature of SRUS is fibromuscular obliteration of the lamina propria. Avoiding straining, regular toilet habit, use of bulk laxatives, steroid and sucralfate enemas are the mainstay of treatment. Biofeedback mechanism is another treatment option. Because the clinical presentation varies, the diagnosis requires a high index of suspicion for both the clinician and the pathologist.
Topics: Child; Constipation; Diagnostic Errors; Gastrointestinal Hemorrhage; Humans; Laxatives; Rectal Diseases; Steroids; Sucralfate; Ulcer; Young Adult
PubMed: 36189574
DOI: No ID Found -
Cureus Apr 2023Diabetic foot ulcer (DFU) is a major cause of lower limb amputations. Many treatment recommendations have been proposed. This study was conducted to evaluate the...
INTRODUCTION
Diabetic foot ulcer (DFU) is a major cause of lower limb amputations. Many treatment recommendations have been proposed. This study was conducted to evaluate the effectiveness of topical sucralfate when combined with mupirocin ointment, in the treatment of diabetic foot ulcer in comparison to topical mupirocin alone, in terms of healing rates.
METHODS
This open-labeled randomized study was conducted on 108 patients to evaluate the effectiveness of topical sucralfate and mupirocin combination, compared to topical mupirocin alone. The patients were administered the same parenteral antibiotic, and wounds were subjected to daily dressing. The healing rates (determined by the percentage reduction in wound area) in the two groups were calculated. The mean healing rates in both groups were expressed in percentage and compared using the Student's t-test.
RESULTS
A total of 108 patients were included in the study. Male-to-female ratio was 3:1. The incidence of diabetic foot was the highest (50.9%) in the age group of 50-59 years. The mean age of the study population was 51 years. The incidence of diabetic foot ulcers was highest in the months of July-August (42%). A total of 71.2% patients had random blood sugar levels between 150-200 mg/dL, and 72.2% patients had diabetes for five to 10 years. The mean±standard deviation (SD) of the healing rates in the sucralfate and mupirocin combination group and the control group were 16.2±7.3% and 14.5±6.6%, respectively. Comparison of the means by Student's t-test failed to show a statistical difference in healing rates between the two groups (p=0.201).
CONCLUSION
We concluded that the addition of topical sucralfate does not show any obvious benefits in terms of healing rates in diabetic foot ulcers as compared to mupirocin alone.
PubMed: 37197136
DOI: 10.7759/cureus.37570