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1.
Klin Lab Diagn ; 64(8): 484-489, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479604

RESUMO

The aim of research was to evaluate the effectiveness of the effect of eradication therapy on the cytokine status of gastric juice in patients with chronic non-atrophic gastritis (CNG) and duodenal ulcer (DU) associated with Helicobacter pylori. Clinical observations and laboratory-instrumental studies performed in 95 patients aged 20 to 55 years with CNG and duodenal ulcer with determination of cytokine content of IL-1ß, IL-6 and TNF-α in the fasting portion of gastric juice. The most pronounced decrease in the content of proinflammatory cytokines in gastric juice on the background of treatment was found in patients of the 1st group who received combined therapy according to the scheme omeprazole + clarithromycin + amoxicillin. Analysis of the content of proinflammatory cytokines (IL-1ß, IL-6 and TNF-α) in gastric juice in patients with acute exacerbation showed that their concentration in all 8 patients after the course of therapy exceeded the norm (P < 0.05) and was IL -1ß - 30,30 + 1,15 pg/l, IL-6 - 10,4 + 0,83 pg / l and TNF-α - 32,5 + 1,13 pg / l. At the same time, the level of proinflammatory cytokines in gastric juice correlated with the degree of dissemination of H. pylori in the mucosa of the gastroduodenal zone. Helicobacter pylori infection in inflammation and ulceration in the mucous membrane of the stomach and duodenum, possibly in addition to other mechanisms, affects the activation of pro-inflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in gastric juice. Incomplete eradication of H. Pylori after treatment during clinical endoscopic remission in patients with duodenal ulcer in the vast majority of cases is accompanied by the preservation of an increased level of pro-inflammatory cytokines in gastric juice, which may be one of the reasons for the relapse of the disease.


Assuntos
Citocinas/análise , Suco Gástrico/química , Gastrite/terapia , Infecções por Helicobacter/terapia , Adulto , Mucosa Gástrica , Gastrite/microbiologia , Helicobacter pylori , Humanos , Pessoa de Meia-Idade , Adulto Jovem
2.
Minerva Med ; 110(5): 464-470, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31368293

RESUMO

INTRODUCTION: Helicobacter pylori is a gram-negative bacterium that is colonized in the stomach. H. pylori infection can lead to a series of stomach diseases. However, the relationship between H. pylori infection and colorectal cancer is currently controversial. Therefore, we performed this meta-analysis to further understand the relationship between H. pylori infection and colorectal cancer. EVIDENCE ACQUISITION: We conducted a comprehensive retrieval from electronic databases, included the PubMed, Medline, China National Knowledge Infrastructure (CNKI), and China Wanfang Data Knowledge Service Platform databases (Wanfang Databases) through May 1st, 2018. We used the search terms H. pylori and colorectal cancer or colorectal carcinoma and collected all relevant studies to explore the association between H. pylori infection and colorectal cancer. EVIDENCE SYNTHESIS: Twenty-seven studies including 14357 cases were included. H. pylori infection was associated with an increased risk of colorectal cancer. A pooled odds ratio (OR) of 1.27 with a 95% CI of 1.17-1.37 (P<0.001) was calculated by using a fixed-effects model (I2=45.5%, P=0.006). The subgroup analysis revealed that H. pylori infection was associated with an increased risk of colorectal cancer in the subgroups of Western countries (OR=1.34, 95% CI: 1.14-1.57) (P<0.001), serological testing (OR=1.20, 95% CI: 1.08-1.34) (P=0.001), multiple methods of testing (OR=2.63, 95% CI: 1.09-6.31) (P=0.031), cross-sectional studies (OR=1.92, 95% CI: 1.17-3.16) (P=0.010) and case-control studies (OR 1.26, 95% CI: 1.16-1.36) (P<0.001). CONCLUSIONS: The present meta-analysis provides evidence suggests that a positive association between H. pylori infection and the risk of colorectal cancer.


