Papers by RICARDO CORREA BARBUTI
Gastroenterology, 2009
Introduction: Refractory GERD describes those patients who continue to have symptoms despite trea... more Introduction: Refractory GERD describes those patients who continue to have symptoms despite treatment with proton-pump inhibitors (PPI)1. The participation of eosinophilic esophagitis (EE) in the refractory GERD has been scarcely studied. When both disorders are simultaneously present, the clinical, endoscopic and histologic findings may be nonspecific and as such the overlap of refractory GERD and EE has been matter of debate. Aim: To study the occurrence of EE in patients with refractory GERD. Methods: Upper digestive endoscopies (UDE) were performed, obtaining mucosal biopsies of distal, middle and lower esophagus and stomach (body and antrum) in 97 adult consecutive patients. Erosive esophagitis was classified according to Los Angeles classification. Seventy three (75.3%) were female, with mean age of 44,4 (+ 9.09) of years. Eighty seven patients (89.6%) were submitted to esophageal manometry and pHmetry. The patients (82, 84%) have been receiving high doses of PPI (40 mg omeprazol b.i.d.) for at least 6 weeks. The main complaint was heartburn and regurgitation. The diagnosis of GERD was based on UDE and pHmetry. The diagnosis of EE was based on the presence of ≥20 eosinophils per high power field (eo/hpf) in the esophageal biopsies. Results: UDE was normal in 78 patients (81%). Erosive esophagitis (grade A in 9, B in 2 and C in 2 of LA) was found in 13 (13%) patients. All the others 6 (6%) were classified as non-erosive esophagitis (NERD). One patient ( 1 %) presented > 20 eo/hpf. In 25 (27.8%) patients the pHmetry was altered during PPI treatment (80 mg/day). The manometry showed hypomotility before the treatment for EE and, inespecific motor disturbances after the decreasing of eosinophils post the appropriate treatment. Conclusions: There was a very low prevalence of EE in patients with refractory GERD. (1) Spechler SNat Clin Pract Gastroenterol Hepatol, 2007
Arquivos De Gastroenterologia, 2020
Journal of Allergy and Clinical Immunology, 2015
Manifestações gastrintestinais
O acometimento esofágico por doenças autoimunes tem sido cada vez mais reportado na literatura. A... more O acometimento esofágico por doenças autoimunes tem sido cada vez mais reportado na literatura. A incidência e a prevalência de esofagite eosinofílica têm aumentado nas últimas décadas e as opções terapêuticas têm evoluído bastante, mas o corticoide tópico e o uso de inibidores de bombas de prótons permanecem como excelentes opções terapêuticas. Diversas doenças sistêmicas autoimunes podem cursar com acometimento esofágico secundário, com prejuízos da motilidade do corpo esofágico e do esfíncter esofagiano inferior. Esse acometimento se traduz principalmente em disfagia e refluxo gastroesofágico patológico, com suas complicações associadas. Atenção deve ser dada ao tratamento da doença do refluxo gastroesofágico nesses pacientes, de tal forma a melhorar a qualidade de vida e evitar complicações, como esôfago de Barrett e estenoses pépticas. Unitermos: esclerose sistêmica; esofagite eosinofílica; manometria; disfagia; refluxo gastroesofágico.
The American Journal of Gastroenterology, 2005
OBJECTIVE: Patients with primary head and neck cancer show a predisposition to develop esophageal... more OBJECTIVE: Patients with primary head and neck cancer show a predisposition to develop esophageal cancer. The aim of this study was to investigate in these patients: the prevalence of esophageal cancer comparing the value of chromoendoscopy using Lugol's solution examination to standard endoscopy, in the early diagnosis of esophageal cancer. METHODS: Prospective observational study at a state general university hospital in Sao Paulo, Brazil. 326 consecutive adult patients with primary head and neck cancer were evaluated. A standard endoscopy was performed, followed by a 2% lugol's dye spray chromoendoscopy and histopathologic study. The prevalence of esophageal cancer was defined. The results of the two endoscopic methods were compared. RESULTS: Twenty-four patients with esophageal cancer and high-grade intraepithelial neoplasia were detected and had a prevalence of 7.36%. Chromoendoscopy and standard endoscopy were equivalent to the diagnosis of advanced and invasive esophageal cancer. However, standard endoscopy diagnosed 55% of high-grade intraepithelial neoplasia, in comparison to chromoendoscopy that detected 100%. CONCLUSIONS: Patients with primary head and neck cancer should be considered as high risks for the presence of esophageal cancer. Lugol's dye chromoendoscopy diagnosed high-grade intraepithelial neoplasia, which went unnoticed with standard endoscopy. It permits a more exact detection of lesion boundaries and facilitates a more precise targeting of biopsy fragments.
