Incidence Of Helicobacter Pylori Infection Research Articles

Recent Advances in Vitamin D3 Intervention to Eradicate Helicobacter pylori Infection.

Helicobacter pylori (HP) infections affect approximately one-third of children worldwide. In China, the incidence of HP infection in children ranges from approximately 30% to 60%. In addition to damaging the gastrointestinal tract mucosa, HP infection in children can negatively affect their growth and development, hematology, respiratory and hepatobiliary system, skin, nutritional metabolism, and autoimmune system. However, the rate of HP eradication also fell considerably from the previous rate due to the presence of drug-resistant HP strains and the limited types of antibiotics that can be used in young patients. Vitamin D3 (VitD3) is a steroid hormone that can reduce inflammation in the stomach mucosa induced by HP and can alleviate and eradicate HP through a variety of pathways and mechanisms, including immune regulation and the stimulation of antimicrobial peptide (AMP) secretion and Ca2+ influx, to reestablish lysosomal acidification; thus, these results provide new strategies and ideas for the eradication of drug-resistant HP strains.

Do people who have had a cholecystectomy have a lower incidence of Helicobacter pylori infection?

Do people who have had a cholecystectomy have a lower incidence of Helicobacter pylori infection?

Incidence of Helicobacter Pylori Infection from the Endoscopy Register

Helicobacter pylori (HP) infection is one of the most prevalent infections worldwide, contributing to inflammation of the gastric mucosa which is of great interest given its involvement in many gastroduodenal pathologies and some extra-digestive diseases. Aim of the Study: Report the incidence of HP from the endoscopy and anatomopathology register. Methods: This is a descriptive retrospective study performed during a period from January 2019 to November 2022, based on data from the endoscopy and anatomopathology register. We included all patients over 16 years of age who underwent esophago-gastroduodenal fibroscopy (EGD) with gastric biopsies performed according to the Sydney protocol. Results: 903 patients were included in our study. The incidence of HP infection was 60% (n=541).The average age was 50 years [17-90], the Sex Ratio W/M: 1.3, the most frequent symptom was represented by epigastralgia. The esophago-gastroduodenal fibroscopy had objectified an erythemato-congestive gastric mucosa in 481 (89%) of the cases, erythemato-whitish in 27 (5%), nodular in 16 (3%) and it was normal in 16 (3%) of the cases. On anatomopathological study, the gastritis was antro-fundal, antral and fundal in respectively 487 (90%), 43 (8%) and 11 (2%) of the cases. The intensity of gastritis was mild in 6.8%, moderate in 92% and severe in 1.2% of patients. Gastritis activity was absent in 6 (1.1%), mild in 74 (13.8%), moderate in 455 (84.1%) and severe in 5 (1%) cases. The density of HP was mild in 75 (14%), moderate in 437 (80.8%), and severe in 28 (5.2%) cases. Intestinal metaplasia was observed in only 9 cases (1.7%), as for dysplasia, it was not identified in any of our patients. Adenocarcinoma was revealed in 9 (1.7%) patients. Conclusion: The results of our study indicate an incidence of 60% (n=541). The association of chronic gastritis was important. Its pathogenic role has been revealed in many gastroduodenal pathologies in particular gastric cancer objectified in our series in 1.7% of cases, hence the interest in researching HP infection and its eradication.

Helicobacter pylori kolonizasyon yoğunluğu çölyak hastalığının gelişmesinde önemli rol oynayabilir

Background and Aims: The aim of this study was to investigate the relationship between celiac disease and Helicobacter pylori infection and to compare the severity of celiac disease and Helicobacter pylori infection in adults according to the modified Marsh score.
 Materials and Methods: This study included 148 patients with celiac disease and 240 control patients without celiac disease who underwent endoscopy for various reasons in a tertiary hospital. Age, gender, endoscopy indications, descriptive characteristics, complaints, serological, endoscopic and histopathological findings of the patients were recorded and analyzed. Results: Helicobacter pylori colonization in the celiac disease patients was 43.9% and in control group was 57.5% (p = 0.009). Helicobacter pylori positivity rate was significantly lower in Marsh 2, 3A, 3B, 3C groups ( p = 0.04). Pearson correlation analysis revealed a significant but weak negative relationship between the severity of Helicobacter pylori and celiac disease (r = -.109, p = 0.031). When Marsh score was increasing, Helicobacter pylori grade decreased. Conclusion: The current study indicated that the incidence of Helicobacter pylori infection was lower in adults with celiac disease compared to control patients, and Helicobacter pylori colonization density was associated with milder duodenal lesions in celiac patients. Helicobacter pylori colonization may have a protective role in the development of celiac disease.

