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1.
Article | IMSEAR | ID: sea-227957

ABSTRACT

Background: India introduced fractional-dose inactivated poliovirus vaccine (fIPV) into its routine immunization program as part of the polio eradication and endgame strategic plan. The study aimed to assess the uptake of the 3rd dose of fIPV among eligible beneficiaries and explore the implementation challenges perceived by auxiliary nurse midwives (ANMs) at two primary healthcare centers in urban Bengaluru. Methods: A mixed-method study was conducted between April and May 2023. A cross-sectional design was used for quantitative objectives, while in-depth interviews were conducted with ANMs for qualitative insights. Data were collected through vaccination registers, questionnaires, and key informant interviews. The study population included all eligible beneficiaries for the 3rd dose of fIPV from January to March 2023. Results: Out of 296 eligible beneficiaries, 139 (47%) had received the 3rd dose of fIPV. The challenges faced by ANMs in fIPV3 implementation included difficulties in recording and reporting activities, fear of managing adverse events, lack of confidence in administering intradermal injections, obtaining consent from parents, inadequate training, and concerns about vaccine wastage and increased workload. Conclusions: The uptake of fIPV3 was suboptimal, and ANMs encountered several challenges during implementation. To enhance fIPV3 integration into the vaccination schedule, the health system needs to improve awareness among the community, strengthen health worker capacity, and provide better training and support. Strengthening routine immunization programs can contribute to sustained polio eradication efforts.

2.
Article in Chinese | WPRIM | ID: wpr-1018706

ABSTRACT

Helicobacter pylori(HP)infection is a Class Ⅰ carcinogen in gastric cancer,closely related to the occurrence of gastric cancer.Many studies have shown that HP eradication has a preventive effect on gastric cancer.However,2.7%-6.1%of patients with early gastric cancer who have been eradicated after endoscopic submucosal dissection(ESD)can still develop metachronous gastric cancer(MGC),and the mechanism of its occurrence is still unclear.In this review,the atrophy of gastric mucosa and intestinal metaplasia cannot be completely reversed after HP eradication,the excessive proliferation of gastric mucosa epithelial cells,the accumulation of genetic abnormalities,the homeostasis imbalance of the epigenetic group,changes in immune microenvironment,the abnormality of stem cells in gastric mucosa,chromatin accessibility,and changes in chromosome remodeling were discussed in the mechanism of carcinogenesis caused by the above molecular changes after ESD and HP eradication in early gastric cancer.

3.
Journal of Clinical Hepatology ; (12): 649-653, 2024.
Article in Chinese | WPRIM | ID: wpr-1016503

ABSTRACT

Hepatitis C virus (HCV) can develop into liver cirrhosis or hepatocellular carcinoma, imposing a heavy burden on the patient’s family and the society. Hepatitis C is one of the major public threats for humans, and eliminating hepatitis C is a common goal of all humans. Direct-acting antiviral agents (DAAs) are currently a relatively safe treatment regimen for hepatitis C that can reach a relatively high cure rate and can target different HCV genotypes, making it possible to eliminate HCV infection. China actively promotes the clinical application of DAAs, accelerates drug approval, improves the accessibility of DAAs, and strengthens population intervention. National Medical Insurance Administration has gradually included DAAs in the national medical insurance directory, providing strong support for eliminating HCV infection. In response to the WHO’s goal of eliminating viral hepatitis as a public health hazard by 2030, China has successively released national strategic plans and action plans in recent years, making significant achievements in HCV infection elimination, forming a joint prevention and control system across multiple sectors of the society, and ultimately achieving the goal of eliminating HCV infection. With a focus on the current status of HCV infection in China and prominent prevention and control strategies, this article analyzes and summarizes the practical process of the prevention, control, and micro-elimination of HCV infection, in order to provide a policy reference for carrying out HCV elimination in China and help to achieve the goal of comprehensive elimination of HCV infection.

4.
Journal of Clinical Hepatology ; (12): 659-664, 2024.
Article in Chinese | WPRIM | ID: wpr-1016505

ABSTRACT

The hemodialysis population is increasing year by year in China. Due to the specific nature of hemodialysis treatment, the prevalence and incidence rates of hepatitis C virus (HCV) infection in hemodialysis patients are much higher than the general population. In order to achieve the WHO’s initiative to eliminate HCV by 2030 and realize the micro-elimination of HCV in the hemodialysis population, standard infection control and hand hygiene procedures should be implemented to cut off the route of iatrogenic infection, especially to prevent the outbreak of HCV infection in hemodialysis centers. Screening for HCV infection should be conducted for patients newly admitted to the hemodialysis center or transferred to another hemodialysis center, and regular screening should be conducted for patients receiving maintenance hemodialysis to identify new HCV infections in the early stage. It is also necessary to collaborate with specialists and provide direct-acting antiviral therapy for hemodialysis patients with HCV infection.

