Correlation analysis of glucose and lipid metabolism in elderly patients with Helicobacter pylori infection complicated with metabolic syndrome / 公共卫生与预防医学

Objective To investigate the correlation of glucose and blood lipid metabolism in elderly patients with Helicobacter pylori (Hp) infection complicated with metabolic syndrome (MS), and to provide theoretical basis for clinical diagnosis and treatment of MS patients. Methods A total of 176 elderly MS patients treated in our hospital from February 2020 to February 2021 were selected. Uremic [13C] tablet breath test kit was used to determine Hp infection. According to Hp infection, they were divided into Hp positive group (n=59) and Hp negative group (n=117). Glucose metabolism indexes (FBG, 2hPG, HbA1c, FINS) and serum lipid metabolism indexes (TC, HDL-C, LDL-C) were determined in all subjects. Risk factors of Hp infection in MS patients were analyzed by multivariate logistic regression. Pearson correlation analysis was conducted between sreum LDL-C, HbA1c and FINS levels and DOB value in MS patients. Results The levels of FBG, 2hPG, HbA1c, FINS and LDL-C in Hp positive group were significantly higher than those in Hp negative group (P0.05). It showed that LDL-C, HbA1c and FINS were independent risk factors for Hp infection in MS patients (P<0.05). Pearson correlation analysis showed that There was a positive correlation between DOB and LDL-C, HbA1c and FINS levels in MS patients (r=0.475,0.512,0.459,P<0.05). Conclusion Hp infection can affect glucose and lipid metabolism in elderly MS patients, and there is a close relationship between Hp infection and ldL-C, HbA1c and FINS levels in elderly MS patients.

Peptic ulcer bleeding in the elderly and analysis of its correlation with Helicobacter pylori infection / 公共卫生与预防医学

Objective To analyze the risk factors of bleeding in elderly patients with peptic ulcer disease (PUD) and its correlation with Helicobacter pylori (Hp) infection, and to provide a theoretical basis for clinical diagnosis and treatment of elderly patients with PUD bleeding. Methods A total of 418 elderly PUD patients admitted to our hospital from June 2019 to June 2020 were selected. The 13C-urea breath test was used to determine HP infection. PUD patients were divided into observation group (n=87, bleeding) and control group (n=331, no bleeding). Age, sex, ulcer number, ulcer location, ulcer stage, ulcer diameter and other clinical data were collected. Univariate analysis and logistic regression were used to analyze the risk factors of bleeding in elderly PUD patients. The Forrest classification was used to evaluate the severity of PUD bleeding patients. Pearson correlation analysis was performed between Forrest classification and Hp infection in elderly PUD bleeding patients. Results There were statistically significant differences between the two groups in the course of disease, PUD history, NSAIDs application/ulcer number, ulcer diameter, ulcer location, ulcer stage, Hp infection and NSAIDs application (P<0.05). Multivariate logistic regression analysis showed that the use of NSAIDs, active ulcer, Hp infection and ulcer diameter ≥2 cm were risk factors for bleeding in elderly patients with PUD (P<0.05). The Hp positive rate in Forrest I patients was significantly higher than that in Forrest II and Forrest III patients (P<0.05). The positive rate of Hp in Forrest II patients was significantly higher than that in Forrest III patients. Pearson correlation analysis showed that Hp infection was positively correlated with the severity of peptic ulcer bleeding in the elderly (r=0.512, P<0.05). Conclusion The risk of bleeding from PUD is higher in the elderly, especially in patients with active ulcer, Hp infection and ulcer diameter ≥ 2 cm. In the treatment process of PUD patients, the eradication therapy of Hp should be emphasized, which can reduce the risk of bleeding.

