Abstract：
OBJECTIVE:Peptic ulcers are the leading cause of upper gastrointestinal (GI) bleeding. The aim of this study was the evaluation of the recent clinical practice in drug therapy and endoscopic treatment of ulcer bleedings in Germany and to compare the results with the medical standard. METHODS:A structured questionnaire (cross-sectional study) was sent to 1371 German hospitals that provide an emergency service for upper GI bleeding. The project was designed similar to a nationwide inquiry in France in 2001. Forty-four questions concerning the following topics were asked: hospital organisation, organisation of emergency endoscopy service, endoscopic and drug therapy of ulcer bleeding, endoscopic treatment of variceal bleeding. Return of the questionnaires was closed in August 2004. RESULTS:Response rate was 675 / 1371 (49 %). Mean hospitals size was < 200 beds, 49 % (n = 325) had basic care level. 92 % provided a 24-hour endoscopy service, specialized nurses were available in 75 %. Fiberscopes were used only in 15 %. A mean of 10 +/- 12 (range: 0 - 160) bleeding cases/month were treated, 6 +/- 6 cases per month (60 %) were ulcer bleedings. Endoscopy was performed in 72 % immediately after stabilization but in all cases within 24 hours. The Forrest classification was used in 99 % whereas prognostic scores were applied only in 3 %. Forrest Ia,/Ib/IIa/IIb/IIc/III ulcers were indications for endoscopic therapy in 99 %/ 99 %/ 90 %/ 58 %/ 4 %/ 2 % respectively. Favoured initial treatment was injection (diluted epinephrine, mean volume 17 +/- 13 mL/lesion) followed by clipping. In re-bleedings, 93 % tried endoscopic treatment again. Scheduled re-endoscopy was performed in 63 %. PPI were used in 99.6 %, 85 % administered standard dose twice daily. PPI administration was changed from intravenous to oral with the end of fasting in nearly all hospitals. PPI administration schemes can be improved. Indications for Helicobacter pylori eradication followed rational principles. CONCLUSION:Medical and endoscopic treatment of bleeding ulcers reached a high standard, although some therapeutic strategies leave room for improvement. Bigger hospitals tend to be closer to the medical standard.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Maiss J,Schwab D,Ludwig A,Naegel A,Ende A,Hahn G,Zopf Ydoi
10.1055/s-0028-1109783subject
Has Abstractpub_date
2010-02-01 00:00:00pages
246-55issue
2eissn
0044-2771issn
1439-7803journal_volume
48pub_type
杂志文章abstract：:Potential therapeutic benefits of dietary n-3 fatty acids are presently evaluated in arteriosclerotic and chronic inflammatory diseases. Because some other long-chain fatty acids inhibit intestinal fluid absorption, the effects of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on fluid and electrolyte tran...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:Within the conversion of the 2nd Council Directive on Driving Licences of the Council of the European Communities (91/439/EEC) into national law, changes became necessary to the Road Traffic Act (StVG) and a new Driving Licence Ordinance (FeV) was created which has been in force since 01.01.1999 (Federal Law Gazette, ...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：10.1055/s-2002-23611
更新日期：2002-04-01 00:00:00
abstract：:The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all pat...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:We report on a 43-year-old patient presenting to the emergency department with acute abdominal pain the source of which turned out to be acute hemorrhagic jejunal infarction due to portal and mesenteric vein occlusion with no apparent cause. In spite of a lacking history of hereditary thrombophilic risk factors, furth...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：10.1055/s-2007-963528
更新日期：2008-02-01 00:00:00
abstract：:Autoimmune Hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and overlap syndromes of these three disease entities are regarded as autoimmune liver diseases. These conditions are important differential diagnoses of elevated liver function tests as about 10 % of liver transplantatio...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章,评审
doi：10.1055/s-2004-812686
更新日期：2004-01-01 00:00:00
abstract：:Even simple assay techniques for serum lipase which apply to a triolein substrate are more useful than alpha-amylase measurements in the recognition of acute and chronic relapsing pancreatitis because of the inevitable presence of alpha-amylase from parotid origin. ...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：:The growing data about new endoscopic therapies for gastroesophageal reflux disease (GERD) seem to indicate that these techniques might be effective at least in a part of patients suffering from GERD. However, up to now it is not clear which technique is the best. Randomized studies comparing the different techniques ...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章,评审
