Various clinical studies indicated a lower prevalence of HP infection in HIV patients. The present study was initiated to determine whether the decreased frequency of HP infections in HIV patients might be associated with the stage of the underlying HIV disease or concomitant drug regimens the patients had received. 60 randomly selected HIV outpatients were stratified according to the stage of their HIV infection (CDC classification), their CD4 cell count and to the drug regimens they were given. Within these subgroups of patients, HP infection prevalence was separately investigated by serological and C13 breath testing. Data were compared to a reference population of 30 healthy volunteers. No difference in HP infection prevalence was found between the HIV infected patients in general and the reference cohort. A significantly lower proportion of HP infected individuals was observed among those HIV patients who had AIDS-defining diseases. Furthermore, a substantial but insignificant decrease of HP infection prevalence was noted in HIV patients with an extensive decline of CD4 cell count (< 100/microl). HIV patients who had received antimicrobial or H2-antagonizing drugs within 12 months prior to the study commencement also were found to have a remarkably decreased frequency of HP infections independently of their CD4 cell count. No association between HP infection prevalence and patients age, sex, risk group and the type of their antiretroviral treatment was found.We concluded from these results that the decreased HP infection prevalence in HIV patients may, apart from frequent antibiotic treatment, be correlated to the stage of HIV-mediated immune suppression.

Systemic mast cell disease often becomes clinically manifest as a mast cell mediator activation syndrome with episodic or chronic nonspecific abdominal symptoms. As a result of genetic alterations, pathological mast cells have an increased proliferation rate as well as accumulation within different organs with consequential effect on gastrointestinal secretion, absorption, pain perception and motility caused by release of their mediators. These changes may not be detected in routine laboratory or imaging methods. This report describes how the diagnosis systemic mast cell disease can be established with a diagnostic questionnaire based on a synopsis of clinical findings relevant to a mast cell mediator activation syndrome.

Erst die Einführung der endoskopischen Papillotomie (EPT) ermöglichte die Entwicklung der endoskopischen retrograden Cholangiopankreatographie (ERCP) von einem rein diagnostischen Verfahren zu einer Methode mit vielfältigen therapeutischen Möglichkeiten. Zum einen ist die elektive endoskopische Extraktion von Gallengangskonkrementen mit oder ohne vorherige Zerkleinerung in den meisten Fallen möglich geworden, zum anderen eignet sich die ERCP zur notfallmäβigen Therapie von steinbedingten Komplikationen (biliäre Pankreatitis, Cholangitis). In der palliativen Therapie maligner Gallengangsstenosen hat die Implantation von Kunststoff- oder Metallprothesen (Stents) einen festen Platz. Sie hat in den meisten Fallen die früher praktizierte externe Ableitung abgelöst. Gutartige Stenosen (Strikturen) nach operativen Eingriffen im Oberbauch (laparoskopische Cholezystektomie) oder Anastomoseninsuffizienzen nach Lebertransplantationen sind weitere Indikationen zur endoskopischen Intervention an den Gallenwegen, meist zur Implantation extrahierbarer Kunststoff-Stents.

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