Pylori In Patients Research Articles

Correlation between Cryptosporidium parvum and Helicobacter Pylori Infections in Gastrointestinal Patients at Wasit Province

The present study aimed to identify the relationship between Cryptosporidium parvum parasite andHelicobacter pylori in patients at Wasit province and its environs. One hundred stool samples were collected(male and female) from suspected diarrheal patients of parasitic and bacterial infection during the periodOctober 2020 to April 2021 who attended to Al-Karamah Teaching Hospital at Wasit province and GeneralHospital of Martyr Fairuz at Hay district.The investigation of the oocysts of the Cryptosporidium parvum parasite was carried out by staining withModified Ziehl Neelson method and also detecting of Helicobacter pylori by using dipstick. The results ofour study revealed that 55( 55%) was positive for C. parvum and 48 (48%) was positive for Helicobacterpylori and the co- infections between the parasite and bacteria reached to 32( 32%). The age group(1-20years) showed the highest11 (11%) prevalence rate while the lowest prevalence was in patient with agegroup (21-40 years) reached to 6(6%) interplay infections between the parasite and bacteria .

The Affect of Salty Food Intake on the Risk of Helicobacter Pylori Infection among Patients Attending Benghazi Medical Center (A Retrospective Cohort Study)

Human infection by Helicobacter pylori is a great public health hazard because they colonize the stomach of approximately half world’s population. The current work tries to detect and assess the association between salty foods and the prevalence of H. Pylori in Benghazi outpatients who attending Benghazi Medical Centre. It is retrospective cohort study on 293 patients in Benghazi Medical Center Gastroenterological Unit. The study includes all adult patients, a confirmed H. Pylori immunity test, a body weight records, and twenty four dietary recalls. Exclusion criteria; this work does not involve study of peptic ulcer and or any other gastric diseases. (69.7%) of the subjects prefer eating salty foods. (72.2%) of the subjects prefer pickled foods; and (83%) of the subjects prefer canning foods. Age, sex, body mass index, nutritional supplement intake were the variables associated with high salt intake among H. pylori patients. All patients in Benghazi Medical Center should be routinely screened for H. Pylori due to their health and financial consequences. Early nutritional intervention strategies including nutrition education should be implemented with an appropriate follow up.

Correlation of Clinical, Endoscopic, and Pathological Findings among Suspected Peptic Ulcer Disease Patients in Abuja, Nigeria.

Background Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t-test at 95% confidence intervals. Results One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD (p < 0.001) and abnormal endoscopic findings (p < 0.001). No association was found between normal endoscopic findings and histological findings (p = 0.924). Conclusion There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.

Prevalence of Helicobacter Pylori Infection Before and One Year After Classic Gastric Bypass Surgery

Background: The aim of this study was to evaluate the prevalence of H.pylori, before and one year after Roux-en Y gastric bypass surgery. Method: The laparoscopic research center database from 2018 to 2020 was queried to identify patients undergoing laparoscopic Roux-en Y gastric bypass surgery(LRYGB). Retrospectively, the patients were evaluated for the presence of H.pylori infection via endoscopy or H. pylori Stool Ag before and 1 year after the surgery. Results: Among the 106 patients, H.pylori was positive in 50 (47.2%) patients pre-operatively. Based on post-op evaluation among 54 patients, only 4 (7.4%) developed post-op H.pylori infection. Conclusion:. eradicating H. pylori in patients under Roux-en Y gastric bypass surgery remains efficient. So, it is not recommended to re-checked H.pylori Ag in patients after Roux-en Y gastric bypass surgery in the short term; but, further studies are suggested to evaluate the need for re-screening patients for H.pylori Ag in the long term after Roux-en Y gastric bypass surgery Keywords: Helicobacter Pylori; Iran;LRYGB.

