Helicobacter Pylori Infection In Patients Research Articles

Immunoglobulin G-mediated food intolerance and metabolic syndrome influence the occurrence of reflux esophagitis in Helicobacter pylori-infected patients.

Reflux esophagitis has an increasing prevalence and complex and diverse symptoms. Identifying its risk factors is crucial to understanding the etiology, prevention, and management of the disease. The occurrence of reflux esophagitis may be associated with food reactions, Helicobacter pylori (H. pylori) infection, and metabolic syndromes. To investigate the risk factors for reflux esophagitis and analyze the effects of immunoglobulin (Ig) G-mediated food intolerance, H. pylori infection, and metabolic syndrome on reflux esophagitis. Outpatients attending the Second Medical Center of the PLA General Hospital between 2017 and 2021 were retrospectively enrolled. The patients' basic information, test results, gastroscopy results, H. pylori test results, and IgG-mediated food intolerance results were collected. Multivariate logistic regression analysis was used to analyze risk factors for reflux esophagitis. Statistical mediation analysis was used to evaluate the effects of IgG-mediated food intolerance and metabolic syndrome on H. pylori infection affecting reflux esophagitis. A total of 7954 outpatients were included; the prevalence of reflux esophagitis, IgG-mediated food intolerance, H. pylori infection, and metabolic syndrome were 20.84%, 61.77%, 35.91%, and 60.15%, respectively. Multivariate analysis showed that the independent risk factors for reflux esophagitis included IgG-mediated food intolerance (OR = 1.688, 95%CI: 1.497-1.903, P < 0.00001) and metabolic syndrome (OR = 1.165, 95%CI: 1.030-1.317, P = 0.01484), and the independent protective factor for reflux esophagitis was H. pylori infection (OR = 0.400, 95%CI: 0.351-0.456, P < 0.00001). IgG-mediated food intolerance had a partially positive mediating effect on H. pylori infection as it was associated with reduced occurrence of reflux esophagitis (P = 0.0200). Metabolic syndrome had a partially negative mediating effect on H. pylori infection and reduced the occurrence of reflux esophagitis (P = 0.0220). Patients with IgG-mediated food intolerance and metabolic syndrome were at higher risk of developing reflux esophagitis, while patients with H. pylori infection were at lower risk. IgG-mediated food intolerance reduced the risk of reflux esophagitis pathogenesis in patients with H. pylori infection; however, metabolic syndrome increased the risk of patients with H. pylori infection developing reflux esophagitis.

Study of Helicobacter pylori infection in patients with chronic atrophic gastritis and its relationship with lifestyle habits and dietary nutrient intake: A retrospective analysis.

To explore Helicobacter pylori (Hp) infection status and its relationship with lifestyle habits and dietary factors in patients with chronic atrophic gastritis. Six hundred thirty-eight patients with chronic atrophic gastritis, who were admitted to our hospital from March 2021 to April 2023, were selected for the study. All patients underwent the 13C urea breath test. The relationship between the detection rate of Hp infection and the clinical characteristics, lifestyle habits, and dietary factors of the patients was analyzed. Among the 638 patients with chronic atrophic gastritis, 531 patients were tested positive for Hp infection, the positive rate for Hp infection was approximately 83.23%. Analyzing the clinical characteristics of the patients, it was found that age, family history of gastric cancer, degree of chronic inflammation, degree of glandular atrophy, presence of low-grade dysplasia, and intestinal metaplasia all have an impact on the positive detection rate of patients (P < .05). Analyzing the patients' lifestyle habits, it was found that BMI, smoking history, alcohol consumption, preference for spicy food, dining location, consumption of pickled foods, frequent consumption of grilled/barbecued foods, preference for strong tea, consumption of sweets, and work-related stress had an impact on the positive rate of Hp infection in patients (P < .05). The discovery showed that the levels of total protein, albumin, hemoglobin, cholesterol, and the intake of livestock and poultry meat, seafood, dairy products, vegetables, fruits, and fats have an impact on the positivity rate of Hp infection in patients (P < .05). A multiple logistic regression analysis was performed, and it was found that patients' age, family history of gastric cancer, degree of chronic inflammation, degree of glandular atrophy, presence of low-grade dysplasia, presence of wasting or obesity, history of alcohol consumption, preference for spicy food, dining location, frequent consumption of strong tea, high work pressure, high intake of fish and seafood, low intake of dairy products, low intake of vegetables, low intake of fruits, and low intake of fats all had an impact on the occurrence of Hp infection in patients (P < .05). There is a certain correlation between patients' lifestyle habits, dietary factors, and clinical characteristics with the occurrence of Hp infection. These factors can assist in the prevention of Hp infection.