Assuntos
Neoplasias Colorretais/etiologia , Gastrite/epidemiologia , Infecções por Helicobacter/complicações , Helicobacter pylori/patogenicidade , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/microbiologia , Comorbidade , Suscetibilidade a Doenças , Estudos Epidemiológicos , Gastrite/microbiologia , Infecções por Helicobacter/epidemiologia , Humanos , Razão de Chances , Viés de Publicação , Fatores de Risco , Sensibilidade e Especificidade
3.
Chem Pharm Bull (Tokyo) ; 67(8): 810-815, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31366830

RESUMO

Helicobacter pylori (H. pylori) infection is common and can result in gastric and duodenal ulcers, and in some cases, gastric lymphoma and cancer. Omeprazole (OMP)-in combination with clarithromycin (CLR), amoxicillin (AMX), tinidazole (TND), or metronidazole (MET)-is used in double or triple combination therapy for eradication of H. pylori. However, the roles of the drugs other than OMP are not clearly understood. Therefore, in the present study, we aimed to investigate any effects of these drugs on OMP metabolism by wild-type CYP2C19 using spectroscopy and enzyme kinetics. The dissociation constants (Kd) for CYP2C19 with OMP, CLR, AMX, TND, and MET were 8.6, 126, 156, 174, and 249 µM, respectively. The intrinsic clearance of OMP was determined to be 355 mL/min/µmol of CYP2C19. Metabolism of OMP was significantly inhibited by 69, 66, 28, and 40% in the presence of CLR, TND, AMX, and MET, respectively. Moreover, the combination of CLR and TND resulted in 76% inhibition of OMP metabolism, while the combination of AMX and MET resulted in 48% inhibition of OMP metabolism. Both combinations of drugs not only have antibacterial effects, but also enhance the effect of OMP by inhibiting its metabolism by CYP2C19. These results indicate that drug-drug interactions of co-administered drugs can cause complex effects, providing a basis for OMP dose adjustment when used in combination therapy for H. pylori eradication.


Assuntos
Antibacterianos/farmacologia , Citocromo P-450 CYP2C19/metabolismo , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Omeprazol/farmacologia , Amoxicilina/química , Amoxicilina/farmacologia , Antibacterianos/química , Antibacterianos/metabolismo , Cromatografia Líquida de Alta Pressão , Claritromicina/química , Claritromicina/farmacologia , Citocromo P-450 CYP2C19/química , Combinação de Medicamentos , Humanos , Metronidazol/química , Metronidazol/farmacologia , Testes de Sensibilidade Microbiana , Estrutura Molecular , Omeprazol/antagonistas & inibidores , Omeprazol/metabolismo , Tinidazol/química , Tinidazol/farmacologia
4.
Nihon Shokakibyo Gakkai Zasshi ; 116(8): 660-667, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31406071

RESUMO

An 82-year-old man with abdominal pain was admitted to our hospital. Laboratory tests revealed the following:white blood cells, 14300/µl;serum hemoglobin level, 12.9g/dl;serum C-reactive protein level, 0.38mg/dl;and negative anti-Helicobacter pylori immunoglobulin G test. Abdominal computed tomography revealed a tumor in the appendix along with multiple swollen lymph nodes. Colonoscopy revealed a submucosal tumor (SMT) of approximately 30mm in diameter with central ulceration. However, a tumor tissue specimen could not be obtained for biopsy;thus, the tumor could not be diagnosed. In esophagogastroduodenoscopy, abnormalities or gastric mucosal atrophy was not observed. A rapid urease test yielded negative results. Hence, endoscopic ultrasound-guided fine needle aspiration for the SMT was recommended;however, the patient preferred to undergo a definitive surgery to establish exact diagnosis. Therefore, right hemicolectomy and lymph node dissection (D3) were performed. Histopathologically, the resected tumor specimen showed atypical lymphocytes. Additionally, immunohistochemical evaluation demonstrated positive staining of the tumor cells for CD20 and BCL2 and negative staining for CD34, CD4, CD10, and BCL6. The tumor was finally diagnosed as a stage II2 mucosa-associated lymphoid tissue lymphoma (Lugano classification). Postoperatively, the patient received chemotherapy with four cycles of rituximab based on his age and activities of daily living.


