scholarly journals Damage to the musculoskeletal system during eradication therapy of Helicobacter pylori with levofloxacin

Author(s):  
I. N. Kupriyanova ◽  
V. A. Vedensky ◽  
E. Ya. Valieva ◽  
M. A. Sinitsina

Eradication therapy is the mainstay of treatment for H. pylori-associated diseases. A case of the development of tendinitis of the left patellar ligament proper during eradication therapy using a triple regimen with levofoloxacin for 14 days for exacerbation of duodenal ulcer is presented.

2019 ◽  
Vol 91 (8) ◽  
pp. 28-33 ◽  
Author(s):  
A M Veliev ◽  
I V Maev ◽  
D N Andreev ◽  
D T Dicheva ◽  
A V Zaborovskii ◽  
...  

Aim. Evaluation of the efficacy and safety of quadrupletherapy without bismuth (concomitant therapy) in patients with Helicobacter pylori - associated gastric ulcer and duodenal ulcer in the framework of a comparative research in the population of patients in Russia. Materials and methods. A prospective randomized trial was conducted, which included 210 patients with H. pylori - associated gastric/duodenal ulcer without complications. During the process of randomization, the patients were divided into three equal groups (n=70) depending on the prescribed 10-day scheme of eradication therapy (ET): the first group received the classic triple scheme (Omeprazole 20 mg 2 times a day, Amoxicillin 1000 mg 2 times a day and Clarithromycin 500 mg 2 times a day); the second group received quadruple therapy with bismuth drugs (Omeprazole 20 mg 2 times a day, Tetracycline 500 mg 4 times a day, Metronidazole 500 mg 3 times a day, Bismuth subcitrate potassium 120 mg 4 times a day); the third group received quadruple therapy without bismuth - concomitant therapy (Omeprazole 20 mg 2 times a day, Amoxicillin 1000 mg 2 times a day, Clarithromycin 500 mg 2 times a day and Metronidazole 500 mg 2 times a day). Diagnostics of H. pylori infection during screening and control of eradication was carried out via the fast urease biopsy sample test and urea breath test system. Control of the effectiveness of ET of the microorganism was carried out not earlier than 4 weeks after the end of the treatment. During the course of therapy, the frequency of development of side effects was assessed using a special questionnaire. Results and discussion. The effectiveness of triple therapy was 72.8% (ITT; 95% CI of 62.17-83.54) and 78,4% (PP; 95% CI 68.19-88.72); quadruple therapy with the preparation of bismuth - 80.0% (ITT; 95% CI 70.39-89.6) and 84,8% (PP; 95% CI, 75.96-93.73); quadruple therapy without bismuth - concomitant therapy - 84.2% (ITT; 95% CI 75.54-93.02) and 92.1% (PP; 95% CI 85.43-98.94). Quadruple therapy without bismuth was reliably more effective than the classical triple therapy in the PP selection (p=0.044883). Statistical analysis showed a tendency to poorer effectiveness of ET in patients who had previously used antibiotic therapy (OR 0.4317; 95% CI 0.1776-1.049), and in individuals with a rapid metabolism genotype - CYP2C19*1/*1 (OR 0.12; 95% CI 0.005848-2.4624). The frequency of development of side effects during the use of triple therapy was 18.5% (95% CI of 9.23-27.91), when using quadruple therapy with bismuth - 20.0% (95% CI 10.39-29.6), and with the use of quadruple therapy without bismuth - concomitant therapy - 24.2% (95% CI 13.98-34.58). Conclusion. This prospective randomized study demonstrated the high efficiency of quadruple therapy without bismuth (concomitant therapy) in the framework of eradication of H. pylori infection in Russia.


1970 ◽  
Vol 15 (2) ◽  
pp. 59-63
Author(s):  
Maleeha Hussain ◽  
Mian Ahmad Mashud ◽  
Hazera Khatun ◽  
Tareak Al Nasir

This study was carried out with an aim to investigate the relationship between gastricmetaplasia with H. pylori and the effect of eradication therapy. A total of 210 patients withhistory of dyspepsia were included in the study of which 50 were enrolled in the eradicationtherapy. After the eradication therapy 35 patients came for follow-up endoscopy. Pairedendoscopic biopsies were taken from antrum and duodenal ulcer margin and were examined forH. pylori and for duodenitis and gastric metaplasia. Gastric metaplasia was significantlyassociated with H. pylori. After eradication H. pylori showed further extension of gastricmetaplasia. It can be recommended that these patients can be further followed up to see thecourse of gastric metaplasia and what impact it has on ulcer recurrence and re-infection.doi: 10.3329/taj.v15i2.3908TAJ December 2002; Vol.15(2):59-63


1995 ◽  
Vol 9 (2) ◽  
pp. 91-95 ◽  
Author(s):  
ABR Thomson ◽  
CN Williams

Since its rediscovery 10 years ago,Helicobacter pylorihas reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications ofH pyloriinclude gastritis, gastric cancer and possible maltomas. Therapy ofH pyloriinfection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination againstH pyloriis on the far horizon.