5.
Article | IMSEAR | ID: sea-223136

ABSTRACT

Introduction: The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives: To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods: Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results: Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations: The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion: The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis

6.
Rev. Fac. Med. (Bogotá) ; 71(2): e11, Apr.-June 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1575742

ABSTRACT

Abstract Introduction: Adding probiotics to triple and quadruple therapies has been proposed to improve their effectiveness in the eradication of Helicobacter pylori, but there is controversy about their usefulness. Objective: To assess the effectiveness and safety of probiotics as adjuvants in triple or quadruple therapies for H. pylori eradication in adults. Materials and methods: Systematic review and meta-analysis. Randomized clinical trials (RCTs) assessing the effectiveness and safety of probiotics as adjuvant therapy in combination with triple and quadruple therapies for the eradication of H. pylori in adults and published in English or Spanish between January 2010 and May 2020 were searched in the Embase, Ovid Medline, Cochrane Library, and LILACS databases. Regarding the meta-analysis, a fixed-effects model was used to calculate the pooled measure (OR and RR) of the effectiveness and safety of using adjuvant probiotics in triple and quadruple therapy. Results: Twelve RCTs were included (1 091 patients in total): 9 assessed triple therapy, 2 assessed quadruple therapy, and 1 assessed both triple and quadruple therapy. In the case of triple therapy, the use of adjuvant probiotics was more effective than placebo: 79.4% vs. 71.1%, (OR=1.42; 95%CI: 1.05-2.09), but in the case of quadruple therapy, their use did not increase effectiveness. The most widely used probiotic was Lactobacillus reuteri, with an eradication rate of 77.9% (95%CI: 70.5-84.19) versus 66.8% (95%CI: 58.8-74.2) for placebo. Probiotics decreased the occurrence of adverse effects in both triple therapy (OR=0.50; 95%CI: 0.28-0.90) and quadruple therapy (OR=0.26; 95%CI: 0.09-0.74). Conclusions. Adjuvant probiotics improve the effectiveness of triple therapy to eradicate H. Pylori by 8.5%, but the final effectiveness is <90%. Furthermore, their use does not increase the effectiveness of quadruple therapy. However, the use of these microorganisms reduces the adverse effects of these therapies.


Resumen Introducción. Se ha propuesto agregar probióticos a las terapias triples y cuádruples para mejorar su efectividad en la erradicación de Helicobacter pylori, pero existe controversia sobre su utilidad. Objetivo. Evaluar la efectividad y seguridad del uso adyuvante de probióticos en la terapia triple o cuádruple para la erradicación de H. pylori en adultos. Materiales y métodos. Revisión sistemática y metaanálisis. Se realizó una búsqueda en Embase, Ovid Medline, Cochrane Library y LILACS de ensayos clínicos aleatorizados (ECA) publicados en inglés o español entre enero de 2010 y mayo de 2020 que evalúan la efectividad y seguridad de usar probióticos como terapia coadyuvante en combinación con la terapia triple o cuádruple en la erradicación de H. pylori en adultos. En el metaanálisis se utilizó un modelo de efectos fijos para calcular la medida combinada (OR y RR) de efectividad y seguridad de los probióticos coadyuvantes en terapia triple y cuádruple. Resultados: Se incluyeron 12 ECA (1 091 pacientes en total): 9 evaluaron terapia triple; 2, terapia cuádruple, y I, terapia triple y cuádruple. En la terapia triple el uso coadyuvante de probióticos fue más efectivo que el uso de placebo: 79.4% vs. 71.1% (OR=1.42; IC95%: 1.05-2.09), pero en la terapia cuádruple, su uso no aumentó la efectividad. El probiótico más utilizado fue Lactobacillus reuteri, con una tasa de curación de 77.9% (IC95%: 70.5-84.19) versus 66.8% (IC95%: 58.8-74.2) del placebo. Los probióticos disminuyeron la ocurrencia de efectos adversos tanto en terapia triple (OR=0.50; IC95%: 0.28-0.90) como en cuádruple (OR=0.26; IC95%: 0.09-0.74). Conclusiones. El uso coadyuvante de probióticos mejora la efectividad de la terapia triple para erradicar H. Pylori en un 8.5%, pero la efectividad final es <90%. Además, su uso no aumenta la efectividad de la terapia cuádruple. No obstante, el uso de estos microorganismos disminuye los efectos adversos de estas terapias.