Incidence of Helicobacter pylori in patients with upper gastrointestinal symptoms: a hospital-based study

Background: Commonest complaints for which patients seek hospital care are upper gastrointestinal (UGI) symptoms. Prevalence of these symptoms range from 8-54%. Most common cause is Helicobacter pylori. The objective of this study was to investigate incidence of Helicobacter pylori in patients with UGI symptoms.Methods: Hospital-based study was carried out among 200 cases with esophageal disorders, gastric disorders, duodenal disorders, gastro duodenitis. Predesigned and pretested questionnaire was used to record information. Gastric and duodenal biopsy was taken. Rapid antigen test kit was used to identify for Helicobacter pylori. Results: Incidence of Helicobacter pylori was 80%. Most common disorders associated with UGI symptoms were gastritis (29%), gastritis with duodenal ulcer (21%) and esophagitis (21%). They were more common in males except esophageal varices. Gastritis and esophagitis were significantly more in 21-40 years (46.55%) (p&lt;0.05). Most common age of UGI symptoms was 21-40 years (34.5%). H. pylori infection was more among males (62.50%). Most common indication for endoscopy was dyspepsia in 48 (24%).Conclusions: Incidence of H. pylori was 80%. Upper GI diseases are more common in men (65.5%) compared to females (34.5%) with the most affected age group between 21-60 years (68%). H. pylori was the commonest cause of chronic gastroduodenitis in this study.

Increased Reflux Esophagitis after Helicobacter pylori Eradication Therapy in Cases Undergoing Endoscopic Submucosal Dissection for Early Gastric Cancer

Simple SummaryHelicobacter pylori infection is associated with the development of gastric cancer. Reflux esophagitis may occur in the postoperative period of patients undergoing surgical therapy for gastric cancer. The role of eradication therapy of Helicobacter pylori in reflux esophagitis is controversial. Here, we evaluated the occurrence of reflux esophagitis before and after Helicobacter pylori eradication in patients having endoscopic submucosal resection for early gastric cancer. Reflux esophagitis before and after eradication therapy was evaluated during the follow-up. While reflux esophagitis incidence increased from 3.1% to 18.8% in the successful eradication group, no case of reflux esophagitis was observed in the failed eradication group. There was a significant correlation between successful Helicobacter pylori eradication rate and reflux esophagitis development. This study demonstrates that a successful Helicobacter pylori eradication therapy is a risk factor for newly developed reflux esophagitis in patients having endoscopic submucosal dissection for early gastric cancer.Background: The role of Helicobacter pylori in the pathogenesis of reflux esophagitis is controversial. This study investigated the frequency of reflux esophagitis before and after H. pylori eradication in patients having endoscopic submucosal dissection for early gastric cancer. Methods: This study included 160 patients that fulfilled the study’s criteria. Endoscopy was performed before and after H. pylori eradication, and reflux esophagitis was evaluated during the follow-up period. Results: Seropositivity for H. pylori in patients with early gastric cancer was 68.8%, 101 of them received eradication therapy. During the follow-up period, the incidence of reflux esophagitis increased from 3.1% to 18.8% in the successful eradication group but no case of reflux esophagitis was observed in the failed eradication group. The univariate and multivariate analyses showed a significant correlation between successful H. pylori eradication rate and the development of reflux esophagitis. Conclusions: This study demonstrated that a successful H. pylori eradication therapy is a risk factor for newly developed reflux esophagitis in patients with endoscopic submucosal dissection for early gastric cancer.

Endoscopic tunneling procedures in achalasia and gastroparesis

Since the first publication of peroral endoscopic myotomy (POEM) by Haruhiro Inoue et al. in 2008 in Japan, various novel endoscopic procedures have been established, which are performed after iatrogenic creation of a submucosal tunnel as a "new space" 1. Through the artificially formed access in the tela submucosa, interventions in the muscular layer of the esophagus and stomach can be performed while carefully sparing the mucosal layer 2. These include, peroral myotomy of the esophageal muscle layer in patients with achalasia (POEM) and myotomy of the pylorus in patients with gastroparesis (antropyloromyotomy, G-POEM). Further indications include splitting of Zenker diverticulum in POEM technique ("Z-POEM") as well as the removal of subepithelial tumors (STER: submucosal tunneling, endoscopic resection). The long-term therapeutic success (with > 80 % response) of these innovative procedures has now been proven by controlled studies, especially in achalasia 2 3 4 5 6.

