POPULATION-BASED AND OPPORTUNISTIC SCREENING AND ERADICATION OF HELICOBACTER PYLORI

1999 ◽  
Vol 15 (4) ◽  
pp. 649-660 ◽  
Author(s):  
James M. Mason ◽  
Paul Moayyedi ◽  
Philip J. Young ◽  
Sara Duffett ◽  
Will Crocombe ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Savings ◽  
Population Based ◽  
Opportunistic Screening ◽  
Test Results ◽  
Data Set ◽  
Limited Dependent Variable ◽  
H Pylori ◽  
The Cost ◽  
Care Costs

Objectives: To examine whether screening and eradication of Helicobacter pylori by population-based invitation or opportunistic screening by general practitioners reduces costs to the National Health Service (NHS) of treating dyspepsia.Methods: A limited dependent, variable, two-step regression analysis was used to explore the baseline annual health care costs of dyspepsia for men and women aged 40–49 enrolled in the Leeds H. pylori screening and eradication trial.Results: Epidemiological and clinical questionnaires, general practitioner notes, and 13C urea breath test results were available for 4,754 individuals. After adjusting for covariates, H. pylori was associated with a 6.7% increased probability of incurring gastrointestinal-related NHS costs (p < .0001) in the population aged 40-49. Additionally, H pylori increased average costs in those who seek medical care (p = .001). In consequence, H. pylori is associated with an average increased cost to the NHS of £0.30 per year (95% CI: £0.17 to £0.45) per adult aged 40–49. In those consulting for dyspepsia, the increased cost to the NHS was £1.04 per year (95% CI: £0.42 to £1.75) per patient. The cost of population screening and treatment would not be recovered in reduced dyspepsia costs in the lifetime of those screened. Assuming laboratory-based serology screening is used opportunistically in patients presenting with dyspepsia, it is estimated that costs would be recouped in 18 years.Conclusions: This observational data set suggests that the costs of screening and treatment in all individuals aged 40–49 or in those presenting in primary care with dyspeptic symptoms are unlikely to be attractive on the basis of cost savings alone.

scholarly journals Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Tsachi Tsadok Perets ◽  
Hemda Schmilovitz-Weiss ◽  
Rachel Gingold-Belfer ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Treatment Success ◽  
Population Based ◽  
Urea Breath Test ◽  
First Line Therapy ◽  
13C Urea Breath Test ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

scholarly journals Helicobacter pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy: an open randomized clinical trial

2005 ◽  
Vol 42 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Laura Cidrão Frota ◽  
Maria do Perpétuo Socorro Saldanha da Cunha ◽  
Carlos René Lima Luz ◽  
Antonio Haroldo de Araujo-Filho ◽  
Luciano A. S. Frota ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Protocol Analysis ◽  
Urea Breath Test ◽  
Test Results ◽  
Suitable Alternative ◽  
Helicobacter Pylori Eradication ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
To Receive

BACKGROUND: Optimal anti-Helicobacter pylori treatment has not yet been established. AIM: To evaluate H. pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy in northeastern of Brazil. PATIENTS AND METHODS: One hundred and four patients with H. pylori infection, as determined by rapid urease testing and histology, were randomly assigned to receive either: lansoprazole (30 mg q.d.), tetracycline (500 mg q.i.d.), and furazolidone (200 mg t.i.d.) for 7 days (LTF; n = 52); or lansoprazole (30 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week, plus azithromycin (500 mg q.d.) for the first 3 days (LAAz; n = 52). H. pylori eradication was assessed 3 months following completion of therapy by means of rapid urease testing, histology and a 14C-urea breath test. RESULTS: H. pylori eradication was achieved in 46 of 52 (88.4%, 95% CI: 77.5%-95.1%) patients in LTF group and in 14 of 52 (26.9%, 95% CI: 16.2%-40,1%) patients in LAAz group. On a per-protocol analysis, eradication rates were 91.8% (95% CI: 81.4%-97.3%) and 28.5% (95% CI: 17.2%-42.3%), respectively in LTF and LAAz groups. CONCLUSION: The LAAz regimen yielded unacceptably low eradication rates. On the other hand, the LTF scheme represents a suitable alternative for H. pylori eradication.

scholarly journals The Effect of Gastric Helicobacter pylori Colonization on Nasal Functions

2019 ◽  
Vol 98 (6) ◽  
pp. 346-350 ◽  
Author(s):  
Tolgar Lütfi Kumral ◽  
Yasemin Gökden ◽  
Ziya Saltürk ◽  
Güler Berkiten ◽  
Güven Yıldırım ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Laryngopharyngeal Reflux ◽  
Test Results ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Olfactory Test ◽  
Sinonasal Outcome Test ◽  
H Pylori ◽  
Nasal Function ◽  
Snot 22