Endoscopic and morphological features of chronic gastritis in patients with lumbar spine osteochondrosis.

Aim: of the study is to determine the endoscopic and morphological features of chronic gastritis (CG) in patients with lumbar spinal OC. Materials and Methods: 102 patients with lumbar spine OC and CG were examined. The patients were diagnosed with Helicobacter pylori (HP) infection, according to which the patients were divided into two groups: the first group included 92 HP-positive patients, the second group consisted of 10 HP-negative patients. Results: Among HP infected patients with lumbar spine OC, erosive gastropathy was most often diagnosed (in 40 (43.5%) of the examined), as well as erosive-papular and erosive-hemorrhagic gastropathy (in 14 (15.2%) and in 16 (17, 4 %) of patients, respectively), while erythematous gastropathy was more often diagnosed among HP-negative patients (in 7 (70.0 %) cases, respectively). Conclusions: 1. 90.2% of patients with lumbar spine OC and CG have been diagnosed with HP infection. 2. Endoscopically, the lesion of the stomach MM in patients with lumbar spine OC corresponds mainly to erosive and erosive-hemorrhagic forms of gastropathy. 3. During histological examination of stomach MM, mainly 2nd and 3rd degrees of inflammation were established, especially in patients with erosive, erosive-papular and erosive-hemorrhagic forms of gastropathy.

Metaproteomic assessment of gut microbial and host functional perturbations in Helicobacter pylori-infected patients subjected to an antimicrobial protocol

ABSTRACT The impact of therapeutic interventions on the human gut microbiota (GM) is a clinical issue of paramount interest given the strong interconnection between microbial dynamics and human health. Orally administered antibiotics are known to reduce GM biomass and modify GM taxonomic profile. However, the impact of antimicrobial therapies on GM functions and biochemical pathways has scarcely been studied. Here, we characterized the fecal metaproteome of 10 Helicobacter pylori-infected patients before (T0) and after 10 days (T1) of a successful quadruple therapy (bismuth, tetracycline, metronidazole, and rabeprazole) and 30 days after therapy cessation (T2), to investigate how GM and host functions change during the eradication and healing processes. At T1, the abundance ratio between microbial and host proteins was reversed compared with that at T0 and T2. Several pathobionts (including Klebsiella, Proteus, Enterococcus, Muribaculum, and Enterocloster) were increased at T1. Therapy reshaped the relative contributions of the functions required to produce acetate, propionate, and butyrate. Proteins related to the uptake and processing of complex glycans were increased. Microbial cross-feeding with sialic acid, fucose, and rhamnose was enhanced, whereas hydrogen sulfide production was reduced. Finally, microbial proteins involved in antibiotic resistance and inflammation were more abundant after therapy. Moreover, a reduction in host proteins with known roles in inflammation and H. pylori-mediated carcinogenesis was observed. In conclusion, our results support the use of metaproteomics to monitor drug-induced remodeling of GM and host functions, opening the way for investigating new antimicrobial therapies aimed at preserving gut environmental homeostasis.

Transcriptional alteration of NF-κB-associated long noncoding RNAs in the stomach of Helicobacter pylori-infected and non-infected patients.

