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PubMedDate not supplied

The media of rapid urease test influence the diagnosis of Helicobacter pylori.

BACKGROUND/AIMS: The influence of different media on the validity of the rapid urease test, including accuracy, reaction time and cost-effectiveness is evaluated. METHODOLOGY: Biopsies were obtained from the antral and body mucosa of 100 KMUH patients (51 men, 49 women; mean age: 54.0 years, range: 21-79 years old) undergoing gastroendoscopy due to dyspepsia. None of the patients had received any Helicobacter pylori eradicating treatment, nor any other antibiotic or bismuth treatment in the previous one month, nor had they had any type of gastric operation in the past. Helicobacter pylori status was evaluated by seven different tests: culture, histology, home-made rapid urease test, 13C-urea breath test, and three different commercially available rapid urease tests--including the CLO test, the ProntoDry test, and the Pyloriset Urease test. Helicobacter pylori status was defined as positive when the culture was positive or if concordance of two of the other three tests (histology, homemade rapid urease test and 13C-urea breath test) was positive. RESULTS: Three different rapid urease tests have similar sensitivities (97.3% vs. 100% vs. 100%) and specificities (98.4% vs. 96.8% vs. 98.2%), and accuracy (98.4% vs. 96.8% vs. 98.2%). But the reaction time was longer in the CLO test than for the other two rapid urease tests (22.3 vs. 5.6 vs. 10.1 minutes) (P < 0.05). The ProntoDry test and the Pyloriset Urease test also have more rapid positive rate than CLO test. However, in vitro study, three tests show similar rapidity of positive reaction at different densities of Helicobacter pylori. CONCLUSIONS: These three tests have practical advantages for physicians who need a rapid and accurate method of diagnosing Helicobacter pylori infections. The ProntoDry test and Pyloriset Urease test have degrees of accuracy similar to the CLO test, but results are obtained more rapidly and they are cheaper. Furthermore, The ProntoDry test can be stored at room temperature and thereby save on the storage expense.

Adult↗
PubMedDate not supplied

[High frequency of precancerous lesions of gastric cancer associated with Helicobacter pylori and response to treatment, in Chiapas, Mexico].

Stomach cancer is the second cause of death in Mexico in patients with malignant tumors. This disease represents a public health problem. A strong association has been described between chronic infection with Helicobacter pylori and gastric cancer. This malignancy is preceded by a series of preneoplastic conditions, including chronic atrophic gastritis (CAG), intestinal metaplasia (IM), and dysplasia. The objective of this study was to establish the prevalence of preneoplastic conditions associated with infection of Helicobacter pylori in the state of Chiapas and its eradication with antibiotics. Persons infected with Helicobacter pylori and with CAG were identified by serology against CagA protein and serologic levels of gastrin. An endoscopy with biopsy was performed at the beginning of the study, and at 6 weeks and 1 year thereafter. A total of 281 people were enrolled and randomly assigned to treatment or placebo group. CAG was found in 59%, IM in 51%, and dysplasia in 13%. In intent-to-treat and per-protocol analysis, Helicobacter pylori was eliminated in 70 and 76%, respectively. These results indicate high frequency of preneoplastic conditions associated with Helicobacter pylori and an excellent eradication rate. They also offer a possible alternative for preventing gastric cancer.

Adult↗
PubMed2002

[Diagnosis of Helicobacter pylori infection].

The diagnostics of Helicobacter pylori infection is now one of the most important aspects of the diagnosis of various gastroduodenal diseases. New data have shown that Helicobacter pylori is a causative agent of peptic ulcer disease and an important factor in cancer development. Numerous diagnostic tests are now available. They can be divided into two groups: invasive and noninvasive tests. All invasive test methods are based on endoscopic examination during which biopsy specimens are obtained for direct (histological analysis, isolation) or indirect (urease test) diagnosis of Helicobacter pylori infection. Noninasive methods reveal the presence of Helicobacter pylori by measuring the activity of urease (urea breath test), then by confirming the presence of antibodies in the serum or saliva of the infected person or by confirming the presence of Helicobacter pylori antigens in the feces.