The aim of this study is to investigate the effect of gastric Helicobacter pylori colonization on nasal functions. The study enrolled patients (n = 100) who underwent endoscopy for gastroesophageal reflux disease. Patients with laryngopharyngeal reflux (LPR) were identified by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). Patients were divided into 2 groups: LPR (+) (n = 64) H pylori (+), RSI > 13, RFS > 7; LPR (−) (n = 36) H pylori (+), RSI < 13, RFS < 7. Visual analog scale (VAS), sinonasal outcome test-22 (SNOT-22), peak nasal inspiratory flowmeter (PNIF), mucociliary clearance (MCC), and olfactory tests were used to evaluate the nasal functions. The average VAS for nasal obstruction, PNIF, and MCC did not differ significantly between the LPR (+) and LPR (−) groups ( P > .05). However, the average olfactory test scores were lower in the LPR (+) patients than the LPR (−) patients ( P < .05). Also, the SNOT-22 scores were significantly higher in LPR (+) patients than in LPR (−) ( P < .01). Nasal functions and symptom scores were also evaluated according to the H pylori grading. The PNIF, MCC, SNOT-22, and olfactory test results deteriorated as the gastric mucosal H pylori colonization increased ( P < .05). In conclusion, nasal functions differed between LPR disease and GERD only, while the density of H pylori colonization in the gastric mucosa had an effect on nasal function.

scholarly journals Will Treatment of Helicobacter Pylori Infection in Childhood Alter the Risk of Developing Gastric Cancer?

2005 ◽  
Vol 19 (7) ◽  
pp. 409-411 ◽  
Author(s):  
Billy Bourke
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Precancerous Lesions ◽  
Positive Family History ◽  
Population Based ◽  
Screening Programs ◽  
History Of ◽  
Different Populations ◽  
H Pylori ◽  
Developed Nations

Helicobacter pylori has been classified as a group 1 carcinogen for gastric cancer. It is estimated that there is between a two- and sixfold increase in the risk of developing gastric cancer among infected patients. Among different populations, the risk of H pylori-infected individuals developing gastric cancer varies greatly. However, on a worldwide scale, gastric cancer is the second most common cause of cancer-related death. Therefore, H pylori eradication could help prevent up to three to four million gastric cancer deaths per year. H pylori is usually acquired in childhood. Because infected children have not harboured the organism for long enough to have developed precancerous lesions, childhood is theoretically an attractive time for H pylori eradication and, thus, could help prevent gastric cancer later in life. However, as H pylori prevalence and the incidence of gastric cancer are falling rapidly in developed nations, widespread population screening programs aimed at the eradication of H pylori in these countries would be enormously expensive. Therefore, except in groups with a high risk for development of gastric cancer (eg, Japanese or those with a strong positive family history of gastric cancer), a population-based test-and-treat policy is not justified.

scholarly journals Elimination of Helicobacter pylori Infection in Patients with Gastrointestinal Problems After Administration of Four-Drug Regimen: A Brief Report

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Mohammad Hosseini Azar ◽  
Mohammad Jafari Heidarloo ◽  
Hamze Majidi ◽  
Sahar Paryab ◽  
Omid Garkaz ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Drug Regimen ◽  
Helicobacter Pylori Infection ◽  
Antimicrobial Compounds ◽  
Test Results ◽  
Chi Square ◽  
Treatment Regimens ◽  
Included Patient ◽  
Gastrointestinal Problems ◽  
H Pylori

Background: There are a variety of treatment regimens containing several antimicrobial compounds to treat Helicobacter pylori infection. Objectives: The aim of this study was to eradicate H. pylori infection in patients with gastrointestinal problems after the administration of a four-drug regimen. Methods: This study was performed among 100 patients with gastrointestinal problems visiting Imam Khomeini Hospital in Urmia, Iran. The data were collected using a checklist that included patient information and analyzed by chi-square and t-test. Results: Out of the 100 patients visiting the clinic, 60 (60%) were male, and the rest were women. Also, 67% of the patients had pain type dyspepsia, and 33% of them postprandial distress type. In pathologic study, 38% of the patients had H. pylori infection, with a significantly higher incidence in patients with pain type dyspepsia. Conclusions: The results showed a relationship between the type of indigestion and the improvement of symptoms after receiving a four-drug regimen, indicating the need for proper planning to diagnose and treat the type of indigestion.

scholarly journals Comparison of rapid cassette test and micro ELISA method for Helicobacter pylori diagnosis in patients with gastric complaints

2019 ◽  
Author(s):  
Sadik Akgun ◽  
Sezgin Barutcu ◽  
Sumeyya Capuk ◽  
Arzu Tanriverdi ◽  
Serihan Kübra Emikoglu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Quantitative Methods ◽  
Elisa Test ◽  
Diagnostic Methods ◽  
Clinical Microbiology Laboratory ◽  
Test Results ◽  
Serum Samples ◽  
Blood Samples ◽  
Study Results ◽  
H Pylori

