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Bodh V, Sharma B, Kumar R, Sharma R. Current Trends in Etiological Profile of Acute Upper Gastrointestinal Bleeding in Northern India: A Retrospective Analysis of 5-Year Endoscopic Data. JOURNAL OF DIGESTIVE ENDOSCOPY 2021. [DOI: 10.1055/s-0041-1728232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Introduction The etiological spectrum of acute upper gastrointestinal bleeding (AUGIB) varies from region to region. This study was performed to find out the latest etiological spectrum of the AUGIB in a tertiary care hospital in North India and to compare it with etiological spectra from a previous study from the same center and from the other regions of India.
Methods Clinical notes and endoscopic data of all consecutive patients who had presented with AUGIB in Indira Gandhi Medical College Shimla, Himachal Pradesh, from May 2015 to December 2019, were analyzed retrospectively with the objective of finding out the various endoscopic etiologies that lead to AUGIB. The findings were compared with the previous study from the same center and with the data from the other regions of the country.
Results A total of 1,513 patients were enrolled and majority were males (74.6%) with male:female ratio of 2.9:1. Majority were 41 to 60 years (46.46%) of age. Melena was the presenting complaint in 93.98% and hematemesis in 46.06%. Peptic ulcer disease (PUD; 46.19%) was the commonest cause of AUGIB followed by portal hypertension (26.23%). Other less common causes were erosive mucosal disease, erosive esophagitis, neoplasm, Mallory–Weiss tear, gastric angiodysplasia, anastomotic site ulcers, and Dieulafoy’s lesion.
Conclusion PUD was still the commonest cause of AUGIB followed by portal hypertension. This is in agreement with the previous report from the same center and in contrast to the reports from other studies from Northern and Western India that create the impression that portal hypertension related bleeding is the most common cause of AUGIB in India.
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Affiliation(s)
- Vishal Bodh
- Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India
| | - Brij Sharma
- Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India
| | - Rajesh Kumar
- Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India
| | - Rajesh Sharma
- Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India
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Bertolo Guariento MR, Pereira da Silva J, Guariento GB, Pinasco GC, Sales AB, Alves CBR, Pimassoni LHS, Ramos-Silva V. Children and adolescents’ health on focus: Gastrointestinal injuries associated with Helicobacter pylori. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i4.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To describe the prevalence of Helicobacter pylori (HP) in children and adolescents, and to assess its association with lesions in the esophagus, stomach, and duodenum according to the patient’s life cycle. Methodsː A cross-sectional analytical study with children and adolescents referred to a gastroenterology service and underwent esophagogastroduodenoscopy at a hospital in Vitória, Espírito Santo, Brazil, from 2001 to 2013. Variables analyzed were the following: sex, age, macro and microscopic alterations and severity of infestation. The Chi-square and Fisher's exact tests and adjusted residue analysis were used (α = 5%). Resultsː the prevalence of infection was 24.4%. Esophagitis (29.4%) and gastritis (34.1%) were associated with HP. The life cycle was associated with esophagitis and duodenitis. Infection was associated with life cycle: infants (0.8%), preschool children (10.5%), school-aged children (16.5%), and adolescents (72.2%). The residues showed a strong association between HP and gastritis, and no association between the school-aged and esophagitis. Adolescents were the major contributors to the association between life cycle and infection, and life cycle and lesion. Conclusionsː Infection with HP was associated with esophagitis and gastritis and was higher among adolescents, who had a marked tendency to develop gastritis and a milder tendency to develop esophagitis. The tendency of developing infection and gastritis was not present in the other life cycles. Public policies focusing on promotion and protecting health, especially in vulnerable population groups, are needed.