Adult↗
PubMed2002

[Duodenal ulcer and Helicobacter pylori infection].

The research accomplishment of Australian investigators Marshall and Warren, published in 1983, has entirely changed our understanding of ulcer genesis and proposed a new strategy in diagnostics and therapy of peptic ulcer disease. The key etiopathogenetic role of Helicobacter pylori has been recognised. Marshall confirmed on himself that Helicobacter pylori, as an infectious agent, fulfilled all Koch's postulates. The bacterial infection caused the mucosal inflammatory changes in his stomach which were rapidly resolved by antibiotics. During later clinical and experimental investigations the association of Helicobacter pylori and peptic ulcer has also been proved. Etiopathogenetic influence of Helicobacter pylori infection on duodenal ulcer development is nowadays very well known. Diagnostic guidelines, the modes of treatment and clinical management of these patients are mostly precisely defined. In this article, besides the general review of modern knowledge about Helicobacter pylori infection concerning epidemiology, etiopathogenesis, diagnostics and duodenal ulcer therapy, we are going to present also our results in the management of the large group of patients with duodenal peptic ulcer or ulcer scars.

Adolescent↗
PubMed2002

[Extra-gastrointestinal tract diseases and Helicobacter pylori infection].

Helicobacter pylori infection is linked to conditions of the upper gastrointestinal tract, including peptic ulcer and gastric adenocarcinoma na MALT lymphoma. It has also been associated with wide variety of extragastric and non-gastrointestinal conditions. However, the evidence in support of Helicobacter pylori infection as a cause of the non-gastrointestinal tract diseases is not widely understood. We reviewed the medical literature in regard to putative association of Helicobacter pylori infection and non-gastrointestinal tract condition, notably cardiovascular, autoimmune and dermatological diseases. The majority of published papers examining the potential causal relationship were case-control studies, cross-sectional and cohort studies while only a few recent articles that did not confirm the evidence of causal relationship represent well designed population-based prospective studies. The lack of clear evidence for etiopathogenetic associations of Helicobacter pylori infection and non-gastrointestinal tract conditions should focus our attention on appropriate testing and treatment of Helicobacter pylori infection in patients with conditions that are of proven association such as peptic ulcer disease.

Autoimmune Diseases↗
PubMed2002

[Prevalence of Helicobacter pylori infection in duodenal ulcer. Data of a prospective study apropos of 78 NSAID-negative patients with duodenal ulcer].

The aim of our study was to evaluate, the prevalence of Helicobacter pylori infection in duodenal ulcer tunisian patients not using non steroidal anti inflammatory drugs. Seventy eight patients having a non complicated duodenal ulcer and not using non steroidal anti inflammatory drugs were enrolled in this prospective study carried out between February 2000 and January 2001. Six gastric biopsies were undertaken in all patients; five for an histologic analysis and one for urease test. A serum sample was taken for a Helicobacter pylori serology. Patients were considered infected if two tests were positive. Helicobacter pylori infection was present in 77 patients (98.7%). Helicobacter pylori infection is still high among patients with a non complicated duodenal ulcer and not using non steroidal anti inflammatory drugs suggesting an empirical Helicobacter pylori eradication therapy in this group of patients.

Adult↗
PubMedDate not supplied

Inhibition of peptic ulcer relapse by ranitidine and ecabet independently of eradication of Helicobacter pylori: a prospective, controlled study versus ranitidine.

