scholarly journals Study on Association between Chronic Idiopathic Urticaria and Helicobacter Pylori Infection in Armed Forces Personnel

2016 ◽  
Vol 12 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Md Sayeed Hasan ◽  
Md Shirajul Islam Khan ◽  
Jannatun Nayeem

Introduction: Chronic Idiopathic Urticaria (CIU) has an estimated prevalence of 35-65% and impacts 15 to 25% of the population at some point in their lives. Studies have shown the possible involvement of Helicobacter pylori (H. pylori) infection in chronic idiopathic urticaria (CIU), but the relationship remains controversial. Objective: To quantitatively assess the association between H. pylori infection and chronic idiopathic urticaria. Materials and Methods: This was a case-control type of analytical study and 100 patients were enrolled fifty patients of CIU fulfilling inclusion criteria with no identifiable cause were taken as case and patients without urticaria were taken as control, attending in the department of Dermatology & Venereology, CMH Dhaka for treatment from May 2015 to Aug 2016. Helicobacter pylori infection was confirmed by serum IgG for H. pylori test. Results: The result showed that H. pylori infection significantly affected a high percentage of patients 30 (60%) with chronic idiopathic urticaria. Male respondents were more positive 16(53.3%) than female 14(46.7%), in the middle aged 31-50 year about 18(60%) and triple drug therapy was successful in 16(53.33%) patients in whom H. pylori was detected. Conclusion: Urticaria is a common clinical disorder with complex triggering factors. Chronic urticaria has provided evidence that enteric infection with H. pylori may induce the disease. In this case control study, it was evident that chronic idiopathic urticaria was associated with positive serum IgG for H. Pylori. A trial of H. pylori eradication therapy may be offered to patients with CIU and evidence of H. pylori infection. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 122-126

2020 ◽  
Vol 92 (8) ◽  
pp. 52-59
Author(s):  
S. R. Abdulkhakov ◽  
D. S. Bordin ◽  
R. A. Abdulkhakov ◽  
D. D. Safina ◽  
A. R. Gizdatullina ◽  
...  

Background. As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.


Author(s):  
Hafiz Qazi Muhammad Amir ◽  
Omaila Ikram ◽  
Muhammad Tayyab Zia ◽  
Fareha Kashan Theba ◽  
Naila Ikram ◽  
...  

Background: Helicobacter pylori infection has been associated with hyperglycemia among type 2 diabetics. The objective of this study was to compare the H. pylori infection frequency in diabetic and non-diabetic patients.Methods: This case-control study was done at Al-Tibri Medical College and Hospital from May 2019 to August 2019. After written and informed consent, patients between 18-75 years with epigastric burning, dyspepsia, regurgitation were included and with history of eradication therapy, antibiotic or NSAID use in the last 6 months or surgery of upper GI tract months were excluded. Type 2 diabetics were placed in one group and non-diabetic individuals in another. Both groups were compared for presence of H. pylori infection. Data was analysed using SPSS. Demographic variables included age, gender and status of H. pylori infection. Quantitative data was expressed as frequency and percentages. Chi-square test was applied to test for significance keeping p-value of <0.05 statistically significant.Results: From 480 patients, 355 patients showed positive H. pylori, among them 282 were diabetic and 73 non-diabetic (p-value <0.001). Amongst the 355 diabetics, 55% were male Among 73 non-diabetics, 64% were male. All the patients in the study had dyspeptic symptoms and complained of dyspepsia, epigastric burning and regurgitation.Conclusions: A substantial relationship between H. pylori infection among type 2 diabetes mellitus patients was observed compared to non-diabetics. As a result, diabetic patients having active dyspeptic symptoms should undergo further confirmatory tests for diagnosing H. pylori infection.


2005 ◽  
Vol 19 (7) ◽  
pp. 433-439 ◽  
Author(s):  
Sibylle Koletzko

Noninvasive tests can be used for the initial diagnosis of Helicobacter pylori infection and to monitor the success of eradication therapy. In populations with a low prevalence of H pylori infection (children living in North America and Europe), a high sensitivity is required to make the test valuable for clinical practice. The13C-urea breath test has been validated in children of different age groups in a significant number of infected and noninfected children in several countries and, thus far, is the only noninvasive test that fulfills sensitivity and specificity quality standards. In studies to date, enzyme immunoassays using monoclonal antibodies to detect H pylori antigen in stool provide excellent results, but the number of children tested, particularly post-treatment, is not sufficient to recommend the test. All other noninvasive stool tests or methods based on the detection of specific antibodies in serum, whole blood, urine or saliva have limited accuracy in comparison with the13C-urea breath test. Therefore, these tests cannot be recommended for clinical decision making in pediatric patients.


2022 ◽  
Vol 12 (1) ◽  
pp. 56
Author(s):  
Jeemyoung Kim ◽  
Eun Jeong Gong ◽  
Myeongsook Seo ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  

Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.


2019 ◽  
Vol 37 (6) ◽  
pp. 434-443
Author(s):  
Bernadett Márkus ◽  
László Herszényi ◽  
Melinda Matyasovszky ◽  
Krisztián Vörös ◽  
Péter Torzsa ◽  
...  

