期刊文献+
共找到11,900篇文章
< 1 2 250 >
每页显示 20 50 100
Optimizing proton pump inhibitors in Helicobacter pylori treatment:Old and new tricks to improve effectiveness 预览
1
作者 Enzo Ierardi Giuseppe Losurdo +3 位作者 Rosa Federica La Fortezza Mariabeatrice Principi Michele Barone Alfredo Di Leo 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第34期5097-5104,共8页
The survival and replication cycle of Helicobacter pylori(H.pylori)is strictly dependant on intragastric pH,since H.pylori enters replicative phase at an almost neutral pH(6-7),while at acid pH(3-6)it turns into its c... The survival and replication cycle of Helicobacter pylori(H.pylori)is strictly dependant on intragastric pH,since H.pylori enters replicative phase at an almost neutral pH(6-7),while at acid pH(3-6)it turns into its coccoid form,which is resistant to antibiotics.On these bases,it is crucial to increase intragastric pH by proton pump inhibitors(PPIs)when an antibiotic-based eradicating therapy needs to be administered.Therefore,several tricks need to be used to optimize eradication rate of different regimens.The administration of the highest dose as possible of PPI,by doubling or increasing the number of pills/day,has shown to be able to improve therapeutic outcome and has often proposed in rescue therapies,even if specific trials have not been performed.A pre-treatment with PPI before starting antibiotics does not seem to be effective,therefore it is discouraged.However,the choice of PPI molecule could have a certain weight,since second-generation substances(esomeprazole,rabeprazole)are likely more effective than those of first generation(omeprazole,lansoprazole).A possible explanation is due to their metabolism,which has been proven to be less dependent on cytochrome P450(CYP)2C19 genetic variables.Finally,vonoprazan,a competitive inhibitor of H+/K+-ATPase present on luminal membrane of gastric parietal cells has shown the highest efficacy,due to both its highest acid inhibition power and rapid pharmacologic effect.However current data come only from Eastern Asia,therefore its strong power needs to be confirmed outside this geographic area in Western countries as well as related to the local different antibiotic resistance rates. 展开更多
关键词 HELICOBACTER PYLORI Proton pump inhibitors ERADICATION CYTOCHROME P450 Optimization
在线阅读 免费下载
Is there an association between Helicobacter pylori infection and irritable bowel syndrome?A meta-analysis 预览
2
作者 Qin Xiang Ng Nadine Xinhui Foo +4 位作者 Wayren Loke Yun Qing Koh Vanessa Jing Min Seah Alex Yu Sen Soh Wee Song Yeo 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第37期5702-5710,共9页
BACKGROUND Irritable bowel syndrome(IBS)is a prevalent and debilitating gastrointestinal condition.Research has reported persistent,low-grade mucosal inflammation and significant overlaps between patients with IBS and... BACKGROUND Irritable bowel syndrome(IBS)is a prevalent and debilitating gastrointestinal condition.Research has reported persistent,low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia,suggesting a possible pathogenic role of Helicobacter pylori(H.pylori)in IBS.This study therefore aimed to provide the first systematic review and meta-analysis on the association between H.pylori infection and IBS.AIM To investigate the association between H.pylori infection and IBS.METHODS Using the keywords“H.pylori OR Helicobacter OR Helicobacter pylori OR infection”AND“irritable bowel syndrome OR IBS”,a preliminary search of PubMed,Medline,Embase,Cochrane Database of Systematic Reviews,Web of Science,Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018.Attempts were also made to search grey literature.RESULTS A total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis.Random-effects meta-analysis found a slight increased likelihood of H.pylori infection in patients with IBS,albeit this was not statistically significant(pooled odds ratio 1.47,95%confidence interval:0.90-2.40,P=0.123).It must also be acknowledged that all of the available studies reported only crude odd ratios.H.pylori eradication therapy also does not appear to improve IBS symptoms.Although publication bias was not observed in the funnel plot,there was a high degree of heterogeneity amongst the studies included in the meta-analysis(I2=87.38%).CONCLUSION Overall,current evidence does not support an association between IBS and H.pylori infection.Further rigorous and detailed studies with larger sample sizes and after H.pylori eradication therapy are warranted. 展开更多
关键词 IRRITABLE BOWEL syndrome Functional HELICOBACTER PYLORI INFECTION Metaanalysis
在线阅读 免费下载
Infections with Helicobacter pylori and challenges encountered in Africa 预览
3
