Alopecia areata is a disease of the hair follicles, with strong evidence supporting autoimmune etiology. Alopecia areata is frequently associated with immune-medi- ated diseases with skin manifestations such as psoria...Alopecia areata is a disease of the hair follicles, with strong evidence supporting autoimmune etiology. Alopecia areata is frequently associated with immune-medi- ated diseases with skin manifestations such as psoriasis and lichen planus, or without skin manifestations such as autoimmune thyroiditis and idiopathic thrombocytopenic purpura. Helicobacter py/ori （H. pylorl） infection is present in around 50% of the world＇s population and has been associated with a variety of immune-mediated extra-digestive disorders including autoimmune thyroid- itis, idiopathic thrombocytopenic purpura, and psoriasis. A case of a 43-year old man with an 8-too history of alopecia areata of the scalp and beard is presented. The patient was being treated by a dermatologist and had psychiatric support, without any improvement. He had a history of dyspepsia and the urea breath test confirmed H. pylori infection. The patient went into remission from alopecia areata after H. pylori eradication. If such an association is confirmed by epidemiological studies designed for this purpose, new therapeutic options could be available for these patients, especially in areas where infection with H, pylori is highly prevalent.展开更多
AIM:To compare the effectiveness of sequential therapy for Helicobacter pylori(H.pylori) infection with that of triple therapy of varying durations.METHODS:The 460 patients enrolled in this study had H.pylori-associat...AIM:To compare the effectiveness of sequential therapy for Helicobacter pylori(H.pylori) infection with that of triple therapy of varying durations.METHODS:The 460 patients enrolled in this study had H.pylori-associated gastritis or a gastric or duodenal ulcer.After screening,H.pylori-infected patients were randomly assigned to receive either conventional triple therapy for 7,10 or 14 d,or a new 10-d sequential therapy.Each of the 4 treatment groups included 115 patients.The outcomes of eradication therapy were assessed 4 wk after treatment by the urea breath test and histology.RESULTS:The overall eradication rate was 81.0%,and eradication rates were 75.7% for 7-d conventional triple therapy,81.9% for 10-d conventional triple therapy,84.4% for 14-d conventional triple therapy,and 82.0% for 10-d sequential therapy.Neither intention-to-treat analysis nor per protocol analysis showed significant differences in eradication rates using sequential therapy or the standard triple therapy(P = 0.416 and P = 0.405,respectively).CONCLUSION:There are no significant differences between 10-d sequential eradication therapy for H.pylori and any duration of standard triple treatment in Korean patients.展开更多
AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electro...AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed. RESULTS： We identified 14 randomized trials （1431 patients）. Pooled Hpylori eradication rates were 72.01% （95% CI： 58.09%-85.93%） and 69.78% （95% CI： 66.47%-73.09%） for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio （OR） was 1.17 （95% CI： 0.64-2.14）. The occurrence of side effects differed significantly and was 15.81% （95% CI： 12.50%-19.12%） and 25.20% （95% CI： 21.44%-28.96%） for treatment with or without azithromycin, respectively, and the summary OR was 0.58 （95% CI： 0.41-0.82）. Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION： Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of Hpylori compared with standard first-line triple-therapy regimens.展开更多
AIM： To assess long-term effects of Helicobacter pylori （H pylon} eradication on antral G cell morphology and function in patients with and without duodenal ulcer （DU）.METHODS： Consecutive dyspeptic patients refe...AIM： To assess long-term effects of Helicobacter pylori （H pylon} eradication on antral G cell morphology and function in patients with and without duodenal ulcer （DU）.METHODS： Consecutive dyspeptic patients referred to the endoscopy entered the study. Out of 39 Hpylori positive patients, 8 had DU （Hpylori ＋DU） and 31 gastritis （Hpylori＋G）. Control groups consisted of 11 uninfected dyspeptic patients （CG1） and 7 healthy volunteers （CG2）. Basal plasma gastrin （PGL）, antral tissue gastrin concentrations （ATGC）, immunohistochemical and electron microscopic characteristics of G cells were determined, prior to and 6 mo after therapy.RESULTS： We-demonstrated elevated PGL in infected patients compared to uninfected controls prior to therapy.Elevated PGL were registered in all Hpylori＋patients （Hpylori＋DU： 106.78＋22.72 pg/mL, Hpylori＋G： 74.95＋15.63,CGI： 68.59＋17.97, CG2：39.24＋5.59 pg/mL, P〈0.01）.Successful eradication （e） therapy