scholarly journals Influence of smoking and CYP2C19 genotypes on H. pylori eradication success

2006 ◽  
Vol 135 (1) ◽  
pp. 171-176 ◽  
Author(s):  
T. SUZUKI ◽  
K. MATSUO ◽  
A. SAWAKI ◽  
K. WAKAI ◽  
K. HIROSE ◽  
...  
Keyword(s):  
Risk Factor ◽  
Drug Therapy ◽  
Success Rate ◽  
Independent Risk Factor ◽  
Eradication Therapy ◽  
Poor Metabolizer ◽  
Extensive Metabolizer ◽  
Opposite Trend ◽  
Genotype Interaction ◽  
H Pylori

CYP2C19 polymorphisms and smoking influence the efficacy of H. pylori eradication therapy, but interaction between the two have hitherto not been examined. A total of 142 H. pylori-positive patients who received triple drug therapy with lansoprazole, amoxicillin and clarithromycin were categorized into three groups with regard to diplotypes of CYP2C19: homozygous extensive metabolizer (homEM), heterozygous EM (hetEM), and poor metabolizer (PM). The overall success rate was 61·3%. Smoking was an independent risk factor of eradication failure (OR 2·81, 95% CI 1·14–6·91), whereas CYP2C19 polymorphisms were less influential. Among non-smokers, the homEM and hetEM groups showed worse eradication rates (58·5 and 67·3%) relative to PM (76·2%) as expected; however, an opposite trend was observed among smokers (homEM 50·0%, hetEM 46·7%, PM 20·0%), indicating possible interactions with CYP2C19 polymorphisms. Smoking has a greater influence on H. pylori eradication than the CYP2C19 genotype. Interaction between smoking and CYP2C19 should be examined in the future.

Analysis on the factors related to the acute success rate of fluoroless catheter ablation in patients with supraventricular tachycardias: a single-center experience

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Jan ◽  
M Yazici ◽  
S Habjan ◽  
T Prolic Kalinsek ◽  
M Topalovic ◽  
...  
Keyword(s):  
Risk Factor ◽  
Catheter Ablation ◽  
Success Rate ◽  
Independent Risk Factor ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Ablation Procedure ◽  
Group I ◽  
Acute Success ◽  
Procedural Complications ◽  
Group Ii

Abstract Background In this retrospective study, we aimed to detect factors related to the acute success rate (ASR) of radiofrequency (RFA) and cryo-ablation (CRA) of SVTs guided by three-dimensional (3D) electroanatomical mapping (EAM) system completely without the use of fluoroscopy (FLR). Methods and results We analyzed 324 consecutive patients with SVTs [age was 30.65±20.71 (3.6–83.1) years, 147 patients <19 years old and 50.3% (163/224) patients were female]. There were 112 patients with accessory pathways (APs), 36 patients with atrial tachycardia (ATs), and 176 patients with atrioventricular nodal reentrant tachycardia (AVNRT). All procedures [(RFA (n=257), CRA (n=51), combined RFA and CRA (n=16)] were performed guided by the 3D EAM system completely without the use of FLR. Intracardiac echocardiography (ICE) was used as an imaging tool when transseptal approach was needed for treatment of left-sided arrhythmias. The acute success rate (ASR) was 90.4% (293/224). There were no procedural complications. After the first procedure, patients were divided into the “ablation success” group (group I, n=293) and the “ablation failure” group (group II, n=31). Two groups were similar in terms of age, BMI, gender distribution, and type of ablation procedure. In group II, number of ablation lesions was significantly higher than group I [respectively; 17.93±11.7 vs. 10.5±14.5; p=0.003]. Additionally, total ablation time (TAT) [respectively; 552.6±298.6 vs. 449.7±448.1; p=0.1] and total procedural time (TPT) [respectively; 116.3±54.2 vs. 94.5±82.0; p=0.05] were mildly higher. When compared to Group I, the number of patients with right-sided tachycardias was significantly higher in Group II.[67.74% (21/31 vs. 21.5% (63/293; p<0.001]. ASR was the highest for patients with AVNRT and lowest for patients with ATs [respectively; 95.4% (168/176) vs. 75.0% (27/36); p<0.001]. Binary logistic regression analysis (Nagelkerke R Square=0.201) showed that SVTs originating from the right side were an independent risk factor for procedural failure. Patients with right-sided SVTs faced an approximately 11-fold increased risk of failed ablation (OR=10.69, 95% CI 2.49–45.78, p=0.001). Type of arrhythmia, type of ablation procedure, the sex category, age, and BMI were not independent risk factors for failed ablation. A significant risk factor for recurrence could not be detected. Conclusions This study revealed that catheter ablation of SVTs completely without the use of fluoroscopy can be performed with high ASR and without procedural complications. Likewise, ASR of fluoroless ablation was the highest for patients with AVNRT and lowest for patients with AT. Moreover, right-sided SVTs were an independent risk factor for ablation failure. Funding Acknowledgement Type of funding source: None