作者 Stella Smith Muinah Fowora Rinaldo Pellicano 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第25期3183-3195,共13页
Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Afr... Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Africa its prevalence reach as high as 80%as the infection is acquired during childhood.Risk factors for H.pylori acquisition have been reported to be mainly due to overcrowding,to have infected siblings or parent and to unsafe water sources.Despite this high H.pylori prevalence there still does not exist an African guideline,equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection.In this continent,although there is a paucity of epidemiologic data,a contrast between the high prevalence of H.pylori infection and the low incidence of GC has been reported.This phenomenon is the so-called“African Enigma”and it has been hypothesized that it could be explained by environmental,dietary and genetic factors.A heterogeneity of data both on diagnosis and on therapy have been published.In this context,it is evident that in several African countries the increasing rate of bacterial resistance,mainly to metronidazole and clarithromycin,requires continental guidelines to recommend the appropriate management of H.pylori.The aim of this manuscript is to review current literature on H.pylori infection in Africa,in terms of prevalence,risk factors,impact on human health,treatment and challenges encountered so as to proffer possible solutions to reduce H.pylori transmission in this continent. 展开更多
关键词 HELICOBACTER PYLORI AFRICA Risk factors African ENIGMA Prevalence Treatment Diagnosis
在线阅读 免费下载
Gastric adenocarcinoma of fundic gland type after Helicobacter pylori eradication: A case report 预览
4
作者 Ya-Nan Yu Xiao-Yan Yin +5 位作者 Qi Sun Hua Liu Qi Zhang Yun-Qing Chen Qing-Xi Zhao Zi-Bin Tian 《世界临床病例杂志》 2019年第13期1696-1702,共7页
BACKGROUND Gastric adenocarcinoma of fundic gland type (GA-FG) has recently been proposed as a novel histological type of gastric cancer. CASE SUMMARY We report a case of GA-FG in a 77-year-old Chinese woman with epig... BACKGROUND Gastric adenocarcinoma of fundic gland type (GA-FG) has recently been proposed as a novel histological type of gastric cancer. CASE SUMMARY We report a case of GA-FG in a 77-year-old Chinese woman with epigastric distention who was referred to endoscopy for the management of an incidentally found submucosal tumor-like elevated lesion in the lower part of the gastric body. The tumor occurred after Helicobacter pylori (H. pylori) eradication therapy without long-term use of proton pump inhibitors. Complete and curable removal of the tumor was performed by endoscopic submucosal dissection. Histopathological findings showed numerous cells with basophilic cytoplasm and mildly atypical nuclei-like chief cells of the fundic gland. The tumor was observed to have the so-called “endless glands” pattern of the well-differentiated mixed phenotype. A safe resection margin without lymphatic and venous invasion was observed. As the tumor occurred after H. pylori eradication therapy, it is unknown whether there was a relationship with H. pylori eradication. The patient will be followed up by periodic gastroscopic observation. CONCLUSION In conclusion, we report a case of GA-FG after H. pylori eradication therapy without long-term proton pump inhibitors use. Further analysis of similar cases will reveal the clinical behavior of GA-FG. 展开更多
关键词 GASTRIC ADENOCARCINOMA Fundic GLAND HELICOBACTER PYLORI ERADICATION Case report
在线阅读 免费下载
How does Helicobacter pylori cause gastric cancer through connexins: An opinion review 预览
5
作者 Huan Li Can-Xia Xu +3 位作者 Ren-Jie Gong Jing-Shu Chi Peng Liu Xiao-Ming Liu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第35期5220-5232,共13页
Helicobacter pylori (H. pylori) is a Gram-negative bacterium with a number of virulence factors, such as cytotoxin-associated gene A, vacuolating cytotoxin A, its pathogenicity island, and lipopolysaccharide, which ca... Helicobacter pylori (H. pylori) is a Gram-negative bacterium with a number of virulence factors, such as cytotoxin-associated gene A, vacuolating cytotoxin A, its pathogenicity island, and lipopolysaccharide, which cause gastrointestinal diseases. Connexins function in gap junctional homeostasis, and their downregulation is closely related to gastric carcinogenesis. Investigations into H. pylori infection and the fine-tuning of connexins in cells or tissues have been reported in previous studies. Therefore, in this review, the potential mechanisms of H. pylori-induced gastric cancer through connexins are summarized in detail. 展开更多
关键词 Helicobacter pylori CONNEXIN GAP JUNCTIONAL INTERCELLULAR communications GAP junction proteins Gastric cancer Transcription factors DNA methylation Proliferation Apoptosis