Background Aims: Most patients with Helicobacter pylori infection are consulted for the first time by family physicians. We aimed to survey the adherence to the newest guidelines of the management of H. pylori infection in the primary and secondary care settings in Hungary. Methods: From a total of 793 physicians, 94 trainees in family medicine, 334 family physicians without and 195 with board certification in internal medicine, 87 internists, 78 family paediatricians were invited to take part in the study. Diagnostic and therapeutic attitudes towards H. pylori infection were compared by a voluntary and anonymous questionnaire. Results: Participants test for H. pylori infection in 92.8% of cases with a family history of peptic ulcer or 76.9% of gastric cancer, 68.9% of dyspepsia and 49.9% of non-specific abdominal complaints, before initiation of non-steroidal anti-inflammatory drug (NSAID; 17.3%) and antiplatelet treatment (14.5%), respectively. They confirm the success of eradication therapy in 88.1% mainly by urea breath test. Most of them initiate eradication therapy by themselves and only 22.4% refer their patients to a gastroenterologist. Clarithromycin-based standard triple therapy is the most preferred (62.1%) and only 3.7% choose quadruple combination with bismuth as first-line and 48.1% as second-line therapy. We found significant differences between groups with respect to the physicians’ own infection, localization of practice, and sources of information on H. pylori infection. Internists are more likely to clarify H. pylori status before the initiation of NSAID and antiplatelet therapies, initiate second-line therapies and use bismuth compared to the other groups. Family physicians with board certification in internal medicine are also prone to start eradication therapy and less prone to refer patients to a gastroenterologist. Family paediatricians prefer stool antigen determination, screen family members and prefer gastroenterologist consultation more often, and use bismuth less frequently than the other groups. Family physicians with previous infection check for H. pyloriinfection more frequently before the initiation of NSAID treatment and are more likely to use histology to detect H. pylori. Postgraduate trainings were the most popular source of information. Conclusion: The adherence to the recent recommendations of current guidelines is moderate. There is a need to increase adherence to current recommendations by family physicians and internists.


2005 ◽  
Vol 19 (7) ◽  
pp. 412-414 ◽  
Author(s):  
Kevan Jacobson

While several studies have demonstrated a decline in the overall prevalence of Helicobacter pylori infection in developed countries, there is variability in the burden of infection linked to socioeconomic status and living conditions. Improved socioeconomic status, living conditions and the availability of H pylori-eradication therapy have been associated with a lower prevalence of infection in First World populations, yet immigrants and indigenous people continue to have a high burden of H pylori infection and disease. Although the changing prevalence of H pylori infection in children has been recognized in a few reports, further studies are required to determine the impact of H pylori infection in this population. Moreover, additional studies are required for those populations at risk.


2020 ◽  
Vol 92 (4) ◽  
pp. 64-69
Author(s):  
L. I. Butorova ◽  
M. D. Ardatskaya ◽  
M. A. Osadchuk ◽  
N. G. Kadnikova ◽  
E. I. Lukianova ◽  
...  

Low patient compliance due to the development of adverse events in the form of antibiotic-associated diarrhea (AAD) is considered as the main reason for the failure of the eradication of optimized anti-Helicobacter therapy regimens. A key mechanism for the development of AAD is to reduce the number and species diversity of bacteria that form butyric acid. Aim. The purpose of this study was to study the comparative effect on the clinical effectiveness of eradication therapy (ET) of Helicobacter pylori infection and metabolic changes in the colon microbiota of additional inclusion in the optimized treatment regimen of the combined prebiotic Zakofalk (inulin + butyrate) with probiotics (lacto- and bifidobacteria in an amount of at least 1017 СFU). Materials and methods. 120 patients with chronic gastroduodenal diseases and infected H. pylori were еxamined. A comparative analysis of the effect of a combined prebiotic and lacto-bifid-containing probiotics on improving the effectiveness of the optimized ET scheme and improving its tolerability, as well as on the quantitative and qualitative content of short-chain fatty acids (SFA) in feces. The success of eradication was controlled by a 13C urease breath test. Results. According to the results of the study in randomized groups of patients, an excellent percentage of eradication (95%) was achieved in patients who performed ET with the addition of the prebiotic Zakofalk. In the same group of patients, there was an increase in the absolute content of SFA and a significant increase in the concentration of butyric acid. In the group of patients who received ET with the addition of probiotics, an acceptable level of eradication was achieved (85.7%), but no changes in SFA were found indicating an increase in the number or activity of the butyrate-producing flora. Patients who performed ET without the addition of pre-probiotics did not achieve the target percentage of successful eradication (83.3%), and a significant quantitative decrease in SFA was found with a significant decrease in the proportion of butyric acid. Conclusion. The inclusion of Zakofalk in the ET scheme, in comparison with probiotics, significantly increases the probability of successful eradication, more effectively restores the metabolic potential of the microbiota, and prevents the development of AAD.