Assuntos
Apendicite/diagnóstico , Apêndice , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Atividades Cotidianas , Idoso de 80 Anos ou mais , Helicobacter pylori , Humanos , Masculino
5.
N Engl J Med ; 381(6): 587-588, 2019 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-31390511
7.
N Engl J Med ; 381(6): 588-589, 2019 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-31390513
9.
J Med Microbiol ; 68(9): 1287-1291, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31364966

RESUMO

The molecular mechanism of Helicobacter pylori resistance to tetracycline involves mutations in the primary binding site of the ribosome. A resistance or reduced susceptibility to tetracycline could be the result of single, double or triple mutations in the 16S rRNA gene of H. pylori. We investigated if the genotype was correlated to tetracycline resistance as determined phenotypically in vitro for 96 H. pylori isolates in the gastroesophageal mucosa of Venezuelan individual hosts. E-test for antimicrobial susceptibility test and real-time PCR for the detection of 16S rRNA gene mutations were performed in 96 H. pylori isolates (48 obtained from antrum, and 48 from oesophagus) from eight dyspeptic patients. In the gastric mucosa, 38 isolates were identified sensitive and 10 resistant to tetracycline by E-test, whereas 44 sensitive and 4 resistant isolates were found in the oesophagus. Real-time PCR detection of the 16S rRNA gene exhibited mutants with a single base-pair substitution (AGA926GGA) in six antrum isolates and seven oesophagus isolates, whereas only three harboured a low level of tetracycline resistance in vitro. Our results indicate that real-time PCR detection of 16S rRNA is a reliable method to classify among tetracycline-resistant genotypes and useful in patients who have experienced a first-line treatment failure with triple therapy.


Assuntos
Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/genética , RNA Ribossômico 16S/genética , Resistência a Tetraciclina/genética , Tetraciclina/farmacologia , Antibacterianos/farmacologia , Mucosa Esofágica/microbiologia , Mucosa Gástrica/microbiologia , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Mutação , Reação em Cadeia da Polimerase em Tempo Real
10.
Medicine (Baltimore) ; 98(30): e16619, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348311

RESUMO

Helicobacter pylori (H. pylori) is the most prevalent chronic bacterial infection and is associated with chronic gastritis, peptic ulcer disease, and gastric adenocarcinoma. Although eradication therapy is widely performed for H. pylori infection, adverse events (AEs) are of particular concern in the elderly. This study investigated the efficacy and safety of H. pylori eradication therapy for elderly patients.Retrospective investigation of 1271 cases (median age: 61 years, 730 male) of H. pylori infection was performed to compare clinical indications and outcomes among the younger group (<65 years old), elderly group (65-74 years old), and super-elderly group (>75 years old).Chronic gastritis (77.0%) and gastric and/or duodenal ulcer (16.4%) were the most frequent indications for eradication therapy in the cohort. The respective eradication and AE rates for the first and second treatment regimens were 92.1% (1044 of 1133 cases) and 9.1% (103 of 1133 cases) and 84.2% (123 of 146 cases) and 8.9% (13 of 146 cases). No significant differences were detected for eradication rate or AE frequency between the super-elderly group and the other groups. Prior to therapy, the super-elderly group had significantly less frequent chronic gastritis than the other groups but more frequent gastric or duodenal ulcer and post-gastric cancer treatment (all P < .001), indicating a reluctance for clinicians to treat very old patients, possibly due to unfounded concerns of complications.Triple therapy for H. pylori eradication is effective and safe, even for elderly patients.


