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World Journal of Gastroenterology Sep 2011With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less)... (Review)
Review
With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H. pylori) infection. Novel first-line anti-H. pylori therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy. This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects. The best second-line therapy for patients who fail to eradicate H. pylori with first-line therapies containing clarithromycin, amoxicillin and metronidazole is unclear. However, a levofloxacin-based triple therapy is an accepted rescue treatment. Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test. Nonetheless, an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H. pylori infection if antimicrobial sensitivity data are unavailable.
Topics: Amoxicillin; Anti-Infective Agents; Bismuth; Clarithromycin; Drug Resistance, Bacterial; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Humans; Levofloxacin; Metronidazole; Ofloxacin; Tetracycline
PubMed: 22046084
DOI: 10.3748/wjg.v17.i35.3971 -
Chemistry (Weinheim An Der Bergstrasse,... Dec 2022The synthesis and characterisation of a library of acyclic antimony(III) and bismuth(III) triaryl pnictogen bonding (PnB) receptor systems are reported. In the...
The synthesis and characterisation of a library of acyclic antimony(III) and bismuth(III) triaryl pnictogen bonding (PnB) receptor systems are reported. In the first-generation receptor series, quantitative H NMR chloride titration experiments in THF solvent media reveal halide anion binding potency is intimately correlated with both the electronic-withdrawing nature of the aryl- substituent and the polarisability of the PnB donor. Further extensive anion binding investigations with the most potent Sb- and Bi-based PnB receptors: 1⋅Sb and 1⋅Bi , reveal novel selectivity profiles, both displaying Cl selectivity relative to the heavier halides and, impressively, to a range of highly basic oxoanions. The synthesis and preliminary chloride anion binding studies of a series of novel tripodal tris-proto-triazole triaryl Sb(III) and Bi(III) mixed PnB-HB receptor systems are also described. Whereas parent triphenyl Sb(III) and Bi(III) compounds are incapable of binding Cl in THF solvent media, the PnB-triazole HB host systems exhibit notable halide affinity.
Topics: Antimony; Bismuth; Chlorides; Anions; Halogens; Triazoles; Solvents
PubMed: 35968660
DOI: 10.1002/chem.202201838 -
Molecules (Basel, Switzerland) Jun 2023Polymerase chain reaction (PCR) has extensive bioanalytical applications in molecular diagnostics and genomic research studies for rapid detection and precise genomic...
Polymerase chain reaction (PCR) has extensive bioanalytical applications in molecular diagnostics and genomic research studies for rapid detection and precise genomic amplification. Routine integrations for analytical workflow indicate certain limitations, including low specificity, efficiency, and sensitivity in conventional PCR, particularly towards amplifying high guanine-cytosine (GC) content. Further, there are many ways to enhance the reaction, for example, using different PCR strategies such as hot-start/touchdown PCR or adding some special modifications or additives such as organic solvents or compatible solutes, which can improve PCR yield. Due to the widespread use of bismuth-based materials in biomedicine, which have not yet been used for PCR optimization, this attracts our attention. In this study, two bismuth-based materials that are inexpensive and readily available were used to optimize GC-rich PCR. The results demonstrated that ammonium bismuth citrate and bismuth subcarbonate effectively enhanced PCR amplification of the GNAS1 promoter region (∼84% GC) and APOE (75.5% GC) gene of Homo sapiens mediated by Ex Taq DNA polymerase within the appropriate concentration range. Combining DMSO and glycerol additives was critical in obtaining the target amplicons. Thus, the solvents mixed with 3% DMSO and 5% glycerol were used in bismuth-based materials. That allowed for better dispersion of bismuth subcarbonate. As for the enhanced mechanisms, the surface interaction of PCR components, including Taq polymerase, primer, and products with bismuth-based materials, was maybe the main reason. The addition of materials can reduce the melting temperature (T), adsorb polymerase and modulate the amount of active polymerase in PCR, facilize the dissociation of DNA products, and enhance the specificity and efficiency of PCR. This work provided a class of candidate enhancers for PCR, deepened our understanding of the enhancement mechanisms of PCR, and also explored a new application field for bismuth-based materials.