Foram estudados 83 pacientes com esofagite erosiva graus I e II, pela classificação de Savary-Mil... more Foram estudados 83 pacientes com esofagite erosiva graus I e II, pela classificação de Savary-Miller modificada, divididos em 3 grupos. Um sem Helicobacter pylori, dois outros com Helicobacter pylori, com e sem o gene cagA. Avaliou-se a participação da bactéria e de seu gene cagA, associados à estudo histopatológico de antro e corpo e à gastrinemia basal, na cicatrização da mucosa do esôfago após tratamento com pantoprazol 40 mg ao dia por 6 semanas. Verificou-se que a presença do Helicobacter pylori, independentemente da presença do gene cagA, facilita a cicatrização esofágica. Indivíduos com gastrinemias maiores também tendem a cicatrizar melhor. Não houve relação do resultado do estudo histopatológico com a resposta terapêuticaEighty three patients with grade I-II of the modified Savary-Miller classification have been studied. They were divided in three groups. One without Helicobacter pylori infection, two with the bacterium, one with and other without the cagA gene. We verified...
Arquivos de Gastroenterologia
Background Chronic idiopathic constipation (CIC) is a condition that widely affects the global po... more Background Chronic idiopathic constipation (CIC) is a condition that widely affects the global population, represents relevant healthcare resource utilization and costs, and impacts the individual’s well-being. Objective To review the consensus of expert societies and published guidelines on the diagnosis and treatment of CIC in adults, seeking to assist reasoning and decision-making for medical management of patients with CIC and provide a practical reference material. Methods A Brazilian medical task force searched the scientific literature in the following electronic databases: MEDLINE/PubMed, SciELO, EMBASE and Cochrane, using the following descriptors: chronic constipation, diagnosis, management of chronic constipation. In addition, a review of articles on the mechanism of action, safety, and efficacy of therapeutic options available in Brazil was carried out. Results The diagnostic approach and the understanding of the pathophysiology present in CIC are essential items to indi...
PURPOSE: Many of the currently used eradication regimens against Helicobacter pylori fail to cure... more PURPOSE: Many of the currently used eradication regimens against Helicobacter pylori fail to cure the infection either due to antimicrobial resistance or to poor patient compliance. The infection leads to increased risk of developing potentially severe complications, such as gastric cancer. This study was aimed at assessing the efficacy and safety of a quadruple therapy with furazolidone for H. pylori retreatment. METHODS: Patients who had failed one or more eradication regimens against H. pylori infection underwent upper gastrointestinal endoscopy. Biopsy specimens were taken from the gastric antrum and corpus for histology and for a urease test and. Patients received omeprazole 20 mg, bismuth citrate 240 mg, tetracycline 500 mg, and furazolidone 200 mg, all twice daily for 7 days. Therapeutic success was evaluated by endoscopy and biopsies 8 weeks after the end of treatment. RESULTS: Sixty two patients were enrolled, and 58 completed the study. Under this protocol, H. pylori eradi...
doi:10.3748/wjg.14.6224 © 2008 The WJG Press. All rights reserved. Quadruple therapy with furazol... more doi:10.3748/wjg.14.6224 © 2008 The WJG Press. All rights reserved. Quadruple therapy with furazolidone for retreatment in
Journal of Infection in Developing Countries, Nov 24, 2010
The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line trea... more The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients. This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes. Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor fo...
Background: Increasing resistance to clarithromycin and nitroimidazole is the main cause of failu... more Background: Increasing resistance to clarithromycin and nitroimidazole is the main cause of failure in the Helicobacter pylori eradication. The ideal retreatment regimen remains unclear, especially in developing countries, where the infection presents high prevalence and resistance to antibiotics. The study aimed at determining the efficacy, compliance and adverse effects of a regimen that included furazolidone, levofloxacin and lansoprazole in patients with persistent Helicobacter pylori infection, who had failed to respond to at least one prior eradication treatment regimen. 3. It would be helpful to include the following in the results section of the abstract: “Compared to furazolidone-naïve patients, eradication rates were inferior in those who had failed prior furazolidone-containing regimen(s) (74% vs. 100%, p=0.002)” We included in results section the data concerning the furazolidone previous use: ! "! #$ ! ! ! %! & ' ( "! ) (**! # + , + ! (**! .* **% Gratitude ...
