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The Turkish Journal of Gastroenterology... Apr 2023The polymorphisms in the region between 58 and 62 amino acids of the 194-amino acid CagL protein (CagL hypervariable motif) affect the binding affinity of CagL to...
BACKGROUND
The polymorphisms in the region between 58 and 62 amino acids of the 194-amino acid CagL protein (CagL hypervariable motif) affect the binding affinity of CagL to integrin α5β1 (ITGA5B1) receptor in host epithelial cells and have an effect on the development of various gastrointestinal diseases. We aimed to evaluate the associations of gastroduodenal pathologies, with the polymorphisms of cagL gene of Helicobacter pylori (H. pylori) and also associations between vacA genotypes and cagL polymorphisms.
METHODS
A total of 19 gastric cancer, 16 duodenal ulcer, and 26 non-ulcer dyspepsia patients were included in this case-control study. All cases had H. pylori. A fragment of 651 bp from gene cagL (hp0539) and cagA, vacA genes was amplified by polymerase chain reaction. Purified polymerase chain reaction products were sequenced by Sanger sequencing, and nucleotide sequences were translated into amino acid sequences.
RESULTS
All of the H. pylori strains had cagL and cagA genes. In the 16 (84%) gastric cancer cases, the D58 amino acid polymorphism was significant than the 4 (15.4%) duodenal ulcer cases (P = .029), and the D58/K59 amino acid polymorphism was significant in 12 (63.1%) of the gastric cancer cases than 1 (3.85%) duodenal ulcer case (P = .008). D58/K59 and DKIGQ (n = 10; 52.63%) were the most common polymorphisms in the gastric cancer and were associated with the vacA genotype s1/m2, respectively (P = .022 and P = .008). The D58/K59 amino acid polymorphism was found to have a significant Odds Ratio (OR) value of 8.9 (P = .0017) in multivariate logistic regression analysis.
CONCLUSIONS
The risk of gastric cancer development is 8.9 times higher with D58/K59 polymorphism.
Topics: Humans; Bacterial Proteins; Helicobacter pylori; Duodenal Ulcer; Stomach Neoplasms; Case-Control Studies; Genotype; Amino Acids; Helicobacter Infections; Antigens, Bacterial
PubMed: 36789984
DOI: 10.5152/tjg.2023.22274 -
Gut and Liver Mar 2021infection is one of the most common infectious diseases worldwide. Although the prevalence of is gradually decreasing, approximately half of the world's population... (Meta-Analysis)
Meta-Analysis Review
infection is one of the most common infectious diseases worldwide. Although the prevalence of is gradually decreasing, approximately half of the world's population still becomes infected with this disease. is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the clinical practice guidelines in 2013 in Korea, the eradication rate of has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.
Topics: Clarithromycin; Duodenal Ulcer; Helicobacter Infections; Helicobacter pylori; Humans; Randomized Controlled Trials as Topic; Republic of Korea
PubMed: 33468712
DOI: 10.5009/gnl20288 -
Applied Microbiology and Biotechnology Dec 2020Helicobacter pylori, a member of Epsilonproteobacteria, is a Gram-negative microaerophilic bacterium that colonizes gastric mucosa of about 50% of the human population.... (Review)
Review
Helicobacter pylori, a member of Epsilonproteobacteria, is a Gram-negative microaerophilic bacterium that colonizes gastric mucosa of about 50% of the human population. Although most infections caused by H. pylori are asymptomatic, the microorganism is strongly associated with serious diseases of the upper gastrointestinal tract such as chronic gastritis, peptic ulcer, duodenal ulcer, and gastric cancer, and it is classified as a group I carcinogen. The prevalence of H. pylori infections varies worldwide. The H. pylori genotype, host gene polymorphisms, and environmental factors determine the type of induced disease. Currently, the most common therapy to treat H. pylori is the first line clarithromycin-based triple therapy or a quadruple therapy replacing clarithromycin with new antibiotics. Despite the enormous recent effort to introduce new therapeutic regimens to combat this pathogen, treatment for H. pylori still fails in more than 20% of patients, mainly due to the increased prevalence of antibiotic resistant strains. In this review we present recent progress aimed at designing new anti-H. pylori strategies to combat this pathogen. Some novel therapeutic regimens will potentially be used as an extra constituent of antibiotic therapy, and others may replace current antibiotic treatments. KEY POINTS: • Attempts to improve eradication rate of H. pylori infection. • Searching for new drug targets in anti-Helicobacter therapies.
