Lack of association between appendectomy and primary biliary cirrhosis

Objective Children with inflammatory bowel disease (IBD) suffer from malabsorption and malnutrition and therefore may be at risk of developing polyunsaturated fatty acid (PUFA) deficiency. The aim of this study was to investigate PUFA status in children with IBD and the possible relationship to disease activity and nutritional status.

Material and methods We assessed the fatty acid composition of plasma phospholipids (%wt/wt) of 21 children aged 5.5–18 years with IBD (ulcerative colitis, 15; Crohn's disease, 6) with mild or moderate disease activity. The clinical symptoms and biochemical indices of disease activity and nutritional status (lean and fat body mass, Hb, albumin serum conc.) were also determined.

Results The patients had lower phospholipid PUFAs than 13 healthy, aged-matched controls (25.8±5.2 versus 34.2±5.7, M±SD, p<0.001), mainly due to lower values of linoleic acid (18:2n?6, 14.0±3.8 versus 18.3±4.3, p<0.01) and its major metabolite arachidonic acid (20:4n?6, 5.3±2.0 versus 9.3±1.9, p<0.0001). There were also higher values of α-linolenic acid (18:3n?3, 0.3±0.4 versus 0.2±0.1, p<0.01) while the long-chain n?3 PUFA-eicosapentaenoic and docosahexaenoic acids were normal. Total n?6 PUFA correlated inversely to erythrocyte sedimentation rate (p<0.01), seromucoid (p<0.05) and positively to Hb concentration (p<0.01).

Conclusions Children with inflammatory bowel disease have a high risk of n?6 PUFA depletion, which is related to disease activity.     

Lack of association between appendectomy and primary biliary cirrhosis

OBJECTIVE: In view of the possible implication of various environmental factors in the pathogenesis of primary biliary cirrhosis (PBC), the role of appendectomy in patients with PBC and other chronic liver diseases from Central Greece was investigated. MATERIAL AND METHODS: The medical files of 68 patients with PBC and gender- and age-matched controls with chronic hepatitis C virus (HCV) infection (n=65) and chronic hepatitis B virus (HBV) infection (n=67) were reviewed for the history and time of appendectomy. RESULTS: Nineteen of 68 (27.9%) PBC patients, 32 of 65 (49.2%) patients with chronic HCV infection and 22 of 67 (32.8%) patients with chronic HBV infection had a history of appendectomy. There was a significant higher frequency of appendectomy in patients with chronic hepatitis C (p = 0.012, chi(2) test) compared to patients with PBC. There were no significant differences in the clinical and histological characteristics of PBC patients with or without a history of appendectomy. CONCLUSION: In this case-control study we were unable to provide evidence of an association between primary biliary cirrhosis and the occurrence of appendectomy.     

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects.

BACKGROUND: There are conflicting data on the association between Helicobacter pylori (HP) infection and cardiovascular diseases. AIM: To determine if there is an association between gastric HP infection and atherosclerosis of cerebral or peripheral arteries in elderly subjects. METHODS: 90 dyspeptic elderly subjects had upper gastro-intestinal endoscopy and the gastroduodenal pathology was identified. HP infection was confirmed by gastric histology and the rapid urease test. Vascular ultrasonography of extracranial cerebral arteries and leg arteries was performed to evaluate (i) the presence of an atherosclerotic lesion, (ii) the total length of all plaques documented and (iii) the number of arteries with atherosclerotic lesions. Statistical analysis was by the chi2 test, Yates's corrected chi2 test, the Mann-Whitney test and logistic regression. RESULTS: 59 subjects were HP-positive. These had a higher prevalence of peptic ulcer disease (P = 0.01) and higher serum levels of IgG anti-HP antibodies (P = 0.0001), but no significant differences in the number of atherosclerotic lesions, the total length of the plaques or the number of arteries with lesions. No significant association of HP positivity was found with diabetes mellitus, hypertension, cigarette smoking or coronary heart disease, nor with serum concentrations of HDL-cholesterol, fibrinogen, triglycerides or glucose. CONCLUSIONS: Elderly dyspeptic subjects with gastric HP infection had significantly more peptic ulcer disease but no more atherosclerotic lesions than those who were HP-negative. Atherosclerosis was not associated with HP infection. In this cross-sectional study of elderly patients with dyspepsia, no association between HP infection and extracardiac atherosclerosis was found.     