在线阅读 免费下载
Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance? 预览
6
作者 Sho Suzuki Mitsuru Esaki +2 位作者 Chika Kusano Hisatomo Ikehara Takuji Gotoda 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第16期1907-1912,共6页
Helicobacter pylori (H. pylori) antimicrobial resistance is an urgent, global issue. In 2017, the World Health Organization designated clarithromycin-resistant H. pylori as a high priority bacterium for antibiotic res... Helicobacter pylori (H. pylori) antimicrobial resistance is an urgent, global issue. In 2017, the World Health Organization designated clarithromycin-resistant H. pylori as a high priority bacterium for antibiotic research and development. In addition to clarithromycin, resistance to metronidazole and fluoroquinolones has also increased worldwide. Recent international guidelines for management of H. pylori infection recommend bismuth or non-bismuth quadruple therapy for 14 d as a first-line treatment for H. pylori in areas of high clarithromycin and/or metronidazole resistance. Although these treatment regimens provide acceptable H. pylori eradication rates, the regimens used should not contribute to future resistance of H. pylori to antimicrobials. Moreover, these regimens can promote resistance, due to prolonged therapy with multiple antibiotics. A new strategy that can eradicate H. pylori as well as reduce the antibiotics used is required to prevent future antimicrobial resistance in H. pylori. Dual-therapy with vonoprazan and amoxicillin could be a breakthrough for H. pylori eradication in an era of growing antimicrobial resistance. This regimen may provide a satisfactory eradication rate of H. pylori and also minimize antimicrobial resistance due to single antibiotic use and the strong inhibitory effect of vonoprazan on gastric acid secretion. 展开更多
关键词 HELICOBACTER PYLORI Antibiotic RESISTANCE ANTIMICROBIAL RESISTANCE Dual therapy Vonoprazan
在线阅读 免费下载
南京市高淳地区幽门螺杆菌感染现状及危险因素分析 预览
7
作者 曹友红 刘筱韵 +3 位作者 张志刚 丁松 王小平 凌亭生 《实用医技杂志》 2019年第2期136-139,共4页
目的研究江苏省南京市高淳地区幽门螺杆菌(Hp)的感染分布情况及其发生危险因素的探讨分析。方法回顾性分析2015年1月至2018年2月我院Hp检查室进行Hp检测及治疗的1 367名体检及门诊患者检查资料。从检查者的性别、年龄、吸烟、饮酒、检... 目的研究江苏省南京市高淳地区幽门螺杆菌(Hp)的感染分布情况及其发生危险因素的探讨分析。方法回顾性分析2015年1月至2018年2月我院Hp检查室进行Hp检测及治疗的1 367名体检及门诊患者检查资料。从检查者的性别、年龄、吸烟、饮酒、检查通道、检查底气、样气13C浓度、饮食前手卫生、外出就餐、经济情况、文化程度、收入、口味及是否医务人员等相关指标进行分组分析。结果高淳地区2015—2018年初的幽门螺杆菌感染率为35.78%,Hp感染与性别、不同年龄段、不同检测通道、检查底气13C浓度、不同文化程度以及不同家庭收入水平无明显关联,差异无统计学意义;Hp感染阳性与吸烟、饮酒、饭前不洗手、经常外出就餐、饮食口味偏重情况、为医务人员、检查样气13C浓度明显高有明显关联性,差异有统计学意义;回归分析提示吸烟、饮酒、饮食前手卫生情况、是否经常外出就餐、饮食口味、是否为医务人员为导致人群Hp阳性的危险因素;吸烟对于Hp阳性的影响最大。结论南京市高淳地区Hp感染率低于全国平均水平,建立地方相关Hp感染数据档案能提供当地人群Hp感染流行数据,为防治Hp感染提供指导作用。 展开更多
关键词 螺杆菌 幽门 13C呼气试验 危险因素
在线阅读 下载PDF
Review of current diagnostic methods and advances in Helicobacter pylori diagnostics in the era of next generation sequencing 预览
8
作者 Daniel Pohl Peter M Keller +1 位作者 Valentine Bordier Karoline Wagner 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第32期4629-4660,共32页
Helicobacter pylori(H.pylori)infection is highly prevalent in the human population and may lead to severe gastrointestinal pathology including gastric and duodenal ulcers,mucosa associated tissue lymphoma and gastric ... Helicobacter pylori(H.pylori)infection is highly prevalent in the human population and may lead to severe gastrointestinal pathology including gastric and duodenal ulcers,mucosa associated tissue lymphoma and gastric adenocarcinoma.In recent years,an alarming increase in antimicrobial resistance and subsequently failing empiric H.pylori eradication therapies have been noted worldwide,also in many European countries.Therefore,rapid and accurate determination of H.pylori’s antibiotic susceptibility prior to the administration of eradication regimens becomes ever more important.Traditionally,detection of H.pylori and its antimicrobial resistance is done by culture and phenotypic drug susceptibility testing that are cumbersome with a long turn-around-time.Recent advances in diagnostics provide new tools,like real-time polymerase chain reaction(PCR)and line probe assays,to diagnose H.pylori infection and antimicrobial resistance to certain antibiotics,directly from clinical specimens.Moreover,high-throughput whole genome sequencing technologies allow the rapid analysis of the pathogen’s genome,thereby allowing identification of resistance mutations and associated antibiotic resistance.In the first part of this review,we will give an overview on currently available diagnostic methods for detection of H.pylori and its drug resistance and their implementation in H.pylori management.The second part of the review focusses on the use of next generation sequencing technology in H.pylori research.To this end,we conducted a literature search for original research articles in English using the terms“Helicobacter”,“transcriptomic”,“transcriptome”,“next generation sequencing”and“whole genome sequencing”.This review is aimed to bridge the gap between current diagnostic practice(histology,rapid urease test,H.pylori culture,PCR and line probe assays)and new sequencing technologies and their potential implementation in diagnostic laboratory settings in order to complement the currently recommended H.pylori man 展开更多
