scholarly journals Symptoms of Dyspepsia and Their Dynamics After H. pylori Eradication. Results of the Educational and Research Project "Real Clinical Practice of Treatment of Acid-Dependent Diseases"

2021 ◽  
Vol 17 (16) ◽  
pp. 16-24
Author(s):  
D.S. Bordin ◽  
◽  
I.G. Bakulin ◽  
N.V. Bakulina ◽  
T.A. Ilchishina ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Clinical Manifestations ◽  
Average Score ◽  
Outpatient Basis ◽  
Research Project ◽  
The Third ◽  
H Pylori ◽  
Real Clinical Practice

Within the framework of the educational and research project "Real Clinical Practice of Treatment of Acid-Dependent Diseases", H. pylori-associated pathology and their dynamics after the eradication the nature and severity of clinical manifestations were evaluated. In the analysis 1,474 patients were included aged 18 to 87 years old (average age 45.7 years) with confirmed H. pylori infection, who were observed on an outpatient basis in 188 doctors in Moscow, the Moscow Region and St. Petersburg. Diagnosis of H. pylori and subsequent eradication control were carried out with the use of methods available in real clinical practice. The severity of symptoms was assessed using “7×7” Questionnaire (seven symptoms for seven days). On the first visit, the average score was 12.5, on the second 4.5, and on the third 1.7 points. The significant relationship between smoking and the severity of dyspeptic manifestations was revealed. Rabeprazole was the most commonly prescribed proton pump inhibitor (84.3%) in the eradication regimens.

scholarly journals European Registry on Helicobacter pylori Management: single-capsule bismuth quadruple therapy is effective in real-world clinical practice

2020 ◽  
pp. 205064062097261
Author(s):  
Olga P Nyssen ◽  
Angeles Perez-Aisa ◽  
Manuel Castro-Fernandez ◽  
Rinaldo Pellicano ◽  
Jose M. Huguet ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Real World ◽  
Case Report Form ◽  
First Line ◽  
Quadruple Therapy ◽  
Intention To Treat ◽  
H Pylori

Background There has been resurgence in the use of bismuth quadruple therapy (proton pump inhibitor, bismuth, tetracycline and metronidazole) for treating Helicobacter pylori infection thanks to a three-in-one single-capsule formulation. Objective To evaluate the effectiveness and safety of the single-capsule bismuth quadruple therapy. Methods Data were collected in a multicentre, prospective registry of the clinical practice of gastroenterologists on the management of H. pylori infection, where patients were registered at the Asociación Española de Gastroenterología REDCap database on an electronic case report form until January 2020. Effectiveness by modified intention-to-treat and per-protocol as well as multivariable analysis were performed. Independent factors evaluated were: age, gender, indication, compliance, proton pump inhibitor dose and treatment line. Results Finally, 2100 patients were prescribed single-capsule bismuth quadruple therapy following the technical sheet (i.e. three capsules every 6 hours for 10 days). The majority of these patients were naive (64%), with an average age of 50 years, 64% women and 16% with peptic ulcer. An overall modified intention-to-treat effectiveness of 92% was achieved. Eradication was over 90% in first-line treatment (95% modified intention-to-treat, n = 1166), and this was maintained as a rescue therapy, both in second (89% modified intention-to-treat, n = 375) and subsequent lines of therapy (third to sixth line: 92% modified intention-to-treat, n = 236). Compliance was the factor most closely associated with treatment effectiveness. Adverse events were generally mild to moderate, and 3% of patients reported a severe adverse event, leading to discontinuation of treatment in 1.7% of cases. Conclusions Single-capsule bismuth quadruple therapy achieved H. pylori eradication in approximately 90% of patients in real-world clinical practice, both as a first-line and rescue treatment, with good compliance and a favourable safety profile.

scholarly journals The Current Strategy of Helicobacter pylori Eradication

2021 ◽  
Vol 96 (1) ◽  
pp. 13-21
Author(s):  
Yong Hwan Kwon
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Cure Rate ◽  
Helicobacter Pylori Eradication ◽  
H Pylori