7.
Rev. gastroenterol. Perú ; 43(2)abr. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450017

ABSTRACT

Nuestro objetivo es determinar si el tratamiento para Helicobacter pylori (HP) con doxiciclina, furazolidona, bismuto y un inhibidor de bomba de protones mantiene su efectividad en nuestra población. Se realizó un estudio retrospectivo, no aleatorio, realizado en una clínica privada de Lima, Perú. Se obtuvo la información de la historia clínica digital. Se incluyó a pacientes con el diagnóstico de infección por HP por biopsia y/o test rápido de la ureasa, obtenidos al realizar una endoscopía entre enero 2017 a octubre 2022. Debían haber recibido el tratamiento cuádruple en estudio o un esquema triple alternativo con amoxicilina, levofloxacino e inhibidor de bomba de protones y tener una prueba de aliento para HP en el lapso de 1 a 6 meses después del tratamiento. El esquema cuádruple con furazolidona logró la erradicación en 117/122 casos (95,9%) mientras que el triple con levofloxacino en 5/16 (31,2%) cuando se usó por 7 dias y en 22/38 (57,9%) cuando se usó por 10 días, siendo las diferencias altamente significativas (p>0,001). En conclusión, el tratamiento cuádruple con furazolidona mostró alta efectividad, mientras que el triple con levofloxacino no alcanzó niveles aceptables.


Our objective is to determine the effectiveness of a therapeutic regimen for helicobacter pylori that includes a proton pump inhibitor, doxycycline, furazolidone and bismuth in our location. We carried out a retrospective study, non-randomized, in a private hospital in Lima, Peru. Patients with biopsy and/or rapid urease test proven helicobacter pylori infection after an endoscopy, from January 2017 to October 2022 were included. They received the therapeutic regimen of the study or an alternative triple regimen with a proton pump inhibitor, amoxicillin and levofloxacin and were followed with a urea breath test within 1 to 6 months upon completion of therapy. The quadruple therapy with furazolidone obtained success in 117/122 cases (95.9%) while the triple therapy with levofloxacin only in 5/16 (31.2%) when used for 7 days and 22/38 (57.9%) when used for 10 days, a statistically significant difference with p<0.001. Conclusion: Quadruple therapy with furazolidone reached high effectiveness in our location, while triple therapy with levofloxacin was not an acceptable alternative.

8.
Acta méd. costarric ; 65(1): 21-25, ene.-mar. 2023. graf
Article in Spanish | LILACS, SaludCR | ID: biblio-1527609

ABSTRACT

Resumen Objetivo: Este estudio tiene como objetivo principal determinar la respuesta al esquema de tratamiento de primera línea con triple terapia estándar (amoxicilina, claritromicina, omeprazol), para erradicación de Helicobacter pylori en una determinada población, para determinar si este esquema propuesto en guías internacionales es aún una opción adecuada para pacientes en una determinada región de Costa Rica. Métodos: Se realizó una búsqueda en el servicio de gastroenterología del Hospital San Francisco de Asís, Grecia, Alajuela, Costa Rica; de todos los pacientes con infección por Helicobacter pylori y que recibieron tratamiento de primera línea con triple terapia (amoxicilina, claritromicina y omeprazol) por 14 días, en el periodo comprendido entre febrero 2017 a febrero 2019, incluyendo para el análisis solamente en los que se contaba con una prueba confirmatoria posterior a tratamiento, ya fuera por antígeno fecal de H. pylori o biopsia convencional. Resultados: Se identificaron un total de 369 casos. El diagnóstico se realizó con biopsia en el 96,4% de los pacientes. La respuesta al tratamiento de primera línea se alcanzó en un 90.5% corroborada por antígeno fecal en el 92.1% de los casos. Conclusiones: Este estudio muestra que la terapia triple con amoxicilina, claritromicina e Inhibidor de bomba de protones por 14 días mantiene un adecuado nivel de eficacia. Sin embargo, hay que tomar en cuenta que estos datos son únicamente de un área de atracción determinada y puede que no reflejen la realidad de todo el país.


Abstract Aim: The main objective of this study is to determine the response to the firstline treatment regimen with triple standard therapy (amoxicillin, clarithromycin, omeprazole), to eradicate Helicobacter pylori in a certain population. The goal is to determine if the proposed regimen in international guidelines services is still a suitable option for patients in a certain region of Costa Rica. Methods: The study took place in San Francisco de Asís Hospital, Grecia, Alajuela, Costa Rica. All patients with a Helicobacter pylori infection that were given first- line treatment with triple therapy (amoxicillin, clarithromycin and omeprazole) for its eradication for 14 days, in the period between February of 2017 and February of 2019, were included in the study. Results: A total of 369 cases were identified. The diagnosis was made with biopsy in 96.4% of patients. Response to first-line treatment was achieved in 90.5% corroborated by fecal antigen in 92.1% of all cases. Conclusions: This study shows that triple therapy with amoxicillin, clarithromycin and omeprazole for 14 days maintains an adequate level of efficacy. However, it must be considered that these results are from a specific area and may not reflect the reality of the entire country.


