Frequency of Helicobacter pylori Infection in Patients Requiring GI Endoscopy in Seven Units in Three Antioquia Subregions

Aim: To determine the frequency of Helicobacter pylori and sociodemographic factors, life habits, and personal and family history of gastroduodenal diseases in patients who required and were taken to GI endoscopy (symptomatic or by screening) in seven endoscopy units in three Antioquia subregions. Materials and methods: A cross-sectional study conducted between 2016 and 2018 included 272 participants. Sociodemographic factors, life habits, and personal and family history were related to H. pylori infection. Descriptive statistics and bivariate analysis were performed to establish the association between the variables, and multivariate analysis (binomial regression) was used to adjust the prevalence ratios of the associated factors. A p-value ≤ 0.05 was considered statistically significant. Results: The frequency of H. pylori infection was 55.9%, with differences by subregion (Valle de Aburrá metropolitan area: 54.3%, Oriente: 64%, and Urabá: 79.2%). Factors associated with H. pylori infection were male sex (adjusted prevalence ratio [APR] = 1.26; 95% confidence interval [CI] = 1.04-1.52), age 18-55 years (APR = 1.62; CI 95% = 1.22-2.16), absence of drinking water (APR = 1.40; 95% CI: 1.15-1.72) and educational level below university (APR = 1.73; 95% CI% = 1.26-2.38). Conclusion: The frequency of H. pylori was higher than in other recent studies because different diagnostic tests were used for its detection, and differences were found in the frequency of infection by region, which is explained by the heterogeneity in the populations analyzed. This study suggests the need to improve the population's living conditions to reduce H. pylori and direct measures of primary prevention of the infection, especially in family groups, men, individuals between 18 and 55 years old without drinking water, and with an educational level lower than university.

Objetivo: determinar la frecuencia de Helicobacter pylori y la presencia de factores sociodemográficos, hábitos de vida y antecedentes personales y familiares de enfermedades gastroduodenales en pacientes que requirieron y fueron llevados a endoscopia digestiva (sintomáticos o por tamización) en siete unidades de endoscopia de tres subregiones de Antioquia. Materiales y métodos: estudio transversal realizado entre 2016 y 2018 que incluyó a 272 participantes. Los factores sociodemográficos, hábitos de vida, antecedentes personales y familiares se relacionaron con la infección por H. pylori. Se realizó estadística descriptiva y análisis bivariado para establecer la asociación entre las variables y el análisis multivariado (regresión binomial) para ajustar las razones de prevalencia de los factores asociados. Un valor p ≤ 0,05 se consideró estadísticamente significativo. Resultados: la frecuencia de infección por H. pylori fue de 55,9%, con diferencias por subregión (área metropolitana del Valle de Aburrá: 54,3%, oriente: 64% y Urabá: 79,2%). Los factores asociados a la infección por H. pylori fueron sexo masculino (razón de prevalencia ajustada [RPA] = 1,26; intervalo de confianza [IC] del 95% = 1,04-1,52), edad de 18-55 años (RPA = 1,62; IC 95% = 1,22-2,16), ausencia de agua potable (RPA = 1,40; IC 95%: 1,15-1,72) y nivel educativo inferior al universitario (RPA = 1,73; IC 95% = 1,26-2,38). Conclusión: la frecuencia de H. pylori fue mayor que en otros estudios recientes porque se emplearon diferentes pruebas diagnósticas para su detección y se demostraron diferencias en la frecuencia de la infección por región, lo cual se explica por la heterogeneidad en las poblaciones analizadas. Este estudio sugiere la necesidad de mejorar las condiciones de vida de la población para reducir la infección por H. pylori y dirigir medidas de prevención primaria de la infección especialmente en los grupos familiares, en hombres, individuos entre 18 y 55 años, sin agua potable y con un nivel educativo inferior al universitario.

