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Trabalhos Publicados em Janeiro / 2018

RECORD 1

 

The importance of helicobacter pylori in the development of gastric MALT  lymphoma - Induction of proliferation and immune suppressionKrzyzek P.  Kwiatkowska B.Nowotwory (2017) 67:4 (261-266). Date of Publication: 29 Dec  2017Marginal zone B-cell lymphomas are indolent, slow-growing lymphomas derived  from mature B cells. They represent about 8% of all lymphomas and about 50%  of all primary gastric lymphomas. Based on numerous epidemiological and  microbiological studies, Helicobacter pylori is believed to be responsible  for the progression of gastric MALT lymphomas (GML). Lymphoid tissue is  physiologically absent from the stomach. However, GML can arise from chronic  H. pylori infection and immune cell infiltration. This review article  describes the mechanisms favouring the development of H. pylori-induced GML,  and suggests potential targets for a more effective remission of lymphomas  localized within the stomach.                                                                               

 

RECORD 2

 

Eradication rate of helicobacter pylori  on the US-Mexico border using the  urea breath testLiu R.P. Romero R. Sarosiek J. Dodoo C. Dwivedi A.K. Zuckerman  M.J.Southern Medical Journal (2018) 111:1 (51-55). Date of Publication: 1 Jan  2018Objectives Helicobacter pylori is prevalent worldwide, especially in Latin  America. Triple and quadruple antibiotic therapies have been relatively  effective; however, resistance has emerged in recent years. The treatment  success rate of these regimens on the border of the United States and Mexico  is unknown. Our study attempted to determine eradication rates of two major  regimens based on urea breath test (UBT) results in patients previously  diagnosed as having H. pylori in a single center in El Paso, Texas, a city  on the geographic border with Mexico. Methods This was a retrospective  cohort study of adult patients with H. pylori who underwent UBT after being  treated with triple therapy (amoxicillin/clarithromycin/proton pump  inhibitor for 14 days), quadruple therapy  (tetracycline/metronidazole/bismuth/proton pump inhibitor, usually for 10  days), or both for H. pylori from 2010 to 2015 in a county hospital.  Patients were excluded if they did not complete therapy or if their  treatment regimen was unknown. The Student t test and the χ 2 test were used  to analyze the data. The cumulative incidence and 95% confidence interval  (CI) for treatment success were estimated. Results A total of 104 patients  completed the treatment for H. pylori and had UBT. Mean age was 53 years,  76% were women, 85% were Hispanic, and mean body mass index was 30.5 kg/m 2.  Of the 104 patients diagnosed as having H. pylori, 88 received triple  therapy (84.6%) and 16 received quadruple therapy: 12 (11.5%) standard  quadruple therapy, 4 (3.9%) triple therapy plus metronidazole. There were no  differences between groups regarding age, sex, body mass index, or  ethnicity. Overall, 90 (86.5%, 95% CI 78-92) patients had negative UBT after  initial treatment. Based on posttreatment UBT, the triple therapy group had  a similar eradication rate compared with the quadruple therapy group (78/88,  88.6% vs 12/16, 75.0%, P = 0.22). Of the 14 patients with positive  posttreatment UBT, 12 (85.7%) received retreatment (2 were lost to  follow-up), 11 (91.7%) received quadruple therapy, and 1 (8.3%) received  triple therapy. Eradication was successful in 9 of 12 (75%, 95% CI 43-95)  patients at retreatment. As such, of the initial 104 patients, 99/104  (95.2%) achieved H. pylori eradication posttreatment (either initial or  retreatment). Conclusions In a predominantly Hispanic population on the  US-Mexico border, H. pylori eradication rates based on UBT results were  relatively high and were similar for triple therapy and quadruple therapy.  Quadruple therapy was effective for those who failed the initial H. pylori  treatment. This may have implications for cost-effective therapy in our  region.                                                                               

 

RECORD 3

 

Twelve-day quintuple regime containing four antibiotics a s a rescue therapy  for Helicobacter pylori eradication in the central region of PortugalBranquinho  D. Almeida N. Gregório C. Casela A. Manuel-Donato M. Tomé L.Revista Espanola  de Enfermedades Digestivas (2017) 109:6 (430-434). Date of  Publication: 2017Background: Helicobacter pylori eradication rates with standard triple  therapy in many countries are clinically unacceptable. Fluoroquinolone  resistance is increasing and jeopardizing secondline regimens. There is a  growing need for an effective strategy in patients who failed previous  therapies. Methods: This is a single-center, non-randomized clinical study  conducted in the central region of Portugal. Sixty-four patients were  included with a positive (13)C-urea breath test (UBT) or histology for H.  pylori, and at least one failed eradication attempt. The patient cohort  included 71.7% of females with a median of age of 52 (range 23-87). They  were treated with a twelve-day regimen consisting of a proton-pump inhibitor  (PPI) bid, amoxicillin at 1,000 mg 12/12h and levofloxacin at 500 mg bid  during the first seven days, followed by PPI bid, clarithromycin at 500 mg  12/12 h and either tinidazole or metronidazole at 500 mg bid/tid for five  days. Eradication was assessed by UBT. The local Ethics Committee approved  this study. Results: Eradication therapy was prescribed due to dyspepsia  (66.7%), peptic ulcer (10%) and thrombocytopenia (8.3%). The median number  of failed therapies was one (range 1-4). The eradication rate was 64.6%  according to an intention-to-treat analysis (95% CI: 53-77%), and 70% by the  per-protocol analysis (95% CI: 58-82%). Age, smoking, indication for  eradication, previous therapies and the use of a second-generation or  full-dose PPI did not affect success rates. Conclusions: Even though  treatment with four antibiotics was used, this “reinforced” therapy achieved  suboptimal results. This fact highlights the lack of effective H. pylori  antimicrobials and suggests that second-line treatment in our region should  be prescribed according to susceptibility testing.                                                                              

 

RECORD 4

 

The influence of  Vitamin D deficiency on eradication rates of Helicobacter  pyloriYildirim O. Yildirim T. Seckin Y. Osanmaz P. Bilgic Y. Mete R.Advances  in Clinical and Experimental Medicine (2017) 26:9 (1376-1381). Date  of Publication: 1 Dec 2017Background. Helicobacter pylori eradication therapy  improves the healing of  various gastro-duodenal diseases such as chronic gastritis and peptic ulcer,  and also reduces gastric cancer incidence. Several studies have reported on  risk factors other than antibiotic resistance related to Helicobacter pylori  eradication failure. Objectives. In this study, we aimed to investigate  whether or not the serum levels of 25-hydroxy-vita-min D (25(OH)D) influence  eradication rates of H.pylori. Material and methods. 220 patients diagnosed  with H.pylori gastritis using endoscopic biopsy had their 25-OH vitamin D  levels measured via the electrochemiluminescence method before beginning  eradication therapy of H.pylori. Gastric biopsies obtained at endoscopy were  examined for H.pyloristrains and histopathologic findings. All patients were  treated with bismuth-containing quadruple therapy for 14 days. H.pylori  eradication was determined via the 14C-urea breath test performed 4 weeks  after the end of therapy. Based on the 25-OH vitamin D levels, the patients  were divided into 2 groups: group 1 (deficient) had a vitamin D level of <10  ng/mL, while group 2 (sufficient) had a vitamin D level of ≥10 ng/ mL.  Results. Eradication was successful in 170 (77.2%) patients and failed in 50  (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean  25(OH)D levels were significantly lower in the eradication failure group  compared to the successful treatment group (9.13 ±4.7 vs 19.03 ±8.13; p =  0.001). There were significantly more patients with deficient 25(OH)D levels  in the failed treatment group compared to the successful treatment group (p  = 0.001). Conclusions. Our findings suggest that 25-OH vitamin D deficiency  may be considered a risk factor related to eradication failure of H.pylori,  which may lead to a need for supplementation of vitamin D before eradication  of H.pylori.                                                                              

 

RECORD 5

 

Probiotic monotherapy and Helicobacter pylori eradication:  A systematic  review with pooled-data analysisLosurdo G. Cubisino R. Brone M. Principi M.  Leandro G. Ierardi E. Di Leo A.World Journal of Gastroenterology (2018)  24:1 (139-149). Date of  Publication: 7 Jan 2018AIM To define probiotic monotherapy effect on Helicobacter  pylori (H. pylori  ) status by performing a systematic review. METHODS Methods of analysis and  inclusion criteria were based on PRISMA recommendations. Relevant  publications were identified by searching PubMed, MEDLINE, Science Direct,  and EMBASE. The end-point was to estimate eradication rate and urea breath  test delta value before and after probiotic monotherapy across all studies  and, overall, with a pooled data analysis. Adverse events of probiotic  therapy were evaluated. The data were expressed as proportions/percentages,  and 95%CIs were calculated. For continuous variables, we evaluated the  weighted mean difference. Odd ratios (ORs) were calculated according to the  Peto method for the comparison of eradication rates between probiotics and  placebo. RESULTS Eleven studies were selected. Probiotics eradicated H.  pylori in 50 out of 403 cases. The mean weighted eradication rate was 14%  (95%CI: 2%-25%, P = 0.02). Lactobacilli eradicated the bacterium in 30 out  of 235 patients, with a mean weighted rate of 16% (95%CI: 1%-31%).  Saccharomyces boulardii achieved eradication in 6 out of 63 patients, with a  pooled eradication rate of 12% (95%CI: 0%-29%). Multistrain combinations  were effective in 14 out of 105 patients, with a pooled eradication rate of  14% (95%CI: 0%-43%). In the comparison of probiotics vs placebo, we found an  OR of 7.91 in favor of probiotics (95%CI: 2.97-21.05, P < 0.001). Probiotics  induced a mean reduction in delta values higher than placebo (8.61% with a  95%CI: 5.88-11.34, vs 0.19% for placebo, P < 0.001). Finally, no significant  difference in adverse events was found between probiotics and placebo (OR =  1, 95%CI: 0.06-18.08). CONCLUSION Probiotics alone show a minimal effect on  H. pylori clearance, thus suggesting a likely direct role.                                                                              

 

RECORD 6

 

Review:  Impact of Helicobacter pylori on Alzheimer's disease: What do we  know so far?Doulberis M. Kotronis G. Thomann R. Polyzos S.A. Boziki M. Gialamprinou D.  Deretzi G. Katsinelos P. Kountouras J.Helicobacter (2018) 23:1 Article Number:  e12454. Date of Publication: 1 Feb  2018Background: Helicobacter pylori has changed radically gastroenterologic  world, offering a new concept in patients' management. Over time, more  medical data gave rise to diverse distant, extragastric manifestations and  interactions of the “new” discovered bacterium. Special interest appeared  within the field of neurodegenerative diseases and particularly Alzheimer's  disease, as the latter and Helicobacter pylori infection are associated with  a large public health burden and Alzheimer's disease ranks as the leading  cause of disability. However, the relationship between Helicobacter pylori  infection and Alzheimer's disease remains uncertain. Methods: We performed a  narrative review regarding a possible connection between Helicobacter pylori  and Alzheimer's disease. All accessible relevant (pre)clinical studies  written in English were included. Both affected pathologies were briefly  analyzed, and relevant studies are discussed, trying to focus on the  possible pathogenetic role of this bacterium in Alzheimer's disease.  Results: Data stemming from both epidemiologic studies and animal  experiments seem to be rather encouraging, tending to confirm the hypothesis  that Helicobacter pylori infection might influence the course of Alzheimer's  disease pleiotropically. Possible main mechanisms may include the  bacterium's access to the brain via the oral-nasal-olfactory pathway or by  circulating monocytes (infected with Helicobacter pylori due to defective  autophagy) through disrupted blood-brain barrier, thereby possibly  triggering neurodegeneration. Conclusions: Current data suggest that  Helicobacter pylori infection might influence the pathophysiology of  Alzheimer's disease. However, further large-scale randomized controlled  trials are mandatory to clarify a possible favorable effect of Helicobacter  pylori eradication on Alzheimer's disease pathophysiology, before the  recommendation of short-term and cost-effective therapeutic regimens against  Helicobacter pylori-related Alzheimer's disease.                                                                               

 

RECORD 7

 

Colchicine intoxication  in familial Mediterranean fever patients using  clarithromycin for the treatment of Helicobacter pylori: a series of six  patientsHaj Yahia S. Ben Zvi I. Livneh A.Rheumatology International (2018)  38:1 (141-147). Date of Publication: 1 Jan  2018Familial Mediterranean fever is a hereditary disease, characterized by  recurrent episodes of inflammation. Colchicine, the mainstay of therapy, is  administered continuously to all diagnosed FMF patients. Drug–drug  interaction between colchicine and clarithromycin, resulting in colchicine  intoxication, has been noted, mainly in association with gout and pneumonia.  In FMF, this adverse event has been scarcely described. We present and  characterize six patients with clarithromycin-related colchicine  intoxication, aiming mainly at characterizing the FMF-specific features of  this event. This study is a retrospective analysis, based on clinical and  hospital                                                                              Records of all FMF patients admitted to one hospital during  2002–2015, for colchicine intoxication, precipitated by consumption of  clarithromycin. All six patients were women who received colchicine for FMF,  and clarithromycin for Helicobacter pylori (HBP) gastric infection. Their  daily dosages of colchicine ranged from 1.5 to 2.5 mg. Two had mild FMF, two  moderate and two severe diseases. Colchicine intoxication occurred despite  intact kidney function and was characterized by abdominal pain, diarrhea,  weakness, rhabdomyolysis, hepatitis, kidney impairment and bone marrow  injury. It is concluded that clarithromycin-induced colchicine intoxication  is a hazard in FMF. It occurs despite normal kidney function and standard  colchicine dose and is associated with female sex and moderate to severe  FMF.                                                                              

 

RECORD 8

 

Helicobacter pylori seropositivity protects against childhood asthma and  inversely correlates to its clinical and functional severityFouda E.M. Kamel T.B.  Nabih E.S. Abdelazem A.A.Allergologia et Immunopathologia (2018) 46:1 (76-81). Date of Publication: 1  Jan 2018Background In recent years, the prevalence of asthma has risen in developed  countries, and its extent related to a change in our indigenous microbiota.  Helicobacter pylori disappearance across the population represents a  fundamental change in our human microbiota and has preceded the rise in  asthma prevalence. Objective To assess the relationship between childhood  asthma and Helicobacter pylori infection. Methods Quantitative determination  of Helicobacter pylori IgG among 90 asthmatic children and 90 – age and  gender – matched non-atopic, non-asthmatic healthy children was performed  using ELISA in serum of all participants. Results Helicobacter pylori IgG  seropositivity was found in 25.6% of asthmatics compared to 44.4% of  controls. Asthmatics showed lower median Helicobacter pylori IgG titre  compared to healthy controls. We also detected a significant inverse  relationship between Helicobacter pylori IgG titre and asthma severity.  Conclusion Helicobacter pylori seropositivity protects against childhood  asthma and inversely correlates to its clinical and functional severity.                                                                                

 

RECORD 9

 

Prevalence of Helicobacter pylori Infection in Asia: Remembrance of Things  Past?Sugano K. Hiroi S. Yamaoka Y.Gastroenterology (2018) 154:1 (257-258).  Date of Publication: 1 Jan 2018                                                                              

 

RECORD 10

 

The Effect of Helicobacter pylori  on Postoperative Outcomes in Patients  Undergoing Bariatric Surgery: a Systematic Review and Meta-analysisMocanu  V. Dang J.T. Switzer N. Skubleny D. Shi X. de Gara C. Birch D.W.  Karmali S.Obesity Surgery (2018) 28:2 (567-573). Date of Publication: 1 Feb  2018Helicobacter pylori (HP) occurs in 50% of people worldwide with higher rates  reported in the bariatric population. HP has been associated with adverse  outcomes following bariatric surgery; however, its true impact has not yet  been defined. We aimed to systematically review the effect of HP on  bariatric surgery outcomes. A comprehensive literature review was conducted  yielding seven studies with 255,435 patients. Meta-analysis found comparable  rates of bleeding, leak, hospital length of stay, and weight loss between  HP-positive and HP-negative patients. HP was, however, found to be the  largest independent predictor of marginal ulceration in those undergoing  RYGB, with a tenfold increase versus HP-negative patients. Overall, HP is  associated with increased marginal ulceration rates, but has little impact  on other bariatric surgery outcomes.                                                                              

 

RECORD 11

 

A potential impact of Helicobacter  pylori-related galectin-3 in  neurodegenerationBoziki M. Polyzos S.A. Deretzi G. Kazakos E. Katsinelos P. Doulberis M.  Kotronis G. Giartza-Taxidou E. Laskaridis L. Tzivras D. Vardaka E.  Kountouras C. Grigoriadis N. Thomann R. Kountouras J.Neurochemistry International  (2018) 113 (137-151). Date of Publication: 1  Feb 2018Neurodegeneration represents a component of the central nervous system (CNS)  diseases pathogenesis, either as a disability primary source in the frame of  prototype neurodegenerative disorders, or as a secondary effect, following  inflammation, hypoxia or neurotoxicity. Galectins are members of the lectin  superfamily, a group of endogenous glycan-binding proteins, able to interact  with glycosylated receptors expressed by several immune cell types.  Glycan-lectin interactions play critical roles in the living systems by  involving and mediating a variety of biologically important normal and  pathological processes, including cell-cell signaling shaping cell  communication, proliferation and migration, immune responses and  fertilization, host-pathogen interactions and diseases such as  neurodegenerative disorders and tumors. This review focuses in the role of  Galectin-3 in shaping responses of the immune system against microbial  agents, and concretely, Helicobacter pylori (Hp), thereby potentiating  effect of the microbe in areas distant from the ordinary site of  colonization, like the CNS. We hereby postulate that gastrointestinal Hp  alterations in terms of immune cell functional phenotype, cytokine and  chemokine secretion, may trigger systemic responses, thereby conferring  implications for remote processes susceptible in immunity disequilibrium,  namely, the CNS inflammation and/or neurodegeneration.                                                                              

 

RECORD 12

 

Helicobacter  pylori management in ASEAN: The Bangkok consensus reportMahachai V. Vilaichone  R.-K. Pittayanon R. Rojborwonwitaya J. Leelakusolvong  S. Maneerattanaporn M. Chotivitayatarakorn P. Treeprasertsuk S. Kositchaiwat  C. Pisespongsa P. Mairiang P. Rani A. Leow A. Mya S.M. Lee Y.-C. Vannarath  S. Rasachak B. Chakravuth O. Aung M.M. Ang T.-L. Sollano J.D. Trong Quach D.  Sansak I. Wiwattanachang O. Harnsomburana P. Syam A.F. Yamaoka Y. Fock K.-M.  Goh K.-L. Sugano K. Graham D.Journal of Gastroenterology and Hepatology  (Australia) (2018) 33:1 (37-56).  Date of Publication: 1 Jan 2018Helicobacter pylori (H. pylori) infection  remains to be the major cause of  important upper gastrointestinal diseases such as chronic gastritis, peptic  ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue  lymphoma. H. pylori management in ASEAN: the Bangkok consensus report  gathered key opinion leaders for the region to review and evaluate clinical  aspects of H. pylori infection and to develop consensus statements,  rationales, and grades of recommendation for the management of H. pylori  infection in clinical practice in ASEAN countries. This ASEAN Consensus  consisted of 34 international experts from 10 ASEAN countries, Japan,  Taiwan, and the United States. The meeting mainly focused on four issues:  (i) epidemiology and disease association; (ii) diagnostic tests; (iii)  management; and (iv) follow-up after eradication. The final results of each  workshop were presented for consensus voting by all participants.  Statements, rationale, and recommendations were developed from the available  current evidence to help clinicians in the diagnosis and treatment of  H. pylori and its clinical diseases.                                                                            

