Helicobacter Infection Research Articles

Is the human race winning the war against Helicobacter Infections?

The incidence of helicobacter infections in human population appears not to have significantly wane over the years. Even though there are reports indicating that the prevalence rate is reducing in the developed world, constant migration, general globalization and other environmental factors has kept every population a risk. Moreover, the rising incidence of infection with non-pylori helicobacter species, which were considered hitherto non-virulent, puts a question in the seemingly progress made so far in the treatment and eradication of these bacteria and their infections. The purpose of this mini review is to access the clinical and epidemiological gains and the challenges so far in the treatment and eradication of helicobacter spp. infections.

INFLUENCE OF PECULARITIES OF ANATOMICAL STRUCTURE (SHAPE) OF DUODENAL BULB ON THE MECHANISM OF FORMATION OF “KISSING” ULCERS OF PATIENTS WITH CHRONIC NON-ATROPHIC GASTRITIS

The aim: To determine of the factors influencing the formation of "kissing" duodenal bulb ulcer in patients with chronic non-atrophic gastritis. Materials and methods: The data of a comprehensive examination of 34 patients with chronic non-atrophic gastritis were analyzed, in which the examination revealed "kissing" ulcers of the duodenal bulb (primary group), and 37 patients with chronic non-atrophic gastritis, in which single ulcers were detected in the bulb (control group). Comprehensive examination included: step-by-step intragastric pH-metry, esophagogastroduodenoscopy, helicobacter infection test (НР) (helicobacter urease test and microscopic examination of stained smears), histological investigations of the gastric stump mucous, material for which was taken during endoscopy from 4 topographical zones: from the middle third of the gastric antrum and body of stomach on the big and small curvature. Results: In the course of the examination, the presence of chronic non-atrophic gastritis in 100% of cases was confirmed with a different degree of activity of the inflammatory process on the gastric mucosa, as well as the presence of Helicobacter pylori infection with a high degree of colonization of the gastric mucosa in the absence of a significant difference (p> 0.05) in the stomach zones. It was found that the main difference that can be traced in 100% of cases is the difference in the anatomical structure of the bulb of the duodenum, namely, the shape: in the control group, the shape and lumen of the duodenal bulb are round, while in the patients of the main group the bulb the duodenum, starting from the pylorus, is stretched toward the large and small curvature, which gives the lumen bulb its oval shape. Conclusions: "Kissing" ulcers of the duodenal bulb are formed in patients with chronic non-atrophic gastritis only if the patients have a peculiar anatomical structure of the bulb, in which the lumen has an oval shape.

