A population-based study of Helicobacter pylori: Does asymptomatic infection mean no gastroscopic lesions?

OBJECTIVES

We determined the common clinical characteristics of patients infected with Helicobacter pylori (H. pylori) and investigated the relationship between H. pylori infection, and clinical symptoms, and gastroscopic manifestations. Our focus was specifically on the clinical manifestations in asymptomatic patients.

METHODS

We obtained the physical examination data of patients who underwent the 14C urea breath test between January 2018 and December 2020 at our Hospital. Basic demographic data, questionnaire data on clinical symptoms, and clinical examination data of the patients were also collected, and the correlation analysis was performed.

RESULTS

A total of 2863 participants were included in the study. The overall H. pylori infection rate was 26.30%. The clinical symptoms between H. pylori-positive patients and H. pylori-negative patients did not differ significantly (P > .05). However, H. pylori-positive patients exhibited more severe gastroscopic manifestations (P < .001). The 14C urea breath test disintegrations per minute (DPM) values in H. pylori-positive patients correlated with their serum pepsinogen and gastrin-17 levels. With an increase in the DPM value, more combinations of clinical symptoms appeared in the patients. Among H. pylori-positive patients, DPM levels in asymptomatic patients were lower than those in symptomatic patients (P < .001). However, gastroscopic manifestations did not vary significantly between asymptomatic and symptomatic patients (P > .05).

CONCLUSION

Patients infected with H. pylori showed no specific gastrointestinal symptoms. Patients with asymptomatic infection showed lower DPM levels, but their gastroscopic manifestations were similar to those of patients with symptomatic infection, and their lesions were more severe than H. pylori-negative people.

Endoscopic ultrasound-guided intraportal injection of autologous bone marrow in patients with decompensated liver cirrhosis: A case series

BACKGROUND

Recently, stem cell therapy has been extensively studied as a promising treatment for decompensated liver cirrhosis (DLC). Technological advances in endoscopic ultrasonography (EUS) have facilitated EUS-guided portal vein (PV) access, through which stem cells can be precisely infused.

AIM

To investigate the feasibility and safety of fresh autologous bone marrow injection into the PV under EUS guidance in patients with DLC.

METHODS

Five patients with DLC were enrolled in this study after they provided written informed consent. EUS-guided intraportal bone marrow injection with a 22G FNA needle was performed using a transgastric, transhepatic approach. Several parameters were assessed before and after the procedure for a follow-up period of 12 mo.

RESULTS

Four males and one female with a mean age of 51 years old participated in this study. All patients had hepatitis B virus-related DLC. EUS-guided intraportal bone marrow injection was performed in all patients successfully without any complications such as hemorrhage. The clinical outcomes of the patients revealed improvements in clinical symptoms, serum albumin, ascites, and Child-Pugh scores throughout the 12-mo follow-up.

CONCLUSION

The use of EUS-guided fine needle injection for intraportal delivery of bone marrow was feasible and safe and appeared effective in patients with DLC. This treatment may thus be a safe, effective, non-radioactive, and minimally invasive treatment for DLC.

The influence of near-field fluxes on seasonal carbon dioxide enhancements: results from the Indianapolis Flux Experiment (INFLUX)

BACKGROUND

Networks of tower-based CO₂ mole fraction sensors have been deployed by various groups in and around cities across the world to quantify anthropogenic CO₂ emissions from metropolitan areas. A critical aspect in these approaches is the separation of atmospheric signatures from distant sources and sinks (i.e., the background) from local emissions and biogenic fluxes. We examined CO₂ enhancements compared to forested and agricultural background towers in Indianapolis, Indiana, USA, as a function of season and compared them to modeled results, as a part of the Indianapolis Flux (INFLUX) project.

RESULTS

At the INFLUX urban tower sites, daytime growing season enhancement on a monthly timescale was up to 4.3-6.5 ppm, 2.6 times as large as those in the dormant season, on average. The enhancement differed significantly depending on choice of background and time of year, being 2.8 ppm higher in June and 1.8 ppm lower in August using a forested background tower compared to an agricultural background tower. A prediction based on land cover and observed CO₂ fluxes showed that differences in phenology and drawdown intensities drove measured differences in enhancements. Forward modelled CO₂ enhancements using fossil fuel and biogenic fluxes indicated growing season model-data mismatch of 1.1 ± 1.7 ppm for the agricultural background and 2.1 ± 0.5 ppm for the forested background, corresponding to 25-29% of the modelled CO₂ enhancements. The model-data total CO₂ mismatch during the dormant season was low, - 0.1 ± 0.5 ppm.

CONCLUSIONS

Because growing season biogenic fluxes at the background towers are large, the urban enhancements must be disentangled from the biogenic signal, and growing season increases in CO₂ enhancement could be misinterpreted as increased anthropogenic fluxes if the background ecosystem CO₂ drawdown is not considered. The magnitude and timing of enhancements depend on the land cover type and net fluxes surrounding each background tower, so a simple box model is not appropriate for interpretation of these data. Quantification of the seasonality and magnitude of the biological fluxes in the study region using high-resolution and detailed biogenic models is necessary for the interpretation of tower-based urban CO₂ networks for cities with significant vegetation.