Subject(s)
Humans , Male , Female , Omeprazole/therapeutic use , Helicobacter pylori/drug effects , Helicobacter Infections/epidemiology , Clarithromycin/therapeutic use , Amoxicillin/therapeutic use , Costa Rica , Drug Resistance, Bacterial
9.
Article in Chinese | WPRIM | ID: wpr-994760

ABSTRACT

Objective:To analyze the efficacy and cost-effectiveness of probiotics in initial Helicobacter pylori ( H. pylori) eradication therapy. Methods:A total of 267 patients with positive H. pylori infection were randomly assigned to two groups, the control group ( n=133) received a 14-day bismuth agent quadruple therapy and the study group ( n=144) received conventional quadruple therapy plus probiotics from January 2020 to August 2021. Eradication status was assessed 4-12 weeks after treatment. The H.pylori eradication rate, adverse reactions, and cost-effectiveness were compared between the two groups. Results:The H.pylori eradication rate was higher in study group than that in the control group in intention-to-treat (ITT) (80.6%(108/134), 95% CI:73.8%-87.4% vs. 68.4%(91/133), 95% CI:60.4%-76.4%, P=0.022) and per-protocol (83.1%(108/130), 95% CI:76.5%-89.6% vs. 72.2%(91/126), 95% CI:64.3%-80.2%, P=0.037). The incidence of adverse effects in the study group was lower than that in the control group (8.2%(11/134) vs. 18.8%(25/133), χ 2=6.415, P=0.011). Cost-effectiveness analysis showed that compared with the control group, the incremental cost-effectiveness ratio (ICER) of the study group was 1 010.49 yuan. The single factor sensitivity analysis showed that the H.pylori eradication rate of the study group had a greater impact on the results, followed by that of the control group and the cost of bifidobacterium quadruplex viable tablets. The probability sensitivity analysis showed that when the willingness to pay value (WTP) was 2 500 yuan, the probability that the probiotics combined with the bismuth agent quadruple therapy group was more cost-effective than the simple bismuth agent quadruple therapy group was 91.2%. Conclusion:As initial Helicobacter pylori treatment, probiotics combined with the bismuth agent quadruple scheme has a higher eradication rate and a lower incidence of adverse events than the bismuth agent quadruple scheme.

10.
Article in Chinese | WPRIM | ID: wpr-996426

ABSTRACT

Objective To analyze the epidemiological characteristics and risk factors of gastric cancer after eradication of ( Helicobacter pylori , Hp) in Fuzhou area, to provide a theoretical basis for reducing the incidence and mortality of gastric cancer after eradication of Hp, and to provide effective suggestions for the prevention of gastric cancer in residents in Fuzhou. Methods A total of 699 patients with Hp eradication admitted to our hospital from January 2020 to December 2020 were selected. According to whether the patients had gastric cancer after eradication, they were divided into control group (no gastric cancer) and observation group (gastric cancer). The serum levels of tumor markers including CEA, CA125 and CA199 were detected and compared between the two groups. Clinical data of the two groups, including age, sex, family history of gastric cancer, course of Hp infection, open atrophy, severe atrophy of gastric mucosa, presence of intestinal metaplasia (IM) of gastric mucosa, xanxoma of gastric mucosa, and long-term use of proton pump inhibitors (PPIs), were analyzed using the self-made survey scale in our hospital. Univariate analysis and logistic regression were used to analyze the risk factors for gastric cancer after Hp eradication. Results Among of 699 patients with Hp eradication, 48 cases (6.96%) developed gastric cancer, including 29 male cases and 19 female cases. The incidence rate of males was significantly higher than that of females (P3 years between the two groups (P3 years (OR=3.631) were independent risk factors for gastric cancer after Hp eradication (P<0.05). Conclusion There is a high risk of gastric cancer after HP eradication in Fuzhou, mainly in elderly male patients, especially in patients with IM, severe atrophy of gastric mucosa and long-term use of PPIs, often accompanied by elevated levels of tumor markers. Close gastroscopy follow-up examination must be conducted within 4 to 5 years after Hp eradication, which is helpful for screening high-risk groups of gastric cancer, preventing gastric cancer and treating gastric cancer as early as possible after Hp eradication.

11.
Yao Xue Xue Bao ; (12): 2623-2631, 2023.
Article in Chinese | WPRIM | ID: wpr-999025

ABSTRACT

Bacterial biofilm widely exists in all kinds of bacteria, and is related to about 80 percent of bacterial infections. It is one of the main reasons for bacterial tolerance and resistance to existing antibiotics. Therefore, there is unmet clinical need for new anti-biofilm drugs. At present, there are three kinds of anti-biofilm agents under research, including biofilm inhibitors, biofilm dispersal agents and biofilm eradication agents. Among them, the biofilm eradication agent is unique, which can not only kill bacteria in biofilm but also eliminate biofilm as a monotherapy. Based on modifications of natural products with antibacterial activity, a variety of compounds with biofilm eradicating activities have been obtained, such as, acyldepsipeptides, pyrrolomycins, halogenated phenazines and halogenated 8-hydroxyquinolines. In this review, we summarize several major biofilm eradication agents above according to their structures and mechanisms.