scholarly journals The Relationship between the Sydney Classification and the First-Line Treatment Efficacy in Helicobacter-Associated Gastritis

2020 ◽  
Vol 29 (6) ◽  
pp. 551-557
Author(s):  
Elif Şenocak Taşçı ◽  
Türkay Akbaş
Keyword(s):  
Success Rate ◽  
Triple Therapy ◽  
Chronic Inflammation ◽  
Precancerous Lesion ◽  
Eradication Therapy ◽  
Ease Of Use ◽  
University Hospital ◽  
First Line ◽  
Standard Triple Therapy ◽  
H Pylori

<b><i>Objective:</i></b> <i>Helicobacter pylori</i>is responsible for a wide spectrum of diseases. Due to ease of use and access, the standard triple therapy is being used as first-line eradication in many areas. Intestinal metaplasia (IM) is a precancerous lesion that requires eradication therapy. Our aim is to investigate the effect of IM on the standard triple therapy success in <i>H. pylori</i>-positive patients. <b><i>Subjects and Methods:</i></b> The patients who were referred to Düzce University Hospital and Avrasya Hospital Gastroenterohepatology clinic between January 2014 and December 2016 and diagnosed with <i>H. pylori</i>-positive gastritis and underwent first-line eradication were evaluated retrospectively. Biopsy specimens were evaluated according to the updated Sydney system. All patients diagnosed with <i>H. pylori</i> started treatment with pantoprazole 40 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 14 days. <b><i>Results:</i></b> The mean age of 181 patients included in the study was 55.5 ± 7.8. The success rate of <i>H. pylori</i> eradication was found to be low in severe chronic inflammation (<i>p</i> = 0.001). The success rate was found to be high among patients with no neutrophil activity (<i>p</i> = 0.009). As the intensity of IM increased, density of <i>H. pylori</i> was found to be decreased (<i>p</i> = 0.019). There was no correlation between glandular atrophy, IM, and <i>H. pylori</i> eradication success rate (<i>p</i> = 0.390 and <i>p</i> = 0.812). <b><i>Conclusion:</i></b> The severity of chronic inflammation is the most effective Sydney criteria for success of eradication, while the presence on IM does not have any effect.

scholarly journals Helicobacter pylori Infection Acts as an Independent Risk Factor for Intracranial Atherosclerosis in Women Less Than 60 Years Old

2022 ◽  
Vol 8 ◽  
Author(s):  
Yinjie Guo ◽  
Canxia Xu ◽  
Linfang Zhang ◽  
Zhiheng Chen ◽  
Xiujuan Xia
Keyword(s):  
Helicobacter Pylori ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Tube Formation ◽  
Endothelial Cell Migration ◽  
Intracranial Atherosclerosis ◽  
Carotid Artery Calcification ◽  
Atherosclerosis Risk Factors ◽  
H Pylori

