Prevalence Of Hp Research Articles

The renal osteodystrophy pattern in Brazil and Uruguay: An overview

The prevalence of the types of renal osteodystrophy (ROD) has changed in the last two decades. This study evaluates the prevalence and determining factors of the types of ROD in two countries in South America. Symptomatic patients who underwent bone biopsies for diagnostic purposes (1985 through 2001) were included in the study. In Brazil, a total of 2340 patients were reviewed, 93.1% on hemodialysis (HD), and 6.9% on continuous ambulatory peritoneal dialysis (CAPD). In Uruguay, 167 patients on hemodialysis were included. Uncalcified bone samples were analyzed in order to diagnose the different types of ROD. Comparing the 1980s to the 1990s, the prevalence of Brazilian patients with hyperparathyroid bone disease (HP) increased from 32.3% to 44.0%, while Al overload decreased from 61.3% to 42.4%. A logistic regression analysis showed that the main factors associated with HP included female gender, age of less than 40 years, black patients, longer time on dialysis, and absence of Al overload. In Uruguay, HP also increased over time from 31.8% to 70.5% (P < 0.05), while Al overload decreased from 42% to 27% (P < 0.05). A better control of Al overload may lead to a change in histologic pattern, as evidenced by the increasing prevalence of HP.

Possible protective effect of 5-aminosalicylic acid on Helicobacter pylori infection in patients with inflammatory bowel disease.

To evaluate the prevalence of (Hp) infection in a group of inflammatory bowel disease (IBD) outpatients and the possible influence of treatment. The low prevalence of Hp infection in these patients is usually attributed to environmental factors; the role of drugs has not been fully investigated. Seventy-two consecutive outpatients underwent a C13-urea breath test for Hp: 32 with Crohn's disease (13 men; mean age, 48 years; range, 20-72 years) and 40 with ulcerative colitis (25 men; mean age, 49 years; range, 25-71 years). Thirty-one patients were treated with sulfasalazine and 41 with 5-ASA. The control group consisted of 72 age- and sex-matched subjects. The prevalence of Hp infection was 47% in the IBD patients and 61% in the controls (p = 0.089; odds ratio = 0.55; 95% CI = 0.283-1.089) with a statistically significant increase for each year of age ( p= 0.044; odds ratio = 1.02; 95% CI = 1.001-1.052). Among the IBD patients, age and gender, the type, activity, duration, extent of the disease, or the calendar year of diagnosis, had no influence on Hp infection. was detected in 65% of the patients treated with sulfasalazine and in 34% treated with 5-ASA (p = 0.017). Although low, the prevalence of Hp infection in our patients was not significantly different from that in the controls. 5-ASA, and not sulfasalazine, may have a protective effect against Hp infection.

Progastrin and cyclooxygenase-2 in colorectal cancer.

Colorectal cancers (CRCs) are one of the most common forms of cancer in Poland and one of the leading causes of death. The tumors have been attributed to genetic, dietary, and other environmental factors, but recently growth factors such as gastrin have also been implicated in the carcinogenesis. The relationship between plasma amidated and nonamidated gastrin in CRCs is controversial. This study was designed (1) to determine the plasma levels of progastrin and amidated gastrin in 50 CRC patients before and 3-6 months after removal of the tumor, (2) to determine the tumor concentrations of these gastrin peptides and the level of expression for gastrin mRNA and gastrin/CCK(B) receptor mRNA, (3) to examine the expression of cyclooxygenase COX-1 and COX-2 mRNA in CRC tissue, and (4) to compare the prevalence of Hp and its cytotoxic protein, CagA, and cytokines (TNFalpha, IL-1beta, and IL-8) in CRCs, before and after removal of tumor. It was found that the CRC, its resection margin, and the plasma contained severalfold higher levels of progastrin than of amidated gastrins and that the removal of the CRC tumor resulted in a marked reduction in plasma progastrin level without a significant alteration in plasma levels of amidated gastrins. Both gastrin and CCK(B)-R mRNA were detected in the cancer tissue and resection margin by RT-PCR, and similarly, COX-1 and COX-2 mRNA were expressed in these tissues of most CRCs. The seroprevalence of Hp, especially that expressing CagA, and levels of IL-1beta, but not other cytokines, were significantly higher in CRC patients than in 100 age-, gender-, and profession-matched controls and did not change significantly about 3-6 months after tumor resection. We conclude that (1) the CRC and its margin contain large amounts of progastrin and show gene expression of gastrin, CCK(B)-R, and COX-2; (2) removal of the CRC markedly reduces the plasma concentrations of progastrin; (3) the Hp infection rate is higher in CRC, and this may contribute to colorectal cancerogenesis via enhancement of progastrin and gastrin release; and (4) plasma progastrin concentrations might serve as a biomarker of CRC.