Helicobacter pylori could colonize the gastric mucosa and cause gastritis, ulcers and cancer. Numerous virulence factors have been identified in this bacterium that play important roles in promoting gastric disorders. Although the interaction of long noncoding RNAs (lncRNAs) with transcription, processing, and translation of genes associated with different diseases are described, their interaction with the inflammatory genes and H. pylori infection in the gastric tissue is not well known. This study compared changes in common NF-κB-regulatory lncRNAs in the gastric tissue of H. pylori-infected and non-infected patients with gastritis. Moreover, a link between the virulence entity of the strains and the transcriptional changes was analyzed. Two groups of infected and non-infected patients with chronic gastritis were included in the study. Genotyping of the H. pylori strains was done by PCR and relative changes in the expression of NF-κB and regulatory lncRNAs, lincRNA-p21, MALAT1, NKILA, were measured by relative quantitative real time-PCR. Transcriptional levels of MALAT1, lincRNA-p21, and NKILA genes decreased in the infected patients compared with the non-infected patients, which was significantly linked with increased NF-κB gene expression. Our results showed that a hypervirulent strain of H. pylori with oipA"on"/HP-NAP+/iceA1+/iceA2+/vacA s1m1/s1m2+/cagA+ genotype can promote a higher level of NF-κB transcription in the inflamed tissue. H. pylori infection could promote down-regulation of lincRNA-p21, MALAT1 and NKILA in the infected gastric tissue in correlation with NF-κB upregulation. More detailed studies are needed to show a link between the virulence genes and their impact on the regulation of lncRNAs in the stomach.

Diagnostic usefulness of deep learning methods for Helicobacter pylori infection using esophagogastroduodenoscopy images.

We aimed to assess the diagnostic potential of deep convolutional neural networks (DCNNs) for detecting Helicobacter pylori infection in patients who underwent esophagogastroduodenoscopy and Campylobacter-like organism tests. We categorized a total of 13,071 images of various gastric sub-areas and employed five pretrained DCNN architectures: ResNet-101, Xception, Inception-v3, InceptionResnet-v2, and DenseNet-201. Additionally, we created an ensemble model by combining the output probabilities of the best models. We used images of different sub-areas of the stomach for training and evaluated the performance of our models. The diagnostic metrics assessed included area under the curve (AUC), specificity, accuracy, positive predictive value, and negative predictive value. When training included images from all sub-areas of the stomach, our ensemble model demonstrated the highest AUC (0.867), with specificity at 78.44%, accuracy at 80.28%, positive predictive value at 82.66%, and negative predictive value at 77.37%. Significant differences were observed in AUC between the ensemble model and the individual DCNN models. When training utilized images from each sub-area separately, the AUC values for the antrum, cardia and fundus, lower body greater curvature and lesser curvature, and upper body greater curvature and lesser curvature regions were 0.842, 0.826, 0.718, and 0.858, respectively, when the ensemble model was used. Our study demonstrates that the DCNN model, designed for automated image analysis, holds promise for the evaluation and diagnosis of Helicobacter pylori infection.

Frequency of H-Pylori Infection in Immune Thrombocytopenic Purpura

Objective: To determine the frequency of Helicobacter pylori infection in patients with Immune Thrombocytopenia (ITP) and the impact of eradication therapy on platelet counts. Study design &amp; Setting: It was a cross-sectional study conducted at National institute of blood disease and bone marrow transplant (NIBD) hospital, Karachi, Pakistan from January 2021 to September 2022. Methodology: Adults between 18 to 70 years of either gender with thrombocytopenia (platelet count less than 100x109/L) with or without bleeding manifestation from last six months were recruited. The immunoassay was used for stool sample to detect H. pylori antigen, eradication therapy was administered and platelet counts were evaluated at 3rd and 6th month of treatment. Results: Of 120 patients with ITP, the mean age was 36.67±15.32 years, and 76.7% were female. 35.83% had H. pylori positive. The eradication treatment on platelet counts was statistically significant (p=0.001). Median platelet counts at baseline, 3 months and 6 months were 43.50(23.00- 77.00), 136.50 (57.00- 237.00), and 192.00 (130.50-275.50) patients respectively. Platelet counts were statistically different between baseline with three and six months (p=0.007 and p=0.001, respectively). Conclusion: People with ITP frequently have H. pylori infections, and eradication treatment could contribute to the increase in platelet count.

