Pylori In Patients Research Articles

Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori (H. pylori ) is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. H. pylori infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of H. pylori in the development of cholelithiasis remains inconclusive. AIM To investigate the potential association between H. pylori infection and the development of cholelithiasis. METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between H. pylori and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of H. pylori on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about H. pylori and cholelithiasis was also executed. RESULTS In our multi-center study, H. pylori was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, P = 0.049]. Furthermore, H. pylori patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in H. pylori -positive participants (P < 0.05). In the published articles, the cohort studies indicated H. pylori was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, P < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between H. pylori and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, P = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, P = 0.246). Besides, H. pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, P = 0.033). CONCLUSION H. pylori is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in H. pylori patients.

Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori (H. pylori ) is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. H. pylori infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of H. pylori in the development of cholelithiasis remains inconclusive. AIM To investigate the potential association between H. pylori infection and the development of cholelithiasis. METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between H. pylori and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of H. pylori on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about H. pylori and cholelithiasis was also executed. RESULTS In our multi-center study, H. pylori was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, P = 0.049]. Furthermore, H. pylori patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in H. pylori -positive participants (P < 0.05). In the published articles, the cohort studies indicated H. pylori was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, P < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between H. pylori and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, P = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, P = 0.246). Besides, H. pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, P = 0.033). CONCLUSION H. pylori is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in H. pylori patients.

Association Between Rapid Urease Test For H. Pylori Incidence And Non-Ulcer Dyspepsia In Bangladeshi Patients

Introduction: Dyspepsia is a fairly common group of symptoms including epigastric pain, epigastric burning, postprandial fullness, early satiation, bloating in the upper abdomen, nausea, vomiting and belching. Interestingly the majority of them are found to have no ulcer, and they are termed as non-ulcer dyspepsia (NUD). However. Different studies worldwide have found there is an association between H. Pylori infection and NUD. Objective: To evaluate the infection rates of H. pylori in patients, presenting with dyspepsia without any evidence of ulcer on endoscopy. Materials and methods: This cross-sectional study was conducted from June, 2022 to December, 2022. The study included 100 patients (46 males and 54 females) with NUD and recruited by convenient sampling method. Result: In the study, the prevalence of H. pylori infection in patients with NUD is 53% on the basis of (Rapid urease test) RUT. Gender-based prevalence was found to be 53.7% and 52.17% for women and men, respectively. The highest prevalence rate was found in the age group of 25-34 years. The prevalence of H. pylori infection was slightly higher for urban people. Conclusion: H.Pylori infection can be easily identified by RUT. The study has found significant correlation of H. pylori infection with NUD by using RUT. J Dhaka Med Coll. 2023; 32(1) : 4-8

The potential role of Helicobacter pylori in chronic rhinosinusitis with or without nasal polyposis

BackgroundCertain gastrointestinal and extra-intestinal diseases are caused by the gram-negative bacterium Helicobacter pylori (H. pylori). We aimed to determine the potential H. pylori role in chronic rhinosinusitis (CRS) with or without nasal polyposis. This cross-sectional study was conducted on 80 subjects of any age and sex diagnosed with CRS (CRSWNP and CRSSNP) who had failed medical treatment and scheduled for surgery. Patients were further categorised into two equal groups: study group (n = 40) were diagnosed with CRS with or without nasal polyposis (CRSWNP and CRSSNP) who had failed medical treatment and scheduled for surgery, and control group (40 patients) were admitted for septoplasty. All patients had clinical assessment, physical assessment, diagnosis of rhinosinusitis (according to EPOS), based on symptoms, rhinoscopic/endoscopic findings, CT scan findings, questionnaire for gastroesophageal reflux disease (GERD), and questionnaire for laryngopharyngeal reflux (LPR). Samples were collected in the operating room during surgery from both groups and PCR tissue was done.ResultsThe study group patients demonstrated significantly higher history of GERD, LPR, and H. pylori. H. pylori patients had significantly lower ages than those without (P = 0.03). Patients with H. pylori revealed significantly higher GERD history (P < 0.001) and LPR (P = 0.002) than those without H. pylori. History of GERD (P = 0.003), LPR (P = 0.043), and H. pylori presence (P = 0.028) were significant predictors, controlling for the abovementioned variables.ConclusionsWe concluded that a significant correlation was observed between the H. pylori presence in the sinonasal mucosa and nasal polyps and the development of chronic rhinosinusitis with or without nasal polyps.