Iron Deficiency Anemia Caused By Malabsorption from Proton Pump Inhibition

Introduction: Iron deficiency anemia (IDA) not responding to oral iron replacement usually requires a hematologic evaluation. 48 patients taking a proton pump inhibitor (PPI) and not responding to oral iron replacement were found to have an elevated serum gastrin (SG). No patient had gastrointestinal bleeding, gastric resection, bariatric surgery, or menorrhagia. Other causes for iron malabsorption such as celiac disease or helicobacter infection were not present. 94 percent responded to intravenous iron (IV iron). Methods: All patients previously had undergone diagnostic gastrointestinal evaluations. Testing for celiac disease and helicobacter infection was negative. Gastric biopsies did not demonstrate atrophy. Most referrals were from gastroenterologists. Results: 94% responded to IV iron with a rise in their hemoglobin of >/= 2 grams per cent. 83 percent (40/48) were women. Iron dextran (ID) at a fixed dose of 825 mgm was given to 85% of the patients. Twelve of these 41 patients were given a second infusion of ID as the first dose did not produce a satisfactory response. Ferric carboxymaltose and ferumoxytol were each given once at the fixed recommended dose, and second infusions was not necessary. Four patients received iron sucrose at a weight based dose, and a second series of infusions were not necessary. One patient responded to ferumoxytol after a suboptimal response to iron dextran. An elevated SG was defined as >100 pg/mL. The average SG was 370.25 pg/mL (114 to 2101 pg/mL). Hemoglobin rose an average of 3.35 gram% (9.56 to 12.91 gm%). The change in hemoglobin was minus 0.4 to plus 7.0 gm% with a baseline hemoglobin ranging between 6.6 to 14.3 gm% and rising between 9.3 to 16.2 gram%. Ferritin rose an average of 14.8 to 158 ng/mL with baseline ferritin ranging between 3 to 73 ng/mL and rising between 22 to 659 ng/mL The average MCV rose from 75.89 to 84.93 fL with baseline MCV ranging between 61 to 93 fL rising between 69 to 96 fL The average iron saturation rose from 7.49 to 22.89% with baseline saturation ranging between 2 to 34% and rising between 10 to 39%. Discussion: Dietary iron consists of both heme and non heme iron. Heme iron is derived from the hemoglobin and myoglobin in animal food sources such as meat, seafood, and poultry. Heme iron is in the ferrous (II) oxidation state, is easily absorbable, and contributes 10% or somewhat more of total absorbed iron. Non heme iron is in the ferric (III) form and is derived from plants and iron fortified food. Normally 1-2 mgm of iron is absorbed daily. Heme iron is well absorbed after its release by pancreatic enzymes. Non heme iron is less well absorbed and requires acid secretion from gastric parietal cells for the denaturing of ingested proteins and subsequent proteolysis. PPI causes decreased hydrogen ion (H+) production by inhibiting the hydrogen/potassium pump within gastric parietal cells. The elevated SG derives from G cell hyperplasia as a response to the lowered H+ activity caused by PPI. The decreased H+ activity inhibits the release of ferric iron from non animal sources. Iron absorption occurs in the proximal duodenum through the action of a brush border ferrireductase such as duodenal cytochrome B which reduces ferric iron to ferrous iron. With less ferric iron available for reduction less ferrous iron is absorbed, and iron deficiency results. Intravenous iron fully corrected the IDA in 94% of treated patients. Two of the 3 non responders were obese and only received one infusion of ID. Perhaps a second infusion might have been beneficial. However no relation between weight, response, and ID dosing could be detected. Both patients had normal hemoglobins before the iron infusion but were very symptomatic from their iron deficiency. Both patients experienced a rise in their hemoglobin (1.9 gram% and 1.4 gm%). The third non responder actually had a fall in the hemoglobin from 10.5 to 10.1 gm%. No clear explanation was apparent. No clear explanation for the female predominance was apparent. Conclusion: In 2009 119 million prescriptions for PPI were written in the USA. The gastrointestinal literature suggests that anemia from PPI is uncommon. Very likely IDA due to IM from PPI is much more common than recognized and should be considered for any iron deficient patients without evidence for other causes for IDA. Intravenous iron is highly effective. Disclosures No relevant conflicts of interest to declare.

Diagnosis of Helicobacter pylori in cholelithiasis and cholecystitis: by histology and serological association

Background: Biliary calculus disease is one of the most common disorders affecting the gastrointestinal tract. It is an important cause of morbidity. There has been marked rise in the incidence of gall stone disease in the west. In India, it is more common in northern states than in South India. Incidence of gallstones increases with age with a male to female ratio of 1:4. About 50% of these patients are asymptomatic.Methods: An analytical prospective study on patients diagnosed with cholecystitis and/or cholelithiasis was conducted in R. L. Jalappa Hospital Tamaka, Kolar. 58 patients were included in the study between June 2018 and May 2019. Data was collected and analysed using SPSS 22 version software. Categorical data was represented in the form of frequencies and proportions.Results: The age incidence was found to be highest between 31 to 40 years. The incidence of cholelithiasis was more in females. All patients presented with pain abdomen. Calculous cholecystitis was the most common mode of presentation. Open cholecystectomy was commonly done for cholelithiasis in our set up. Chronic calculous cholecystitis is the commonest histopathology.Conclusions: According to our findings evidence of recent and chronic infection Helicobacter pylori as shown by demonstration of IgM and IgG class of antibodies respectively to the organism was found in most of patients and histological evidence of the patients with cholecystitis and cholelithiasis. Thus, the frequency of helicobacter infection seems to be low in the patient population studied.

Atypical Lymphoid Proliferations and Clonality in Helicobacter-associated Inflammatory Infiltrates in Children.