S1908 Exploring the Prevalence of Helicobacter pylori Infection in Patients Diagnosed with Gastric Cancer in Southern India and Proposing Eradication Treatment for Family Members

S1908 Exploring the Prevalence of Helicobacter pylori Infection in Patients Diagnosed with Gastric Cancer in Southern India and Proposing Eradication Treatment for Family Members

Transcriptional analysis of Helicobacter pylori cytotoxic-associated gene-pathogenicity islandin response to different pH levels and proton pump inhibitor exposure.

Long-term use of proton pump inhibitors (PPIs) can increase therisk of gastric cancer in Helicobacter pylori-infected patients; nevertheless, there is no data about their impact on the pathogenicity of H. pylori. This study aimed at investigating thetranscriptional alteration of key gene mediators of cytotoxin-associated gene-pathogenicity island (cag-PAI) among clinical H. pylori isolates in response to omeprazole at different pH levels. Accordingly, H. pylori isolates with the same virulence genotypes selected from the gastric biopsies of patients and transcriptional alteration in the cag-PAI genes studied in the presence or absence of omeprazole (2mg/mL) at pH 2.0, 4.0 and 7.0 after 30 and 90minutes of the treatment. Relative changes in the transcriptional levels were recorded in each assay, separately. Of 18 H. pylori isolates, the cag-PAI empty site was detected in four strains, while the presence of cagA, cagL and cagY was characterized in 77.7%, 83.3% and 83.3% of the cag-PAI-positive strains, respectively. Transcriptional analysis of the selected strains showed up-regulation of cagA and cagL, mainly at pH 2.0 and 4.0 after 30 and 90-minute exposure. A diversity in the expression levels of cag-PAI genes was seen among the strains at the extent and time of induction. Our results showed that omeprazole could increase the expression of H. pylori cagA and cagL at acidic pH. Heterogeneity among the strains probably has an impact on the extent of their interplay with PPIs. Further studies are needed to establish this correlation.

The association between periodontal diseases and helicobacter pylori: an updated meta-analysis of observational studies

IntroductionVarious studies have examined the association between periodontitis and helicobacter pylori and reported conflicting results. The aimed of this systematic review and meta-analysis estimating the association between these two variables.MethodsElectronic databases including PubMed (Medline), Scopus, Web of Sciences and Medline (Elsevier) were searched using the relevant keywords. All observational studies comparing the association between periodontitis and helicobacter pylori were considered. The Newcastle - Ottawa Quality Assessment Scale (NOS) checklist was used for assessing quality of included studies. All statistical analyses were completed using STATA (Version 16).ResultsTwenty-three studies with 8,638 patients (15 case-control with 2,366 patients and 8 cross-sectional with 6,272 patients) were included in this meta-analysis. After combining the selected studies, the odds of presence the Helicobacter pylori infection in patients with the periodontal disease was 2.47 (OR: 2.47; 95% CI: 2.01, 3.03; I2: 50.87%; P: 0.001). Also, the odds after combining case-control studies was 2.77 (OR: 2.77; % 95 CI: 2.11, 3.66; I2: 37.16%; P: 0.049) and after combining cross-sectional analytical ones, it was equal to 2.07 (OR: 2.07; 95% CI: 1.62, 2.65; I2: 43.25%; P: 0.050).ConclusionBased on the results of this meta-analysis, the association between Helicobacter pylori infection and the periodontal disease is evident.

