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1.
Hyun Young Kim Nayoung Kim Seon Mie Kim Ji-Hyun Seo Eun-Ha Park Dong Ho Lee 《Gut and liver》2013,7(6):648-654
Background/Aims
The aims of this study were to evaluate whether doctors and nurses in a single hospital were at an increased risk of acquiring Helicobacter pylori infection in 2011 and to identify risk factors for H. pylori seroprevalence.Methods
Nurses (n=362), doctors (n=110), health personnel without patient contact (medical control, n=179), and nonhospital controls (n=359) responded to a questionnaire during a health check-up, which included questions on socioeconomic status, education level, working years, and occupation in 2011. The prevalence of H. pylori was measured by serology.Results
The seroprevalence rate was 29.8% (nurses), 34.5% (doctors), 30.7% (medical control), and 52.9% (nonhospital control). Among younger subjects (<40 years of age), the nonhospital control had a higher seropositivity rate (48.1%) than nurses (29.2%), doctors (29.8%), and the medical control (24.8%), which was not observable in subjects ≥40 years of age. The risk factors for H. pylori seroprevalence were not different for health and nonhealth personnel. A multivariate analysis indicated that seropositivity significantly increased with age, the province of residence, and a gastroscopic finding of a peptic ulcer.Conclusions
The medical occupation was not associated with H. pylori infection. The seroprevalence of H. pylori in one hospital in 2011 was found to be 38.7%, most likely due to the improvement in socioeconomic status and hospital hygiene policy in Korea. 相似文献2.
Tajeldin Mohammedien Abdallah Hashim Balla Mohammed Mamoon Hassan Mohammed Abdel Aziem Abdalla Ali 《亚太热带病杂志(英文版)》2014,4(2):115-119
Objective
To investigate the prevalence of Helicobacter pylori (H. pylori) among patients with dyspepsia and to evaluate the correlation between H. pylori infection and socio-demographic factors.Methods
This cross-sectional hospital-based study, which ran from June to August 2012, determined seroprevalence of H. pylori among adult patients in Eastern Sudan. The presence of H. pylori was determined using ELISA.Results
A total of 225 adult Sudanese patients were enrolled in the study. Of these, 148 (65.8%) tested positive for H. pylori. In logistic regression analysis, rural residency (OR=3.933, CI=1.337-11.26, P=0.01) was the only socio-demographic factor that was associated with H. pylori infection. The most common symptoms among seropositive patients were heartburn (OR=30.442, CI=9.478-97.776, P≤0.001) and/or epigastria pain (OR=28.225, CI=4.365-182.508, P≤0.001).Conclusions
Clinical suspicion can facilitate the detection of H. pylori among patients with dyspeptic symptoms in a geographic area with high prevalence of H. pylori infection. 相似文献3.
Mohammed Said Al-Balushi Juma Z Al-Busaidi Muna S Al-Daihani Mohammed O Shafeeq Sidgi S Hasson 《亚太热带病杂志(英文版)》2013,3(2):146-149
Objective
To investigate the prevalence of Helicobacter pylori (H. pylori) infection, a cross-sectional epidemiological study, based on the age and gender-specific seroprevalence of H. pylori antibodies in asymptomatic healthy Omani blood donors attending the SQUH blood bank.Methods
Analysis of the sera from 133 apparently healthy subjects, based on the serological determination of the IgM, IgG and IgA antibodies against H. pylori, was carried out using a commercially available kit ELISA (NovaLisa, NovaTec, Germany). While the presence of H. pylori-specific IgG antibodies is the marker for a “chronic” infection with this pathogen. Therefore, there was no indicator of the time of acquisition of the infection. However, the H. pylori-specific IgM antibody was a more specific marker for a recently acquired infection with H. pylori.Results
Of the 133 subjects, there were 100 (74%) males and 33 (26%) females. The age range was 15 to 50 years with a mean of 25.75±3.75 years. The overall prevalence of H. pylori infection in our study was 69.5%. The overall seroprevalence was found to be increased 69%-86% with age. Subjects between 15–20 years of age showed 71% seroprevalence, while those between 21–40 years showed gradual increase (63%–70%) with age and reached up to 87% in subjects between 41–50 years of age. A significant inverse association was found between sex and age groups. This is when each age group was examined individually; a higher positive percentage of H. pylori antibodies increasing with age was seen in males between 21–40 years of age group in comparison to the females of the same age group. Male subjects with age group between 21 to 40 years were found to have a significant seropositivity compared to the female subjects within the same group. This may reflect how frequent were the male subjects being exposed to the outer environment and their conduct than the females in this society like Oman.Conclusions
The seropositivity of H. pylori is moderately higher between ages of 21 to 30 more than any other age group. 相似文献4.