幽门螺杆菌感染与肝硬化

探讨幽门螺杆菌(Hp)在肝硬化中的感染率并对其与肝功能、门脉高压、传播途径作相关分析。对30例胃十二指肠疾病患者和30例肝硬化患者进行胃镜检查、Hp快速尿素酶试验、14C呼吸试验同时记录年龄、饮食结构、习惯;肝功能指标(白蛋白、凝血酶原时间),门脉高压(腹水、脾大、食道静脉曲张),血常规(记录Hb)的相关资料。结果显示:Hp在肝硬化的感染率低于胃十二指肠疾病。Hp在肝硬化感染中的现象:分餐和低唾液可能是感染率低的一个主要因素,Hh减少、肝功能差、门脉高压增加与Hp感染率低有重要相关。肝硬化的低感染率与肝功能失代偿期、门脉高压和贫血不适宜Hp生存有关。口一口传播途径与Hp减少有重要相关性。     

The association between diabetes mellitus and Helicobacter pylori infection

Helicobacter pylori is a major cause of duodenal and gastric diseases. The aim of this study was to estimate the prevalence of H. pylori infection in patients with diabetes mellitus, and to investigate the association between H. pylori infection and upper gastrointestinal symptoms. In this case-control study, 79 diabetic patients and 84 control subjects with upper gastrointestinal symptoms were included. Upper gastrointestinal endoscopy was performed and gastric mucosa biopsied. H. pylori was identified by rapid urease test and by histology. A serum sample was obtained to measure H. pylori antibodies. The adjusted odds ratio estimates of H. pylori infection among pre-diabetic and diabetic subjects compared to non-diabetic subjects were 0.51 (95 % CI: 0.16, 1.63) and 1.33 (95 % CI: 0.64, 1.79) respectively. No association was found between H. pylori infection and upper gastrointestinal symptoms among three groups. The serology test for H. pylori was positive in 54.4 % (43) of diabetics and 61.4 % (43) of non-diabetic patients (P?=?0.689, non-significant). There was significant difference in rapid urease test between diabetes mellitus patients and non-diabetes patients (70.9 % versus 48.6 %, P?=?0.002). There was no association between upper gastrointestinal symptoms among diabetes mellitus, pre-diabetic and non-diabetic patients. We found no association between H. pylori infection and diabetes mellitus.     

口腔幽门螺杆菌感染与胃幽门螺杆菌感染的相关性探讨

目的 分析口腔和胃幽门螺杆菌(Hp)感染的检测结果,探讨口腔Hp感染与胃Hp感染的相关性,及口腔Hp感染对Hp根除治疗的影响.方法 采用唾液测定螺旋杆菌抗原技术(HPS)和13C/14C尿素呼气试验(UBT)同步检测的方法,对114例有上消化道症状的初诊患者(第1组),129例确诊为胃Hp感染经根除治疗后4周复查的患者(第2组)和33例无消化道症状的健康志愿者(第3组),进行口腔和胃Hp检测.结果 第1组、第2组和第3组HPS阳性检出率分别为77.19%、75.97%和81.82%,3组比较差异无统计学意义(χ2=0.47,P值均>0.05);UBT阳性检出率第1组(52.63%)比第2组(34.11%)和第3组(21.21%)高,第1组与第2组和第3组比较,差异有统计学意义(χ2=8.48和10.19,P均<0.05),第2组与第3组之间差异无统计学意义(χ2=2.03,P>0.05);在UBT阳性者中,HPS阳性检出率差异无统计学意义(3组分别为81.67%、88.64%和100%,χ2=2.25,P值均>0.05).结论 唾液中存在高Hp抗原检出现象,口腔可能是Hp在胃以外的"第二定居地".口服药物治疗对口腔Hp感染几乎无效,口腔Hp的存在可能是胃病发病和复发的一个重要和直接的原因.