关键词 HELICOBACTER PYLORI ADVANCES in DIAGNOSTICS Next generation SEQUENCING Whole genome SEQUENCING Clinical management
在线阅读 免费下载
Banxia Xiexin Decoction for patients with peptic ulcer or chronic gastritis infected with Helicobacter pylori 预览
9
作者 Mei Han Amanda Clery +5 位作者 Jianping Liu Xuemei Li Jie Zhang Ce Dong Shuo Feng Yun Xia 《中医科学杂志(英文)》 2019年第2期122-130,共9页
Objective:To compare the effectiveness and safety of Banxia Xiexin Decoction (BXD) as alternative therapy versus standard triple therapy or quadruple therapy for patients with peptic ulcer or chronic gastritis infecte... Objective:To compare the effectiveness and safety of Banxia Xiexin Decoction (BXD) as alternative therapy versus standard triple therapy or quadruple therapy for patients with peptic ulcer or chronic gastritis infected with Helicobacter pylori (H.pylori).Methods:Databases including China National Knowledge Infrastructure,Chongqing VIP,Wanfang Database,PubMed,the Cochrane Library and clinicaltrials.gov were searched in December 2018 for relevant randomized controlled trials (RCTs).Two authors independently screened and selected studies,extracted data and checked data extraction.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed by using RevMan 5.3.5 software.Results:Fourteen RCTs were included in our analysis involving 1300 patients.Thirteen RCTs compared the effects of BXD alone versus standard therapy,11 involving triple therapy and 2 in quadruple therapy.The cure rate for both diseases were higher in the BXD alone group than in the standard therapy group (RR and 95% Cl:1.85 [1.07,3.17] and 1.48 [1.24,1.75],respectively).And also,the same result with effectiveness rate (RR and 95% CI:1.18 [1.08,1.29] and 1.14 [1.08,1.20],respectively).However,there was no significant difference in the clearance of H.pylori one month after treatment,neither compared with quadruple therapy nor triple therapy (RR and 95% CI:1.10 [1.00,1.22] and 1.04 [0.97,1.12],respectively).Adverse events appeared in 3 participants in the BXD group and 26 participants in the conventional therapy group.The quality of the trials included in this review was not very good.Conclusion:BXD has a superior effect to standard conventional therapy in improving clinical symptoms and repair of the mucosal lesion,and a similar effect to standard conventional therapy in clearing H.pylori.We still need good quality trials,especially placebo-controlled trials,in the future to confirm this result. 展开更多
关键词 Banxia Xiexin DECOCTION RANDOMIZED controlled trial Meta-analysis HELICOBACTER PYLORI
在线阅读 下载PDF
Recurrence of Helicobacter pylori infection:incidence and influential factors
10
作者 Yan Xue Li-Ya Zhou +1 位作者 Hao-Ping Lu Jin-Zhe Liu 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第7期765-771,共7页
Background:Helicobacter pylori(H.pylori)eradication has been widely used.The recurrence rate of H.pylori after eradication and its related factors are gaining more and more attention.Our study aimed to determine the r... Background:Helicobacter pylori(H.pylori)eradication has been widely used.The recurrence rate of H.pylori after eradication and its related factors are gaining more and more attention.Our study aimed to determine the recurrence rate of H.pylori infection after successful eradication,and analyze its influential factors.Methods:We prospectively studied 1050 patients with upper gastrointestinal symptoms who were diagnosed as H.pylori infection by gastroscopy and underwent eradication therapies from April 2013 to January 2014.The 13C-urea breath test(UBT)or Warthin-Starry(WS)staining was done at 8 to 12 weeks after the therapy.Patients with successful eradication were followed by repeated UBT or gastroscopy at one year and 3 years after therapy,as well as,questionnaire surveys.Recurrence was considered if the UBTs or WS staining of biopsy were positive.One-year and 3-year recurrence rates were calculated,and analyzed the differences between recurred patients and others in basic data,socio logical characteristics,lifestyle.Results:A total of 743 patients finished the 1-year follow-up,and the 1-year recurrence rate was 1.75%.Of the 607 