 

RECORD 13

 

Helicobacter pylori Primary  Antibiotic Resistance in 2015 in Morocco: A  Phenotypic and Genotypic Prospective and Multicenter StudyBouihat N. Burucoa  C. Benkirane A. Seddik H. Sentissi S. Al Bouzidi A.  Elouennas M. Benouda A.Microbial Drug Resistance (2017) 23:6 (727-732).  Date of Publication: 1 Sep  2017Knowledge of local antibiotic resistance is crucial to adaption of the  choice of effective empirical first-line treatment for Helicobacter pylori  infection. The aim of this study was to evaluate, for the first time in  Morocco, the prevalence of the primary resistance of H. pylori to  clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and  rifamycin. We conducted a 1-year prospective study (2015), including 255  Moroccan patients referred for gastro-duodenal endoscopy to two hospitals of  Rabat (Morocco) and never previously treated for H. pylori infection. Three  gastric biopsies were collected: one for histology, one for culture, and one  for molecular detection of H. pylori and the mutations in 23S rRNA genes  that confer resistance to clarithromycin. Antimicrobial susceptibility  testing was performed on isolated strains by Etest and disk diffusion  methods. One hundred seventy-seven patients were infected (69.4%). The  prevalence of primary resistances of H. pylori to clarithromycin was 29%,  40% to metronidazole, 0% to amoxicillin, tetracycline, and rifamycin, and  11% to levofloxacin. Only four isolates (2%) were resistant to both  clarithromycin and metronidazole. The high level of primary clarithromycin  resistance in the H. pylori strains infecting the Moroccan population leads  us to recommend the abandonment of the standard clarithromycin-based triple  therapy as a first-line treatment in Morocco and to prefer a concomitant  quadruple therapy.                                                                               

 

RECORD 14

 

The first-line treatment of Helicobacter pylori  infection in Piedmont in the  year 2017Pellicano R. Ribaldone D.G. Fagoonee S. Astegiano M. Saracco G.M. Panminerva medica (2017) 59:2 (199). Date of Publication: 1 Jun 2017                                                                            

 

RECORD  15

 

DNA double-strand breaks caused by different microorganisms: A special focus  on helicobacter pyloriErkekoglu P. Oral D. Kocer-Gumusel B. Chao M.-W.Journal  of Environmental Pathology, Toxicology and Oncology (2017) 36:2  (131-150). Date of Publication: 2017The association between inflammation and  cancer has long been recognized.  Several studies have found that different types of tumors develop at sites  of chronic inflammation. It is stated that over 15%–20% of malignancies  worldwide can be related to infections caused by viruses, bacteria, and  schistosomes. Inflammatory conditions are characterized by overexpression of  inducible nitric oxide synthase (iNOS) and overproduction of nitric  oxide/reactive nitrogen species (ROSs/RNSs) in epithelial cells. Reactive  oxygen species (ROSs) may also lead to cellular alterations and eventually  to inflammation. A variety of chronic infectious diseases can generate  steady-state levels of ROSs/RNSs within infected cells and possibly lead to  different types of DNA lesions. Accumulation of DNA lesions may finally lead  to mutations that may activate oncogenes or inactivate tumor suppressor  genes. Helicobacter pylori has been shown to generate ROSs/RNSs, induce DNA  damage, and lead to chronic inflammation in gastric epithelial cells. A  limited number of studies have addressed the effects of Helicobacter pylori  on DNA damage, particularly its impact on single-strand and double-strand  DNA breaks. This bacterium is classified as a Group I carcinogen by the  International Agency for Research on Cancer on the basis of numerous animal  and epidemiological studies. Chronic Helicobacter pylori infection can lead  to increased risk of gastric cancer and mucosa-associated lymphoid tissue  (MALT) lymphoma. This review addresses the DNA-damaging and double-strand  break–inducing effects of different microorganisms and their toxins,  specifically focusing on Helicobacter pylori.                                                                              

 

RECORD 16

 

Long-term proton pump  inhibitors and risk of gastric cancer development  after treatment for Helicobacter pylori: a population-based studyCheung K.S.  Chan E.W. Wong A.Y.S. Chen L. Wong I.C.K. Leung W.K.Gut (2018) 67:1 (28-35).  Date of Publication: 1 Jan 2018OBJECTIVE: Proton pump inhibitors (PPIs) is  associated with worsening of  gastric atrophy, particularly in Helicobacter pylori (HP)-infected subjects.  We determined the association between PPIs use and gastric cancer (GC) among  HP-infected subjects who had received HP therapy.DESIGNS: This study was  based on a territory-wide health database of Hong Kong. We identified adults  who had received an outpatient prescription of clarithromycin-based triple  therapy between year 2003 and 2012. Patients who failed this regimen, and  those diagnosed to have GC within 12 months after HP therapy, or gastric  ulcer after therapy were excluded. Prescriptions of PPIs or histamine-2  receptor antagonists (H2RA) started within 6 months before GC were excluded  to avoid protopathic bias. We evaluated GC risk with PPIs by Cox  proportional hazards model with propensity score adjustment. H2RA was used  as a negative control exposure.RESULT: Among the 63 397 eligible subjects,  153 (0.24%) developed GC during a median follow-up of 7.6 years. PPIs use  was associated with an increased GC risk (HR 2.44, 95% CI 1.42 to 4.20),  while H2RA was not (HR 0.72, 95% CI 0.48 to 1.07). The risk increased with  duration of PPIs use (HR 5.04, 95% CI 1.23 to 20.61; 6.65, 95% CI 1.62 to  27.26 and 8.34, 95% CI 2.02 to 34.41 for ≥1 year, ≥2 years and ≥3 years,  respectively). The adjusted absolute risk difference for PPIs versus  non-PPIs use was 4.29 excess GC (95% CI 1.25 to 9.54) per 10 000  person-years.CONCLUSION: Long-term use of PPIs was still associated with an  increased GC risk in subjects even after HP eradication therapy.                                                                                

 

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Helicobacter pylori CagA protein activates Akt and attenuates  chemotherapeutics-induced apoptosis in gastric cancer cellsLan K.-H. Lee  W.-P. Wang Y.-S. Liao S.-X. Lan K.-H.Oncotarget (2017) 8:69 (113460-113471).  Date of Publication: 2017Infection with cagA-positive Helicobacter pylori is  associated with a higher  risk of gastric cancer. The cagA gene product, CagA, is translocated into  gastric epithelial cells and perturbs host cellular biological functions.  Etoposide, a topoisomerase II inhibitor widely used to couple DNA damage to  apoptosis, is a common cytotoxic agent used for advanced gastric cancer. We  investigate the effect of CagA on etoposideinduced apoptosis in gastric  cancer cells to elucidate whether CagA play a role in gastric carcinogenesis  via impairing DNA damage-dependent apoptosis. AGS cell lines stably  expressing CagA isolated from H. pylori 26695 strain were established. In  the presence of etoposide, viability of parental AGS cells was decreased in  a time-and dose-dependent manner, whereas CagA-expressing AGS cells were  less susceptible to etoposide induced cell-killing effect. Suppression of  etoposide-induced apoptosis was shown in CagA-expressing but not in parental  AGS cells by DNA fragmentation, cell cycle, and annexin-V assays. This  inhibitory effect of etoposide-induced apoptosis conferred by CagA was also  demonstrated in SCM1 and MKN45 gastric cancer cell lines, with two  additional chemotherapeutics, 5-FU and cisplatin. The effect of Akt  activation on inhibition of etoposide-induced cytotoxicity by CagA was also  evaluated. CagA expression and etoposide administration activate Akt in a  dose-dependent manner. Enhancement of etoposide cytotoxicity by a  PI-3-kinase inhibitor, LY294002, was evident in parental but was attenuated  in CagA-expressing AGS cells. CagA may activate Akt, either in the absence  or presence of etoposide, potentially contributing to gastric carcinogenesis  associated with H. pylori infection and therapeutic resistance by impairing  DNA damage-dependent apoptosis.                                                                              

 

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Detection of Helicobacter pylori in  stool samples of young children using  real-time polymerase chain reactionBeer-Davidson G. Hindiyeh M. Muhsen K. Helicobacter (2018) 23:1 Article Number: e12450. Date of Publication: 1 Feb  2018Background: The aims of this study were to develop and validate a multiplex  real-time polymerase chain reaction (q-PCR) assay of Helicobacter pylori in  stool samples of healthy children. Additionally, we determined the  prevalence of clarithromycin resistance and cagA gene in H. pylori-positive  samples. Materials and methods: Archived stool samples from 188 children  aged 6-9 years and 272 samples of 92 infants aged 2-18 months were tested  for H. pylori antigens using enzyme immunoassay (EIA). A multiplex q-PCR  assay was designed to detect H. pylori 16S rRNA and urease and the human  RNase P gene as an internal control. Kappa coefficient was calculated to  assess the agreement between q-PCR and EIA. Results: Laboratory validation  of the q-PCR assay using quantitated H. pylori ATCC 43504 extracted DNA  showed S-shaped amplification curves for all genes; the limit of detection  was 1 CFU/reaction. No cross-reactivity with other bacterial pathogens was  noted. Applying the multiplex q-PCR to DNA extracted from fecal samples  showed clear amplification curves for urease gene, but not for 16S rRNA. The  prevalence of H. pylori infection was 50% (95% CI 43%-57%) by q-PCR (urease  cycle threshold <44) vs 59% (95% CI 52%-66%) by EIA. Kappa coefficient  was.80 (P <.001) and.44 (P <.001) for children aged 6-9 years and  2-18 months, respectively. Sixteen samples were positive for cagA and three  were positive for clarithromycin resistance mutation (A2143G) as confirmed  by sequencing. Conclusions: The developed q-PCR can be used as a cotechnique  to enhance the accuracy of H. pylori detection in epidemiological studies  and in clinical settings.                                                                              

 

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Helicobacter pylori eradication improves the  quality of life regardless of  the treatment outcomeTaguchi H. Kanmura S. Maeda T. Iwaya H. Arima S. Sasaki F.  Nasu Y. Tanoue S.  Hashimoto S. Ido A.Medicine (United States) (2017) 96:52. Date of Publication:  1 Dec 2017Helicobacter pylori (Hp) eradication is recommended for improving the  quality of life (QOL) of patients with epigastric symptoms, especially  reflux and dyspepsia. However, no reports have investigated the improvement  of QOL after the eradication of Hp irrespective of epigastric symptoms. The  aim of this study was to investigate the improvement in the QOL after the  eradication of Hp irrespective of epigastric symptoms, and evaluate the  factors associated with an improved QOL after the eradication of Hp. This  prospective cohort study was performed at 15 referral institutions from  September 2013 to December 2014. The patients' QOL and epigastric symptoms  were evaluated before and after the eradication of Hp using the 8-item  Short-Form Health Survey (SF-8) and the modified Frequency Scale for the  Symptoms of Gastroesophageal Reflux Disease, respectively. One hundred  sixty-five of 184 Hp-infected patients underwent Hp eradication treatment.  The treatment was successful in 82.4% (136/165) of the cases. One hundred  sixty of the 165 Hp-infected patients were eligible for inclusion in the QOL  analysis. In the indices of QOL on the SF-8, the scores on both the mental  component summary (MCS) and the physical component summary (PCS) were found  to have significantly improved after the eradication of Hp. However, the  epigastric symptoms before the eradication of Hp were not correlated with  either the MCS or PCS. A low QOL value before the eradication of Hp was the  factor what was most strongly associated with the improvement in the QOL.  The eradication of Hp improved the QOL, regardless of the outcome of the  treatment, especially in patients who had an impaired QOL before the  eradication.                                                                              

 

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NF-KB/miR-223-3p/ARID1A axis is involvedin Helicobacter  pylori CagA-induced  gastriccarcinogenesis and progressionYang F. Xu Y. Liu C. Ma C. Zou S.  Xu X. Jia J. Liu Z.Cell Death and Disease (2018) 9:1 Article Number: 12.  Date of Publication: 1  Jan 2018Infection with Helicobacter pylori (H. pylori) and the resulting gastric  inflammation is regarded as the strongest riskfactor for gastric  carcinogenesis and progression. NF-?B plays an important role in linking H.  pylori-mediatedinflammation to cancer. However, the underlying mechanisms  are poorly understood. In this study, we find thatH. pylori infection  induces miR-223-3p expression in H. pylori CagA-dependent manner. NF-?B  stimulates miR-223-3pexpression via directly binding to the promoter of  miR-223-3p and is required for H. pylori CagA-mediatedupregulation of  miR-223-3p. miR-223-3p promotes the proliferation and migration of gastric  cancer cells by directlytargeting ARID1A and decreasing its expression.  Furthermore, miR-223-3p/ARID1A axis is involved in CagA-inducedcell  proliferation and migration. In the clinical setting, the level of  miR-223-3p is upregulated, while ARID1A isdownregulated significantly in  human gastric cancer tissues compared with the corresponding noncancerous  tissues.The expression level of miR-223-3p is significantly higher in H.  pylori-positive gastric cancer tissues than that in H.  pylorinegativetissues. Moreover, a negative correlation between miR-223-3p  and ARID1A expression is found in the gastriccancer tissues. Taken together,  our findings suggested NF-?B/miR-223-3p/ARID1A axis may link the process of  H. pyloriinducedchronic inflammation to gastric cancer, thereby providing a  new insight into the mechanism underlyingH. pylori-associated gastric  diseases.                                                                              

 

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Helicobacter pylori controls NLRP3 expression by regulating hsa-miR-223-3p  and IL-10 in cultured and primary human immune cellsPachathundikandi S.K.  Backert S.Innate Immunity (2018) 24:1 (11-23). Date of Publication: 1 Jan 2018 Inflammasome-mediated production of mature IL-1β and IL-18 cytokines  represents an important innate immune response against infecting pathogens.  Helicobacter pylori, one of the most successful and persistent human  pathogens, induces severe inflammation leading to gastritis and more serious  gastric diseases. H. pylori modulates different immune responses for its  survival and inflammasome signaling is manipulated by the cag pathogenicity  island (cagPAI), urease and VacA cytotoxin. Here we report that H. pylori  regulates NLRP3 expression, an inflammasome forming regulator, in infected  THP-1 monocytes. This response was independent of the major H. pylori  pathogenicity-associated factors CagA, VacA, Cgt, FlaA and cagPAI. Two NLRP3  expression controlling factors, the NLRP3 mRNA targeting microRNA  hsa-miR-223-3p and cytokine IL-10, were found to work in tandem for its  regulation. H. pylori infection also induced copious amount of pro-IL-1β in  THP-1 monocytes/macrophages but secreted a very low amount of mature IL-1β.  Moreover, secreted IL-10 correlated with the down-regulation of  nigericin-induced NLRP3 inflammasome activation of LPS-primed THP-1  monocytes and human PBMCs from volunteers. However, H. pylori-treated PBMCs  secreted significantly more mature IL-1β throughout the infection period,  which suggests a different mode of activation. Taken together, this study  demonstrates targeting of inflammasome-forming NLRP3, an important innate  immunity component, and crucial manipulation of pro- and anti-inflammatory  cytokines in H. pylori infection.                                                                              

 

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Candida accommodates non-culturable  Helicobacter pylori in its vacuole -  Koch's postulates aren't applicableSiavoshi F. Saniee P.World Journal of  Gastroenterology (2018) 24:2 (310-314). Date of  Publication: 14 Jan 2018The following are the responses to the "letter to  the editor" ("Helicobacter  is preserved in yeast vacuoles! Does Koch's postulates confirm it?")  authored by Nader Alipour and Nasrin Gaeini that rejected the methods,  results, discussions and conclusions summarized in the review article  authored by Siavoshi F and Saniee P. In the article, 7 papers, published  between 1998 and 2013, were reviewed. The 7 papers had been reviewed and  judged very carefully by the assigned expertise of the journals involved,  including the reviewers of the World Journal of Gastroenterology (WJG ),  before publication. In the review article, 121 references were used to  verify the methods, results and discussions of these 7 papers. The review  article was edited by the trustworthy British editor of the (WJG ), and the  final version was rechecked and finally accepted by the reviewers of (WJG ).  None of the reviewers made comments like those in this "letter to the  editor", especially the humorous comments, which seem unprofessional and  nonscientific. Above all, the authors' comments show a lack of understanding  of basic and advanced microbiology, e.g. bacterial endosymbiosis in  eukaryotic cells. Accordingly, their comments all through the letter contain  misconceptions. The comments are mostly based on personal conclusions,  without any scientific support. It would have been beneficial if the letter  had been reviewed by the reviewers of the article by Siavoshi and Saniee.                                                                                

 

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Macrolide use in the previous years is associated with failure to eradicate  Helicobacter pylori with clarithromycin-containing regimensMuñoz-Gómez  P. Jordán-Castro J.A. Abanades-Tercero M. Blanco-González J.J.  Andrés Esteban E.M. Valle-Muñoz J.Helicobacter (2018) 23:1  Article Number: e12452. Date of Publication: 1 Feb  2018Background: There is some evidence that prior use of macrolide antibiotics  is a useful predictor of the likelihood of standard triple therapy failure  in Helicobacter pylori eradication. In this study, we have evaluated whether  previous intake of macrolides correlates with failure to eradicate H. pylori  using two different first-line clarithromycin-containing regimens. Materials  and Methods: Retrospective study of 212 patients with H. pylori infection  treated with one of two first-line clarithromycin-containing regimens: 108  patients treated with triple therapy for 10 days and 104 patients treated  with concomitant therapy for 10 days. The intake of macrolides  (clarithromycin, azithromycin, and other macrolides) prior to the  eradication therapy was obtained from the electronic medical                                                                              Record, which  contains information regarding all the medication prescribed to the patients  since the year 2004. Results: One hundred of 212 patients (47.2%) had  received at least one treatment with macrolides during the years prior to  the eradication therapy. H. pylori eradication rates were significantly  lower in patients with previous use compared to patients without previous  use of macrolides, both with triple therapy (60.8% vs 92.9%; P <.0001) and  with concomitant therapy (85.7% vs 98.2%; P =.024). Conclusions: Previous  use of macrolides correlates with a low H. pylori eradication rate with  triple and concomitant clarithromycin-containing regimens. In addition, our  study shows that in patients without previous use of macrolides, triple  therapy achieves per-protocol eradication rates over 90%.                                                                               

 

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 Evaluation of first-line bismuth-containing 7-day concomitant quintuple  therapy for Helicobacter pylori eradicationYe J.F. Hong J.B. Zhu Y. Xie Y.  Shu X. Luo L.Y. Xie C. Zhu Z.H. Lu N.H.Journal of Digestive Diseases (2017)  18:12 (704-708). Date of Publication: 1  Dec 2017OBJECTIVE: Helicobacter pylori (H. pylori) infection is difficult to cure,  mainly due to antibiotic resistance. This study aimed to determine the  efficacy and safety of 7-day bismuth-containing concomitant quintuple  regimen for H. pylori eradication. METHODS: Conducted from August 2015 to  February 2016 at the First Affiliated Hospital of Nanchang University, this  prospective trial enrolled 70 untreated patients who were positive for H.  pylori. The patients received 7-day quintuple therapy consisting of bismuth  subcitrate 220 mg, esomeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1  g and metronidazole 400 mg, each was given twice daily. All patients  underwent a (13)C-urea breath test at 4 weeks after treatment. RESULTS: A  total of 70 patients at a mean age of 43.5 years, including 36 men, were  included in this trial. One person who violated the protocol was further  excluded. The treatment compliance rate was 99.6%. The overall eradication  rates of the 7-day bismuth-containing concomitant quintuple therapy were  75.4% (intention-to-treat analysis) and 86.7% (per-protocol analysis). The  prevalence of side effects was 31.9%, including a bitter taste (23.2%),  nausea (4.3%), dizziness (2.9%), diarrhea (2.9%), limb asthenia (2.9%), skin  rash (1.4%), numbness of the tip of the tongue (1.4%) and insomnia (1.4%).  CONCLUSIONS: The 7-day bismuth-containing concomitant quintuple therapy may  not be superior to traditionally widely accepted therapy due to its lack of  acceptable efficacy and high rate of side effects.                                                                               