Abstract Background: Helicobacter pylori (H. pylori) is a significant contributor of various gastrointestinal disorders and cancers all around the world. Its diagnosis is dependent on several qualitative and quantitative methods. The present study aims to compare the results of rapid cassette and micro ELISA test methods for diagnosis of H. pylori and determining associations with patient endoscopy reports. Methods: The study was performed using blood samples collected from 224 patients (142 (63%) females and 82 (37%) males) in various clinics between January 2018 and August 2019, which were sent to the Clinical Microbiology Laboratory of Training Hospital. Serum samples obtained after centrifugation of the blood samples were initially tested with rapid H. pylori IgG cassette method, and afterwards in the auto analyzer using ELISA assays specific for H. pylori. Results: Upper gastrointestinal system endoscopy was performed in 88 of these patients, and biopsy results confirmed definitive diagnosis of H. pylori infection in 63 of the patients. Rapid H. pylori cassette test results of the 224 patients were negative for 158 (70.5%) patients and positive for 66 (29.5%) patients, whereas micro ELISA IgA test results were negative for 110 (49.1%) patients and positive for 114 (50.9%) patients. Micro ELISA IgG test results were negative for 85 (37.9%) patients and positive for 139 (62.1%) patients. Conclusions: Invasive diagnostic methods for H. pylori infection may sometimes be inconvenient, and therefore the diagnosis may have to rely on non-invasive tests. Bases on the study results, we believe micro ELISA test results are more reliable with regard to avoidance of missed diagnosis. Keywords: Helicobacter pylori, Rapid casette test, ELISA, Gastric ulcer

scholarly journals Reliability of Helicobacter pylori and CagA Serological Assays

2002 ◽  
Vol 9 (2) ◽  
pp. 412-416 ◽  
Author(s):  
James E. Everhart ◽  
Deanna Kruszon-Moran ◽  
Guillermo Perez-Perez
Keyword(s):  
Helicobacter Pylori ◽  
Mexican Americans ◽  
Odds Ratio ◽  
Serological Test ◽  
Population Based ◽  
Immune Serum ◽  
Serological Tests ◽  
Population Based Study ◽  
Health And Nutrition ◽  
H Pylori

ABSTRACT Background serological assays for Helicobacter pylori are commonly used without knowledge of reliability. This information is needed to define the ability of serological tests to determine either new cases of infection or loss of infection in longitudinal studies. We evaluated the reproducibility and the interrelationships of serological test results for H. pylori and cytotoxin-associated gene product A (CagA) enzyme-linked immunoassays within a subset of participants in a population-based study. Stored samples from 1,229 participants in the third U.S. National Health and Nutrition Examination Survey were replicate serologically tested for H. pylori and CagA. Overall disagreement was 3.4% between duplicate tests for H. pylori (or 2.3% if equivocal results were disregarded). Six percent of samples positive on the first test had an immune serum ratio at least 30% lower on repeat testing. The odds ratio for H. pylori seropositivity on retesting was 2.8 (95% confidence interval [CI] = 1.8 to 4.5) when CagA serology was positive versus when it was negative. CagA antibody was found among 47.8% of H. pylori-equivocal and 7.0% of H. pylori-negative samples. CagA-positive yet H. pylori-negative samples were more likely to occur among Mexican Americans (odds ratio, 5.2; 95% CI = 2.4 to 11.4) and non-Hispanic blacks (odds ratio, 5.5; 95% CI = 2.3 to 13.0) than among non-Hispanic whites. Relying on repeated H. pylori serological tests over time to determine infection rates may result in misinterpretation due to limits in test reproducibility. CagA testing may have a role in verifying infection.

scholarly journals The Association between Serum Vitamin D Levels and Helicobacter pylori Presence and Eradication

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 278
Author(s):  
Asher Shafrir ◽  
Michal Shauly-Aharonov ◽  
Lior H. Katz ◽  
Ora Paltiel ◽  
Yishai Pickman ◽  
...  
Keyword(s):  
Vitamin D ◽  
Helicobacter Pylori ◽  
Health Maintenance Organization ◽  
Serum Vitamin ◽  
Population Based ◽  
Health Maintenance ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Antigen Tests ◽  
H Pylori