Eun Jung Kim Woo Chul Chung Kang-Moon Lee Chang Nyol Paik Sang Bae Kim You Suk Oh Yang Woon Lee Sung-Goo Kang Seung June Noh 《Gut and liver》2013,7(3):317-322
Background/Aims
We aim to evaluate the association between promoter polymorphism of the clusters of differentiation 14 (CD14) gene and Helicobacter pylori-induced gastric mucosal inflammation in a healthy Korean population.Methods
The study population consisted of 267 healthy subjects who visited our hospital for free nationwide gastric cancer screening. Promoter polymorphism at -260 C/T of the CD14 gene was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. The severity of gastric mucosal inflammation was estimated by a gastritis score based on the sum of the values of the grade and activity of the gastritis. Expression of soluble CD14 (sCD14) was assessed by quantitative sandwich ELISA.Results
CD14 polymorphism was not associated with H. pylori infection. There were no significant differences in gastritis scores among the genotype subgroups, but subjects carrying the CD14 -260 CT/TT genotype had significantly higher sCD14 levels than those carrying the CC genotype. Subjects with the 260-T allele of the CD14 gene and H. pylori infection had significantly higher sCD14 levels than those with the same genotype but without infection.Conclusions
In individuals with the T allele at the -260 site of the promoter region of the CD14 gene, H. pylori infection accentuates gastric mucosal inflammation. 相似文献5.
Woo Chul Chung Sung Hoon Jung Kyu Re Joo Min Ji Kim Gun Jung Youn Yaeni Kim Joune Seup Lee Hyewon Lee Ji Han Jung Yun Kyung Lee 《Gut and liver》2013,7(6):688-695
Background/Aims
This study was performed to determine the association between RUNX3 expression and Helicobacter pylori infection in premalignant gastric lesions.Methods
We examined 107 patients with gastric epithelial dysplasia who had undergone endoscopic mucosal resection or submucosal dissection. All tissue samples were evaluated by RUNX3 staining and subclassified by immunophenotype. H. pylori infection in dysplastic lesions and the normal surrounding tissue was examined by silver staining, and cagA status was assessed by polymerase chain reaction.Results
The loss of RUNX3 expression was observed in 62 cases (57.9%), and an association with H. pylori infection was found in 54 cases (50.5%). The infection rate with the cagA-positive H. pylori strain was 63.0%. In RUNX3-negative lesions, the rate of H. pylori infection (p=0.03) and the frequency of category 4 lesions (according to the revised Vienna classification) were high (p=0.02). In addition, the gastric mucin phenotype was predominant. In RUNX3-negative category 4 lesions, the rate of cagA-positive H. pylori infection rate was high but not significantly increased (p=0.08).Conclusions
Infection with H. pylori is associated with inactivation of RUNX3 in early gastric carcinogenesis. This mechanism was prominent in gastric cancer with a gastric mucin phenotype. 相似文献6.