Significance of pathogen identification for urinary tract infection and &lt;i&gt;Helicobacter pylori&lt;/i&gt; infection in type 1 and type 2 diabetes mellitus patients

Objective. The aim of this study was to understand the significance of pathogen identification for Urinary tract infection and Helicobacter pylori infection in Diabetes Mellitus Type 1 and Diabetes Mellitus Type 2 patients.Materials and methods. The study was conducted among 1749 patients with Type 1 and Type 2 Diabetes Mellitus. Using microbiological techniques, the frequency of urinary tract infection was identified and the aetiology and sensitivity of microorganisms to antibacterial drugs were assessed. Data collected on Helicobacter pylori infection were verified through PCR tests on biopsies collected from the gastric mucosa.Results. The study showed that urinary tract infection has a high incidence rate with 58.3% of cases from Type 1 diabetes mellitus, and in 47.2% of cases from Type 2 diabetes. Pathogens such as Escherichia coli, Staphylococcus saprophyticus, Enterococcus faecalis and Klebsiella pneumoniae were the main causative agents of urinary tract infections. Helicobacter pylori infection was common in DM and more in cases of Type 2 Diabetes Mellitus at 27.1%, compared to cases in Type 1 Diabetes Mellitus at 22.8%. Also 5.9 % cases of Type 2 Diabetes Mellitus had combined Helicobacter pylori and urinary tract infections.Conclusion. The study showed the significance in identification of urinary tract infections and Helicobacter pylori infections in patients with Type 1 and Type 2 Diabetes Mellitus, and especially significant for Type 2 Diabetes Mellitus patients.

Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Membranous nephropathy (MN) is a common cause of nephrotic syndrome in middle-aged and older adults. MN etiology is mainly primary or idiopathic; however, it may also be secondary to infections, drugs, neoplasms, and autoimmune diseases. We present the case of a 52-year-old Japanese man with coexisting nephrotic MN and immune thrombocytopenic purpura (ITP). Renal biopsy revealed glomerular basement membrane thickening with immunoglobulin (Ig) G and complement component 3 deposition. Glomerular IgG subclass analysis revealed predominant IgG4 deposition with weak IgG1 and IgG2 deposition. IgG3 and phospholipase A2 receptor deposits were negative. Upper endoscopy revealed no ulcers, but histological examination demonstrated Helicobacter pylori infection in the gastric mucosa with elevated IgG antibodies. After gastric Helicobacter pylori eradication, the nephrotic-range proteinuria and thrombocytopenia of the patient were markedly improved without initiation of immunosuppressive treatment. Therefore, clinicians should consider the possibility of Helicobacter pylori infection in patients with coexisting MN and ITP. Further studies are required to demonstrate the associated pathophysiological aspects.

Helicobacter pylori Diagnostic Tests Used in Europe: Results of over 34,000 Patients from the European Registry on Helicobacter pylori Management.

Several methods are available to diagnose Helicobacter pylori infection. Our objective was to evaluate the tests used for both the initial diagnosis and the confirmation of eradication after treatment in Europe. The European Registry on the management of Helicobacter pylori infection is an international, multicentre, prospective, non-interventional registry aiming to evaluate the management of Helicobacter pylori-infected patients in Europe. Countries with at least 100 cases registered from June 2013 to April 2021, and with a validated diagnostic method were analysed. Data were quality reviewed. A total of 34,920 adult patients from 20 countries were included (mean age 51 years; 61% women). To establish the initial diagnosis, invasive tests were performed in 19,801 (71%) patients, non-invasive in 11,369 (41%), and both in 3437 (12%). The most frequent were histology (n = 11,885; 43%), a rapid urease test (n = 10,636; 38%) and an urea breath test (n = 7577; 27%). According to the age, invasive tests were indicated in 11,179 (77%) ≥50 years, and in 8603 (65%) <50 years. Depending on the country, the use of invasive tests ranged from 29-99% in <50 years to 60-99% in ≥50. Most of the tests used to confirm eradication were non-invasive (n = 32,540; 93%), with the urea breath test being the most frequent (n = 32,540; 78%). In 2983 (9%) post-treatment tests, histology (n = 1887; 5%) or a rapid urease test (n = 1223; 4%) were performed. A great heterogeneity was observed for the initial diagnosis and confirmation of the eradication. The reasons for the apparent lack of adherence to the clinical guidelines should be further explored.