Efficacy of Bismuth Therapy in Eradicating Helicobacter pylori in Children-Data From the RENIHp Registry.

To evaluate the efficacy of colloidal bismuth subcitrate (CBS) therapy for the eradication of H. pylori in patients from a national pediatric registry of H. pylori infection. The Spanish Registry of Children with H. pylori Infection (RENIHp) is a national, multi-center, prospective, non-interventional registry that includes children aged 5-18 years with H. pylori infection diagnosed by endoscopy. All patients in the registry who were treated with CBS between the period 2020 and 2023 were included in this study. The primary outcome was the eradication rate, which was assessed using a 13C-urea breath test or monoclonal antigen in the stool 6-8 weeks post-treatment. The registry included 682 patients, 38 (5.6%) of whom underwent treatment with CBS. Fifty percent (19/38) of patients had previously undergone unsuccessful eradication treatment. In 78.9% (30/38) of patients, treatment was guided by an antibiotic sensitivity test. In the remaining patients, an empirical approach was employed. The CBS therapies used were as follows: quadruple therapy with proton pump inhibitors (PPIs), CBS, amoxicillin, and metronidazole (MET) [18/38 (47.3%)]; quadruple therapy with PPIs, CBS, tetracycline, and MET [13/38 (34.2%)]; and other therapies [7/38 (18.4%)]. Thirty-two patients (84.2%) treated with CBS were followed-up with eradication monitoring. The overall eradication rate in patients treated with CBS was 93.8% (30/32, [95% CI: 85.4%-100%]), whereas it was 86.7% in patients in the registry who were not on CBS treatment (430/496, [95% CI: 83.3%-89.5%], p = 0.208). In the six patients with dual resistance to clarithromycin (CLA) and MET who were treated with quadruple therapy with CBS, the eradication rate was 100% (n = 6/6, [95% CI: 61.0%-100%]). CBS therapies in our registry, although only used in selected cases and at lower than recommended levels, were very effective and showed an eradication rate of > 90%.

Prevalence of Helicobacter pylori in routine adult tonsillectomies

ABSTRACT Helicobacter pylori, a curved bacterial rod and causative agent of peptic ulcer and gastric adenocarcinoma, is found as an infectious agent in the stomach of over half of the global population. H. pylori has been identified in oral biofilms and its presence in adenotonsillar tissues has been suggested, with variations in testing methodology both proving and disproving its presence. The current study employed 119 formalin-fixed paraffin-embedded tonsillar tissues from an adult population (n=86) in a major metropolitan city with immunohistochemistry procedures using a monoclonal antibody to determine the incidence of H. pylori in the tonsils. H. pylori was identified in 72.1% of the patients and was associated with Actinomyces spp. in 92.0% of those cases. The high incidence of H. pylori in patients undergoing tonsillectomy suggests that H. pylori may be a contributing factor for tonsillitis and tonsillar hypertrophy. Furthermore, the reservoir for H. pylori in the tonsils may explain why some persons remain refractory to antibiotic treatment for gastric H. pylori.

Curative Effect of Helicobacter Pylori Radical Treatment on Gastric Cancer Patients with Helicobacter Pylori Infection

To explore the role and value of radical treatment of Helicobacter pylori in patients with gastric cancer complicated with Helicobacter pylori infection. Methods: From January 2022 to January 2023, 152 patients with gastric cancer complicated with Helicobacter pylori infection who were treated in our hospital were included in this study by random number table method. According to whether each patient received radical treatment based on Helicobacter pylori infection while receiving chemotherapy treatment, they were divided into the control group of single chemotherapy treatment and the observation group of combined radical treatment of Helicobacter pylori. The difference of treatment indexes between the two groups was analyzed. Results: The effective rate of treatment in the observation group was 88.16%, the total adverse reaction rate was 39.47%, and the treatment satisfaction rate was 93.42%; The effective rate of treatment in the control group was 78.95%, the total adverse reaction rate was 68.42%, and the treatment satisfaction rate was 82.89%. The difference was statistically significant (P&lt;0.05). Conclusion: For patients with gastric cancer complicated with Helicobacter pylori infection, while receiving chemotherapy for gastric cancer, radical treatment for Helicobacter pylori can significantly improve the effective rate of clinical symptom relief of disease treatment, reduce the incidence of adverse reactions during various treatments, and improve the overall satisfaction of patients and their families with treatment.