Histopathologic findings in laparoscopic sleeve gastrectomy: is routine full pathologic evaluation indicated?

Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric surgery. The resected gastric segment is routinely sent for pathology evaluation. No formal national recommendation exists that mandates pathology review. We proposed to study the largest histopathologic series in SG patients yet reported. The primary objective of our study was to determine whether a subgroup of patients who underwent bariatric surgery in the northeastern Unites States is more susceptible to having clinically significant pathologic findings that may benefit from routine histopathologic evaluation of the gastric sleeve specimen. University hospital. A retrospective electronic chart review of patients who underwent SG at a single large academic institution was performed. Patient demographics, body mass index, and histopathologic reports of the gastric specimens obtained during SG were analyzed. The records of 3543 patients were reviewed. A total of 1076 patients had abnormal pathologies, including gastritis (938), follicular gastritis (98), intestinal metaplasia (25), gastrointestinal stromal tumor (12), leiomyoma (1), lymphoma (1), and other malignancy (1). Black and Hispanic patients had a higher incidence of developing gastrointestinal stromal tumor and intestinal metaplasia. A higher incidence of Helicobacter pylori infection among specimens with abnormal pathologies was noted. The findings of this study call into question the routine use of pathology workup in gastric specimens after SG. Our data suggest that such analysis may be warranted in certain subtypes of patients such as older Black and Hispanic patients in the northeastern United States.

Helicobacter pylori infection is associated with increased accumulation of advanced glycation end products in the skin in patients with type 1 diabetes: A preliminary study.

Helicobacter pylori infection (HPI) is more frequently diagnosed in patients with diabetes. Insulin resistance in patients with type 1 diabetes (DMT1) is associated with the accumulation of advanced glycation end products (AGEs) in the skin and progression of chronic complications. Assessment of the relationship between the incidence of HPI and skin AGEs in patients with DMT1. The study included 103 Caucasian patients with a DMT1 duration >5 years. A fast qualitative test was performed to detect the HP antigen in fecal samples (Hedrex). The content of AGEs in the skin was estimated using an AGE Reader device (DiagnOptics). The HP-positive (n = 31) and HP-negative (n = 72) groups did not differ in terms of age, gender, duration of diabetes, fat content, body mass index (BMI) and lipid profile, metabolic control, and inflammatory response markers. The studied groups differed in the amount of AGEs in the skin. The relationship between HPI and increased AGEs in the skin was confirmed in a multifactor regression model taking into account age, gender, DMT1 duration, glycated hemoglobin A1c (HbA1c), BMI, low-density lipoprotein cholesterol (LDL-C) and the presence of hypertension, and tobacco use. The studied groups also differed in serum levels of vitamin D. Increased accumulation of AGEs in the skin of patients with DMT1 with coexisting HPI suggests that eradication of HP may significantly improve DMT1 outcomes.

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics. A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated. The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001). Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.

Incidence of Helicobacter pylori Infection among Hashimoto's Thyroiditis Patients in Amara City, Iraq

Incidence of Helicobacter pylori Infection among Hashimoto's Thyroiditis Patients in Amara City, Iraq

Incidence of Helicobacter pylori Infection in District Haripur Khyber Pakhtunkhwa