2018 ◽  
Vol 90 (8) ◽  
pp. 27-32 ◽  
Author(s):  
D N Andreev ◽  
I V Maev ◽  
D T Dicheva ◽  
A A Samsonov ◽  
E V Partzvania-Vinogradova

Purpose of the study. To evaluate the effectiveness and safety of the use of rebamipide as part of the triple eradication therapy (ET) scheme of Helicobacter pylori infection. Materials and methods. A prospective, randomized comparative study included 94 patients with uncomplicated H. pylori-associated stomach / duodenal ulcer. In the process of randomization, patients are divided into three groups depending on the intended therapy. The first group (n=36) received a classical triple scheme of the first-line ET (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day) for 10 days. Patients of the second group (n=33) were assigned a classical triple scheme of ET with the inclusion of rebamipide (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day, rebamipide 100 mg 3 times a day day) for 10 days. Patients of the third group (n=25) were assigned a classical triple scheme of ET with the inclusion of rebamipide (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day, rebamipide 100 mg 3 times a day) in for 10 days, with the prolongation of the administration of rebamipide for the next 20 days. The effectiveness of ET was determined by the respiratory test after 6 weeks after the end of treatment. Adverse events were recorded by patients in specially developed diaries. All patients with gastric ulcer at the 6th week underwent a histological examination of the biopsy specimens of the antrum and the body of the stomach, assessing the inflammatory activity of the process on a point system in accordance with the updated Sydney system. Results and discussion. Efficiency of H. pylori eradication in the first group was 77.7% (ITT), 82.3% (PP), in the second group - 81.8% (ITT), 84.4% (PP), and in the third group - 84% (ITT), 87.5% (PP). The use of rebamipide in the triple ET regimen was associated with an increase in H. pylori eradication efficiency, both with simultaneous use with the scheme [odds ratio (OR) 1.16; 95% confidence interval (CI) 0.32-4.24], and with subsequent prolonged admission (OR 1.5, 95% CI 0.34-6.7). A somewhat more pronounced dynamics of the epithelization of erosive and ulcerative changes in the mucous membrane of the stomach and duodenum to the 21st and 28th days in the third group of patients was noted. The incidence of adverse events between the groups was comparable: 22.2% in the first group, 24.2% in the second group and 20% in the third group. In the pathomorphological evaluation of biopsy specimens of patients with gastric ulcer at the 6th week after the treatment, significant differences were revealed between the first and third groups in terms of the inflammatory activity in the antrum stomach (2±0.63 vs. 1.4±0.52; p=0,0399). The conclusion. The inclusion of rebamipide in the classical triple scheme of H. pylori ET increases the effectiveness of treatment and does not affect the safety profile. In the post-eradication period, it is advisable to continue the use of rebamipide to potentiate the repair of the gastric mucosa and regress the inflammatory processes.


2019 ◽  
Vol 91 (2) ◽  
pp. 16-24 ◽  
Author(s):  
D S Bordin ◽  
Yu V Embutnieks ◽  
L G Vologzhanina ◽  
T A Ilchishina ◽  
I N Voynovan ◽  
...  

The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: “Hp-EuReg”) allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. Materials and methods. A comparative analysis of the data entered in the register by the Russian research centers “Hp-EuReg”, in the period from 2013 to 2018, was conducted. Results and discussion. Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. Conclusion. In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.


2007 ◽  
Vol 135 (1-2) ◽  
pp. 26-30
Author(s):  
Natasa Opavski ◽  
Milan Spuran ◽  
Slobodanka Djukic ◽  
Vera Mijac ◽  
Lazar Ranin

Introduction: Helicobacter pylori induces gastric inflammation in host and such gastritis increases the risk of gastric and duodenal ulceration as well as adenocarcinoma. Because peptic ulcer disease is the major cause of morbidity, accurate diagnosis of H. pylori infection is very important. Unfortunately, there is no gold standard among diagnostic tests for Helicobacter infections. If gastroscopy is performed, histopathology and urease test are the most often used. Still, culturing of this bacterium is essential for drug susceptibility testing and analysis of virulence factors. Objective The aim of this study was to compare three diagnostic procedures - histopathology, urease test and culture, which are used to verify H. pylori infection. Method Three pairs of gastric mucosal biopsy specimens were collected from each of 28 dyspeptic patients undergoing endoscopy. Nineteen patients were not pretreated with antibiotics, while nine had received eradication therapy earlier. One pair of biopsy specimens was used for histopathologic examination, the second for urease test and the third was simultaneously cultured on nonselective and selective solid media. Isolate was identified as H. pylori on the basis of colony morphology, morphological properties and biochemical tests. Results In 14 out of 28 patients, H. pylori infection was confirmed on the basis of results of all diagnostic procedures. The concordance of these three methods was very good, because the results of histopathology, urease test and culture corresponded in 26 from 28 patients. Conclusion The conclusion of our study is that culture, as the method with high degree of concordance with other two procedures and the only that can give information on drug susceptibility of Helicobacter, is recommended for diagnosis of Helicobacter pylori infection along with histopathology and urease test.


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