Incidence and pathophysiology of peptic ulcer bleeding.

Peptic ulcer accounts for about 50% of all cases of upper gastrointestinal bleeding. Acute mortality may be as high as 14%. Infection with Helicobacter plyori (Hp) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are the predominant risk factors. While the prevalence of Hp in ulcer bleeding is still debated, there is strong evidence that eradication of bacteria reduce the risk of re-bleeding significantly. The use of NSAIDs increases the frequency of ulcer bleeding about four- to sixfold on average. Additional factors such as advanced age, concomitant use of corticosteroids or anticoagulants, prior ulcer complications and co-morbid diseases may further increase the risk of bleeding. Whether or not Hp infection also represents an additive risk factor in NSAID-related bleeding remains to be clarified. The pathophysiologic action of both Hp and NSAIDs is quite complex. Hp promotes the aggressive factor acid and damages several mucosal defence mechanisms by liberating lipopolysaccharide, urease and vacuolating cytotoxin. In NSAID toxicity the cyclo-oxygenase enzymes (COX) have been studied intensively. With the advent of COX-2-selective NSAIDs, the clinical problem of NSAID-induced ulcer bleeding may be markedly reduced or abolished completely.

PREVALENCES OF HELICOBACTER PYLORI AMONG NSAID USERS AND NON USERS

Background:The main etiology of gastroduodenal ulcer are NSAID and Hp. The role if Hp infection to the patients who use NSAID is still controversy. We compare the prevalence of Hp infection among ulcer and non ulcer patients in those who used NSAID and who didn’t use.Material &amp; Methods:A retrospective study had been done from 1995 ‐ 1988 to 248 patients who were proven to have ulcer and non ulcer by endoscopic examination. Infection of Hp was tested by CLO and histopathology. Base on the history of NSAID consumption, the patients were divided into NSAID users group and non users group.Result:Between 1995 and 1998, 248 patients were studied, they consisted of 95 ulcer patients (50 GU, 40DU, 5 GU+DU) and 163 non ulcer patients. Age ranged from 16‐78 years old. The median age of GU;DU and NU wee 61;49 and 44 yrs respectively. Among 95 ulcer patients, 67.4% were NSAID user and 32.6% were non users, the prevalence of Hp among NSAID users and non users were 20.3% and 81.7% respectively (p&lt;0.01).Among 163 non ulcer patients 36.8% were NSAID users and 63.2% were non users, the prevalence of Hp among NSAID users and non users were 33.1% and 60.2% respectively (p&lt;0.05). Ninety percent of 50 GU patients were NSAID users, the prevalence of Hp among them was 11.1%. The prevalence of Hp among GU patients who didnít use NSAID was 4/5(80%). Among 40 patients with DU,35% were NSAID users and 65% were non users, the prevalence of Hp among users and non users were 42.9% and 92.3% respectively (p&lt;0.01). All patients with GU+DU were NSAID users, 40% of them had Hp positive.Conclusion:The prevalence of Hp among NSAID users was lower than non users. In NSAID users group who had ulcer the prevalence of Hp was lower than those who had non ulcer. This finding support that Hp infection may not increase the risk of ulcer in patient who use NSAID.

