H. pylori prophylaxis

BACKGROUND: Accumulating evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. We reviewed current data and assessed the benefits and harms of prophylactic use of aspirin in the general population. METHODS: The effect of aspirin for site-specific cancer incidence and mortality, cardiovascular events was collated from the most recent systematic reviews. Studies identified through systematic Medline search provided data regarding harmful effects of aspirin and baseline rates of harms like gastrointestinal bleeding and peptic ulcer...

Anti-platelet drug-induced gastric mucosal injury correlates with intragastric pH. Our aim was to investigate prophylaxis effects of famotidine, one of the representative histamine-2 receptor antagonists (H2RA), on gastric mucosal injury induced by dual therapy with low-dose aspirin and clopidogrel in relation to Helicobacter pylori (H. pylori) infection and CYP2C19 genotypes. This study was conducted for 20 healthy Japanese volunteers (10 H. pylori-positive and 10-negative subjects) with 100 mg aspirin plus 75 mg clopidogrel (AC) once-daily dosing and AC plus 20 mg famotidine twice-daily dosing (ACH)...

BACKGROUND: The modern management of acute non-variceal upper gastrointestinal bleeding is centred on endoscopy, with recourse to interventional radiology and surgery in refractory cases. The appropriate use of intervention to optimize outcomes is reviewed. METHODS: A literature search was undertaken of PubMed and the Cochrane Central Register of Controlled Trials between January 1990 and April 2013 using validated search terms (with restrictions) relevant to upper gastrointestinal bleeding...

AIM: To evaluate the influence of oral Helicobacter pylori (H. pylori) on the success of eradication therapy against gastric H. pylori. METHODS: A total of 391 patients with dyspepsia were examined for H. pylori using the saliva H. pylori antigen test (HPS), ¹³C-urea breath test (UBT), gastroscopy, and gastric mucosal histopathological detection. Another 40 volunteers without discomfort were subjected to HPS and ¹³C-UBT, and served as the control group. The 233 patients who were (¹³C-UBT+ were enrolled in this study and divided into 4 groups...

BACKGROUND: Data on the role of dental plaque in the transmission of Helicobactor pylori have varied. Furthermore, there has been few reports on the relationship between dental plaque control and H. pylori infection of gastric mucosa. The purpose of this study was to elucidate this potential relationship. METHODS: The 13C urea breath test was conducted on 56 subjects who received dental plaque control and 51 subjects who did not. RESULTS: The prevalence of H...

A best evidence topic was written according to a structured protocol. The question addressed was what is the optimum prophylaxis against gastrointestinal haemorrhage for patients undergoing adult cardiac surgery: histamine receptor antagonists (H(2)RA) or proton-pump inhibitors? A total of 201 papers were found; of which, 8 represented the best evidence. The authors, date, journal, study type, population, main outcome measures and results were tabulated. Only one randomized controlled trial (RCT) with relevant clinical outcomes was identified...

A mass screening program using photofluorography has been used as a secondary prophylaxis of gastric cancer in Japan. However, we are at a turning point for reconsidering the strategy of gastric cancer prevention because of various problems with photofluorography. The shift from current secondary prophylaxis to primary prophylaxis is now required. After a Japanese multicenter randomized controlled trial showed that Helicobacter pylori eradication reduced the incidence of metachronous gastric cancer after endoscopic resection of early gastric cancer, primary prophylaxis of gastric cancer has gained greater attention...

Ulceration corresponds to tissue loss, breaching the muscularis mucosae. When ulcers develop in the acid-peptic environment of the gastroduodenum, they are traditionally called peptic ulcer (PUD). Ulcers never develop spontaneously in a healthy gastroduodenal mucosa. Ulceration is the ultimate consequence of a disequilibrium between aggressive injurious factors and defensive mucosa-protective factors. The dominant aggressors are strong acid and high proteolytic (pepsin) activity in gastric secretions. The dominant defensors are the phospholipid surfactant layer, covering the mucus bicarbonate gel, the mucus bicarbonate layer covering the epithelium, the tight junctional structures between the epithelial cells, restricting proton permeability, and the epithelial trefoil peptides, contributing to healing after injury...

Helicobacter pylori (H. pylori) are gram-negative bacteria that selectively colonizes the gastric mucosa. The prevalence of H. pylori infection varies from 20 to 50% in industrialized countries to over 80% in developing countries. The infection may persist lifelong without specific treatment. Prolonged infection and inflammation due to bacterial virulence and host genetic factors will lead to chronic gastritis. A certain portion of infected patients then develop more severe pathologies such as peptic ulcer (10-15%), gastric cancer (1%), and mucosa-associated lymphoid tissue lymphoma (50...

Recommendations in managing patients with nonvariceal upper gastrointestinal bleeding were recently updated, addressing resuscitation, risk assessment and pre-endoscopic care, endoscopy, pharmacotherapy, and secondary prophylaxis. Initial adequate resuscitation and risk stratification using validated scales remain critical. Intravenous erythromycin improves visualization when likely to find blood in the stomach. Pre-endoscopic proton pump inhibition (PPI) does not improve outcomes, but downstages high-risk endoscopic lesions and may be considered...