Topics: Amoxicillin; Anti-Bacterial Agents; Clarithromycin; Helicobacter Infections; Helicobacter pylori; Humans; Pharmaceutical Preparations
PubMed: 33052519
DOI: 10.1007/s00253-020-10945-w -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Nov 2022Peptic ulcer perforation (PUP) is one of the cause of acute abdomen, incidence of this entity is 5% of all abdominal emergencies. Numerous prognostic factors have been...
BACKGROUND
Peptic ulcer perforation (PUP) is one of the cause of acute abdomen, incidence of this entity is 5% of all abdominal emergencies. Numerous prognostic factors have been reported for morbidity and mortality after PUP, this study attempts to analyze the factors affecting mortality and morbidity in patients with PUP.
METHODS
The medical record of patients who were operated for PUP in our clinic was retrospectively evaluated between January 2008 to January 2018. A total of 318 patients were included in this study. Patients were retrospectively analyzed in terms of age, gender, comorbidity, ASA score, biochemical, hematological parameters, complications, and mortality. The risk factors affected to morbidity and mortality were also evaluated.
RESULTS
The study population consisted of 318 patients and the mean age of the patients was 41.30±19.37 (min-max: 16-89). In the study, 271 (85.22%) patients were male and 47 (14.78%) were female and male to female ratio was 5.76. In the analysis of the predictors of morbidity, age ≥60 years, (p<0.001); perforation-surgery interval >24 h (p<0.001); purulent intraperitoneal contamination (p<0.001); pre-operative renal failure (p<0.001); duodenal perforation (p<0.001); pre-operative shock (p<0.001); and ASA score > III (p<0.0001) were found statistically significant. Gender was not found statistically significant (p=0.672). Mortality developed in 15 (4.71%) of 318 patients in the post-operative period. In the multivariate analysis, age ≥60 years, (p<0.001); perforation-surgery interval >24 h (p<0.001); purulent intraperitoneal contamination (p<0.001); pre-operative renal failure (p<0.001); duodenal perforation (p<0.001); and pre-operative shock (p<0.001) were found to be independent predictors of post-operative mortality.
CONCLUSION
In our study, age ≥60 years, perforation-surgery interval >24 h, purulent intraperitoneal contamination, pre-oper-ative renal failure, duodenal perforation, pre-operative shock, and intensive care unit in the post-operative period were found to be independent predictors of post-operative morbidity and mortality. A comprehensive clinical evaluation, adequate fluid resuscitation, initiation of appropriate antibiotic therapy, and early access to surgery can minimize the risk of morbidity and mortality in PUP.
Topics: Humans; Male; Female; Middle Aged; Peptic Ulcer Perforation; Retrospective Studies; Morbidity; Duodenal Ulcer; Risk Factors; Postoperative Complications; Renal Insufficiency; Anti-Bacterial Agents
PubMed: 36282169
DOI: 10.14744/tjtes.2022.85686 -
Stem Cell Research & Therapy Sep 2021Peptic ulcer is one of the most common gastrointestinal tract disorders worldwide, associated with challenges such as refractory morbidity, bleeding, interference with... (Review)
Review
Peptic ulcer is one of the most common gastrointestinal tract disorders worldwide, associated with challenges such as refractory morbidity, bleeding, interference with use of anticoagulants, and potential side effects associated with long-term use of proton pump inhibitors. A peptic ulcer is a defect in gastric or duodenal mucosa extending from muscularis mucosa to deeper layers of the stomach wall. In most cases, ulcers respond to standard treatments. However, in some people, peptic ulcer becomes resistant to conventional treatment or recurs after initially successful therapy. Therefore, new and safe treatments, including the use of stem cells, are highly favored for these patients. Adipose-derived mesenchymal stem cells are readily available in large quantities with minimal invasive intervention, and isolation of adipose-derived mesenchymal stromal stem cells (ASC) produces large amounts of stem cells, which are essential for cell-based and restorative therapies. These cells have high flexibility and can differentiate into several types of cells in vitro. This article will investigate the effects and possible mechanisms and signaling pathways of adipose tissue-derived mesenchymal stem cells in patients with refractory peptic ulcers.