 

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Blastocystis  subtypes isolated from irritable bowel syndrome patients and  co-infection with Helicobacter pyloriEl-Badry A.A. Abd El Wahab W.M. Hamdy  D.A. Aboud A.Parasitology Research (2018) 117:1 (127-137). Date of Publication: 1 Jan  2018Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal  disease presenting clinically by abdominal pain with alteration of bowel  habits. Although IBS has uncertain etiology, chronic gut inflammation due to  persistent exposure to an infectious agent including Blastocystis sp. was  proposed. The aim of this study was to detect the prevalence of Blastocystis  sp. subtype (ST) isolated from stool of IBS patients and to assess  Blastocystis sp. and H. pylori co-infection in IBS patients from Beni-Suef  Governorate, Egypt. Stool samples were collected from 115 IBS patients,  following Rome III criteria. All stool samples were microscopically examined  by wet mount and permanent trichrome stain, cultured on Jones’ medium with  further sequencing of positive Blastocystis isolates and screened for  detection of H. pylori coproantigen. Blastocystis sp. was the predominant  parasite in IBS patients; it had statistical significant association with  both rural residence (OR = 10) and flatulence (OR = 8.2). There was a  predominance of Blastocystis sp. ST3 (81%) followed by ST1 (19%).  Blastocystis culture results (19.1%) were superior than microscopy (16.5%).  The majority of Blastocystis-positive IBS patients (72.7%) were co-infected  with H. pylori with statistical significance; however, H. pylori was higher  in Blastocystis-negative IBS patients (47/64) than in Blastocystis-positive  IBS patients (17/64). Interestingly, IBS is usually associated with gut  dysbiosis, while the most prevalent parasite in our IBS patients was  Blastocystis sp., which is frequently found in asymptomatic individuals.  Whether Blastocystis sp. is a cause or a consequence of IBS still needs  further investigation, with a particular focus on correlation of IBS with  different Blastocystis sp. subtypes and gut microbiomes.                                                                               

 

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A  comparative study of white light endoscopy, chromoendoscopy and magnifying  endoscopy with narrow band imaging in the diagnosis of early gastric cancer  after helicobacter pylori eradicationHoriguchi N. Tahara T. Kawamura T. Okubo  M. Tahara S. Nagasaka M. Nakagawa  Y. Shibata T. Ohmiya N.Journal of Gastrointestinal and Liver Diseases (2017)  26:4 (357-362). Date  of Publication: 1 Dec 2017Background & Aim: Early-stage gastric cancer (EGC)  found after H. pylori  eradication often has non-tumorous epithelium on the tumorous tissue and/or  surface differentiation of tumors, which may confuse endoscopic and  histologic diagnosis. We investigated the diagnostic reliability of EGC  using conventional white light endoscopy (WLE), chromoendoscopy (CE) using  indigo carmine, and magnifying endoscopy with narrow band imaging (ME-NBI)  in patients with EGC with or without history of prior H. pylori eradication  therapy. Methods: Diagnostic reliability of EGC by using the WLE, CE and  ME-NBI was investigated in 71 EGC lesions diagnosed after successful H.  pylori eradication (eradication group) and 115 EGC lesions with current H.  pylori infection (control group). Results: Diagnostic reliability of EGC was  lower in the eradication group than in the control group using all three  modalities. In particular, the diagnostic accuracy of CE in the eradication  group was especially lower compared to that of the control group (WLE: 74.6%  vs. 86.1%, P=0.05; CE: 64.8% vs. 91.3%, P<0.0001; ME-NBI: 88.7% vs. 98.2%,  P=0.01). The ME-NBI scored better in comparison with WLE and CE in the  eradication group (both P<0.05). The indistinct EGC lesions in the  eradicated group by using CE were associated with the presence of  histological changes such as non-tumorous epithelium on the tumor and/or  surface differentiation of tumors (P=0.005). Conclusions: It should be noted  that the diagnostic reliability of EGC after H. pylori eradication becomes  lower especially using CE. Indistinguishable cases using CE are associated  with histological findings such as non-tumorous epithelium on the tumor  and/or surface differentiation of tumors.                                                                               

 

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Comparative Study of  Clarithromycin-versus Metronidazole-Based Triple  Therapy as First-Line Eradication for Helicobacter pyloriAdachi T. Matsui S.  Watanabe T. Okamoto K. Okamoto A. Kono M. Yamada M.  Nagai T. Komeda Y. Minaga K. Kamata K. Yamao K. Takenaka M. Asakuma Y.  Sakurai T. Nishida N. Kashida H. Kudo M.Oncology (Switzerland) (2017) 93:1  Supplement 1 (15-19). Date of  Publication: 1 Dec 2017Introduction: Clarithromycin (CAM)-based triple  therapy comprising proton  pump inhibitors and amoxicillin is administered as first-line eradication  treatment against Helicobacter pylori infection. However, the eradication  rate achieved with CAM-based triple therapy has decreased to <80% owing to  the emergence of CAM-resistant strains. This prospective randomized study  aimed to compare the efficacy of CAM-based and metronidazole (MNZ)-based  triple therapy in terms of H. pylori eradication. Methods:H. pylori-positive  patients were treated with CAM-based triple therapy comprising esomeprazole  and amoxicillin (EAC group) or with MNZ-based triple therapy comprising  esomeprazole and amoxicillin (EAM group). Results:H. pylori eradication  rates achieved in the intention-to-treat (ITT) and per protocol (PP)  analyses were 70.6 and 72.7%, respectively, in the EAC group. Eradication  rates obtained via ITT and PP analyses were 91.7 and 94.3%, respectively, in  the EAM group. In the EAC group, eradication rates were significantly lower  in patients harboring CAM-resistant strains than in those harboring  CAM-sensitive strains. In contrast, eradication rates were comparable  between patients harboring CAM-resistant strains and those harboring  CAM-sensitive strains in the EAM group. Conclusion: MNZ-based triple therapy  consisting of esomeprazole and amoxicillin is superior to CAM-based triple  therapy containing esomeprazole and amoxicillin as first-line eradication  treatment against H. pylori.                                                                               

 

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Treatment of Helicobacter pylori infection:  A clinical practice updateZagari R.M. Rabitti S. Eusebi L.H. Bazzoli F.European  Journal of Clinical Investigation (2018) 48:1 Article Number:  e12857. Date of Publication: 1 Jan 2018Background: Helicobacter pylori infection  is still frequent in the community  and all infected subjects should be offered an eradication therapy. Nowadays  physicians have to face the challenge of antibiotic resistance in treating  Helicobacter pylori-infected individuals. Aim: This review provides an  overview of current international guidelines and reports recent evidence  from systematic reviews and clinical trials on the treatment of Helicobacter  pylori infection and should help physicians to better treat their patients.  Results: General rules to optimize the management of Helicobacter pylori  infection include: (i) considering previous patient's exposure to  antibiotics; (ii) using high dose of proton-pump inhibitors; and (iii)  avoiding repeating the same regimen, if it has already failure. Bismuth  quadruple therapy and concomitant therapy are the best first-line empirical  treatments in areas with high clarithromycin resistance and in individuals  with previous use of macrolides; otherwise, the 14-day  clarithromycin-containing triple therapy is a valid regimen. The sequential  therapy is no longer a suggested treatment by international guidelines.  Conclusions: Current international guidelines are consistent in defining  treatment strategies for Helicobacter pylori infection. The use of national  registries to monitor the efficacy and tolerability of different regimens in  the real world of clinical practice is now needed.                                                                               

 

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Helicobacter pylori  infection and esophageal adenocarcinoma: A review and a  personal viewPolyzos S.A. Zeglinas C. Artemaki F. Doulberis M. Kazakos E. Katsinelos P.  Kountouras J.Annals of Gastroenterology (2018) 31:1 (8-13). Date of Publication:  2018Esophageal adenocarcinoma (EAC) is etiologically associated with  gastroesophageal reflux disease (GERD). There is evidence to support the  sequence GERD, Barrett’s esophagus (BE), dysplasia, and finally EAC, with  Helicobacter pylori (H. pylori) being implicated in each step to EAC. On the  other side of this relation stands the hypothesis of the protective role of  H. pylori against EAC. Based on this controversy, our aim was to review the  literature, specifically original clinical studies and meta-analyses linking  H. pylori infection with EAC, but also to provide our personal and others’  relative views on this topic. From a total of 827 articles retrieved, 10  original clinical studies and 6 meta-analyses met the inclusion criteria.  Original studies provided inconclusive data on an inverse or a neutral  association between H. pylori infection and EAC, whereas meta-analyses of  observational studies favor an inverse association. Despite these data, we  consider that the positive association between H. pylori infection and GERD  or BE, but not EAC, is seemingly a paradox. Likewise, the oncogenic effect  of H. pylori infection on gastric and colon cancer, but not on EAC, also  seems to be a paradox. In this regard, well-designed prospective cohort  studies with a powered sample size are required, in which potential  confounders should be taken into consideration since their design.                                                                                

 

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Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A  population-based studyGonzález-Pons M. Soto-Salgado M. Sevilla J. Márquez-Lespier  J.M. Morgan D.  Pérez C.M. Cruz-Correa M.Helicobacter (2018) 23:1 Article Number: e12453.  Date of Publication: 1 Feb  2018Background: Helicobacter pylori is an important etiologic factor for peptic  ulcers and gastric cancer, one of the top ten leading causes of cancer death  in Puerto Rico. However, the prevalence of H. pylori infections in this  population was previously unknown. The aim of this study was to examine the  seroprevalence of H. pylori and its associated risk factors in Puerto Rico.  Materials and Methods: A cross-sectional study was designed using an  existing population-based biorepository. Seropositivity was determined using  the Premier(™) H. pylori immunoassay. Helicobacter pylori seroprevalence was  estimated with 95% confidence using marginal standardization following  logistic regression. To assess the risk factors associated with H. pylori  seropositivity, a multivariable log-binomial model was fitted to estimate  the prevalence ratio (PR) and its 95% confidence interval (95% CI). Results:  A total of 528 population-based serum samples were analyzed. The mean age of  the study population was 41 ± 12 years, of whom 55.3% were females. The  overall seroprevalence of H. pylori was 33.0% (95% CI = 28.3%-38.1%).  Increasing age and having <12 years of education were significantly (P <.05)  associated with H. pylori seropositivity in the multivariable model;  however, residing in counties with low population density reached marginal  significance (P =.085). Conclusions: We report that H. pylori infection is  common among Hispanics living in Puerto Rico. The H. pylori seroprevalence  observed in Puerto Rico is similar to the seroprevalence reported in the  overall population of the United States. The association between H. pylori  seroprevalence and the risk factors analyzed offers insight into the  epidemiology of gastric cancer in Puerto Rico and warrants further  investigation.                                                                               

 

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The association between Helicobacter pylori seropositivity  and risk of  new-onset diabetes: a prospective cohort studyZhou M. Liu J. Qi Y. Wang M.  Wang Y. Zhao F. Hao Y. Zhao D.Diabetologia (2018) 61:2 (300-307).  Date of Publication: 1 Feb 2018Aims/hypothesis: Previous studies have suggested  a possible connection  between Helicobacter pylori (H. pylori) infection and diabetes risk.  However, prospective studies examining direct associations between these two  factors are relatively lacking. In this prospective cohort study, we aimed  to evaluate the association between H. pylori infection and risk of  developing diabetes. Methods: We performed a population-based prospective  study, recruiting participants aged 45–74 years and without diabetes from  the Chinese Multi-provincial Cohort Study in 2002, with a 10 year follow-up  to investigate development of diabetes. H. pylori serostatus was determined  by measuring serum H. pylori antibodies. H. pylori seropositivity was  defined as the antibody concentration ≥ 10 U/ml. To examine the association  between H. pylori seropositivity and diabetes risk, modified Poisson  regression was performed. Results: Of 2085 participants without diabetes,  1208 (57.9%) were H. pylori seropositive in 2002. After multivariate  adjustment of possible diabetes risk factors, H. pylori seropositivity was  associated with lower risk of diabetes (RR 0.78 [95% CI 0.63, 0.97],  p = 0.022). Of the 1275 participants with H. pylori antibody measurements in  both 2002 and 2007, 677 (53.1%) were persistently seropositive. A lower risk  of diabetes was also observed in participants with persistent H. pylori  seropositivity (RR 0.61 [95% CI 0.41, 0.93], p = 0.020), compared with those  persistently seronegative. Conclusions/interpretation: H. pylori  seropositivity was associated with lower risk of diabetes in this  prospective cohort study. Extrapolation of these results and the mechanism  underlying the observed association require further investigation.                                                                                

 

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Similar Helicobacter pylori Eradication Rate in Obese Patients Undergoing  Gastric Bypass Surgery and in General PopulationPellicano R.Obesity Surgery (2018)  28:2 (553-554). Date of Publication: 1 Feb 2018                                                                               

 

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Vaccine as absolute solution  of Helicobacter pylori infectionTalebi Bezmin Abadi A.Panminerva medica (2017) 59:2 (197).  Date of Publication: 1 Jun 2017                                                                               

 

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Response to 'Helicobacter pylori infection  of AZ-521 cells reveals a type IV  secretion defect and VacA-independent CagA phosphorylation'Nakano M. Hirayama T.DMM  Disease Models and Mechanisms (2017) 10:12 (1541-1543). Date of  Publication: 1 Dec 2017                                                                               

 

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Author's Reply: Comments on “Vitamin Pharmacogenomics:  New Insight into  Individual Differences in Diseases and Drug Responses”Liu M.-Z. He H.-Y. Zhang W. Genomics, Proteomics and Bioinformatics (2017) 15:6 (407). Date of  Publication: 1 Dec 2017                                                                               

 

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ReplyNg W.K. Kaplan G.G. Ng S.C.Gastroenterology (2018)  154:1 (258-259). Date of Publication: 1 Jan 2018                                                                               

 

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Iron Overload and Hepatitis  C Virus InfectionPonzetto A. Figura N.Chinese Medical Journal (2018) 131:2 (251).  Date of Publication: 20 Jan 2018                                                                               

 

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Functional dyspepsia and duodenal eosinophilia:  A new modelFan K. Talley N.J.Journal of Digestive Diseases (2017) 18:12 (667-677).  Date of Publication: 1 Dec 2017Functional dyspepsia (FD) is a highly prevalent disorder  that affects more  than 10% of the population. In the past decade, the theoretical underpinning  of the concept of FD has begun to change, in light of new data on the  underlying pathophysiological mechanisms of this disorder, with a focus on  the duodenum. The Rome IV criteria, published in 2016, note that  gastroesophageal reflux disease and irritable bowel syndrome overlap with FD  more than expected by chance, suggesting that they may be part of the same  disease spectrum. Infection by Helicobacter pylori (H. pylori) may explain a  minority of cases of FD and in the Rome IV criteria H. pylori-associated  dyspepsia (defined as symptom relief after eradication therapy) is  considered a separate entity. Duodenal inflammation characterized by  increased eosinophils and in some cases mast cells, may impair the  intestinal barrier. Post-infectious gastroenteritis is now an established  risk factor for FD. Other risk factors may include atopy, owning herbivore  pets and exposure to antibiotics, together with gastroduodenal microbiome  disturbances. Small bowel homing T cells and increased cytokines in the  circulation occur in FD, correlating with slow gastric emptying, and a  possible association with autoimmune rheumatological disease supports  background immune system activation. A genetic predisposition is possible.  FD has been linked to psychological disorders, but in some cases  psychological distress may be driven by gut mechanisms. Therapeutic options  are limited and, aside from responders to H. pylori eradication, provide  only modest and temporary relief. Advances in understanding FD may alter  clinical practice, and the treatment of duodenal inflammation or microbiome  alterations may lead to a cure for a subset of these patients in the future.                                                                                

 

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Helicobacter pylori blood biomarker for gastric cancer risk in East  AsiaCai H. Ye F. Michel A. Murphy G. Sasazuki S. Taylor P.R. Qiao Y.-L. Park  S.K. Yoo K.-Y. Jee S.H. Cho E.R. Kim J. Chen S.-C. Abnet C.C. Tsugane S. Cai  Q. Shu X.-O. Zheng W. Pawlita M. Epplein M.International journal of epidemiology  (2016) 45:3 (774-781). Date of  Publication: 1 Jun 2016BACKGROUND: Incidence and mortality rates for gastric  cancer, the fifth most  commonly diagnosed and third most deadly cancer worldwide, are highest in  East Asia. We sought to identify gastric cancer risk biomarkers among eight  prospective studies from China, Japan and Korea.METHODS: This pooled nested  case-control study included 1608 incident non-cardia gastric cancer cases  and 1958 matched controls. Pre-diagnostic antibody levels to 15 Helicobacter  pylori proteins were assessed using multiplex serology. Conditional logistic  regression models were used to calculate odds ratios (ORs) and 95%  confidence intervals (CIs).RESULTS: Sero-positivity to 10 H. pylori antigens  (Omp, CagA, VacA, HcpC, HP 0305, GroEL, NapA, HyuA, Cad, HpaA) was  associated with a 1.29- to 3.26-fold increase in odds of gastric cancer. Omp  and HP 0305 consistently remained associated with gastric cancer risk after  mutually adjusting for all other markers. Sero-positivity to both Omp and HP  0305 was associated with an over 4-fold increase in gastric cancer incidence  (OR, 4.09; 95% CI 3.26-5.13). When limited to only those who are CagA+ H.  pylori+, Omp/HP 0305 sero-positivity remained strongly associated with an  over 3-fold increase in the odds of gastric cancer (OR, 3.34; 95% CI  2.27-4.91). The results were highly consistent among the  cohorts.CONCLUSIONS: We have confirmed new H. pylori biomarkers that are  strongly associated with gastric cancer risk, even among those infected with  the known H. pylori virulence factor CagA. These results may help to design  cost-efficient prevention strategies to reduce gastric cancer incidence in  East Asia.                                                                               

 