Prevalence and risk factors of Helicobacter pylori-negative peptic ulcer: a multicenter study.

Peptic ulcer disease (PUD) has been described in the absence of Helicobacter pylori (Hp) infection, suggesting that different factors are involved in its etiopathogenesis. We investigated prevalence and characteristics of Hp-negative (Hp-) PUD in an area of Northern Italy and calculated the rate of Hp-positive (Hp+) patients with PUD in whom Hp might be coincidental and not causal. Four hundred nine consecutive patients with endoscopically diagnosed PUD were enrolled in seven hospitals. Hp infection was assessed by rapid urease test and histologic examination. The attributable risk percentages in different age groups were calculated by appropriate formulas. Of 409 patients, 31 (7.6%) were Hp- (gastric, 8.3%; duodenal, 7.6%). Age, nonsteroidal antiinflammatory drug (NSAID) consumption, and complication rates were significantly higher in Hp-than Hp+ patients with duodenal ulcers (DUs). Of the Hp-patients with DU, 58% did not use NSAIDs. In patients with Hp+ DU, the attributable risk percentage for Hp infection in patients aged <40 years, 40-60 years, or >60 years was 98%, 88%, and 66%, respectively. The prevalence of Hp- PUD was about 8%, mainly unrelated to any known etiologic factor. In about one-third of Hp+ patients with PUD aged over 60 years, Hp infection might be coincidental and not causal.

Higher male prevalence of Helicobacter pylori associated hypertrophic gastritis is explained by tobacco and alcohol use

Background: Radiographically detected gastric fold thickening (RGFf) is seen with Helicobacter pylori (Hp) associated hypertrophic gastritis (HpHG). Our recent data showed a higher male prevalence of RGFf in a cohort of Japanese nationals undergoing radiographic gastric cancer screening. Despite the equal prevalence of Hp in both genders, a male predominance is also observed with other Hp associated diseases including gastric cancer. These observations remain unexplained. Purpose: To evaluate a cohort of 323 Japanese nationals who underwent radiographic gastric cancer screening and determine if gender remains an independent risk factor of RGFf as a marker of HpHG. Methods: A previously compiled database of 323 adult Japanese nationals who underwent radiographic gastric cancer screening from 8/93 to 6/97 at a university affiliated clinic in Atlanta, Georgia provided the materials for this study. All patients completed questionnaires and were examined by a bilingual internist prior to radiographic examinations. 41 patients with RGFf were selected as cases. 260 patients who had normal radiographs were selected as controls. The remaining 22 patients with other radiographic abnormalities were excluded from the analysis. Univariate analysis of potential risk factors of RGFf (age, gender, tobacco use, alcohol use, non-steroidal antiinflammatory drug use, history of peptic ulcer disease, and family history of gastric cancer) was conducted. Variables remaining significant (P-values less than 0.05) were further evaluated by multivariate analysis using SAS statistical software. Results: Four variables, male gender (OR=3.38, p=0.002), history of peptic ulcer disease (OR=2.9I, p=0.Ol5), past or present smoking (OR=3.97, p=0.00004), and drinking (> Ig of alcohol! d)(OR=3.85, p=O.OOI) were significant by univariate analysis. Only smoking (aOR=3.01, p=0.013) and drinking (aOR=2.03, p=O.OO04) remained significant by multivariate analysis. Cummulative effects of tobacco and alocohol use (aOR =6.11) were seen in those who smoked and drank compared with those who did neither. No independent risk remained for gender (aOR= 1.03, p=0.95) when controlling for smoking and dringking. Conclusions: I. The gender associated risk of HpHG as represented by RGFf is entirely accounted for by the effects of tobacco and alcohol use. 2. Male predominance of other Hp associated gastric diseases including gastric cancer may be explained by the effects of tobacco and alcohol use.