12.
Article in Chinese | WPRIM | ID: wpr-1016013

ABSTRACT

The sixth national consensus conference on the management of Helicobacter pylori (Hp) infection organized by Helicobacter pylori Study Group of Chinese Society of Gastroenterology was held at Nanchang, Jiangxi Province on December 17, 2021. Experts in the field of Hp research and gastroenterology attended the meeting and several consensus preparatory groups were established to draft the related statements. The level of evidence was evaluated using the 2011 Oxford Centre for Evidence⁃Based Medicine Levels of Evidence. The strength of recommendation was graded by GRADE (grading of recommendations assessment, development, and evaluation) system. The Delphi method using an anonymous electronic system was adopted to develop the consensus of relevant statements. The statements initially reached a consensus were discussed repeatedly in the conference and the experts voted for the final consensus. The consensus contents contained a total of 30 statements and were divided into 4 parts, including: (a) diagnosis of Hp infection, (b) indications for Hp eradication, (c) Hp and gastric cancer, and (d) Hp and gastrointestinal microbiota.

13.
Acta Pharmaceutica Sinica B ; (6): 284-297, 2023.
Article in English | WPRIM | ID: wpr-971682

ABSTRACT

Biofilms are closely associated with the tough healing and dysfunctional inflammation of chronic wounds. Photothermal therapy (PTT) emerged as a suitable alternative which could destroy the structure of biofilms with local physical heat. However, the efficacy of PTT is limited because the excessive hyperthermia could damage surrounding tissues. Besides, the difficult reserve and delivery of photothermal agents makes PTT hard to eradicate biofilms as expectation. Herein, we present a GelMA-EGF/Gelatin-MPDA-LZM bilayer hydrogel dressing to perform lysozyme-enhanced PTT for biofilms eradication and a further acceleration to the repair of chronic wounds. Gelatin was used as inner layer hydrogel to reserve lysozyme (LZM) loaded mesoporous polydopamine (MPDA) (MPDA-LZM) nanoparticles, which could rapidly liquefy while temperature rising so as to achieve a bulk release of nanoparticles. MPDA-LZM nanoparticles serve as photothermal agents with antibacterial capability, could deeply penetrate and destroy biofilms. In addition, the outer layer hydrogel consisted of gelatin methacryloyl (GelMA) and epidermal growth factor (EGF) promoted wound healing and tissue regeneration. It displayed remarkable efficacy on alleviating infection and accelerating wound healing in vivo. Overall, the innovative therapeutic strategy we came up with has significant effect on biofilms eradication and shows promising application in promoting the repair of clinical chronic wounds.

14.
Article in English | WPRIM | ID: wpr-984324

ABSTRACT

Background@#Helicobacter pylori is acknowledged to cause chronic gastritis and peptic ulcer disease and is also implicated in gastric carcinoma and B cell mucosa-associated lymphoid tissue (MALT) lymphoma development. It has infected at least half of the world’s population. Proton Pump Inhibitors (PPIs) have been the conventional antacid of choice for H. pylori eradication triple therapy, while vonoprazan is a novel drug of its class that was recently studied but is limited to an oral form which makes it less feasible in cases of acute gastrointestinal bleeding. According to several systematic reviews and meta-analyses, the vonoprazan-based triple therapy regimen for H. pylori eradication is a non-inferior treatment to traditional PPI-based treatment when given in 1 week for patients having no active gastrointestinal bleeding. Likewise, a safety profile has been established with its use, offering an alternative treatment option.@*Objectives@#The research aims to identify the H. pylori eradication rate among H. pylori-positive patients who received a vonoprazan-based triple therapy regimen as outpatients, describe their clinicodemographic profile, and identify potential side effects associated with the treatment.@*Methods@#This study utilized a cross-sectional study design in a single tertiary institution from January 2018 to December 2020. Descriptive and inferential statistics were used in data analysis. Frequency and percentage were utilized to determine the success and failure rates of H. pylori eradication, describe the clinicodemographic profile of patients who underwent vonoprazan-based triple therapy, and the potential side effects with treatment. The chi-square test of independence was applied to assess the significant difference in the successful and failed eradication rates across the clinicodemographic profile. A P-value of <0.05 was considered statistically significant, and statistical analyses were conducted using SPSS version 20.0.@*Results@#32 (91%) had successful H. pylori eradication, with the majority of them determined by a negative 13C-UBT result (62.8%) and the rest with a negative H. pylori stool antigen test (28.6%). The majority of patients undergoing H. pylori eradication using a vonoprazan-based regimen with documented successful eradication belonged to the 19 to 39 years old group (50%), clerical support workers (40.63%), with a chief complaint of abdominal pain (46.88%), with no known co- morbid illness (75%), and with endoscopic finding limited to antral gastritis alone (46.88%). This study described only two documented side effects of treatment: diarrhea and abdominal pain (2.9%).@*Conclusion@#Vonoprazan-based triple therapy, given at 20 mg twice daily for 7 days, has shown a high H. pylori eradication rate among hemodynamically stable patients, without active bleeding, and treated on an outpatient basis. There was a significant difference in eradication success and failure across co-morbidities, with a higher success rate in those without co-morbid illness. A high success rate was also seen in patients <40 years of age, with a single chief complaint, and with antral gastritis as the sole endoscopic finding.