Helicobacter infection is considered the major predisposing factor for gastric mucosa-associated lymphoid tissue (MALT) lymphoma with initial infection likely occurring in childhood. Primary gastric MALT lymphoma most commonly occurs in patients older than 50 years which is attributed to the lengthy chronic infection time required before the development of MALT lymphoma. Our study analyzes the histologic features and presence of immunoglobulin heavy chain (IGH) clonality in Helicobacter-associated chronic gastritis (62 cases) and Helicobacter-negative chronic gastritis (17 cases) biopsies within the pediatric population, diagnosed between 1996 and 2018. Helicobacter-associated gastritis was more likely to show active inflammation (P=0.01), with no significant difference in number of germinal centers or the strength, linear property, or depth of the inflammatory infiltrate. In total, 47% (29/62) of the Helicobacter-associated cases had at least 1 lymphoepithelial lesion, equivocal or definitive (a modified Wotherspoon score of 3 to 5), compared with 24% (4/17) of the Helicobacter-negative cases (P=0.5). All cases with lymphoepithelial lesions were assessed for IGH clonality, showing the presence of monoclonality in 27% (8/30) of evaluable cases. None of our patients were diagnosed with gastric lymphoma within available follow-up data. Although 4% of our cases could be considered MALT lymphoma in an adult patient based on prominent lymphoepithelial lesions and IGH monoclonality, caution is advised when diagnosing lymphoma in the pediatric population given the good prognosis of Helicobacter-associated gastritis in this age group. It is unclear if these monoclonal lymphoid proliferations require close follow-up.

Helicobacter heilmannii Colonization Is Associated with High Risk for Gastritis

We aimed to study potential associations between colonization by four common non-pylori Helicobacter species and gastroduodenal diseases by comparing samples from patients infected with H. pylori with samples from non-infected subjects. Patients (n=190) who were subjected to upper gastrointestinal endoscopy because of gastroduodenal conditions were enrolled in this cross-sectional study. Antral biopsy samples were taken from patients in two major hospitals (Mehrad and Imam-Hossein) in Tehran, Iran, during 2017-2018. DNA was isolated from the biopsy specimens, and PCR amplification was used to identify the Helicobacter species by using their corresponding specific primer sets. Out of 120 cases positive for H. pylori, 46 (38%) were patients with gastritis, 23 (19%) with duodenal ulcer, 11 (9%) with gastric cancer, and 40 (33.3%) with gastric ulcer. Overall, 70 (36%) patients were negative for H. pylori. H. pylori cases were uninfected by any of the other tested Helicobacter species. Among the 70 patients without H. pylori, 34 had gastritis-31 (94%) of these were positive also for H. heilmannii (p=0.001, Odds Ratio: 51.6; 95% Confidence Intervals: 11.8-225.6). We did not find any patient carrying mixed Helicobacter infections with any non-pylori Helicobacter species in this cohort. Given our evidence about the possibility of involvement of H. heilmannii in patients suffering from gastritis and nonexistence of mixed non-pylori Helicobacter infections, bacteriological testing of subjects negative for H. pylori becomes clinically relevant and important.

THE EFFECT OF INTRACELLULAR “DEPOT” HELICOBACTER PYLORI INFECTION ON THE QUALITY OF ERADICATION WITH MONOTHERAPHY OF PATIENTS WITH CHRONIC NON-ATROPHIC GASTRITIS BY THE BISMUTH COLLOIDAL SUBCITRATE

Noted that monotherapy by the bismuth colloidal subcitrate in the treatment of chronic HP- infection is effective only in 14-40% of cases, but all the reasons that reduce its effectiveness, are not fully explored. The aim: To determine the effectiveness of monotherapy by the bismuth colloidal subcitrate among patients with chronic non-atrophic gastritis with or without intracellular “Depot” of HP- infection. The 36 patients took comprehensive examination: step-by-step рН-metry, esophagogastroduodenoscopy, helicobacter infection test (НР) (helicobacter urease test and microscopic examination of stained smears), histological investigations of the gastric stump mucous, stool test, HELIC – test, the level of natural killers (CD-16). Control studies were performed 1 months after 1-month monotherapy by the bismuth colloidal subcitrate and included a stool test and HELIK- test. Helicobacter infection was detected in 100% of cases. When using two methods: comparing the results of urease test and smears, prints, and the level of natural killerCD-16 intracellular “depot” HP was detected in 29 (80.6%) patients. While control research in 1 month it was found that monotherapy was effective only among 7 (19.4%) patients whose primary integrated survey did not reveal intracellular “Depot” HP- infection. The bismuth colloidal subcitrate is not effective in the presence of intracellular “depot” HP. The definition of “depot” should be carried out by two methods: comparing the results of urease test and smears- prints, and the level of natural killers (CD-16).