Topics: Humans; Dimethyl Sulfoxide; Glycerol; Bismuth; Solvents; Polymerase Chain Reaction
PubMed: 37298991
DOI: 10.3390/molecules28114515 -
Alimentary Pharmacology & Therapeutics May 2012Because of the decrease in the Helicobacter pylori eradication rate after standard triple therapy with a proton pump inhibitor and two antibiotics, bismuth-based therapy... (Comparative Study)
Comparative Study Review
BACKGROUND
Because of the decrease in the Helicobacter pylori eradication rate after standard triple therapy with a proton pump inhibitor and two antibiotics, bismuth-based therapy has recently been recommended as alternate first-line regimen in children.
AIM
To comprehensively review the clinical, pharmacologic and microbiologic properties of bismuth salts, and to summarise the evidence for the therapeutic efficacy of bismuth-based therapy for H. pylori eradication in children.
METHODS
Bibliographical searches were performed in MEDLINE. Results on the efficacy of bismuth-containing regimens on H. pylori eradication were combined using the inverse variance method.
RESULTS
Bismuth monotherapy showed a very low efficacy. Overall, the mean eradication rate with bismuth-based dual therapy was 68% (95% CI, 60-76%) (intention-to-treat analysis-ITT) and 73% (95% CI, 64-81%) (per protocol-PP). In case series, the overall percentages of children with successful eradication for triple therapy containing bismuth were 82% (95% CI, 76-88%) and 86% (95% CI, 80-92%) according to ITT and PP respectively. In comparative studies, H. pylori eradication rates ranged between 69% and 85% according to ITT and between 74% and 96% PP. Side effects included dark stools, urine discoloration, black tongue, burning tongue, and marked darkness of the gums.
CONCLUSIONS
The evidence in favour of bismuth compounds for treating infected children is still not clear. Well-designed, randomised, multi-centre studies of H. pylori eradication trials in children comparing bismuth-based triple therapy with the best available recommended first-line therapies are needed. The evidence obtained from audited case series that produce an eradication rate of >95% on PP analysis should also be considered.
Topics: Animals; Antacids; Anti-Bacterial Agents; Anti-Ulcer Agents; Bismuth; Child; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Humans; Proton Pump Inhibitors; Treatment Outcome
PubMed: 22404517
DOI: 10.1111/j.1365-2036.2012.05055.x -
Nutrients Jul 2022Probiotic supplementation to antibiotic regimens against infection has been proposed to improve eradication rate and to decrease detrimental effects on gut microbiota. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Probiotic supplementation to antibiotic regimens against infection has been proposed to improve eradication rate and to decrease detrimental effects on gut microbiota.
AIMS
To evaluate microbiota modifications due to a low-dose quadruple therapy with bismuth or .
METHODS
Forty-six patients infected with were prospectively enrolled in a single-centre, randomized controlled trial to receive b.i.d. with meals for 10 days low-dose quadruple therapy consisting of rabeprazole 20 mg and bismuth (two capsules of Pylera plus 250 mg each of tetracycline and metronidazole), or the same dose of rabeprazole and antibiotics plus Gastrus (), one tablet twice-a-day for 27 days. Stool samples were collected at the enrolment, at the end and 30-40 days after the treatment. Gut microbiota composition was investigated with 16S rRNA gene sequencing.
RESULTS
Eradication rate was by ITT 78% in both groups, and by PP analysis 85.7% and 95.5% for Gastrus and bismuth group, respectively. Alpha and beta diversity decreased at the end of treatment and was associated with a reduction of bacterial genera beneficial for gut homeostasis, which was rescued 30-40 days later in both groups, suggesting a similar impact of the two regimens in challenging bacterial community complexity.
CONCLUSIONS
Low-dose bismuth quadruple therapy proved to be effective with lower costs and amount of antibiotics and bismuth. Gastrus might be an option for patients with contraindications to bismuth. was unable to significantly counteract dysbiosis induced by antibiotics. How to administer probiotics to prevent gut microbiota alterations remains an open question.
