scholarly journals In Haitian women and preschool children, iron absorption from wheat flour-based meals fortified with sodium iron EDTA is higher than that from meals fortified with ferrous fumarate, and is not affected by Helicobacter pylori infection in children

2017 ◽  
Vol 118 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Isabelle Herter-Aeberli ◽  
Kerline Eliancy ◽  
Yanick Rathon ◽  
Cornelia U. Loechl ◽  
Joseline Marhône Pierre ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Preschool Children ◽  
Wheat Flour ◽  
Geometric Mean ◽  
Cost Effective ◽  
Haitian Women ◽  
Ferrous Fumarate ◽  
Fe Isotopes ◽  
Women And Children ◽  
H Pylori

AbstractFe fortification of wheat flour was proposed in Haiti to combat Fe deficiency, but Fe bioavailability from fortificants has never been investigated in Haitian women or preschool children, two key target groups. We aimed to investigate the bioavailability of ferrous fumarate (FeFum), NaFeEDTA and their combination from fortified wheat flour. We recruited twenty-two healthy mother–child pairs in Port au Prince, Haiti, for an Fe-absorption study. We administered stable Fe isotopes as FeFum or NaFeEDTA individually in low-extraction wheat flour bread rolls consumed by all participants in a randomised, cross-over design. In a final, identical meal, consumed only by the women, FeFum+NaFeEDTA was administered. We measured Fe absorption by using erythrocyte incorporation of stable isotopes 14 d after consumption of each meal, and determined Fe status, inflammatory markers and Helicobacter pylori infection. Fe absorption (geometric mean was 9·24 (95 % CI 6·35, 13·44) and 9·26 (95 % CI 7·00, 12·31) from FeFum and 13·06 (95 % CI 9·23, 19·10) and 12·99 (95 % CI 9·18, 18·39) from NaFeEDTA in mothers and children, respectively (P<0·05 between compounds). Fe absorption from FeFum+NaFeEDTA was 11·09 (95 % CI 7·45, 17·34) and did not differ from the other two meals. H. pylori infection did not influence Fe absorption in children. In conclusion, in Haitian women and children, Fe absorption from NaFeEDTA was 40 % higher than from FeFum, and the combination FeFum+NaFeEDTA did not significantly increase Fe absorption compared with FeFum alone. In the context of Haiti, where the high costs of NaFeEDTA may not be affordable, the use of FeFum at 60 mg Fe/kg flour may be a preferable, cost-effective fortification strategy.

scholarly journals Asymptomatic Helicobacter Pylori Infection in Preschool Children and Young Women Does Not Predict Iron Bioavailability from Iron-Fortified Foods

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2093 ◽  
Author(s):  
Simone Buerkli ◽  
Ndèye Fatou Ndiaye ◽  
Colin I. Cercamondi ◽  
Isabelle Herter-Aeberli ◽  
Diego Moretti ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Preschool Children ◽  
Young Women ◽  
Low Income ◽  
Iron Absorption ◽  
Iron Bioavailability ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Women And Children ◽  
H Pylori

Helicobacter pylori infection is common in low-income countries. It has been associated with iron deficiency and reduced efficacy of iron supplementation. Whether H. pylori infection affects iron absorption from fortified and biofortified foods is unclear. Our objective was to assess whether asymptomatic H. pylori infection predicts dietary iron bioavailability in women and children, two main target groups of iron fortification programs. We did a pooled analysis of studies in women of reproductive age and preschool children that were conducted in Benin, Senegal and Haiti using stable iron isotope tracers to measure erythrocyte iron incorporation. We used mixed models to assess whether asymptomatic H. pylori infection predicted fractional iron absorption from ferrous sulfate, ferrous fumarate or NaFeEDTA, controlling for age, hemoglobin, iron status (serum ferritin), inflammation (C-reactive protein), and test meal. The analysis included 213 iron bioavailability measurements from 80 women and 235 measurements from 90 children; 51.3% of women and 54.4% of children were seropositive for H. pylori. In both women and children, hemoglobin (Hb), serum ferritin (SF), and C-reactive protein (CRP) did not differ between the seropositive and seronegative groups. Geometric mean (95% CI) fractional iron absorption (%), adjusted for SF, was 8.97% (7.64, 10.54) and 6.06% (4.80, 7.67) in H. pylori positive and negative women (p = 0.274), and 9.02% (7.68, 10.59) and 7.44% (6.01, 9.20) in H. pylori positive and negative children (p = 0.479). Our data suggest asymptomatic H. pylori infection does not predict fractional iron absorption from iron fortificants given to preschool children or young women in low-income settings.