BACKGROUND/AIMS: The recent increase in resistant strains of Helicobacter pylori has become a serious problem. Ecabet is a novel anti-ulcer agent that acts directly on the gastric mucosa, has bactericidal activity, and inhibits adhesion of Helicobacter pylori to the gastric mucosa. These actions result from inhibition of urease and ATPase in Helicobacter pylori, a mechanism distinct from that of antibiotics. METHODOLOGY: Sixty-three patients positive for Helicobacter pylori who had been cured of gastric ulcers and duodenal ulcers were randomly assigned to receive maintenance therapy with ranitidine alone or a combination of ranitidine and ecabet. Ulcer relapse was studied in these patients. RESULTS: The cumulative relapse rates in the ranitidine group and the ecabet plus ranitidine group were respectively, 29.6% and 4.4% after 1 year of treatment and 66.1% and 13.0%, after 2 years. These differences were significant (p = 0.006). Multivariate analysis of factors potentially related to relapse showed that outcome was significantly related only to treatment (p = 0.020) and not to other characteristics, such as age, diagnosis, or sex. CONCLUSIONS: We conclude that maintenance therapy with a combination of ranitidine and ecabet prevents ulcer relapse in Helicobacter pylori-positive patients. Controlled studies comparing ulcer relapse rates between eradication treatment and maintenance therapy with ranitidine and ecabet are awaited.

Abietanes↗
PubMed2003

What Bizzozero never could imagine - Helicobacter pylori today and tomorrow.

With the observation of spiral organism in the stomach about one hundred years ago a long history of a bacterium started ending up in a worldwide research programs, studies and consensuses. With this bacterium rediscovered by Marshall and Warren and later named Helicobacter pylori, a milestone of research was laid nearly twenty years ago. Helicobacter pylori is now recognized as the main cause of most cases of gastritis and ulcer disease in the stomach and the duodenum. In the course of the Helicobacter pylori research, Helicobacter pylori was found to trigger neoplastic alterations on the ground of the inflammation in the stomach. At first, a large number of publications served to describe the connection between Helicobacter pylori and the low malignant B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the stomach. Furthermore, on the basis of numerous seroepidemiological studies, researchers succeeded in documenting the participation of H. pylori, at least as a co-factor, in the development of gastric carcinoma. From large epidemiological studies made during the last twenty years as well as from microbiological research we have learned much more about this in the beginning nameless and mysterious bacterium.

Adolescent↗
PubMed1992

[Helicobacter pylori in Barrett esophagus].

The authors evaluated the prevalence of colonize by Helicobacter Pylori in 21 adults patients with Barrett's esophagus; 12 males and 9 females; with ranges of age from 21 to 81 years and a medium of 56.4 years old. It was detected in 23.8% that Helicobacter Pylori was positive in Barrett's esophagus, being quite higher, 26.6% in patients over 50 years old. In the five cases with positive Helicobacter Pylori, the Barrett esophagus presented a fundic gastric mucosa and no one intestinal metaplasia. Helicobacter Pylori was not seen in esophageal biopsies from patients with reflux esophagitis without Barrett's esophagus. The clinical value of the Helicobacter Pylori finding in Barrett's esophagus and its importance of the following at long term must be explained and studied in the future, by the evaluation in numerous patients groups and prolonged follow-up.

Adult↗
PubMedDate not supplied

Simple closure of chronic duodenal ulcer perforation in the era of Helicobacter pylori: an old procedure, today's solution.

BACKGROUND/AIMS: To evaluate the risk of recurrence in our patients with chronic duodenal ulcer perforation, who underwent a simple closure and postoperative Helicobacter pylori eradication therapy. METHODOLOGY: Within 4.5 years (3/1996 to 7/2000), 21 patients with chronic duodenal ulcer perforation, were operated in our hospital. All of them underwent simple closure with omental patch repair plus Helicobacter pylori eradication with omeprazole, clarithromycin and amoxycillin for two weeks. On December 2000, in 14 (66.6%) of these patients, urea breath test for Helicobacter pylori was performed, followed by endoscopy. RESULTS: The mean age of our 14 patients is 55 years. The urea breath test was positive for Helicobacter pylori in 3 (21.4%) patients. Two of them had endoscopically gastritis, confirmed by pathological examination. None of our patients had ulcer relapse. The three patients with positive urea breath test received another course of the same eradication therapy. CONCLUSIONS: Simple closure of perforated chronic duodenal ulcer in combination with postoperative Helicobacter pylori eradication, seems to be an accepted treatment, so the immediate acid-reduction surgery (vagotomy) in the contaminated environment caused by perforation, is probably unnecessary.