Prevalencia de la infección por Helicobacter pylori en atención primaria de salud

To find the prevalence of Helicobacter pylori (Hp) infection in the population as a whole. To assess its relationship with the associated factors described in other studies. Transversal study of an urban population of 20,000. Between 14 and 80 years old. Randomised sampling of the computerised records (640 clinical histories). Necessary sample n = 384 (alpha = 0.05, prior prevalence = 50%, precision 0.05). Breath test with urea marked (13C), age, sex, alcohol and tobacco consumption, social class and dyspepsia and/or gastro-duodenal pathology. 123 exclusions. 122 losses (23%). 397 people screened, 43.6% male. Average age: 42.6. 41.6% consumed alcohol. 30.5% smoked. Prevalence of dyspepsia, gastritis, gastric ulcer and duodenal ulcer, 14%, 2.8%, 2.8% and 2.0%, respectively. Hp prevalence: 56.1% (95% CI, 51.2-60.1). There were no significant differences between prevalence of Hp+ and sex, dyspepsia, peptic ulcer history, gastritis, alcohol consumption and tobacco consumption. Greatest prevalence of Hp+ in over-70s (73%). Significant linear tendency between presence of Hp+ and age (p < 0.05) and low social class (p < 0.05). The logistic regression analysis found a statistically significant relationship only between the presence of H. pylori and age and social class. Prevalence was similar to that in other studies. The relationship between low social class and age and greater Hp prevalence was confirmed. Dyspepsia is not a justification for empirical treatment of Hp. Patients with and without the infection must be followed to evaluate morbidity longitudinally.

The role of autonomic neuropathy as a risk factor of Helicobacter pylori infection in dyspeptic patients with Type 2 diabetes mellitus

A high prevalence of upper gastrointestinal symptoms is described in diabetic patients and, at least in part, this has been attributed to abnormal emptying of the stomach. In an unselected small series of dyspeptic patients with Type 2 diabetes mellitus (DM2), we previously described a higher prevalence of Helicobacter pylori ( Hp) infection associated with autonomic neuropathy (AN) than in non-diabetic subjects. To evaluate the prevalence of Hp and its relationship with AN, we studied 164 DM2 patients, matched for sex, age (±5 years) and body weight (±kg) to 164 non-diabetic subjects, all affected with dyspepsia of unknown origin. Results document that the prevalence of peptic ulcer is similar in both groups of patients (20.1 vs 29.3%, P=n.s.); chronic gastritis was 50% in the control group and 35.4% in the DN2 group ( P<0.01) and dyspepsia without ulcer and gastritis (simple dyspepsia) was significantly more frequent in DM2 patients than in non-diabetics (44.5 vs 20.7%, P<0.01). Hp infection was documented by histology of gastrointestinal mucosa in 74.4% of the DM2 patients and in 50% of the controls ( P<0.01) (ulcer: 97 vs 71%, P<0.05; gastritis: 72 vs 43.5%, P<0.05; simple dyspepsia: 66 vs 35%, P<0.01, respectively). Autonomic neuropathy was found in 65.2% of the DM2 patients (90.9% of patients with ulcer, 65.5% with gastritis and 53.4% with simple dyspepsia). A significant concordance (84.7%, P<0.001) was found between the presence of AN and Hp infection. Data provide, for the first time, direct evidence for a higher frequency of Hp infection in dyspeptic patients affected with DM2 than in non-diabetic subjects. In addition, in diabetic patients the frequency of non-ulcer, non-gastritis dyspepsia is two times higher than in non-diabetics and is strictly associated with autonomic neuropathy, acting as a favoring factor for occurrence and recurrence of gastrointestinal disease.