Pathogenetic relationship and ways of correction of H. pylori in patients with gastric and duodenal peptic ulcers in the combination of arterial hypertension and type 2 diabetes mellitus. Treatment of patient with H. pylori in presence of toxicogenic stra

Objective — to investigate the functional state of endothelium and methods of correction of endothelial dysfunction in patients with gastric and duodenal peptic ulcers (GPU and DPU) in combination with hypertension (AH) and type 2 diabetes mellitus (DM2).&#x0D; Materials and methods. The investigation involved 100 patients, who were divided into the groups: group 1 consisted of 20 apparently healthy individuals (AHI), group 2 included 40 patients with GPU (n = 23) and DPU (n = 17) without signs of AH and DM2, group 3 involved 40 patients with GPU (n = 15) and DPU (n = 25) in combination with hypertension and DM2. The groups were sub‑divided into subgroups A and B depending on the H. pylori strains’ toxigenicity: group A included patients with CagA+ VacA+ strains’ combination, groups B — infected with H. pylori with a combination of strains of CagA+ or VacA+. All patients were administered the traditional antihelicobacter therapy (AHBT) (esomeprazole 20 mg twice daily + amoxicillin 1.0 g twice daily + clarithromycin 500 mg twice daily for 10 days). To increase the effectiveness of eradication therapy, 40 patients in addition to AHBT, received a combined probiotic (Bifidobacterium bifidum, B. lactis, Enterococcusus acidophilus, L. paracasei, L. plantarum, L. rhamnosus, L. salivarius) 1 sachet twice a day for 1 month. Eradication control was monitored 4 weeks after completion of treatment.&#x0D; Results. The increased expression of the vascular cell adhesion molecule‑1 (VCAM‑1) and the number of desquamated endothelial cells (DEK) and improvement of the oxidant‑antioxidant system have been established. Before the treatment, in comparison with the levels in AHI, levels of sVCAM exceeded in 5.88 times (р &lt; 0.05), of erythrocytic malondialdehyde in 1.92 times (р &lt; 0.05), and levels of the reduced glutathione was lower by 46.39 % (р &lt; 0.05). The use of triple therapy improved the endothelial condition and the state of the oxidative‑antioxidant system, and additional application of probiotic promoted more effective correction of the indices of endothelial state and oxidative‑antioxidant system by means of maximal decrease of the levels of sVCAM and erythrocytic malondialdehyde and increase of the reduced glutathione levels.&#x0D; Conclusions. The presence of H. pylori, in particular its toxigenic strains, results in the development of endothelial disfunction in patients with GPU and DPU, combined with arterial hypertension and DM 2. When combined with hypertension and DM2, the course of GPU and DPU is accompanied with «mutual burden» syndrome resulting in the exhaustion of the antioxidant defense system and increased indexes of the glutathione system.&#x0D;

Evaluation of serum levels of copper and selenium in Helicobacter pylori positive and negative gastritis patients

Helicobacter pylori (H. pylori) infection can result in various complications, included micronutrient variations, nutritional impairment, gastric tissue damages and oxidative stress. The present study aimed to evaluate serum variations of Cu and Se in H. pylori infected individuals. A prospective case-control study was performed on 69 participants with abdominal pains (40 patients with H. pylori gastritis versus 29 control group). Serum levels of Cu and Se were measured using Atomic Absorption Spectrophotometer. Statistical analysis was performed using SPSS software. Comparisons of elements between included groups were done using independent sample t-test. Subgroup analysis between male and female (with or without H. pylori) was performed using one way analysis of variance. Correlation between serum Cu and Se was assessed using Pearson’s correlation test. The p-value levels less than 0.05 were considered as significant. There were no significant differences in serum levels of Cu and Se between H. pylori positive and negative persons. In male with H. pylori, Se levels were 38.4% higher than control male (p-value=0.03). A positive and significant correlation was observed between serum Cu and Se levels (r = 0.51, P-value = 0.024). Although no statistic difference was observed in serum Cu and Se levels, the significant correlation between measured elements represents as good evidence for some discrepancies. Given the importance of well controlled micronutrients in whole body health, especially in high-risk H. pylori patients, more studies are needed to clarify the exact relation of these and other trace elements with H. pylori outcomes.