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Hyperglycemia combined Helicobacter pylori infection increases risk of  synchronous colorectal adenoma and carotid artery plaqueHu K.-C. Wu M.-S.  Chu C.-H. Wang H.-Y. Lin S.-C. Po H.L. Bair M.-J. Liu  C.-C. Su T.-H. Chen C.-L. Liu C.-J. Shih S.-C.Oncotarget (2017) 8:65  (108655-108664). Date of Publication: 2017Background: Cardiovascular disease  and colorectal cancer have severe  consequences to human health and may occur simultaneously or sequentially.  Carotid artery plaque is a predictor of cardiovascular disease, and  colorectal adenoma is a premalignant lesion of colorectal cancer. We  investigated the core risk factors of carotid artery plaque and colorectal  adenoma. Results: In total, 2361 subjects were enrolled. In multivariate  analysis, age ≥ 60 years, male sex, BMI > 27, LDL > 130 mg/dL, HbA(1c) ≥  6.5%, hs-CRP > 0.3 mg/L and H. pylori infection were independent risk  factors for synchronous colorectal adenoma and carotid artery plaque  formation. In the H. pylori-positive and -negative groups, the proportions  and odds ratio (OR) for synchronous colon adenoma and carotid artery plaque  increased with increasing HbA(1c). OR for synchronous colon adenoma and  carotid artery plaque was significantly higher in the participants with  HbA(1c) levels of 5.7%-6.4% and HbA(1c) ≥ 6.5% than in those with normal  HbA(1c) in the H. pylori-negative group. The OR was more significant  increased for H. pylori-positive patients when HbA(1c) level ≥ 6.5% was  15.87 (95% CI 8.661-29.082, p < 0.0001). Materials and Methods: The Records  of 4669 subjects aged > 40 years who underwent bidirectional  gastrointestinal endoscopy and carotid artery ultrasound examination on the  same day or within 12 months of endoscopy examination from January 2006 to  December 2015 were reviewed. All subjects had a gastric biopsy specimen  tested for Helicobacter pylori. Conclusions: Hyperglycemia combined with H.  pylori infection was an increased risk factor for synchronous colorectal  adenoma and carotid artery plaque formation. Diabetes control and H. pylori  eradication may be warranted in higher prevalence areas.                                                                               

 

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Meta-analysis  of the correlation between Helicobacter pylori infection and  autoimmune thyroid diseasesHou Y. Sun W. Zhang C. Wang T. Guo X. Wu L. Qin L. Liu T. Oncotarget (2017) 8:70 (115691-115700). Date of Publication: 2017Objective: This study presents a systematic meta-analysis of the correlation  between Helicobacter pylori (H. pylori) infection and autoimmune thyroid  diseases (AITD). Materials and Methods: Fifteen articles including 3,046  cases were selected (1,716 observational and 1,330 control cases). These  data were analyzed using Stata12.0 meta-analysis software. Results: H.  pylori infection was positively correlated with the occurrence of AITD (OR =  2.25, 95% CI: 1.72-2.93). Infection with H. pylori strains positive for the  cytotoxin-associated gene A (CagA) were positively correlated with AITD (OR  = 1.99, 95% CI: 1.07-3.70). There was no significant difference between  infections detected using enzyme-linked immunosorbent assay (ELISA) and  other methods (χ(2) = 2.151, p = 0.143). Patients with Grave's disease (GD)  and Hashimoto's thyroiditis (HT) were more susceptible to H. pylori  infection (GD: OR = 2.78, 95% CI: 1.68-4.61; HT: OR = 2.16, 95% CI:  1.44-3.23), while the rate of H. pylori infection did not differ between GD  and HT (χ2 = 3.113, p = 0.078). Conclusions: H. pylori infection correlated  with GD and HT, and the eradication of H. pylori infection could reduce  thyroid autoantibodies.                                                                               

 

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Antibiotic resistance of Helicobacter pylori in  MongoliaBolor-Erdene M. Namdag B. Yamaoka Y. Jav S.Journal of Infection in Developing  Countries (2017) 11:11 (887-894). Date of  Publication: 1 Nov 2017Introduction. The resistance of Helicobacter pylori to recently available  antibiotic treatment regimens has been recognized as a growing problem.  Therefore, the aim of this study was to determine the prevalence of  antibiotic resistance among H. pylori strains isolated from Mongolians.  Methodology. All gastric biopsy specimens were obtained during upper  gastrointestinal endoscopy from patients referred for the exploration of  dyspepsia. The urease positive samples by rapid urease test were cultured  according to standard microbiological procedures and H. pylori were grown  under microaerophilic conditions on selective Pylori agar. H. pylori  antibiotic sensitivity was examined using E-test. In addition, the mutations  of the corresponding gene were studied by GenoType HelicoDR DNA strip  testing. Results. Three hundred twenty patients, 216 female and 104 male in  the ages range of 18 to 83 years were included in this study. Rapid urease  test yielded positive results for 65.9% (211/320). Among them, we have  successfully obtained 72% H. pylori isolates. The antibiotic resistance  rates were 35.5% for clarithromycin, 68.4% metronidazole, 23.0% amoxicillin,  25.0% tetracycline, 28.2% erythromycin and 14.5% nitrofuranton. Resistance  for 2 drugs was 34.5% and that of 3 drugs was observed in 14.5% of isolates.  The most prevalent mutation was A2147G followed by A2146G and D91Y. The  prevalence of H. pylori infection increased among Mongolian population and  the prevalence of resistance of H. pylori is very high to metronidazole, and  moderate to clarithromycin. Conclusion. The data on antimicrobial  susceptibilities provided by the present study is may assist the clinicians  on the effectiveness of treatment regimens.                                                                               

 

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First-line Helicobacter pylori  eradication therapies in countries with high  and low clarithromycin resistance: a systematic review and network  meta-analysisYeo Y.H. Shiu S.-I. Ho H.J. Zou B. Lin J.-T. Wu M.-S. Liou J.-M. Wu C.-Y.Gut (2018) 67:1 (20-27). Date of Publication: 1 Jan 2018DESIGN: Electronic  search for articles published between January 2005 and  April 2016. Randomised, controlled trials that reported the effectiveness of  first-line eradication therapies in treatment-naïve adults were included.  Two independent reviewers performed articles screening and data extraction.  Network and traditional meta-analyses were conducted using the random effect  model. Subgroup analyses were performed to determine the ranking of regimens  in countries with high (>15%) and low (<15%) clarithromycin resistance. Data  including adverse events and therapeutic cure rate were also extracted and  analysed.RESULTS: 117 trials (totally 32 852 patients) for 17 H. pylori  eradication regimens were eligible for inclusion. Compared with 7-day  clarithromycin-based triple therapy, sequential therapy (ST) for 14 days had  the highest effectiveness (OR=3.74, 95% CrI 2.37 to 5.96). ST-14 (OR=6.53,  95% CrI 3.23 to 13.63) and hybrid therapy (HY) for 10 days or more (OR=2.85,  95% CrI 1.58 to 5.37) represented the most effective regimen in areas with  high and low clarithromycin resistance, respectively. The effectiveness of  standard triple therapy was below therapeutic eradication rate in most of  the countries. Longer duration was associated with higher eradication rate,  but with a higher risk of events that lead to discontinuation.CONCLUSIONS:  ST and HY appeared to be the most effective therapies in countries with high  and low clarithromycin resistance, respectively. The clinical decision for  optimal regimen can be supported by referring to the rank ordering of  relative efficacies stratified by local eradication rates, antibiotic  resistance and safety profile.TRIAL REGISTRATION NUMBER:  CRD42015025445.OBJECTIVE: To determine the optimal regimen of different  first-line Helicobacter pylori eradication therapies according to the  clarithromycin resistance rate.                                                                               

 

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Management of functional dyspepsia: state  of the art and emerging therapiesYamawaki H. Futagami S. Wakabayashi M. Sakasegawa N. Agawa S. Higuchi K.  Kodaka Y. Iwakiri K.Therapeutic Advances in Chronic Disease (2018) 9:1 (23-32). Date of  Publication: 1 Jan 2018Patients with functional dyspepsia, defined in the 2016  Rome IV criteria as  bothersome clinical dyspepsia symptoms, experience markedly reduced quality  of life. Several etiologies have been associated with the disorder. In the  Rome IV criteria, the brain–gut axis was acknowledged as an important factor  in the etiology of functional gastrointestinal (GI) disorders. The distinct  subgroups of functional dyspepsia, epigastric pain syndrome (EPS) and  postprandial distress syndrome (PDS), are treated differently: acid  secretion inhibitors are recommended with patients with EPS, whereas  prokinetic drugs as mosapride and acotiamide are recommended for patients  with PDS. A previous study has reported that proton pump inhibitors (PPIs)  and H(2)-blockers were equally effective in functional dyspepsia. A new  drug, acotiamide, a muscarinic antagonist and cholinesterase inhibitor, has  been shown to improve gastric motility in rodents and dogs, and to reduce  PDS symptoms in patients in double-blind multicenter studies. The  pharmacological mechanisms of acotiamide remain unknown; whether acotiamide  alters gastric emptying and gastric accommodation in patients with  functional dyspepsia remains an open question. Other emerging treatment  options include Rikkunshito, a herbal medicine that improves gastric  emptying through 5-hydroxytryptamine (5-HT)2B-mediated pharmacological  action, and tricyclic antidepressants (TCAs). Different drugs are needed to  accommodate the clinical symptoms and etiology in individual patients.                                                                                

 

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Hyperbolic relation between beta-cell function and insulin sensitivity for  type 2 diabetes mellitus, malaria, influenza, helicobacter pylori, chlamydia  pneumoniae, and hepatitis C virus infection-induced inflammation/oxidative  stress and temporary insulin resistance in central AfricansOn’Kin J.B.K.L. Longo-Mbenza B.  Tchokonte-Nana V. Okwe A.N. Kabangu N.K.Turkish Journal of Medical Sciences  (2017) 47:6 (1834-1841). Date of  Publication: 2017Background/aim: We calculated the homeostatic model assessment (HOMA) for  estimating insulin sensitivity and beta-cell function in normal, healthy  nondiabetics with infections (malaria, influenza, HIV, Helicobacter pylori,  Chlamydia pneumoniae, and hepatitis C virus), type 2 diabetic black  patients, and healthy controls from Kinshasa, DR Congo. Materials and  methods: A case-control study was carried out between 2006 and 2007 for  black Central African participants managed for HOMA. Results: In total, 219  patients and 110 healthy controls were matched for sex and age. The  hyperbolic product for 85 infected patients occupied an intermediate  position between the hyperbolic product for 110 controls and that of 134  type 2 diabetics. Inflammation/ oxidative stress was present in all infected  patients, as well as in the type 2 diabetics. Of the patients, 39.3% and  49.8% had insulin resistance and metabolic syndrome, respectively. Insulin  resistance was more prevalent in nondiabetics with inflammation/oxidative  stress (47.1%; P = 0.041) than in type 2 diabetics (34.3%). Type 2 diabetics  had higher insulin sensitivity and lower beta-cell function but a similar  HOMA-IR score. Conclusion: We recommend the assessment of insulin resistance  in Central African patients with severe infections and type 2 diabetes.                                                                                

 

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Association of Helicobacter pylori infection with Toll-like receptor-4  Thr399Ile polymorphism increased the risk of peptic ulcer development in  North of IranTourani M. Habibzadeh M. Shokri-Shirvani J. Teymournejad O. Mostafazadeh A.  Khafri S. Nouri H.R.APMIS (2018) 126:1 (76-84). Date of Publication:  1 Jan 2018Toll-like receptor-4 (TLR4) polymorphisms may influence host immune response  against Helicobacter pylori (H. pylori). This study aimed to investigate  whether TLR4 polymorphisms are associated with H. pylori susceptibility and  risk of peptic ulcer development or not. The TLR4 + 3725 G/C polymorphism  was studied using polymerase chain reaction with confronting two-pair  primers (PCR–CTPP). In addition, TLR4 Asp299Gly and Thr399Ile polymorphisms  were evaluated by PCR-restriction fragment length polymorphism (RFLP). There  was no significant difference in TLR4 + 3725 G/C and Asp299Gly genotype  frequencies between non-peptic ulcer (NPUD) and peptic ulcer (PUD)  individuals in the context of peptic ulcer development and susceptibility to  infection with H. pylori. Nevertheless, a significant association with  increased risk for PUD development was observed for polymorphism TLR4  Thr399Ile [odds ratio (OR) = 4.2; 95% confidence interval (CI) = 1.35–13.26;  p = 0.01]. Correspondingly, TLR4 Thr399Ile polymorphism was associated with  H. pylori susceptibility (OR = 0.27; 95% CI = 0.08–0.88; p = 0.04). In  addition, TLR4 Thr399Ile polymorphism increased 4.2-fold, the risk of peptic  ulcer development in individuals infected by H. pylori carrying CT + TT  genotype. Our results showed that TLR4 Thr399Ile polymorphism along with  H. pylori infection may play critical roles in peptic ulcer development in  North of Iran.                                                                               

 

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The diagnosis and treatment of peptic ulcer disease and its  complications: A  reviewWunker C.Consultant (2018) 58:1. Date of Publication: 1 Jan 2018 Peptic ulcer disease (PUD) is a common condition with a significant impact  on patients’ quality of life. Although many patients present with  characteristic gnawing epigastric pain, many others—particularly elderly  patients—are asymptomatic and present with gastrointestinal (GI) tract  bleeding, perforation, and malignancy. The most common risk factors are  Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use,  both of which lead to a breakdown of the mucosal barriers that protect GI  tract tissues from acidic gastric contents. Although acid suppression is the  most common treatment for most cases of PUD, accurate determination of the  need for antibiotic therapy is essential. This review discusses the  pathophysiology, epidemiology, clinical manifestations, diagnosis,  treatment, and complications associated with PUD.                                                                               

 

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Rosacea is  associated with Helicobacter pylori: a systematic review and  meta-analysisJørgensen A.-H.R. Egeberg A. Gideonsson R. Weinstock L.B. Thyssen E.P.  Thyssen J.P.Journal of the European Academy of Dermatology and Venereology (2017) 31:12  (2010-2015). Date of Publication: 1 Dec 2017Background: Rosacea is a common  skin disease characterized by facial  erythema, telangiectasia, papules and pustules. Helicobacter pylori  infection has been suggested to play a role in the etiopathogenesis of  rosacea. Objective: To systematically review and meta-analyse the  relationship between rosacea and infection with Helicobacter pylori.  Methods: A literature search was performed using PubMed, EMBASE and Web of  Science. Data extraction and analyses were performed on descriptive data.  Study quality was assessed using the Newcastle–Ottawa Scale. Random-effects  models with DerSimonian–Laird methods were utilized to estimate pooled odds  ratios (ORs), with 95% confidence intervals (95% CIs). Heterogeneity of  results was assessed using I2 statistics. Results: A total of 454 articles  were identified and 42 full-text articles were chosen for further review.  Fourteen studies were included in the quantitative meta-analysis, comprising  a total of 928 rosacea patients and 1527 controls. The overall association  between Helicobacter pylori infection and rosacea was non-significant (OR  1.68, 95% CI 1.00–2.84, P = 0.052), but analysis restricted to C-urea breath  test showed a significant association (OR 3.12, 95% CI 1.92–5.07,  P < 0.0001). Effect of eradication treatment on rosacea symptoms was  assessed in seven studies, but without significant effect (RR 1.28, 95% CI  0.98–1.67, P = 0.069). Conclusion: This meta-analysis found weak  associations between rosacea and Helicobacter pylori infection as well as an  effect of Helicobacter pylori therapy on rosacea symptoms, albeit that these  did not reach statistical significance. Whether a pathogenic link between  the two conditions exists, or whether Helicobacter pylori infection  represents a proxy for other factors remains unknown.                                                                               

 

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A case report  of gastric linitis plastica diagnosed by endoscopic  ultrasound-guided fine needle aspirationMuraoka S. Tsuchida K. Iwasaki M. Izawa  N. Jinnai H. Komatsubara T. Tsunemi  M. Sakuma F. Kashima K. Fukushi K. Hiraishi H.Medicine (United States) (2017)  96:50 Article Number: e8937. Date of  Publication: 1 Dec 2017Rationale: There is currently no consensus on the ideal method for obtaining  deep tissue biopsy material of advanced gastric LP. EUS-FNA has potential as  a useful diagnostic method. Thus, we report the case of a 46-year-old male  with advanced gastric linitis plastica (LP) who was diagnosed using  endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Patient  concerns: The patient underwent esophagogastroduodenoscopy (EGD) because of  epigastric pain at a local clinic. The gastric fold swelling was pointed out  by the EGD and despite the suspected advanced gastric LP, biopsy indicated  Group 1. Repeat biopsy did not suggest malignancy. The patient was referred  to our institution. Diagnoses: Endoscopic ultrasound indicated gastric wall  thickening mainly in the greater curvature of the gastric corpus. Low-level  echoes were detected throughout the entire gastric wall, and gastric wall  layers had been disappeared. EUS-FNA of the gastric wall indicated signet  ring cell carcinoma. Interventions: As a result of EUS - FNA, it became a  policy to administer chemotherapy. In accordance with the patient's wishes,  he was referred to another institution for chemotherapy. Outcomes: Normal  biopsy did not give a definitive pathological diagnosis, and final diagnosis  of LP was obtained with EUS-FNA. Lessons: We expect that EUS-FNA can be  utilized as a relatively non-invasive, highly sensitive, and specific  pathological diagnostic procedure for advanced gastric LP. EUS-FNA should be  considered as one way to obtain a deep tissue biopsy of advanced gastric LP.                                                                                

 

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Association between circulating levels of sex steroid hormones and  esophageal adenocarcinoma in the FINBAR StudyPetrick J.L. Falk R.T. Hyland P.L.  Caron P. Pfeiffer R.M. Wood S.N. Dawsey  S.M. Abnet C.C. Taylor P.R. Guillemette C. Murray L.J. Anderson L.A. Cook  M.B.PLoS ONE (2018) 13:1 Article Number: e0190325. Date of Publication: 1 Jan  2018Background Esophageal adenocarcinoma (EA) is characterized by a strong male  predominance. Sex steroid hormones have been hypothesized to underlie this  sex disparity, but no population-based study to date has examined this  potential association. Methods Using mass spectrometry and ELISA, we  quantitated sex steroid hormones and sex hormone binding globulin,  respectively, in plasma from males- 172 EA cases and 185 controls-within the  Factors Influencing the Barrett/Adenocarcinoma Relationship (FINBAR) Study,  a case-control investigation conducted in Northern Ireland and Ireland.  Multivariable adjusted logistic regression was used to calculate odds ratios  (ORs) and 95% confidence intervals (CIs) for associations between  circulating hormones and EA. Results Higher androgen:estrogen ratio metrics  were associated with increased odds of EA (e.g., testosterone:estradiol  ratio OR(Q4) v.(Q1) = 2.58, 95%CI = 1.23-5.43; P(trend) = 0.009). All  estrogens and androgens were associated with significant decreased odds of  EA. When restricted to individuals with minimal to no decrease in body mass  index, the size of association for the androgen:estrogen ratio was not  greatly altered. Conclusions This first study of sex steroid hormones and EA  provides tentative evidence that androgen: estrogen balance may be a factor  related to EA. Replication of these findings in prospective studies is  needed to enhance confidence in the causality of this effect.                                                                               

 

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Human  leukocyte antigen HLA-DRB1 determinants susceptibility to  gastroesophageal reflux diseaseMahdi B.M. Hasan R.M. Hazim W.Journal of Medicine  (Bangladesh) (2018) 19:1 (3-9). Date of Publication:  2018Background: Gastro oesophageal reflux disease (GERD) is characterized by  diverse symptoms. There is an evidence for a genetic component to Gastro  oesophageal reflux disease as supported by familial aggregation of this  disease. Aim of the study was to investigate whether certain human leucocyte  antigen genes HLA-DRB1 are associated with (GERD). Methods: Patients and  controls were prospectively recruited from GIT center at Al-Kindy Teaching  Hospital (Baghdad-Iraq) between January 2014 and July 2016. Sixty Iraqi Arab  Muslim patients with a history of heartburn and dyspepsia were compared with  100 Iraqi Arab Muslims controls. All study patients and control groups  underwent upper gastrointestinal endoscopic examinations and their serums  were analyzed for CagA antibodies Immunoglobulin G (IgG) for H. pylori.  HLA-DRB1 genotyping were done to both groups. Results: A total of 60  patients with erosive gastritis; GERD (Grade II and III) were evaluated,  together with 100 controls. There is a significant increase of H. pylori  infection (p=0.0001) in GERD patients than control group. HLA-DRB1* 15:  01was significantly increased in GERD patients in comparison with control  group and an increased frequency of HLADRB1*11: 01 in control group compared  with patients group. Conclusions: There is an association between HLA-DRB1  *15: 01 in GERD patients with H pylori positive patients.                                                                               