Adult↗
PubMed2003

[Detection of Helicobacter pylori in the saliva of patients with recurrent aphthous stomatitis].

BACKGROUND: Helicobacter pylori participates significantly on the pathogeny of chronic gastritis, duodenal and gastric ulcer, carcinoma and lymphoma of the stomach. There are some more diseases requiring attention--for example cardiovascular, dermatologic, and autoimmune. METHODS AND RESULTS: Helicobacter pylori was detected in saliva and faeces of 28 persons by the Premier platinum HpSA diagnostic set. Levels of IgA and IgG antibodies were determined by EIA and Western Blott methods. Parameters of salivary immunity were investigated as well. Levels of IgG, SIgA, IgM, lysozyme and albumin were determined. Recommended therapy of Helicobacter infection led to an evident clinical improvement and descent of the documented Helicobacter pylori antigen. CONCLUSIONS: Helicobacter pylori infection can probably participate in some cases of relapsing aphtous stomatitis.

Adolescent↗
PubMed1992

[Prevalence of Helicobacter pylori in gastric pathology in Aragon].

The aim of this study was to evaluate the prevalence of Helicobacter pylori in 400 patients referred for upper digestive tract endoscopy. In our area it hasn't developed yet any epidemiologic study about this disease. Helicobacter pylori was observed in 281 of the 400 patients studied (70%). No significant differences by sex were found in the subjects analyzed. There was a rise in the percentage of positivities as age increased. Helicobacter pylori were positive in 74 of the 88 patients with chronic superficial gastritis (84.1%), in 53 of the 65 with chronic atrophic gastritis (81.5%), in 16 of the 25 with chronic atrophic gastritis and intestinal metaplasia (64%), in 49 of the 63 with gastric ulcer (77.8%), in 73 of the 85 with duodenal ulcer (85.9%), in 9 of the 24 patients with gastric carcinoma (37.5%), in 5 of the 19 with stump gastritis (26.3%), where as only a few Helicobacter pylori were found in 2 of the 31 histologically normal subjects (6.5%). These findings support the wiew that Helicobacter pylori may be etiologically related to chronic gastritis and peptic ulceration, even though their precise role still remains to be determined.

Adolescent↗
PubMed2004

[Special clinical manifestations of Helicobacter pylori infection in children and adolescents].

During the period 1989-1996, we retrospectively investigated 104 children and adolescents with Helicobacter pylori infection diagnosed by gastroscopy. The median age was 12.11 +/- 3.31 years, 55% were female and 45% male. The chief complaint of 92% of the children was abdominal pain, mainly epigastric. The typical macroscopic finding was nodular gastritis. The most common microscopic picture was chronic superficial gastritis with lymphatic follicles and the presence of Helicobacter pylori. We demonstrated correlation between these gastroscopic and histological findings. Children who suffered from peptic ulcer were older than those with nodular gastritis. Most of the Helicobacter pylori positive patients were treated with triple drug therapy. The combination of drugs changed throughout the years according to the newly accepted strategies in the treatment of Helicobacter pylori. The majority of children reported a decrease in symptoms on completion of therapy. Urea breath test was an efficient and convenient method for the follow-up of patients with Helicobacter pylori infection.

Abdominal Pain↗
PubMed2004

Helicobacter bilis-associated hepatitis in outbred mice.