Hala El-Zimaity Stefano Serra Eva Szentgyorgyi Rajkumar Vajpeyi Amir Samani 《Journal canadien de gastroenterologie》2013,27(10):e25-e30
BACKGROUND:
Many consider histology to be the gold standard for Helicobacter pylori detection. Because the number and distribution of H pylori organisms vary, particularly in patients taking proton pump inhibitors (PPIs), the American Gastroenterological Association recommends discontinuing PPIs two weeks before endoscopy, and taking biopsies from both the body and antrum.OBJECTIVE:
To assess the influence of clinical practice on the histopathological detection of H pylori infection.METHODS:
Electronic patient records were evaluated for the sites of gastric sampling and PPI use at endoscopy. One hundred fifty cases with biopsies taken from both antrum and body were randomly selected for pathological re-review with special stains. The gastric regions sampled, H pylori distribution and influence of clinical factors on pathological interpretation were assessed.RESULTS:
Between 2005 and 2010, 10,268 biopsies were taken to detect H pylori. Only one region was sampled in 60% of patients (antrum 47%, body 13%). Re-review of biopsies taken from both antrum and body indicated that the correct regions were sampled in only 85 (57%) patients. Of these, 54 were H pylori positive and 96 were H pylori negative. H pylori was present in the antrum in only 15% of the patients and body only in 21%. Of 96 H pylori-negative patients, two were reinterpreted as positive. Forty-seven per cent of patients were taking PPIs at endoscopy, contributing to both false-negative and false-positive diagnoses.CONCLUSION:
Despite national and international guidelines for managing H pylori infection, the American Gastroenterological Association guidelines are infrequently adhered to, with PPIs frequently contributing to false diagnosis; sampling one region only increases the likelihood of missing active infection by at least 15%. 相似文献7.
Kwang Duck Ryu Gwang Ha Kim Seong Oh Park Kwang Jae Lee Jung Youn Moon Hye Kyung Jeon Dong Hoon Baek Bong Eun Lee Geun Am Song 《Gut and liver》2014,8(4):408-414
Background/Aims
Helicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas.Methods
In total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas.Results
Of the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas.Conclusions
H. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status. 相似文献8.
Yoshiyasu Kono Hiroyuki Okada Ryuta Takenaka Ko Miura Hiromitsu Kanzaki Keisuke Hori Masahide Kita Takao Tsuzuki Seiji Kawano Yoshiro Kawahara Kazuhide Yamamoto 《Gut and liver》2016,10(1):69-75
Background/Aims
The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.Methods
From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed.Results
In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury.Conclusions
H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users. 相似文献9.
Mohammed Al Asqah Nawaf Al Hamoudi Sukumaran Anil Abdulrahman Al jebreen Waleed Khalid Al-hamoudi 《Journal canadien de gastroenterologie》2009,23(3):177-179
BACKGROUND
Helicobacter pylori is considered to be a pathogen responsible for gastritis and peptic ulcers, and a risk factor for gastric cancer. A periodontal pocket in the teeth of individuals with chronic periodontitis may function as a reservoir for H pylori.OBJECTIVE:
The present study was undertaken to evaluate whether the presence of H pylori in the dental plaque of patients with and without periodontitis correlates with gastric involvement.METHODS:
A total of 101 patients with dyspepsia were included in the present study. Subjects were divided into periodontitis and non-periodontitis groups. For the detection of H pylori in dental plaque, samples were collected from two teeth using a periodontal curette. Subgingival plaque was obtained by inserting two sterile paper points into periodontal pockets for 20 s. This was followed by an upper gastrointestinal endoscopy and antral biopsies.RESULTS:
Sixty-five per cent of patients had dental plaque positive for H pylori and more than 50% harboured the bacteria in their stomach. Periodontitis patients had a significantly higher percentage of H pylori in their dental plaque (79% versus 43%; P<0.05) and the stomach (60% versus 33%; P<0.05) than patients with no periodontitis. Additionally, 78% of patients from the periodontitis group versus only 30% from the nonperiodontitis group had a positive test result for the coexistence of H pylori in both dental plaque and the stomach.CONCLUSION:
Patients with poor oral hygiene have a higher prevalence of H pylori in dental plaque and in the stomach. This finding suggests that the oral cavity may be a reservoir for H pylori, and potentially a source of transmission or reinfection. 相似文献10.