patients who finished the 3-year follow-up,28 patients recurred,and the 3-year recurrence rate was 4.61%.Analysis of variance showed that lowincome,poor hygiene condition of dining out place,and receiving invasive diagnoses or treatments were significant risk factors for H.pylori infection recurrence.Logistic regression analysis demonstrated that the combination of invasive diagnoses or treatments,the level of income,and the hygiene standard of dining out place were significant and independent influential factors of the recurrence of H.pylori.Conclusions:The 1-year and 3-year recurrence rates of H.pylori infection after eradication therapy are 1.75%and 4.61%.Lowincome,poor hygiene condition of dining out place,and a combination of invasive diagnoses or treatments are independent risk factors of H.pylori recurrence. 展开更多
关键词 AFFECTING factors FOLLOW-UP study HELICOBACTER PYLORI RECURRENCE
Helicobacter pylori virulence genes 预览
11
作者 Anja Sterbenc Erika Jarc +1 位作者 Mario Poljak Matjaz Homan 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第33期4870-4884,共15页
Helicobacter pylori(H.pylori)is one of the most important human pathogens,infecting approximately half of the global population.Despite its high prevalence,only a subset of H.pylori infected individuals develop seriou... Helicobacter pylori(H.pylori)is one of the most important human pathogens,infecting approximately half of the global population.Despite its high prevalence,only a subset of H.pylori infected individuals develop serious gastroduodenal pathology.The pathogenesis of H.pylori infection and disease outcome is thus thought to be mediated by an intricate interplay between host,environmental and bacterial virulence factors.H.pylori has adapted to the harsh milieu of the human stomach through possession of various virulence genes that enable survival of the bacteria in the acidic environment,movement towards the gastric epithelium,and attachment to gastric epithelial cells.These virulence factors enable successful colonization of the gastric mucosa and sustain persistent H.pylori infection,causing chronic inflammation and tissue damage,which may eventually lead to the development of peptic ulcers and gastric cancer.Numerous studies have focused on the prevalence and role of putative H.pylori virulence genes in disease pathogenesis.While several virulence factors with various functions have been identified,disease associations appear to be less evident,especially among different study populations.This review presents key findings on the most important H.pylori virulence genes,including several bacterial adhesins and toxins,in children and adults,and focuses on their prevalence,clinical significance and potential relationships. 展开更多
关键词 HELICOBACTER PYLORI VIRULENCE genes Disease association Children ADULTS Outer membrane proteins Bacterial TOXINS
在线阅读 免费下载
Issues and controversies in esophageal inlet patch 预览
12
作者 Adriana Ciocalteu Petrica Popa +1 位作者 Mircea Ionescu Dan Ionut Gheonea 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4061-4073,共13页
The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a r... The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a region in which their prevalence is likely underestimated.Various studies have reported correlations between these esophageal marks with different issues such as Barrett’s esophagus,but these findings remain controversial.Conflicting reports complicate the process of interpreting the clinical features of esophageal inlet patches and underestimate their importance.Unfortunately,the limited clinical data and statistical analyses make reaching any conclusions difficult.It is hypothesized that inlet patches are correlated with various esophageal and extraesophageal symptoms,diagnoses and the personalized therapeutic management of patients with inlet patches as well as the differential diagnosis for premalignant lesions or early cancers.Due to its potential underdiagnosis,there are no consensus guidelines for the management and follow up of inlet patches.This review focuses on questions that were raised from published literature on esophageal inlet patches in adults. 展开更多
关键词 INLET PATCH Ectopic GASTRIC MUCOSA Heterotopic GASTRIC MUCOSA ESOPHAGEAL cancer Narrow band imaging Optical chromoendoscopy Cervical ESOPHAGUS Functional dyspepsia Barrett’s ESOPHAGUS Helicobacter pylori
在线阅读 免费下载
Helicobacter pylori and cytokine gene variants as predictors of premalignant gastric lesions 预览
13
作者 Anca Negovan Mihaela Iancu +1 位作者 Emoke Fulop Claudia Banescu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4105-4124,共20页