Background: Studies show inconsistent results regarding the relationship between Helicobacter pylori (H. pylori) infection and stroke. The present study assessed a potential association between H. pylori infection and an important risk factor for stroke, intracranial atherosclerosis.Methods: In total, 15,798 subjects with transcranial Doppler (TCD) and 13C-urea breath test (13C-UBT) were enrolled from March 2012 to March 2017. Intracranial atherosclerosis was further measured using intracranial carotid artery calcification (ICAC) on past or recent head CT, and 14,084 subjects were ultimately included in the study. Baseline demographics, atherosclerosis risk factors, and laboratory results were investigated. Since endothelial dysfunction is critical to the development of atherosclerosis, the role of H. pylori in migration, tube formation, and proliferation of human brain microvascular endothelial cells (HBMECs) was assessed in vitro.Results: The intracranial atherosclerosis group had a higher proportion of women and a greater rate of H. pylori infection than those without intracranial atherosclerosis. H. pylori infection was significantly more common in women with intracranial atherosclerosis than males. In addition, the incidence of intracranial atherosclerosis was significantly higher in women with H. pylori infection than uninfected women (53.8 vs. 46.4%, p &lt; 0.001). In an adjusted model, H. pylori was shown to be an independent risk factor for intracranial atherosclerosis in women ≤ 60 years of age [odds ratio (OR) = 2.261, 95% CI = 1.839–2.780, p &lt; 0.001]. Serum exosomes from patients with H. pylori infection had significantly reduced brain endothelial cell migration, tube formation, and proliferation in vitro.Conclusion:Helicobacter pylori infection may be an important independent risk factor for intracranial atherosclerosis in women ≤ 60 years of age.

scholarly journals Vonoprazan-Based Third-Line Therapy Has a Higher Eradication Rate against Sitafloxacin-Resistant Helicobacter pylori

Cancers ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 116 ◽  
Author(s):  
Yoshimasa Saito ◽  
Kaho Konno ◽  
Moeka Sato ◽  
Masaru Nakano ◽  
Yukako Kato ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Success Rate ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Eradication Therapy ◽  
Drug Resistant ◽  
Success Rates ◽  
Line Therapy ◽  
Third Line ◽  
H Pylori

Eradication of Helicobacter pylori (H. pylori) is an effective strategy for preventing various gastrointestinal diseases such as gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. However, the eradication success rate is decreasing because of a recent increase in drug-resistant strains of H. pylori. Here, we evaluated the success rate of eradication therapy with vonoprazan (VPZ), a new potassium-competitive acid blocker, against drug-resistant H. pylori. In total, 793 patients who received H. pylori eradication therapy were investigated retrospectively. All underwent esomeprazole (EPZ)-based triple therapy (n = 386) or VPZ-based triple therapy (n = 407) for first-, second- and third-line H. pylori eradication for 7 days. The overall success rates of first- and third-line H. pylori eradication were significantly higher for VPZ-based triple therapy (88.4% and 93.0%, respectively, per protocol (PP)) than for EPZ-based triple therapy (69.5% and 56.5%, respectively, PP). Moreover, the success rates of first- and third-line eradication of clarithromycin (CLR)- and sitafloxacin (STFX)-resistant H. pylori were significantly higher for VPZ-based triple therapy (72.0% and 91.7%, PP) than for EPZ-based triple therapy (38.5% and 20.0%, PP). In addition, patient age did not affect the eradication rate of VPZ-based first-line therapy, whereas the success rate of EPZ-based therapy was lower in patients under 65 years of age. Our results clearly demonstrated that VPZ-based therapy achieved a higher eradication rate even against CLR- and STFX-resistant H. pylori, and that patient age did not affect the eradication rate of VPZ-based therapy. These findings suggest that dual therapy using VPZ and amoxicillin may be sufficient for standard H. pylori eradication, and may thus also be beneficial for avoiding antibiotic misuse.

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