Osseous Metaplasia: An Unusual and Poorly Understood Finding in Gastric Polyps

Abstract Osseous metaplasia (OM) is an uncommon finding in gastrointestinal tract biopsies. Metaplastic bone formation has been predominantly reported in the lower GI tract in a background of benign and malignant neoplasms, as well as nonneoplastic inflammatory conditions. OM in the stomach is extremely rare, with less than 10 cases reported in the English literature to date. We present two cases of gastric OM encountered at one institution among more than 10,000 stomach polyps examined since 1994. The first is a 46-year-old female with spastic quadriplegia, peptic ulcer disease, and a jejunal feeding tube who had multiple gastric hyperplastic polyps removed over a 13-year period. The most recent polypectomy revealed a 3-cm gastric adenoma with benign bone formation in the stroma. The second case is of a 67-year-old asymptomatic male with a remote history of intestinal metaplasia and atrophy of the stomach who underwent upper endoscopy and removal of a 1-cm polyp. Sections consisted of hyperplastic foveolar epithelium with focal ossification. Both polyps showed acute and chronic inflammation and stromal fibrosis, and they lacked Helicobacter infection. Mechanisms driving gastrointestinal OM have been proposed since the first reported cases in the early 1900s. The most widely accepted theory is that osteogenic factors released by the neoplastic or inflammatory tissue induce undifferentiated stromal mesenchymal cells or fibroblasts to undergo transformation to osteoblasts. However, with gastrointestinal biopsies being one of the most common specimens, the picture remains incomplete as only very rare cases show bone formation, warranting further research. Although gastrointestinal OM appears to be clinically insignificant, long-term studies have yet to be performed. Nevertheless, it is crucial for pathologists to be aware of this phenomenon in order to avoid misdiagnosing OM as a primary mesenchymal neoplasm or bone invasion in cases of OM arising in the background of malignancy.

Human medicines European public assessment report (EPAR): Helicobacter Test INFAI, 13C-urea, Breath Tests,Helicobacter Infections, Date of authorisation: 14/08/1997, Revision: 16, Status: Authorised

Human medicines European public assessment report (EPAR): Helicobacter Test INFAI, 13C-urea, Breath Tests,Helicobacter Infections, Date of authorisation: 14/08/1997, Revision: 16, Status: Authorised

IS THERE A CONNECTION BETWEEN PYLORIC HELICOBACTER INFECTION AND METABOLIC DISORDERS?

Relevance. There are numerous publications of foreign authors about relationship between Pyloric Helicobacter (H. p.) infection with several gastroduodenal diseases, including metabolic disorders. Russia is one of the countries with high prevalence of H. p. infection and metabolic disorders. Determining their relationship is important for both prevention and treatment of metabolic disorders. Purpose - study the possibility of relationship between H. p. infection and type 2 diabetes, dyslipidemia, overweight and obesity. Methods and materials. The study included 1487 working residents of Moscow and the Moscow region, 931 men and 556 women, aged 21 to 77 years (median - 46). H. p. infection was diagnosed by detecting antibodies to IgG bacteria in the blood serum. In 698 infected individuals, the presence of a CagA strain, a marker of virulence of the bacterium, was studied using ELISA. Serum levels of basal glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides were studied, and the body mass index was determined. Results. Infection was discovered in 1348 people (90.6%), CagA positive - 392 (56.2%). Type 2 diabetes was diagnosed in 77 people, 74 - H. p. positive (5.5% ), and 3 - H. p. negative (2.1%). CagA was studied for 31 persons with diabetes. CagA-positive bacterial strain was determined in 22 cases out of 31 (70.1%, p 0,05, by criterion χ²). Among H. p. positive, overweight was registered in 884 cases (65.6%), in H. p. negative - in 74 cases (53.2%) (p

Comparison of media and growth conditions for culturing enterohepatic Helicobacter species.