Arquivos de Gastroenterologia
BACKGROUND: The intestinal microbiota influences the appropriate function of the gastrointestinal... more BACKGROUND: The intestinal microbiota influences the appropriate function of the gastrointestinal tract. Intestinal dysbiosis may be associated with a higher risk of esophageal lesions, mainly due to changes in gastroesophageal motility patterns, elevation of intra-abdominal pressure, and increased frequency of transient relaxation of the lower esophageal sphincter. OBJECTIVE: The aim of this study was to evaluate the intestinal microbiota in individuals with erosive esophagitis and in healthy individuals using metagenomics. METHODS: A total of 22 fecal samples from adults aged between 18 and 60 years were included. Eleven individuals had esophagitis (eight men and three women) and 11 were healthy controls (10 men and one woman). The individuals were instructed to collect and store fecal material into a tube containing guanidine solution. The DNA of the microbiota was extracted from each fecal samples and PCR amplification was performed using primers for the V4 region of the 16S rRN...
Revista da Associação Médica Brasileira (English Edition), 2012
Nycomed, and Medley; received speaker fees sponsored by AstraZeneca and Nycomed; received financi... more Nycomed, and Medley; received speaker fees sponsored by AstraZeneca and Nycomed; received financial support for organizing educational activities sponsored by Nycomed, Aché and AstraZeneca. Rezende Filho J received speaker fees sponsored by Nycomed. Mion O received speaker fees sponsored by AstraZeneca. Stelmach R received speaker fees; financial support to organize teaching activities and to perform research; and consulting fees sponsored by AstraZeneca, Aché, Bayer Shering Plough, Boerhinger-Inghelhein, Eurofarma, Glaxo-Smith Kline, Novartis and Mantercorpe. Barbut RC received speaker fees; financial support to organize teaching activities and to perform research; and consulting fees sponsored by AstraZeneca, Aché and Medley. Dantas RO received speaker fees sponsored by AstraZeneca. Zaterka S received financial support for teaching and consulting activities sponsored by Jansen-Cilag. Navarro T received speaker fees; financial support for teaching and consulting activities, and performed research sponsored by AstraZeneca.
Arquivos de Gastroenterologia
BACKGROUND: Electrogastrography (EGG) is a noninvasive technique for the assessment of gastric my... more BACKGROUND: Electrogastrography (EGG) is a noninvasive technique for the assessment of gastric myoelectrical activity using electrodes placed on the abdominal surface. Changes in gastric myoelectrical activity may be associated with diseases such as gastroparesis, functional dyspepsia, nausea, and recurrent vomiting. In Brazil, no studies to date have assessed gastric myoelectrical activity using multichannel EGG in healthy individuals. OBJECTIVE: To establish normal values of transcutaneous multichannel EGG in healthy Brazilian individuals. METHODS: This was a prospective study including 20 healthy individuals who underwent EGG. Recording was performed during two periods: a preprandial recording was performed for 30 minutes, and a postprandial recording was performed for 30 minutes after a soft-solid meal of 400 kcal (20 grams of proteins, 60 grams of carbohydrates, and 9 grams of fat). RESULTS: We assessed dominant frequency (DF) parameters, %DF distribution, the instability coeff...
Arquivos de Gastroenterologia
Over the last years, there is growing evidence that microorganisms are involved in the maintenanc... more Over the last years, there is growing evidence that microorganisms are involved in the maintenance of our health and are related to various diseases, both intestinal and extraintestinal. Changes in the gut microbiota appears to be a key element in the pathogenesis of hepatic and gastrointestinal disorders, including non-alcoholic fatty liver disease, alcoholic liver disease, liver cirrhosis, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile - associated diarrhea. In 2019, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Nucleus for the Study of Helicobacter Pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG) sponsored a joint meeting on gut microbiota and the use of prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to provide practical information about this topic, addressing the lates...
Arquivos de gastroenterologia, Jan 16, 2018
Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori ... more Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders...
Ged Gastroenterol Endosc Dig, Apr 1, 2011
Rbm Rev Bras Med, Jul 1, 2003
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Papers by RICARDO CORREA BARBUTI