Topics: Anti-Bacterial Agents; Bismuth; Drug Therapy, Combination; Gastrointestinal Microbiome; Helicobacter Infections; Helicobacter pylori; Humans; Limosilactobacillus reuteri; Metronidazole; Proton Pump Inhibitors; RNA, Ribosomal, 16S; Rabeprazole; Tetracycline; Treatment Outcome
PubMed: 35889746
DOI: 10.3390/nu14142789 -
British Medical Journal Feb 1967
Topics: Bismuth; Humans; Penicillins; Syphilis
PubMed: 6017505
DOI: No ID Found -
Molecules (Basel, Switzerland) Nov 2020The research was focused on developing a potentially antibacterial wound dressing made of polyurethane foam and loaded with bismuth-ciprofloxacin (Cip-Bi). The Cip-Bi...
The research was focused on developing a potentially antibacterial wound dressing made of polyurethane foam and loaded with bismuth-ciprofloxacin (Cip-Bi). The Cip-Bi chemical structure was confirmed by Fourier transform infrared spectroscopic (FTIR) analysis. The sought after antibacterial wound dressing was obtained by modification of the raw dressing with an iodine or bromine solution and subsequently with a Cip-Bi hydrogel. The amount of Cip-Bi loaded into the dressing matrix was determined indirectly on the basis of the differences in Cip-Bi concentrations, before and after the modification process, and the determination was performed with the HPLC (high-performance liquid chromatography) method. The modified dressing was found to have a two-step release of Cip-Bi, a feature helpful in the treatment of locally infected wounds and prevention of secondary bacterial infection. The zone of inhibition test against the selected Gram-positive and Gram-negative bacteria confirmed the antibacterial activity of the Cip-Bi-modified dressing. Preliminary tests conducted so far have been indicative of the Cip-Bi dressing's relatively high activity against the tested organisms.
Topics: Anti-Bacterial Agents; Bandages; Bismuth; Ciprofloxacin; Escherichia coli; Humans; Microbial Sensitivity Tests; Staphylococcus aureus
PubMed: 33153027
DOI: 10.3390/molecules25215096 -
Biomedical Journal Oct 2019To quantify image quality and radiation doses in regions adjacent to and distant from bismuth shields in computed tomography (CT).
BACKGROUND
To quantify image quality and radiation doses in regions adjacent to and distant from bismuth shields in computed tomography (CT).
METHODS
An American College of Radiology accreditation phantom with four solid rods embedded in a water-like background was scanned to verify CT number (CTN) accuracy when using bismuth shields. CTNs, image noise, and contrast-to-noise ratios (CNRs) were determined in the phantom at 80-140 kVp. Image quality was investigated on image portions in the zones adjacent (A zone) to and distant (D zone) from a bismuth shield. Surface radiation doses were measured using thermoluminescent dosimeters. Streak artefacts were graded on a 3-point-scale.
RESULTS
Changes in CTN caused by a bismuth shield resulted in changes in X-ray spectra. CTN changes were more apparent in the A zone than in the D zone, particularly for a low tube voltage. The degrees of CTN changes and image noise were proportional to the thickness of the bismuth shields. A 1-ply bismuth shield reduced surface radiation doses by 7.2%-15.5%. The overall CNRs were slightly degraded, and streak artefacts were acceptable.
CONCLUSIONS
Using a bismuth shield could result in significant CTN changes and perceivable artefacts, particularly for a superficial organ close to the shield, and is not recommended for quantification CT examinations or follow-up CT examinations.
Topics: Artifacts; Bismuth; Breast; Humans; Phantoms, Imaging; Radiation Dosage; Tomography, X-Ray Computed
PubMed: 31783995
DOI: 10.1016/j.bj.2019.04.004 -
BioMed Research International 2021Radiation using conventional X-ray is associated with exposure of radiosensitive organs and typically requires the use of protection. This study is aimed at evaluating...