Endoscopic Biopsy Pathology of Helicobacter pylori Gastritis

1999 ◽  
Vol 123 (9) ◽  
pp. 778-781 ◽  
Author(s):  
Maher Toulaymat ◽  
Sharon Marconi ◽  
Jane Garb ◽  
Christopher Otis ◽  
Shirin Nash
Keyword(s):  
Helicobacter Pylori ◽  
Specific Antibody ◽  
Cost Effective ◽  
Endoscopic Biopsy ◽  
Immunohistochemical Method ◽  
Labor Costs ◽  
Chronic Active Gastritis ◽  
Cost Effective Method ◽  
H Pylori ◽  
Helicobacter Pylori Gastritis

Abstract Objectives.—To describe the endoscopic biopsy pathology of Helicobacter pylori gastritis, compare bacterial detection by immunohistochemistry using a specific antibody with the Genta stain, and to compare the relative costs of the 2 techniques. Design.—One hundred cases of gastritis identified as positive for H pylori by Genta stain and 100 cases considered negative by the same technique were stained using an anti-H pylori–specific polyclonal antibody. Laboratory reagent and labor costs for the 2 methods were compared. Results.—Chronic active gastritis with lymphoid follicles was significantly associated with H pylori infection (P &lt; .0001). The immunohistochemical method had a sensitivity of 97% and a specificity of 98% compared with the Genta stain, with strong agreement for grading density of organisms (κ = 0.85; P &lt; .001). Reagent costs were similar for both methods, but immunohistochemistry using an autoimmunostainer required less dedicated technical time and hence was less expensive than the Genta stain. Conclusions.—Immunohistochemistry using a specific antibody is an accurate and cost-effective method for H pylori detection in gastric biopsies.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

A comparative study of the 14C-Urea Breath Test and histology for the detection of Helicobacter pylori in terms of cost effectiveness and patient acceptability

2001 ◽  
Author(s):  
◽  
Fawzia Ismail Peer
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effectiveness ◽  
Biopsy Specimen ◽  
Breath Test ◽  
Histological Analysis ◽  
Cost Effective ◽  
Urea Breath Test ◽  
Patient Acceptability ◽  
Carbon 14 ◽  
H Pylori

The purpose of this study was to evaluate the Carbon-14 Urea Breath Test e4C-UBT) and histology for the detection of Helicobacter pylori (H pylori) in terms of cost-effectiveness and patient perceptions. It was hypothesized that the 14C_UBTwas more cost-effective and more easily tolerated than a histological analysis of a biopsy specimen obtained on endoscopy for H pylori detection

scholarly journals Helicobacter pylori Infection following Endoscopic Resection of Early Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Lan Li ◽  
Chaohui Yu
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Precancerous Lesions ◽  
Cost Effective ◽  
Reduce Healthcare Cost ◽  
Metachronous Gastric Cancer ◽  
H Pylori ◽  
Meta Analyses

