[Diagnosis and treatment of Helicobacter pylori infection in pediatrics: recommendation for 2014 clinical practice]. / Diagnosi e terapia dell'infezione da Helicobacter pylori in pediatria: raccomandazioni per la pratica clinica del 2014.

Helicobacter pylori (H. pylori) infection is a large worldwide infection usually acquired during childhood, whose prevalence in pediatric population varies, with lower incidence rates in developed countries compared to developing countries (up to 10-15% and 70%, respectively). Diagnosis can be performed both with endoscopic-based methods and noninvasive diagnostic tests, such as urea breath test and fecal antigen. Current guidelines recommend endoscopic evaluation of the young patients, in order to determine the underlying cause of abdominal pain. Even in case of suspected functional pain, patient should not be investigated for infection, unless upper endoscopy is performed to rule out organic causes. Nowadays, in pediatric population, applications of noninvasive tests are limited to verifying eradication after therapy and to investigating the presence of infection in asymptomatic patients with first-degree relatives affected by gastric cancer. Since correlation between abdominal pain and H. pylori gastritis, in absence of peptic ulcer disease is still debated, "test and treat" strategy is not recommended in children. As for adults, treatment regimens are based on the combination of proton-pump inhibitor and two or more antibiotics, for 7-14 days, depending on resistance rates of geographic areas.

Helicobacter pylori infection and diabetes mellitus: the 2013 state of art.

It is well-known the role of Helicobacter pylori (H. pylori) infection in the development of gastroduodenal diseases. From two decades literature has suggested the potential relationship of the bacterium with extragastric manifestations. Aim of the present review was to analyze the consistency of a potential involvement of H. pylori infection in the pathogenesis of diabetes mellitus (DM) as well as in the gastric abnormalities associated with this disease. Several studies reported a higher prevalence of H. pylori infection in diabetic patients with or without dyspeptic symptoms than in controls and a positive association with insulin resistance (IR) has been shown. However, DM has a multifactorial pathogenesis and the detection of the role of each agent is difficult. The different factors implicated in the development of DM as well as of IR include inflammation, autoimmunuty, stimulation of innate immune system, trigger to platelet activation and platelet-leukocyte aggregation, action on leptin and ghrelin regulation, alterated lipid metabolism and insulin sensitivity. Effectiveness of H. pylori eradication results significantly lower in diabetic patients than in controls, most likely because of the large use of antibiotic in DM subjects, causing selection of resistant H. pylori strains. Finally, re-infection after bacterial eradication, although rarely observed in the general population, seems to be more frequent in diabetic patients than in controls.

Therapy of staphylococcal infections in monkeys. IV. Further comparison of triacetyloleandomycin and erythromycins.

Intravenous inoculation of a penicillin-resistant, phage type 80/81 staphylococcus caused lethal infection in 8 of 15 untreated monkeys. Daily intragastric administration of 50 mg/kg of triacetyloleandomycin, erythromycin estolate, and erythromycin ethylsuccinate was followed by mortalities of 0 of 16, 3 of 16, and 3 of 10, respectively. At dose levels of 25 and 12.5 mg/kg, none of 7 and 4 of 7 receiving triacetyloleandomycin and erythromycin estolate, respectively, died, as compared to 3 of 4 deaths in controls. In vitro sensitivity data and serum antibacterial levels would suggest that triacetyloleandomycin would be the least effective therapeutically. However, this prediction was not fulfilled in these studies of experimental infections in monkeys wherein triacetyloleandomycin was a very effective antimicrobial agent.