Young Woon Chang Jae Young Jang Yong Ho Kim Jung-Wook Kim Jae-Jun Shim 《Gut and liver》2015,9(4):486-493
Background/Aims
The aims of this study were to investigate whether a broccoli sprout extract containing sulforaphane (BSES) inhibited the Helicobacter pylori infection density and exerted an antioxidative effect on gastric mucosal damage.Methods
The enrolled subjects were randomized in a double-blinded manner into three groups. Finally, 33 H. pylori (+) BSES treatment subjects (group A), 28 H. pylori (+) placebo subjects (group B), and 28 H. pylori (−) BSES treatment subjects (group C) were studied. H. pylori infection density was indirectly quantified by a 13C-urea breath test (UBT), and the ammonia concentration in gastric juice aspirates was measured through gastroscopic examination. Malondialdehyde (MDA), an oxidative damage biomarker, and reduced glutathione (GSH), an antioxidant biomarker, were measured in the gastric mucosa by an enzyme-linked immunosorbent assay.Results
BSES treatment did not significantly affect the UBT values or ammonia concentration in group A (p=0.634 and p=0.505, respectively). BSES treatment did significantly reduce mucosal MDA concentrations in group A (p<0.05) and group C (p<0.001), whereas the gastric mucosal GSH concentrations did not differ before and after treatment in any of the groups.Conclusions
BSES did not inhibit the H. pylori infection density. However, BSES prevented lipid peroxidation in the gastric mucosa and may play a cytoprotective role in H. pylori-induced gastritis. 相似文献11.
12.
Ji-Hyun Seo Jin-Su Jun Hee-Shang Youn Jung Sook Yeom Ji Sook Park Chan-Hoo Park Hyang-Ok Woo Woo-Kon Lee Myung-Je Cho Kwang-Ho Rhee 《Gut and liver》2013,7(4):437-442
Background/Aims
We aimed to develop a quantitative enzyme-linked immunosorbent assay (ELISA) using whole-cell lysates of Helicobacter pylori 51 and to investigate its validity.Methods
Data from 300 plates were obtained by two different operators. Standard sera were used to make a standard curve to analyze the quantity of anti-H. pylori immunoglobulin G (IgG) and IgA antibody. We obtained reproducible data with fewer dilutions of samples by the addition of serially diluted standard serum to each ELISA plate. To evaluate the validity of this ELISA, the 114 H. pylori-positive and -negative subjects were stratified into four age groups, i.e., 0 to 4, 5 to 9, 10 to 15, and 20 to 29 years, before testing.Results
The mean IgG-antibody titers in H. pylori-positive and -negative subjects were 1,766.4 IU/mL and 654.3 IU/mL (p<0.001). The mean IgA-antibody titers in H. pylori-positive and -negative subjects were 350.1 IU/mL and 193.5 IU/mL (p<0.001). Anti-H. pylori IgG and IgA titers in the four age groups were higher in H. pylori-positive subjects than in H. pylori-negative subjects (p<0.05).Conclusions
Using the current ELISA based on whole-cell lysates of H. pylori 51, reliable anti-H. pylori antibody titers were obtained regardless of the subject''s age. 相似文献13.
Furusyo N Walaa AH Eiraku K Toyoda K Ogawa E Ikezaki H Ihara T Hayashi T Kainuma M Murata M Hayashi J 《Gut and liver》2011,5(4):447-453
Background/Aims
Helicobacter pylori infection causes gastritis, peptic ulcers and gastric malignancies, and its eradication has been advocated by many groups. We determined the H. pylori carrier status and eradication rates of patients with chronic hepatitis C virus (HCV) infection.Methods
In total, 76 chronically HCV-infected patients were enrolled for comparison with 228 HCV-noninfected, age- and sex-matched controls. H. pylori infection was confirmed by H. pylori antibody and urea breath testing.Results
The H. pylori infection rate was significantly higher for HCV-infected patients (67 of 76, 88.2%) than for HCV-noninfected controls (158 of 228, 69.3%). Endoscopic findings showed that the rates of gastric ulcers and gastritis were significantly higher for the 67 HCV-infected patients with H. pylori infection (34.3% and 77.6%) than for the 158 HCV-noninfected controls with H. pylori infection (15.2% and 57.6%). Treatment to eradicate H. pylori had a significantly higher success rate for HCV-infected patients (61 of 67, 91.0%) than for HCV-noninfected controls (115 of 158, 72.8%).Conclusions
The markedly high H. pylori eradication rate observed in this study shows that eradication of H. pylori holds promise for the improvement of the long-term health condition of patients with chronic HCV infection. 相似文献14.