Helicobacter pylori (H. pylori) is the main cause of most gastroduodenal diseases. Triple therapy including two antibiotics, amoxicillin and clarithromycin, and a proton pump inhibitor given for a week has been recommended as the treatment of choice since the revision of the Korean H. pylori Clinical Practice Guidelines in 2013. However, antimicrobial resistance significantly decreased the cure rate of H. pylori eradication to 63.9%. Thus, the new H. pylori treatment regimen would be needed to increase the eradication rate in Korea. Recently, the update of clinical practice guideline for treatment of H. pylori was developed by conducting a meta-analysis. In this review, the recommended H. pylori eradication regimen in current 2020 guideline will be discussed.

scholarly journals AB0963 HOW OFTEN DO DOCTORS TREAT PATIENTS WITH LOCAL DAMAGE TO THE PERIARTICULAR SOFT TISSUES IN REAL CLINICAL PRACTICE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1778.2-1778
Author(s):  
A. Karateev ◽  
A. Lila ◽  
N. Zagorodniy ◽  
E. Pogozheva
Keyword(s):  
Clinical Practice ◽  
Soft Tissues ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Manifestations ◽  
Treatment Result ◽  
The Third ◽  
Orthopedic Surgeons ◽  
Acute Injuries ◽  
Real Clinical Practice

Background:Damage of the periarticular soft tissues (DPST) - tendinitis, entesitis, bursitis, etc. are one of the most common reasons for patients to contact rheumatologists and orthopedic surgeons.Objectives:To evaluate the frequency and localization of DPST in real clinical practice, as well as the effectiveness of therapy for this pathology in the acute period.Methods:68 outpatient orthopaedic surgeons evaluated the frequency of initial patient recourse due to DPST within one month. The study did not include patients with systemic rheumatic diseases such as spondyloarthritis. The localization of DPST and the dynamics of clinical manifestations were evaluated in 1227 patients (women 42.5%, cf. age 51.3±15.5 years). Non-steroidal anti-inflammatory drugs (NSAIDs), mainly meloxicam, were used as a first-line treatment for DPST. The results of treatment were evaluated after 10-14 days with repeated visits of patients.Results:7766 cases of primary outpatient treatment by orthopedic surgeons were evaluated. DPST was the cause of treatment in 1227 (15.8%) patients. This was the third highest incidence after acute injuries (37.2%) and knee osteoarthritis (20.6%).In patients with DPST, the most common lesions were in the knee area (knee entesopathy, prepatellar bursitis, pes anserinus area tendinitis/bursitis) - 21.2%, the foot (plantar fasciitis) - 16.9%, the shoulder (tendinitis of the rotator cuff) – 16.4%, and the elbow (lateral and medial epicondylitis) - 15.3%. After treatment, there was a significant decrease in the severity of pain during movement – from 6.58±1.61 to 2.48±1.60 points on the numerical rating scale (p<0.001), a decrease in the intensity of pain at rest, at night and during palpation, as well as the severity of functional disorders. The need for local injection of glucocorticoids occurred in 22.1% of patients. Significant improvement was observed in all DPST localities, with 68.1% of patients rating the treatment result as “good” and “excellent”. Adverse reactions were observed in 15.0% of patients, and no serious complications were reported.Conclusion:DPST is the third most frequent reason of recourse to a doctor after acute injuries and osteoarthritis of large joints in the practice of outpatient orthopedic surgeons. The use of NSAIDs in the maximum therapeutic dose for 10-14 days allows for significant improvement in DPST of different localization.Disclosure of Interests:None declared

scholarly journals European registry on Helicobacter pylori management (Hp-EuReg) as a tool to evaluate and improve clinical practice in Moscow

2020 ◽  
Vol 92 (2) ◽  
pp. 12-18
Author(s):  
D. S. Bordin ◽  
I. N. Voynovan ◽  
Yu. V. Embutnieks ◽  
O. P. Nyssen ◽  
Francis Megraud ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Antigen Test ◽  
Stool Antigen Test ◽  
Standard Triple Therapy ◽  
Stool Antigen ◽  
H Pylori