Analysis of endoscopic characteristics in 93 cases of early gastric cancer and precancerous lesions after Helicobacter pylori eradication / 中华消化杂志

Objective:To analyze the endoscopic characteristics of early gastric cancer and precancerous lesions after Helicobacter pylori ( H. pylori) eradication. Methods:From May 2019 to June 2022, at Shanghai Sixth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine, the medical data of patients diagnosed with differentiated early gastric cancer and precancerous lesions were collected. A total of 93 patients with early gastric cancer and precancerous lesions who had previous history of H. pylori infection and had undergone standardized eradication treatment were selected, and their endoscopic characteristics were retrospectively analyzed. Independent sample t-test, chi-square test, and Fisher′s exact test were used for statistical analysis. Results:Among 93 patients with early gastric cancer and precancerous lesions after H. pylori eradication, there were 56 males and 37 females, with an average age of (66.9±8.2) years old. The time after H. pylori eradication was 3.4 years (range 1.0 to 7.0 years). A total of 109 early gastric cancer and precancerous lesions were found, including 79 patients with single lesion and 14 patients with multiple lesions (30 lesions). There were 60 cases with 73 lesions in the early gastric cancer group and 33 cases with 36 lesions in the precancerous group. Among 93 patients, 89 cases (95.7%) were diagnosed with atrophy level above C-2 according to Kimura-Takemoto classification under endoscopy. The long diameter of 109 lesions was (1.38±0.70) cm and the short diameter was (1.04±0.53) cm. A total of 80 lesions (73.4%) were located in the lower 1/3 part of the stomach, and 53 lesions (48.6%) were located in the lesser curvature. A total of 106 lesions (97.2%) were superficial type (0-Ⅱ) under the endoscopy. The long diameter and short diameter in the early gastric cancer group after H. pylori eradication were both greater than those in the precancerous lesion group ((1.54±0.78) cm vs. (1.06±0.35) cm, (1.16±0.58) cm vs. (0.78±0.33) cm), and the differences were statistically significant ( t=3.53 and 3.73, both P<0.001). There was statistically significant difference in the morphological types between early gastric cancer group after H. pylori eradication and precancerous lesion group ( χ2=11.01, P=0.012). The main morphological type of early gastric cancer after H. pylori eradication was superficial depression type (0-Ⅱc), accounting for 45.2% (33/73), while the precancerous lesions were mainly superficial protruded and flat type, both accounting for 38.9% (14/36). Conclusions:After H. pylori eradication, the endoscopic atrophy range of early gastric cancer and precancerous lesions is mostly above C-2. And the lesions are mostly located in the middle and lower 1/3 part of the stomach, long diameter of lesions <20 mm. The main morphological type is superficial type, especially superficial depression type.

Changes in serum levels of Hcy and MMP-9 and risk factor analysis in patients with coronary heart disease complicating Helicobacter pylori infection in Chengdu area / 公共卫生与预防医学

Objective To study the changes in serum homocysteine (Hcy) and matrix metalloproteinase-9 (MMP-9) levels and risk factors in patients with coronary heart disease (CHD) complicated with Helicobacter pylori (HP) infection in Chengdu area, and to provide a theoretical basis for the prevention of HP infection in patients with coronary heart disease. Methods A total of 348 CHD patients admitted to our hospital in Chengdu from 2019 to 2021 were selected. Hp infection status was detected by C14 urea breath test. Patients were classified into control group (n=197) and HP infection group (n=151) according to the detection results. Data including gender, age, body mass index and peptic ulcer history were collected, and univariate analysis and logistic regression were used to screen the risk factors affecting the occurrence of HP infection in patients with CHD. Results The prevalence rate of HP infection was 43.39% (151/348) among the selected CHD patients. Serum levels of Hcy and MMP-9 were notably elevated in HP infection group compared with control group (P<0.05). The proportion of patients with age ≥60 years old, hyperlipidemia, proton pump inhibitor use history, and frequent consumption of out-of-home food and spicy food in HP infection group was obviously larger than that in control group (P<0.05). Hyperlipidemia (OR=3.719), history of proton pump inhibitor use (OR=3.254) and frequent consumption of out-of-home food (OR=2.721) were independent risk factors for HP infection in CHD patients (P<0.05). Conclusion CHD patients in Chengdu suffer a prevalence rate of HP infection, and have elevated levels of serum Hcy and MMP-9. Furthermore, the intervention measures for patients with hyperlipidemia, proton pump inhibitor drug use history and frequent consumption of out-of-home food are of vital importance for decreasing the risk of HP infection.