Background: Helicobacter pylori (H. pylori) is a Gram-negative, microaerophilic bacteria residing in stomach area, sometime presence of H. pylori does not demonstrate symptoms and causes disease to the host. H. pylori possibly the most common human pathogen, 60% of the world’s adult population’s guts are infested by this pathogen. Aim: Aim of study was to identify H. pylori in different age groups of Haripur district and examine different parameters associated with H. pylori. Method: Sero-prevalance rate of H. pylori among 150 individuals were analyzed using diaspot kit (Koeman Group of Companies.). Correlation of different parameters such as age group, occupation, gender, foods, water type consumption, sign and symptoms were analyzed in H. pylori infected individuals. The entire samples were collected from DHQ Haripur. All the methods were adopted as per manufacturer protocol using diaspot kit for H. pylori infection. Findings: Current study showed 85(56.6%) were positive samples while 65(43.3%) were negative. Among them, 48(56.4%) male and 37(43.5%) female were positive for H. pylori infection. Ratio of positive cases in age groups ranging from 20-30, 31-40, 41-50 and 51-60 were 21.1%, 31.7%, 24.7% and 22.3% respectively. Housewives (21.4%) employer (54.1%) and students were 24.7% positive for H. pylori. 65% of individual were found positive whose source of drinking water was tube well; water from bore well users were 55% positive and 43% filter users were positive for H. pylori. Among 150, 102(68%) were using spicy foods and remaining 48(32%) were using less spicy foods. 57(38%) of patients were on treatment of H. pylori while the 93(62%) were not taking treatment, results found that 85(56.6%) of individuals were positive while the 65(43.3%) found to be negative for the presence of H. pylori. Conclusion: Various epidemiological features like unhygienic food, increasing age, gender, and water type were also positively associated with H. pylori. Besides that, occupation and spicy food were also directly related to H. pylori. Keywords: Helicobacter pylori, Gram-negative bacteria, Incidence rate, Haripur, Khyber-Pakhtunkhwa

Epidemiological Evaluation of Associated Risk Factors of Helicobacter pylori Infection Using Noninvasive Methods: A Case Study of Peptic Ulcer Patients in Lafia, Nigeria.

Background: Due to its persistent nature, ulcers brought on by Helicobacter pylori have been a significant public health concern. This study looked at how specific risk factors affected the prevalence of Helicobacter pylori infection among peptic ulcer patients visiting medical institutions in Lafia, Nigeria. Methods: The blood and stool samples of 180 individuals (71 men and 109 women) were collected randomly, checked for H. pylori using test strips for H. pylori antibodies and antigens (Azure Biotech Inc.), and the feces also were grown on Columbia blood agar base (TITAN Biotech Ltd). Using a standardized questionnaire, some participant risk data was also gathered.Results: A positive culture method (CM) test result was obtained from 14/71 (19.72%) of the 71 male patients and 37/109 (33.94%) of the 109 female subjects out of a total of 210 subjects. For CM alone, it was discovered that female participants had a considerably greater incidence of Helicobacter pylori infection than their male counterparts (p=0.038). Nevertheless, all analytical techniques discovered no evidence of a significant difference between age groups (p>0.05). Only the blood antibody (BAB) approach showed a substantially greater prevalence (p=0.021) in married patients, with 79/116 (68.10%) reactive instances. The presence of drinking water source (p < 0.001, 0.001, 0.002 using CM, BAB, and SAG, respectively) and number of occupants per room (p < 0.001, 0.001, 0.002 using CM, BAB, and SAG, respectively) as potential risk factors for H. pylori infection was also demonstrated.Conclusion: The majority of risk factors that were taken into consideration for this study demonstrated a strong correlation with Helicobacter pylori infection in Lafia, Nigeria.

Role of H. Pylori infection with Recurrent Abdominal Pain in Young Age Children

Objective: A study was conducted to determine the incidence of Helicobacter pylori infection in children who had chronic abdominal pain. Study Design: Cross-sectional study. Study and Duration of Study: This research was carried out during 1.1.2019 to 1.6.2020 in the DHQ Sargodha. Materials and Methods: According to the findings, there were 200 participants in the study, and 8 percent of those with Recurrent Abdominal Pain had Helicobacter. Results: The patients ranged in age from 12.43 to 12.43 and 1.23 months on average. Between 8 and 16 years old, the average age of the sample group was observed. The average number of months that participants were bothered by stomach discomfort was 4.23. The presence of Helicobacter pylori was confirmed in 47% of those who were tested. Conclusion: Helicobacter pylori is a common cause of recurrent abdominal pain in children, and it can be treated with antibiotics. In children and adolescents, it is a serious problem, and more research is needed to determine the risk factor that is linked to an increased Helicobacter Pylori infection rate. Keywords: Recurrent Abdominal Pain, abdominal pain, Helicobacter pylori

Incidence of Helicobacter Pylori Infection among Dyspeptic Children and Adults Diagnosed through Serum Antibody and Stool Antigen Tests Considering Histopathology as Gold Standard in Mayo Hospital, Lahore Pakistan