 

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Stool antigen  detection versus(13)C-urea breath test for non-invasive  diagnosis of pediatric Helicobacter pylori infection in a limited resource  settingEl-Shabrawi M. El-Aziz N.A. Hassanin F. Eskander A. Abou-Zekri M. Mansour H.  Meshaal S. El-Adly T.Z.Archives of Medical Science (2018) 14:1 (69-73).  Date of Publication: 1 Jan  2018Introduction: The prevalence of childhood infection with Helicobacter pylori  is high, especially in developing countries. Non-invasive methods for  detection of infection in children should be inexpensive, easy to perform,  well tolerated and have a high diagnostic accuracy. We aimed to compare the  reliability, specificity and sensitivity of the H. pylori stool antigen  (HpSA) test with the(13)C-urea breath test ((13)C-UBT) for the diagnosis of  H. pylori infection in a limited resource setting. Material and methods: The  stool samples of 60 symptomatic and dyspeptic children with a mean age of  7.2 ±3.7 years (2–15 years) were evaluated using the rapid One step HpSA  test by lateral flow immunoassay. The(13)C-UBT was used as the gold standard  method for the diagnosis of H. pylori infection. Results: The HpSA test  detected H. pylori antigen in 34 out of 38 positive patients with 4  false-negatives (sensitivity 89.5%, 95% confidence interval (CI):  75.2–97.1%), while 21 patients had true-negative results and one  false-positive (specificity 95.5%, 95% CI: 77.2–99.9%), with a strong  measure of agreement between the HpSA test and the(13)C-UBT (κ = 0.83, 95%  CI: 68–97%, p < 0.001). It had a positive predictive value of 97.1% (95% CI:  85.1–99.9%), a negative predictive value of 84% (95% CI: 63.9–95.5%) and an  accuracy of 91.7%. Conclusions: The rapid lateral flow HpSA test is a  reliable method for the primary diagnosis of H. pylori infections in  children, though not as accurate as the(13)C-UBT. It is more affordable,  simpler to perform and more tolerable, representing a viable alternative,  especially in developing countries.                                                                               

 

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Reversibility of atrophic gastritis  and intestinal metaplasia after  Helicobacter pylori eradication - a prospective study for up to 10 yearsHwang Y.-J.  Kim N. Lee H.S. Lee J.B. Choi Y.J. Yoon H. Shin C.M. Park Y.S.  Lee D.H.Alimentary Pharmacology and Therapeutics (2018) 47:3 (380-390). Date of  Publication: 1 Feb 2018Background: Atrophic gastritis and intestinal metaplasia  are premalignant  conditions for gastric cancer. Their reversibility by Helicobacter pylori  eradication remains controversial. Aim: To evaluate the reversibility of  atrophic gastritis and intestinal metaplasia by H. pylori eradication with  long-term follow-up. Methods: 598 subjects were prospectively enrolled and  followed for up to 10 years. They were categorised as H. pylori-negative (n  = 65), H. pylori non-eradicated (n = 91), and H. pylori-eradicated (n =  442). Histological assessment was performed for antrum and corpus by Sydney  classification. Results: Histological follow-up was performed regularly at  1, 2, 3-4 and ≥5 years, with mean follow-up of 1.07 ± 0.21, 2.29 ± 0.83,  3.93 ± 1.02, and 6.45 ± 1.28 years, respectively. Atrophic gastritis in  antrum and corpus gradually and significantly (both P <.05 for all  timepoints) improved only in the H. pylori-eradicated group compared to that  at baseline. Significant difference in atrophic gastritis between H.  pylori-eradicated and H. pylori-negative groups disappeared from 1-year  follow-up. Similarly, intestinal metaplasia in antrum and corpus improved  significantly (both P <.05 for all timepoints) only in the H.  pylori-eradicated group in comparison with that at baseline. Significant  difference in intestinal metaplasia between H. pylori-eradicated and H.  pylori-negative groups disappeared from ≥5 years of follow-up in the antrum  and from 3 years of follow-up in the corpus. Conclusion: H. pylori  eradication may be a preventative strategy for intestinal-type gastric  cancer by regression of atrophic gastritis and intestinal metaplasia.                                                                                

 

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Efficacy of Reduced Dosage of Amoxicillin in an Eradication Therapy for  Helicobacter pylori Infection in Patients on Hemodialysis: A Randomized  Controlled TrialSahara S. Sugimoto M. Ichikawa H. Kagami T. Sakao Y. Ohashi N. Horio Y.  Sugimoto K. Kato A. Furuta T. Yasuda H.Digestion (2018) (163-169).  Date of Publication: 8 Jan 2018Background: An optimum Helicobacter pylori-eradication  regimen for  hemodialysis patients is yet to be established because of different  pharmacokinetics of amoxicillin involved between hemodialysis patients and  healthy subjects. We investigated to establish appropriate doses of  amoxicillin for H. pylori infection eradication in hemodialysis patients.  Methods: Of 409 hemodialysis patients screened for H. pylori infection, 37  H. pylori-positive patients were randomized to different 1-week eradication  regimens: esomeprazole 20 mg twice a day (b.i.d.) and clarithromycin 200 mg  b.i.d., plus amoxicillin at either 750 mg b.i.d. (group A; conventional) or  250 mg b.i.d. (group B; experimental). Sixty-three patients with normal  renal function received the conventional regimen (group C). Successful  eradication was confirmed by urea breath testing. Results: Eradication rates  of group B (reduced amoxicillin-regimen) were 84.2% in intention-to-treat  analysis and 88.9% in per-protocol analysis, which were similar with group A  (77.8 and 77.8%) and group C (74.6 and 81.0%). However, the incidence of  adverse events in group A was significantly higher than that in group C  (22.2 vs. 5.1%, p = 0.027). Conclusions: In H. pylori-positive hemodialysis  patients, amoxicillin at 250 mg b.i.d. may be an appropriate scheme for  eradication with equivalent effects to the conventional therapy and safety  effects for adverse events.                                                                               

 

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Clinicoepidemiologic Features of Chronic  Urticaria in Patients with versus  without Subclinical Helicobacter pylori Infection: A Cross-Sectional Study  of 150 PatientsKohli S. Mahajan V.K. Rana B.S. Mehta K.S. Raina R.K. Chauhan P.S. Sharma V.  Rawat R.International Archives of Allergy and Immunology (2018). Date of  Publication: 19 Jan 2018Background: The Helicobacter pylori infection is  linked to chronic urticaria  in nearly 60% of patients. We studied clinicoepidemiologic features in  patients with chronic urticaria with and without H. pylori infection.  Methods: Endoscopic antral biopsy for the rapid urease test (RUT) and  histopathology, and serum IgG ELISA for H. pylori infection were performed  in 150 patients (male:female ratio 1:2.4) of chronic urticaria aged 18-68  years. Clinicoepidemiologic features including age, gender, age of onset and  duration, frequency and distribution of wheals, urticaria severity score,  and systemic symptoms were analyzed in patients with and without H. pylori.  The results of serum IgG ELISA for H. pylori were compared with 106 age- and  gender-matched healthy adult controls. Results: The RUT in 84 patients  (56%), histopathology in 76 patients (50.6%), and H. pylori IgG ELISA in 94  patients (62.6%) were positive. H. pylori IgG ELISA was positive only in 35  (33%) controls, suggesting that chronic urticaria patients were more likely  to have asymptomatic H. pylori infection than normal controls. Although not  statistically significant, patients with H. pylori had a higher mean  urticaria severity score, number of urticaria/angioedema episodes per year,  and involvement of more body sites, particularly the scalp, palms, and  soles. The constitutional or gastrointestinal symptoms were statistically  higher in patients with H. pylori infection than those without it.  Conclusion: A subset of chronic urticaria patients appears to have  asymptomatic H. pylori infection. However, its implications in chronicity,  recurrences, the severity of urticaria, other systemic manifestations, and  management remains conjectural in view of 33% of controls also having  positive H. pylori ELISA and the endemicity of infection in developing  countries.                                                                               

 

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Histopathology Findings in Patients Undergoing Laparoscopic Sleeve  GastrectomyCanil A.M. Iossa A. Termine P. Caporilli D. Petrozza V. Silecchia  G.Obesity Surgery (2018) (1-6). Date of Publication: 5 Jan 2018Background:  Laparoscopic sleeve gastrectomy (LSG) has gained popularity in  the last 10 years for its good results in weight loss and comorbidity  control. However, guidelines on the pathological examination of the specimen  are lacking. The aim of this retrospective study was to determine the  usefulness of the routine specimen examination when presurgery endoscopy  (upper gastrointestinal endoscopy, UGIE) and multiple gastric biopsies are  part of the preoperative work-up. Methods: A retrospective review of                                                                              Records  of the patients submitted to LSG between January 2012 and August 2017 was  carried out. Sex, age, histopathology findings in the presurgery endoscopy  biopsies and surgical specimen, and the prevalence of Helicobacter pylori  infection were analyzed. Results: A total of 925 patients entered the study  group (mean age = 44.1 years, Females = 80.3%, BMI = 44.58 kg/m(2)). The  most common histopathology pattern in the endoscopy biopsies and in the  surgical specimens was inactive chronic gastritis (64.4 and 55.6%,  respectively). Helicobacter pylori infection was 24.6 and 2.48%,  respectively. Ninety-nine percent (n 796) of patients with non-significant  endoscopy biopsy findings showed the same patterns in specimen analysis.  Only three patients (0.3%) who had intestinal presurgery metaplasia were  positive in the specimen analysis, and two cases of gastric stromal  neoplasms (gastrointestinal stromal tumor and gastric leiomyoma) were found  intraoperatively. Conclusion: Most of the findings are non-significant and  can be predicted if UGIE plus multiple biopsies is routinely included in the  bariatric work-up with significant cost reduction. In those patients who had  a significant finding prior to the surgery or intraoperatively, the  pathological examination of the specimen is recommended.                                                                               

 

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Exploring  current status of Helicobacter pylori infection in different age  groups of patients with dyspepsiaDutta A.K. Reddy V.D. Iyer V.H. Unnikrishnan L.S.  Chacko A.Indian Journal of Gastroenterology (2018) (1-5). Date of Publication: 24 Jan  2018Recent data from Asian countries including India has shown a significant  decline in the frequency of peptic ulcer disease (PUD) compared to the past.  H. pylori is considered the most important risk factor for PUD, and we aimed  to explore the current frequency of H. pylori infection in different age  groups of patients with dyspepsia. Patients >15 years of age with dyspeptic  symptoms were prospectively recruited in this study from 2010 to 2014 after  obtaining informed consent. Patients were divided into three age groups:  15–30 years, 31–50 years, and >50 years, and the minimum sample size  required in the three groups with a power of 90% was 259, 256, and 188,  respectively. All patients underwent upper gastrointestinal endoscopy; rapid  urease test was done on gastric mucosal biopsy to detect H. pylori. The  clinical, demographic features and socioeconomic status were Recorded. The  institute review board approved the study. We included 1000 patients with  dyspepsia during the study period. Their mean age was 40.0+13.3 years, and  69.3% were males. Infection with H. pylori was detected in 419 (41.9%)  patients. Among men, H. pylori was present in 45.7% while the frequency of  infection in women was lower at 33.2% (p < 0.001). In the 15–30 years age  group (n = 303), the frequency of infection was 42.6% while it was 48.3% in  the 31–50 years group (n = 350) and 34.9% in the above 50 years group (n =  347). Male sex was a significant risk factor for H. pylori infection (p <  0.001). H. pylori infection, an important risk factor for PUD, was detected  in less than half of the dyspeptic patients in the current study.                                                                                

 

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Helicobacter pylori infection and prevalence of high blood pressure among  Chinese adultsWan Z. Hu L. Hu M. Lei X. Huang Y. Lv Y.Journal of Human Hypertension  (2017) (1-7). Date of Publication: 30 Dec 2017Epidemiological studies demonstrated  that Helicobacter pylori (H. pylori)  infection was associated with cardiovascular disease and its risk factors.  However, the association between H. pylori infection and hypertension  remained unclear. The aim of this study was to investigate the association  between H. pylori infection and prevalence of hypertension among Chinese  adults. We performed a cross-sectional study of 5246 adult participants who  were recruited from a health manage center. All participants underwent a  (13)C-urea breath test and a routine health check-up. Logistic and liner  regression models were used to calculate the odds ratios (ORs) and 95%  confidence intervals (CIs) for hypertension in relation to H. pylori  infection. Of the 5168 study participants aged 18–70 years, 2034 (39.4%)  were females and 955 (18.5%) had hypertension. After adjustment for  potential confounders, H. pylori infection was associated with an increased  prevalence of hypertension (OR, 1.23; 95% CI, 1.04, 1.46). In addition,  compared with participants not infected with H. pylori, those with H. pylori  infection had an increase of 0.735 mmHg (95% CI, 0.101, 1.369) for diastolic  blood pressure and 0.723 mmHg (95% CI, 0.034, 1.413) for mean arterial  pressure. There was no significant interaction between H. pylori infection  and age, sex, and body mass index on the prevalence of hypertension (all P  values for interaction >0.05). Findings from this study demonstrate that H.  pylori infection was positively associated with prevalence of hypertension  among Chinese adults. More well-designed studies are warranted to confirm  our findings.                                                                               

 

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Analysis of the Relationship between Helicobacter pylori  Infection and  Diabetic GastroparesisHuang J.Chinese Medical Journal (2017) 130:22 (2680-2685).  Date of Publication: 20  Nov 2017Background: Whether Helicobacter pylori infection is associated with  diabetic gastroparesis (DGP) is unclear. This study aimed to investigate the  potential correlation between H. pylori infection and DGP. Methods: In this  study, 163 patients with type 2 diabetes mellitus and 175 nondiabetic  patients who were treated in our department were divided into DGP, simple  diabetes, non-DGP (NDG), and normal groups based on their conditions. The H.  pylori infection rate in each group was calculated. H. pylori eradication  therapy was performed for patients with H. pylori infection in each group.  The eradication rates were compared between the groups, and the improvements  in gastroparesis-associated symptoms were compared before and after  treatment in patients with DGP. Results: The H. pylori infection rate was  74.6% in the DGP group, which was significantly higher than that in the  simple diabetes (51.1%, P < 0.01), NDG (57.7%, P < 0.05), and normal groups  (48.0%, P < 0.01). With increased disease course, the incidence of DGP and  the H. pylori infection rate gradually increased (P < 0.05). In the DGP  group, the incidences of upper abdominal pain and distention, early satiety,  and anorexia were 75.5%, 66.0%, and 67.9%, respectively, before eradication  treatment; and 43.4%, 35.8%, and 39.6%, respectively, after eradication  treatment, and the difference was statistically significant (P < 0.01). In  patients with DGP with successful H. pylori eradication, the number of  barium strips discharged after eradication was 5.9 ± 1.0, which was  significantly larger than that before treatment (4.1 ± 0.7, P < 0.01). In  addition, the number of barium strips discharged was significantly larger in  patients with DGP with successful H. pylori eradication than those with  failed H. pylori eradication (P < 0.01). Conclusions: DGP development might  be associated with H. pylori infection. H. pylori eradication can  effectively improve dyspepsia-associated symptoms and delayed gastric  emptying in patients with DGP.                                                                               

 

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Helicobacter Pylori infection of the  gallbladder and the risk of chronic  cholecystitis and cholelithiasis: A systematic review and meta-analysisCen L.  Pan J. Zhou B. Yu C. Li Y. Chen W. Shen Z.Helicobacter (2018) 23:1  Article Number: e12457. Date of Publication: 1 Feb  2018Background: Helicobacter pylori is coexisted with various diseases,  including chronic gastritis, ulcer, and gastric cancer. Besides, chronic  cholecystitis and cholelithiasis are extremely widespread over the world,  which are considered as high health-care cost burdens of digestive diseases.  Epidemiologic evidence on Helicobacter pylori infection in gallbladder  increasing the risk of biliary diseases has been contradictory. Aim: Conduct  a meta-analysis of overall studies and investigate an association between  Helicobacter pylori infection of the gallbladder with chronic  cholecystitis/cholelithiasis. Methods: We used PubMed, EMBASE, and Cochrane  library databases to identify all published studies before August 2017.  Pooled odds ratios (OR) and corresponding 95% confidence intervals (CIs)  were obtained using the random effects model. Heterogeneity, sensitivity,  and stratified analyses were also performed. Results: Eighteen studies  involving 1544 participants and 1061 biliary cases with chronic  cholecystitis/cholelithiasis were included. Helicobacter pylori infection of  the gallbladder was significantly associated with an increased risk of  chronic cholecystitis and cholecystitis (OR = 3.022; 95% CI, 1.897-4.815;  I(2) = 20.1%). In addition, country-based subgroup analysis also showed a  positive association between Helicobacter pylori positivity and chronic  cholecystitis/cholelithiasis risk. The ORs (95% CIs) for Asian and non-Asian  region studies were 3.75 (1.83-7.71) and 2.25 (1.29-3.89), respectively.  Conclusion: This meta-analysis suggests that infection of the gallbladder  with Helicobacter pylori is closely related to an increased risk of chronic  cholecystitis and cholelithiasis.                                                                               

 

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Helicobacter pylori, gastric cancer  and gastric cancer stem cellsCaviglia G.P. Bosco C.Minerva Biotecnologica  (2017) 29:4 (180-187). Date of Publication: 1 Dec  2017Chronic Helicobacter pylori (H. pylori) infection is considered the main  cause of gastric cancer (GC). Gastric carcinogenesis is the result of a  series of precancerous changes from atrophic gastritis to intestinal  metaplasia and dysplasia in which H. pylori plays a key role both through  direct and indirect mechanisms. Chronic inflammation caused by H. pylori  infection leads to gastric mucosal damage and consequently increases  turnover in gastric epithelium. During this process, resident stem cells  may, over time, accumulate genetic and epigenetic changes inducing an  aberrant phenotype and thus leading to the emergence of GC stem cells.  Furthermore, H. pylori has direct oncogenic properties regarded to the  cytotoxin-associated gene A (CagA). This bacterial oncoprotein is delivered  into host cells and promotes neoplastic transformation by interacting with  several intracellular signaling pathways. In addition, chronic inflammation  and tissue injury followed by recruitment and engraftment of bone marrow  derived stem cells into the gastric epithelium, may represent another source  of GC stem cells. In this scenario, GC stem cells have been identified as  the cell compartment able of self-renewal and differentiation responsible of  tumor continuous growth. The possibility to isolate and identify these cells  via specific surface markers may provide, in the future, novel targets to  develop specific molecules able to prevent GC development or to counteract  tumor evolution.                                                                               

 