Subject(s)
Helicobacter pylori
15.
China Pharmacy ; (12): 613-619, 2023.
Article in Chinese | WPRIM | ID: wpr-964775

ABSTRACT

OBJECTIVE To systematically evaluate the efficacy and safety of vonoprazan (VPZ) for Helicobacter pylori (Hp) eradication therapy. METHODS Retrieved from The Cochrane Library, Embase, PubMed, CNKI, VIP and Wanfang database, randomized controlled trials about VPZ for Hp eradication therapy (trial group) versus proton pump inhibitor (PPI) (control group) were collected during the inception to July 2022. After data extraction and quality evaluation with bias risk assessment tool recommended by Cochrane System Evaluation Manual 5.1.0, meta-analysis was performed by using RevMan5.3 software. RESULTS Nine studies with 2 134 patients were included. Compared with control group, the overall Hp eradication rate of trial group increased significantly in either the ITT analysis or PP analysis, being 87.5% vs. 76.2% [RR=1.14, 95%CI (1.06,1.21), P<0.001] and 92.4% vs. 80.5% [RR=1.11, 95%CI (1.03,1.21), P<0.01], respectively. According to ITT and PP analysis of primary treatment subgroup, compared with control group, the overall Hp eradication rate of trial group increased significantly, being 88.4% vs. 76.5% [RR=1.15, 95%CI (1.09,1.22), P<0.000 01] and 92.8% vs. 80.9% [RR=1.12, 95%CI(1.03,1.23), P< 0.05]; according to ITT and PP analysis of rescue therapy subgroup, there was no significant difference in the overall Hp eradication rate between control group and trial group (P>0.05). According to ITT and PP analysis of triple therapy subgroup, compared with control group, overall Hp eradication rate of trial group increased significantly, being 88.3% vs. 75.6% [RR=1.16, 95%CI (1.08, 1.25), P<0.000 1] and 92.6% vs. 77.6% [RR=1.15, 95%CI (1.04, 1.28), P<0.01]; according to ITT and PP analysis of quadruple therapy subgroup, there was no significant difference in the overall Hp eradication rate between control group and trial group (P>0.05). Compared with control group, the incidence of adverse events in trial group decreased significantly, being 34.2% vs. 40.9% [RR=0.84, 95%CI(0.70,0.99), P< 0.05]. There was no statistical significance in the incidence of serious adverse events between 2 groups (P>0.05). CONCLUSIONS Compared with PPI therapy, the efficacy of VPZ-based triple therapy is better, particularly in primary treatment patients. However, VPZ has no significant advantage in rescue treatment and bismuth-containing quadruple regimen. And the safety and tolerance of VPZ for Hp eradication therapy are well, even better than PPI.

16.
Rev. Anesth.-Réanim. Med. Urg. Toxicol. ; 15(1): 35-40, 2023. tables, figures
Article in French | AIM | ID: biblio-1438316

ABSTRACT

Introduction: La ligature des varices œsophagiennes constitue un des piliers de la prise en charge de l'hémorragie digestive par rupture des varices œsophagiennes. Cette étude a pour objectif d'analyser la tolérance et l'efficacité de la ligature des varices œsophagiennes dans un échantillon de patients au Centre Hospitalier Universitaire Andrainjato Fianarantsoa, Madagascar. Méthodes: Une étude prospective, observationnelle longitudinale sur une période de 21 mois (mois de janvier 2018 au mois d'août 2019) a été réalisée. Le test de Khi carré a été utilisé pour déterminer les corrélations (SPSS® v22). Résultats : Trente-et-un patients à prédominance masculine (sex ratio 1,5), âgés de 43,0 ± 9,0 ans, ont été retenus et 67 séances de ligatures de varices œsophagiennes ont été effectuées. La prophylaxie secondaire était l'indication de la ligature dans 96,8 % (n = 30) des cas. Les varices œsophagiennes étaient de grade III dans 64,4 % (n = 20) des cas. Toutes les ligatures ont été réalisées sous anesthésie générale. Le nombre de bandes élastiques utilisées était de 3,4 ± 1,1. La bonne tolérance de la ligature élastique était de 97,0 % (n = 65) lors de la procédure et de 58,0 % (n = 39) en post-procédure. La douleur thoracique post-procédure était observée dans 65,7 % (n = 44) des cas. L'éradication était obtenue après 3 séances dans 6,45 % (n = 2) des cas et 58,1 % (n = 18) étaient en cours d'éradication après 1,7 ± 0,9 séances. Conclusion : Cette étude a pu déterminer que la ligature des varices œsophagiennes est une technique bien tolérée et efficace dans la prévention de l'hémorragie digestive par rupture des varices œsophagiennes malgré certains inconvénients postopératoires


Subject(s)
Humans , Effectiveness , Esophageal and Gastric Varices , Esophageal Diseases , Disease Eradication , Gastrointestinal Diseases , Hypertension, Portal
17.
Pan Afr. med. j ; 45(2 Suppl.)2023.
Article in English | AIM | ID: biblio-1524092