Objective: To detect the incidence of Helicobacter pylori (H Pylori) infection in children and adults and to measure the effectiveness of three non invasive, minimally invasive and invasive diagnostic modalities at Mayo hospital, Lahore. Design: Descriptive cross-sectional study Place and duration: East Medical Ward, Pediatric Medical ward Unit 2, Pathology Department, Mayo hospital Lahore from November 2020 to October 2021. Methodology: All the cases with severe recurrent or persistent symptoms of gastritis and dyspepsia referred to adult and pediatric medical outdoor and medical wards were included in the study. Specific sociodemographic details were noted. Blood and stool samples were collected and directed to Pathology department of the hospital for serum H Pylori antibody and H Pylori stool antigen tests respectively. Endoscopic guided gastric biopsy for histopathological presence of H Pylori is done in all the patients with strong recurrent or persistent clinical symptoms not responding to treatment. Results of all these tests were noted. All the variables were analyzed with respect to their percentages and proportions. Results: Among 759 patients with symptoms of gastritis included in our study, 522 (68.7%) were found to have Helicobacter pylori infection. The incidence was more common in adults (mean age 42.5 years). Males were infected more than females. Among pediatric population, found more frequently in school going 6 to 10 years age group. H pylori stool antigen test was more reliable as compared to serum antibody test. Histopathology remained the gold standard test. Conclusion: Helicobacter pylori infection is quite prevalent in our community. However, further researches on large scale should be conducted to find out the exact prevalence of H pylori in the whole country. The diagnostic accuracy of indirect non invasive H Pylori stool antigen test is far better than minimally invasive serology test and can be used effectively in children and adults where urea breath technique cannot be done accurately and to avoid the direct invasive endoscopic guided histopathological examination. Keywords: Incidence, Helicobacter pylori, gastritis, dyspepsia, diagnostic tests, Histopathology, Pakistan

Correlation between Blood Group Phenotypes and Incidence of Helicobacter pyloriInfection

Introduction: Helicobacter pylori is a gram-negative, spiral and flagellated bacteria.Thisinfection might be present in more than 50 percent of people in the world.It has been found for several years that gastric carcinoma occur more frequently in patients with blood group A, while duodenal ulcer had been associated with blood group O. Methodology: This is a prospective randomized controlled study in which patients who were newly diagnosed with H. pylori infectionsincluded. Sixty-one, selected Iraqi patients were (37 female and 24 male), with age ranges between (17-70) years. The Patients who enrolled in this study were divided according to (ABOBlood groups) into four groups.Data were collected from the patientsthrough direct interview included the age, gender, history of the disease, blood group, and Rhesus (Rh) factor. Results: In this study thelargest proportion(42.62%) of H. pylori infected patients according to ABO phenotypes was found in blood group O, and the smallest proportion(8.2%) was in blood group AB. Though the mean age of H. pylori infected patients in blood group O was higher than the other blood groups and less mean age was in blood group B.The female patients exhibited greater percentages of H. pylori infection than males for blood groups A, blood groups B, and blood group AB except for O blood groups patients where proportion of male was more than female. On the other hand the percentage of H. pylori infected patients in this study according to Rh factor distributed as follow: in +Rh factor (78.69%) and -Rh factor (21.31%).Conclusion:The incidence of H. pylori infection is high in patients with blood group O so, the blood group phenotypes may play a role in H. pylori infection. Meanwhile there was no correlation between age, and Rh status with distribution of H. pylori infection among different ABO phenotypes patients.However, larger sample size is needed to further clarify this association.

Suppression of Helicobacter pylori infection by daily cranberry intake: A double-blind, randomized, placebo-controlled trial.