Low dose aspirin (</=325 mg) is routinely used for primary and secondary prophylaxis of cardiovascular and cerebrovascular events. The use of low dose aspirin is associated with two- to four-fold greater risk of symptomatic or complicated peptic ulcers. Risk factors associated with low dose aspirin induced gastrointestinal toxicity includes prior history of ulcer or upper gastrointestinal (GI) bleeding, concomitant use of other nonsteroidal anti-inflammatory drugs, corticosteroid or warfarin, dual antiplatelet therapy, Helicobacter pylori (H...

BACKGROUND: The role of Helicobacter pylori (H. pylori) eradication in non-steroidal anti inflammatory drug (NSAID) users with peptic ulcer disease is controversial especially in countries with a high prevalence of the infection. Furthermore the value of low dose omeprazole for maintenance of remission is not yet known. PATIENTS AND METHODS: 138 symptomatic out-patients receiving continuous COX 1 NSAID therapy, were treated with omeprazole 40 mg/day upon endoscopic confirmation of gastro-duodenal ulceration or erosions while those infected with H...

BACKGROUND: Data on the role of dental plaque in the transmission of Helicobacter pylori have varied. Furthermore, there has been few reports on the relationship between dental plaque control and H. pylori infection of gastric mucosa. The purpose of this study was to elucidate this potential relationship. METHODS: The (13)C urea breath test was conducted on 56 subjects who received dental plaque control and 51 subjects who did not. RESULTS: The prevalence of H...

The work deals with problems of prophylactics and treatment of patients with symptomatic gastroduodenal ulcers complicated by bleedings. In somatically critical patients the main disease in 14% of cases is complicated by the appearance of symptomatic gastroduodenal ulcer which in its turn results in bleedings or perforation in 50% of cases. H. pylori is of no leading significance in formation of acute gastroduodenal ulcers. The only indication to surgery in patients with bleedings from acute ulcers is persistent bleeding which can not be arrested by the method of endoscopic hemostasis or a recurrent bleeding in patients with the state of severity not less that 30 scores by the SAPS II scale...

Tinidazole is a 5-nitroimidazole active in vitro against a wide variety of anaerobic bacteria and protozoa. Tinidazole is an effective treatment against anaerobic microorganisms based on its pharmacokinetic characteristics (C(max) 51 microg/ml, t(1/2) 12.5 h) and its excellent in vitro activity. Its long half-life allows once a day regimens. Tinidazole is as effective as metronidazole in the treatment of infections caused by T. vaginalis, giardiasis and amebiasis and bacterial vaginosis, malaria, odontogenic infections, anaerobic bacterial infections (pelvic inflammatory disease, diabetic foot), surgical prophylaxis (abdominal and hysterectomy) and Helicobacter pylori eradication...

PUD affects both the East and the West. The magnitude of the problem, however, varies within these regions. The study of peptic ulcer epidemiology is impeded by the paucity of general population-based data, invasiveness of diagnostic tests, and variable access to testing facilities. As such, direct comparisons of PUD epidemiology between the East and the West are difficult. The prevalence rates of H pylori are highly variable and depend greatly on the local sanitation conditions. The use of NSAIDs and aspirin is ubiquitous and increasing especially for the antiplatelet activity of aspirin in the prophylaxis of cardiovascular events...

INTRODUCTION: Proton pump inhibitors (PPIs) are widely used for acid-related gastric diseases. However, several national studies reported increasing use of PPIs for yet unlicensed indications. AIM: The aim of our study was to evaluate the extent of PPIs prescription in a Greek tertiary hospital, as well as the adherence to licensed indications according to the Greek National Drug Organization. METHODS: We retrospectively studied the discharge letters of 1693 adult patients who were admitted at the First Propedeutic Department of Internal Medicine at AHEPA hospital in Thessaloniki, Greece between July 2005 and December 2006...

AIMS: To evaluate the activities of six Lactobacillus delbrueckii subsp. bulgaricus (LB) strains against 30 Helicobacter pylori strains by agar-well diffusion method. METHODS AND RESULTS: LB cultures [4 x 10(8)-4 x 10(9) CFU ml(-1)) either were prepared in milk at their native pH, 3.8-5.0, or were adjusted to pH 6.4-7.7. At low and neutralized pH, LB strains inhibited the growth by 40-86.7% and 16.7-66.7% of H. pylori strains, respectively. LB activity was strain-dependent...

AIM: To optimize principles of gastroenterological care management in outpatient clinics and monitoring of medical service quality for patients with acid-dependent gastroenterological disease (ADGED) in the group of poor health patients for making decisions to optimize diagnosis, treatment and prophylaxis in outpatient setting. MATERIAL AND METHODS: Regulated standards were used in examination of 448 ADGED patients. Optimisation of outpatient medical care for poor health patients was conducted basing on the 3-level model of the consulting-diagnostic process...

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