ABSTRACT

Introduction: following the spread of the COVID-19 pandemic to Nigeria, the Federal Government of Nigeria restricted human and vehicular movements to curb the spread of the disease. This action had a negative impact on Acute Flaccid Paralysis (AFP) surveillance, with a resultant reduction in the number of AFP cases reported. This paper describes the impact of the COVID-19 pandemic on poliovirus surveillance in Nigeria and the proactive interventions by Nigeria´s polio program to mitigate the impact of COVID-19 on polio surveillance. Methods: nine innovative strategies were implemented in all 774 Local Government Areas (LGA) of the 36 states and Federal Capital Territory (FCT) of the country. These strategies were developed by the national surveillance officers and operationalized by sub-national surveillance officers with different strategies starting at different epidemiological weeks from week 14 to 23, 2020. Many of the strategy innovations were technology-based and included: the use of mobile phones to send the AFP case definition and video by WhatsApp or by SMS, the use of state-specific toll-free numbers and Mobile Telephone Network (MTN) (mobile service provider) CallerfeelTM to community informants (CI) who were the main targets of the interventions to increase case detection and reporting. Others included the use of abridged e-surveillance integrated supportive supervision (ISS) checklists, virtual monthly DSNO meetings, and batched AFP stool specimen transportation network. Results: compared to the same period in 2019, the cumulative rate of AFP case detection and reporting had gradually declined from 39.1% in January to 16.7% before the commencement of the interventions in week 20, 2020. However, the detection and reporting increased by 57.% from week 20 to week 47 compared to the same period in 2019. This is because with COVID-19, hospital visitation dropped, and the sick remained in the communities, so the CI network was relied on to detect and report AFP cases. The cumulative proportion of AFP cases reported by community informants as of week 47 increased from 13% in 2018 to 21% in 2020. This indicates an increase of 38%. Thirty-five AFP cases were detected and reported using the MTN Caller Feel strategy, while 15 cases were reported through state-specific toll-free numbers. Conclusion: the implementation of the innovative strategies was able to mitigate the low AFP case detection and reporting observed at the initial stage of the COVID-19 pandemic. The use of technology facilitated reaching the CI network, which was more instrumental in detecting and reporting the cases.


Subject(s)
Poliomyelitis , COVID-19 , Creativity
18.
Biomédica (Bogotá) ; Biomédica (Bogotá);42(2): 264-277, ene.-jun. 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1403580

ABSTRACT

Introducción. A mediados de la década de 1950, el país adoptó e implementó la Campaña de Erradicación de la Malaria (CEM), sin que hasta ahora se haya hecho su evaluación. Objetivo. Evaluar los resultados alcanzados en las fases de ataque y consolidación de la campaña de erradicación de la malaria en Colombia, entre 1959 y 1979. Materiales y métodos. Se hizo un estudio descriptivo y retrospectivo de los resultados "malariométricos" y operacionales de la CEM en Colombia entre 1959 y 1979 a partir de los datos recopilados de los archivos del Ministerio de Salud Pública. Se utilizaron los criterios establecidos por la Organización Mundial de la Salud (OMS) relacionados con las fases de un programa de erradicación de malaria. Se almacenó, tabuló y analizó la información, y se elaboraron y aplicaron indicadores malariométricos. Resultados. En el periodo de erradicación a corto plazo (1959-1969), durante el primer año de la fase de ataque (1959), se alcanzó una reducción de la transmisión del 94 % (4.172) y, en el último año (1962), una disminución del 88 % (8.426) en la carga acumulada de casos comparada con el promedio anual de la década del 50 (71.031); estos bajos niveles de transmisión se mantuvieron hasta finales de 1969. En el periodo de intensificación del control para la erradicación (1970-1979), se produjo un incremento de la endemia y resurgió la transmisión epidémica. Debido a problemas financieros que afectaron la regularidad de la operación para mantener los resultados, y no habiéndose logrado la interrupción de la transmisión, se observó un resurgimiento de casos en las fases de ataque y consolidación. Conclusiones. La campaña no logró la meta de interrupción de la transmisión de la malaria en el territorio nacional, pero sí se consiguió un acentuado control en áreas de mediana y baja intensidad.