Topics: Humans; Mesenchymal Stem Cells; Peptic Ulcer; Proton Pump Inhibitors; Stomach Ulcer
PubMed: 34565461
DOI: 10.1186/s13287-021-02584-3 -
World Journal of Emergency Surgery :... Sep 2021The article is a scoping review of the literature on the use of decision support systems based on artificial neural networks in emergency surgery. The authors present... (Review)
Review
The article is a scoping review of the literature on the use of decision support systems based on artificial neural networks in emergency surgery. The authors present modern literature data on the effectiveness of artificial neural networks for predicting, diagnosing and treating abdominal emergency conditions: acute appendicitis, acute pancreatitis, acute cholecystitis, perforated gastric or duodenal ulcer, acute intestinal obstruction, and strangulated hernia. The intelligent systems developed at present allow a surgeon in an emergency setting, not only to check his own diagnostic and prognostic assumptions, but also to use artificial intelligence in complex urgent clinical cases. The authors summarize the main limitations for the implementation of artificial neural networks in surgery and medicine in general. These limitations are the lack of transparency in the decision-making process; insufficient quality educational medical data; lack of qualified personnel; high cost of projects; and the complexity of secure storage of medical information data. The development and implementation of decision support systems based on artificial neural networks is a promising direction for improving the forecasting, diagnosis and treatment of emergency surgical diseases and their complications.
Topics: Acute Disease; Artificial Intelligence; Cholecystitis; Humans; Neural Networks, Computer; Pancreatitis
PubMed: 34565420
DOI: 10.1186/s13017-021-00394-9 -
Cureus Oct 2020Background Laparoscopic surgery is becoming the gold standard for most abdominal surgeries in recent times. Laparoscopic repair of perforated duodenal ulcer (PDU),...
Background Laparoscopic surgery is becoming the gold standard for most abdominal surgeries in recent times. Laparoscopic repair of perforated duodenal ulcer (PDU), however, is still an area of debate. The purpose of this study was to evaluate the safety and efficacy of laparoscopic repair of PDU versus open repair. Methods In this cross-sectional study, patients were consecutively sampled. Out of 101 patients with clinically diagnosed PDU, 36 patients underwent laparoscopic Graham patch repair and 65 underwent open Graham patch repair in a tertiary care academic hospital. Open repair was via upper midline incision, and laparoscopic repair by the three-port technique. The following stages were calculated: operative time, duration of postoperative analgesia, time taken to mobilize, and patient length of stay after the operation. Results The mean operative time was somewhat longer in the laparoscopy group compared to the open repair group (74.01 vs 56.17 minutes, respectively). Mean postoperative analgesia requirement, time taken to mobilize, and hospital stay were significantly shorter after laparoscopy than after open repair (1.21 days, 9.32 hours, and 3.12 days vs 3.83 days, 16.20 hours, and 4.85 days, respectively). Three patients (8%) in the laparoscopy group and 35 (54%) in the open repair group had postoperative complications. Conclusions Laparoscopic repair of PDU is a safe approach and better than open repair in terms of operative time with the right level of expertise only, postoperative analgesia requirement, mobilization, duration of hospital stay, and incidence of postoperative respiratory and wound complications.
PubMed: 33209516
DOI: 10.7759/cureus.10953 -
Cureus Oct 2023Neutrophil-lymphocyte ratio (NLR), a simple, inexpensive, and effective biomarker associated with various inflammatory and neoplastic diseases, has become the focus of...
Assessment of the Relationship Between Neutrophil-Lymphocyte Ratio and Dyspeptic Symptoms in Patients With Peptic Ulcer Diagnosed by Endoscopy and Patients Without Peptic Ulcer.