The role of Helicobacter pylori (H. pylori) infection in patients following endoscopic resection of early gastric cancer (EGC) remains unclear. This article presents a review of literature published in the past 15 years. H. pylori‐mediated persistent methylation levels are associated with the development of metachronous gastric cancer. The methylation of certain specific genes can be used to identify patients with a high risk of metachronous gastric cancer even after H. pylori eradication. H. pylori eradication after endoscopic resection should be performed as early as possible for eradication success and prevention of metachronous precancerous lesions. Although whether the eradication of H. pylori could prevent the development of metachronous cancer after endoscopic resection is controversial, several meta‐analyses concluded that H. pylori eradication could reduce the incidence of metachronous gastric cancer significantly. In addition, H. pylori eradication in gastric cancer survivors after endoscopic resection could reduce healthcare cost and save lives in a cost‐effective way. Taken together, H. pylori eradication after endoscopic resection of EGC is recommended as prevention for metachronous precancerous lesions and metachronous gastric cancer.

scholarly journals Susceptibility-guided bismuth quadruple therapies for resistant Helicobacter pylori infections

2020 ◽  
Vol 3 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Tiankuo Yang ◽  
Renwei Hu ◽  
Xiaoqiong Tang ◽  
Yalin Shen ◽  
Alfred Tay ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Point Mutations ◽  
Previous Treatment ◽  
Cost Effective ◽  
Subsequent Treatment ◽  
Chinese Patients ◽  
23S Rrna ◽  
Molecular Testing ◽  
Sequencing Analysis ◽  
H Pylori

Abstract Increasing Helicobacter pylori resistance to antibiotics has ledthat molecular testing is appropriate as a sub to adoption of seven different bismuth quadruple therapies (BQT) in China without differentiation of first-line or second-line regimens. The objective of this study was to evaluate the efficacy of susceptibility-guided BQT for patients who had experienced previous treatment failures. A total of 133 patients was included and H. pylori was successfully cultured from 101 patients (75.9%) for subsequent antimicrobial susceptibility testing (AST). Based on the AST results, 88 patients completed one of five AST-guided 14-day BQT regimens: esomeprazole and bismuth colloidal pectin, along with either, amoxicillin and clarithromycin (EBAC), amoxicillin and levofloxacin (EBAL), amoxicillin and furazolidone (EBAF), amoxicillin and tetracycline (EBAT), or tetracycline and furazolidone (EBTF). H. pylori eradication rates were 100% for EBAC (5/5), EBAL (13/13), EBAF (14/14), and EBTF (43/43), but 76.9% for EBAT (10/13). The three patients that failed the EBAT regimen were all cured after subsequent treatment with the EBTF regimen. Our study demonstrates the excellent efficacy of the AST-guided BQT for referred H. pylori patients, and that the current EBAT regimen, used in clinics, needs to be optimized. In addition, 57 of the isolates were subjected to whole-genome sequencing. Analysis of the sequences revealed that point mutations in 23S rRNA correlated well with the phenotypic clarithromycin resistance with a concordance of 91.2%, while the concordance between phenotypic levofloxacin resistance and gyrA point mutations was 82.3%. This suggests that molecular testing is appropriate as a substitute for AST as a more rapid and cost-effective method for determining clarithromycin and levofloxacin resistance in Chinese patients.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals Helicobacter pylori rocF Is Required for Arginase Activity and Acid Protection In Vitro but Is Not Essential for Colonization of Mice or for Urease Activity

1999 ◽  
Vol 181 (23) ◽  
pp. 7314-7322 ◽  
Author(s):  
David J. McGee ◽  
Fiona J. Radcliff ◽  
George L. Mendz ◽  
Richard L. Ferrero ◽  
Harry L. T. Mobley
Keyword(s):  
Helicobacter Pylori ◽  
Urease Activity ◽  
Geometric Mean ◽  
Acid Exposure ◽  
Arginase Activity ◽  
Gene Encoding ◽  
Acid Sensitivity ◽  
H Pylori