Urea Breath Testing to Detect Helicobacter pylori in Patients with Peptic Ulcer Bleeding During Proton Pump Inhibitor Treatment.

This was a descriptive study carried out from January to December 2021, at Quanzhou First Hospital, an affiliated hospital of Fujian Medical University, to investigate the efficacy of the urea breath test in detecting Helicobacter pylori infection in patients with peptic ulcer bleeding affected with proton pump inhibitors. A total of 77 patients with peptic ulcer bleeding, who underwent urea breath testing after active bleeding, were divided into two groups. The Helicobacter pylori infection positivity rate in patients with peptic ulcer bleeding was 66.2%. The time from bleeding to detection and from admission to detection was not significantly different between the Helicobacter pylori-positive and -negative groups (p=0.840 and 0.285, respectively). Even with high-dose proton pump inhibitor treatment, a urea breath test can be performed after peptic ulcer bleeding ceases and results in an acceptable positivity rate. There was no significant difference in the accuracy of Helicobacter pylori detection between the time from bleeding to testing and from admission to testing. Key Words: Peptic ulcer, Helicobacter pylori, Upper gastrointestinal bleeding, Urea breath test, Proton pump inhibitor.

The Efficacy and Safety of 14-day Rabeprazole Plus Amoxicillin High Dose Dual Therapy by Comparing to 14-day Rabeprazole-Containing Hybrid Therapy for the Naïve Helicobacter pylori Infection in Taiwan: A Randomized Controlled Trial

High-dose dual therapy (HDDT) can attain acceptable eradication rates provided that the optimal doses, timing and treatment duration are applied. The existing evidence still shows inconsistent reports (< 90%) on HDDT therapy except in some Asian countries. We aimed to assess and compare the efficacy of 14-day HDDT by comparing it to 14-day rabeprazole-containing hybrid therapy (HT) and to investigate the host and bacterial factors predicting the treatment outcomes of eradication therapies. In this open-label, randomized controlled trial, we recruited 243 naïve Helicobacter pylori-infected patients from September 1, 2018, to November 30, 2021. They were randomly allocated (1:1) to the HDDT group (rabeprazole 20mg and amoxicillin 750mg q.i.d for 14days, n = 122) and the HT group (rabeprazole 20mg and amoxicillin 1g b.i.d. for 7days, followed by rabeprazole 20mg, amoxicillin 1g, clarithromycin 500mg and metronidazole 500mg b.i.d. for 7days, n = 121). Twelve patients were absent during follow-up in the HDDT group and 4 in the HT group, resulting in 110 for the HDDT group and 117 for HT group in the per protocol (PP) study. The outcome was determined by urea breath tests 8 weeks later. The eradication rates for the HDDT and HT groups were 77.0% (95% confidence interval [CI]: 68.5% to 84.1%) and 94.2% (95% CI: 88.4% to 97.6%) (P < 0.001) in intention-to-treat analysis; 85.5% (95% CI: 77.5% to 91.5%) and 97.4% [95% CI: 92.6% to 99.5%] (P = 0.001) in per protocol analysis. The adverse event rates were 7.3% in the HDDT group and 14.5% in the HT group (P = 0.081). The habit of coffee drinking was the dependent factor for eradication failure in the HDDT group (88.2% vs. 68.8%, P = 0.040), but had no influence in the HT group (97.9% versus 95.0%, P = 0.449) in the univariate analysis. This study demonstrated that 14-day rabeprazole-containing HDDT did not achieve > 90% eradication rates for first-line H. pylori eradication as 14-day rabeprazole-containing HT did. HDDT is a potentially beneficial combination, which involves only two drugs with mild adverse effects; more precise studies are urged to find answers regarding these failures. This clinical trial was registered retrospectively on 28 November, 2021, as ClinicalTrials.gov identifier: NCT05152004.

