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1.
Braz. j. med. biol. res ; 54(7): e10889, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249311

ABSTRACT

Utilization of plant resources for treatment of Helicobacter pylori infections is one of the appealing approaches as rapid emergence of antibiotic-resistant strains is occurring throughout the world. Ethanol extract and its fractions from Hibiscus rosa-sinensis red flower were assessed for antibacterial and urease inhibitory activities towards forty-three clinical strains and two reference strains of H. pylori. The ethyl acetate fraction exhibited the most potent bacteriostatic activity with minimum inhibitory concentrations (MICs) of 0.2-0.25 mg/mL and minimum bactericidal concentrations (MBCs) of 1.25-1.5 mg/mL against all test strains, including forty-three strains resistant to one to four antibiotics, azithromycin (MICs, 8-256 µg/mL), erythromycin (MICs, 8-128 µg/mL), levofloxacin (MICs, 8-256 µg/mL), and/or metronidazole (MICs, 8-256 µg/mL). The fraction had similar antibacterial activities toward these test strains suggesting the preparation and the antibiotics do not have a common mechanism of anti-H. pylori activity. The fraction also had stronger effects on biofilm formation, morphological conversion, and urease activity of H. pylori than the other fractions and the ethanol extract. These flower preparations were non-toxic to three human cell lines, and nine compounds were also isolated and identified from the ethyl acetate fraction. In vivo research needs to be conducted to confirm the potential usefulness of H. rosa-sinensis flower and its constituents for effective prevention and treatment of H. pylori disease.


Subject(s)
Humans , Helicobacter pylori , Helicobacter Infections/drug therapy , Rosa , Hibiscus , Plant Extracts/pharmacology , Microbial Sensitivity Tests , Flowers , Anti-Bacterial Agents/pharmacology
2.
Rev. cuba. med. mil ; 49(4): e616, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156518

ABSTRACT

Introducción: El Helicobacter pylori se ha relacionado con el desarrollo de gastritis crónica atrófica, metaplasia intestinal y displasia, lesiones que pueden evolucionar a carcinoma gástrico. Existen investigaciones que demuestran que la erradicación de esta bacteria disminuye el riesgo de progresión histopatológica de las lesiones preneoplásicas, excepto la metaplasia intestinal y la displasia. Se realizó una revisión de los artículos publicados en las bases de datos Pubmed, Scielo, Medline y Cochrane, relacionados con el tema. Objetivo: Profundizar en los conocimientos relacionados con la infección por Helicobacter pylori y cáncer gástrico. Desarrollo: El adenocarcinoma es el tumor gástrico más frecuente y el Helicobacter pylori es el agente etiológico principal. En poblaciones de riesgo elevado, el adenocarcinoma gástrico de tipo intestinal, se precede de lesiones preneoplásicas (atrofia, metaplasia intestinal y displasia) que evoluciona al cáncer invasor. Conclusiones: Helicobacter pylori favorece la carcinogénesis gástrica, aunque existen otros factores de riesgo para el surgimiento del cáncer gástrico como son: la historia familiar, la pobre ingestión de frutas y vegetales y el bajo nivel socioeconómico(AU)


Introduction: Helicobacter pylori has been linked to the development of chronic atrophic gastritis, intestinal metaplasia, and dysplasia, lesions that can progress to gastric carcinoma. There is research showing that the eradication of this bacterium reduces the risk of histopathological progression of preneoplastic lesions, except for intestinal metaplasia and dysplasia. A bibliographic review was made of the articles published in the Pubmed, Scielo, Medline and Cochrane data bases, related to the topic, belonging to authors dedicated to the study of this problem. Objective: To go deepen in the knowledge related to Helicobacter pylori infection and gastric cancer. Development: Adenocarcinoma is the most frequent gastric tumor and Helicobacter pylori is the main etiologic agent. In high-risk populations, gastric adenocarcinoma of the intestinal type, is preceded by preneoplasic lesions (atrophy, intestinal metaplasia, and dysplasia), that progresses to invasive cancer. Conclusions: Helicobacter pylori favors gastric carcinogenesis, although there are other risk factors for the development of gastric cancer such as: family history, poor intake of fruits and vegetables, and low socioeconomic leve(AU)


Subject(s)
Animals , Stomach Neoplasms/epidemiology , Helicobacter Infections/complications , Helicobacter Infections/drug therapy
3.
Medicina (B.Aires) ; 80(2): 111-116, abr. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1125050