doi：10.1055/s-2003-41824
更新日期：2003-09-01 00:00:00
abstract：:Cholestasis is a combination of defined clinical, paraclinical and morphological findings of which icterus is the direct symptom. It is the consequence of the delay or detention of the bile flow. By means of light microscopy different changes can be observed in hepatic tissue: formation of biliary thrombi, intracellul...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:A 61-year-old white female with chronic hepatitis C virus (HCV) infection first diagnosed in 1994 was admitted with two newly discovered lesions in the liver suspected to represent hepatocellular carcinoma. The alpha-1-fetoprotein (AFP) level was within normal limits and there was neither clinical nor sonographic evid...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1996-05-01 00:00:00
abstract：:Squamous cell carcinomas account for more than 80 % of esophageal malignancies in Germany. Alcohol and tobacco smoke are two of the most important risk factors. In superficial esophageal squamous cell carcinoma, endoscopic mucosal resection (EMR) is a very useful and effective treatment modality. However, in patients ...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：10.1055/s-2004-813221
更新日期：2004-07-01 00:00:00
abstract：:Recent advances in our understanding of viral hepatitis involve the discovery and further characterization of the hepatitis C virus and the interferon treatment of patients with chronic viral hepatitis. Liver cirrhosis and primary hepatocellular carcinoma can develop after some years of disease. Interferon is the only...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Humoral and/or cell-mediated (CMI) immune responses to HBAg components, human and rabbit liver specific proteins (HLP and RLP) and tuberculin were tested in patients with acute virus B and non-B-hepatitis, asymptomatic HBsAg carriers and HBsAg positive chronic active hepatitis (CAH). Furthermore, the presence of HBsAg...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1976-05-01 00:00:00
abstract：:A report is given of current diagnosis and treatment of overlooked stones of the common bile duct, reviewing 81 patients seen in our hospital. Problems arise mainly in icteric and postoperatively critical patients. There is still not enough clinical experience in medical or endoscopic treatment in the disease. Therefo...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1977-02-01 00:00:00
abstract：:Severe chronic pancreatitis can be easily diagnosed by means of pancreatic function tests and/or imaging procedures, whereas the mild form of the disease or its early stages are more difficult to detect and are often only retrospectively diagnosed. The reliability of imaging procedures depends mainly on the experience...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:In a 16 years old girl we found the syndrome of exsudative enteropathy with intestinal lymphangiectasy which differs from previous reported cases by several malformations of the lymphatic system. Besides changes in the intestinal lymphatics there was a retroperitoneal lymphangiodysplasia, a reduction and hypoplasia of...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1976-12-01 00:00:00
abstract：:Recently, H. pylori has been associated with several extradigestive diseases such as cardio-vascular, cutaneous, autoimmune, allergic, liver, hematologic disorders, diabetes mellitus, pediatric diseases (sudden infant death syndrome, growth retardation), extragastric MALT-type lymphomas and even colorectal cancer. The...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章,评审
doi：10.1055/s-2001-12872
更新日期：2001-04-01 00:00:00
abstract：:Pseudomembranous colitis is a well known complication of antibiotic therapy. Only recently few cases of another form of an antibiotic-associated colitis, the acute segmental haemorrhagic penicillin-associated colitis, have been described. We report another case and point out the importance of early colonoscopy to dist...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:We describe a patient with a "cryptogenic" massive upper gastrointestinal bleeding due to a pseudoxanthoma elasticum, recognized only postoperatively. She underwent twice emergency abdominal surgery with total gastrectomy and partial jejunal resection, with a complicated postoperative course. An insufficient enteral a...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：:We conducted a retrospective study in 112 chronic alcoholics in order to evaluate the incidence of simultaneous damage of both pancreas and liver. In all patients, an endoscopic retrograde pancreaticography (ERP) and a liver biopsy were performed. 65 patients had alterations of the pancreatic ducts compatible with the...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：:There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. Retrospectively we have, therefore, analyzed 78 foreign body ingestion's in 42 patients (age 15-72 years) admitted to the Emergency Department of the Uni...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1996-03-01 00:00:00