INTRODUCTION
Neutrophil-lymphocyte ratio (NLR), a simple, inexpensive, and effective biomarker associated with various inflammatory and neoplastic diseases, has become the focus of attention in recent years. Nevertheless, it has not been adequately studied in dyspeptic patients with peptic ulcer (PU) and without PU, i.e., patients with non-ulcer dyspepsia (NUD).
MATERIALS AND METHODS
The population of this retrospective study consisted of patients with dyspeptic complaints who underwent esophagogastroduodenoscopy between April 2023 and June 2023. A total of 180 patients included in the study sample were categorized into two groups based on the endoscopy results: patients without PU or NUD patients (Group 1) and those with PU (Group 2). Age, gender and pre-procedural NLR data, upper gastrointestinal endoscopy results, and the presence of (Hp) in endoscopic biopsy information were recorded for all patients.
RESULTS
Of the 180 patients, 140 were diagnosed with NUD (Group 1), and 40 were diagnosed with PU (Group 2). There was a significant difference between Groups 1 and 2 in terms of NLR (Group 1: 2.5±1.8 vs. Group 2: 3.6±3.7, p=0.014). There was also a significant difference in NLR between Group 1 and Group Gastric Ulcer (p=0.030) but not between Group 1 and Group Duodenal Ulcer (p=0.064). Rates of patients with positive Hp test results were 25% and 32.5% in Groups 1 and 2, respectively, indicating a significant difference between the groups (p=0.026).
CONCLUSION
The NLR measured in patients who presented with dyspeptic complaints was found to be significantly higher in PU patients than in NUD patients. The elevated NLR levels were even more evident in PU patients with GU compared to PU patients with DU.
PubMed: 37954706
DOI: 10.7759/cureus.46820 -
World Journal of Gastroenterology Aug 2020() is a microaerophilic, Gram-negative, human gastric pathogen found usually in the mucous lining of stomach. It infects more than 50% of the world's population and... (Review)
Review
() is a microaerophilic, Gram-negative, human gastric pathogen found usually in the mucous lining of stomach. It infects more than 50% of the world's population and leads to gastroduodenal diseases. The outcome of disease depends on mainly three factors: Host genetics, environment and bacterial factors. Among these, bacterial virulence factors such as , are well known for their role in disease outcomes. However, based on the global epidemiological results, none of the bacterial virulence (gene) factors was found to be associated with particular diseases like duodenal ulcer (DU) in all populations. Hence, substantial importance has been provided for research in strain-specific genes outside the pathogenicity island, especially genes located within the plasticity regions. found within the plasticity regions was first demonstrated in 2005 and was proposed for duodenal ulcer development and reduced risk of gastric cancer in certain geographical regions. Due to the discrepancies in report from different parts of the world in DU development related to virulence factor, became an interesting area of research in elucidating the role of this gene in the disease progression. In this review, we shed light on the detailed information available on the polymorphisms in and their clinical relevance. We have critically appraised several pertinent studies on and discussed their merits and shortcomings. This review also highlights gene as an important biomarker for DU in certain populations.
Topics: Antigens, Bacterial; Bacterial Proteins; Duodenal Ulcer; Helicobacter Infections; Helicobacter pylori; Humans; Stomach Neoplasms; Virulence Factors
PubMed: 32921954
DOI: 10.3748/wjg.v26.i32.4739 -
Caspian Journal of Internal Medicine 2023infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the...
BACKGROUND
infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of -positive with idiopathic duodenal ulcers.
METHODS
A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn's disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) -positive ulcer group and (II) -negative and non-NSAID (idiopathic) ulcer group.
RESULTS
The findings showed that 417 patients (64.5%) had duodenal ulcers induced by , and 111 patients (17.1%) had -negative and non-NSAID ulcers. The mean ages of patients in -positive and idiopathic ulcer groups were 39±15 and 42±17, respectively. In this case, 33 patients (29.7%) with idiopathic ulcers and 56 patients (25.1%) with -positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21%) with idiopathic ulcers and 31 patients (16.5%) with -positive ulcers had multiple duodenal ulcers.
CONCLUSION
The present study demonstrated that the idiopathic ulcers included 17.1% of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers.
PubMed: 37223285
DOI: 10.22088/cjim.14.2.179