Abstract：

Objective To explore association between Helicobacter pylori (Hp) infection in oral cavity and gastric Hp infection through oral cavity and gastric Hp infection testing results analysis, and also to study the effect of Hp infection in oral cavity on Hp eradication treatment. Methods Through Hp saliva test (HPS) and 13C/14C urea breath test (UBT) method, the Hp in oral cavity and stomach were tested in 114 first-visit patients with upper gastrointestinal symptoms (group 1), 129 re-visiting patients who were diagnosed gastric Hp infection with eradication treatment for four weeks (group 2) and 33 volunteers without gastrointestinal symptoms. Results The positive rates of Hp infection by HPS method were 77.19%, 75.97% and 81.82% in group 1, group 2 and group 3 respectively. There was no significant difference between these three groups (χ2=0.47, P>0.05). The positive rate of Hp infection by UBT method in group 1 (52.63%) was higher than those of group 2 (34.11%) and group 3 (21.21%). Compared group 1 with group 2 or group 3, there was significant difference (χ2=8.848, 10.19, P<0.05). There was no significant difference between group 2 and 3 (χ2=2.03, P>0.05). In positive individuals of these three groups tested by UBT method, there was no significant difference of positive rate tested by HPS method (81.67%, 88.64% and 100% of three groups respectively, χ2=2.25, P>0.05). Conclusions The High detection of Hp antigen in saliva indicates that the oral cavity may be the "second settlement" of Hp beside stomach. The oral medicine haslittle effect on oral cavity Hp infection. The existence of oral Hp may be an important and direct factor of incidence and recurrent of gastric diseases.     

No specific association between primary biliary cirrhosis and bacteriuria?

160 consecutive patients with primary biliary cirrhosis (PBC) (M:F, 13:147; total samples 286), 140 patients with other chronic liver disease (CLD) (M:F, 75:65; total samples 200), and 28 patients with primary Sj?gren's syndrome (all F; total samples 37), were examined for bacteriuria over 6 months by midstream urine (MSU) examination. The overall prevalence of bacteriuria in PBC was 11.2% (7.5% on first MSU), in CLD 12.1% (10.7% on first MSU), 18.4% in the 65 female CLD patients, 10.7% in Sj?gren's syndrome patients (3.5% on first MSU). The prevalence of bacteriuria was related to the age of the patient (P less than 0.02) in PBC and to the presence or absence of cirrhosis in both PBC and CLD (P less than 0.02). There was no difference in the prevalence of bacteriuria between PBC and CLD patients taken as a whole or among females alone, cirrhotic or non-cirrhotic groups. In a second prospective study of the cumulative incidence of bacteriuria in PBC versus CLD and Sj?gren's no significant differences between groups was observed but among 29 PBC patients the cumulative proportion of positive tests for bacteriuria after 5 months (monthly testing) was 34%. We conclude that there is no specific association between PBC and bacteriuria compared with the prevalence of bacteriuria in other CLD.     