in Hpylori＋patients lead to significant decrease in PGL （Hpylori＋DU： 59.93＋9.40 and Hpylori＋Ge： 42.36＋10.28 pg/mL, P〈0.001）. ATGC at the beginning of the study were similar in infected and uninfected patients and eradication therapy lead to significant decrease in ATGC in Hpylori＋gastritis, but not in DU patients. In the Hpylori＋DU patients, the mean number of antral G cells was significantly lower in comparison with all other groups （P〈0.01）, but after successful eradication was close to normal values found in controls. By contrast, G cell number and volume density were significantly decreased （P〈0.01） in Hpylori＋Ge group after successful eradication therapy （294＋32 and 0.31＋0.02,respectively）, in comparison to values before eradication （416~40 and 0.48~0.09）. No significant change of the G cell/total endocrine cell ratio was observed during the 6 mo of follow up in any of the groups. A reversible increase in G cell secretory function was seen in all infected individuals, demonstrated by a more prominent secretory apparatus. However, differences between DU and gastritis group were identified.CONCLUSION： H py/oriinfection induces antral G cell hyperfunction resulting in increased gastrin synthesis and secretion. After eradication therapy complete morphological and functional recovery is observed in patients with gastritis. In the DU patients some other factors unrelated to the Hpyloriinfection influence antral G cell morphology and function.展开更多
AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high ris...AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.展开更多
目的:探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与糖尿病性脂肪肝的关系,为临床诊治提供依据.方法:131例2型糖尿病患者行胃黏膜组织切片染色确定H.pylori感染,分为H.pylori阳性组62例,H.pylori阴性组69例,行腹部彩超检查和血...目的:探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与糖尿病性脂肪肝的关系,为临床诊治提供依据.方法:131例2型糖尿病患者行胃黏膜组织切片染色确定H.pylori感染,分为H.pylori阳性组62例,H.pylori阴性组69例,行腹部彩超检查和血脂、血清C肽、空腹血糖、空腹胰岛素,并计算胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMR-IR)及体质量指数(body mass index,BMI).结果:H.pylori阳性组的糖尿病性脂肪肝发生率71.0%(44/62),H.pylori阴性组糖尿病性脂肪肝发生率50.7%(35/69),差异有统计学意义(P<0.05);H.pylori阳性组甘油三酯、HOMR-IR均明显高于H.pylori阴性组,血清C肽低于H.pylori阴性组,差异均有统计学意义(P<0.05),而胆固醇及低密度脂蛋白(lowdensity lipoprotein,LDL)、高密度脂蛋白(high-density lipoprotein,HDL)、BMI在两组间均无统计学差异(P>0.05).结论:糖尿病性脂肪肝患者中H.pylori感染率高,高H.pylori感染加重糖尿病性糖脂代谢紊乱及胰岛素抵抗,加重脂肪肝进展,或许积极抗H.pylori治疗,有利于缓解或减少糖尿病性脂肪肝的发生、发展.展开更多
文摘Alopecia areata is a disease of the hair follicles, with strong evidence supporting autoimmune etiology. Alopecia areata is frequently associated with immune-medi- ated diseases with skin manifestations such as psoriasis and lichen planus, or without skin manifestations such as autoimmune thyroiditis and idiopathic thrombocytopenic purpura. Helicobacter py/ori （H. pylorl） infection is present in around 50% of the world＇s population and has been associated with a variety of immune-mediated extra-digestive disorders including autoimmune thyroid- itis, idiopathic thrombocytopenic purpura, and psoriasis. A case of a 43-year old man with an 8-too history of alopecia areata of the scalp and beard is presented. The patient was being treated by a dermatologist and had psychiatric support, without any improvement. He had a history of dyspepsia and the urea breath test confirmed H. pylori infection. The patient went into remission from alopecia areata after H. pylori eradication. If such an association is confirmed by epidemiological studies designed for this purpose, new therapeutic options could be available for these patients, especially in areas where infection with H, pylori is highly prevalent.
文摘AIM:To compare the effectiveness of sequential therapy for Helicobacter pylori(H.pylori) infection with that of triple therapy of varying durations.METHODS:The 460 patients enrolled in this study had H.pylori-associated gastritis or a gastric or duodenal ulcer.After screening,H.pylori-infected patients were randomly assigned to receive either conventional triple therapy for 7,10 or 14 d,or a new 10-d sequential therapy.Each of the 4 treatment groups included 115 patients.The outcomes of eradication therapy were assessed 4 wk after treatment by the urea breath test and histology.RESULTS:The overall eradication rate was 81.0%,and eradication rates were 75.7% for 7-d conventional triple therapy,81.9% for 10-d conventional triple therapy,84.4% for 14-d conventional triple therapy,and 82.0% for 10-d sequential therapy.Neither intention-to-treat analysis nor per protocol analysis showed significant differences in eradication rates using sequential therapy or the standard triple therapy(P = 0.416 and P = 0.405,respectively).CONCLUSION:There are no significant differences between 10-d sequential eradication therapy for H.pylori and any duration of standard triple treatment in Korean patients.
