Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims of this study were to determine the levels of procalcitonin (PCT) and C-reactive protein (CRP) in Helicobacter pylori-positive (HP+) patients diagnosed with duodenal and gastric ulcer and to evaluate the correlation of PCT and CRP levels with other invasive and non-invasive diagnostic methods for determination of H. pylori eradication in post-treatment follow-up. Thirty-five HP+ patients with dyspepsia were included in this study. Serum samples (5 ml) were collected at admission and after 24 h. Antimicrobial therapy (omeprazole, amoxycillin and clarithromycin) was given for 1 week to HP+ patients who were positive only by culture or by urease test plus pathology. After 1 month, serum samples (5 ml) were collected again and culture, urease and pathology investigations were performed on endoscopic samples. PCT and CRP levels were measured in the collected blood samples. Thirty-five H. pylori-negative (HP-) cases with dyspepsia, 38 cases with bacteraemia and 35 healthy blood donors were included in this study as control groups. The mean and minimum-maximum levels of PCT were 1.39 (0.25-6.75), 0.35 (0.12-0.71), 7.45 (0.68-51.5) and 0.40 (0.12-0.71) ng ml(-1) for the groups of HP+, HP- and bacteraemia patients and healthy donors, respectively. Mean CRP levels were 1.00 (<0.5-8.11), 0.62 (<0.5-3.2), 11.5 (3.2-43.5) and 0.63 (<0.5-5.46) mg dl(-1) for the same groups. A statistically significant difference was found between HP+ patients and both HP- cases and healthy blood donors for PCT levels, and higher PCT levels were found on admission in cases of bacteraemia than in the other groups (P < 0.05). PCT levels of HP+ cases decreased significantly (from 1.39 to 0.86) between admission and the post-treatment period (30 days); however, PCT levels remained higher than the cut-off value (0.5 ng ml(-1)). Similar ranges of CRP levels were found over the same time-period. The sensitivity of PCT was found to be higher than that of CRP on admission, but the specificity of PCT was found to be lower than that of CRP on the day of admission (65 and 74%, respectively). The sensitivity of PCT was the same as that of CRP for the post-treatment period, but specificity of PCT was higher than that of CRP for the post-treatment period (83 and 76%, respectively). It was concluded that PCT and CRP are not very effective markers for H. pylori infection in primary diagnosis or in eradication follow-up after therapy when used in parallel with conventional diagnostic methods, even if there is a difference in PCT and CRP levels between HP+ and HP- cases on admission.
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PMID:Do procalcitonin and C-reactive protein levels have a place in the diagnosis and follow-up of Helicobacter pylori infections? 1518 35

Diagnosis and treatment of stomach ulcer associated with helicoid-bacterial infection and with hemorrhage are discussed in the paper. The many-year observations show that the risk of relapsing hemorrhage is high in patients with the above diagnosis. Eradication of the causative agent by using the modern therapeutic schemes cuts significantly the rate of such relapses. The most effective method of monitoring the infection and eradication results is suggested, i.e. urease test combined with microbiological diagnosis involving the method of polymerase chain reaction.
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PMID:[Diagnosis and treatment of Helicobacter infections in patients with stomach ulcer associated with hemorrhage]. 1532 56

Helicobacter pylori is prevalent worldwide, especially in developing countries, and is associated with several upper gastrointestinal diseases. Since it is present in over 90% of duodenal ulcer patients, empirical eradication in these patients is often recommended. In gastric ulcer patients, eradication is indicated only after the infection is confirmed. Testing for H. pylori infection should be carried out in patients with peptic ulcer hemorrhage, because eradication has been shown to reduce recurrent bleeding. Both H. pylori and NSAIDs are risk factors for peptic ulceration, and it is reasonable to screen for and eradicate H. pylori infection in peptic ulcer patients taking NSAIDs. H. pylori is a group I carcinogen for gastric adenocarcinoma, and should be eradicated for the primary prevention of this cancer. Eradication of this organism has been reported to result in regression of early low-grade mucosa-associated lymphoid tissue lymphoma. The role of H. pylori infection in the causation of gastroesophageal reflux and non-ulcer dyspepsia is not clearly established. Several tests are available for the diagnosis of H. pylori infection. These include invasive tests, such as histology, culture and urease test, and non-invasive tests, such as serology, urea breath test and stool antigen test. The choice of test is determined by clinical indication, pretest probability of infection, as well as the availability, cost, sensitivity and specificity of the test. H. pylori eradication therapy using proton pump inhibitor with clarithromycin and amoxycillin for 7 days has a success rate of 85-90%. Improved living standard and sanitation are vital in the control of H. pylori transmission and infection. Future development may include the use of vaccines against H. pylori, and therapies specifically targeting cagA strains of the bacteria.
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PMID:Eradication of Helicobacter pylori in clinical situations. 1559 83