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Helicobacter pylori and gastric cancer: Adaptive cellular  mechanisms  involved in disease progressionDíaz P. Valderrama M.V. Bravo J. Quest A.F.G.Frontiers  in Microbiology (2018) 9:JAN Article Number: 5. Date of  Publication: 22 Jan 2018Helicobacter pylori (H. pylori) infection is the major risk factor  associated with the development of gastric cancer. The transition from  normal mucosa to non-atrophic gastritis, triggered primarily by H. pylori  infection, initiates precancerous lesions which may then progress to  atrophic gastritis and intestinal metaplasia. Further progression to  dysplasia and gastric cancer is generally believed to be attributable to  processes that no longer require the presence of H. pylori. The responses  that develop upon H. pylori infection are directly mediated through the  action of bacterial virulence factors, which drive the initial events  associated with transformation of infected gastric cells. Besides genetic  and to date poorly defined environmental factors, alterations in gastric  cell stress-adaptive mechanisms due to H. pylori appear to be crucial during  chronic infection and gastric disease progression. Firstly, H. pylori  infection promotes gastric cell death and reduced epithelial cell turnover  in the majority of infected cells, resulting in primary tissue lesions  associated with an initial inflammatory response. However, in the remaining  gastric cell population, adaptive responses are induced that increase cell  survival and proliferation, resulting in the acquisition of potentially  malignant characteristics that may lead to precancerous gastric lesions.  Thus, deregulation of these intrinsic survival-related responses to H.  pylori infection emerge as potential culprits in promoting disease  progression. This review will highlight the most relevant cellular adaptive  mechanisms triggered upon H. pylori infection, including endoplasmic  reticulum stress and the unfolded protein response, autophagy, oxidative  stress, and inflammation, together with a subsequent discussion on how these  factors may participate in the progression of a precancerous lesion.  Finally, this review will shed light on how these mechanisms may be  exploited as pharmacological targets, in the perspective of opening up new  therapeutic alternatives for non-invasive risk control in gastric cancer.                                                                                

 

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Management of multi-drug resistant Helicobacter pylori infection by  supplementary, complementary and alternative medicine; a reviewRezaeimanesh N. Farzi N.  Pirmanesh S. Emami S. Yadegar A.Gastroenterology and Hepatology from Bed to Bench (2017)  10 Supplement 1  (S8-S14). Date of Publication: 2017Helicobacter pylori is recognized as the most  common bacterial pathogens  colonizing the gastric epithelium of nearly half of the world's population.  This bacterium is the main etiological cause of gastroduodenal ulcers, and  more importantly as the substantial risk factor for development of gastric  cancer. The emergence and rapid increase in the prevalence of multi-drug  resistant phenotypes have posed major pitfalls in effectiveness of various  treatment regimens and eradication strategies against H. pylori infections.  Several natural products and supplementary food components have been  reported to have established anti-H. pylori activity. Herein, we review the  application and efficacy of some specific natural products and foodstuffs  such as milk, bee products (honey and propolis), fish oil, vitamins C and E,  and also a nickel free-diet used as anti-H. pylori alternative treatment  regimens.                                                                            

 

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Is there a low prevalence of Helicobacter pylori infection in Jordanian  patients with gastric cancer?Pellicano R.Saudi Medical Journal (2017) 38:12 (1265).  Date of Publication: 1 Dec 2017                                                                               

 

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Role of sulforaphane in protection of  gastrointestinal tract against H.  Pylori and NSAID-induced oxidative stressYanaka A.Current Pharmaceutical Design  (2017) 23:27 (4066-4075). Date of Publication:  1 Aug 2017Background: Sulforaphane (SFN), a phytochemical found in abundance in  broccoli sprouts, potently induces a variety of antioxidant enzymes, and  thereby protects cells from injury induced by various kinds of oxidative  stresses. It has been suggested that both H. pylori infection and intake of  non-steroidal anti-inflammatory drugs (NSAIDs) induce chronic oxidative  stress in gastrointestinal (GI) mucosa, thereby causing mucosal injury in  the GI tract. Therefore, it would be a reasonable assumption that SFN  protects GI mucosa against oxidative injury induced by H. pylori or NSAIDs.  Methods: We examined the effects of SFN on H. pylori viability in vitro,  levels of gastritis in H.pylori-infected mice in vivo, and in  H.pylori-infected human subjects. We also examined the effects of SFN on  NSAID-induced small intestinal injury in mice. Results: Our data from the H.  pylori infection study clearly demonstrated that SFN inhibited H. pylori  viability both in vitro and in vivo, and mitigated H. pylori-induced  gastritis in mice and humans. Similarly, our study on NSAID-induced small  intestinal injury showed that SFN not only mitigated aspirin-induced injury  of small intestinal epithelial cells in vitro, but also ameliorated  indomethacin-induced small intestinal injury in mice in vivo. Conclusions:  These data strongly suggest that SFN contributes to the protection of GI  mucosa against oxidative injury induced by H. pylori or NSAIDs.                                                                               

 

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Long non-coding RNA ZFAS1 sponges miR-484 to promote cell proliferation and  invasion in colorectal cancerXie S. Ge Q. Wang X. Sun X. Kang Y.Cell Cycle (2018) (1-8).  Date of Publication: 1 Jan 2018The incidence and mortality rate of colorectal cancer (CRC) have been  significantly increasing. However, mechanisms involved in CRC progression  are still unclear. LncRNA ZFAS1 has been verified as oncogenic molecular in  a series of tumors, including CRC. However, the underlying mechanism of  ZFAS1 in CRC carcinogenesis remains unclear. In the present study, our data  showed that ZFAS1 expression was significantly upregulated in CRC tissues  and cell lines. Correlation analysis showed that high ZFAS1 expression was  significantly associated with Helicobacter pylori infection, lymph nodes  metastasis, advanced TNM stage and poor overall survival of CRC patients.  Loss-of-function experiments revealed that ZFAS1 inhibition could markedly  suppress CRC cells proliferation and invasion both in vitro and in vivo.  Bioinformatics analysis and luciferase reporter assay revealed that ZFAS1  directly interacted with miR-484. Rescue experiments showed that miR-484  inhibitor reversed the tumor suppressing roles of ZFAS1 knockdown on CRC  cells. Therefore, our study suggested that ZFAS1 could act as an oncogene in  CRC tumorigenesis, and discovered the functional regulatory pathway of ZFAS1  sponging miR-484.                                                                              

 

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Vonoprazan: A Novel and Potent Alternative in the  Treatment of Acid-Related  DiseasesYang X. Li Y. Sun Y. Zhang M. Guo C. Mirza I.A. Li Y.-Q.Digestive Diseases  and Sciences (2017) (1-10). Date of Publication: 27 Dec  2017Although proton pump inhibitors (PPIs) have been used widely, acid-related  diseases are still associated with a huge burden on the health care system.  Recently, the efficacy and safety of a new acid suppressant named vonoprazan  in the treatment of acid-related diseases have been evaluated by a series of  studies. As a novel potassium-competitive acid blocker, vonoprazan may  provide reversible acid suppression by preventing K(+) from binding to  gastric H(+)/K(+)-ATPase. It has been clinically used for the short-term  treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease  and Helicobacter pylori (H. pylori) infection in Japan. The healing rate of  GERD and gastric ulcers by vonoprazan is more than 95 and 90%, respectively;  also, it is effective in curing PPI-resistant GERD. It increases H. pylori  eradication rate to more than 88% as part of both first-line and second-line  therapy. It is also effective in the eradication of clarithromycin-resistant  H. pylori strains. All of these short-term studies show vonoprazan is safe  and well-tolerated. As a safe and effective acid inhibitor, vonoprazan might  be a novel alternative in the treatment of acid-related diseases.                                                                               

 

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Serum pepsinogen levels indicate the requirement of upper gastrointestinal  endoscopy among Group A subjects of ABC classification: a multicenter study Chinda D. Shimoyama T. Mikami T. Arai T. Chiba D. Sasaki Y. Komai K. Sawada  Y. Saito Y. Chiba H. Fukuda S.Journal of Gastroenterology (2018) (1-8).  Date of Publication: 20 Jan 2018Background: ABC classification has been used  to assess the risk for gastric  cancer. The current problem of ABC classification is that Group A contains  individuals with current and past H. pylori infection. The aims of this  study were to assesse the proportion of current and past infection in Group  A and to establish a criteria for the identification of subjects with past  infection from Group A subjects with negative results of urea breath test  (UBT) and/or stool antigen test. Methods: 201 subjects classified into Group  A received UBT and/or stool antigen test, and also subsequent upper  gastrointestinal endoscopy. The subjects were classified by the status of H.  pylori infection defined by endoscopic findings. Levels of pepsinogen (PG)  I, PG II and PG I/II ratio were compared between the groups, and receiver  operating characteristic curves were constructed to extract the  corresponding cutoff values. Results: 22 subjects were tested positive by  UBT and/or stool antigen test. Endoscopic images of 157 out of 179 subjects  were studied. 15 of the subjects were regarded to have past H. pylori  infection. The optimal cut-off value of PG I and PG I/II ratio for the  determination of past H. pylori infection were ≤ 31.2 ng/mL and ≤ 4.6,  respectively. Conclusions: Approximately 20% of Group A subjects have  current or past H. pylori infection. Addition of UBT and/or stool antigen  test can identify current but not past infection. Serum PG levels would be  useful to identify subjects with past H. pylori infection.                                                                                

 

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Association of gastric intestinal metaplasia and East Asian ethnicity with  the risk of gastric adenocarcinoma in a U.S. populationChoi A.Y. Strate L.L.  Fix M.C. Schmidt R.A. Ende A.R. Yeh M.M. Inadomi J.M.  Hwang J.H.Gastrointestinal Endoscopy (2018). Date of Publication:  2018Background and Aims: Although the incidence of gastric cancer is higher than  that of esophageal cancer in the United States, no screening or surveillance  guidelines exist. The aim of this study is to evaluate the association  between gastric intestinal metaplasia and the risk of gastric cancer in a  U.S. tertiary care system with a large immigrant population. Methods: This  is a retrospective case-control study with cases of biopsy-proven gastric  cancer matched (by age and gender) to controls without gastric cancer who  had undergone EGD. The presence of gastric intestinal metaplasia was  ascertained from pathology reports. Other potential risk factors for gastric  cancer were abstracted from medical                                                                              Records as follows: country of origin,  Helicobacter pylori infection, family history of gastric cancer, alcohol  consumption, smoking, and history of partial gastrectomy (Billroth I or II).  Conditional logistic regression was used to identify independent risk  factors for gastric cancer. Results: One hundred fifty-two cases of gastric  cancer were compared with 456 age- and gender-matched controls. The mean age  was 66 years, and 57% were male. Multivariable analysis identified 2  significant predictors of gastric cancer: the presence of gastric intestinal  metaplasia (odds ratio [OR], 9.3; 95% confidence interval [CI], 4.5-18.9; P  < .001) and East Asian ethnicity (OR, 15.9; 95% CI, 5.8-43.6; P < .001).  Conclusion: The presence of gastric intestinal metaplasia on endoscopy and  East Asian ethnicity were significant risk factors for gastric cancer.  Screening East Asian immigrants and surveying patients with gastric  intestinal metaplasia may improve the rates of early detection of gastric  cancer in the United States.                                                                              

 

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The resolution of helicobacter suis-associated  gastric lesions after  eradication therapyNakagawa S. Shimoyama T. Nakamura M. Chiba D. Kikuchi H. Sawaya M. Chinda D.  Mikami T. Fukuda S.Internal Medicine (2018) 57:2 (203-207).  Date of Publication: 2018A reddish depressed lesion was found in the corpus of the  stomach of a  56-year-old man. Gastric biopsy showed no findings of mucosa-associated  lymphoid tissue lymphoma, including lympho-epithelial lesions. A urea breath  test, stool antigen test and serum IgG antibody to Helicobacter pylori test  were negative. Magnifying endoscopy using narrow-band-imaging showed no  malignant structures. Gastric biopsy specimens were subjected to  immunohistochemistry and a polymerase chain reaction, which identified  Helicobacter suis infection. Triple therapy with esomeprazole,  metronidazole, and amoxicillin was administered for 10 days. Three months  later, endoscopy showed the significant improvement of the lesion. H. suis  infection should be considered in chronic gastritis patients without H.  pylori infection.                                                                              

 

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Decrease in PSCA expression caused by Helicobacter  pylori infection may  promote progression to severe gastritisToyoshima O. Tanikawa C. Yamamoto R.  Watanabe H. Yamashita H. Sakitani K.  Yoshida S. Kubo M. Matsuo K. Ito H. Koike K. Seto Y. Matsuda K.Oncotarget (2018)  9:3 (3936-3945). Date of Publication: 2018SNP rs2294008 in Prostate Stem Cell Antigen (PSCA) and decreased PSCA  expression are associated with gastric cancer. The objective of this study  is to investigate the role of rs2294008 and PSCA expression in the  gastritis-gastric cancer carcinogenic pathway. We conducted a case-control  association study of H. pyloriinfected gastritis and gastric cancer.  rs2294008 was associated with the progression to chronic active gastritis (P  = 9.4 × 10(-5); odds ratio = 3.88, TT + TC vs CC genotype), but not with H.  pylori infection per se nor with the progression from active gastritis to  gastric cancer. We also assessed the association of rs2294008 with PSCA mRNA  expression in the gastric mucosa at various disease stages and found that  rs2294008 was associated with PSCA expression (P = 1.3 × 10(-12)). H. pylori  infection (P = 5.1 × 10(-8)) and eradication therapy (P < 1 × 10(-11))  resulted in the reduced and increased PSCA expression, respectively,  indicating negative regulation of PSCA expression by H. pylori infection.  PSCA expression was decreased in severe gastritis compared with mild  gastritis only among T allele carriers. Our findings revealed the regulation  of PSCA expression by host genetic variation and bacterial infection might  contribute to gastritis progression after H. pylori infection.                                                                               

 

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Probiotics  for gastrointestinal disorders: Proposed Recommendations for  children of the Asia-Pacific regionCameron D. Hock Q.S. Kadim M. Mohan N. Ryoo E. Sandhu B. Yamashiro Y. Jie C.  Hoekstra H. Guarino A.World Journal of Gastroenterology (2017) 23:45 (7952-7964). Date of  Publication: 7 Dec 2017Recommendations for probiotics are available in several regions. This paper  proposes recommendations for probiotics in pediatric gastrointestinal  diseases in the Asia-Pacific region. Epidemiology and clinical patterns of  intestinal diseases in Asia-Pacific countries were discussed. Evidence-based  recommendations and randomized controlled trials in the region were revised.  Cultural aspects, health management issues and economic factors were also  considered. Final recommendations were approved by applying the Likert scale  and rated using the GRADE system. Saccharomyces boulardi CNCM I-745 (Sb) and  Lactobacilus rhamnosus GG (LGG) were strongly recommended as adjunct  treatment to oral rehydration therapy for gastroenteritis. Lactobacilus  reuteri could also be considered. Probiotics may be considered for  prevention of (with the indicated strains): antibiotic-associated diarrhea  (LGG or Sb); Clostridium difficile-induced diarrhea (Sb); nosocomial  diarrhea (LGG); infantile colic (L reuteri) and as adjunct treatment of  Helicobacter pylori (Sb and others). Specific probiotics with a history of  safe use in preterm and term infants may be considered in infants for  prevention of necrotizing enterocolitis. There is insufficient evidence for  recommendations in other conditions. Despite a diversity of epidemiological,  socioeconomical and health system conditions, similar recommendations apply  well to Asia pacific countries. These need to be validated with local  randomized-controlled trials.                                                                              

 

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Helicobacter pylori and corpus gastric  pathology are associated with lower  serum ghrelinMantero P. Matus G.S. Corti R.E. Cabanne A.M. Gabriel G. De Palma Z. Olid  L.M. Piskorz M.M. Zubillaga M.B. De Palma G.G.Z. Janjetic M.A. Goldman C.G. World Journal of Gastroenterology (2018) 24:3 (397-407). Date of  Publication: 21 Jan 2018AIM To evaluate the association of Helicobacter pylori (H. pylori ), cagA  genotype, and type of gastric pathology with ghrelin, leptin and nutritional  status. METHODS Fasted dyspeptic adults (18-70 years) referred for an upper  digestive endoscopy were enrolled in this crosssectional study. Height and  weight were assessed for body mass index (BMI) calculation. A  sociodemographic survey was administered and nutrient intake was evaluated  with 24 h dietary recalls. Serum total ghrelin and leptin levels were  analyzed by enzymelinked immunosorbent assay. (13)C-Urea Breath Test was  performed and four gastric biopsies were obtained during endoscopy for  histopathology and H. pylori DNA amplification and genotyping. Data analysis  was performed using X (2), Mann-Whitney U , Kruskal-Wallis tests, Spearman's  correlation and linear regression. RESULTS one hundred and sixty-Three  patients (40.8 ± 14.0 years), 98/65 females/males, were included. Overall,  persistent H. pylori prevalence was 53.4% (95%CI: 45.7%-65.8%). Neither  nutrient intake nor BMI differed significantly between H. pylori positive  and negative groups. Serum ghrelin was significantly lower in infected  patients [median 311.0 pg/mL (IQR 230.0-385.5)] than in uninfected ones  [median 355.0 pg/mL (IQR 253.8-547.8)] (P = 0.025), even after adjusting for  BMI and gender (P = 0.03). Ghrelin levels tended to be lower in patients  carrying cagA positive strains both in the antrum and the corpus; however,  differences with those carrying cagA negative strains did not reach  statistical significance (P = 0.50 and P = 0.49, respectively). In addition,  the type and severity of gastric pathology in the corpus was associated with  lower serum ghrelin (P = 0.04), independently of H. pylori status.  Conversely, leptin levels did not differ significantly between infected and  uninfected patients [median 1.84 ng/mL (0.80-4.85) vs 1.84 ng/mL  (0.50-5.09), (P = 0.51)]. CONCLUSION H. pylori infection and severity of  gastric corpus pathology are associated with lower serum ghrelin. Further  studies could confirm a lower ghrelin prevalence in cagA-positive patients.                                                                              

 

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Stool antigen detection versus(13)C-urea breath test for non-invasive  diagnosis of pediatric Helicobacter pylori infection in a limited resource  settingEl-Shabrawi M. El-Aziz N.A. Hassanin F. Eskander A. Abou-Zekri M. Mansour H.  Meshaal S. El-Adly T.Z.Archives of Medical Science (2018) 14:1 (69-73). Date of Publication: 1 Jan  2018Introduction: The prevalence of childhood infection with Helicobacter pylori  is high, especially in developing countries. Non-invasive methods for  detection of infection in children should be inexpensive, easy to perform,  well tolerated and have a high diagnostic accuracy. We aimed to compare the  reliability, specificity and sensitivity of the H. pylori stool antigen  (HpSA) test with the (13)C-urea breath test ((13)C-UBT) for the diagnosis of  H. pylori infection in a limited resource setting. Material and methods: The  stool samples of 60 symptomatic and dyspeptic children with a mean age of  7.2 ±3.7 years (2–15 years) were evaluated using the rapid One step HpSA  test by lateral flow immunoassay. The(13)C-UBT was used as the gold standard  method for the diagnosis of H. pylori infection. Results: The HpSA test  detected H. pylori antigen in 34 out of 38 positive patients with 4  false-negatives (sensitivity 89.5%, 95% confidence interval (CI):  75.2–97.1%), while 21 patients had true-negative results and one  false-positive (specificity 95.5%, 95% CI: 77.2–99.9%), with a strong  measure of agreement between the HpSA test and the (13)C-UBT (κ = 0.83, 95%  CI: 68–97%, p < 0.001). It had a positive predictive value of 97.1% (95% CI:  85.1–99.9%), a negative predictive value of 84% (95% CI: 63.9–95.5%) and an  accuracy of 91.7%. Conclusions: The rapid lateral flow HpSA test is a  reliable method for the primary diagnosis of H. pylori infections in  children, though not as accurate as the (13)C-UBT. It is more affordable,  simpler to perform and more tolerable, representing a viable alternative,  especially in developing countries.                                                                              