The relationship between Helicobacter pylori infection and intestinal parasites in individuals from Khartoum state, Sudan: a case-control study.

Background: In developing countries, Helicobacter pylori infection is common, as are intestinal parasites. Socioeconomic circumstances and low personal hygiene lead to the spread of these infections. This research aimed to evaluate the relationship between intestinal parasites and H. pylori in Khartoum, Sudan. Methods: This study was conducted in various hospitals in Khartoum between June and October 2018. The study involved 200 individuals: 100 patients with H. pylori as a case group and 100 healthy individuals as a control group. A stool sample was taken from each individual, and wet preparation, saturated sodium chloride flotation and formal ether concentration were used to detect intestinal parasites. Results: The results showed that 23% of H. pylori patients and 10% of healthy individuals had gastrointestinal parasites; Entamoeba histolytica was found in 12% of H. pylori cases followed by Entamoeba coli (7%) and Giardia lamblia (4%). Control group: Entamoeba histolytica in 5% followed by G. lamblia in 3% and E. coli in 2% of individuals. There was a significant difference in the prevalence of intestinal parasites between groups (P = 0.013). The prevalence rate of intestinal parasites among men and women was 24% and 22%, respectively, in the case group, and 9% and 11%, respectively, in the control group. In the case group, the highest prevalence rates (40% and 38%) were found among the age groups 1-15 and 46-60 years old, respectively, while the lowest rate (10.7%) was found among the 31-45 age group. In the control group, the highest prevalence rate (15%) was among the 31-45 age group, the lowest prevalence rate (8%) was found among the 16-30 age group. Conclusion: Together, we found that intestinal parasites are more common in patients with H. pylori. We also noticed that the rate of infection was not affected by gender while the age group was affected.

Helicobacter Pylori-Associated Iron-Deficiency Anemia and Interleukins Effect

Helicobacter pylori (H. pylori) is a highly prevalence microbial infection, that acts as an iron stressor insusceptible individuals the relationship between ferritin and cytokine levels in individuals infected with H.pylori remains controversial. Based on serology testing for anti-H. pylori IgG, participants (70 seropositiveand 70 seronegative aged 30-60 years were enrolled. Serum iron profiles including iron, ferritin, and totaliron-binding capacity, were measured. IL-1? and IL-6 serum levels were compared. The mean value ofinterleukin 1beta (IL-1?) level of patients and controls revealed that H. pylori patients had a significantlyhigher at (P&lt; 0.001) mean of (IL-1?) when compared to the controls, as shown in this study there is positivecorrelation between gastric interleukin 1beta (IL-1?) and iron deficiency anemia (IDA) blood parametersobserved in resent study could be due to the powerful capability of IL-1? in inhibiting gastric acid secretion.The mean value of Interleukin-6 (IL-6)) level of patients and controls revealed that H. pylori patients had asignificantly higher at (P&lt; 0.001) mean of (IL-6) when compared to the controls.

Synergistic effect of cumin (Cuminum cyminum L.) decoction alongside with three-drug and four-drug treatment protocols on Helicobacter pylori eradication