ABSTRACT

La resistencia bacteriana a ciertos antibióticos condiciona el éxito del tratamiento erradicador de la infección gástrica por Helicobacter pylori y es motivo de creciente preocupación a nivel mundial. Dada la escasa evidencia publicada en Argentina sobre este tema, nuestro objetivo fue investigar factores asociados a la persistencia de H. pylori post-tratamiento antibiótico. Se determinó la frecuencia de fracaso terapéutico en 81 pacientes con gastritis por H. pylori tratados en nuestro Servicio y sometidos al estudio de urea en aire espirado para confirmar la erradicación de la infección. La edad promedio fue 58±12 y 43.2% eran hombres. La frecuencia de fracaso terapéutico fue 17.3%. De los dos esquemas más utilizados, la frecuencia de fracaso fue mayor con claritromicina + amoxicilina que con levofloxacina + amoxicilina (25% vs. 6.6%, p=0.04). Como factores de riesgo investigamos las siguientes variables: edad, género, síntomas, tabaquismo, consumo de anti-inflamatorios, diabetes, obesidad, tipo y duración de tratamiento. En el análisis univariado, el uso de esquemas con claritromicina y el género masculino se asociaron significativamente a persistencia de la infección [OR 4.2 (1.1-15.6) y 5.2 (1.1-26.4)]. En el análisis multivariado, el uso de esquema con claritromicina permaneció asociado al fracaso terapéutico [OR 5.38 (1.1-29.5)]. Concluimos que la inclusión de claritromicina en el esquema terapéutico para la gastritis por H. pylori se asoció a mayor fracaso terapéutico. Este fracaso es atribuible a alta prevalencia de resistencia de H. pylori a ese antibiótico en la población atendida en nuestro hospital y cuestiona las prácticas habituales de tratamiento en nuestro medio.


Antibiotic resistance may hinder the efficacy of eradication therapy against Helicobacter pylori infection and it has become a major concern worldwide. Due to the relatively scarce evidence published in Argentina on this topic, our aim was to describe factors associated with H. pylori persistence after antibiotic treatment. The therapeutic failure rate was described among 81 patients with H. pylori gastritis treated in our Hospital with a post-treatment urea breath test to determine successful eradication. Mean age was 58 ± 12 and 43.2% were male subjects. H. pylori persistence was observed in 17.3% of subjects. Therapeutic failure was more common among patients receiving clarithromycin + amoxicillin therapy that among those receiving levofloxacin + amoxicillin (25% vs. 6.6%, p = 0.04). The following variables were assessed: age, gender, referral symptoms, smoking, anti-inflammatory use, diabetes, obesity, treatment type and duration. Clarithromycin-based therapy and male gender were associated with infection persistence on univariate analysis [OR 4.2 (1.1-15.6) and 5.2 (1.1-26.4)]. On multivariate analysis, clarithromycin-based was associated with infection persistence [5.38 (1.1-29.5)]. We conclude that clarithromycin-based therapy is significantly associated with treatment failure. This failure may be due to an elevated prevalence of H. pylori resistance to clarithromycin in the population under study and raises the question on the utility of such therapeutic alternative.


Subject(s)
Humans , Male , Female , Middle Aged , Helicobacter Infections/drug therapy , Drug Resistance, Bacterial , Gastritis/drug therapy , Anti-Bacterial Agents/therapeutic use , Argentina , Cross-Sectional Studies , Retrospective Studies , Helicobacter pylori , Helicobacter Infections/microbiology , Treatment Failure , Clarithromycin/therapeutic use , Drug Therapy, Combination , Levofloxacin/therapeutic use , Gastritis/microbiology , Amoxicillin/therapeutic use
4.
Clinics ; 75: e1857, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133374

ABSTRACT

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.


