RESUMEN
Background: we assessed the prevalence, the related symptoms, and the endoscopic and histologic gastric features of celiac disease (CD) in patients with Helicobacter pylori (Hp).Methods: 450 dyspeptic patients were studied. Biopsies of gastric antrum and duodenum, CD serology, and total IgA were obtained. Histological findings were scored with the Marsh-Rostami criteria. Results: 411 (91.3%) patients were Hp positive. Duodenal histology was normal in 385 (85.6%) patients, 124 (27.5%) had duodenitis and 28 (6.2%) showed duodenal abnormalities (Marsh I-IIIc). Twenty three/28 (82.1%) patients with malabsorption pattern were also Hp positive. Serological analysis: 12 of 31 (38.7%) positive patients had abnormal histology (Marsh I,-IIIc). Nine out 450 patients were IgA deficient; none of them was serologically positive for CD. Conclusion: although a high prevalence of Hp infection was found in this study, the relationship between Hp infection and C D was similar to that reported in other geographic areas(AU)
Asunto(s)
Humanos , Masculino , Femenino , Helicobacter pylori/aislamiento & purificación , Helicobacter pylori/patogenicidad , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Enfermedad Celíaca/complicaciones , Enfermedad Celíaca/diagnóstico , Duodenitis/complicaciones , Duodenitis/diagnóstico , Irán/epidemiología , Enfermedad Celíaca/fisiopatología , Enfermedad Celíaca , Biopsia/métodos , Enfermedad Celíaca/clasificaciónRESUMEN
BACKGROUND: Vitamin C in gastric juice and in vitro has been shown to inhibit the growth of Helicobacter pylori (H. pylori). AIMS: The purpose of this study was to investigate the effect of addition of vitamin C to eradication regimen on H. pylori eradication rate. PATIENTS: This randomised controlled clinical trial was conducted on 312 patients with H. pylori infection who had referred to the Taleghani Research Center of Gastroenterology and Liver Disease. METHODS: Patients were randomly divided into two groups. Group A patients (162 patients) received amoxicillin 1g and metronidazole 500 mg b.i.d., bismuth 240 mg b.i.d. and omeprazole 40 mg q.i.d. in two divided doses. Patients in group B (150 patients) received the same regimen plus 500 mg vitamin C per day. All patients received therapy for 2 weeks. Four weeks later all patients underwent urea breath test and results were compared. RESULTS: A total of 140 patients in group A and 141 in group B completed the study. On intention-to-treat analysis 48.8% of patients in group A in comparison to 78% in group B responded to eradication therapy and had negative urea breath test (p<0.0001). CONCLUSION: Addition of vitamin C to H. pylori treatment regimen of amoxicillin, metronidazole and bismuth can significantly increases H. pylori eradication rate.
Asunto(s)
Ácido Ascórbico/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Adolescente , Adulto , Anciano , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Antiinfecciosos , Antiulcerosos/uso terapéutico , Bismuto/uso terapéutico , Suplementos Dietéticos , Quimioterapia Combinada , Endoscopía Gastrointestinal , Femenino , Humanos , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Omeprazol/uso terapéutico , Adulto JovenRESUMEN
BACKGROUND: The cag pathogenicity island (PAI), which can be divided into two parts, cagI and cagII, is the most well-known virulence factor of Helicobacter pylori. AIMS: We investigated the association between genetic variations within the cag PAI (cagA and cagE in the cagI and cagT in the cagII) and clinical outcomes in Iranian patients. SUBJECTS: A total of 231 patients including 182 patients with gastritis, 41 with peptic ulcer and 8 with gastric cancer. METHODS: The presence of the cagA, cagE and cagT genes were measured by polymerase chain reaction and the results were compared with clinical outcomes and gastric histology. RESULTS: The cagA, cagE and cagT genes were found in 154 (66.7%), 90 (39.0%) and 70 (30.3%) of clinical isolates. At least 144 (62.3%) strains possessed partially deleted cag PAI (e.g., 69 [29.9%] strains were cagA-positive, but cagE and cagT-negative). CONCLUSION: The single genes as well as the combination of genes in the cag PAI appeared not to be useful markers to predict H. pylori-related diseases in Iranian patients. The genomic sequences of the cag PAI in Iranian strains might be considerably different from those in other geographic locations.
Asunto(s)
Islas Genómicas/genética , Helicobacter pylori/patogenicidad , Factores de Virulencia/aislamiento & purificación , Adolescente , Adulto , Anciano , Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Femenino , Gastritis/genética , Variación Genética/genética , Infecciones por Helicobacter/genética , Helicobacter pylori/genética , Humanos , Irán , Masculino , Persona de Mediana Edad , Factores de Virulencia/genética , Adulto JovenRESUMEN
BACKGROUND: we assessed the prevalence, the related symptoms, and the endoscopic and histologic gastric features of celiac disease (CD) in patients with Helicobacter pylori (Hp). METHODS: 450 dyspeptic patients were studied. Biopsies of gastric antrum and duodenum, CD serology, and total IgA were obtained. Histological findings were scored with the Marsh-Rostami criteria. RESULTS: 411 (91.3%) patients were Hp positive. Duodenal histology was normal in 385 (85.6%) patients, 124 (27.5%) had duodenitis and 28 (6.2%) showed duodenal abnormalities (Marsh I-IIIc). Twenty three/28 (82.1%) patients with malabsorption pattern were also Hp positive. Serological analysis: 12 of 31 (38.7%) positive patients had abnormal histology (Marsh I,-IIIc). Nine out 450 patients were IgA deficient; none of them was serologically positive for CD. CONCLUSION: although a high prevalence of Hp infection was found in this study, the relationship between Hp infection and CD was similar to that reported in other geographic areas.