This research aims to compare the culturing conditions for enterohepatic Helicobacter, evaluating culture media, incubation atmosphere and susceptibility to antimicrobials used to generate selective conditions. Four common media for the closely related genus Campylobacter (Columbia, Bolton, Brucella and CCDA agar), as well as the need for hydrogen in the microaerobic incubation atmosphere, were evaluated. Serial dilutions of 13 strains belonging to six species (H. apodemus, H. bilis, H. canicola, H. canis, H. equorum and Helicobacter sp.) were inoculated in each media and incubated at 37°C for 48 to 96h using CampyGen (OXOID) and gaseous exchange (including hydrogen) in parallel. Columbia or Brucella agars were the most appropriate for culturing EHH (P<0·05). However, there was no significant difference between the atmospheres evaluated (P=0·13). In addition, minimal inhibitory concentration for six antibiotics showed that all isolates were resistant to trimethoprim, whereas for the rest of the antibiotics (cephalothin, cefoperazone, cefsulodin, teicoplanin and vancomycin) the inhibition range was between 8 and 64μgml- 1 . Our findings suggest that Columbia or Brucella media, regardless of the use of hydrogen, can be used for the EHH isolation. In addition, the concentration of antibiotics included in commercial campylobacteria supplements is suitable for EHH species recovery. SIGNIFICANCE AND IMPACT OF THE STUDY: Enterohepatic Helicobacter (EHH) infections have been associated with several diseases in humans such as acute gastroenteritis, inflammatory bowel disease and hepatobiliary diseases. Although they are frequently detected in clinical samples by molecular methods, only occasionally they are isolated using culture conditions described for the taxonomic related pathogen Campylobacter sp. This is because the optimal conditions for the isolation of EHH have not yet been described, which results in an underestimation of the prevalence and clinical importance of these emerging pathogens. Therefore, this study provides insight for culturing EHH species.

Gastric Subserous Vaccination With Helicobacter pylori Vaccine: An Attempt to Establish Tissue-Resident CD4+ Memory T Cells and Induce Prolonged Protection.

Tissue-resident memory T (Trm) cells are enriched at the sites of previous infection and required for enhanced protective immunity. However, the emergence of Trm cells and their roles in providing protection are unclear in the field of Helicobacter pylori (H. pylori) vaccinology. Here, our results suggest that conventional vaccine strategies are unable to establish a measurable antigen (Ag)-specific memory cell pool in stomach; in comparison, gastric subserous injection of mice with micro-dose of Alum-based H. pylori vaccine can induce a pool of local CD4+ Trm cells. Regional recruitment of Ag-specific CD4+ T cells depends on the engagement of Ag and adjuvant-induced inflammation. Prior subcutaneous vaccination enhanced this recruitment. A stable pool of Ag-specific CD4+ T cells can be detected for 240 days. Two weeks of FTY720 administration in immune mice suggests that these cells do not experience the recirculation. Immunohistochemistry results show that close to the vaccination site, abundant CD4+T cells locate on epithelial niches, independent of lymphocyte cluster. Paradigmatically, Ag-specific CD4+ T cells with a phenotype of CD69+CD103- are preferential on lymphocytes isolated from epithelium. Upon Helicobacter infection, CD4+ Trm cells orchestrate a swift recall response with the recruitment of circulating antigen-specific Th1/Th17 cells to trigger a tissue-wide pathogen clearance. This study investigates the vaccine-induced gastric CD4+ Trm cells in a mice model, and highlights the need for designing a vaccine strategy against H. pylori by establishing the protective CD4+ Trm cells.

Mo1269 – Development of Neoplasia in the Absence of Myd88 During Helicobacter Infection is Associated with Activation of Trif and Related Type I Interferon Pathway

Mo1269 – Development of Neoplasia in the Absence of Myd88 During Helicobacter Infection is Associated with Activation of Trif and Related Type I Interferon Pathway

Частота выявления активной формы хеликобактерной инфекции у больных хроническим неатрофическим гастритом с различными формами дискинезии желчевыводящих путей

Частота выявления активной формы хеликобактерной инфекции у больных хроническим неатрофическим гастритом с различными формами дискинезии желчевыводящих путей

Дискуссионные вопросы гастроэзофагеальной рефлюксной болезни на основе клинико-эндоскопических исследований