Continuous evaluation of the actual clinical practice of diagnosis and treatment of Helicobacter pylori is crucial in order to provide the best standard of care and to compare health outcomes with expert recommendations. Aim:to evaluate the effectiveness of the standard triple therapy (amoxicillin, clarithromycin, a proton pump inhibitor) and the standard triple therapy plus bismuth tripotassium dicitrate. Materials and methods.Observational, prospective, multicenter study, carried out in one single Russian centre A.S. Loginov Moscow Clinical Scientific Center as part of the Hp-EuReg. Patients were included from 2013 to November 2019 by Russian gastroenterologists. Results.A total of 647 patients were collected and 330 were administered either standard triple therapy ((amoxicillin, clarithromycin, a proton pump inhibitor) or standard triple therapy plus bismuth tripotassium dicitrate. Invasive methods is dominates in the initial diagnosis of H. pylori: the frequency of use of the quick urease test decreased from 50% in 2013 to 31% in 2019. Serology was used in 27.9%. There has been an increase in the use of the13C-urea breath test from 13% in 2013 to 31% in 2019. The histological method (7.5%) and the stool antigen test (3.2%) were used less frequently. For eradication control non-invasive methods are mostly used:13C-UDT (82.7%) and the stool antigen test (14.4%). The effectiveness of standard triple therapy (mITT) was 68% with a 7-day course, 79% with a 10-day course, and 70% with a 14-day course. Combination of bismuth and standard triple therapy eradicates H. pylori (mITT) in 63%, 75% and 89%, respectively. Conclusion.An improvement in the clinical practice of managing patients with H. pylori infections has been noted. The standard triple therapy in combination with bismuth tripotassium dicitrate, prescribed for 14 days, is more effective.

scholarly journals Canadian Helicobacter Study Group Consensus Conference: Update on the Approach to Helicobacter Pylori Infection in Children and Adolescents – an Evidence-Based Evaluation

2005 ◽  
Vol 19 (7) ◽  
pp. 399-408 ◽  
Author(s):  
Nicola L Jones ◽  
Philip Sherman ◽  
Carlo A Fallone ◽  
Nigel Flook ◽  
Fiona Smaill ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Consensus Conference ◽  
Helicobacter Pylori Infection ◽  
Diagnostic Tools ◽  
Study Group ◽  
Evidence Based ◽  
H Pylori

As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented. The clinical issues addressed and recommendations made were: population-based screening for H pylori in asymptomatic children to prevent gastric cancer is not warranted; testing for H pylori in children should be considered if there is a family history of gastric cancer; the goal of diagnostic interventions should be to determine the cause of presenting gastrointestinal symptoms and not the presence of H pylori infection; recurrent abdominal pain of childhood is not an indication to test for H pylori infection; H pylori testing is not required in patients with newly diagnosed gastroesophageal reflux disease; H pylori testing may be considered before the use of long-term proton pump inhibitor therapy; testing for H pylori infection should be considered in children with refractory iron deficiency anemia when no other cause has been found; when investigation of pediatric patients with persistent or severe upper abdominal symptoms is indicated, upper endoscopy with biopsy is the investigation of choice; the 13C-urea breath test is currently the best noninvasive diagnostic test for H pylori infection in children; there is currently insufficient evidence to recommend stool antigen tests as acceptable diagnostic tools for H pylori infection; serological antibody tests are not recommended as diagnostic tools for H pylori infection in children; first-line therapy for H pylori infection in children is a twice-daily, triple-drug regimen comprised of a proton pump inhibitor plus two antibiotics (clarithromycin plus amoxicillin or metronidazole); the optimal treatment period for H pylori infection in children is 14 days; and H pylori culture and antibiotic sensitivity testing should be made available to monitor population antibiotic resistance and manage treatment failures.

scholarly journals Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

2001 ◽  
Vol 56 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Fernando Marcuz Silva ◽  
Schlioma Zaterka ◽  
Jaime Natan Eisig ◽  
Ethel Zimberg Chehter ◽  
Décio Chinzon ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Eradication Rate ◽  
Response To Therapy ◽  
Urease Test ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
H Pylori

Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs) change the response to therapy. METHODS: Two hundred patients with peptic ulcer (upper endoscopy) and H. pylori infection (histology and rapid urease test - RUT) were included. A proton pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg), tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT. RESULTS: The eradication rate of H. pylori per protocol was 65% (128/196 patients). This rate was 53% for previously treated patients, rising to 76% for not previously treated patients, with a statistical difference p<0.01. No significant difference was observed regarding sex, tobacco use, alcohol consumption, and NSAID use, but for elderly patients the difference was p = 0.05. Adherence to treatment was good, and side effects were mild. CONCLUSIONS: A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65% of the patients. Previous treatments were the main cause of treatment failure.

Sign in / Sign up

Export Citation Format

Share Document