Background: Helicobacter pylori is a major cause of peptic ulcer. On the other hand, cumin (Cuminum cyminum L.) is an effective medicinal plant for the treatment of gastrointestinal disease in traditional Persian medicine. This study aimed at investigating the synergistic effect of the decoction of cumin with the three- and four-drug protocols against H. pylori in patients with peptic ulcer. Patients with peptic ulcer infected with H. pylori were treated with cumin decoction, three- and four-drug protocols, and their co-administration to eradicate H. pylori. Materials and Methods: Patients were randomly divided into five groups, including group (1) omeprazole with cumin decoction, (2) cumin decoction with the three-protocol treatment, (3) cumin decoction with the four-drug protocol treatment, and (4 and 5) three- and four-drug protocols alone. The cumin fruit powder was given to patients in 3-g packages and decoction was prepared according to the traditional Iranian medicine guidelines. H. pylori eradication was measured by the 14C–urea breath test (14C-UBT) after 4 weeks of intervention. The Kolmogorov–Smirnov test, χ2 test, logistic regression, and ANOVA (SPSS, 11.5) were used for data analyses. Results: In total, 75 patients (48 male and 27 female patients) participated in this study. The results showed that eradication of H. pylori was observed in all five study groups. Eradication of H. pylori in cumin decoction with the three-drug protocol group was more than the other groups (85.72%), although this difference was not statistically significant. In addition, this eradication was 61.5% in the cumin + omeprazole group, while the H. pylori eradication rates for the three-drug and four-drug protocols were 77.8% and 58.33%, respectively. Conclusions: The results showed that decoction of cumin could be used as a complementary treatment alongside conventional medicine therapy to increase the H. pylori eradication.

Comparison of Lansoprazole, Amoxicillin and Clarithromycin (LAC) treatment versus Levofloxacin, Omeprazole, Nitazoxanide and Doxycycline (LOND) in eradication of Helicobacter pylori in patients with functional dyspepsia

Comparison of Lansoprazole, Amoxicillin and Clarithromycin (LAC) treatment versus Levofloxacin, Omeprazole, Nitazoxanide and Doxycycline (LOND) in eradication of Helicobacter pylori in patients with functional dyspepsia

Original Article Prevalence and Diagnosis of Helicobacter Pylori Infection in a Tertiary Hospital in the Kingdom of Bahrain

Background: Helicobacter Pylori, is a gram-negative bacterium. It is a major cause of gastritis, gastric ulcer and gastric cancer. The aim of this study was to determine the prevalence of Helicobacter Pylori infection in Bahrain and compare our prevalence with the prevalence of H. Pylori infection in different countries through systematic review of the literature. We also attempted to determine the diagnostic tests used in Bahrain. Methods: We conducted a retrospective study during one year interval from January 2018 to December 2018 for all gastric biopsies taken through endoscopy for dyspepsia, we determined the prevalence of H. Pylori, and we also analyzed the diagnostic modalities used in our institution. Results: A total of 942 patients had gastric biopsy, including 544(57.8%) females and 398 males (42.2%). A higher prevalence of H. Pylori was found in men versus women (98/392) (25%) vs (110/536) (20.5%), respectively, which was statistically not significant (p 50 years (49.1%) and 472 patients are <50 years (50.9%). H. Pylori prevalence was 22.4 % by histology and 38.5% by urea breath test (UBT). Among those with a result for both tests, there was 59.4% concordance. Conclusion: This study revealed that the overall prevalence of H. Pylori in patients with dyspepsia in our institute is 22.4%. The prevalence of H. Pylori was higher in men. Concordance between histology and UBT was 59.4% in this group. Funding: None Declaration of Interest: The authors have declared no conflicts of interest. Ethical Approval: Ethical approval was obtained from our institutional Review Board.

Detection of Helicobacter pylori in Patients with Oral Squamous Cell Carcinoma and Oral Potentially Malignant Disorders at a Tertiary Care Centre in Gujarat: A Case-Control Study

Introduction: Oral squamous cell carcinoma (OSCC) contribute to 90% of cancer cases in head and neck region and entails remarkable morbidity and mortality inspite of immense research and advances. Amongst other causes, infection with Helicobacter pylori is an emerging cause of OSCC. There is still perplexity in the exact etiopathogenesis of H. pylori related oral cancer. Aim: In order to explore this much unattended area, present study was aimed to find out the association between H. pylori in premalignant disorders and OSCC. Materials and methods: A Prospective case-control Pilot study of 35 patients (11 confirmed cases of Oral squamous cell carcinoma and 24 with oral potentially malignant disorders along with 15 age and sex matched healthy control) from June 2018 - September 2018 was conducted in the Department of Microbiology, Smt. B. K. Shah Medical Institute, Piparia, Gujarat. H. pylori was detected by methods like Rapid urease test, Gram’s staining and Serology. Results: H. pylori was detected in five cases with OSCC with male predominance and mean age 45.6 yrs. All the five positive patients were severely addicted to tobacco and betel quid since decades. Tobacco was found to be the major risk of OSCC with the OD of 16.19, followed by betel quid (OD-4.56) and H. pylori infection (OD-0.83). Conclusion: The results of this pilot study do not establish a definite causal relationship between H. pylori and OSCC due to the low sample size. Study definitely offers an avenue for further work on larger populations to confirm this possible association.