Utility of immature granulocyte in severity of helicobacter pylori infection

Introduction: Helicobacter pylori infection is a chronic bacterial infection associated with some extragastric diseases as well as gastric involvements that occur most commonly worldwide. In our study, we aimed to investigate the usability of immature granulocytes as a basic indicator that can reflect the severity of helicobacter pylori inflammation, to the best of our knowledge, for the first time. Materials and Methods: Patients who underwent upper gastrointestinal endoscopy between April 2019 and April 2020 and were diagnosed with antral gastritis were included in this study. The relationship between helicobacter infection and its severity detected in gastric biopsies of patients and immature granulocyte count (IGC), immature granulocyte percentage (IG%), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) were investigated. Results: Of the 868 patients, 210 were HP negative, 658 were HP positive (218 mild HP positive, 293 moderate HP positive, and 147 severe HP positive). There were statistically significant differences between the HP negative and HP positive groups in terms of IGC, IG%, NLR, and PLR. However, IG% and IGC were not clinically useful because the median IG% (0.3 vs 0.3) and IGC (0.02 vs 0.02) were the same in the HP negative and total HP positive groups. Conclusion: In our study, IGC and IG% were not found useful to detect H. pylori intensity and severity of inflammation.

The association between carotid artery plaque and Helicobacter pylori infection / 中华健康管理学杂志

Objective:To investigate the prevalence of carotid artery plaque (CP) in the population undergoing health examinations and to assess the association between CP and Helicobacter pylori (Hp) infection.Methods:The subjects were 3066 patients who underwent carotid ultrasonography examination and 13C urea breath test (UBT) at the health examination center of China-Japan friendship hospital from January 2019 to December 2019. The subjects were divided into CP and non-CP groups; the differences of physicochemical parameters and UBT positive rate between the two groups were analyzed by independent sample t test, Mann-Whitney U test, and Chi-squared test. The association between UBT positive and CP was analyzed by logistic regression. Results:The proportion of CP positive subjects was significantly higher in males than in females (33.4% vs 19.5%, P<0.001); the proportion of Hp positive subjects was not significant in sex composition (29.1% vs 30.9%, P=0.245); the age [(59.39±10.24) vs (46.44±9.88) years], P<0.01), BMI [(25.44±3.23) vs (24.21±3.54) kg/m 2, P<0.01], SBP [(135.91±19.07) vs (123.03±16.66) mmHg, P<0.01], DBP [(79.64±11.47) vs (75.10±11.55) mmHg, P<0.01], TC [(4.96±0.98) vs (4.86±0.98) mmol/L, P=0.004], TG [1.43 (1.03, 2.06) vs 1.20 (0.82,1.88) mmol/L, P<0.001], LDL-c [(3.21±0.93) vs (3.04±0.83) mmol/L, P<0.01)], FBG [5.55 (5.11,6.47) vs 5.16 (4.83,5.56) mmol/L, P<0.001], UA [(339.13±79.92) vs (319.85±87.62) mmol/L, P<0.01] and Hcy [13.10 (11.30,15.60) vs 11.7 (10.00,13.90) mmol/L, P<0.001] were significantly higher in the CP group than that in the non-CP group; HDL-c was significantly lower in the CP group than in the non-CP group [1.12 (0.95,1.32) vs 1.20 (1.00,1.43) mmol/L, P<0.001]. The proportion of male (62.4% vs 44.6%, P<0.01), prevalence of tobacco smoking (31.9% vs 19.6%, P<0.01), hypertension (33.8% vs 12.5%, P<0.01), and diabetes (13.45% vs 3.5%, P<0.01) were significantly higher in the CP group than that in the non-CP group. The proportion of UBT positive subjects was significantly higher in the CP group than in the non-CP group (34.5% vs 28.4%, P=0.001). Logistic regression analysis showed a significantly positive association between CP and UBT positive after adjusted confounding factors ( OR=1.270, P=0.028). Conclusions:The formation of CP is related to many risk factors; Hp infection is also an important risk factor. Controlling Hp infections might be one of the effective methods for the prevention and control of carotid plaque formation.