Background and aimDietary strategies that contribute to reducing incidence of Helicobacter pylori infection without negative side effects are highly desirable owing to worldwide bacterial prevalence and carcinogenesis potential. The aim of this study was to determine dosage effect of daily cranberry consumption on H. pylori suppression over time in infected adults to assess the potential of this complementary management strategy in a region with high gastric cancer risk and high prevalence of H. pylori infection.MethodsThis double‐blind, randomized, placebo‐controlled trial on 522 H. pylori‐positive adults evaluated dose–response effects of proanthocyanidin‐standardized cranberry juice, cranberry powder, or their placebos on suppression of H. pylori at 2 and 8 weeks by 13C‐urea breath testing and eradication at 45 days post‐intervention.Results H. pylori‐negative rates in placebo, low‐proanthocyanidin, medium‐proanthocyanidin, and high‐proanthocyanidin cranberry juice groups at week 2 were 13.24%, 7.58%, 1.49%, and 13.85% and at week 8 were 7.35%, 7.58%, 4.48%, and 20.00%, respectively. Consumption of high‐proanthocyanidin juice twice daily (44 mg proanthocyanidin/240‐mL serving) for 8 weeks resulted in decreased H. pylori infection rate by 20% as compared with other dosages and placebo (P < 0.05). Percentage of H. pylori‐negative participants increased from 2 to 8 weeks in subjects who consumed 44 mg proanthocyanidin/day juice once or twice daily, showing a statistically significant positive trend over time. Encapsulated cranberry powder doses were not significantly effective at either time point. Overall trial compliance was 94.25%. Cranberry juice and powder were well‐tolerated.ConclusionsTwice‐daily consumption of proanthocyanidin‐standardized cranberry juice may help potentiate suppression of H. pylori infection. Trial registration: ChiCTR1800017522, per WHO ICTRP.

Comparative Study between incidence of Helicobacter Pylori Infection in Women with Hyperemesis Gravidarum and Normal Pregnancy

Background: Nausea and vomiting in early pregnancy is so common that it can be considered a normal part of pregnancy. It is referred to as morning sickness although this is a misnomer because symptoms will often persist throught the day. Nausea and vomiting occurs significantly more often in primigravidas and women who were less educated younger-nonsmokers, obese or those with a history of nausea and vomiting in previous pregnancy. Objective: This work aimed at assessing the possible relation between H. Pylori infection and hyperemesis gravidarum (HG). Patient and Methods: Study setting: Al Azhar University Hospitals (Al_ Hussein and Sayed Galal), Duration of study: November 2018 to May 2019. The Study included two groups Group (A): (Thirty) pregnant women with hyperemesis gravidarum in the first trimester attending at antenatal clinics and admitted in the ward in addition to Group (B): (Thirty) normal pregnant women with antenatal care. The pregnant women with hyperemesis gravidarum, aged 18-40 years old and less than 16 weeks gestation. Results: The current study found significant difference between two groups regarding positivity of HPSA. Positive stool antigen were found in 26 out of 30 of hyperemesis gravidarum (86.7%) compared with 11 out of 30 controls (36.7%) and highly statistical significant difference between studied groups as regard H pylori antibodies. Conclusion: There was a significant association between Helicobacter Pylori infection and pathogenesis of hyperemesis gravidarum.

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

Abstract Objective: This study aims to determine the correlation between risk factors and erosive esophagitis development. Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification. Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p &lt; 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p &lt; 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%). Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

Presence of cagPAI genes and characterization of vacA s, i and m regions in Helicobacter pylori isolated from Alaskans and their association with clinical pathologies.

Introduction. Gastric cancer is a health disparity in the Alaska Native people. The incidence of Helicobacter pylori infection, a risk factor for non-cardia gastric adenocarcinoma, is also high. Gastric cancer is partially associated with the virulence of the infecting strain.Aim. To genotype the vacA s, m and i and cag pathogenicity island (cagPAI) genes in H. pylori from Alaskans and investigate associations with gastropathy.Methodology. We enrolled patients with gastritis, peptic ulcer disease (PUD) and intestinal metaplasia (IM) in 1998-2005 and patients with gastric cancer in 2011-2013. Gastric biopsies were collected and cultured and PCR was performed to detect the presence of the right and left ends of the cagPAI, the cagA, cagE, cagT and virD4 genes and to genotype the vacA s, m and i regions.Results. We recruited 263 people; 22 (8 %) had no/mild gastritis, 121 (46 %) had moderate gastritis, 40 (15%) had severe gastritis, 38 (14 %) had PUD, 30 (11 %) had IM and 12 (5 %) had gastric cancer. H. pylori isolates from 150 (57%) people had an intact cagPAI; those were associated with a more severe gastropathy (P≤0.02 for all comparisons). H. pylori isolates from 77 % of people had either the vacA s1/i1/m1 (40 %; 94/234) or s2/i2/m2 (37 %; 86/234) genotype. vacA s1/i1/m1 was associated with a more severe gastropathy (P≤0.03 for all comparisons).Conclusions. In this population with high rates of gastric cancer, we found that just over half of the H. pylori contained an intact cagPAI and 40 % had the vacA s1/i1/m1 genotype. Infection with these strains was associated with a more severe gastropathy.