Long-term persistence of gastric dysbiosis after eradication of Helicobacter pylori in patients who underwent endoscopic submucosal dissection for early gastric cancer

BackgroundGastric microbiome, other than Helicobacter pylori, plays a role in the tumorigenesis of gastric cancer (GC). Patients who undergo endoscopic submucosal dissection for early GC have a high risk of developing metachronous GC even after successful eradication of H. pylori. Thus, we investigated the microbial profiles and associated changes in such patients after the eradication of H. pylori.MethodsA total of 19 H. pylori-infected patients with early GC who were or to be treated by endoscopic resection, with paired biopsy samples at pre- and post-eradication therapy, were retrospectively enrolled. Ten H. pylori-negative patients were enrolled as controls. Biopsy samples were analyzed using 16S rRNA sequencing.ResultsH. pylori-positive patients exhibited low richness and evenness of bacteria with the deletion of several genera, including Blautia, Ralstonia, Faecalibacterium, Methylobacterium, and Megamonas. H. pylori eradication partially restored microbial diversity, as assessed during a median follow-up at 13 months after eradication therapy. However, post-eradication patients had less diversity than that in the controls and possessed a lower abundance of the five genera mentioned above. The eradication of H. pylori also altered the bacterial composition, but not to the same extent as that in controls. The microbial communities could be clustered into three separate groups: H. pylori-negative, pre-eradication, and post-eradication.ConclusionChanges in dysbiosis may persist long after the eradication of H. pylori in patients with a history of GC. Dysbiosis may be involved in the development of both primary and metachronous GC after the eradication of H. pylori in such patients.

Impaired cholesterol efflux capacity in patients with Helicobacter pylori infection and its relation with inflammation

BackgroundGut microorganisms are associated with atherosclerosis and related cardiovascular disease. Helicobacter pylori (H. pylori) infection is associated with dyslipidemia and inflammation contributing to the progression of atherosclerosis. ObjectiveSeveral studies have reported reduced HDL-C levels in H. pylori infected patients, but HDL cholesterol efflux capacity (CEC) as the most important function of HDL has not been evaluated yet. MethodsThis cross-sectional study was conducted with 44 biopsy confirmed H. pylori patients and 43 controls. ABCA1-mediated, non-ABCA1 and total CEC were measured in ApoB-depleted serum and levels of ApoA-I, ApoB and hsCRP were estimated using ELISA technique. ResultsTotal and ABCA1 mediated-CEC were reduced in patients compared to controls, independent of age, sex, body mass index and HDL-C (p < 0.001), while non-ABCA1 CEC indicated no significant change between the groups. In addition, patients showed lower serum levels of ApoA-I but increased levels of hsCRP when compared to controls. Total CEC and ABCA1-mediated CEC positively correlated with ApoA-I and HDL-C, furthermore, ABCA1-mediated CEC as well as ApoA-I inversely correlated with hsCRP. ConclusionThe results of the present study indicate reduced CECs in H. pylori infected patients, especially ABCA1-mediated CEC which is associated with decreased ApoA-I and increased inflammation.

Designing strategies for eradication of Helicobacter pylori based on prevalence patterns of infection and antibiotic resistance in a low-income, medically underserved community in the United States.