Objective: to improve the diagnosis of gastroesophageal reflux disease and its complications. Materials and methods: clinical and endoscopic studies were performed on 1052 patients, 110 of them healthy, 722 - with gastric ulcer and duodenal ulcer, after Billroth II stomach resection, with a hiatus hernia, gallstone disease, etc., 210 children. Studied 100 macropreparations of the esophageal-gastric junction and 70 longitudinal histotopograms from patients who died from diseases not related to diseases of the gastrointestinal tract, histotopograms of 10 cases with esophageal adenocarcinoma and esophageal-gastric junction. Results: The location of the Z-line is individually variable, the range is limited to two levels: up to 40 mm above and 18 mm below the outlet of the cardia. The presence of a mucous membrane with a cylindrical epithelium in the distal esophagus is a variant of the norm. In the area of the Z-line in 70% of cases there is a duplication at a distance of 10 mm, consisting of a mucous membrane with a stratified squamous epithelium, covering the mucous membrane with the gastric epithelium. High Helicobacter infection of the mucous membrane with gastric epithelium was detected, its pre-neoplastic changes in adults (17.2%), in children (10.9%) and Barrett’s esophagus are often found in mild degrees of esophagitis, and there are also indirect signs of HP in the esophagus. Conclusions: The presence of a mucous membrane with a cylindrical epithelium in the esophagus up to 40 mm above the outlet of the cardia is a variant of the norm. In the area of the Z - line there is in 70% of cases duplication at a distance of 10 cm, consisting of a mucous membrane with a stratified squamous epithelium, under which there is a mucous membrane with a gastric epithelium, and a step biopsy is required to diagnose changes in it. The presence of HP in the mucous membrane of gastro-esophageal junction has indirect endoscopic signs, contributes to the development of pre-neoplastic changes of the mucous membrane, which in most cases are found in mild degrees of esophagitis, which requires antihelicobacter therapy.

Peptic Ulcer-related Stenosis

Peptic ulcer disease involves breakdown of the epithelial lining of the stomach or duodenum. Stenosis and associated gastric outlet obstruction is the least frequent complication of peptic ulcer disease. Most cases of stenosis occur because of duodenal or pyloric cannel ulceration. Although etiologies of peptic ulcer disease and the affected patient populations have changed, the most common etiologic factors remain Helicobacter pylori infection and use of non-steroidal anti-inflammatory drugs. In recent years, eradication of H. pylori and the use of proton pump inhibitors have reduced the incidence of complications. Because the predominant cause of gastric outlet obstruction has increasingly been attributed to malignant cancer in recent years, endoscopic examination is important to differentiate benign peptic stenosis from malignant stenosis. Medical treatment such as acid-reducing drugs or H. pylori eradication is the mainstay of treatment. Endoscopic dilation or surgical management may be considered in cases of refractory or recurrent stenosis despite medical treatment. Among the major complications of peptic ulcer disease, this report will provide an overview of peptic ulcer-related stenosis. Key words: Dilatation; Endoscopy; Helicobacter pylori; Peptic ulcer; Stenosis

Incidence and prognosis of multiple organ involvement at gastric MALT lymphoma.

18 Background: MALT (mucosa-associated lymphoid tissue) lymphoma usually occurs in stomach but various MALT organs can be afflicted including salivary glands, ocular adnexa, lung, intestine and thyroid. In this study, we aimed to evaluate the prevalence and characteristics of gastric MALT lymphoma with multi-organ involvement. Methods: We retrospectively analyzed a total of 174 consecutive patients who had been diagnosed with gastric MALT lymphoma at Seoul St. Mary’s Hospital from January 2009 to May 2018. Clinical data were obtained from the medical records. At the time of diagnosis, neck, chest, abdominal CT, PET-CT and bone marrow biopsy were performed for the purpose of staging work-up. Organ involvement was identified by biopsy. Results: Nine out of 174 (5.2%) gastric MALT lymphoma patients were found to have multi-organ involvement. Three patients had biopsy proven lymphoma at lung, two patients had colon involvement, and two patients had ocular involvement. A patient with involvement at small bowel and duodenum were found, respectively. Seven patients were examined for Helicobacter infection. Two of them were positive for H. pylori infection and received eradication treatment. Except one patient treated with palliative care, eight patients underwent chemotherapy, in which two of them received additional radiation therapy and other two patients underwent bone marrow transplantation. Except one patient died of pneumonia during chemotherapy and one patient underwent palliative treatment, 7 patients had maintained complete remission. Conclusions: The overall prevalence of gastric MALT lymphoma with multi-organ involvement was 5.2%. The result suggests that the gastric MALT lymphoma patients require a careful investigation of other MALT organs. [Table: see text]

No association between Helicobacter pylori infection and gastrointestinal complaints in a large cohort of symptomatic children.