Gastric Carcinoids and Polyps

Gastric polyps are commonly found on upper endoscopy. With the increasing use of proton pump inhibitors and decreasing incidence of Helicobacter pylori infection, fundic gland polyps are now the most common gastric polyps in Western countries. Most of the other polyps, such as hyperplastic polyps, gastric adenomas, and gastric neuroendocrine tumors (NETs), are strongly associated with the presence of chronic atrophic gastritis, commonly due to either H. pylori infection or autoimmune gastritis. Gastric NETs, previously termed carcinoids, are rare neoplasms that often present as polypoid lesions and can be subcategorized into three subtypes. The most common subtype, type 1, is associated with chronic atrophic gastritis and generally thought to have low malignant potential. Type 2 NETs behave similarly to type I NETs but are specifically associated with the Zollinger-Ellison syndrome. Type 3 NETs are sporadic and highly malignant. All gastric polypoid lesions require histopathologic examination for diagnosis. The key aspect to the management of gastric NETs and other gastric polyps is to determine the malignant potential of the lesion in question. This then informs whether the patient needs removal of additional polyps if multiple, whether the patient needs further endoscopic surveillance, or whether surgery is indicated. This review contains 5 figures, 5 tables, and 50 references. Key Words: atrophic gastritis, fundic gland polyp, gastric adenoma, gastric carcinoid, gastric neuroendocrine tumor, gastric polyp, hyperplastic polyp, intestinal metaplasia

Gastric Carcinoids and Polyps

Gastric polyps are commonly found on upper endoscopy. With the increasing use of proton pump inhibitors and decreasing incidence of Helicobacter pylori infection, fundic gland polyps are now the most common gastric polyps in Western countries. Most of the other polyps, such as hyperplastic polyps, gastric adenomas, and gastric neuroendocrine tumors (NETs), are strongly associated with the presence of chronic atrophic gastritis, commonly due to either H. pylori infection or autoimmune gastritis. Gastric NETs, previously termed carcinoids, are rare neoplasms that often present as polypoid lesions and can be subcategorized into three subtypes. The most common subtype, type 1, is associated with chronic atrophic gastritis and generally thought to have low malignant potential. Type 2 NETs behave similarly to type I NETs but are specifically associated with the Zollinger-Ellison syndrome. Type 3 NETs are sporadic and highly malignant. All gastric polypoid lesions require histopathologic examination for diagnosis. The key aspect to the management of gastric NETs and other gastric polyps is to determine the malignant potential of the lesion in question. This then informs whether the patient needs removal of additional polyps if multiple, whether the patient needs further endoscopic surveillance, or whether surgery is indicated. This review contains 5 figures, 5 tables, and 50 references. Key Words: atrophic gastritis, fundic gland polyp, gastric adenoma, gastric carcinoid, gastric neuroendocrine tumor, gastric polyp, hyperplastic polyp, intestinal metaplasia

Urticaria in children and adolescents: An updated review of the pathogenesis and management.

The present survey represents the latest data on diagnosis and management of childhood urticaria. It has been observed that urticaria occurs less often in children than adults, with symptoms rarely lasting for over 6weeks. Triggers or aggravating factors can be found only in 21%-55% of cases. Finding autoantibodies in children does not impact a disease prognosis, unlike in adult patients, where the presence of autoantibodies is associated with a more prolonged run of the disease, a more severe prognosis and more intensive treatment methods. The incidence of food allergy equals to 8%-10% of cases. The incidence of Helicobacter Pylori infection in children is lower than that in adults and comes to 10%-18%. Medical experts recommend using the same treatment schemes for adults and children. This survey describes different urticaria management patterns suggested by experts from Europe, America, and Russia in their recent guidelines. It has been noted that unlike the guidelines from 2014, the 2018 clinical practice guidelines for the diagnosis and management of urticarial once again suggest a four-step treatment scheme with assigning omalizumab for Step 3 and cyclosporine A for Step 4 in the event of low therapeutic efficacy of the previous step or its impossibility. Leukotriene antagonists (LTRAs) are currently removed from basic management to alternative programs.