Frank Wong George Ou Sigrid Svarta Ricky Kwok Kieran Donaldson Joe Frenette Robert Enns 《Journal canadien de gastroenterologie》2013,27(11):636-638
BACKGROUND:
Helicobacter pylori infection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates of H pylori-related ulcers as well as other complications such as gastric cancer.OBJECTIVE:
To determine the rate of appropriate treatment in patients following a diagnosis of H pylori infection on biopsy during esophagoduodenoscopy for upper gastrointestinal bleeding over a four-year period at a tertiary centre in Vancouver, British Columbia. Also evaluated was the rate of eradication confirmation using the urea breath test.METHODS:
A retrospective review of 1501 inpatients who underwent esophagoduodenoscopy for upper gastrointestinal bleeding (January 2006 to December 2010) was undertaken. Patients who were biopsy stain positive for H pylori were selected for drug review either via a provincial database (PharmaNet) or via records from patients’ family practitioners. Data were also obtained via two provincial laboratories that perform the urea breath test to determine the rates of confirmation of eradication.RESULTS:
Ninety-eight patients had biopsy-proven H pylori. The mean (± SD) age was 56.13±17.9 years and 65 were male. Data were not available for 22 patients; the treatment rate was 52.6% (40 of 76). Of those treated, 12 patients underwent a post-treatment urea breath test for eradication confirmation.CONCLUSION:
There was substantial discrepancy between the number of diagnosed H pylori infections and the rate of treatment as well as confirmation of eradication. Numerous approaches could be taken to improve treatment and eradication confirmation. 相似文献15.
Ho Dong Kim Do Hyun Kim Hyeuk Park Woo Jong Kim Yong Soo Ahn Young Jik Lee Sun Mi Park Eun Seon Seo Chul Park Yang Ho Kim Hyung Rag Kim Young Eun Joo Young Do Jung 《Gut and liver》2013,7(1):30-34
Background/Aims
The objective of this study was to evaluate a monoclonal antibody-based test to detect Helicobacter pylori-specific antigen in gastric aspirates from humans.Methods
Sixty-one volunteers were enrolled in the study. All of the subjects underwent a 13C-urea breath test (UBT) before esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia and used for polymerase chain reaction (PCR), culture, and monoclonal antibody-based detection of H. pylori. Multiple biopsies of the gastric antrum and body were obtained for a rapid urease test (RUT) and histological evaluation.Results
Thirty-six subjects were H. pylori-positive and 25 were H. pylori-negative according to the UBT results. Compared with the H. pylori-negative subjects, H. pylori-positive subjects had a higher pH (4.77±1.77 vs 3.49±1.30, p<0.05) and ammonia level (1,130.9±767.4 vs 184.2±126.3, p<0.0001). The sensitivities and specificities of the PCR test, RUT, culture test, and monoclonal antibody-based test were 100% and 72%, 89% and 100%, 47% and 100%, and 78% and 100%, respectively.Conclusions
The monoclonal antibody-based test for diagnosing H. pylori infection in gastric aspirates has increased sensitivity compared with the culture test and specificity as high as that of the RUT. The test may be useful as an additive test for examining gastric aspirates. 相似文献16.
Background/Aims
The role of Helicobacter pylori in gastric carcinogenesis is unclear, but H. pylori infection is thought to predispose carriers to gastric cancer. The aim of this study was to investigate the relationship between the extent of DNA damage in normal gastric epithelial cells and H. pylori-positive and -negative gastritis according to histological diagnosis. We also compared the percentage of cometed cells on the surface of the gastric epithelial cells to the percentage beneath the gastric mucosal cells using serial incubations times.Methods
The comet assay is a rapid, efficient and reproducible measure of DNA damage in single cell and it was used in this study. DNA damage was evaluated in 52 cases using alkaline single cell gel electrophoresis (comet assay). Comparisons were made between 19 normal individuals, 19 patients with H. pylori-positive and -negative gastritis and 14 mixed cases with different histology gradings to determine if there was a relationship between histological diagnosis and DNA damage (comet percentage).Results
The comet percentages in specimens from cases with normal histology were significantly higher than the comet percentages in specimens from cases with H. pylori-positive gastritis. In addition, there was a significant increase in the percentage of cometed cells on the surface of gastric epithelial cells in both normal and H. pylori-infected cells compared to the subsequent gastric cell layers of the same specimen.Conclusions
A relationship between the comet percentage and the histological diagnosis was observed. 相似文献17.