Regional variation in Helicobacter pylori resistance patterns is a significant contributing factor for the ineffectiveness of traditional treatments. To improve treatment outcomes, we sought to create an individualized, susceptibility-driven therapeutic approach among our patient population, which is one of the poorest in the nation. It is medically underserved, minority-predominant and has high incidence of H pylori infection. We compiled various factors involved in the antibiotic resistance of H pylori from literature. We then created a predictive model to customize therapies based on analyzed data from 2,014 H pylori patients with respect to several of these factors. The predictions of the model were further tested with analysis of patient stool samples. A clear pattern of H pylori prevalence and antibiotic resistance was observed in our patients. We observed that majority of H pylori patients were women (62%) and over the age of 40years (80%). 30% and 36% of the H pylori patients were African American and Hispanic, respectively. A median household income of less than $54,000, past H pylori infection, previous use of certain antibiotics for any infection decreased the chance of eradication. Results of the stool testing were consistent with model predictions (90% accuracy). This model demonstrates the predictive accuracy of H pylori infection and antibiotic resistance based on patient attributes and previous treatment history. It will be useful to formulate customized treatments with predicted outcomes to minimize failures. Our community attributes may contribute toward broad applicability of model for other similar communities.

Clinical characterization of Helicobacter pylori infected patients 15 years after unsuccessful eradication.

Background and aimsPatients that have failed therapy for Helicobacter pylori (H. pylori) infection are incompletely characterized. The aim of this study was to characterize a H. pylori treatment resistant cohort compared to the cohorts of newly diagnosed, earlier eradicated and non-infected.Material and methodsPatients were selected from routine referrals to the Endoscopy units at three different Norwegian hospitals. In all four cohorts, gastric biopsies were scored according to the Sydney classification, and symptoms according to the Gastrointestinal Symptom Rating Scale score, including sub-scores for upper gastrointestinal symptoms and functional bowel symptoms. Patients in the H. pylori resistant group were treated with a triple therapy regimen that consisted of levofloxacin, amoxicillin and a proton pump inhibitor.ResultsWe included 185 patients, 42 H. pylori treatment resistant, 50 newly diagnosed, 61 previously H. pylori eradicated and 32 never infected. The treatment-resistant cohort had higher scores for upper gastrointestinal symptoms and functional bowel symptoms compared to the other groups except for the group being never H. pylori infected. The H. pylori resistant patients had lower Sydney scores than patients with newly diagnosed H. pylori infection. The triple combination showed a high efficacy of 91% to eradicate H. pylori.ConclusionsPatients with treatment-resistant H. pylori infection had more gastrointestinal symptoms, but a lower Sydney score than patients with newly diagnosed infection. A treatment regimen including levofloxacin showed a high efficacy in eradicating H. pylori in patients that previously had failed eradication treatment.

The effect of Helicobacter pylori infection on the decline of lung function in a health screening population.

Although Helicobacter pylori (H. pylori) infection has long been associated with many extragastric diseases, its long-term effects on declining lung function and the development of chronic obstructive pulmonary disease (COPD) remains controversial. We conducted a retrospective study in a health screening population (Gene-Environment of Interaction and Phenotype Cohort at Seoul National University Gangnam Health Center in Korea) recruited from 2004 to 2015. The annual decline rates of lung function and the risk for COPD were compared to the seropositivity for H. pylori. We also assessed the impact of the H. pylori eradication treatment on lung function. Among 3,619 subjects, 1,849 subjects (51.1%) tested positive for H. pylori-specific IgG. In the first year, 95 (2.6%) patients were diagnosed with COPD. however, there was no difference in seropositivity for H. pylori in patients with COPD compared to non-COPD subjects (P=0.756). There was no significant difference in the incidence of COPD between the seronegative (2.2%) and the seropositive group (2.0%; P=0.728) even during the follow-up period. The decline rates of the mean FVC and FEV1 were not different between the seronegative and seropositive group (35.38 vs. 34.34 mL/year for FVC, P=0.389; 39.23 vs. 37.49 mL/year for FEV1, P=0.086). The eradication treatment for H. pylori did not affect the decline rates of mean FVC and FEV1. Infection or eradication treatment of H. pylori was not associated with the decline of lung function or COPD progression in this general population health screening. As a result, H. pylori may not be a significant contributor to deteriorating lung function.