Efficacy and Safety of Vonoprazan-Based Quadruple Therapy for the Eradication of Helicobacter pylori in Patients with Peptic Ulcers: A Pooled Analysis of Two Randomized, Double-Blind, Double-Dummy, Phase 3 Trials.

Helicobacter pylori eradication is crucial in the treatment of peptic ulcers caused by H. pylori infection, a disease highly prevalent in Asia. We present a pooled analysis of two randomized, double-blind, double-dummy, phase 3 studies evaluating the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy for H. pylori eradication. Patients aged ≥18 years with endoscopically confirmed duodenal or gastric ulcers were randomized 1 : 1 to receive vonoprazan 20 mg or lansoprazole 30 mg once daily for up to 6 (duodenal ulcers) or 8 weeks (gastric ulcers). H. pylori-positive patients received vonoprazan- or lansoprazole-based bismuth-containing quadruple therapy for the first 2 weeks. H. pylori eradication was determined using the carbon-13 urea breath test at a follow-up visit 4 weeks post-treatment. The H. pylori eradication rate was 90.6% with vonoprazan vs. 85.2% with lansoprazole (difference: 5.4%; 95% confidence interval (CI): -0.1, 10.8). H. pylori eradication rates were 7.1% (95% CI: 1.4, 12.8) and 12.6% (95% CI: 3.9, 22.0) higher in patients aged <65 years and current smokers, respectively, with vonoprazan vs. lansoprazole. In the Chinese subpopulation, the H. pylori eradication rate was 92.0% with vonoprazan vs. 86.0% with lansoprazole (difference: 6.1%; 95% CI: 0.5, 11.7). Treatment-emergent adverse events occurred in 72.7 vs. 62.6% of H. pylori-positive patients at baseline in the vonoprazan vs. lansoprazole arm. H. pylori eradication with vonoprazan-based quadruple therapy was noninferior to lansoprazole-based quadruple therapy and exceeded 90%, a clinically relevant threshold for determining the efficacy of H. pylori eradication regimens (ClinicalTrials.gov identifier: NCT03050359; NCT03050307).

Antimicrobial resistance pattern of Helicobacter pylori in patients evaluated for dyspeptic symptoms in North-Eastern India with focus on detection of clarithromycin resistance conferring point mutations A2143G and A2142G within bacterial 23S rRNA gene

PurposeIn India there is evidence of antimicrobial resistance in Helicobacter pylori, a definitive pathobiont whose only known niche is human gastric mucosa. This in turn can lead to failure of treatment, persistence or chronicity of infection. This hospital based, prospective, observational study investigates the presence of antimicrobial resistance in the organism with focus on detection of A2143G and A2142G major point mutations in domain V of H. pylori 23S rRNA gene as a molecular mechanism of conferring resistance. MethodsEndoscopic gastric biopsy samples from 52 patients presenting with dyspeptic symptoms from January 2016 to December 2016 were subjected to culture in a microaerophilic environment using Campylobacter agar with for 2–5 days. Isolates were identified using gram-staining, motility test and biochemical reactions. Modified Kirby-Bauer Disc diffusion method was used to determine antimicrobial susceptibility against Clarithromycin, Metronidazole, Amoxycillin, Levofloxacin, Tetracycline, Cotrimoxazole and Erythromycin. Additionally, detection of A2143G and A2142G point mutations conferring Clarithromycin resistance was carried out using real time PCR following extraction and quantification of bacterial DNA. Histopathological examination was carried out on all biopsy samples. Descriptive and inferential statistical analytical methods were used. Differences were considered significant for p < 0.05. ResultsCulture positivity for H. pylori by phenotypic method was found to be 36.54%. Histopathologic Examination detected H. pylori in 55.7% and PCR detected 48.08% for either the wild type or one of two mutant strains A2143G and A2142G. No sample was found positive for both mutations. Metronidazole showed the highest resistance among antibiotics (78.9%) followed by Clarithromycin (47.3%). ConclusionPrevalence of antimicrobial resistance in H. pylori in North-Eastern India is substantially high with A2143G mutation being clinically most important in conferring Clarithromycin resistance. This resistance might be associated with low eradication rates despite initiation of therapy. ROC analysis of PCR proved it to be a good diagnostic tool.