Status and related factors of helicobacter pylori infection in Nantong Area / 公共卫生与预防医学

Objective To investigate status of helicobacter pylori (Hp) infection in Nantong Area and its related factors. Methods A cluster of 1 680 people who underwent a physical examination at a hospital in the Nantong area from June 2020 to February 2021 were selected as the subjects of this survey. All subjects were tested for Hp infection through the 14C-urea breath test and the Hp infection status analyzed. At the same time, the self-filled and interrogative questionnaires made by our hospital were used to collect general data of the research subjects, and then single-factor and multi-factor logistic regression was used to analyze the related factors affecting Hp infection in the physical examination population in Nantong area. Results Among the 1 680 medical examiners investigated in this study, 980 were positive for Hp infection, and the overall positive rate of infection was 58.33%. The results of univariate analysis found that Hp infection was related to the age, drinking, hotness, frequent eating of pickled food, family history of gastric cancer, and chronic gastritis in the physical examination population in Nantong area (P60 years old (OR=3.46, 95%CI: 1.35-8.84), drinking (OR=5.22, 95%CI: 2.79-9.77), addiction to spicy food (OR=5.47, 95%CI: 2.45-9.30), regular consumption of pickled foods (OR=5.28, 95%CI: 3.48-7.92), family history of gastric cancer (OR=4.29, 95%CI: 2.86-76.45), chronic gastritis (OR=5.07, 95%CI: 2.79-9.22) were all related factors affecting Hp infection(P<0.05). Conclusion Positive rate of HP infection in physical examination population in Nantong area is high, and it is related to age, drinking alcohol, spicy food, eating pickled food frequently, family history of gastric cancer, chronic gastritis and other factors. To strengthen the publicity and education of HP infection, establish good eating habits and reduce the risk factors to prevent HP infection in physical examination population in Nantong area.

Anti-Helicobacter pylori treatment can effectively improve the clinical remission rates of irritable bowel syndrome: a controlled clinical trial meta-analysis

Here we used a meta-analysis of several clinical trials to determine whether anti-Helicobacter pylori therapy has any positive effect on IBS patients. Here we compared the effective clinical remission rates between IBS patients treated with anti-H. pylori therapy and those who were not. This data would provide more clinical evidence regarding the efficacy of novel treatments and intervention points for IBS patients. Relevant studies were identified using keyword searches on various electronic databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials, CNKI, and CBM. Keywords included "helicobacter pylori" and "irritable bowel syndrome" among others. The literature was screened using relatively strict inclusion and exclusion criteria and RevMan 5.3.5 and Stata 15.1 software were used for meta-analysis and to assess publication bias and sensitivity. A total of ten studies met all of the inclusion criteria; these included 655 IBS patients with H. pylori infection, of these, 385 patients were in the experimental group and 270 patients were in the control group. A random-effects model was used to pool the odds ratios (ORs) with a 95% confidence interval (CIs) and the combined OR was 2.87 (95% CI: 1.74-4.72), p<0.0001. These findings suggest that anti-H. pylori therapy can effectively improve the remission rates of H. pylori-positive IBS patients. H. pylori infection is known to correlate with the incidence of IBS. Anti-H. pylori treatment can effectively improve the clinical remission rates of IBS patients. Whether this means that IBS patients should be actively treated with anti-H. pylori compounds as a novel strategy to improve the remission rates needs to be evaluated in vivo.

Relationship between the intake of salt and salted food and the infection of Helicobacter pylori in 40-69 years old local residents in a county with high gastric cancer risk in Anhui Province / 中华疾病控制杂志

Objective The aim of the present study was to investigate the relationship between the intake of salt and salted food and the infection of Helicobacter pylori (Hp) among 40-69 years old local residents in a county with high gastric cancer risk in Anhui province. Methods From July 2015 to August 2018, we conducted a questionnaire and a serological test for Hp among 40-69 years old local residents in Lujiang county, Anhui province. The questionnaire focused on the consumptions of salt and salted food. The relationship between Hp infection and risk factors was analyzed by gender. Univariate and multivariate logistic regression analysis were used to analyze the relevant influencing factors. Results The Hp infection rate of total local residents was 50.07%. Among male subjects, age, body mass index(BMI), marital status, educational level, job, labor intensity and income had no link to Hp infection (all P>0.05). But among female subjects, BMI was associated with Hp infection ( 2=13.454,P=0.001). Besides, alcohol consumption was a risk factor for Hp infection in male subjects(OR=1.789，95% CI:1.188-2.694，P=0.003). But, high intake of salt and salted food had no effect on Hp infection after adjustment for alcohol consumption variable in men using multivariate analysis (all P>0.05). After adjusted for BMI variable among female individuals, high salt intake (≥9 g/day) (OR=1.462，95% CI:1.060-2.015，P=0.021) and the high salted food intake (≥1 times /day) were risk factors for Hp infection in women(OR=1.560，95% CI:1.021-2.383，P=0.040). Conclusions In one county with high gastric cancer risk in Anhui province, high salt intake (≥9 g/day) and high salted food intake (≥1 times/day) are risk factors for Hp infection among 40-69 years old female local residents.