Gastric cancer remains the third leading cause of mortality from cancer worldwide and carries a poor prognosis,due largely to late diagnosis.The importance of the interaction between Helicobacter pylori(H.pylori)infec... Gastric cancer remains the third leading cause of mortality from cancer worldwide and carries a poor prognosis,due largely to late diagnosis.The importance of the interaction between Helicobacter pylori(H.pylori)infection,the main risk factor,and host-related genetic factors has been studied intensively in recent years.The genetic predisposition for non-hereditary gastric cancer is difficult to assess,as neither the real prevalence of premalignant gastric lesions in various populations nor the environmental risk factors for cancer progression are clearly defined.For non-cardiac intestinal-type cancer,identifying the factors that modulate the progression from inflammation toward cancer is crucial in order to develop preventive strategies.The role of cytokines and their gene variants has been questioned in regard to non-self-limiting H.pylori gastritis and its evolution to gastric atrophy and intestinal metaplasia;the literature now includes various and non-conclusive results on this topic.The influence of the majority of cytokine single nucleotide polymorphisms has been investigated for gastric cancer but not for preneoplastic gastric lesions.Among the investigated gene variants onlyIL10T-819C,IL-8-251,IL-18RAP917997,IL-22 rs1179251,IL1-B-511,IL1-B-3954,IL4R-398 and IL1RN were identified as predictors for premalignant gastric lesions risk.One of the most important limiting factors is the inhomogeneity of the studies(e.g.,the lack of data on concomitant H.pylori infection,methods used to assess preneoplastic lesions,and source population).Testing the modifying effect of H.pylori infection upon the relationship between cytokine gene variants and premalignant gastric lesions,or even testing the interaction between H.pylori and cytokine gene variants in multivariable models adjusted for potential covariates,could increase generalizability of results. 展开更多
关键词 Helicobacter pylori GASTRITIS PREMALIGNANT GLANDULAR ATROPHY Intestinal METAPLASIA Single-nuclear polymorphism Gene variants INTERLEUKINS
在线阅读 免费下载
Pathogenesis and clinical management of Helicobacter pylori gastric infection 预览
14
作者 Breno Bittencourt de Brito Filipe Antonio Franca da Silva +5 位作者 Aline Silva Soares Vinícius Afonso Pereira Maria Luísa Cordeiro Santos Mariana Miranda Sampaio Pedro Henrique Moreira Neves Fabrício Freire de Melo 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第37期5578-5589,共12页
Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factor... Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies. 展开更多
关键词 HELICOBACTER PYLORI VIRULENCE factors Immune response ANTIBIOTICS Vaccines
在线阅读 免费下载
Allicin as add-on therapy for Helicobacter pylori infection: A systematic review and meta-analysis 预览
15
作者 Xiao-Bei Si Xu-Min Zhang +3 位作者 Shuai Wang Yu Lan Shuo Zhang Lin-Yu Huo 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第39期6025-6040,共16页
BACKGROUND Allicin(2-propene-1-sulfinothioic acid S-2-propenyl ester,diallyl thiosulfinate)extracted from garlic,has proven activity against Helicobacter pylori(H.Pylori)infection.In recent years,clinical trials have ... BACKGROUND Allicin(2-propene-1-sulfinothioic acid S-2-propenyl ester,diallyl thiosulfinate)extracted from garlic,has proven activity against Helicobacter pylori(H.Pylori)infection.In recent years,clinical trials have explored its utility as an add-on therapy with variable outcomes reported.AIM To perform a systemic review of allicin as an add-on treatment for H.Pylori infection and assess its efficacy in randomized controlled trials(RCTs).METHODS Electronic databases including MEDLINE,EMBASE,the Web of Science,the Cochrane Database,the China National Knowledge Infrastructure Database,Chinese VIP Information Databases,Chinese Medical Databases,and the Wan-Fang Database were searched for keywords including“allicin”,“Helicobacter pylori”,“randomized clinical trials”,and their synonyms.A meta-analysis was performed using the fixed-effects model for low heterogeneity and the randomeffects model for high heterogeneity with sensitivity analysis.Bias was evaluated using Egger’s tests.Trial sequential analysis(TSA)was used to evaluate information size and treatment benefits.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)was used to assess the level of quality,and studies were classed as“high quality”,“moderate quality”,“low quality”,and“very low quality”.RESULTS A total of eight RCTs consisting of 867 participants(435 from the allicin group and 432 from the control group)were included.Eradication rate in the allicin group(93.33%,406/435)was significantly higher than that of the control group(83.56%,361/432)[I2=0%,odds ratio(OR)=2.75,95%confidence interval(CI):1.74-4.35,P<0.001].The healing rate of ulcers following H.pylori therapy in the allicin group(86.17%,349/405)was significantly higher than that of the control group(75.87%,305/402)[I2=0%,OR=2.05,95%CI:1.39-3.03,P<0.001].The total remission rate of peptic ulcers across all allicin groups was 95.99%,which was significantly higher than that of controls[95.99%(359/374)vs 89.25%(332/372),I2=0,heterogeneity P=0.84,O 展开更多