Assuntos
Envelhecimento , Antibacterianos/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Quimioterapia Combinada , Feminino , Gastrite/etiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/etiologia , Estudos Retrospectivos
11.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 35(6): 533-539, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31292058

RESUMO

Objective To screen aptamers that specifically bind to adhesin HpaA from Helicobacter pylori (H. pylori) by systematic evolution of ligands by exponential enrichment (SELEX) and identify the binding properties of aptamers. Methods The prokaryotic expression recombinant plasmid pET28a/HpaA was constructed and the HpaA protein was expressed and purified with IPTG. With the recombinant HpaA protein as target, we screened aptamers with high affinity and specificity binding force by SELEX. The binding force between aptamers and H. pylori in vitro and the performance of aptamers in H. pylori detection from the biopsy of gastric mucosa were examined using the aptamers we had screened. Results We extracted genome from H. pylori ATCC26695 strains and amplified 699 bp HpaA gene using PCR. The recombinant plasmid pET28a/HpaA was constructed successfully. The recombinant HpaA was expressed and purified up to 98% as target for aptamer screening. The six highest affinity aptamers were obtained and named HA1 to HA6 through 10-round positive screening and five-round negative screening by SELEX. The full-length aptamer HA6 and the core sequence of HA6 showed highest affinity and specificity in H. pylori detection in vitro. In view of this, the FAM-labelled aptamer HA6 was used to detect H. pylori in gastric mucosa from 166 patients. The aptamer HA6 showed a higher detection rate (94.58%) than URT (87.95%) in the same batch of clinical samples. Conclusion The aptamers that specifically bind to HpaA may be applied for the detection of H. pylori in gastric mucosa as a novel method.


Assuntos
Adesinas Bacterianas/genética , Aptâmeros de Nucleotídeos/genética , Mucosa Gástrica/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Reação em Cadeia da Polimerase , Proteínas Recombinantes/genética
12.
Z Gastroenterol ; 57(7): 883-888, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31288284

RESUMO

Viruses and bacteria play central roles in gastrointestinal tumor development. This includes well-characterized contributions of Helicobacter pylori to gastric carcinoma and MALT lymphoma and of Hepatitis B and C virus infections to hepatocellular cancer. However, recent studies have demonstrated a much broader role of the microbiota in the regulation of cancer development. As such, it was shown that barrier defects and alterations in microbial community structure contribute to colorectal and hepatocellular cancer. Moreover, intriguing studies have highlighted the microbiota as a central regulator of the efficacy of systemic anti-tumor therapies. Here, we provide an overview of recent observations on the role of the microbiota in tumor development and the regulation of therapeutic anti-tumor responses and discuss the implications of these findings for clinical diagnostics and treatment.


Assuntos
Microbioma Gastrointestinal , Neoplasias Gastrointestinais/microbiologia , Helicobacter pylori , Linfoma de Zona Marginal Tipo Células B/microbiologia , Microbiota , Neoplasias Gástricas/microbiologia , Estômago/microbiologia , Infecções por Helicobacter , Humanos
13.
Medicine (Baltimore) ; 98(29): e16561, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335741

RESUMO

BACKGROUND: Peptic ulcer disease (PUD) is a major burden worldwide. Several challenges remain with standard Western treatment of PUD, such as persistent weakness, fatigue, and relapse. A dietary traditional Chinese medicine (TCM) formula, Hou Gu Mi Xi (HGMX), has been developed as a complementary treatment for PUD. AIMS: This multicenter, double-blind, randomized controlled trial will assess efficacy and safety of HGMX in patients with PUD. METHODS: Three hundred sixty eligible patients will be assigned to receive HGMX, placebo, HGMX + rabeprazole or placebo + rabeprazole for 4 weeks after 2 weeks of standard Western treatment. This first step, with a 2 × 2 factorial design, will focus on assessing the main and interaction effects of HGMX and rabeprazole on ulcer healing. Then, rabeprazole will be stopped, and HGMX will be continued for up to 1 year. The second step, with a placebo-controlled design, will compare the long-term effects of HGMX and placebo. Extended follow-up with no treatment will continue for up to 2 years. Independent and paired t tests, Pearson χ test and the rank-sum test will be used to compare between-group differences. The P value will be adjusted using the O'Brien & Fleming method for multiple comparisons. EXPECTED OUTCOMES: The primary outcomes are total efficacy rate of PUD treatment, quality of ulcer healing, and changes in spleen qi deficiency symptoms. The secondary outcomes include ulcer area, PUD recurrence, Helicobacter pylori eradication rate, gastric function, body weight, and body mass index. Adverse events (AEs), severe AEs, treatment-related AEs, and withdrawal owing to AEs will be recorded to assess treatment safety. DISCUSSION: The trial results will provide high-quality evidence for HGMX, as a complementary therapy, for the long-term management of PUD and will be valuable for the development of related guidelines and regulations. TRIAL REGISTRATION: The protocol of this trial was approved in all research hospitals and was registered in ClinicalTrials.gov at October 25, 2017(No. NCT03320538).