A Study on the Healing of Peptic Ulcer Disease after Eradication of Helicobacter Pylori Infection in Rural People Bangladesh

Objective: In this study our main aim is to evaluate the healingof peptic ulcer disease after eradication of helicobacter pyloriinfection in rural people Bangladesh.Methodology: This Prospective observational study wasconducted at tertiary hospital Dhaka district from Tertiarymedical college and hospital among 100 patients diagnosedcoming to the gastroenterology outpatient departmentaccording to inclusion and exclusion criteria was included inthe study.Result: In our study among 100 patients, most of the patientsbelong to 31-40 years age group, which was 37.78% and 57%were male and 43% were female. 15.07% patients hadduodenal ulcer and 21.09% had gastric ulcer for H. pyloripositive.18% patients were still positive for H.pylori aftereradication therapy.Conclusion: In conclusion, we can say that, prolonged Followup with upper GI endoscopy for additional period for recurrenceof ulcer should have been done for patients whose peptic ulcerdisease had resolved but could not attain H. pylori eradication.

Antibiotic-potentiation Activities of Cameroonian Medicinal Plants against Multidrug-resistant Phenotype Helicobacter pylori Clinical Isolates

Background: Helicobacter pylori are the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. The emergence of multi-drug resistant phenotypes is a major public health problem today in the treatment of Helicobacter pylori infection. The present study was designed to evaluate the anti-Helicobacter activities of six Cameroonian medicinal plants on ten Helicobacter pylori clinical isolate from dyspeptic patients and their ability to potentiate the effect of common antibiotics against multidrug-resistance phenotypes Helicobacter pylori. Methodology: Broth microdilution assay was used for the antimicrobial evaluation of plant-extracts alone or in combination with antibiotics, while Time-kill assay was used to study the bactericidal activity. Results: Plant-extracts showed different anti-Helicobacter activity with the minimum inhibitory concentration (MIC) values varying from 64 to >1024 µg/ml. The methanol extract of E. cocaine leaves showed the best anti-Helicobacter activity with MIC value of 64 µg/ml against 60% of the tested isolate. Moreover, E. cocaine extract at a concentration equal to 8MIC, produced from 24 to 72 h a viability decrease of 2 logs lower than those for the control against the tested clinical isolates. Synergistic concentration dependent effects were observed when combining this plant extract with erythromycin, or amoxicillin against Helicobacter pylori multi-drug resistant phenotypes with minimum fold inhibition of 16 and eight respectively for erythromycin and amoxicillin. Conclusion: The overall results provide information for the possible use of E. cocaine extract in the control of Helicobacter pylori infections involving multi-drug resistant phenotypes.

Clinical effect of probiotics combined with triple therapy in the treatment of helicobacter pylori infection in children / 中国基层医药

Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children.Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole,amoxicillin and clarithromycin treatment,and 10 d was 1 treatment course.B group was given probiotic pretreatment,prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.In group C,triple therapy before using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece /time,cold water after meals.The clinical therapeutic effects were recorded.Results The helicobacter pylori clearance rate of group A was 55.00%,that of group B was 86.00%,that in group C was 89.00%,the helico-bacter pylori clearance rate of group B and group C was significantly higher than that in group A,the difference was statistically significant (χ2 =23.103 7,28.670 6,all P 0.05 ).In A group,nausea and vomiting occurred in 5 cases,2 cases of diarrhea,abdominal distension abdominal pain in 4 cases,skin rash in 5 cases.In group B,nausea and vomiting occurred in 2 cases,0 cases of diarrhea,abdominal distension abdominal pain in 1 case,skin rash in 1 case.In group C,nausea and vomiting occurred in 1 case,0 cases of diarrhea,abdominal distension abdominal pain 0 cases,skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A,the difference was statistically significant (χ2 =11.965 8,8.000 0,all P 0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance,reduce the triple therapy drug adverse reactions,it is worthy of popularization and application in clinic.