Helicobacter pylori seroprevalence in hepatitis C virus positive patients with cirrhosis

BACKGROUND/AIMS: Liver cirrhosis is a significant cause of death in Italy and one of the most frequent causes of hospitalization. Acute peptic ulcer and upper gastrointestinal bleeding reportedly occur in over one-third of cirrhotic patients. Since Helicobacter pylori (H. pylori) infection strongly correlates with peptic ulcer, we sought to ascertain the prevalence of H. pylori infection in cirrhotic patients. METHODS: In a case-control study, we examined 254 consecutive patients (127 male and 127 female, age range 30-82 years) suffering from hepatitis C virus (HCV)-related cirrhosis and 463 sex- and age-matched patients admitted to the Department of Emergency Care of our hospital (254 male, 209 female, age range 30-79 years) resident in the same area. RESULTS: Antibodies to H. pylori were present in 226/254 (89%) cirrhotic patients and in 275/463 (59%) controls (p<0.0001). The difference was significant both in males and in females. CONCLUSIONS: The very high prevalence of H. pylori infection may explain the frequent occurrence of gastroduodenal ulcer in cirrhotic patients and may possibly determine the prognosis of those who are also infected with HCV.     

肺炎衣原体感染与原发性胆汁性肝硬化的相关性研究

目的 通过检测原发性胆汁性肝硬化(PBC)患者血清中抗肺炎衣原体(CP)IgG、IgM水平,探讨CP感染与PBC之间的相关性。 方法 采用CP酶联免疫固相吸附试验检测41例PBC患者(PBC组)、70例肝炎后肝硬化(疾病对照组,PHC组)和57名健康查体者(正常对照组)血清抗CP IgG、IgM抗体水平。 结果 PBC组和PHC组的抗CP IgG平均水平(RU/ml)较正常对照组高(46.8±43.4、49.5±45.2与28.3±32.7,P=0.042与P<0.001),但PBC组与PHC组之间差异无显著性(P=O.059);PBC组、PHC组抗CP IgG阳性率亦高于正常对照组(68.3％、71.4％与42.1％,x2值分别为5.389、11.110,P值均小于0.05),PBC组与PHC组差别无显著性(x2=0.378,P>0.05);PBC组患者的血清抗CP IgM阳性率最高(22.0％),明显高于其它两组。与正常对照组比较,PBC组抗CP IgG、IgM阳性的比率比(OR)分别为2.7(95％ CI:0.9～6.1)、5.1(95％ CI:1.4～18.5);血清抗CP IgG水平与总IgG浓度无相关性(r=-0.857,P=0.344),而抗CP IgM阳性与总IgM异常升高有关。 结论 血清学研究结果尚不能支持肺炎衣原体是PBC的一个始动因素这一观点,但CP感染可能是造成PBC中IgM升高的原因之一。     

幽门螺杆菌感染与肝硬化患者的高氨血症

一、背景———问题的提出氨的来源有外源性与内源性之分。内源性氨是体内蛋白质分解生成 ,对外源性氨来源的认识经历了一个较长的过程。早期认为是存在于消化道粘膜尿素酶分解由血液弥散到消化道的尿素生成 ,但 1976年Ｍｅｙ ｅｒｓ等[1] 发现氨苄青霉素及新霉素可使胃液内氨浓度下降 ,提示胃内尿素酶活性并非来源于粘膜本身而是来源于细菌 ,至此外源性氨的生成有了较一致的意见即肠菌丛 (主要是大肠杆菌 )分解由血液弥散到消化道的尿素以及食物蛋白质分解产物氨基酸而生成。这便是长期以来一致公认的氨的肠源性学说。但自 1983年Ｍａｒｓ…     

Bone disease in primary biliary cirrhosis: Lack of association with distal renal tubular acidosis

Background and Aims: Primary biliary cirrhosis (PBC) might be complicated by osteoporosis, whose etiology remains unknown but seems to be multifactorial. Prevalence rates of 30% to 60% for distal renal tubular acidosis (DRTA) have been reported in PBC patients, generally as incomplete DRTA. Although it is undisputed that a reduced bone mineral density (BMD) is the expected outcome among patients who have been suffering from longstanding chronic metabolic acidosis, it is unclear if incomplete DRTA is also associated with metabolic bone disease in PBC patients. The present study was undertaken to compare the BMD of PBC patients with and without DRTA.
Methods: The BMD of 23 PBC patients (11 with DRTA and 12 without), all with normal clearance of creatinine, was assessed by dual energy radiograph absorptiometry. The diagnosis of DRTA was made if the urine pH was above 5.4 in all samples after the oral acid overload, showing tubular inability to acidify urine in the presence of test-induced systemic metabolic acidosis.
Results: Densitometric signs of osteoporosis were found in 82% of DRTA cases and in 83% of patients without DRTA (difference not significant). There were no significant differences in BMD measurement, T and Z scores of patients with and without DRTA.
Conclusions: The present study could not support a correlation between the presence of DRTA and the bone loss observed in PBC patients.     