PREVALENCE OF HELICOBACTER PYLORI (HP) IN SIDS/NON- SIDS AUTOPSIES

A preliminary study showed HP in 6/7 SIDS infants (Gastroenterol 1997; 112:A254). Because of the potential importance of this association, additional SIDS cases and controls were evaluated for presence of HP in a multicenter study. METHODS: Consecutive autopsies from SIDS and non-SIDS deaths between 1 and 6 months old performed in 3 different cities were included. Tissue from gastric antrum and trachea from each infant was examined by H&E (inflammation) and Steiner (HP) stains by a single experienced pathologist. RESULTS: Of 33 SIDS cases, HP was found in the antrum of 15 (45.5%), trachea of 17 (51.5%), and either antrum or trachea in 20 (60.6%). Of controls, 2 of 6 (33%) had HP in both antrum and trachea while the other 4 were negative. CONCLUSIONS:HP infection appears to be more frequent in SIDS infants than in non-SIDS controls, although statistical significance was not achieved. The prevalence of HP in both groups is alarming related to potential long term sequelae and transmission of infection within families and day care centers. Further studies are indicated to explore a possible relationship of HP in the pathophysiology of SIDS; specifically, confirmation of bacteria as HP with monoclonal antibody and/or PCR will be important, as will additional case-control comparison. Grant from the Jack H. Hill Continuing Medical Education Foundation.

Helicobacter pylori infection in haemodialysis patients and renal transplant recipients.

It is known that Helicobacter pylori (Hp) plays an important role in gastritis and peptic ulcer disease in the general population. Although dyspeptic complaints are frequent in haemodialysis (HD) patients and renal transplant recipients, there are few reports regarding the prevalence of Hp and its possible effects on this group of patients. This study was performed to examine the prevalence of Hp infection in patients on regular HD treatment and to detect its role in the pathogenesis of dyspepsia in this group of patients. Two hundred and one patients with dyspeptic complaints were included in the study. The groups consisted of 47 HD, 54 renal transplant recipients, and 100 non-renal disease patients. Upper gastro-intestinal endoscopies were performed and gastric antral biopsies were obtained for urease test in all patients. Twenty-eight (60%) of the 47 HD and 38 (70%) of the 54 RTR were positive for Hp. Sixty-four (64%) of the 100 patients with various gastrointestinal complaints and known to have no renal dysfunction were positive for Hp. The Hp prevalences among the three groups were not significantly different (P > 0.05). The prevalence of Hp infection did not correlate with the haemodialysis duration nor the post-transplantation duration (P > 0.05). There was no correlation between the prevalence of Hp infection and duration of haemodialysis therapy or time post-transplantation. These findings suggest that HD patients are not protected against Hp infection as the Hp prevalences are as high as that for the non-renal disease group. The increased dyspeptic complaints may be partly related to Hp infection.

Helicobacter Pylori, Active Chronic Antral Gastritis, and Gastrointestinal Symptoms in Alcoholics

The frequency of Helocobacter pylori (Hp.) infection and active chronic antral gastritis among people with excessive alcohol consumption is not known. A high alcohol intake regularly causes acute gastroduodenitis. In this study, the prevalence of Hp. infection and active chronic antral gastritis in alcoholics compared with nonalcoholic controls was studied. Further, the frequency of gastrointestinal symptoms was registered. Diagnostic methods for Hp. were compared. Twenty-four alcoholics admitted to the hospital for detoxification underwent upper gastrointestinal endoscopy regardless of symptoms. Twelve individuals admitted to upper endoscopy mainly for dyspepsia, with low alcohol consumption and without gross pathology by upper endoscopy, were chosen as controls. Three diagnostic methods for Hp. were used: culture, direct microscopy, and histology. Hp. infection was found in 7 of the 24 alcoholics (29%) according to culture. In controls, 4 of 12 (33%) had a positive Hp. culture. In the alcoholic group, culture was more sensitive than histology. There was a good correlation between the different diagnostic methods in the control group. Histologically active chronic antral gastritis was found in 6 of the alcoholics (25%) and in 5 of the controls (42%). Five of the 7 Hp.-positive alcoholics and all of the Hp.-positive controls had an active chronic antral gastritis. Hp. infection is not more frequent in alcoholics than in controls. In both groups, there was a good correlation between Hp. infection and histologically, active chronic antral gastritis.