Background: The success of Helicobacter pylori (H. pylori) eradication depends on several host and treatment factors. Serum vitamin D levels may be associated with H. pylori infection and eradication rates. We investigated the association between vitamin D and H. pylori infection and eradication, using a large electronic database based on medical records from a population-based health maintenance organization. Methods: Data regarding adults who underwent H. pylori testing and had vitamin D measurements within one month of H. pylori testing were collected. H. pylori infection was ascertained using urea breath or stool antigen tests. A negative H. pylori test following a positive result implied eradication. Multivariate regression models were constructed to assess associations between H. pylori infection, eradication, and vitamin D. Results: Among 150,483 members who underwent H. pylori testing from 2009 to 2018, 27,077 (18%) had vitamin D measurements. Vitamin D levels were inversely associated with H. pylori infection, p < 0.001. The odds of a positive H. pylori test were 31% higher among patients with vitamin D levels <20 ng/mL, compared with those with levels ≥20 ng/mL (OR 1.31, 99% CI 1.22–1.4, p < 0.001). Purchase of vitamin D supplements was associated with a negative subsequent H. pylori test (p < 0.001). Mean vitamin D levels were moderately higher in those with successful vs. failed H. pylori eradication (19.34 ± 9.55 vs. 18.64 ± 9.61, p < 0.001). Conclusions: Vitamin D levels are associated with H. pylori infection. Increased vitamin D levels are associated with successful H. pylori eradication. Vitamin D may have a role in H. pylori eradication.

scholarly journals “Strokenomics”: bending the cost curve in stroke care

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Stephan A. Munich ◽  
Kunal Vakharia ◽  
Matthew J. McPheeters ◽  
Michael K. Tso ◽  
Adnan H. Siddiqui ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Cost Savings ◽  
Cost Benefit ◽  
Stroke Care ◽  
Cost Curve ◽  
The Cost ◽  
Care Costs

OBJECTIVEThe mortality rates for stroke are decreasing, yet it remains a leading cause of disability and the principal neurological diagnosis in patients discharged to nursing homes. The societal and economic burdens of stroke are substantial, with the total annual health care costs of stroke expected to reach $240.7 billion by 2030. Mechanical thrombectomy has been shown to improve functional outcomes compared to medical therapy alone. Despite an incremental cost of $10,840 compared to medical therapy, the improvement in functional outcomes and decreased disability have contributed to the cost-effectiveness of the procedure. In this study the authors describe a physician-led device bundle purchase program implemented for the delivery of stroke care.METHODSThe authors retrospectively reviewed the clinical and radiographic data and device-associated charges of 45 consecutive patients in whom a virtual “stroke bundle” model was used to purchase mechanical thrombectomy devices.RESULTSUse of the stroke bundle to purchase mechanical thrombectomy devices resulted in an average savings per case of $2900.93. Compared to the traditional model of charging for devices à la carte, this represented an average savings of 25.2% per case. The total amount of savings for these initial 45 cases was $130,542.00. Thrombolysis in Cerebral Infarction scale grade 2b or 3 recanalization occurred in 38 patients (84.4%) using these devices.CONCLUSIONSPurchasing devices through a bundled model resulted in substantial cost savings while maintaining the therapeutic efficacy of the procedure, further pushing the already beneficial long-term cost-benefit curve in favor of thrombectomy.

scholarly journals Prevalence and Factors associated with Helicobacter pylori among Adults between 18 and 40 Years at Butembe Health Centre III Kyankwanzi district, Uganda.

2021 ◽  
Author(s):  
◽  
Shubeika Kakooza
Keyword(s):  
Helicobacter Pylori ◽  
Health Centre ◽  
Antibody Test ◽  
Population Based ◽  
Helicobacter Pylori Infection ◽  
Cross Sectional ◽  
Face To Face ◽  
Factors Associated ◽  
Cross Sectional Design ◽  
H Pylori

Background: The prevalence of Helicobacter pylori infection varies by geography, ethnicity, and socioeconomic factors. Available data on the prevalence of Helicobacter pylori infection in Uganda are not representative of the general population. We sought to describe the prevalence and factors associated with H.pylori among adults between 18 and 40 years at Butemba Health Centre III. Methodology: Using a cross-sectional design, H. pylori infection was assessed by the H.pylori antibody test among 181respondents attending Butemba Health Centre III in Kyankwanzi. Data were collected by face-to-face interviews using a questionnaire. Associations between H. pylori infection and factors associated were analyzed using logistic regression. Results: The overall prevalence of H. pylori infection was 29.2%. However, H. pylori infection was highest (54.14%) in the age of 18 to 30 years study participants followed by 31 to 40 years (45.8%). H. pylori was associated with smoking of cigarettes (AOR = 0.732; 95% CI: 0.275-1.950), drinking alcohol (AOR = 4.373; 95% CI: 1.359-14.06), Poor sanitation (AOR = 5.33; 95% CI: 2.556-11.11) were also independently associated with H. pylori infection.    Conclusion and recommendation: The prevalence of H. pylori infection in Kyakwanzi at 29.2% calls for population-based studies in the region and offers an opportunity to study the transmission dynamics of H. pylori infection. Changes in public health measures need to be instituted in the management of H. pylori infection to include education of the population and health care workers on the non-specific and insidious clinical presentation of the condition. 

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