 

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A meta-analysis of the association  between Helicobacter pylori (H. pylori)  infection and hyperemesis gravidarumNg Q.X. Venkatanarayanan N. De Deyn M.L.Z.Q.  Ho C.Y.X. Mo Y. Yeo W.-S.Helicobacter (2018) 23:1 Article Number: e12455.  Date of Publication: 1 Feb  2018Background: Hyperemesis gravidarum remains a common, distressing, and  significant yet poorly understood disorder during pregnancy. The association  between maternal Helicobacter pylori (H. pylori) infection and hyperemesis  gravidarum has been increasingly recognized and investigated. This study  thus aimed to provide an updated review and meta-analysis of the topic.  Methods: Using the search terms (H. pyloriOR Helicobacter ORHelicobacter  pyloriOR infection) AND (pregnancy OR emesis OR hyperemesis gravidarum OR  nausea OR vomiting), a preliminary search on the PubMed, Ovid, Web of  Science, Google Scholar, and WanFang database yielded 372 papers published  in English between January 1st, 1960 and June 1st, 2017. Results: A total of  38 cross-sectional and case-control studies, with a total of 10 289 patients  were eligible for review. Meta-analysis revealed a significant association  between H. pylori infection and hyperemesis gravidarum during pregnancy,  with a pooled odds ratio of 1.348 (95% CI: 1.156-1.539, P <.001). Subgroup  analysis found that serologic and stool antigen tests were comparable  methods of detecting H. pylori as they yielded similar odds ratios.  Limitations: Although the studies did not have high heterogeneity  (I(2) = 28%), publication bias was observed, and interstudy discrepancies in  the diagnostic criteria adopted for hyperemesis gravidarum limit the  reliability of findings. Also, 15 of the included studies were from the same  country (Turkey), which could limit the generalizability of current  findings. The prevalence of H. pylori infection varies throughout the world,  and there may also be pathogenic differences as most strains of H. pylori in  East Asia carry the cytotoxin-associated gene A gene. Conclusion: H. pylori  infection was associated with an increased likelihood of hyperemesis  gravidarum during pregnancy. Given the high prevalence of H. pylori  infections worldwide, detecting H. pylori infection and the eradication of  maternal H. pylori infection could be part of maternal hyperemesis  gravidarum management. Further confirmation with robust longitudinal studies  and mechanistic investigations are needed.                                                                              

 

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NLRP3 Controls the  Development of Gastrointestinal CD11b(+) Dendritic Cells  in the Steady State and during Chronic Bacterial InfectionArnold I.C. Zhang X.  Urban S. Artola-Borán M. Manz M.G. Ottemann K.M. Müller  A.Cell Reports (2017) 21:13 (3860-3872). Date of Publication: 26 Dec 2017 The gastric lamina propria is largely uncharted immunological territory.  Here we describe the evolution and composition of the gastric, small  intestinal, and colonic lamina propria mononuclear phagocyte system during  the steady state and infection with the gastric pathogen Helicobacter  pylori. We show that monocytes, CX(3)CR1(hi) macrophages, and CD11b(+)  dendritic cells are recruited to the infected stomach in a CCR2-dependent  manner. All three populations, but not BATF3-dependent CD103(+) DCs, sample  red fluorescent protein (RFP)(+) Helicobacter pylori (H. pylori). Mice  reconstituted with human hematopoietic stem cells recapitulate several  features of the myeloid cell-H. pylori interaction. The differentiation in  and/or recruitment to gastrointestinal, lung, and lymphoid tissues of  CD11b(+) DCs requires NLRP3, but not apoptosis-associated speck-like protein  containing a carboxy-terminal CARD (ASC) or caspase-1, during steady-state  and chronic infection. NLRP3(−/−) mice fail to generate Treg responses to H.  pylori and control the infection more effectively than wild-type mice. The  results demonstrate a non-canonical inflammasome-independent function of  NLRP3 in DC development and immune regulation. Arnold et al. report that the  gastric pathogen Helicobacter pylori is sampled by CD11b(+) cDC2 dendritic  cells that require NLRP3, but not other inflammasome components, for their  differentiation in gastrointestinal tissues. NLRP3 deficiency is further  associated with loss of regulatory T cells and corresponding dysregulated  Th1 responses.                                                                              

 

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Association between Severity of liver disease, frequency of helicobacter  pylori infection, and Degree of Gastric Lesion in Egyptian Patients with  Hepatitis B Virus InfectionMohamed A.A. Elshimy A.A. ElSadik A.O. Ezzat E. Nasar M. Elshaer S.S.M.  Sayed M.M.American Journal of Tropical Medicine and Hygiene (2018) 98:1 (221-226).  Date of Publication: 2018The relationship between hepatitis B virus (HBV) infection, severity of  liver disease, frequency of Helicobacter pylori infection, and degree of  gastric lesions was not yet fully investigated in Egyptian patients. The  present work was performed on 100 Egyptian patients with HBV from the  National Hepatology and Tropical Medicine Institute and 70 healthy  volunteers as control group. The participants were subjected to full medical  history taking, clinical examination, and laboratory investigations.All  patientswere positive forHBV surface antigen (HBV sAg),HBVDNA, and negative  for hepatitis C virus antibodies. The severity of the liver disease was  assessed using Child-Pugh scoring system. Screening of all participants for  H. pylori Ag in stool was performed. Biopsy specimens were taken from the  gastric lesions of H. pylori-infected patients for histopathological  examination. The mean age of the patients and control group were 34.9 and  33.4 years, respectively. The levels of the liver enzymes were statistically  higher in HBV patients than the control group. Helicobacter pylori Ag in  stool was detected in 45.7% of the control group, and a higher percentage  (60%) was detected in the patients group. Chronic gastritis with glandular  atrophy and metaplasia was found in 15.6% of patients of Child-Pugh A, 70%  of Child-Pugh B, and 100% of Child-Pugh C. It could be concluded that the  prognosis of the liver disease significantly influences the severity of the  gastric pathology in H. pylori infection.                                                                             

 

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Relationship between β-thalassemia  minor and Helicobacter pylori infectionZamani M. Vahedi A. Tamaddoni A. Bijani A.  Bagherzade M. Shokri-Shirvani J.Caspian Journal of Internal Medicine (2018) 9:1 (54-59). Date of  Publication: 2018Background: Until now, no study has been reported investigating the  association between β-thalassemia minor and Helicobacter pylori (H. pylori)  infection. This study was designed to compare H. pylori infection rate  between β-thalassemia minor patients and healthy controls. Methods: A number  of 100 β-thalassemia minor patients (50 males, 50 females) and 100  gender-matched healthy controls were prospectively recruited in this study  in a period of 3 months. The study population consisted of the people who  referred to a health center in Babol, North of Iran, for premarital  counseling. H. pylori status was assessed by measuring the anti-H. pylori  IgG antibodies using enzyme-linked immunosorbent assay. Demographic  information and informed consent were collected from all participants.  Results: The overall H. pylori infection rate was 43%. The infection was  significantly more prevalent in thalassemia patients (53%) than in the  controls (33%) in both univariate (OR=2.29, 95% CI: 1.3-4.06) and  multivariable analyses (OR=2.05, 95% CI: 1.12-3.76). Age was the only  significant factor which was positively correlated with the infection in  β-thalassemia minor cases (OR=1.11, 95% CI: 1.02-1.2). Gender, blood groups,  residency, and education level were not related to the infection.  Conclusions: According to the results, it can be concluded that  β-thalassemia minor patients are possibly more susceptible to H. pylori  infection than healthy people. Further studies are needed to discover more  about the exact mechanisms of increased susceptibility to H. pylori  infection in β-thalassemia minor patients.                                                                              

 

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Gastric bacterial Flora  in patients Harbouring Helicobacter pylori with or  without chronic dyspepsia: Analysis with matrix-assisted laser desorption  ionization time-of-flight mass spectroscopyPereira V. Abraham P. Nallapeta S.  Shetty A.BMC Gastroenterology (2018) 18:1 Article Number: 20. Date of Publication: 26  Jan 2018Background: The gastric microbiota has recently been implicated in the  causation of organic/structural gastroduodenal diseases (gastric and  duodenal ulcers, gastric cancer) in patients with Helicobacter pylori (H.  pylori) infection. We aimed to ascertain, in patients harbouring H. pylori,  the role of the gastric microbiota in the causation of symptoms (chronic  dyspepsia) in the absence of organic disease. Methods: Seventy-four gastric  biopsy samples obtained at endoscopy from patients with (n=21) or without  (n=53) chronic dyspepsia, and that tested positive by the bedside rapid  urease test for H. pylori infection, were cultured for detection of H.  pylori and non-H. pylori organisms. The cultured organisms were identified  by matrix-assisted laser desorption ionization time-of-flight mass  spectroscopy (MALDI-TOF MS). Results: A total of 106 non-H. pylori isolates  were obtained from 74 patients' samples. This included 33 isolates (median  2, range 1-2 per patient) from dyspeptic and 73 (median 2, range 1-2 per  patient) from non-dyspeptic patients. These were identified from the Bruker  Biotyper 2 database as Staphylococcus spp., Streptococcus spp.,  Lactobacillus spp., Micrococcus spp., Enterococcus spp., Pseudomonas spp.,  Escherichia spp., Klebsiella spp. and Bacillus spp., Staphylococcus and  Lactobacillus were identified significantly more commonly in dyspeptics and  Streptococcus, Pseudomonas, Escherichia coli and Klebsiella pneumoniae in  non-dyspeptics. All identified organisms belonged to the phyla Firmicutes  and Proteobacteria. Conclusions: There is a qualitative difference in the  gastric microbial spectrum between patients harbouring H. pylori with and  without chronic dyspepsia. Whether these organisms have an independent role  in the development or prevention of dyspepsia or act in concurrence with H.  pylori needs study.                                                                              

 

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Study on relationship between acute gastrointestinal disease and  Helicobacter pylori infectionsSalehi M. Sadeghi F. Shirvani J.S. Shahandashti E.F.  Khafri S. Rajabnia R.Journal of Acute Disease (2017) 6:6 (264-267).  Date of Publication: 1 Nov  2017Objective: To assess the relation between acute gastrointestinal disease and  Helicobacter pylori (H. pylori) infections. Methods: Over the 18-month  period, a total of 323 patients referred to three hospitals in Babol (north  of Iran) were enrolled in this cross-sectional study. H. pylori status  (rapid urease test), endoscopic findings in the patients, personal habits  (smoking or alcohol intake) and administration of drugs, such as  non-steroidal anti-inflammatory drugs (NSAIDs) were analyzed using standard  Chi-square test and multinomial logistic regression analysis. Results:  Results showed that acute gastric ulcer patients had a significant  association with alcohol (P=0.001, OR=6.183), opium (P=0.022, OR=2.823),  smoking (P=0.016, OR=2.579) and NSAIDs (P=0.046, OR=2.071). However,  patients with in acute duodenal ulcer have a significant association with  opium (P=0.023, OR=2.326) and alcohol (P=0.003, OR=3.888). As well as,  gastric cancer had significant association with alcohol (P<0.05, OR=6.937),  smoking (P=0.012, OR=2.738), family history (P=0.005, OR=4.380) and gender  (P≤0.05, OR=5.103). Conclusions: Current investigation shows that H. pylori  infection, alcoholism, male gender, age and family history have an additive  impact on the incidence of gastric cancer. In addition, alcoholism, opium  usage, NSAIDs and family history have more impact on the incidence of acute  gastric ulcer and acute duodenal ulcer in patients.                                                                              

 

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Associations between  cagA, vacA, and the clinical outcomes of helicobacter  pylori infections in Okinawa, JapanInagaki T. Nishiumi S. Ito Y. Yamakawa A.  Yamazaki Y. Yoshida M. Azuma T.Kobe Journal of Medical Sciences (2017) 63:2 (E58-E67).  Date of Publication:  1 Jan 2017Helicobacter pylori, which is involved in the pathogenesis of gastroduodenal  disease, produces CagA and VacA as major virulence factors. CagA is  classified into East Asian and Western types based on the number and  sequences of its Glu-Pro-Ile-Tyr-Ala motifs. The vacA gene has three  polymorphic regions: the signal (s), intermediate (i), and middle (m)  regions. The lowest gastric cancer mortality rate is seen in Okinawa. On the  Japanese mainland (Honshu), most H. pylori produce s1/m1-VacA, which  exhibits strong toxicity, and East Asian-type CagA. However, the H. pylori  detected in Okinawa produces s1/m2-VacA, which exhibits weak toxicity, or  s2/m2-VacA, which is non-toxic, and Western-type CagA. Studies about the  i-region of vacA have been performed around the world, but there have been  few such studies in Japan. Therefore, the aim of this study was to assess  the relationships between the clinical outcomes of H. pylori infections in  Okinawa, vacA (especially the i-region genotype), and cagA. H. pylori  strains that were collected from patients with gastric cancer or gastric  ulcers in Okinawa only produced the i1-type VacA virulence factor. The  vacuolating cytotoxin activity of i1-type VacA was stronger than that of  i2-type VacA, suggesting that the i-region genotype of vacA is closely  associated with vacuolating cytotoxin activity. These results indicate that  the i-region genotype of vacA is a useful marker of both H. pylori virulence  and the clinical outcomes of H. pylori infections in Okinawa, Japan.                                                                                

 

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Protein profiling of infected human gastric epithelial cells with an Iranian  Helicobacter pylori clinical isolateFazeli Z. Alebouyeh M. Mansouri V. Malekpour  H.Gastroenterology and Hepatology from Bed to Bench (2017) 10 Supplement 1  (S139-S145). Date of Publication: 2017Aim: The main objective of this study was  to use high throughput approach to  characterize the response of human gastric epithelial cells to Helicobacter  pylori (H. pylori) infection at protein level. Background: Alteration of  host cell protein profiles occurs due to H. pylori infection. This  alteration seems to be strain specific. High throughput approaches, such as  proteomics, can describe changes that occurs at the protein levelin the  infected cells in response to H. pylori infection. In accordance with this  point of view, we used two dimensional electrophoresis (2-DE)/MS to  determine changes in proteome profile of gastric epithelial cells infected  with a clinical isolate of H. pylori from an Iranian patient. Methods: Human  gastric epithelial cells (AGS) were infected by an Iranian H. pylori isolate  (complete cagPAI, vacA s2m2, babA2, iceA1, sabA). The altered protein  patterns separated by 2-DE were identified by matrix-assisted laser  desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS)  analysis. Results: The results showed 40 spots with significantly different  intensities between the 2-DE gels. Protein SETSIP and Endoplasmic reticulum  resident protein 29 were identified by MALD-TOF and Mascot search. Proteomic  analysis for functional roles of these proteins showed that mechanisms to  deal with stress conditions and transcriptional activator related to cell  reprogramming are involved in H. pylori infection. Conclusion: Using high  throughput approaches, such as proteomics, we can provide further molecular  details about interaction of H. pylori strains with the infected cells at  protein level.                                                                              

 

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Culture of gastric biopsies in celiac disease and its  relationship with  gastritis and Helicobacter pylori infectionBorghini R. Donato G. Marino M. Casale R.  Picarelli A.Digestive and Liver Disease (2018) 50:1 (97-100). Date of Publication: 1 Jan  2018                                                                               

 

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The impact of Helicobacter pylori Urease upon platelets and consequent  contributions to inflammationScopel-Guerra A. Olivera-Severo D. Staniscuaski F. Uberti A.F. Callai-Silva  N. Jaeger N. Porto B.N. Carlini C.R.Frontiers in Microbiology (2017) 8:DEC Article Number: 2447. Date of  Publication: 12 Dec 2017Gastric infection by Helicobacter pylori is considered a risk factor for  gastric and duodenal cancer, and extragastric diseases. Previous data have  shown that, in a non-enzymatic way, H. pylori urease (HPU) activates  neutrophils to produce ROS and also induces platelet aggregation, requiring  ADP secretion modulated by the 12-lipoxygenase pathway, a signaling cascade  also triggered by the physiological agonist collagen. Here we investigated  further the effects on platelets of recombinant versions of the holoenzyme  HPU, and of its two subunits (HpUreA and HpUreB). Although HpUreA had no  aggregating activity on platelets, it partially inhibited collagen-induced  aggregation. HpUreB induced platelet aggregation in the nanomolar range, and  also interfered dose-dependently on both collagen- and ADP-induced platelet  aggregation. HPU-induced platelet aggregation was inhibited by antibodies  against glycoprotein VI (GPVI), the main collagen receptor in platelets.  Flow cytometry analysis revealed exposure of P-selectin in HPU-activated  platelets. Anti-glycoprotein IIbIIIa (GPIIbIIIa) antibodies increased the  binding of FITC-labeled HPU to activated platelets, whereas anti-GPVI did  not. Evaluation of post-transcriptional events in HPU-activated platelets  revealed modifications in the pre-mRNA processing of pro-inflammatory  proteins, with increased levels of mRNAs encoding IL-1β and CD14. We  concluded that HPU activates platelets probably through its HpUreB subunit.  Activation of platelets by HPU turns these cells into a pro-inflammatory  phenotype. Altogether, our data suggest that H. pylori urease, besides  allowing bacterial survival within the gastric mucosa, may have an  important, and so far overlooked, role in gastric inflammation mediated by  urease-activated neutrophils and platelets.                                                                              

 

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Association between receptor  interacting serine/threonine kinase 2  polymorphisms and gastric cancer susceptibilityOta M. Tahara T. Otsuka T.  Jing W. Nomura T. Hayashi R. Shimasaki T.  Nakamura M. Shibata T. Arisawa T.Oncology Letters (2018) 15:3 (3772-3778).  Date of Publication: 1 Mar 2018The present study aimed to investigate whether  single nucleotide  polymorphisms in receptor interacting serine/threonine kinase 2 (RIPK2),  which encodes a component of the nucleotide binding oligomerization domain  containing 2-RIP2 pathway, may compromise the innate immune response to  Helicobacter pylori infection, leading to increased susceptibility to  gastric cancer in the Japanese population. The present case control study  investigated the associations between RIPK2 single nucleotide polymorphisms  and gastric mucosal inflammation, atrophy and cancer susceptibility in 528  patients with gastric cancer and 697 patients without gastric malignancies  on upper gastro-duodenal endoscopy. Overall, the RIPK2 rs16900627 minor  allele was significantly associated with the susceptibility to gastric  cancer [OR, 1.37; 95% confidence interval (CI), 1.06-1.77; P=0.016],  particularly of the intestinal type (OR, 1.53; 95% CI, 1.13-2.07; P=0.0062).  It was also significantly associated with gastric mucosal atrophy (OR, 1.83;  95% CI, 1.14-2.93; P=0.011). When assessing the severity of chronic  gastritis using the updated Sydney system, the activity and inflammation  scores, as well as atrophy and metaplasia scores, were significantly higher  in rs16900627 minor allele carriers compared with wild-type homozygotes. In  patients younger than 60 years old, the pepsinogen I/II ratio was  significantly lower in rs16900627 minor allele carriers compared with  wild-type homozygotes (P=0.037). The rs16900627 minor allele is associated  with the severity of gastric mucosal inflammation and the development of  gastric mucosal atrophy. Carriers of this allele may have an increased risk  for the development of gastric cancer, particularly of the intestinal type.                                                                               

 