No evidence of an association between Helicobacter pylori infection and Raynaud phenomenon

BACKGROUND: Raynaud phenomenon (RP) is a vasospastic condition that manifests itself as cold-induced ischemic attacks of the fingers with skin color changes. It may be classified as primary (PRP) or secondary (SRP), if associated to other diseases, mainly connective-tissue diseases. Recently, the association between PRP and Helicobacter pylori infection has been reported. The aims of this study were to evaluate the prevalence of gastric H. pylori infection in a large group of patients affected by PRP and SRP and to assess whether it was more evident in patients with more recent onset of RP. METHODS: Ninety-eight consecutive patients (93 F and 5 M), referring to our videocapillaroscopic service for the diagnosis of vascular and connective-tissue diseases, were evaluated. Forty-nine of them were affected by PRP and 49 by SRP. Patients were classified as having PRP on the basis of normal serological and immunological findings, normal videocapillaroscopic examination and exclusion of other conditions inducing RP. H. pylori infection was diagnosed by 13C-urea breath test (UBT). Two groups of 49 age-and sex-matched controls, respectively, were also evaluated. RESULTS: Patients with SRP resulted significantly older than those with PRP (P < 0.006). UBT was found positive in 22/49 patients with PRP (45%) and in 29/49 patients with SRP (59%). The positivity of the respective control groups was 36% and 53% (P = NS). There was no higher prevalence of H. pylori infection in patients with RP lasting for less than 4 years. CONCLUSIONS: The results do not confirm the previously reported high prevalence of H. pylori infection in patients with PRP. A high association was not even found between the presence of the microorganism and SRP. There was no difference in the prevalence of H. pylori infection among the subgroups with more recent onset of both PRP and SRP.     

幽门螺杆菌感染与原发性胃淋巴瘤

目的探讨幽门螺杆菌（Ｈｐ）感染与原发性胃淋巴瘤、胃ＭＡＬＴ淋巴瘤的关系．方法经内镜、手术诊断的胃淋巴瘤患者２９例，其中男１９例，女１０例；年龄３０岁～７５岁，中位数年龄５２５岁．胃窦部１３例，胃体部９例，贲门部２例．凹陷溃疡型９例，蕈样隆起型８例，结节型１２例．胃粘膜标本切片，采用ＨＥ及ＷａｒｔｈｉｎＳｔａｒｙ染色后观察组织中有无Ｈｐ感染．结果原发性胃淋巴瘤患者２９例，胃粘膜组织中发现Ｈｐ感染２４例，阳性率８２８％．其中胃ＭＡＬＴ淋巴瘤８例，Ｈｐ感染７例，阳性率８７５％．明显高于同期胃良性病变Ｈｐ阳性率４６％（Ｐ＜００１）．２９例中１１例进行了术后随访，３例仍存在Ｈｐ感染，阳性率２７３％．结论Ｈｐ感染在原发性胃淋巴瘤的发病机制中起一定作用．     