The study involved a dynamic comparative efficacy survey of the standard triple and quadruple therapies recommended by the Maastricht Consensus as first line therapies for eradication of Helicobacter pylori infection with the time period of 5 years. The study included 199 Hp-positive patients with stomach ulcer; 101 of them were under examination in 1997 and 98 in 2002. Depending on the therapy type, patients were assigned to one of two groups: the OCM/A group (48 and 53 patients in 1997 and 2002, respectively) was treated with Omeprazole, Clarithromycin and Metronidazole for 7 days and ODTM group (46 and 52 patients in 1997 and 2002, correspondingly) was treated with Omeprazole, De-Nol, Tetracycline and Metronidazole. To discover and confirm Hp eradication, cytological, histological and rapid urease tests were used. Hp eradication was considered as successful when all the tests were negative. The eradication frequency was assessed with the help of ITT and PP analyses. In the OCM/A group Hp was eradicated in 81.3% and 62.3% (p<0.05) of patients when analyzed by the intention-to-treat and in 88.6% and 66.0% (p<0.01) of patients when analyzed by per-protocol in 1997 and 2002, respectively. In the ODTM group Helicobacter pylori was eradicated in 89.1% and 88.5% (p<0.05) of patients when analyzed by intention-to-treat and 95.3% and 93.9% (p<0.05) when analyzed by per-protocol in 1997 and 2002, respectively. The frequency of ulcer cicatrisation and cuticularization of erosions did not depend on the type of the treatment. There was no significant difference between the compliance and side effects of the triple and quadruple therapies. Taking into account the decrease in the efficacy of the triple anti-Hp therapy, the need to use the quadruple therapy as a first line therapy for Hp infection eradication was substantiated.
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PMID:[Methods to optimize the management of Helicobacter pylori infection. The comparative efficacy of the triple and quadruple therapy used as a first line therapy]. 1577 Aug 58

The prevalence of H. pylori infection in AIDS patients has been controversial. A. controlled prospective and descriptive study was conducted in a group of 64 HIV-infested patients. H. pylori detection was carried out by endoscopic study during which two biopsy samples of gastric antrum and body were taken for the histologic study and other 2 samples of gastric antrum and body for urease testing. H.pylori infection prevalence was 56.3%. The comparison group was composed by 110 serologically HIV-negative patients, with an infection prevalence rate of 77.2%. In the HIV-AIDS group, the frequency of gastric ulcer was 1,5% and no duodenal ulcer was found whereas the comparison group showed a frequency of gastric and duodenal ulcers of 1.8 and 15.5% respectively. HIV+/AIDS patients in category I exhibited an H. pylori infection prevalence of 68.7%, category II, 39.2% and category III, 21,0%. A reversed association was observed between the level of immune deterioration and the prevalence of H. pylori infection.
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PMID:[Helicobacter pylori infection in a group of HIV/AIDS patients]. 1584 24

Helicobacter pylori (H. pylori) is the principal cause of peptic ulcer disease and important risk factor in gastric cancer. Gastric mucosal biopsy specimens taken from 110 patients were examined by polymerase chain reaction (PCR), culture and urease test. The ureA gene was detected in 52 out of 110 examined samples. The cagA gene was detected in 35 (67.3%) out of these 52 specimens (ureA+). This gene was presented in all of patients with stomach ulcer, in 75.0% of patients with duodenitis, 69.6% of patients with duodenal ulcer and 58.3% of patients with gastritis. H. pylori was detected by culture in 24 (25.3%) out of 95 samples. These results were confirmed by PCR. H. pylori was detected additionally in 20 samples only by PCR. This bacterium was detected more frequently by PCR than by culture (46.3% vs 25.3%). Results obtained by using three methods: culture, urease test and PCR were concordant in 47.0% (39 out of 83 patients). In 16 (19.3%) cases H. pylori was detected by two methods: urease test and PCR. Infection was detected only by PCR in 3 (3.6%) cases and in 25 cases (30.1%) only by urease test.
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PMID:[Comparison of diagnostic methods for Helicobacter pylori detection and identification of cagA gene in clinical specimens]. 1586 38