Introduction: In the mid-fifties, Colombia adopted and implemented the Malaria Eradication Campaign (MEC), which has not been evaluated yet in the country. Objective: To evaluate the results achieved during the attack and consolidation phases of the MEC regarding malaria transmission in Colombia between 1959 and 1979. Materials and methods: We conducted a descriptive and retrospective study based on the malariometric and operational results of the MEC in Colombia from 1959 to 1979 compiled from the archives of the Ministry of Public Health. We used the criteria defined by the WHO Expert Committee on Malaria. The information was stored, tabulated, and analyzed based on the malariometric indicators we developed. Results: In the short-term eradication period (1959-1969), a reduction of 94% (4,172) in transmission was achieved during the first year of the attack phase (1959) while in the last year (1962), there was an 88% (8,426) reduction of the accumulated load of cases compared to the annual average of the 1950s (71,031). These low levels of transmission were maintained until the end of 1969. During the intensification period of control of the eradication (1970-1979), there was an increase in malaria endemicity and a resurgence of the epidemic transmission. Due to financial problems affecting the regularity of the operations, Colombia was unable to sustain the results and achieve an interruption of transmission, which resulted in a resurgence of cases during the attack and consolidation phases. Conclusions: The campaign did not achieve the goal of interrupting malaria transmission in the national territory but there was marked control in areas of medium and low intensity.


Subject(s)
Disease Eradication , Malaria , Mosquito Control , Epidemiology , Colombia , History
19.
J. bras. nefrol ; 44(1): 109-111, Jan-Mar. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365022

ABSTRACT

Abstract Infection by the hepatitis C virus is more prevalent in patients on dialysis than in the general population in Brazil, and has been associated with worse outcomes. Current therapy for hepatitis C is highly effective, safe, and widely available in Brazil, with coverage provided to dialysis patients with chronic kidney disease, which makes the elimination of hepatitis C a viable target. The Brazilian Society of Nephrology, the Brazilian Society of Hepatology, and the Brazilian Liver Institute developed the "Brazilian Registry for the Elimination of Hepatitis C in Dialysis Units". This project aims to identify, treat, and monitor the response to treatment of patients on chronic dialysis infected with the hepatitis C virus in Brazil. This article presents the issue and invites Brazilian nephrologists to rally around the achievement of a significant goal.


Resumo A infecção pelo vírus da hepatite C é mais prevalente em pacientes em diálise do que na população geral no Brasil e implica um pior prognóstico. O tratamento atual para hepatite C é altamente eficaz, seguro e disponível no país, inclusive para a população de pacientes crônicos em diálise, o que torna a eliminação do vírus da hepatite C uma meta viável. A Sociedade Brasileira de Nefrologia, a Sociedade Brasileira de Hepatologia e o Instituto Brasileiro do Fígado desenvolveram o "Registro Brasileiro para Eliminação da Hepatite C nas Unidades de Diálise". O projeto visa identificar pacientes em diálise crônica com vírus da hepatite C no Brasil, além de tratar e monitorar a resposta virológica após o tratamento. Este breve artigo apresenta o problema e convida os nefrologistas brasileiros a unirem forças nesse objetivo comum.

20.
Article in Chinese | WPRIM | ID: wpr-954379

ABSTRACT

Objective:To investigate the clinical efficacy of Jinghua Weikang capsule combined with Bifidobacterium for curing patients featured by spleen-stomach damp-heat syndrome and Helicobacter pylori (Hp) infection with low DOB values.Methods:To enroll 130 cases who were admitted to the Digestion Center of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from March 2019 to March 2020. According to the treaatment protocols, the quadruple therapy group and dual therapy group, each had 65 patients. The quadruple therapy group had two different treatment protocols, 34 cases with Rabeprazole sodium enteric-coated tablet, Bismuth potassium citrate capsule, Amoxicillin capsule, and Clarithromycin, the other one had 31 cases with Rabeprazole sodium enteric-coated tablet, Bismuth potassium citrate capsule, Amoxicillin capsule, and Levofloxacin tablets. The Dual therapy group was treated with Jinghua Weikang capsule combined with Bifidobacterium. As for quadruple therapy group, 14 days was a course of treatment, while28 days was a course of treatment for dual therapy group. The two groups were treated for one course, respectively. The TCM syndromes were scored before and after treatment. After 4-weeks long drug withdrawal, all cases were reexamined via 13C-UBT. The Hp eradication rate, efficacy evaluation and adverse reactions were compared between both groups.Results:The eradication rate was 90.8% (59/65) in quadruple therapy group and 78.5% (51/65) in dual therapy group. There was no statistical difference between two groups ( χ2=3.78, P=0.052). As for quadruple therapy group, the eradication rate was 91.2% (31/34) in Protocol One and 90.3% (28/31) in Protocol Two. There was no statistical difference between two protocols ( χ2=0.01, P=0.906). After treatment, the TCM syndrome score of quadruple therapy group [(7.02±0.89) vs. (6.51±0.85), Z=-3.01], was significantly higher than that of dual therapy group ( P<0.01). The total effective rate was 93.9% (61/65) in dual therapy group and 78.5% (51/65) in quadruple therapy group. There was statistically significantly difference between two groups ( χ2=6.45, P=0.011). The adverse reactions was 24.6% (16/65) in quadruple therapy group and 6.2% (4/65) in dual therapy group. There was statistically significantly difference in two groups ( χ2=8.51, P=0.004). Conclusions:The Jinghua Weikang capsule combined with Bifidobacterium had curative effects on Hp infected patients with low DOB values. It could improve TCM Syndromes with little adverse reactions.

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