Pathohistological Changes in the Gastric Mucosa in Correlation with the Immunohistochemically Detected Spiral and Coccoid Forms of Helicobacter pylori.

The coccoid form of Helicobacter pylori (H. pylori) is resistant to antibiotics. There are only a few studies that have analyzed the frequency of coccoid H. pylori in patients with gastritis. The aim of this work was to examine the correlation between the H. pylori form and the pathohistological characteristics of the stomach in patients with gastritis. This research was cross-sectional and focused on the gastric mucosa samples of 397 patients from one general hospital in Croatia. Two independent pathologists analyzed the samples regarding the pathohistological characteristics and the form of H. pylori. There was a statistically significant difference in the gender of patients with H. pylori gastritis. Only the coccoid form of H. pylori was present in 9.6% of patients. There was a statistically significant difference in the frequency of a certain form of the bacterium depending on its localization in the stomach. The intensity of the bacterium was low in the samples where only the coccoid or spiral form was described. In cases of infection in the antrum, premalignant lesions and the coccoid form of H. pylori were more often present. In the diagnosis of H. pylori infection, the determination of the form of the bacterium via immunohistochemistry should be included to increase the rate of eradication therapy and reduce the incidence of gastric malignancy.

Vitamin B12 Deficiency among Cases of Helicobacter Pylori Gastritis: A Cross Sectional Study

Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium associated with various gastrointestinal diseases, including peptic ulcer disease, gastric cancer, and vitamin B12 deficiency. Recent research has highlighted a potential link between chronic H. pylori infection and significant malabsorption of vitamin B12, particularly in populations with high prevalence rates of infection. Objective: This study aims to investigate the frequency of vitamin B12 deficiency among patients with H. pylori gastritis and to explore the association between H. pylori infection and vitamin B12 levels. Methods: A cross-sectional study was conducted from September 2023 to March 2024 at the Department of Medicine, Ayub Teaching Hospital, Abbottabad. A total of 120 patients presenting with symptoms of gastritis were enrolled after obtaining ethical approval from the hospital’s review board. Exclusion criteria included patients already on vitamin B12 supplementation. Diagnostic testing for H. pylori was performed using stool antigen tests, and vitamin B12 levels were assessed through serum measurements. Data analysis was conducted using IBM SPSS Statistics version 23, with the Chi Square test applied to examine the association between H. pylori infection and vitamin B12 deficiency, setting the level of significance at p ≤ 0.05. Results: Out of the 120 patients studied, 49 (40.8%) tested positive for H. pylori. Vitamin B12 deficiency was observed in 35 (29.2%) patients. Among those infected with H. pylori, 51.0% (25 patients) also had vitamin B12 deficiency, compared to 14.1% (10 patients) among those not infected (p = 0.0001). Conclusion: The findings indicate a significant association between H. pylori infection and vitamin B12 deficiency. This study suggests that H. pylori is a potential risk factor for vitamin B12 deficiency, underscoring the need for screening and appropriate management of H. pylori in patients presenting with vitamin B12 deficiency.

Helicobacter pylori Secondary Antibiotic Resistance after One or More Eradication Failure: A Genotypic Stool Analysis Study.

Helicobacter pylori (H. pylori) antibiotic resistance is the leading cause for unsuccessful eradication therapy. After one or more failures, the chance of encountering secondary antibiotic resistance increases. The aim of this study was to characterize genotypic secondary resistance in a cohort of southern Italian H. pylori patients with at least one previous failure. Such patients collected stool samples using a dedicated kit (THD fecal testTM), and bacterial DNA was extracted and amplified using RT-PCR. Resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline was assessed using a high-resolution melting curve. We enrolled 50 patients. A total of 72% of patients failed one previous antibiotic course, 16% failed two, 10% failed three, and 2% failed four. The rate of secondary antibiotic resistance was 16% for clarithromycin, 18% for metronidazole, 14% for amoxicillin, 14% for levofloxacin, and 2% for tetracycline. Among the eight clarithromycin-resistant patients, five (62.5%) previously received a clarithromycin-based regimen. The same rate was 33.3% (3/9) for metronidazole. The only tetracycline-resistant patient had received Pylera. In conclusion, our data seem to show that, even though secondary resistance is not very high, resistance to clarithromycin could be very likely related to previous exposure to this antibiotic.