This Polish study estimated the prevalence of the Helicobacter pylori infection in symptomatic children aged 3-18 and investigated its association with gastrointestinal complaints. We prospectively enrolled 1984 children (54% female) with a mean age of 9.5±4.1years, from Silesia, Poland, for the Good Diagnosis Treatment Life screening programme from 2009 to 2016. They underwent a 13 C-isotope-labelled urea breath test (UBT) to assess their Helicobacter pylori status, making this the biggest Polish study to use this approach. Further analysis included parental-reported gastrointestinal symptoms and standard deviation scores (SDS) of anthropometric measurements. The Helicobacter pylori infection was identified in 220 (11%) children (48% female) and was independent of age and sex. The frequency of symptoms did not differ between Helicobacter positive and negative children (all p>0.05). Children with a positive UBT result had a lower body mass SDS (-0.41±0.98 versus -0.26±1.01, p=0.04) and height SDS (-0.45±1.34 versus -0.23±1.27, p=0.02), but similar body mass index SDS. We found a low prevalence of Helicobacter pylori in symptomatic children, and positive UBT results were not associated with symptoms that suggested Helicobacter pylori infections. Our findings support the 2017 European and North American guidelines for Helicobacter infections in children.

Prevalence of Helicobacter pylori infection in Sari Northern Iran; a population based study.

In this study prevalence rate of Helicobacter pylori and its associated factors have been investigated in urban and rural areas of Sari. Helicobacter pylori has an important role in gastrointestinal diseases including peptic ulcer and gastric cancer. It is the most common infection in human population worldwide. Hence, the epidemiology of this infection in all parts of the world is of utmost importance. We conducted a cross-sectional study on 497 individuals ranging 15-65 years of age in Sari city and its surrounding rural residents. The sampling method was a cluster random sampling multi staged in stratified population by urban and rural areas. Questionnaires for personal and socio-economic data were filled. Blood samples were drawn and kept for analysis (IgG antibody ELISA for Helicobacter pylori). The data was analyzed by SPSS statistical software and Chi-square test and logistic regression were used. The prevalence of helicobacter infection was 44.5% in the studied population. This prevalence was 41.3% and 47.8% in urban and rural areas, respectively. Just a significant association between the infection and the age of subjects was observed in multiple regression analysis (p=0.001). However, in univariate analysis the level of education was also significantly associated with Helicobacter pylori infection (p=0.015). No other variable was associated with the infection. The prevalence of helicobacter infection has dropped significantly in the region in comparison with the previous studies during the last 15 years.

Prevalence of &amp;lt;i&amp;gt;Helicobacter pylori&amp;lt;/i&amp;gt; Infection among Internally Displaced Persons from Bakassi Peninsular and Etim Ekpo in South Southern, Nigeria

Helicobacter pylori (H. pylori), is an important global infection with a worldwide prevalence of about 40 percent. This infection is contagious and mostly acquired during childhood through the fecal-oral and oral-oral route. A total of 1560 blood specimens were aseptically collected from Internally Displaced Persons comprising female and male from the warring communities of Bakassi Peninsular and Etim Ekpo Local Government Area in South Southern, Nigeria. The specimens were screened for H. pylori using Elisa kits following standard serological techniques. The overall prevalence rate was 464 (29.7%). There was significant difference (p H. pylori infection; its distribution varied between age group, educational status, habits or behaviors of the subjects with children within 5 to 14 years having the highest rate of 274 (17.6%), followed by 78 (4.99%) from adults (51 years and above) and 17 (1.08%) from active age range of 36 - 45 years old. Subjects with primary and quranic level of education showed a total of 274 (17.56%) positive cases to H. pylori. Analysis of sex-specific distribution revealed that females had the highest prevalence of 312 (20%). The helicobacter infection shows a significant difference at (p H. pylori infection. Crowding in camps and increasing household contact have been considered as risk factors of H. pylori infection. Adequate infrastructural provision and availability of portable water with good hygienic environment will drastically reduce the high rate spread of H. pylori bacterium in the IDPs communities in Nigeria.