Hee Jin Kim Nayoung Kim Hyuk Yoon Yoon Jin Choi Ju Yup Lee Yong Hwan Kwon Kichul Yoon Hyun Jin Jo Cheol Min Shin Young Soo Park Do Joong Park Hyung Ho Kim Hye Seung Lee Dong Ho Lee 《Gut and liver》2016,10(2):212-219
Background/Aims
Controversy exists regarding the characteristics of Helicobacter pylori infection-negative gastric cancer (HPIN-GC). The aim of this study was to evaluate clinicopathologic features of HPIN-GC compared to H. pylori infection-positive gastric cancer (HPIP-GC) using a comprehensive analysis that included genetic and environmental factors.Methods
H. pylori infection status of 705 resectable gastric cancer patients was determined by the rapid urease test, testing for anti-H. pylori antibodies, histologic analysis and culture of gastric cancer tissue samples, and history of H. pylori eradication. HPIN-GC was defined as gastric cancer that was negative for H. pylori infection based on all five methods and that had no evidence of atrophy in histology or serology.Results
The prevalence of HPIN-GC was 4% (28/705). No significant differences with respect to age, sex, smoking, drinking, family history of gastric cancer or obesity were observed between the two groups. HPIN-GC tumors were marginally more likely to involve the cardia (14.3% for HPIN-GC vs 5.3% for HPIP-GC, p=0.068). The Lauren classification, histology, and TNM stage did not differ according to H. pylori infection status. Microsatellite instability was not different between the two groups, but p53 overexpression in HPIN-GC was marginally higher than in HPIP-GC (56.0% for HPIN-GC vs 37.0% for HPIP-GC, p=0.055).Conclusions
The prevalence of HPIN-GC was extremely low, and its clinicopathologic characteristics were similar to HPIP-GC. 相似文献18.
Ji Yoon Moon Gwang Ha Kim Hyun Seok You Bong Eun Lee Dong Yeop Ryu Jae Hoon Cheong Jung Im Jung Jae Hoon Jeong Chul Soo Song Geun Am Song 《Gut and liver》2013,7(4):406-410
Background/Aims
Several rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole, and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment.Methods
In total, 113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7 days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days.Results
According to intention-to-treat analysis, the infection was eradicated in 38 of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%) in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%) from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group.Conclusions
LML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary second-line strategy for patients experiencing a failure of first-line H. pylori therapy in Korea. 相似文献19.
Background/Aims
Our aim was to compare the long-term clinical outcomes of idiopathic peptic ulcer disease (IPUD) with those of Helicobacter pylori-positive and nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcer disease (PUD).Methods
Patients with endoscopically diagnosed PUD were retrospectively reviewed. According to their H. pylori-infection status and history of NSAIDs use, patients were categorized into three groups: H. pylori-positive PUD, NSAID-induced PUD, and IPUD. Clinical outcomes were analyzed, and the recurrence rate of PUD was compared among the three groups.Results
A total of 238 patients were enrolled. Those with IPUD, NSAID-induced PUD, and H. pylori-positive PUD comprised of 56, 60, and 122 patients, respectively. The 5-year cumulative incidences of recurrent ulcers were 24.3% (95% confidence interval [CI], 11.6% to 37.0%) in IPUD, 10.9% (95% CI, 2.6% to 19.2%) in NSAID-induced PUD, and 3.8% (95% CI, 0.1% to 7.5%) in H. pylori-positive PUD (IPUD vs NSAID-induced PUD/H. pylori-positive PUD, p=0.43/p<0.001 by log-rank test). In the Cox-proportional hazards model, only IPUD remained as an independent risk factor associated with recurrent ulcers (hazard ratio, 5.97; 95% CI, 1.94 to 18.34; p=0.002).Conclusions
IPUD exhibited a higher recurrence rate than H. pylori-positive and NSAID-induced PUD in long-term follow-up and was an independent risk factor for ulcer recurrence. 相似文献20.
Cho SJ Choi IJ Kim CG Lee JY Kook MC Seong MW Park SR Lee JS Kim YW Ryu KW Lee JH Nam BH Park YI 《Gut and liver》2010,4(4):466-474