关键词 ALLICIN Helicobacter pylori Randomized controlled trials Add-on therapy Systematic review META-ANALYSIS
在线阅读 免费下载
Prevention of overuse:A view on upper gastrointestinal endoscopy 预览
16
作者 Judith J de Jong Marten A Lantinga Joost PH Drenth 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第2期178-189,共12页
Many upper gastrointestinal(GI)endoscopies worldwide are performed for inappropriate indications.This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services.Dyspepsia is on... Many upper gastrointestinal(GI)endoscopies worldwide are performed for inappropriate indications.This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services.Dyspepsia is one of the most common inappropriate indications for upper GI endoscopy as diagnostic yield is low.Reasons for untimely referral are:unfamiliarity with dyspepsia guidelines,uncertainty about etiology of symptoms,and therapy failure.Unfiltered openaccess referrals feed upper GI endoscopy overuse.This review highlights strategies applied to diminish use of upper GI endoscopies for dyspepsia.First,we describe the impact of active guideline implementation.We found improved guideline adherence,but resistance was encountered in the process.Secondly,we show several forms of clinical assessment.While algorithm use reduced upper GI endoscopy volume,effects of referral assessment of individual patients were minor.A third strategy proposed Helicobacter pylori test and treat for all dyspeptic patients.Many upper GI endoscopies can be avoided using this strategy,but outcomes may be prevalence dependent.Lastly,empirical treatment with Proton pump inhibitors achieved symptom relief for dyspepsia and avoided upper GI endoscopies in about two thirds of patients.Changing referral behavior is complex as contributing factors are manifold.A collaboration of multiple strategies is most likely to succeed. 展开更多
关键词 ENDOSCOPY DYSPEPSIA Medical OVERUSE Guidelines PROTON Pump Inhibitors HELICOBACTER PYLORI
在线阅读 免费下载
Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified 预览
17
作者 Giovanni Bruno Piera Zaccari +5 位作者 Giulia Rocco Giulia Scalese Cristina Panetta Barbara Porowska Stefano Pontone Carola Severi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第22期2706-2719,共14页
Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastri... Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastric parietal cells, are used in the treatment of several acid-related disorders. PPIs are generally well tolerated but, through the long-term reduction of gastric acid secretion, can increase the risk of an imbalance in gut microbiota composition (i.e., dysbiosis). The gut microbiota is a complex ecosystem in which microbes coexist and interact with the human host. Indeed, the resident gut bacteria are needed for multiple vital functions, such as nutrient and drug metabolism, the production of energy, defense against pathogens, the modulation of the immune system and support of the integrity of the gut mucosal barrier. The bacteria are collected in communities that vary in density and composition within each segment of the gastrointestinal (GI) tract. Therefore, every change in the gut ecosystem has been connected to an increased susceptibility or exacerbation of various GI disorders. The aim of this review is to summarize the recently available data on PPI-related microbiota alterations in each segment of the GI tract and to analyze the possible involvement of PPIs in the pathogenesis of several specific GI diseases. 展开更多
关键词 Proton pump inhibitors Hypochloridria Gut MICROBIOTA DYSBIOSIS GASTROINTESTINAL TRACT Cancer HELICOBACTER pylori GASTROINTESTINAL INFECTIONS
在线阅读 免费下载
Premalignant lesions and gastric cancer:Current understanding 预览
18
作者 Athanasios Koulis Andrew Buckle Alex Boussioutas 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第9期665-678,共14页
Over the last two decades there has been a broad paradigm shift in our understanding of gastric cancer(GC)and its premalignant states from gross histological models to increasingly precise molecular descriptions.In th... Over the last two decades there has been a broad paradigm shift in our understanding of gastric cancer(GC)and its premalignant states from gross histological models to increasingly precise molecular descriptions.In this review we reflect upon the historic approaches to describing premalignant lesions and GC,highlight the current molecular landscape and how this could inform future risk assessment prevention strategies. 展开更多