Nigella sativa powder for helicobacter pylori infected patients: a randomized, double-blinded, placebo-controlled clinical trial

ObjectiveThis double-blind, placebo-controlled, clinical trial was conducted to define the effects of Nigella sativa (N. Sativa) powder plus conventional medical treatment of Helicobacter pylori (H. pylori) on serum ghrelin level and appetite in H. pylori-infected patients.MethodsIn the present study, 51 H. pylori-positive patients were randomly allocated to treatment (n = 26) or placebo (n = 25) groups. They received 2 g/day N. Sativa with quadruple therapy or 2 g/day placebo plus quadruple therapy for 8 weeks. The serum level of ghrelin was assessed before and after the intervention. Appetite was evaluated at the onset and at the end of the intervention.ResultsAt the end of the study, the appetite of the treatment group improved significantly compared with the placebo group (P = 0.02). Statistically, the difference in serum ghrelin levels between the study’s groups was insignificant (P > 0.05).ConclusionSupplementation with N. Sativa powder may be a beneficial adjunctive therapy in H. pylori-infected patients.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (IRCT20170916036204N7) on 08/08/2018.

Clinical features of chronic pancreatitis in Helicobacter pylori-infected patients

Helicobacter pylori infection (Hp) in patients with chronic pancreatitis (CP) is analyzed in this article. A comparative assessment of the clinical manifestations of the disease in Hp-infected and non-infected patients is carried out. Peculiarities of pain, dyspeptic syndromes, and palpation data are revealed.&#x0D; 96 patients with CP were examined, including 58 (60.4%) women and 38 (39.6%) men from 16 to 75. In addition to patients with CP, 30 patients with chronic gastritis, duodenitis, gastric ulcer, or duodenal ulcer without clinical, biochemical, or sonographic signs of pancreatic disease were examined (as a comparison group). The control group consisted of 30 healthy individuals.&#x0D; In patients with CP, the Hp infection rate is higher than in patients with acid-related disorders of the gastroduodenal zone. It is equal to 86.5%.&#x0D; Pain in the epigastrium, in its right half, and in the right hypochondrium is more typical for CP patients infected with Hp than for non-infected patients. Full belt pain irradiation is more frequent in Hp-infected patients. Constant, intense pain occurs in these patients both before and after meals. The intensity of pain in CP patients infected with Hp is higher than in non-infected patients. In the case of Hp infection, pancreatic pain is more clearly stopped by antisecretory drugs and less clearly by antispasmodics and hunger. In non-infected patients, pain relief is preferably achieved through hunger and antispasmodic drugs.&#x0D; The severity of dyspeptic manifestations, symptoms associated with functional pancreatic insufficiency, is higher in CP patients infected with Hp than in non-infected patients.&#x0D; It is proven that the clinical manifestations of functional pancreatic insufficiency are more severe in infected patients.

Prevalence, Clinical and Demographic Characteristics of Helicobacter pylori in Patients Undergoing Esophagogastroduodenoscopy in Specialized Health Centers in Two Departments of the Colombian Coffee Growing Axis

Helicobacter pylori is a Gram-negative, microaerophilic bacterium with the ability to survive in extreme acid environments, with pH below 4.0. It is estimated that more than half of the world’s population is infected with this bacterium. Objective: To determine the prevalence, clinical and demographic characteristics of Helicobacter pylori infection in patients undergoing esophagogastroduodenoscopy in two specialized centers of the Coffee Growing Axis in Pereira and Manizales from February to October 2018. Method: Cross-sectional descriptive observational study in which the proportion of positivity to Helicobacter pylori in a period of time was determined. Results: The study included 94 patients; the prevalence of positivity to Helicobacter pylori was 86.1% (81/94), 56 (59.5%) of which were diagnosed by culture and 52 (55.3%) by histology. In the histological study, of the 24 (25.5%) subjects who presented precursor lesions of malignancy, 9 (9.5%) were positive for Helicobacter pylori, while in the 70 subjects (74.5%) without precursor lesions of malignancy, 43 (45.7%) were positive. The significant variables for Helicobacter pylori infection were: Histological response for precursor lesions of malignancy: OR of 0.3808 (95% CI: 0.1408-0.9907) p=0.04 and epigastric pain: OR 0.09489 (95% CI: 0.01928-0.3637) p=0.001. Conclusion: The frequency of Helicobacter pylori infection in the Departments of Risaralda and Caldas is high, and does not discriminate against gender, age, race or origin of the study subjects; Epigastric pain continues to be the most relevant symptom in the diagnosis of Helicobacter pylori infection and the combination of diagnostic tests improves the diagnosis of Helicobacter pylori infection.