Although Helicobacter bilis infects mice worldwide, it is not known whether H. bilis causes enterohepatic disease in outbred Swiss Webster (SW) mice. Intestinal and liver specimens from four groups of 39 SW mice, five of which were treated with creatine in the drinking water, were obtained for culture for the presence of H. bilis and were analyzed as to whether infection status was associated with H. bilis seroconversion and/or hepatitis. Helicobacter bilis was isolated from the colon of all 27 mice of groups I-III, but only from the liver of one 12- to 13-month-old female mouse. Ten of 27 livers were H. bilis-positive based on polymerase chain reaction (PCR) analysis; 8 of 10 (80%) of the positive results were for older mice. Results of PCR analysis for H. bilis were negative, and H. bilis was not isolated from 12 control mice (group IV). Irrespective of treatment group or controls, severity of histologic lobular and periportal chronic inflammatory lesions in the liver of H. bilis-infected outbred mice ranged from minimally to moderately severe. Helicobacter bilis infection was associated with increased portal inflammation in group III mice, compared with age-matched, helicobacter-free, group IV mice (P < 0.03). A comparison of potential sex effects in group III mice indicated that H. bilis-infected female mice developed more severe portal inflammation than did H. bilis-infected male mice (P < 0.01). On the basis of results of an ELISA, 8 of 11, 6- to 8-month-old H. bilis-infected mice of group III seroconverted to H. bilis outer membrane antigen. Helicobacter bilis infection is associated with hepatitis in SW mice and can confound experimental results.

Administration, Oral↗
PubMedDate not supplied

[Helicobacter pylori detection in children with initially negative Gram, Giemsa and Wharting-Starry methods, using other histologic techniques].

OBJECTIVE: To identify Helicobacter pylori by Gram, Giemsa and Warthing-Starry histological staining methods in biopsies of the digestive tract in children, when Helicobacter pylori identification was negative with hematoxilin and eosin. MATERIAL AND METHODS: We carried out a retrospective, cross-sectional and comparative study of 36 gastric biopsies received in the department of Anatomic-Pathology, in a period often months. All the biopsies were initially stained with routine Hematoxilin and Eosin. Of the 36 biopsies, 24 were negative to Helicobacter pylori. From paraffin blocks of these last biopsies three new histological sections were obtained to dye them with Gram, Giemsa and Warthing-Starry, and two medical pathologists performed the microscopic interpretation of these samples. RESULTS: The search for Helicobacter pylori was carried out in 24 initially negative biopsies, one was positive for Gram (4.16%) and negative for Giemsa and Warthing-Starry and four were both positive for Giemsa and Warthing-Starry (16.66%) and both were also negative for Gram. Only one biopsy was positive for the three methods. The remaining samples were negative for the three stains. CONCLUSION: The Giemsa and/or Warthing-Starry histologic techniques can be a more specific alternative for the determination of Helicobacter pylori in patients with negative digestive tract biopsies with the traditional method of hematoxilin and eosin.

Biopsy↗
PubMed1991

[Chronic gastritis and Helicobacter pylori infection on the Ivory Coast. A series of 277 symptomatic patients].

Only a few reports have established the importance of chronic gastritis and Helicobacter pylori infection in Africa. The aim of this study was to ascertain the prevalence of chronic gastritis and Helicobacter pylori infection in a symptomatic population in Abidjan, Côte-d'Ivoire. The study included 277 consecutive patients referred for gastroscopy. Two hundred nine patients complained of abdominal pain without gastroduodenal ulcer or cancer: 26 had a duodenal ulcer, 23 had a gastric ulcer, and 6 had gastric cancer. The remaining 14 patients underwent gastroscopy for various other reasons. Chronic gastritis was present in 89 percent of cases, of which 96 percent showed signs of activity. There were four cases of lymphocytic gastritis. Patients with antral chronic gastritis were older (39.43 +/- 14.3 years) than those with normal antral mucosa (33.7 +/- 12 years, P less than 0.05). Helicobacter pylori was present in 91.3 percent of cases, representing all patients with active chronic gastritis, and 60 percent of the patients with normal gastric mucosa. Chronic gastritis was present in 86 percent of patients with abdominal pain, in 100 percent of those with duodenal of gastric ulcer, and Helicobacter pylori were observed in 90, 100, and 91 percent of the same patient groups, respectively. This study demonstrates the high prevalence of chronic gastritis and the very high level of Helicobacter pylori infection in Ivorian patients complaining of various gastrointestinal symptoms. The usefulness and feasibility of therapeutic trials still have to be investigated.