Role of MIC levels and 23S rRNA mutation sites to clarithromycin in 14-day clarithromycin bismuth quadruple therapy for Helicobacter pylori eradication: A prospective trial in Beijing

BackgroundRising clarithromycin resistance undermines Helicobacter pylori (H. pylori) treatment efficacy. We aimed to determine clarithromycin's minimum inhibitory concentration (MIC) levels and identify specific mutation sites in the 23S ribosomal subunit (23S rRNA) that predict treatment outcomes in a 14-day regimen of clarithromycin bismuth quadruple therapy (amoxicillin 1g, clarithromycin 500 mg, rabeprazole 10 mg, and colloidal bismuth pectin 200 mg). Materials and methodsWe included adult H. pylori patients who hadn't previously undergone clarithromycin-based treatment, either as initial or rescue therapy. Exclusions were made for penicillin allergy, recent use of related medications, severe illnesses, or inability to cooperate. Patients underwent a 14-day clarithromycin bismuth quadruple therapy. Gastric mucosa specimens were obtained during endoscopy before eradication. MIC against amoxicillin and clarithromycin was determined using the E-test method. The receiver operating characteristic (ROC) curve helped to find the optimal clarithromycin resistance MIC breakpoint. Genetic sequences of H. pylori 23S rRNA were identified through Sanger Sequencing. (ChiCTR2200061476) ResultsOut of 196 patients recruited, 92 met the inclusion criteria for the per-protocol (PP) population. The overall intention-to-treat (ITT) eradication rate was 80.00 % (84/105), while the modified intention-to-treat (MITT) and PP eradication rates were 90.32 % (84/93) and 91.30 % (84/92) respectively. No amoxicillin resistance was observed, but clarithromycin resistance rates were 36.19 % (38/105), 35.48 % (33/93), and 34.78 % (33/92) in the ITT, MITT, and PP populations respectively. Compared with the traditional clarithromycin resistance breakpoint of 0.25 μg/mL, a MIC threshold of 12 μg/mL predicted better eradication. Among 173 mutations on 152 sites in the 23S rRNA gene, only the 2143A > G mutation could predict eradication outcomes (p < 0.000). ConclusionsInterpretation of elevated MIC values is crucial in susceptibility testing, rather than a binary "susceptible" or "resistant" classification. The 2143A > G mutation has limited specificity in predicting eradication outcomes, necessitating further investigation into additional mutation sites associated with clarithromycin resistance.

The Efficacy of Paraprobiotic, Probiotic, and Mineral Supplementation on the Eradication Rate of Helicobacter pylori in Patients with Dyspepsia: A Randomized Clinical Trial

Background. Helicobacter pylori (H. pylori) eradication regimens have been a concern, all along. Our study is aimed at assessing the effect of para- and probiotics plus minerals (Pyloshot) on H. pylori eradication rate. Methods. In this open-label randomized trial, 69 eligible adult patients with naïve H. pylori infection-related dyspepsia were randomly assigned into the group A, who received esomeprazole 40 mg BID, amoxicillin 1000 mg BID, and clarithromycin 500 mg BID, and group B with the same regimen plus one Pyloshot capsule BID for 10 days. Demographics and dyspepsia symptom severity scores (SSS), number needed to treat (NNT), dyspepsia SSS, and drug adverse effects were recorded at baseline and the end of treatment. H. pylori eradication was confirmed via 14C UBT eight weeks later. Results. Sixty-six patients completed the study. The intention-to-treat (ITT) and per-protocol (PP) eradication rates were slightly better in group B (85.2% vs. 80%, p=0.562, and 87.8% vs. 84.8%, p=0.720, respectively). Adverse effects were significantly lower in group B (20.6% vs. 54.3%; p=0.004). No significant differences in dyspepsia symptom improvement rates (p=0.255) and mean difference of SSS (p=0.231) were found between treatment groups. NNT for overall dyspepsia and epigastric pain syndrome (EPS) was 11 and 5 at the end of treatment, respectively. Conclusion. Adding Pyloshot to the H. pylori regimen could slightly improve the eradication rate and SSS of dyspepsia. NNT was considerably better among EPS patients. Adverse effects were significantly decreased by this regimen. Further trials with larger sample sizes should be thought out. This trial is registered with IRCT20141201020178N10.