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Rodrigues MF, Guerra MR, Alvarenga AVRD, Souza DZDO, Costa RAVES, Cupolilo SMN. HELICOBACTER PYLORI INFECTION AND GASTRIC CANCER PRECURSOR LESIONS: PREVALENCE AND ASSOCIATED FACTORS IN A REFERENCE LABORATORY IN SOUTHEASTERN BRAZIL. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:419-424. [PMID: 31800739 DOI: 10.1590/s0004-2803.201900000-84] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Helicobacter pylori infection is the most important risk factor for gastric atrophy and intestinal metaplasia, both considered gastric cancer precursor lesions. Therefore, the investigation of the occurrence of H. pylori infection, precursor lesions and associated factors guides the adoption of specific strategies for the control this type of cancer. OBJECTIVE To evaluate the prevalence of H. pylori infection in patients undergoing upper digestive endoscopy, as well as the prevalence of intestinal metaplasia, atrophy and chronic inflammation and their association with H. pylori infection. METHODS A retrospective study was performed based on reports of gastric endoscopic biopsies performed in a private laboratory affiliated to the Brazilian Public Health System (SUS). Patients were evaluated for age, gender and type of health service. The samples were evaluated for the presence of H. pylori, and also of chronic inflammation, intestinal metaplasia and glandular atrophy. RESULTS Of a total of 4,604 patients (mean age 51±16.6), 63.9% were female and 63.1% coming from private health care service. The prevalence of H. pylori infection was 31.7% (n=1,459), and the percentage of infection was significantly higher in patients from public health service (42.0%) in relation to patients from private health service (25.6%). Among H. pylori (+) patients, a higher percentage of intestinal metaplasia (17.7% vs 13.3%) and glandular atrophy (17.6% vs 6.9%) were observed when compared to those H. pylori (-) (P<0.01). From the patients H. pylori (+) with at least one type of precursor lesion (n=418), 161 (38.5%) had metaplasia and chronic inflammation, 160 (38.3%) had atrophy and chronic inflammation and finally 97 (23.2%) presented metaplasia, atrophy and chronic inflammation simultaneously. CONCLUSION The present study reinforces the association of H. pylori infection with gastric cancer precursor lesions in a Brazilian population, emphasizing the importance of infection prevention measures, as well as the treatment of infected patients, especially in regions with lower socioeconomic levels that show a higher prevalence of infection by H. pylori.
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Affiliation(s)
| | - Maximiliano Ribeiro Guerra
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em Saúde Coletiva, Juiz de Fora, MG, Brasil
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Fotoohi F, Kazemi MJ, Ansariniya H. Challenges of Accurate Diagnosis of Helicobacter pylori in Iran. INTERNATIONAL JOURNAL OF ENTERIC PATHOGENS 2019. [DOI: 10.15171/ijep.2019.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Helicobacter pylori-associated gastritis is regarded as the most prevalent gastrointestinal infection, as well as the major cause of several other diseases. Despite being discovered over 30 years ago, no golden diagnostic method has yet been suggested for this microorganism. Objective: The present study aimed to compare two common diagnostic methods of histology and serology. Materials and Methods: This cross-sectional study began in July, 2016, and was conducted at Imam Jafar Sadegh Hospital (a university hospital) in Maybod, Yazd, Iran, on 70 patients. All the patients underwent endoscopy, and biopsy samples were taken for histology, as well as blood samples for ELISA test. Finally, sensitivity, specificity, NPV (negative predictive values), and PPV (positive predictive values) were calculated and analyzed. Results: The sensitivity, specificity, accuracy, PPV, and NPV of the ELISA method with histology as the gold standard were 87.5%, 36.9%, 54.2%, 42%, and 85%, respectively. Still, the histology method appears to be the most reliable test for the diagnosis of H. pylori in Iran. Conclusion: Regarding the high prevalence of H. pylori in Iran, the present study recommends the use of histology as a diagnostic method in combination with other diagnostic methods for detecting H. pylori infection.