ABSTRACT Arginase of the Helicobacter pylori urea cycle hydrolyzes l-arginine to l-ornithine and urea.H. pylori urease hydrolyzes urea to carbon dioxide and ammonium, which neutralizes acid. Both enzymes are involved inH. pylori nitrogen metabolism. The roles of arginase in the physiology of H. pylori were investigated in vitro and in vivo, since arginase in H. pylori is metabolically upstream of urease and urease is known to be required for colonization of animal models by the bacterium. The H. pylori genehp1399, which is orthologous to the Bacillus subtilis rocF gene encoding arginase, was cloned, and isogenic allelic exchange mutants of three H. pylori strains were made by using two different constructs: 236-2 androcF::aphA3. In contrast to wild-type (WT) strains, all rocF mutants were devoid of arginase activity and had diminished serine dehydratase activity, an enzyme activity which generates ammonium. Compared with WT strain 26695 of H. pylori, the rocF::aphA3 mutant was ∼1,000-fold more sensitive to acid exposure. The acid sensitivity of the rocF::aphA3 mutant was not reversed by the addition of l-arginine, in contrast to the WT, and yielded a ∼10,000-fold difference in viability. Urease activity was similar in both strains and both survived acid exposure equally well when exogenous urea was added, indicating that rocF is not required for urease activity in vitro. Finally, H. pylorimouse-adapted strain SS1 and the 236-2 rocF isogenic mutant colonized mice equally well: 8 of 9 versus 9 of 11 mice, respectively. However, the rocF::aphA3 mutant of strain SS1 had moderately reduced colonization (4 of 10 mice). The geometric mean levels of H. pylori recovered from these mice (in log10 CFU) were 6.1, 5.5, and 4.1, respectively. Thus,H. pylori rocF is required for arginase activity and is crucial for acid protection in vitro but is not essential for in vivo colonization of mice or for urease activity.

scholarly journals Screening and eradication of Helicobacter pylori for gastric cancer prevention: the Taipei global consensus

Gut ◽  
2020 ◽  
Vol 69 (12) ◽  
pp. 2093-2112 ◽  
Author(s):  
Jyh-Ming Liou ◽  
Peter Malfertheiner ◽  
Yi-Chia Lee ◽  
Bor-Shyang Sheu ◽  
Kentaro Sugano ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Eradication Therapy ◽  
Population Level ◽  
Cost Effective ◽  
Current Evidence ◽  
Global Consensus ◽  
Vulnerable Subjects ◽  
H Pylori

ObjectiveA global consensus meeting was held to review current evidence and knowledge gaps and propose collaborative studies on population-wide screening and eradication of Helicobacter pylori for prevention of gastric cancer (GC).Methods28 experts from 11 countries reviewed the evidence and modified the statements using the Delphi method, with consensus level predefined as ≥80% of agreement on each statement. The Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach was followed.ResultsConsensus was reached in 26 statements. At an individual level, eradication of H. pylori reduces the risk of GC in asymptomatic subjects and is recommended unless there are competing considerations. In cohorts of vulnerable subjects (eg, first-degree relatives of patients with GC), a screen-and-treat strategy is also beneficial. H. pylori eradication in patients with early GC after curative endoscopic resection reduces the risk of metachronous cancer and calls for a re-examination on the hypothesis of ‘the point of no return’. At the general population level, the strategy of screen-and-treat for H. pylori infection is most cost-effective in young adults in regions with a high incidence of GC and is recommended preferably before the development of atrophic gastritis and intestinal metaplasia. However, such a strategy may still be effective in people aged over 50, and may be integrated or included into national healthcare priorities, such as colorectal cancer screening programmes, to optimise the resources. Reliable locally effective regimens based on the principles of antibiotic stewardship are recommended. Subjects at higher risk of GC, such as those with advanced gastric atrophy or intestinal metaplasia, should receive surveillance endoscopy after eradication of H. pylori.ConclusionEvidence supports the proposal that eradication therapy should be offered to all individuals infected with H. pylori. Vulnerable subjects should be tested, and treated if the test is positive. Mass screening and eradication of H. pylori should be considered in populations at higher risk of GC.

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