2016 ◽  
Vol 25 (2) ◽  
pp. 139-146 ◽  
Author(s):  
Lin Li ◽  
Xiaoying Zhou ◽  
Shuping Xiao ◽  
Feng Ye ◽  
Guoxin Zhang

Background: Recent reports have indicated that Helicobacter pylori (H. pylori) might have an effect on gastrointestinal flora; moreover, gastric commensual bacteria have been observed in the development of duodenal ulcer (DU). Aims: In our study, we aimed to evaluate the effect of H. pylori eradication on gastrointestinal flora in DU patients. Methods: A case-control study was performed at Jiangsu Shengze Hospital between December, 2013 and April, 2014. The patients received antibiotic eradication therapy if H. pylori testing was positive. At least four weeks after cessation of the eradication therapy, a repeat gastroscopy was performed to collect biopsies again in the same position. Gastric mucosa samples and feces specimens were collected to extract bacteria DNA and then to quantify by real-time polymerase chain reaction (PCR). Results: After the eradication of H. pylori, an increase of Lactobacillus group, Clostridium leptum subgroup, Enterobacteria and a decrease of Clostridium coccoides subgroup were found in the antrum. In the corpus, the number of bacteria in the Lactobacillus group was increased and the expression of Clostridium coccoides subgroup was significantly down-regulated. In the feces samples, only the number in the Lactobacillus group was increased. Moreover, the distribution was significantly different between female and the male patients. Conclusions: The presence of H. pylori in the stomach suppressed the colonization with Lactobacillus group, Clostridium leptum subgroup and Enterobacteria. Gender might affect the distribution and/or recolonization of the bacteria in DU patients. Abbreviations: DU: duodenal ulcer; GI: gastrointestinal; GIN: gastrointestinal neoplasia; GU: gastric ulcer; PPI: proton pump inhibitors; UBT: urea breath test.


2012 ◽  
Vol 3 (2) ◽  
pp. 157-161 ◽  
Author(s):  
N.V. Baryshnikova

This article presents the results of original research conducted in St. Petersburg, Russia, which showed that the Helicobacter pylori strains isolated from patients with duodenal ulcer and chronic gastroduodenitis possess significantly higher levels of the pathogenicity islands (cag-PAI) genes than the strains isolated from healthy volunteers. The most frequently detected cag-PAI genes were cagA and cagH in the strains isolated from patients with chronic gastroduodenitis, and cagA and cagE in the strains isolated from patients with duodenal ulcer. A comparison of the clinical strains isolated from patients from St. Petersburg, Russia and patients from Dushanbe, Tajikistan showed that cagA gene was more prevalent in the strains from St. Petersburg. These findings demonstrate the necessity of implementation of molecular genetic identification of H. pylori in the clinical diagnostics practice reflecting the virulent genes profile of the strain. Addition of probiotics to the standard eradication therapy of H. pylori significantly improves the results of this therapy.


Author(s):  
Yu. V. Tchumak ◽  
H. A. Loban ◽  
M. O. Faustova ◽  
M. M. Ananieva ◽  
V. F. Voynash

Infection caused by Helicobacter pylori (H. pylori) is one of the most common human infections. The discovery of H. pylori contributed to a revolution in the ideas of aetiology, pathogenesis, treatment and prevention of some diseases, i.e. gastric ulcer, duodenal ulcer, gastritis, duodenitis. Ulcerative disease in almost 100% of cases is associated with H. pylori. Such factors as distress, psychological and genetic factors are also associated with the development of the disease. Н. pylori are detected in 80-100% of patients with chronic gastritis, and in 90 – 100% of patients with duodenal ulcer. Traditionally, Н. pylori-associated diseases are treated by gastroenterologists and general practitioners, although they are infectious diseases in their essence. In our country, the quite typical is the type of the infection with its onset in childhood and very high prevalence rate in adults. Another characteristic of "national" Н. pylori is a pronounced carcinogenic potential that is accompanied by gastric malignancies. For preventing and managing a number of H. pylori-associated diseases, eradication therapy (ET) is used. Literally, eradication means the complete destruction of something. In medical terminology, this word is applied to integrated therapeutic methods aimed at eliminating a pathogen, and antibacterials are the non-alternative components of the eradicating therapy. The presence of flagella, as well as a smooth cell wall and spiral shape, allows this microorganism to move in the mucus along the pH gradient. The cell wall of H. pylori is smooth; the electron-dense glycocalyx (capsule-like membrane) including carbohydrate-containing polymers needed for adhesion of the microorganism on the surface of epithelial cells is outside of the cell membrane. H. pylori produce highly active enzymes such as urease, oxidase and mucinase. Flagella provide the mobility, which is necessary for colonizing the mucous membrane. Biological and biochemical properties, pathogenicity factors can impede antibacterial therapy to some extent. The effectiveness of the number of modes of antibacterial therapy often recommended for H. Pylori-associated diseases is increasingly reducing due to the ever-increasing resistance of bacterium to many antimicrobial drugs such as : metronidazole, amoxicillin, tetracyclines, clarithromycin, furazolidone.