Is there an Association between Migraine and Gastrointestinal Disorders?

Migraine is a primary episodic headache disorder that represents a substantial burden and disability worldwide. Its pathogenesis is multifactorial and remains hitherto poorly elucidated. An interesting but less-well-known association is that between migraine and gastrointestinal disorders. We have reviewed the literature for relevant papers reporting on the clinical association between migraine and gastrointestinal symptoms. Several studies have shown different gastrointestinal diseases to be associated with migraine, but the underlining pathophysiology remains elusive. The data gathered and analyzed have shown great variability across studies, making it impossible to draw definitive conclusions. Further research is required to elucidate this potential relationship. An understanding of the relationship between migraine and gastrointestinal disorders is of great clinical importance for prompt diagnosis and treatment.

Helicobacter pylori Antigens Inducing Early Immune Response in Infants

To identify the Helicobacter pylori antigens operating during early infection in sera from infected infants using proteomics and immunoblot analysis. Two-dimensional (2D) large and small gel electrophoresis was performed using H. pylori strain 51. We performed 2D immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) antibody immunoblotting using small gels on sera collected at the Gyeongsang National University Hospital from 4–11-month-old infants confirmed with H. pylori infection by pre-embedding immunoelectron microscopy. Immunoblot spots appearing to represent early infection markers in infant sera were compared to those of the large 2D gel for H. pylori strain 51. Corresponding spots were analyzed by matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDI-TOF-MS). The peptide fingerprints obtained were searched in the National Center for Biotechnology Information (NCBI) database. Eight infant patients were confirmed with H. pylori infection based on urease tests, histopathologic examinations, and pre-embedding immunoelectron microscopy. One infant showed a 2D IgM immunoblot pattern that seemed to represent early infection. Immunoblot spots were compared with those from whole-cell extracts of H. pylori strain 51 and 18 spots were excised, digested in gel, and analyzed by MALDI-TOF-MS. Of the 10 peptide fingerprints obtained, the H. pylori proteins flagellin A (FlaA), urease β subunit (UreB), pyruvate ferredoxin oxidoreductase (POR), and translation elongation factor Ts (EF-Ts) were identified and appeared to be active during the early infection periods. These results might aid identification of serological markers for the serodiagnosis of early H. pylori infection in infants.

Etiology of Non-variceal Bleeding of upper Gastrointestinal System: A Brief Review.

Upper gastrointestinal bleeding (UGB) has important morbidity and mortality risk and these risk increases when co-morbidities exist. Nonsteroidal anti-inflammatory drugs use and Helicobacter Pylori infection are risk factors for peptic ulcer bleeding. Peptic ulcer disease is the most common cause of non variceal UGB. However, other rare causes should be responsible for UGB especially in treatment resistant cases.

Validación de Sensibacter pylori test® como prueba de ureasa para el diagnóstico de infección por Helicobacter pylori en Chile / Validation of Sensibacter pylori test ® as urease tests for the diagnosis of Helicobacter pylori infection in Chile

Introduction: Helicobacter pylori is a highly prevalent bacterium in Chile that causes various gastric pathologies including gastric cancer, which corresponds to the leading cause of cancer-related death in Chile in men. This is why early detection of an Helicobacter pylori infection is gaining importance, for tis purpose there are various diagnostic methods, including rapid urease tests (RUT) such as the Sensibacter pylori test®. Objectives: To validate the Sensibacter pylori test® in Chile, so that it may be used in healthcare centres in our country. Materials and Methods: Upper gastrointestinal endoscopies were performed on symptomatic patients in 3 healthcare centres and gastric mucosa samples were obtained following established protocols. These underwent the health centre ́s RUT and the Sensibacter pylori test®, and the results were compared to the gastric mucosa histology (gold standard) Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each test. Kappa test was used to assess agreement between the RUT’s and the turning time of each test was measured. Results: Sensibacter pylori test® showed a sensitivity of 82.6 percent, specificity 92.3 percent, PPV 95 percent and NPV 75 percent. The consistency with the other RUT’s was 0.958 (p < 0.001) and 0.872 (p < 0.001). The turning time was 15 min. Conclusion: Sensibacter pylori test® is a sensitive and specific method, similar to other tests used daily in Chile, which has the advantage of yielding results within a few minutes.