文摘AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed. RESULTS： We identified 14 randomized trials （1431 patients）. Pooled Hpylori eradication rates were 72.01% （95% CI： 58.09%-85.93%） and 69.78% （95% CI： 66.47%-73.09%） for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio （OR） was 1.17 （95% CI： 0.64-2.14）. The occurrence of side effects differed significantly and was 15.81% （95% CI： 12.50%-19.12%） and 25.20% （95% CI： 21.44%-28.96%） for treatment with or without azithromycin, respectively, and the summary OR was 0.58 （95% CI： 0.41-0.82）. Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION： Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of Hpylori compared with standard first-line triple-therapy regimens.
基金Supported by a Grant From Serbian Ministry for Science, Technology and Development, No. 1752
文摘AIM： To assess long-term effects of Helicobacter pylori （H pylon} eradication on antral G cell morphology and function in patients with and without duodenal ulcer （DU）.METHODS： Consecutive dyspeptic patients referred to the endoscopy entered the study. Out of 39 Hpylori positive patients, 8 had DU （Hpylori ＋DU） and 31 gastritis （Hpylori＋G）. Control groups consisted of 11 uninfected dyspeptic patients （CG1） and 7 healthy volunteers （CG2）. Basal plasma gastrin （PGL）, antral tissue gastrin concentrations （ATGC）, immunohistochemical and electron microscopic characteristics of G cells were determined, prior to and 6 mo after therapy.RESULTS： We-demonstrated elevated PGL in infected patients compared to uninfected controls prior to therapy.Elevated PGL were registered in all Hpylori＋patients （Hpylori＋DU： 106.78＋22.72 pg/mL, Hpylori＋G： 74.95＋15.63,CGI： 68.59＋17.97, CG2：39.24＋5.59 pg/mL, P〈0.01）.Successful eradication （e） therapy in Hpylori＋patients lead to significant decrease in PGL （Hpylori＋DU： 59.93＋9.40 and Hpylori＋Ge： 42.36＋10.28 pg/mL, P〈0.001）. ATGC at the beginning of the study were similar in infected and uninfected patients and eradication therapy lead to significant decrease in ATGC in Hpylori＋gastritis, but not in DU patients. In the Hpylori＋DU patients, the mean number of antral G cells was significantly lower in comparison with all other groups （P〈0.01）, but after successful eradication was close to normal values found in controls. By contrast, G cell number and volume density were significantly decreased （P〈0.01） in Hpylori＋Ge group after successful eradication therapy （294＋32 and 0.31＋0.02,respectively）, in comparison to values before eradication （416~40 and 0.48~0.09）. No significant change of the G cell/total endocrine cell ratio was observed during the 6 mo of follow up in any of the groups. A reversible increase in G cell secretory function was seen in all infected individuals, demonstrated by a more prominent secretory apparatus. However, differences between DU and gastritis group were identified.CONCLUSION： H py/oriinfection induces antral G cell hyperfunction resulting in increased gastrin synthesis and secretion. After eradication therapy complete morphological and functional recovery is observed in patients with gastritis. In the DU patients some other factors unrelated to the Hpyloriinfection influence antral G cell morphology and function.
文摘AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.
文摘目的:探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与糖尿病性脂肪肝的关系,为临床诊治提供依据.方法:131例2型糖尿病患者行胃黏膜组织切片染色确定H.pylori感染,分为H.pylori阳性组62例,H.pylori阴性组69例,行腹部彩超检查和血脂、血清C肽、空腹血糖、空腹胰岛素,并计算胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMR-IR)及体质量指数(body mass index,BMI).结果:H.pylori阳性组的糖尿病性脂肪肝发生率71.0%(44/62),H.pylori阴性组糖尿病性脂肪肝发生率50.7%(35/69),差异有统计学意义(P<0.05);H.pylori阳性组甘油三酯、HOMR-IR均明显高于H.pylori阴性组,血清C肽低于H.pylori阴性组,差异均有统计学意义(P<0.05),而胆固醇及低密度脂蛋白(lowdensity lipoprotein,LDL)、高密度脂蛋白(high-density lipoprotein,HDL)、BMI在两组间均无统计学差异(P>0.05).结论:糖尿病性脂肪肝患者中H.pylori感染率高,高H.pylori感染加重糖尿病性糖脂代谢紊乱及胰岛素抵抗,加重脂肪肝进展,或许积极抗H.pylori治疗,有利于缓解或减少糖尿病性脂肪肝的发生、发展.