Subject(s)
Humans , Helicobacter pylori , Helicobacter Infections/drug therapy , Irritable Bowel Syndrome/drug therapy , Randomized Controlled Trials as Topic , Incidence
6.
Evid. actual. práct. ambul ; 23(3): e002070, 2020.
Article in Spanish | LILACS | ID: biblio-1120506

ABSTRACT

La dispepsia constituye un motivo de consulta frecuente en atención primaria. A propósito de un paciente con diagnóstico de dispepsia funcional, la autora se plantea si el tratamiento de erradicación del Helicobacter pylori podría mejorar los síntomas. Luego de una búsqueda rápida se encontró evidencia que señala que el tratamiento de la infección por este germen podría ser beneficiosa para aliviar los síntomas de la dispepsia funcional a largo plazo, aunque con mayor riesgo de efectos adversos, por lo que otros tratamientos alternativos continúan siendo ser una opción válida en el manejo de los pacientes con este problema de salud. (AU)


Subject(s)
Humans , Male , Middle Aged , Helicobacter Infections/drug therapy , Dyspepsia/drug therapy , Primary Health Care , Abdominal Pain/etiology , Helicobacter pylori , Helicobacter Infections/diagnosis , Helicobacter Infections/etiology , Helicobacter Infections/therapy , Dyspepsia/diagnosis , Dyspepsia/etiology , Dyspepsia/therapy , Heartburn/etiology , Anti-Bacterial Agents/therapeutic use
8.
Rev. medica electron ; 41(4): 979-992, jul.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094102

ABSTRACT

RESUMEN La infección por helicobacter pylori afecta aproximadamente al 50% de la población mundial, es causante de gastritis crónica, úlcera péptica, cáncer gástrico y linfoma del tejido linfoide asociado a la mucosa. Desde su descubrimiento, la erradicación ha sido uno de los más importantes retos en Gastroenterología. En muchos países se desconoce la prevalencia de resistencia primaria del microorganismo a los diferentes antibióticos que empíricamente se utilizan, y por no realizar pruebas de rutina que verifican su erradicación en la práctica diaria, se ignora la efectividad de los esquemas prescritos. El incremento progresivo de la resistencia a la claritromicina y metronidazol, unido a una ausencia de antibioticoterapia alternativa, desafía la capacidad para eliminar de manera efectiva a ésta bacteria. El subcitrato de bismuto ha resurgido y su adición en la terapia ha permitido aumentar las tasas de curación por encima del 90%. Actualmente se invoca que para mejorar la eficacia en el tratamiento se debe combinar una supresión potente del ácido gástrico en tratamientos combinados cuádruples con una duración de 14 días, para la mayoría de los casos. La adherencia al tratamiento es crucial para obtener buenos resultados terapéuticos.


ABSTRACT The infection for helicobacter pylori affects approximately to the world population's 50%, it is causing of chronic gastritis, peptic ulcer, gastric cancer and linfoma associated to the mucous one. From their discovery, the eradication has been one of the most important challenges in Gastroenterología. In many countries the prevalencia of primary resistance is ignored from the microorganism to the different antibiotics that empirically they are used, and for not carrying out routine tests that verify its eradication in the daily practice, the effectiveness of the prescribed outlines it is ignored. The progressive increment of the resistance to the claritromicina and metronidazol, together to an absence of alternative antibioticotherapy, challenges the capacity to eliminate from an effective way to this bacteria. The bismuth subcitrato has resurged and its addition in the therapy has allowed to increase the cure rates above 90%. At the moment it is invoked that to improve the effectiveness in the treatment, that is should combine a potent suppression of the gastric acid in combined quadruple treatments with a duration of 14 days, for most of the cases. The adherence to the treatment is crucial to obtain therapeutic good results.


Subject(s)
Humans , Drug Resistance, Microbial , Risk Factors , Helicobacter Infections/etiology , Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Treatment Outcome , Drug Therapy, Combination , Disease Eradication , Peptic Ulcer/diagnosis , Stomach Neoplasms/diagnosis , Tetracycline/therapeutic use , Bismuth/therapeutic use , Adenocarcinoma/diagnosis , Clarithromycin , Lymphoma, B-Cell, Marginal Zone/diagnosis , Acidity Regulator , Proton Pump Inhibitors/therapeutic use , Treatment Adherence and Compliance , Gastritis/diagnosis , Gastroenterology , Metronidazole , Metronidazole/therapeutic use
9.
Article in English | AIM | ID: biblio-1272793

ABSTRACT

Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy.Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance


Subject(s)
Bacterial Infections , Disease Eradication , Drug Therapy, Combination , Egypt , Helicobacter Infections/drug therapy , Moxifloxacin
10.
Gastroenterol. latinoam ; 30(supl.1): S18-S25, 2019. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1116305