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Affiliation(s)
- Farahnaz Fotoohi
- Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran
| | - Mohammad javad Kazemi
- Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran
| | - Hossein Ansariniya
- Department of Immunology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Ferrari F, Dutra ECG, Zanardi HC, Scolaro BL, Ferrari OM. TIME TRENDS OF HELICOBACTER PYLORI PREVALENCE IN ITAJAÍ - SC: A RETROSPECTIVE STUDY OF 25 YEARS BASED ON ENDOSCOPIC DATABASE. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:10-14. [PMID: 31141059 DOI: 10.1590/s0004-2803.201900000-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The bacterium Helicobacter pylori is strongly associated with the development of gastric adenocarcinoma. Currently, the prevalence in developed countries is 40%, but this value increases considerably in developing countries, which can reach rates bigger than 90%. OBJECTIVE The objective of this study was to determine the mean and annual prevalence of Helicobacter pylori infection in patients from Itajaí during the period from July 1992 to April 2016, as well as the gender and age groups most affected. METHODS After consent of the clinical director of the Gastroclinica Itajaí and confidentiality commitment about the research, the database of the Endoscopy Service of the clinic was evaluated. All the patients who underwent their first upper digestive endoscopy with urease test and/or histological analysis were included. The data were submitted to statistical analysis of prevalence by gender, age group and years of study, with subsequent correction through the confidence interval. RESULTS The mean prevalence of Helicobacter pylori infection thru all years of study was 50.07%. With the calculation of the annual prevalences, it was evident the gradual reduction of infection in the population of Itajaí, that was 81.3% in 1992, declining to 33% in the year of 2016. When classifying the prevalence of infection by gender, it was higher in males (53.59%), and gender distribution by age group showed no statistically significant difference among genders between the ages of 40 and 80 years. In relation to the age group, the highest prevalence was in the group between 40 and 49 years. CONCLUSION Although this study is retrospective and based on endoscopic database analysis, without access to clinical data of patients such as prior use of proton pump inhibitor and antibiotics to endoscopy, its results are important because they may reflect the current panorama of Helicobacter pylori infection in the city under study, where it has been presenting a gradual reduction of prevalence over the years, with current rates similar to that of developed countries (33%). Future studies are needed to confirm our data.
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Affiliation(s)
- Fangio Ferrari
- Universidade do Vale do Itajaí, Departamento de Gastroenterologia, Itajaí, SC, Brasil
| | | | | | - Bruno Lorenzo Scolaro
- Universidade do Vale do Itajaí, Departamento de Gastroenterologia, Itajaí, SC, Brasil
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Epidemiological and Clinical-Pathological Aspects of Helicobacter pylori Infection in Brazilian Children and Adults. Gastroenterol Res Pract 2018; 2018:8454125. [PMID: 30254670 PMCID: PMC6142780 DOI: 10.1155/2018/8454125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/10/2018] [Indexed: 12/11/2022] Open
Abstract
Aim To evaluate the prevalence and risk factors of H. pylori infection in the pediatric and adult population seen at a public hospital in São José do Rio Preto, SP, Brazil. Methods This is a retrospective study that evaluated 2406 medical records of children, adolescents, and adults with dyspeptic symptoms who underwent upper gastrointestinal endoscopy. H. pylori diagnosis and demographic and clinical-pathological features were recorded. Results A total of 852 subjects were H. pylori positive, with an overall prevalence of infection of 35.4%, occurring mainly in adults over 40 years of age, and a 24.7% prevalence considering only children and adolescents. No association was observed between H. pylori infection and risk factors. However, the H. pylori positive individuals showed a higher frequency of pangastritis (p < 0.01), severe lesions (p = <0.001), and erosive lesions (p = 0.04). The bacterium was eradicated in 83.5% (127) of the patients who received the standard therapy. Conclusions The prevalence of H. pylori detected in a public service in São José do Rio Preto, SP, Brazil, is as expected for developed countries, showing growing rates with increasing age. As H. pylori infection occurs during childhood, screening programs for detection and prevention in the pediatric population are important to reduce the prevalence of this infection in adults.