2018 ◽  
Vol 11 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Petruta Violeta Filip ◽  
◽  
Denisa Cuciureanu ◽  
Laura Sorina Diaconu ◽  
Ana Maria Vladareanu ◽  
...  

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.


2002 ◽  
Vol 16 (8) ◽  
pp. 527-532 ◽  
Author(s):  
M Fatih Abasiyanik ◽  
Ersan Sander ◽  
Barik A Salih

BACKGROUND: Several reports have shown the prevalence of anti-CagA antibodies to be associated with the development of peptic ulcer diseases, while others have indicated that there is no such association.AIM: To examine the prevalence of antibodies to CagA and otherHelicobacter pyloriantigens in symptomatic and asymptomatic subjects in Turkey.SUBJECTS AND METHODS: Sixty-six symptomatic subjects, 16 to 74 years of age, were examined forH pyloriby biopsy-based tests and ELISA. One hundred nineteen asymptomatic subjects, 20 to 65 years of age, were also tested serologically for the presence ofH pylori. Samples from both groups that were found to be positive forH pyloriby ELISA were then tested by immunoblotting.RESULTS: Fifty-four (82%) symptomatic subjects and 76 (64%) asymptomatic subjects were found to beH pylori-positive by ELISA. Samples from 30 symptomatic subjects who were found to beH pylori-positive by ELISA were analyzed by immunoblotting. Antibodies to CagA (116 kDa) antigen were detected in immunoblots of 11 of 14 (79%) with chronic gastritis, 12 of 13 (92%) with duodenal ulcer and three of three (100%) with gastric cancer. Antigens of the following molecular weights were also detected in these 30 subjects: 89 kDa (VacA) in 21 (70%), 37 kDa in 21 (70%), 35 kDa in 19 (63%), 30 kDa in 27 (90%) and 19.5 kDa in 19 (63%). Immunoblots of 40 ELISA-positive asymptomatic subjects showed that 33 (83%) had antibodies to CagA antigen, 26 (65%) to VacA antigen, 30 (75%) to a 37 kDa antigen, 30 (75%) to a 35 kDa antigen, 39 (98%) to a 30 kDa antigen and 36 (90%) to a 19.5 kDa antigen.CONCLUSIONS: Antibodies to CagA antigen were prevalent in both groups, regardless of the presence of gastroduodenal disease.


2017 ◽  
Vol 55 (07) ◽  
pp. 653-656 ◽  
Author(s):  
Caspar Franck ◽  
Armin Hoffmann ◽  
Alexander Link ◽  
Christian Schulz ◽  
Kerstin Wuttig ◽  
...  

Abstract Background In the federal state of Saxony-Anhalt, gastric cancer (GC) incidence ranks among the highest in Germany. Helicobacter pylori prevalence is a surrogate marker for GC risk in a given population. In 2010 we reported an H. pylori seroprevalence of 44.4 % in patients at the emergency ward of the University Hospital of Magdeburg, the capital of Saxony-Anhalt. Our aim is to update these findings in a cohort of healthy blood donors from the same region. Materials and methods The sera of 516 consecutive blood donors (40.1 ± 14.1 years; 286 males and 230 females) were tested for antibodies against H. pylori and CagA. Data on demographics and previous H. pylori eradication therapy were obtained by means of a structured questionnaire. Blood donors with positive serology for H. pylori or CagA and/or history of eradication therapy were classified as H. pylori-positive. Results Overall, 28.9 % of the study cohort were H. pylori-positive. The prevalence was higher in older generations (9 % in 18 – 20 years up to 47 % in 61 – 70 years). In 44.4 % of H. pylori IgG-positive donors, CagA serology was also positive. This proportion was not age-dependent. Study participants with siblings were by trend more often H. pylori-positive (p = 0.066). Conclusion Compared to our previous study in patients at the emergency ward, we found by trend lower age-related H. pylori prevalence rates. In our cohort of healthy blood donors, we confirmed a lower H. pylori prevalence in younger generations.


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