Helicobacter pylori (H. pylori) is the commonest bacterial pathogen found worldwide and more than half the world population aged 40 years and above is colonized with it. The infection rate is >95 % in some African countries. In 1994, the International Agency for Research on cancer classified H. pylori as a class I carcinogen in humans. It causes chronic active gastritis, duodenal and gastric ulcer and gastric malignancy, and is thought to be associated with coronary artery disease, cerebral stroke, vitamin B12 and iron-deficiency anaemia, etc. Therefore, non-invasive test-and-treatment strategies are widely recommended in primary care settings. Conventionally, H. pylori infection can be diagnosed by invasive techniques using an upper gastrointestinal endoscope for obtaining multiple biopsies from different sites of the stomach for RUT, culture, histological examination, polymerase chain reaction (PCR), etc. and by non-invasive tests such as Urea breath test (UBT), stool antigen test and blood serology. At present, 13/14C-UBT is considered the test of choice for confirmation of H. pylori infection. The UBT is based on the principle, that isotopically labelled urea ingested by an H. pylori--infected patient is rapidly hydrolysed by the microbial urease. The released 13/14CO2 is absorbed across the mucous layer to the gastric mucosa and hence, excreted via the systemic circulation in the breath which is collected and measured. The non-hydrolysed urea is excreted completely in the urine within 3-4 days. 13C-UBT being non-radioactive, 13C-UBT can be used in pregnant women and children, and a user's license is not required. There is still no standard protocol accepted and followed internationally for this test. Although the methods are almost similar, various laboratories/clinics use variable tracer doses, test meals, timings and methods for breath collection, and different cut-off values, which make formal validation studies necessary. This review describes the present status of the UBT and its application in the detection of H. pylori infection.
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PMID:Urea breath test for Helicobacter pylori detection: present status. 1591 72

The prevalence of Helicobacter pylori infection varies between different geographic locations. The objectives of this study were to determine the prevalence of H. pylori infection in patients with gastrointestinal (GI) symptoms and to describe the association of H. pylori infection with demographic data, clinical diagnosis, and previous histories of patients. The study was carried out at the gastroenterology unit of Queen Sawang Wattana Memorial Hospital, Chon Buri, Thailand. The diagnosis of H. pylori infection was done by culture and rapid urease test on the gastric biopsy specimens of 112 patients. The overall prevalence of H. pylori infection by the gastric biopsy-based method was 58%. The prevalence of H. pylori infection in duodenal ulcer (DU) patients (75%) was significantly higher than in gastric ulcer (GU) patients (56.4%) and patients with gastritis (44.1%). A reverse correlation was observed between H. pylori infection and household income. The prevalence of H. pylori infection in patients who usually consumed unboiled water was 61.6%, which was significantly higher than in those who consumed boiled water (30.8%). We conclude that the prevalence of H. pylori infection in patients with GI symptoms is relatively high, and H. pylori infection is associated with DU disease. The data suggests that the household income and not boiling drinking water are related to the high H. pylori infection in our study.
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PMID:The prevalence of Helicobacter pylori infection in patients with gastrointestinal symptoms in Chon Buri, Thailand. 1591 39

We investigated the topographic expression of MUC5AC and MUC6 in relationship with gastric diseases. The immunoexpression of MUC5AC and MUC6 was evaluated in 75 adults presenting Helicobacter pylori gastritis (n = 22; 11 cagA positive), duodenal ulcer (DU, n = 11), gastric ulcer (GU, n = 9), gastric carcinoma (GC, n = 20), and normal mucosa (H. pylori negative, n = 13). Five gastric areas (antral and corporeal lesser and greater curvatures and incisura) were studied. H. pylori was detected by carbolfuchsin, urease, and culture; cagA was determined by PCR. All patients with DU (eight with GU and 13 with GC) were H. pylori-positive. In H. pylori gastritis, MUC5AC expression was higher in the antrum than in the corpus; no difference was observed with respect to cagA status. MUC5AC expression was higher in the antrum of gastritis than in DU, and it was lower in the incisura among GU patients compared to DU. MUC6 expression was higher in the antrum of H. pylori gastritis compared to DU and to uninfected patients. No difference was observed in the topographic pattern of expression of MUC5AC and MUC6 among GC cases. The topographic over- and under-expression of mucins in H. pylori-associated gastritis and peptic disease suggest a role for these mucins in the pathogenesis of H. pylori infection and associated diseases.
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PMID:Topographic expression of MUC5AC and MUC6 in the gastric mucosa infected by Helicobacter pylori and in associated diseases. 1632 8

Helicobacter pylori is one of the most common bacterial infections worldwide. It is associated with chronic gastritis, peptic ulcer disease and constitutes a major risk factor for gastric adenocarcinoma and lymphoma. The aim of this study was to evaluate the specific serologic immunoglobulin G (IgG) response to whole cells proteins, CagA and urease antigens of Helicobacter pylori in a Venezuelan population. We evaluated 66 patients from the Hospital Universitario de Caracas, attending in the gastroscopy service. H. pylori infection was detected by culture and rapid urease test. IgG antibodies against, CagA and ureases were tested by enzyme-linked immunosorbent assay method using highly purified recombinant antigens. We demonstrated the presence of H. pylori in 48/66 (72.7%), by culture and rapid urease test. We found a seroprevalence of 45 (68%) to whole cells, 34/66 (51%) to CagA and 18/66 (27%) to urease. The positive rates of CagA antibodies in patients with gastric ulcer, gastric cancer and chronic gastritis were 87.8%, 77.7% y 40.8% respectively. The serum antibodies anti-CagA were similar between peptic ulcer disease and gastric cancer patients.
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PMID:[Importance of IgG anti-CagA antibodies of Helicobacter pylori in Venezuelan patients with gastric diseases]. 1635 43


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