关键词 HELICOBACTER PYLORI Correa cascade ATROPHIC GASTRITIS Intestinal METAPLASIA Point of no return DYSPLASIA Stem cells Gastric cancer
在线阅读 免费下载
Probiotic monotherapy and Helicobacter pylori eradication:A systematic review with pooled-data analysis 预览
19
作者 Giuseppe Losurdo Rossella Cubisino +4 位作者 Michele Barone Mariabeatrice Principi Gioacchino Leandro Enzo Ierardi Alfredo Di Leo 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第1期139-149,共11页
AIM to define probiotic monotherapy effect on Helicobacter pylori(H.pylori)status by performing a systematic review.METHODS Methods of analysis and inclusion criteria were based on PRISMA recommendations.Relevant publ... AIM to define probiotic monotherapy effect on Helicobacter pylori(H.pylori)status by performing a systematic review.METHODS Methods of analysis and inclusion criteria were based on PRISMA recommendations.Relevant publications were identified by searching PubMed,MEDLINE,Science Direct,and EMBASE.The end-point was to estimate eradication rate and urea breath test delta value before and after probiotic monotherapy across all studies and,overall,with a pooled data analysis.Adverse events of probiotic therapy were evaluated.The data were expressed as proportions/percentages,and 95%CIs were calculated.For continuous variables,we evaluated the weighted mean difference.Odd ratios(ORs)were calculated according to the Peto method for the comparison of eradication rates between probiotics and placebo.RESULTS Eleven studies were selected.Probiotics eradicated H.pylori in 50 out of 403 cases.The mean weighted eradication rate was 14%(95%CI:2%-25%,p=0.02).Lactobacilli eradicated the bacterium in 30 out of 235 patients,with a mean weighted rate of 16%(95%CI:1%-31%).Saccharomyces boulardii achieved eradication in 6 out of 63 patients,with a pooled eradication rate of 12%(95%CI:0%-29%).Multistrain combinations were effective in 14 out of 105 patients,with a pooled eradication rate of 14%(95%CI:0%-43%).In the comparison of probiotics vs placebo,we found an OR of 7.91 in favor of probiotics(95%CI:2.97-21.05,p<0.001).Probiotics induced a mean reduction in delta values higher than placebo(8.61%with a 95%CI:5.88-11.34,vs 0.19%for placebo,p<0.001).Finally,no significant difference in adverse events was found between probiotics and placebo(OR=1,95%CI:0.06-18.08).CONCLUSION Probiotics alone show a minimal effect on H.pylori clearance,thus suggesting a likely direct role. 展开更多
关键词 HELICOBACTER PYLORI PROBIOTICS ERADICATION meta-analysis BREATH test
在线阅读 免费下载
Priming the seed:Helicobacter pylori alters epithelial cell invasiveness in early gastric carcinogenesis 预览
20
作者 Silvia Molina-Castro Vanessa Ramírez-Mayorga Warner Alpízar-Alpízar 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2018年第9期231-243,共13页
Helicobacter pylori(H.pylori)infection is a wellestablished risk factor for the development of gastric cancer(GC),one of the most common and deadliest neoplasms worldwide.H.pylori infection induces chronic inflammatio... Helicobacter pylori(H.pylori)infection is a wellestablished risk factor for the development of gastric cancer(GC),one of the most common and deadliest neoplasms worldwide.H.pylori infection induces chronic inflammation in the gastric mucosa that,in the absence of treatment,may progress through a series of steps to GC.GC is only one of several clinical outcomes associated with this bacterial infection,which may be at least partially attributed to the high genetic variability of H.pylori.The biological mechanisms underlying how and under what circumstances H.pylori alters normal physiological processes remain enigmatic.A key aspect of carcinogenesis is the acquisition of traits that equip preneoplastic cells with the ability to invade.Accumulating evidence implicates H.pylori in the manipulation of cellular and molecular programs that are crucial for conferring cells with invasive capabilities.We present here an overview of the main findings about the involvement of H.pylori in the acquisition of cell invasive behavior,specifically focusing on the epithelial-to-mesenchymal transition,changes in cell polarity,and deregulation of molecules that control extracellular matrix remodeling. 展开更多
关键词 HELICOBACTER pylori PLASMINOGEN activation system Invasion Epithelial-to-mesenchymal transition Cell polarity Gastric CARCINOGENESIS
在线阅读 免费下载
上一页 1 2 250 下一页 到第
使用帮助 返回顶部 意见反馈