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Raaf N, Amhis W, Saoula H, Abid A, Nakmouche M, Balamane A, Ali Arous N, Ouar-Korichi M, Vale FF, Bénéjat L, Mégraud F. Prevalence, antibiotic resistance, and MLST typing of Helicobacter pylori in Algiers, Algeria. Helicobacter 2017; 22. [PMID: 29035009 DOI: 10.1111/hel.12446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Helicobacter pylori infection is common in Algeria, but there are few data on the characterization of isolated strains. The aim of this study was to update data on the prevalence of H. pylori in patients submitted to endoscopy, antibiotic resistance, and phylogeography of H. pylori strains isolated in Algiers. MATERIALS AND METHODS This is a prospective study carried out between November 2015 and August 2016. The culture of H. pylori was performed on antral and fundic gastric biopsies of adult patients from 3 hospitals. A real-time PCR using the fluorescence resonance energy transfer (FRET) principle for the detection of H. pylori followed by a melting curve analysis for the detection of mutations associated with resistance to clarithromycin was applied. Differentiation between antral and fundic isolates of the same patient was also determined by RAPD, and an MLST typing was performed for characterization of the phylogeographic group of H. pylori. RESULTS By real-time PCR, the prevalence of H. pylori infection among the 147 patients included was 57%. Culture was positive in only 29% of the cases. Twenty-seven percent of patients had received H. pylori eradication treatment. The primary and secondary resistance rates to clarithromycin were 23% and 36%, respectively, and to metronidazole, 45% and 71%, respectively. Only one isolate was resistant to levofloxacin, and no resistance to amoxicillin, tetracycline, and rifampicin was detected. A double population was present in 14 patients. The MLST analysis classified the 42 H. pylori strains from 38 patients in 2 haplotypes: hpEurope (33) and hpNEAfrica (9). CONCLUSION The prevalence of H. pylori remains high in Algeria but appears to be decreasing in recent years. High resistance to clarithromycin requires increased monitoring of the evolution of antibiotic resistance and adaptation of eradication therapy.
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Affiliation(s)
- Naïma Raaf
- Département de Microbiologie, Faculté des Sciences de la Nature et de la Vie, Université Ferhat Abbas, Setif, Algeria.,Laboratoire Central de Biologie Clinique, EPH Ibn Ziri Bologhine, Algiers, Algeria
| | - Wahiba Amhis
- Laboratoire Central de Biologie Clinique, EPH Ibn Ziri Bologhine, Algiers, Algeria
| | - Houria Saoula
- Service de Gastroentérologie, CHU Lamine Debaghine Bab El Oued, Algiers, Algeria
| | - Ahmed Abid
- Service de Gastroentérologie, CHU Isaad Hassani Beni Messous, Algiers, Algeria
| | - Mhamed Nakmouche
- Service de Gastroentérologie, CHU Lamine Debaghine Bab El Oued, Algiers, Algeria
| | - Abdelmalek Balamane
- Service de Gastroentérologie, CHU Isaad Hassani Beni Messous, Algiers, Algeria
| | - Nassima Ali Arous
- Servive de Médecine interne, EPH Ibn Ziri Bologhine, Algiers, Algeria
| | - Mounira Ouar-Korichi
- Laboratoire des Entérobactéries et autres bactéries apparentées, Institut Pasteur d'Algérie, Algiers, Algeria
| | - Filipa F Vale
- Host-Pathogen Interactions Unit, Research Institute for Medicines (iMed-ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - Lucie Bénéjat
- French National Reference Center for Campylobacters and Helicobacters, Laboratoire de Bactériologie, Hôpital Pellegrin, & INSERM U 1053, Université de Bordeaux, Bordeaux, France
| | - Francis Mégraud
- French National Reference Center for Campylobacters and Helicobacters, Laboratoire de Bactériologie, Hôpital Pellegrin, & INSERM U 1053, Université de Bordeaux, Bordeaux, France
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