ABSTRACT

Helicobacter pylori (H. pylori) is a gram negative bacteria that survives in the gastric acid environment. The infection is acquired mainly during childhood. Fifty to 70% of adult population has the infection. However, in the last 10 year, a decrease in the prevalence of this infection has been observed in all age groups, in particular in pediatric population and elderly patients over 60 years old. The evolution of the infection depends on bacterial factors (virulence and toxins) and host immune response. People infected mainly develop gastrointestinal diseases such as gastritis, peptic ulcer and MALT lymphoma. H. pylori infection is the main risk factor of gastric cancer and for that reason, the eradication is recommended if H. pylori has been detected through invasive or non-invasive tests. Among children, eradication is not recommended unless there is a clinical manifestation that merits. H. pylori eradication is recommended in symptomatic adults and there is a controversy about massive eradication in asymptomatic population due to the risk of development of antibiotic resistance. Treatment is based on the use of proton pump inhibitors (PPI) associated to antibiotics, that should be chosen taking into account the increasing antibiotic resistance, and local availability. Clarithromycin (CLA) and levofloxacin resistance is increasingly high, and CLA-free quadruple therapy schemes are currently recommended for first-line therapy. H. pylori eradication must be confirmed with invasive or non-invasive tests. Second-line therapy based on antibiotics not previously used, PPI high doses and bismuth is recommended.


Helicobacter pylori (H. pylori) es una bacteria gramnegativa que sobrevive en el medio ácido gástrico. La infección se adquiere principalmente en la niñez. Un 50 a 70% de la población adulta es portadora, pero en los últimos 10 años, se ha observado una disminución en la prevalencia de infección en todos los grupos etarios, en particular en población pediátrica y mayores de 60 años. La evolución de la infección depende de factores propios de la bacteria (virulencia, toxinas) y de la respuesta inmune del huésped. Los individuos infectados desarrollan principalmente patologías gastrointestinales como gastritis, úlcera péptica y linfoma MALT. La infección por H. pylori es el principal factor de riesgo del cáncer gástrico por lo que se recomienda su erradicación en caso de haberse detectado mediante test invasivo o no invasivo. En niños, no es recomendable la erradicación a menos que exista una manifestación clínica que lo amerite. Se recomienda su erradicación en adultos sintomáticos y existe controversia respecto a la erradicación masiva en población asintomática debido al riesgo de desarrollar resistencia antibiótica. El tratamiento se basa en el uso de inhibidores de la bomba de protones asociado a antibióticos, los cuales deben ser escogidos teniendo en cuenta la tasa de resistencia antimicrobiana y disponibilidad local. La resistencia a claritromicina (CLA) y levofloxacino es creciente, por lo que se recomienda el uso de esquemas de cuadriterapia libre de CLA en esquemas de primera línea. Se recomienda confirmar su erradicación con test no invasivos y retratar con esquema de segunda línea con antibióticos no utilizados previamente, asociado a dosis altas de inhibidores de bomba de protones y sales de bismuto.


Subject(s)
Humans , Child , Adult , Helicobacter Infections/drug therapy , Remission Induction , Helicobacter pylori/drug effects , Helicobacter pylori/pathogenicity , Helicobacter Infections/diagnosis , Helicobacter Infections/physiopathology , Age Factors , Clarithromycin/therapeutic use , Drug Resistance, Bacterial/drug effects , Drug Therapy, Combination , Proton Pump Inhibitors/therapeutic use , Levofloxacin/therapeutic use
13.
Braz. j. infect. dis ; 22(4): 311-316, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974231