Assuntos
Antiulcerosos/efeitos adversos , Antiulcerosos/uso terapêutico , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Método Duplo-Cego , Quimioterapia Combinada , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Úlcera Péptica/microbiologia , Prevenção Secundária
14.
Medicine (Baltimore) ; 98(26): e16188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261556

RESUMO

Neutrophil to lymphocyte ratio (NLR) is a simple, noninvasive, inexpensive inflammatory marker that can useful in the assessment of inflammatory activity, especially in pediatric ages. The aim of our study was to establish correlations between the presence of Helicobacter pylori (HP) proved histologically and NLR in children.A prospective, case-control study was performed on 137 pediatric patients aged between 1 and 18 years, admitted in a Pediatric Tertiary Hospital from Romania, between April 2016 and January 2018. According to the histologic examination, the children were divided into 2 groups: group 1: 50 children with HP infection, and group 2: 87 children without any pathologic findings.The mean age for the study group was 12.86 ±â€Š3.796 years, whereas for control group, it was 12.10 ±â€Š3.879 years (P = .3001). HP infection was significantly more frequent among children from rural area (P = .0089). Epigastric pain and loss of appetite were significantly associated with HP infection (P = .0350 /P = .0281). We noticed that the leukocyte and neutrophil counts were significantly higher in group 1 (P = .0076/P = .0306). We did not find any significant statistical differences between the 2 groups in terms of lymphocytes, erythrocyte sedimentation rate, and NLR or other assessed laboratory parameters. Regarding the IgA antibodies anti-HP and rapid urease test, they were both significantly associated with histologically confirmed HP infection (P < .0001).Even though, we did not identify significant differences in term of NLR between HP-induced gastritis children and healthy controls, the mean NLR values were higher HP-positive patients.


Assuntos
Gastrite/sangue , Gastrite/imunologia , Adolescente , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Feminino , Gastrite/patologia , Infecções por Helicobacter/sangue , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/patologia , Helicobacter pylori , Humanos , Inflamação/sangue , Inflamação/imunologia , Inflamação/patologia , Masculino , Estudos Prospectivos
15.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(6): 628-633, 2019 Jun 28.
Artigo em Chinês | MEDLINE | ID: mdl-31304923

RESUMO

OBJECTIVE: To investigate the effects of equal concentration of Helicobacter pylori suspension on gastric mucosal infection in mice by different gavage methods. 
 Methods: Six-week-old male C57BL/6 mice were infected by a suspension of Brucella broth containing the same amount of NCTC11637 Helicobacter pylori suspension by A, B, C, and D methods. For method A, the mice were intragastrically administered with Helicobacter pylori suspension (0.2 mL per mouse), once two day for 5 times; for method B, the mice were intragastrically administered with Helicobacter pylori (0.2 mL per mouse) once a day for 5 times; for method C, the mice were perfused with 0.4 mL per mouse of Helicobacter pylori suspension on the first day, then once a day and 0.2 mL per mouse for 3 times; for method D, the mice were administrated with 0.4 mL per mouse Helicobacter pylori suspension on the first day, 0.2 mL per mouse every other day for 3 times. For method E, the mice received equal amounts of normal saline. The mice were killed at 2, 4, and 6 weeks after gavage. The gastric mucosa was detected by rapid urease test for Helicobacter pylori infection, and gastric mucosa was taken for HE staining to observe the degree of infection.
 Results: After 2 weeks of gavage, the infection rates of the mice in A, B, C, and D group were 33.3%, 50.0%, 66.7%, and 33.3%, respectively. The degree of inflammation infection was as following order: C group>B group>D group>A group>E group. The infection rates of mice after 4 weeks of gavage in the A, B, C, and D groups were 50.0%, 83.3%, 83.3%, and 66.7%, respectively. The degree of inflammation infection was as following order: C group>B group>D group>A group>E group. After 6 weeks of gavage, the infection rate in A, B, C, and D groups was 100%, while the degree of inflammation infection was as following order: C group>D group>B group>A group>E group.
 Conclusion: At the acute stage of Helicobacter pylori infection, different gavage methods show different infection rates in mice, and the degree of inflammation is different. At the chronic stage, different gavage methods display the same infection rate in mice with different degree. The gavage method that 0.4 mL Helicobacter pylori suspension on the first day, then once a day and 0.2 mL for 3 times is most conducive to Helicobacter pylori colonization in the gastric mucosa of mice. This method can induce the the most seriou inflammatory infection and is beneficial to the successful establishment of the Helicobacter pylori infection model.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Animais , Mucosa Gástrica , Masculino , Camundongos , Camundongos Endogâmicos C57BL
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46601