Treatment of Helicobacter pylori Infection in Patients with Penicillin Allergy.

Helicobacter pylori is among the prevalent causes of infections worldwide, and its resistance rate to antibiotics has been rising over time. Amoxicillin is the cornerstone for the treatment regimen. However, the prevalence of penicillin allergy ranges from 4% to 15%. In patients with true allergy, Vonoprazan-Clarithromycin-Metronidazole and bismuth quadruple therapy have demonstrated excellent eradication and high adherence rates. Vonoprazan-based therapy is administered less frequently and may be better tolerated than bismuth quadruple therapy. Therefore, vonoprazan-based therapy may be considered as a first-line therapy if accessible. Bismuth quadruple therapy can be used as the initial therapy when vonoprazan is unavailable. Levofloxacin or sitafloxacin-based regimens achieve a moderately high eradication rate. However, these are associated with potentially serious adverse effects and should only be used when other effective and safer regimens are unavailable. Cephalosporins such as cefuroxime have been used as an alternative to amoxicillin. Microbial susceptibility studies can guide the selection of appropriate antibiotics. PPI-Clarithromycin-Metronidazole fails to achieve a high eradication rate and should be used as a second-line therapy. PPI-Clarithromycin-Rifabutin should not be used because of low eradication rate and frequent adverse reactions. The choice of the most effective antibiotic regimen can enhance clinical outcomes in patients with H. pylori infection and penicillin allergy.

Increased IL-17A Serum Levels and Gastric Th17 Cells in Helicobacter pylori-Infected Patients with Gastric Premalignant Lesions

Background:Helicobacter pylori infection is characterized by an inflammatory infiltrate that might be an important antecedent of gastric cancer. The purpose of this study was to evaluate whether interleukin (IL)-17 inflammation is elicited by gastric T cells in Helicobacter pylori patients with gastric intestinal metaplasia and dysplasia (IM/DYS). We also investigated the serum IL-17A levels in Helicobacter pylori patients with gastric intestinal metaplasia and dysplasia, and patients with Helicobacter pylori non-atrophic gastritis (NAG). Methods: the IL-17 cytokine profile of gastric T cells was investigated in six patients with IM/DYS and Helicobacter pylori infection. Serum IL-17A levels were measured in 45 Helicobacter pylori-infected IM/DYS patients, 45 Helicobacter pylori-infected patients without IM/DYS and in 45 healthy controls (HC). Results: gastric T cells from all IM/DYS patients with Helicobacter pylori were able to proliferate in response to Helicobacter pylori and to produce IL-17A. The Luminex analysis revealed that IL-17A levels were significantly increased in Helicobacter pylori IM/DYS patients compared to healthy controls and to Helicobacter pylori gastritis patients without IM/DYS (452.34 ± 369.13 pg/mL, 246.82 ± 156.06 pg/mL, 169.26 ± 73.82 pg/mL, respectively; p < 0.01, p < 0.05). Conclusions: the results obtained indicate that Helicobacter pylori is able to drive gastric IL-17 inflammation in IM/DYS Helicobacter pylori-infected patients, and that IL-17A serum levels are significantly increased in Helicobacter pylori-infected patients with IM/DYS.