Evaluation of the Inflammatory Response After Eradication of Helicobacter pylori in Patients With Familial Mediterranean Fever.

Evaluation of the inflammatory response after Helicobacter pylori (Hp) eradication in patients with Familial Mediterranean Fever (FMF) during the non-attack period and determining whether there is a change in the ongoing inflammation during the non-attack period. Sixty-four patients, who have not been eradicated for Hp in the last 2 years, diagnosed with FMF, and evaluated in the non-attack period, were included in the study. Hp eradication therapy was administered to patients who were found to be Hp-positive. C-reactive protein (CRP), high-sensitive C-reactive protein (hs-CRP), interleukin-6, interleukin-8, tumor necrosis factor-alpha, and serum amyloid A values were compared between the groups before and after eradication. CRP and hs-CRP levels were found to be statistically higher in the FMF group than in the control group. A statistically significant decrease was found in the values of CRP and hs-CRP, in the number of patients with attacks, and in attack frequency after eradication in the Infected Patients compared to the values before eradication. We determined a decrease in CRP and hs-CRP values, the number of patients with attacks, and attack frequency with the eradication of Infected Patients. In patients with FMF, in whom it has been proven by different studies that the inflammation continues during the non-attack period, it may be recommended to investigate the presence of Hp infection, which is thought to contribute to this inflammation and to give Hp eradication therapy to patients who are found positive to reduce the development of secondary complications caused by chronic inflammation.

Analysis of Helicobacter pylori resistance in patients with different gastric diseases

Helicobacter pylori (H. pylori) resistance is the most important risk factor for eradication failure. However, in most regions, antibiotic resistance rates of H. pylori in patients with different types of gastric mucosal lesions are still unclear. An 8-year clinical retrospective cohort study involving 2847 patients was performed. In this study, we first summarized and compared the resistance status of H. pylori in different years, ages, sexes, and gastric diseases. The resistance profiles of amoxicillin (AMX), clarithromycin (CLR), levofloxacin (LVX) and furazolidone (FR) and their changing trends in the clinic were described. Then, multiple antibiotic resistance in different gastric diseases and years were described and compared. The relationship between proton pump inhibitor (PPI) medication history and antibiotic resistance in H. pylori was also explored. Finally, an antibiotic resistance risk model was constructed for clinical resistance risk prediction. The overall resistance rates of AMX, CLR, LVX and FR in gastric diseases were 8.18%, 38.11%, 43.98%, and 13.73%, respectively. The mono resistance, double resistance, triple resistance, and quadruple resistance rates were 30.17%, 25.96%, 6.46%, and 0.63%, respectively. Compared with the period from 2014 to 2016, the rates of mono-resistance and multiple resistance all showed relatively downward trends in the past 5 years. Factors including age, sex, type of gastric lesions and recent PPI treatment history are associated with the antibiotic resistance rate of H. pylori. Atrophic gastritis is an important clinical feature of high-risk antibiotic resistance in H. pylori-infected patients. Patients with atrophic gastritis have higher risk of resistant strains infection. In this study, our data provide the association between antibiotic resistance of H. pylori and gastritis pattern, which indicate the higher risk of resistant strain infection if the patients with atrophic gastritis, PPI history and older age.

Helicobacter pylori infection diagnosis and management: current practices of Greek gastroenterologists.

The diagnosis and management of Helicobacter pylori (H. pylori) infection vary significantly, depending on country, area, and specialty. The aim of this study was to record the current practices of Greek gastroenterologists in the screening and treatment of H. pylori infection. An anonymous questionnaire consisting of 19 questions about the management of H. pylori infection was sent with the aid of the Hellenic Society of Gastroenterology to all members of the Society. The questionnaire was completed by 180 gastroenterologists, with a response rate of 31.4%. Diagnostic tests to confirm H. pylori infection are ordered by >90% of the gastroenterologists for patients with current peptic ulcer disease, gastric lymphoma, family history of gastric cancer, and an endoscopic appearance suggestive of gastritis. Most gastroenterologists (55.8%) also tested for H. pylori in patients with gastroesophageal reflux disease (GERD). Histopathology was the most preferred (60.6%) method when testing was decided during endoscopy, while urea breath test was the most preferred method (67.8%) regardless of endoscopy. Most gastroenterologists use quadruple eradication regimens supported by international guidelines (90%), while 65.6% of the physicians answered that they systematically recommend the addition of probiotics to standard therapy. Most physicians (82.8%) answered that they always confirm the eradication of the pathogen. The majority of Greek gastroenterologists conform to the recommendations of international guidelines regarding the diagnosis and management of H. pylori infection, except for the screening of patients with GERD. A considerable number of doctors use probiotics in addition to standard therapy.