RESUMO

A gastrite é uma inflamação do revestimento interno do estômago. Pode ser aguda, quando aparece de repente e dura pouco, ou crônica, quando se instala aos poucos e leva muito tempo para ser controlada.


Assuntos
Gastrite , Gastrite Atrófica , Gastrite Hipertrófica , Helicobacter pylori
17.
Georgian Med News ; (289): 102-107, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31215888

RESUMO

Functional dyspepsia (FD) is the most common cause of chronic epigastric pain and abdominal fullness. Helicobacter pylori-associated gastritis is one of the pathophysiological factors of FD, however the peculiarities of it are still unknown. Aim of the study - to compare the morphological changes in biopsy specimens of gastroduodenal area in patients with different types of functional dyspepsia. This study was conducted as a cross-sectional study in adult subjects with FD. Biopsy specimens were taken from the stomach as per the Houston-updated gastric biopsy sampling protocol. To measure gastritis grade we used OLGA and OLGIM staging systems. Analysis was performed by pathologist who was blinded to the clinical diagnosis of the patients. We compare the degree of inflammation, activity of gastritis, presence and degree of atrophy, metaplasia and dysplasia in patients with different types of FD. This study included 33 subjects with postprandial distress syndrome (PDS) and 28 subjects with epigastric pain syndrome (EPS) according to Rome IV criteria. The level of gastric body and antral inflammation, activity degree, and metaplasia were detected at the same frequency in both groups (p>0.05). The grade of antral atrophy was significantly higher in patients with PDS (p=0,002) with no difference in the gastric body.


Assuntos
Dispepsia , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Adulto , Estudos Transversais , Dispepsia/patologia , Gastrite/patologia , Infecções por Helicobacter/patologia , Humanos , Metaplasia
18.
BMC Infect Dis ; 19(1): 546, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226948

RESUMO

BACKGROUND: The effectiveness of Helicobacter pylori first-line treatment has decreased drastically with the rise of strains resistant to clarithromycin. Therapy failure has also been described in patients with infections by strains with dissimilar antimicrobial susceptibilities. The present study aims to estimate the prevalence of resistance and heteroresistance to clarithromycin in H. pylori isolates from antrum and corpus of Colombian patients. METHODS: The study material included 126 isolates from antrum and corpus biopsies from 63 symptomatic patients over 18 years old who had a gastric endoscopy performed on them between June 2014 to August 2016. PCR amplification and sequencing of the H. pylori 23S rDNA gene was performed to determine the presence of mutations associated with clarithromycin resistance. Random amplified polymorphic DNA analysis was implemented in cases of resistance and heteroresistance. RESULTS: The overall frequency of resistance to clarithromycin was 38.1% (24/63 patients), of which 19 patients had resistant isolates in both stomach segments (14 with A2143G mutation and 5 with A2142G mutation), and 5 patients had a heteroresistant status. The remaining 61.9% (39/63 patients) presented only susceptible isolates. DNA fingerprinting analysis showed different patterns in 4/22 paired isolates. CONCLUSIONS: The high prevalence of H. pylori clarithromycin-resistance obtained (> 15%) constitutes an alert for gastroenterologists and suggests the need for reconsideration of the current eradication regimen for H. pylori in the studied population. The data show that heteroresistance status is an additional factor to be considered in the assessment of resistance. In consequence, it is advisable to examine at least two biopsies from different gastric segments.