肝硬化并发消化性溃疡与Helicobacter pylori感染的临床相关性研究

目的探讨Helicobacter phylori(H.pylori)与肝硬化并发消化性溃疡的临床相关性。方法 H.pylori阳性患者1 887例和H.pylori阴性患者685例,采用Logistic回归分析计算其比值比(OR)和95%CI,以此确定H.pylori感染是否是肝硬化并发消化性溃疡的独立因素。结果 100例失代偿期肝硬化合并消化性溃疡患者,H.pylori阳性38例,H.pylori阴性62例。364例代偿期肝硬化并发消化性溃疡患者,H.pylori阳性195例,H.pylori阴性169例。非肝硬化患者消化性溃疡H.pylori阳性1 654例、H.pylori阴性454例。Logistic回归分析显示,失代偿期肝硬化患者(OR=0.25,P0.001)和代偿期肝硬化患者(OR=0.52,P0.001)H.pylori感染率较低。结论 H.pylori感染可能不是肝硬化合并消化性溃疡的主要病因。     

Helicobacter pylori seroprevalence in cirrhotic patients with hepatitis B virus infection

Liver cirrhosis is a significant cause of death in Italy and one of the most frequent causes of hospitalization. The burden of cirrhotic patients on the National Health System is extremely high due to the frequent need for medical care. Acute peptic ulcer and upper gastrointestinal bleeding reportedly occur in over one-third of cirrhotic patients. Since Helicobacter pylori (H. pylori) infection strongly correlates with peptic ulcer, we wished to ascertain the prevalence of H. pylori infection in cirrhotic patients. In a case-control study we looked for this infection in 45 consecutive male patients suffering from hepatitis B virus (HBV)-related cirrhosis and 310 sex and age matched blood donors resident in the same area. Antibodies against H. pylori were present in 40/45 (89%) patients and 183/310 (59%) blood donors (P<0.001). This very high prevalence of H. pylori may explain the frequent occurrence of gastroduodenal ulcer in cirrhotic patients. (See Editorial p. 203)     

小儿缺铁性贫血与幽门螺杆菌感染相关性研究

目的探讨小儿缺铁性贫血（IDA）与幽门螺杆菌（Hp）感染的相关性。方法对85例幼儿园儿童进行全血血常规、血清铁、总铁结合力及Hp检测，并将其分为IDA组和非IDA对照组，对两组Hp感染情况进行统计分析。结果41例贫血儿童中有27例感染Hp（65-85％），44例正常儿童中有12例感染Hp（27．27％），两者比较有显著差异（χ^2=12．72，P〈0．001）。结论小儿IDA与Hp感染具有相关性。     

Inverse association between Helicobacter pylori infection and allergic rhinitis in young Japanese

Background and Aim: The prevalence of allergic disorders, including asthma, atopic dermatitis, and allergic rhinitis has been increasing, and the prevalence of Helicobacter pylori (H. pylori) infection has been decreasing. Chronic bacterial infection during childhood is reported to protect the development of allergic diseases. The aim of the present study was to identify whether H. pylori infection influences the prevalence of allergic rhinitis, which has become a serious social problem, especially in the developed countries. Methods: We initially investigated the association between the prevalence of H. pylori and pollinosis symptoms in 97 healthy volunteers. We had investigated the association between the serum H. pylori–immunoglobulin (Ig) G antibodies and specific IgE antibodies for pollen, mites, and house dust in 211 consecutive patients. Results: There were 52.2% (36/69) of H. pylori‐negative volunteers with allergic symptoms, which was significantly higher than H. pylori‐positive volunteers (14.3%, 4/28, P < 0.05). The risk of pollinosis symptoms by H. pylori infection was 0.148 (95% confidence interval): 0.046–0.475, P < 0.05). The prevalence of H. pylori infection increased according to age, whereas that of specific IgE‐positive patients gradually decreased. Among the IgE‐positive patients, the prevalence of H. pylori‐negative patients was significantly higher than H. pylori‐positive patients who were younger in age (P < 0.05). Conclusion: H. pylori infection decreased the pollinosis effects, especially among the younger volunteers. However, the prevalence of pollinosis in patients who were 50 years or older were almost same between H. pylori‐positive and H. pylori‐negative patients; therefore, the recent increase of pollinosis might relate to not only H. pylori infection, but also change in social environment.