PCR-based analysis of Helicobacter pylori virulent genotypes among dyspeptic patients from Chittagong, Bangladesh

Aims: Helicobacter pylori is a causative agent of gastroduodenal diseases in Bangladesh as well as throughout the world. This study aimed to determine the H. pylori cagA, vacA and iceA virulent genotypes by PCR directly in gastric biopsies from dyspeptic patients of Chittagong, Bangladesh and evaluating the association of these genotypes with clinical manifestations. Methodology and results: CLO (Campylobacter-Like Organism) test and Hp16s PCR (16S rRNA based H. pylori specific PCR) was performed to confirm H. pylori infection. Among 111 patients, H. pylori infection was found in 60 patients by CLO test, while Hp16s PCR revealed that 54 patients were H. pylori positive. PCR amplification of the H. pylori virulence genes was successful in 35 gastric biopsies amongst the 54 Hp16s PCR positive biopsies. The positive rates for the cagA, vacAs1, vacAs2, vacAm1, vacAm2, iceA1, iceA2 genes were 34.3%, 71.4%, 8.6%, 62.9%, 28.6%, 20% and 11.4%, respectively. The allelic variant vacAs1m1 had a predominant percentage with 51.4%, followed by vacAs1m2, vacAs2m2 and vacAs1m1m2 with 14.3%, 5.7% and 2.9%, respectively. Among the subtypes of vacAs1, only s1a was detected in 54.3% of biopsies while none of the cases showed the s1b and s1c genotypes. However, there was no statistically significant association (p>0.05) observed between the virulent genotypes and clinical conditions. Conclusion, significance and impact of study: We found that cagA, vacAs1m1 and iceA1 were the most frequent H. pylori genotypes in severe clinical outcomes of the infection. The data in this study would provide a basis for understanding the diverse virulence pattern of this bacterium in Bangladeshi dyspeptic patients.

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.

Clinical Features of Re-infection of Helicobacter pylori after Successful Eradication / 대한소화기내시경학회지

BACKGROUND/AIMS:Studies on re-infection of Helicobacter pylori are limited. This study was designed to determine if there are clinical features of H. pylori re- infection related to gastroduodenal diseases or histological findings. METHODS: From a population of patients that were treated for H. pylori eradication from May 2003 to September 2007, 129 subjects were enrolled. Regimens were PPI-based triple or quadruple agents and follow-up methods were UBT, CLO or histology. RESULTS: A total of 29 subjects experienced a recurrence (within one year, 17 subjects; between one and two years, eight subjects; more than two years, four subjects). Recurrence periods were 2 to 32 months, and the mean period was 12.62+/-8.40 months. Among 29 subjects, eight subjects had chronic atrophic gastritis, 14 subjects had a peptic ulcer, five subjects had stomach cancer and two subjects had a MALT lymphoma; there were no statistical differences of the odds ratio between matched diseases. By use of the Updated Sydney System, neither H. pylori colonization density nor neutrophil infiltration nor monocyte infiltration grade in histology was associated with recurrence or re-infection. CONCLUSIONS: Neither histological findings nor gastroduodenal diseases was associated with H. pylori re-infection. The re-infection rate in this study was approximately 6.2%. This rate was slightly higher than rates reported in other recent studies in Korea.

IL-1beta and IL-1RN polymorphisms in gastroduodenal diseases / 대한내과학회지

BACKGROUND: IL-1beta and IL-1 receptor antagonist (IL-1RN) genetic polymorphisms have been associated with development of gastric atrophy and increased risk of gastric carcinoma. This study aimed to determine the effects of these polymorphisms in gastroduodenal diseases. METHODS: This study population was comprised of 297 patients and they were grouped into gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. We determined IL-1beta-511/-31/+3954 and IL-1RN genotype by polymerase chain reaction using gastric biopsy specimens. RESULTS: The genotype of IL-1beta-511 C/T, -31 T/C, +3954 C/C, and IL-1RN *1/*1 was predominant in all four groups. Allelic and genotypic frequencies of IL-1beta-511/-31/+3954 and IL-1RN showed no significant difference in four groups. IL-1beta-511 T/T, -31 C/C, +3954 C/T, and IL-1RN *2 carriers did not show increased risk of gastric ulcer, duodenal ulcer and gastric cancer. Classification of gastric cancer into intestinal and diffuse type also showed no significant difference of IL-1beta-511/-31/+3954 and IL-1RN genotypic frequencies. CONCLSUION: There was no significant difference of IL-1beta and IL-1RN polymorphisms between patients with gastritis, gastric ulcer, duodenal ulcer and gastric cancer. Therefore, other endogenous or exogenous factors will play more important role in the development of gastroduodenal diseases in Korean.