Assuntos
Técnicas de Tipagem Bacteriana , Claritromicina/uso terapêutico , Farmacorresistência Bacteriana/genética , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Claritromicina/farmacologia , Colômbia/epidemiologia , Feminino , Genótipo , Técnicas de Genotipagem , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mutação , Reação em Cadeia da Polimerase/métodos , Prevalência , Antro Pilórico/microbiologia , Antro Pilórico/patologia , Estômago/microbiologia , Estômago/patologia , Adulto Jovem
19.
Wiad Lek ; 72(5 cz 1): 946-949, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31175802

RESUMO

OBJECTIVE: Introduction: In certain situations the constituents of food can serve as a catalysator for the formation of such a pathology as peptic ulcer. Not the last role in the formation of ulcerous defects under certain conditions play physical excertion, which is accompanied by sharp rhythmic contraction of the muscles of the anterior abdominal wall. The aim: To analyze the case of formation of "kissing" ulcers of the duodenal bulb of the 25-year-old patient. PATIENTS AND METHODS: Materials and methods: The patient took comprehensive examination: step-by-step рН-metry, esophagogastroduodenoscopy, helicobacter infection test (НР) (helicobacter urease test and microscopic examination of stained smears), histological investigations of the gastric stump mucous, HELIC - test. RESULTS: Case report: It was found that on the eve of the ulcer in the patient's diet during breakfast there was a salad of fresh white cabbage, fresh cucumbers, tomato and radishes and at lunch the patient was subjected to prolonged physical exercise. The level of gastric juice corresponded to the basal normacidity total; endoscopic diagnosis: «Kissing¼ ulcers duodenal bulb in an active stage. Chronic gastritis type B ¼. Testing for HP infection revealed a high concentration of the active form of bacteria, the HELIC -test showed a high concentration of ammonia in the stomach cavity. CONCLUSION: Conclusions: An abrupt stimulation of secretion by cabbage juice and the presence of urea in vegetables, of which the salad was cooked, led to the formation of a large level of "residual ammonia" in the cavity of the stomach. Physical strain finally formed the mechanism of ulcer formation.


Assuntos
Gastrite , Infecções por Helicobacter , Helicobacter pylori , Adulto , Mucosa Gástrica , Humanos , Esforço Físico , Úlcera , Verduras
20.
Harefuah ; 158(6): 398-403, 2019 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-31215194

RESUMO

INTRODUCTION: Treatment of Helicobacter pylori (Hp) infection remains a challenge for both primary care physicians and gastroenterologists. Over the past years, resistance of Hp to antibiotics has increased in Israel and abroad. Macrolide resistance remains the single most important factor responsible for failure to eradicate the organism. Effective treatment for the eradication of Hp must consider local resistance patterns. For this reason, representatives with clinical and research experience in the field of Hp convened under the auspices of the Israel Gastroenterology Association (IGA) to review the medical literature regarding the diagnosis and treatment of Hp, with particular emphasis on studies emanating from our region, and to develop local guidelines. The IGA does not recommend the use of clarithromycin-based triple therapy for the first-line treatment of Hp infection. Options for the first-line treatment of Hp infection include concomitant therapy, bismuth-based quadruple therapy and sequential therapy. Additional recommendations highlight the need to treat Hp whenever it is diagnosed, given its oncogenic potential, while adhering to the outlined indications for testing. The IGA calls for prospective studies to assess the comparative efficacy of different treatment protocols in Israel.


Assuntos
Gastroenterologia , Infecções por Helicobacter , Amoxicilina , Antibacterianos , Farmacorresistência Bacteriana , Quimioterapia Combinada , Gastroenterologia/tendências , Infecções por Helicobacter/terapia , Helicobacter pylori , Humanos , Israel , Macrolídeos , Guias de Prática Clínica como Assunto , Estudos Prospectivos
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