BACKGROUND
Radiation using conventional X-ray is associated with exposure of radiosensitive organs and typically requires the use of protection. This study is aimed at evaluating the use of bismuth shielding for radiation protection in pediatric pelvic radiography. The effects of the anteroposterior and lateral bismuth shielding were verified by direct measurements at the anatomical position of the gonads.
METHODS
Radiation doses were measured using optically stimulated luminescence dosimeters (OSLD) and CIRS ATOM Dosimetry Verification Phantoms. Gonad radiographs were acquired using different shields of varying material (lead, bismuth) and thickness and were compared with radiographs obtained without shielding to examine the effects on image quality and optimal reduction of radiation dose. All images were evaluated separately by three pediatric orthopedic practitioners.
RESULTS
Results showed that conventional lead gonadal shielding reduces radiation doses by 67.45%, whereas dose reduction using one layer of bismuth shielding is 76.38%. The use of two layers of bismuth shielding reduces the dose by 84.01%. Using three and four layers of bismuth shielding reduces dose by 97.33% and 99.34%, respectively. Progressively lower radiation doses can be achieved by increasing the number of bismuth layers. Images obtained using both one and two layers of bismuth shielding provided adequate diagnostic information, but those obtained using three or four layers of bismuth shielding were inadequate for diagnosis.
CONCLUSIONS
Bismuth shielding reduces radiation dose exposure providing appropriate protection for children undergoing pelvic radiography. The bismuth shielding material is lighter than lead, making pediatric patients more comfortable and less apt to move, thereby avoiding repeat radiography.
Topics: Bismuth; Child; Humans; Pelvis; Phantoms, Imaging; Radiation Dosage; Radiation Exposure; Radiation Protection; Tomography, X-Ray Computed; X-Rays
PubMed: 34671681
DOI: 10.1155/2021/9985714 -
Seminars in Nuclear Medicine Mar 2020Within the last decades, there has been no major improvement in treatment of patients with glioma, especially with glioblastoma multiforme (GBM) which is related to... (Review)
Review
Within the last decades, there has been no major improvement in treatment of patients with glioma, especially with glioblastoma multiforme (GBM) which is related to specific features of this tumor type, such as heterogeneity at the macroscopic, microscopic and genetic level, the infiltrative nature of tumors and the obstacle of the brain-blood barrier which limits the accessability of most drugs. The current standard of care is surgical resection, followed by radio- and chemotherapy. After first-line treatment of the primary lesion, tumor recurrence is diagnosed in virtually all GBM patients. Treatment of tumor recurrence represents a challenging clinical task. Surgical resection to relief symptoms of mass effect and/or salvage chemotherapy are often considered as last therapeutic option. A new treatment option is urgently needed. Targeted alpha therapy with an intratumoral injection of Bi-DOTA-Substance P (SP) or Ac-DOTAGA-Substance P has been introduced into the therapeutic armamentarium of recurrent GBM. There are many advantages of using SP such as very high prevalence of increased NK-1 expression in GBM cells, regardless of the degree of malignancy, and expression of the NK-1 receptor system not only on the membrane of cancer cells but also strong expression of NK1 receptors within the tumor neovasculature suggesting concomitant targeting of vascular and neoplastic structures. Radioisotopes with different physical properties, mainly beta-emitting metallic radionuclides, were implemented for brain tumor treatment. Based on their radiophysical properties, however, alpha emitters exhibit more promising properties. In investigator-initiated phase I and II studies, targeted alpha therapy using Bi-213/Ac-225 radiolabeled Substance P for malignant gliomas compare favorably with standard therapy, with the limitation that no large controlled series have so far been generated. Further development should focus on the improvement of the biological and chemical properties of the compound and the application by dedicated catheter systems to improve the intratumoral distribution of the radiopharmaceutical within growth and infiltrative zone of these glial neoplasms.
Topics: Actinium; Bismuth; Glioma; Humans; Radioisotopes; Substance P
PubMed: 32172799
DOI: 10.1053/j.semnuclmed.2019.11.004