abstract：:The phenomenon of the spontaneous parietal cell sensitivity not induced by drugs is described in a number of gastric diseases. Different parietal cell sensitivity can be assumed. 1. when there is a shift in the dose response curve between the aid output and continuous intravenous application of a stimulant, 2. when th...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1981-07-01 00:00:00
abstract：:Irritable bowel syndrome is frequently encountered in clinical practice, and it has been repeatedly suggested that abnormal colonic motor activity is one of the major pathophysiological mechanisms responsible for the origin of symptoms in such disorder. If this statement is true, then high-amplitude propagated colonic...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1998-09-01 00:00:00
abstract：:A new method of exocrine pancreatic function testing is described. After oral administration of a standard meal containing fluorescein dilaurate (FDL) metoclopramide (10 mg) and secretin (1 U/kg) are given as intravenous bolus injection. The best discrimination between normal and abnormal pancreatic function was found...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1987-04-01 00:00:00
abstract：:In a 63-year-old cirrhotic patient, recanalisation of a partial portal vein thrombosis was achieved by a low dose of rivaroxaban (10 mg daily). After anticoagulant therapy was stopped, partial vein thrombosis recurred. Restarting rivaroxaban at a dose of 10 mg led to recanalisation. The patient did not suffer any comp...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：10.1055/s-0034-1385171
更新日期：2014-10-01 00:00:00
abstract：:Until 1979 there were explored 192 surgical specimens from patients with Crohn's disease at the Institute of Pathology of the University of Hamburg. For the present study there was a follow-up examination of 161 specimens. Among these Crohn's specimens we found five (3.1%) simultaneously existing ("Crohn-associated") ...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1980-11-01 00:00:00
abstract：:About 5-10% of all bile-duct stones cannot be removed by endoscopic papillotomy and mechanic lithotripsy. Intracorporal laser lithotropsy has meanwhile become a safe technique which can be used in an endoscopic retrograde way or percutaneously transhepatically. The greatest clinical experience exists in connection wit...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:A case report is given on two patients receiving halothane anesthesia while beeing treated with isoniacid, ethambutol and rifampicin. Following halothane anesthesia, both patients developed a severe liver disease with encephalopathy grade III. We observed a moderate increase of bilirubin and SGOT and a more severe inc...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1977-08-01 00:00:00
abstract：:Junction potentials at the tip of a 0.15 M NaCl- and a 3 M KCl-flowing bridge dependent on the surrounding electrolyte solution were measured and calculated. There was a close correlation between the calculated and measured junction potentials. The magnitude of the calculated and experimentally determined junction pot...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:Budesonide is a locally acting steroid with a high first-pass metabolism in the liver and low systemic effects. We performed the first pilot study comparing budesonide foam (1 mg/50 ml b.i.d.) with mesalazine enemas (4 g/60 ml o.d.). 33 patients from 3 centres were enrolled in this open randomized clinical trial. 16 p...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1055/s-2000-14869
更新日期：2000-04-01 00:00:00
abstract：:Cholesteryl ester storage disease (CESD) is a rare, autosomal recessively inherited disorder resulting from deficient activity of lysosomal acid lipase (LAL). LAL is the key enzyme hydrolyzing cholesteryl esters and triglycerides stored in lysosomes after LDL receptor-mediated endocytosis. Mutations within the LIPA ge...
journal_title：Zeitschrift fur Gastroenterologie
pub_type： 杂志文章
doi：10.1055/s-0033-1350463
更新日期：2013-10-01 00:00:00