Introducción: Helicobacter pylori es una bacteria de gran prevalencia en Chile y es causante de variadas patologías gástricas, entre las cuales se encuentra el cáncer gástrico, que corresponde a la primera causa de muerte por cáncer en Chile en hombres. Por esto, cobra relevancia detectar a tiempo la existencia de Helicobacter pylori, para lo cual existen diversos métodos diagnósticos, entre los que se encuentran los test rápidos de ureasa (TRU) como Sensibacter pylori test®. Objetivos: Validar Sensibacter pylori test® en Chile, para poder ser utilizado en centros de salud de nuestro país. Materiales y Métodos:Se realizaron endoscopias digestivas altas a pacientes sintomáticos en tres centros de salud y se obtuvieron muestras de mucosa gástrica según protocolos establecidos. Estas se sometieron al TRU del centro de salud y a Sensibacter pylori test®, comparándose el resultado con histología de la mucosa gástrica (estándar de oro), calculándose sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN). Se utilizó test kappapara evaluar concordancia entre TRU y se midió el tiempo de viraje de cada test. Resultados: Sensibacter pylori test® demostró una sensibilidad de 82,6 por ciento, especificidad de 92,3 por ciento, VPP de 95 por ciento y VPN de 75 por ciento. La concordancia con los otros TRUs fue de 0,958 (p < 0,001) y 0,872 (p < 0,001). El tiempo de viraje fue de 15 min. Conclusión: Sensibacter pylori test® es un método sensible y específico comparable con otros test de uso diario en Chile, y tiene la ventaja de mostrar resultados en pocos minutos.

Meta-analysis on relationship between Helicobacter pylori infection and esophagogastric junction adenocarcinoma / 中华流行病学杂志

Objective To systematically evaluate the etiological association between esophagogastric junction adenocarcinoma and Helicobacter pylori (Hp) infection and the pathogenicity of Cag pathogenic island in Hp infection cases.Methods Literatures about Hp infection and esophagogastric junction adenocarcinoma published from January 1980 to April 2015 were retrieved from CNKI,Wanfang data,VIP,the Cochrane Library,PubMed,EMBase databases.The literatures which met the inclusion criteria were collected and evaluated by using Newcastle-Ottawa Scale,then the heterogeneity was analyzed with Review Manager 5.3,and the pooled OR value and 95％ confidence interval were calculated.Results A total of 5 547 study subjects were recruited in 13 studies,including 1 446 esophagogastric junction adenocarcinoma cases and 4 101 controls.The combined OR for Hp infection was 0.95 (95％CI:0.66-1.36),P=0.71;The OR in high risk areas was 1.66 (95％CI:1.33-2.08,P＜0.001),higher than that in low-risk areas (0.68,95％CI:0.49-0.94,P=0.020).In addition,six studies found that the combined detection rates of Cag pathogenic island in esophagogastric junction adenocarcinoma cases and controls were 80.50％ and 79.80％,respectively.There was no significant difference between two group,the combined OR was 1.24 (95％CI:0.96-1.60).Conclusion The association between Hp infection and esophagogastric junction adenocarcinoma was not significant,however,the significant difference was observed between high risk area and low risk area;the detection rate of Gag pathogenic island in Hp infection cases was high,but the pathogenicity for esophagogastric junction adenocarcinoma needs further study.

A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers

An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis.

Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients

BACKGROUND: Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients. METHODS: In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index. RESULTS: The mean age of participants was 54+/-10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24+/-0.23 microg/mL and 9.9+/-9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (beta=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; beta=0.43, P<0.01), and triglycerides/HDL-C ratio (beta=-0.28, P<0.05) were observed. CONCLUSION: Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.