Adolescent↗
PubMedDate not supplied

[Prevalence of seropositividad to antibodies IgG and IgM against Helicobacter pylori in the medical residents of the University Hospital of Puebla].

BACKGROUND: Helicobacter pylori is a gram-negative, curved, microaerophilic, oxidase, catalase and urease positive bacillus. It lives in the gastric mucosa, and is the main etiological agent of peptic ulcer, and of atrophic and multifocal gastritis. It is associated with extraintestinal, vascular, autoimmune and cutaneous diseases. The infection by this bacteria causes a chronic inflammatory process related with the sensibilization of mast cells, which increases the incidence of allergic diseases. OBJECTIVE: To estimate the seropositivity prevalence of IgG and IgM antibodies against Helicobacter pylori in medical resident personnel. PATIENTS AND METHOD: A transversal, descriptive and observational study was carried out in medical residents of the Hospital Universitario de Puebla. Serum levels of IgG and IgM antibodies against Helicobacter pylori were determined by chemiluminescence. Data were analyzed applying descriptive statistics, such as: frequency, central tendency and dispersion measures. RESULTS: 57 residents were included, 54.4% were men. The mean age was 28.4 (SD 2.9). Seropositivity prevalence of IgG and IgM antibodies was 24.6 and 33.3%, respectively. Combined seropositivity prevalence of IgG and IgM was of 43.9%. CONCLUSION: Seropositivity prevalence of IgG and IgM antibodies against Helicobacter pylori in the medical resident personnel of the Hospital Universitario de Puebla was similar to the reported in the general population. This estimation might be considered a reference to other epidemiological and clinical studies such as those pretending to evaluate and demonstrate the relationship between infection by Helicobacter pylori and other entities, even allergies.

Adult↗
PubMed2006

[Prevalence of Helicobacter pylori infection among children and youth with acid gastroesophageal reflux].

AIM: The aim of the study was to estimate the prevalence of Helicobacter pylori infection in patients with acid gastroesophageal reflux. PATIENTS NAD METHODS: Analysis of medical records of 160 children and youth admitted to the hospital between October 2003 and December 2004 was performed. All of these patients were diagnosed for acid gastroesophageal reflux due to clinical features and results of oesophageal pH-metry. During routine diagnostic procedures of abdominal pain, vomiting, nausea and other non-specific symptoms, endoscopy of upper gastrointestinal tract was simultaneously performed. Helicobacter pylori infection among analysed patients was diagnosed due to histopathological studies of specimens sampled during endoscopy and positive urease test. RESULTS: Analysed group included 75 girls and 85 boys between 12 month old and 18 years old (mean age 8.47). Helicobacter pylori infection was observed in 29 patients (18.1%) of 160 analysed cases. Mean age of patients with H. pylori infection was 11.83 years, whereas mean age of patients without H. pylori infection was 7.72 years. Oesophagitis was presented in 28 (17.4%) of all patients. In the group with H. pylori infection oesophagitis was observed only in 4 patients (13,8%). In the group without H. pylori infection oesophagitis was presented in 24 patients (18,3%). CONCLUSIONS: 1. Prevalence of Helicobacter pylori infection among patients with acid gastroesophageal reflux was lower than prevalence of infection in children and youth population of Kujawsko-Pomorski region. 2. Helicobacter pylori infection among children and youth with acid gastroesophageal reflux doesn't influence the prevalence of oesophagitis.

Adolescent↗