The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Raluca Anica Ionescu

Raluca Anica Ionescu

Treatment of Helicobacter Pylori – an Overview of Current Strategies of Diagnostic and Treatment

Helicobacter Pylori infection, responsible for ulcerous disease, atrophic gastritis,gastric cancer and MALT lymphoma (mucosa-associated lymphoid tissue) has a very high prevalence in the general population (approximately 50%). In Romania there are few data related to the prevalence of Helicobacter Pylori infection, as well as the resistance to antibiotic treatment, and the methods of patient surveillance are limited by costs and low accessibility. The aim of our paper is to recall the current possibilities of treatment and supervision of this category of patients, taking into account that the appropiate treatment and good monitoring of the patient can cure the complications of the disease and may prevent the occurrence of malignancies.

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Endoscopic Procedures In Patients Taking Novel Oral Anticoagulants

The use of direct oral anticoagulants (DOAC) for the treatment of atrial fibrillation and prevention of strokes is encouraged by their superior properties compared to vitamin K antagonists: predictable anticoagulant effect, greater patient compliance, few drug interactions, low risk of intracranial hemorrhages. Although practicing gastroenterologists may never prescribe a DOAC, they are likely to encounter DOAC-related GI adverse events (gastrointestinal bleeding), and they will need to manage DOACs around the time of endoscopy. The present paper aims to present the management possibilities of the patient treated with DOAC undergoing endoscopy, most studies performed so far focusing on the risk of spontaneous bleeding in this category of subjects. The current guidelines provided by the British Society of Gastroenterology and the European Society of Gastrointestinal Endoscopy orientate us, but endoscopic maneuvers should be preceded by a detailed analysis of the risks of secondary bleeding and thrombosis associated with DOAC users.

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