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Frequency of Helicobacter pylori infection (detected by gastric biopsy  culture and histopathology) in children presenting with recurrent abdominal  pain (RAP)Nazimuddin Chohan M.N. Memon I.A.Journal of the Liaquat University of  Medical and Health Sciences (2017) 16:4  (205-208). Date of Publication: 1 Oct 2017OBJECTIVE: To determine the frequency  of Helicobacter pylori infection  (detected by Gastric Biopsy culture and histopathology) in children  presenting with recurrent abdominal pain. DURATION: Six months from June  2014 to November 2014. SETTING: Department of Pediatric unit II, Civil  Hospital Karachi, DUHS. STUDY DESIGN: Descriptive study, Case series  METHODOLOGY: Children 2-15 years of age with either sex, presenting with  history of recurrent abdominal pain as per defined criteria were included in  the study. Children were excluded from the study if having history of intake  of Steroids, antibiotic, NSAIDs, H(2) receptor blockers, proton pump  inhibitors or bismuth subsalicylate preceding 4 weeks prior to endoscopy,  already diagnosed as having H. pylori infection, inflammatory bowel disease,  chronic liver disease, acute appendicitis and renal disease. Recurrent  abdominal pain (RAP) was diagnosed on the basis of history of recurrent  severe abdominal pain occurring at-least once in a month for 3 consequent  months. Prior to upper GI endoscopy and biopsy, other causes of recurrent  abdominal pain were ruled out by performing appropriate tests that includes  complete blood picture, urine detailed examination, stool detailed  examination, stool culture and sensitivity, liver function tests, renal  function tests, abdominal and pelvic ultra-sonograms. Upper Gastrointestinal  endoscopy was performed in all patients RESULTS: Out of 60 cases of RAP  61.7% were males and 38.3% were females. Male to female ratio was 1.60. Mean  age of children was 7.71 ± 2.68 years. Mean duration of RAP was 5.55 ± 1.83  months. Frequency of RAP episodes per month ranged from 3-11 episodes (mean  5.97 ± 2.09). On culture of total 60 biopsy cases H Pylori was positive in  36.7% while it was negative in 63.3% cases. Out of 22children having H.  Pylori infection14 were males and 8were females. Mean age of children with  H. pylori positive was 8.09 ± 2.18 years. Mean duration of RAP in positive  case was 5.77 ± 1.88 months. Conclusion: H pylori infection is a major cause  of RAP in children and therefore should always be considered in differential  diagnosis. Large scale studies are warranted to build national database.                                                                               

 

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Contribution of matrix metalloproteinases-1 genotypes to gastric cancer  susceptibility in TaiwanYang M.-D. Lin K.-C. Lu M.-C. Jeng L.-B. Hsiao C.-L.  Yueh T.-C. Fu C.-K. Li  H.-T. Yen S.-T. Lin C.-W. Wu C.-W. Pang S.-Y. Bau D.-T. Tsai F.-J.BioMedicine  (France) (2017) 7:2 (18-24). Date of Publication: 1 Jun 2017Expression of matrix  metalloproteinase-1 (MMP1), an interstitial collagenase  regulating the extracellular matrix, plays a major role in carcinogenesis of  gastric cancer, a leading cause of death worldwide. In literature, the  single-nucleotide polymorphism (SNP) promoter -1607 1G/2G (rs1799750) at the  MMP1 gene promoter has been reported to alter its own transcription level.  While the importance's of the genotype of MMP1 promoter -1607 has not yet  been studied in gastric cancer in Taiwan, our aim was to investigate MMP1  promoter -1607 genotypes and gastric cancer (GC) susceptibility in central  Taiwan population. In the current hospital-based case-control study, the  contribution of MMP1 promoter -1607 genotypes to GC risk was investigated  among 121 GC patients and 363 gender- and age-matched healthy controls  recruited and genotyped by the polymerase chain reaction-based restriction  fragment length polymorphism (PCR-RFLP) methodology. We found that the  genotypic and allelic frequencies were not differentially distributed  between GC patient and control groups. The variant 1G containing genotypes  have interactions with cigarrete smoking behaviors and Helicobacter pylori  infection status, but not alcoholism on GC susceptibility determination. Our  findings suggest that the variant 1G allele on MMP1 promoter -1607 may  contribute to GC carcinogenesis and may be useful for GC early detection and  prevention when combined with cigarrete smoking behaviors and Helicobacter  pylori infection status.                                                                               

 

RECORD 88

 

Modifiable factors and esophageal cancer:  a systematic review of published  meta-analysesCastro C. Peleteiro B. Lunet N.Journal of Gastroenterology (2018) 53:1 (37-51).  Date of Publication: 1 Jan  2018There are marked differences in the etiology of the major histological types  of esophageal cancer (EC)—squamous cell carcinomas (ESCC) and  adenocarcinomas (EAC). This study aimed to summarize the current scientific  knowledge on modifiable risk factors for EC, by histological type, through a  systematic review of meta-analyses referenced in PubMed and ISI Web of  Knowledge. We identified 100 meta-analyses on risk factors for ESCC  (n = 54), EAC (n = 43), or EC (n = 51). ESCC risk significantly increased  with alcohol and maté drinking, smoking, red and processed meat consumption  and human papillomavirus infection, while it was negatively associated with  body mass index and consumption of fruit, vegetables, white meat, folate,  and some carotenoids. Cessation of drinking and smoking significantly  reduced ESCC risk. For EAC, an increased risk was reported for smoking, body  mass index, and red and processed meat consumption, while risk decreased  with Helicobacter pylori infection, low/moderate alcohol drinking, physical  activity, and consumption of fruit, vegetables, folate, fiber,  beta-carotene, and vitamin C. Differences in results between meta-analyses  and mechanisms underlying some of the associations found are discussed. This  work reinforces the importance of a separate assessment of EC subtypes to  allow for a proper evaluation of incidence trends and planning of  prevention/control interventions.                                                                              

 

RECORD 89

 

Environmental contributions to  gastrointestinal and liver cancer in the  Asia–Pacific regionKo K.-P. Shin A. Cho S. Park S.K. Yoo K.-Y.Journal of  Gastroenterology and Hepatology (Australia) (2018) 33:1  (111-120). Date of Publication: 1 Jan 2018In the Asia–Pacific region, gastric,  colorectal, and hepatocellular (liver)  cancer show substantial regional variation in incidence consistent with the  presence of important environmental factors. For gastric cancer, global  incidence is concentrated in Asia with substantially higher rates in East  Asia than in South-East Asia and Australia. The differences in incidence  rates for gastric cancer in the Asia–Pacific region may be due, in part, to  differences in the prevalence of Helicobacter pylori infection and the  prevalence of H. pylori virulence factors. Smoking is also correlated with  gastric cancer risk and is responsible for the highest population  attributable fraction among men in East Asia. Colorectal cancer has  increased rapidly in incidence to become the third most common digestive  cancer in Asia. According to cohort studies in Asia, smoking, alcohol use,  obesity, and physical inactivity increase the risk of colorectal cancer.  Unlike West Asia, East Asia and Australia have high incidence rates for  colorectal cancer that correlates to a high Human Development Index and a  high prevalence of alcohol consumption and obesity. Liver cancer is the  second most common digestive cancer in Asia. The high incidence of liver  cancer in East Asia and South-East Asia is concordant with the high  prevalence of hepatitis B virus and hepatitis C virus infection. Other  important risk factors include alcohol use, smoking, and diabetes. The  identification of the earlier and other environmental factors (currently  under investigation) is central to the development and implementation of  effective cancer control programs for the region.                                                                              

 

RECORD 90

 

TLR2 Arg677Trp but  not TLR2 -196 to -174 ins/del and Arg753Gln polymorphism  alter the risk of peptic ulcer in north of IranHabibzadeh M. Tourani M.  Shokri-Shirvani J. Mostafazadeh A. Khafri S. Nouri  H.R.Journal of the Chinese Medical Association (2018) 81:1 (25-30). Date of  Publication: 1 Jan 2018Background Most polymorphisms that occur in TLR-2 are  associated with  gastrointestinal disorders such as peptic ulcer disease (PUD). Hence, in  current study, association between TLR2-196 to -174 ins/del, Arg753Gln and  Arg677Trp polymorphisms and risk of PUD development in north of Iran was  evaluated. Methods This case-control study included 50 patients with PUD as  cases and 50 people without peptic ulcer as control group. Blood and  endoscopic biopsies were collected. Helicobacter pylori infection was  screened by rapid urease test, specific IgG measurement and specific PCR for  glmM gene. Then, TLR2-196 to -174 ins/del polymorphism was assessed by using  allele-specific PCR. The Arg753Gln and Arg677Trp polymorphism in TLR2 gene  were analyzed by the PCR-restriction fragment length polymorphism (RFLP).  Results There was no significant difference in the allele and genotype  frequencies of polymorphisms in the TLR2-196 to -174 ins/ins and Arg753Gln  genes between controls and patients, respectively. However, an association  with increased risk for PUD was observed for polymorphism TLR-2 Arg677Trp  (odds ratio [OR] = 7.9; 95% confidence interval [CI] = 0.94–67.5). Further  analysis showed that H. pylori infection was associated with a significant  difference in genotype and allele frequencies of TLR2-196 to -174 ins/ins  and Arg753Gln polymorphism, respectively. Furthermore, there was no  association between variant haplotypes and PUD development in H. pylori  infected subjects. However, no association was detected between gender and  genotypic frequencies of all polymorphisms in TLR2. Conclusion Our findings  showed that TLR2 Arg677Trp polymorphism and H. pylori infection may play  crucial roles in peptic ulcer development respectively in north of Iran.                                                                               

 

RECORD 91

 

Impact of gluten consumption in patients with functional dyspepsia: A  case–control studyDu L. Shen J. Kim J.J. He H. Chen B. Dai N.Journal of Gastroenterology  and Hepatology (Australia) (2018) 33:1  (128-133). Date of Publication: 1 Jan 2018Background and Aim: Dietary factors  and immune dysfunction may induce  symptoms in patients with functional dyspepsia (FD). The aim of the study  was to evaluate whether gluten consumption impacts symptom onset in patients  with FD and to evaluate for possible histologic alterations in the duodenum  of patients with FD. Methods: We prospectively enrolled 101 patients newly  diagnosed with FD and 31 asymptomatic controls. Specific FD symptoms and  gluten consumption patterns were evaluated by self-reported questionnaires.  Tight junction protein (claudin-1) expression and presence of  intraepithelial lymphocyte (IEL) infiltration in the bulb (D1) and second  portion (D2) of the duodenum were assessed by immunohistochemistry. Results:  Wheat bun consumption had higher frequency (P = 0.047) and increased average  consumption (P = 0.01) scores in patients with FD compared with the control  group. Of the 101 patients with FD, early satiety (P = 0.03) was associated  with increased wheat bun consumption frequency score. On histologic  evaluation, claudin-1 expression was decreased in D1 (0.003 ± 0.001 vs  0.012 ± 0.002, P = 0.003) and D2 (0.002 ± 0.0004 vs 0.012 ± 0.001,  P < 0.001), while duodenal IEL counts were increased in D1 (15.5 ± 7.8 vs  3.1 ± 2.5, P < 0.001) and D2 (20.6 ± 7.7 vs 5.8 ± 3.4, P < 0.001) among  patients with FD compared with the control group. Finally, Helicobacter  pylori infection was associated with increased IELs in D1 (20.6 ± 7.0 vs  14.2 ± 7.4, P = 0.001) among patients with FD. Conclusions: Among patients  with FD, gluten-rich food may lead to symptom onset, specifically early  satiety. Intestinal epithelial barrier dysfunction characterized by  decreased claudin-1 expression and mucosal immune activation demonstrated by  IEL infiltration may contribute to the pathogenesis of FD.                                                                              

 

RECORD 92

 

Familial  adenomatous polyposis with multiple Helicobacter-negative early  gastric cancers treated by endoscopic submucosal dissectionYaguchi K. Makazu M.  Hirasawa K. Sugimori M. Kobayashi R. Sato C. Ikeda R.  Fukuchi T. Ishii Y. Kaneko H. Shibata W. Yamanaka S. Inayama Y. Maeda S.Internal Medicine  (2017) 56:24 (3283-3286). Date of Publication: 2017Stomach cancer rarely develops in patients  with familial adenomatous  polyposis (FAP), and Helicobacter pylori infection may increase the risk of  FAP-related gastric cancer. We describe the case of a 64-year-old woman who  developed multiple synchronous early gastric cancers without H. pylori  infection. Nine cancer lesions were successfully treated by endoscopic  submucosal dissection. An immunohistochemical analysis revealed that the  tumors were positive for mucin (MUC)2, MUC6, and CDX2, but negative for  MUC5AC, suggesting that the tumors were gastrointestinal mixed type.  Periodical endoscopic surveillance is important for the detection of cancers  at an early stage.                                                                               

 

RECORD 93

 

Surveillance strategy according to age after endoscopic  resection of early  gastric cancerYang H.-J. Kim S.G. Lim J.H. Choi J.M. Oh S. Park J.Y. Han S.J. Kim J. Chung  H. Jung H.C.Surgical Endoscopy and Other Interventional Techniques (2018) 32:2  (846-854). Date of Publication: 1 Feb 2018Background: Whether surveillance strategy  after curative endoscopic  submucosal dissection (ESD) for early gastric cancer (EGC) differs in young  patients is unclear. This study aimed to evaluate the risk of metachronous  and extragastric recurrence in young patients with EGC after curative ESD.  Methods: We retrospectively enrolled 1237 consecutive patients who underwent  curative ESD for EGC from 2005 to 2014 at a single tertiary hospital. The  patients were divided into group 1 (<50 years of age, n = 86), group 2 (age  50–74, n = 985), or group 3 (≥75 years of age, n = 166). The clinical  characteristics and outcomes were compared among the three age groups.  Results: Group 1 had more frequent Helicobacter pylori infection  (P < 0.001), less frequent intestinal metaplasia (P = 0.021), and more  frequent undifferentiated tumors (P = 0.039). Although the 5-year risk of  developing metachronous recurrence appeared to be lower in group 1 (2.7%)  than in groups 2 (8.6%) or 3 (8.7%), the risk became quite similar at the  7-year follow-up (6.4, 12.7, and 8.7% for groups 1, 2, and 3, respectively;  P = 0.409 by log-rank test). Extragastric recurrences developed in only 2  cases in group 2 (0.2%). Conclusions: Surveillance for metachronous and  extragastric recurrence after curative ESD in patients <50 years of age  should not be different from that in patients ≥50 years of age. Endoscopic  surveillance for metachronous recurrence should be continued for longer than  5 years, even in young patients.                                                                              

 

RECORD 94

 

Diagnostic yield of esophagogastroduodenoscopy  in children with chronic  abdominal painEmeksiz H.C. Kocak F.G. Livaoglu A. Akbulut U.E.Archives of Medical Science  (2018) 14:1 (74-80). Date of Publication: 1 Jan  2018Introduction: Chronic abdominal pain (CAP) is one of the most common  indications of esophagogastroduodenoscopy (EGD) in the pediatric population.  However, there is not enough information about the diagnostic yield of EGD  in children with CAP. We aimed to evaluate the diagnostic yield of EGD in  children with CAP in the Eastern Black Sea region of Turkey. Material and  methods: The study included children (n = 372) who underwent EGD for the  primary indication of chronic abdominal pain during an 18-month period. We  collected data on demographic features (age, sex), clinical characteristics  (alarm symptoms), and EGD results for each patient. Results: Patients’ mean  age was 13 years (range: 4–17 years; mean ± SD: 12.65 ±3.39 years), and the  majority were female (n = 234, 62.9%). Endoscopy was diagnostic in 209  patients (56.2%; 95% CI: 30.35–40.05%). The most common diagnosis was  Helicobacter pylori gastritis (35.2%) followed by reflux esophagitis.  Significantly greater diagnostic yield of EGD was determined in patients  with alarm symptoms (65.1%) compared to those without (45.2%) (OR = 2.26,  95% CI: 1.49–3.44, p = 0.001). Conclusions: We determined a high diagnostic  yield of EGD in children with CAP. Although the diagnostic yield of EGD in  the assessment of CAP was found to be higher in the presence of alarm  symptoms, a significant number of children without alarm symptoms were also  found to have gastrointestinal system pathology diagnosed by EGD.                                                                               

 

RECORD 95

 

Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A  Survey of 210 SurgeonsMahawar K.K. Kular K.S. Parmar C. Van den Bossche M. Graham Y. Carr W.R.J.  Madhok B. Magee C. Purkayastha S. Small P.K.Obesity Surgery (2018) 28:1 (204-211).  Date of Publication: 1 Jan 2018Background: There is currently little evidence available on the  perioperative practices concerning one anastomosis/mini gastric bypass  (OAGB/MGB) and no published consensus amongst experts. Even the published  papers are not clear on these aspects. The purpose of this study was to  understand various perioperative practices concerning OAGB/MGB. Methods:  Bariatric surgeons from around the world were invited to participate in a  questionnaire-based survey. Only surgeons performing this procedure were  included. Results: Two hundred and ten surgeons from 39 countries with a  cumulative experience of 68,442 procedures took the survey. Surgeons  described a large number of absolute (n = 55) and relative contraindications  (n = 59) to this procedure in their practice. Approximately 71.0%  (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively,  routinely perform a preoperative endoscopy, screening for Helicobacter  pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of  the surgeons used a constant bilio-pancreatic limb (BPL) length for all the  patients with remaining preferring to tailor the limb length to the patient  and approximately half (49.0%, n = 101/206) routinely approximate  diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208)  and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron  and calcium supplementation. Conclusion: This survey is the first attempt to  understand a range of perioperative practices with OAGB/MGB. The findings  will help in identifying areas for future research and allow consensus  building amongst experts with preparation of guidelines for future practice.                                                                               

 

RECORD 96

 

May gender or ethnicity affect delta over baseline values obtained by 13-C  urea breath test?Petruzziello C. Sinatti D. Gnarra M. Migneco A. Tesori V. Graziani C.  Gasbarrini A. Franceschi F. Ojetti V.Reviews on Recent Clinical Trials (2017) 12:3 (187-192). Date of  Publication: 1 Sep 2017Introduction: 13C-urea breath test (UBT) is a non-invasive test for  detecting active H. pylori infection. Previous studies showed a correlation  of delta over baseline (DOB) values with bacterial load, mucosal  inflammation and successful eradication. Gender has been shown to affect DOB  in children. Aim of our study was to verify whether gender or ethnicity  affects DOB in adults. Patients and Methods: We retrospectively analyzed  data of 2922 patients (1024M/1898F mean age 47±15 years) that underwent UBT  in our outpatient unit, from October 2015 to October 2016. Patients were  divided based on gender and ethnicity; mean DOB values were then compared.  Results: 686 pts (23.4%, 258M/428F, mean age 45±17 years) of 2922 pts showed  a positive UBT. Prevalence of H. pylori infection was significantly higher  in males compared to females (29% vs 22%; p=0,03). Females showed a  significant higher mean DOB (34±25 vs 27,6±22; p=0,008). A total of 2922 UBT  were performed during the study period (F:1898, 65%; M: 1024 35%). The  prevalence of H. pylori infection is 32% in those from Eastern Countries,  28% in those from South America and 40% in both those coming from Africa and  Asia. We found significantly lower DOB values in Italians compared to  non-Italian (mean DOB 36±27 vs 69±32; p<0.0001). Conclusion: Our study  showed that in our geographic area, prevalence H. pylori infection is higher  in males. Moreover, it demonstrates for the first time in our geographic  area that adult females show a significantly higher DOB compared to males  (p=0,008). Whether this effect may be due to hormonal differences, able to  influence gastric emptying, bacterial load, or even the production of urease  by H. pylori, merits further investigation. 

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