ABSTRACT

ABSTRACT Aim To analyze the influence of the -31 C/T polymorphism of the interleukin-1β gene on Helicobacter pylori eradication therapy success in patients with functional dyspepsia. Methods Functional dyspepsia was diagnosed according to the Rome III criteria. All patients underwent upper gastrointestinal endoscopy, and gastric biopsies were obtained at screening and 12 months after randomization (last follow-up visit). Urease test and histological examination were performed to define the H. pylori status. Patients received twice-daily amoxicillin, clarithromycin and omeprazole for 10 days. Genotyping of the interleukin-1beta -31 C/T polymorphism (rs1143627) was performed using polymerase chain reaction-restriction fragment length polymorphism. Results One hundred forty-nine patients received treatment with triple therapy for H. pylori eradication. Only one patient was lost to follow-up, and adherence to study medication was 94.6%. A total of 148 patients (mean age 46.08 ± 12.24 years; 81.8% women) were evaluated for the influence of the interleukin-1beta -31 C/T polymorphism on the outcome of H. pylori eradication therapy. After treatment, bacteria were eradicated in 87% of patients (129/148). Genotype frequencies of the polymorphism were as follows: CC, 38/148 (25.7%); CT, 71/148 (47.9%); and TT, 39/148 (26.4%). Successful eradication rate was 78.9%, 94.4% and 82.1% for the CC, CT and TT genotypes, respectively. The CT genotype was significantly associated with successful H. pylori eradication (p= 0.039). Conclusion This study suggests that the CT genotype of the interleukin-1beta -31 C/T polymorphism plays a role in the successful eradication of H. pylori among patients with functional dyspepsia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Polymorphism, Genetic , Helicobacter pylori/drug effects , Helicobacter Infections/drug therapy , Dyspepsia/drug therapy , Interleukin-1beta/genetics , Anti-Bacterial Agents/therapeutic use , Omeprazole/therapeutic use , Double-Blind Method , Follow-Up Studies , Helicobacter pylori/genetics , Treatment Outcome , Clarithromycin/therapeutic use , Dyspepsia/diagnosis , Genotype , Amoxicillin/therapeutic use , Anti-Ulcer Agents/therapeutic use
15.
Middle East Journal of Digestive Diseases. 2018; 10 (1): 5-17
in English | IMEMR | ID: emr-192419

ABSTRACT

Helicobacter pylori [H. pylori] infection is one of the most common bacterial infections, affecting almost half of the world's population. It is associated with peptic ulcer disease, gastric adenocarcinoma, and lymphoma. In Iran, the prevalence of H. pylori infection has been reported to be between 36% and 90% in different geographic regions. Several studies have assessed the efficacy of different therapeutic options for first line and second-line H. pylori eradication in Iran; however, the results are conflicting. Therefore, we conducted a review to evaluate different studies in order to select the best options and to provide recommendations for H. pylori eradication in Iran. Accordingly, we searched through PubMed to obtain relevant randomized clinical trials published in English language up to June 2017. According to our study, among first-line eradication regimens, bismuth-based furazolidone-or clarithromycin-containing quadruple therapies, hybrid regimen, and concomitant therapy seem to be appropriate options. Also, 10- or 14-day clarithromycin-containing triple therapy can be used if local H. pylori resistance to clarithromycin is known to be less than 15%. For second-line H. pylori eradication, bismuth-based quadruple therapies and 14-day levofloxacin-based triple therapy can be used, provided that antibiotics other than those used in the first-line regimen are used. Third-line H. pylori eradication regimens have not been addressed in Iranian studies. However, most guidelines recommend treatment according to the results of culture and susceptibility testing. Although we limited our investigation to H. pylori eradication regimens in Iran, the results are transferrable to any region as long as the patterns of antibiotic resistance are the same


Subject(s)
Humans , Helicobacter Infections/epidemiology , Disease Eradication , Helicobacter pylori , Helicobacter Infections/drug therapy
16.
Govaresh. 2018; 22 (4): 261-265
in English | IMEMR | ID: emr-192476

ABSTRACT

Background: Clinical trials and meta-analyses have reported about 20% failure rates in first-line Helicobacter pylori [H. pylori] eradication. This reflects the need for effective second-line eradication regimens


Materials and Methods: 61 patients with H. pylori infection who had failed previous non-bismuth clarithromycin-containing first line therapies entered the study. They were given a 14-day levofloxacin-containing triple regimen consisted of pantoprazole 40 mg, amoxicillin 1gr, and levofloxacin 500mg, each given twice daily. Eight weeks after the treatment, H. pylori eradication was assessed by 14C-urea breath test


Results: All patients completed the study. The eradication rate was 91.8% [95% confidence interval = 84.9% - 98.6%] by both intention to treat and per-protocol analyses. Side effects of therapy were reported by eight patients [13.1%], but they were severe in only two patients [3.2%]


Conclusion: According to the high H. pylori eradication rate and the very low rate of severe adverse effects, levofloxacin-containing triple therapy seems to be a suitable second-line option in case of previous failure by clarithromycin-containing therapies. We suggest further studies with shorter duration of treatment or lower dose of levofloxacin


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Helicobacter Infections/drug therapy , Disease Eradication , Levofloxacin/therapeutic use , Clarithromycin/therapeutic use , Amoxicillin , Drug Therapy, Combination
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