Laparoscopic Surgery for Gastric and Duodenal Disease

PURPOSE: The current work is aimed at illustrating the feasibility and assessing the efficacy of laparoscopic surgery in the treatment of gastric and duodenal diseases. METHODS: 27 patients who suffered from various gastroduodenal diseases were operated on between Feb. 1996 and July 1997. Operating times, procedures associated with pathologic diagnosis, bleeding during operation, mean starting times of oral intake, postoperative hospital stays, and complications were examined using the operating records and the medical charts. RESULTS: The procedures and the associated pathologic conditions were a feeding jejunostomy (gastric cancer peritonei), 12 wedge resections (1 duodenal diverticulum, 1 Brunner's gland hyperplasia, 2 gastric polyps, 6 gastrointestinal stromal tumors, and 2 early gastric carcinomas, 3 gastrojejunostomies (unresectable gastric cancers), 10 subtotal gastrectomies (9 complicated peptic ulcers and early gastric cancer), and a radical (D1 alpha) subtotal gastrectomy. The average operating times were 85 minutes in the feeding jejunostomy, 132 minutes in the wedge resections, 95 minutes in the gastro jejunostomies, 208 minutes in the subtotal gastrectomies (Billroth-I: 160 min; Billroth-II: 262 min.), and 300 minutes in the radical operation. The mean intraoperative bleeding was 80-800 cc. The mean start ing time of solid oral intake and postopeative hospital stay were shorter than in open surgery (oral intake: 1-5 day; hospital stay: 6-9 days). There were six postoperative complications. One patient died due to a cerebral infarction during the operation. one wound infection, one stump leakage, one pulmonary edema, and two cases of postoperative bleeding occurred, but they were treated conventionally without reoperation. CONCLUSION: Minimally invasive surgery appears to be an invaluable tool for treating gastroduodenal diseases. Furthermore, it is a valid option in experienced hands and in selected cases of gastric cancer, allowing patients to benefit from a less cumbersome hospital stay and from more satisfaction.

Laparoscopic Surgery for Gastric and Duodenal Disease

PURPOSE: The current work is aimed at illustrating the feasibility and assessing the efficacy of laparoscopic surgery in the treatment of gastric and duodenal diseases. METHODS: 27 patients who suffered from various gastroduodenal diseases were operated on between Feb. 1996 and July 1997. Operating times, procedures associated with pathologic diagnosis, bleeding during operation, mean starting times of oral intake, postoperative hospital stays, and complications were examined using the operating records and the medical charts. RESULTS: The procedures and the associated pathologic conditions were a feeding jejunostomy (gastric cancer peritonei), 12 wedge resections (1 duodenal diverticulum, 1 Brunner's gland hyperplasia, 2 gastric polyps, 6 gastrointestinal stromal tumors, and 2 early gastric carcinomas, 3 gastrojejunostomies (unresectable gastric cancers), 10 subtotal gastrectomies (9 complicated peptic ulcers and early gastric cancer), and a radical (D1 alpha) subtotal gastrectomy. The average operating times were 85 minutes in the feeding jejunostomy, 132 minutes in the wedge resections, 95 minutes in the gastro jejunostomies, 208 minutes in the subtotal gastrectomies (Billroth-I: 160 min; Billroth-II: 262 min.), and 300 minutes in the radical operation. The mean intraoperative bleeding was 80-800 cc. The mean start ing time of solid oral intake and postopeative hospital stay were shorter than in open surgery (oral intake: 1-5 day; hospital stay: 6-9 days). There were six postoperative complications. One patient died due to a cerebral infarction during the operation. one wound infection, one stump leakage, one pulmonary edema, and two cases of postoperative bleeding occurred, but they were treated conventionally without reoperation. CONCLUSION: Minimally invasive surgery appears to be an invaluable tool for treating gastroduodenal diseases. Furthermore, it is a valid option in experienced hands and in selected cases of gastric cancer, allowing patients to benefit from a less cumbersome hospital stay and from more satisfaction.