Clinical Study on the Eradication of Helicobacter pylori by Vonoprazan Combined with Amoxicillin for 10-Day Dual Therapy.

Vonoprazan holds significant research promise for Helicobacter pylori eradication, with the goal of determining the most effective drug regimen. In this study, H. pylori patients (426) were enrolled and randomized into 3 groups: an EA14 group (20mg of esomeprazole qidand 1000mg of amoxicillin tid for 14 days), a VA14 group (20mg of vonoprazan bid and 750mg of amoxicillin qid for 14 days), and a VA10 group (20mg of vonoprazan bid and 1000mg of amoxicillin tid for 10 days). Key outcomes encompassed the H. pylori eradication rate, patient adverse effects, and compliance. In the EA14, VA14, and VA10 groups, H. pylori eradication rates were 89.4%, 90.1%, and 88.7% in intention-to-treat analysis, and 94.2%, 94.4%, and 94.6% in per-protocol analysis, respectively. Adverse events incidences were 14.8%, 12.7%, and 5.6%, while compliance rates were 88.7%, 90.9%, and 95.8%, respectively. Notably, the VA10 regimen demonstrated comparable H. pylori eradication rates, adverse effect incidences, and compliance levels to the EA14 and VA14 regimens.

The Effect of 131I Therapy on the Eradication of Helicobacter pylori in Patients with Thyroid Disorders: A Preliminary Study.

The leading cause of gastritis and its complications is Helicobacter pylori Radioactive iodine (131I) accumulates significantly in the stomach after consumption. On this basis, we decided to determine whether different doses of 131I in the stomach would be effective in eradicating the infection. Methods: All patients with hyperthyroidism or differentiated thyroid carcinoma who were referred for 131I treatment were invited to the study. A stool antigen test was conducted before consumption of 131I (0.15-5.5 GBq) and was repeated 2 mo later to detect H. pylori infection. Results: H. pylori positivity was found in 51.8% (14/27) of the patients. At 2 mo after treatment, 13 of the 14 patients with differentiated thyroid carcinoma or hyperthyroidism who had been identified as positive for H. pylori stool antigen before 131I administration were still positive, representing a nonsignificant eradication rate of 7.1%. Conclusion: Administration of 131I to patients with H. pylori did not show potential to eliminate the infection.

Identifying and Isolating of H. pylori in patients who are experiencing Inflammation in their Gastrointestinal tract

Background: Peptic ulcer illness, stomach cancer and chronic gastritis are gastro-duodenal diseases that are mostly caused by Helicobacter pylori, or H. pylori. Objective: To find out how common Helicobacter pylori infection is among patients at Al Sadder Teaching Hospital in Al-Najaf, Iraq, as well as related factors including age, gender, residency, and blood group. Methods: The entirety of 197 patients—79 men and 118 women—of both genders and various age groups—from under 10 to around 60 years old—were reported to have symptoms of gastrointestinal inflammation. Result: The total numbers of participants in the current study were 197 patients, found 156 (79.2%) positive and 41(20.8%) negative results. Females had a greatest percentage of H. pylori (47.2%), while males had the lowest incidence of prevalence (32%). The age group (31-40) had greatest percentage with (14.7%), followed by the age group (41-50) with (13.2%), and then the age group (21-30) with (11.7%) while lowest percentages in age groups &lt; 10 and ˃ 60 years old. The blood group type O, which had the greatest positive rate (27.9%), was followed by the blood groups types A, B, and AB, with 16.8%, 13.7%, and 4.1%, respectively. People who live in rural areas (30.4%) have a elevated frequency of H. pylori infection when compared with persons who reside in urban areas (28.4%). Conclusion: The findings showed that H. pylori was more frequent in women than men, in rural areas, and in patients between the ages of 31 and 40. Additionally, individuals with the O blood group had higher H. pylori frequency.