Summary Background Results are conflicting with respect to the renal effects of anti‐viral agents used for hepatitis B virus infection. Aim To compare short and long‐term renal effects in real‐life settings and to determine risk factors for renal impairment during treatment. Methods 2221 treatment‐naïve patients were enrolled. Among these, 895 (302 lamivudine, 27 telbivudine, 282 entecavir, 273 tenofovir and 11 adefovir initiated patients) had ‘repeated measures’ of creatinine (baseline, 1st, 6th, 12th and 24th month of treatment). Telbivudine and adefovir groups were excluded from further analysis because of the low number of patients. We calculated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula at each time point. Hypophosphataemia was also recorded. Risk factors for renal impairment were analysed. Results Tenofovir caused a decline in GFR at each time point when compared to baseline levels. However, lamivudine and entecavir did not change GFR. GFR‐shifting from ≥90 to 60–89 mL/min/1.73 m2 was comparable among groups. The proportion of patients whose baseline creatinine increased more than 25% was comparable among all anti‐virals. GFR showed a decline in patients who switched from entecavir to tenofovir. One patient with compensated cirrhosis needed to change from tenofovir because of renal safety. Seven and three patients developed transient hypophosphataemia in the tenofovir and lamivudine groups, respectively. Conclusions Although tenofovir caused a decline in GFR, differences between the anti‐viral agents do not appear to be so impressive. In patients with and without renal risk factors at baseline, there is no impact of anti‐virals, including tenofovir.

Liver-to-spleen ratio and the MPV-to-spleen ratio are important indices in the pathogenesis of H. pylori-linked liver and spleen manifestations, and thrombocytopenia.

Background and Aim. Helicobacter pylori (H. pylori) infection is reported to be associated with various extragastrointestinal conditions such as insulin resistance, diabetes mellitus and metabolic syndrome. These conditions are attributed to systemic inflammation, leptin or ghrelin changes due to H. pylori infection. Therefore, increasing trends in the management of H. pylori infection are ordered to maintain glycemic control. In this study, we evaluated the effect of H. pylori eradication on insulin resistance in patients with normal blood glucose concentrations. Method. A total of 370 patients with successful eradication were included in the study. Patients with H. pylori were given triple eradication treatment. All patients with H. pylori infection were tested for fasting glucose, fasting insulin, glicated hemoglobin (HbA1c) at baseline and 6 months after eradication treatment. Also, insulin resistance was calculated using the homeostatic model assessment of insulin resistance (HOMA-IR). Body mass index was also determined as a metabolic syndrome criteria effecting insulin resistance.Results. There were significant differences in fasting glucose, fasting insulin, HbA1c, and HOMA-IR values between before treatment and after treatment(P <0.04, <0.01, <0.01, <0.01). The favorable effect of eradication was more significant in patients with BMI≥25 mg/m²(P<0.05). Conclusion. Eradication treatment has beneficial effects on insulin resistance in patients with normal glucose concentrations.

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Bismuth-lansoprazole-amoxicillin-clarithromycin regimen as a 2-week course achieved an acceptable eradication rate with relatively mild side effects.

Abstract:Background: Ulcerative colitis is a chronic infl ammatory condition of the colon, and reactive oxidative metabolites (ROMs) play an important role in its pathogenesis. Alternative therapies such as herbal remedies are increasingly being used in the treatment of ulcerative colitis for better clinical outcome of ulcerative colitis and less adverse effects. Echinacea has many features including antioxidant and wound-healing properties. Hence, the present study was undertaken to evaluate the protective effect of Echinacea spp. on experimental colitis model induced by acetic acid in Wistar albino rats. Methods: Acute colitis was induced by intrarectal administration of acetic acid. Rats were divided into four groups, namely control, Echinacea-administered, Echinacea-administered-colitis and colitis. Malondialdehyde and total antioxidant status were assayed in tissue samples. Histopathological evaluation was also performed. Results: Macroscopic and microscopic scores were signifi cantly higher in colitis group compared to control, Echinacea and Echinacea-colitis groups (p < 0.001). There was no signifi cant differences in respect of macroscopic and microscopic scores between control, Echinacea and Echinacea-colitis groups (p > 0.3, p > 0.22). Malondialdehyde levels were elevated in colitis group compared to other groups (p < 0.001). Total antioxidant status was signifi cantly higher in Echinacea group compared with other groups and also signifi cantly higher in Echinacea-colitis group compared with colitis group (p < 0.001, p < 0.001, respectively). Conclusion: Echinacea may possibly have some therapeutic usefulness in the management of ulcerative colitis (Tab. 2, Fig. 4, Ref. 35). Text in PDF www.elis.sk.

Background/Aim:Increasing resistance of Helicobacter pylori to antimicrobials necessitated the development of new regimens and the modification of existing regimens. The present study aimed to compare the efficacy of two bismuth-containing quadruple regimens–one including clarithromycin (C) instead of metronidazole (M) and triple therapy.Patients and Methods:Patients with H. pylori infection given the following regimens were sequentially enrolled in this retrospective study: (1) Triple therapy: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d., (2) bismuth group C: Lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d., and bismuth subsalicylate 524 mg b.i.d., and (3) bismuth group M: Lansoprazole 30 mg b.i.d., amoxicillin 1 g b.i.d., metronidazole 500 mg t.i.d., and bismuth subsalicylate 524 mg b.i.d. for 14 days. Gastroscopy and 14C-urea breath test were performed before enrollment, and urea breath test was repeated four weeks after the treatment.Results:At per-protocol analysis, the eradication rates were 64.7% (95% confidence interval 60.4–68.7) with the triple therapy (n = 504), 95.4% (95% confidence interval 91.5–99.4) with the bismuth group C (n = 501), and 93.9% (95% confidence interval 89.7–98.7) with the bismuth group M (n = 505). The eradication rates were similar between the two bismuth groups (P > 0.05) but significantly greater than that of the triple therapy (P < 0.05).Conclusion:In our study, both of the bismuth-containing quadruple therapies reached high eradication rates, whereas triple therapy was shown to be ineffective. Moreover, clarithromycin may also be a component of bismuth-containing quadruple therapy.