Underwater rocks of anti - helicobacter therapy

Livzan, M. А.; Анатольевна, Ливзан Мария

doi:10.26442/00403660.2019.08.000386

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…Следовательно, крайне важным является выявление группы лиц высокого риска по развитию рака желудка среди пациентов с экс-геликобактерным гастритом для проведения своевременной канцеропревенции. Указанным пациентам в программу лечения необходимо включать курсы цитопротективной терапии, позволяющей защитить клетки слизистой оболочки желудка от повреждающего действия продуктов воспаления и перикисного окисления липидов с целью профилактики прогрессирования предраковых изменений [30].…”

Section: резюмеunclassified

Gastric cancer in a patient with chronic gastritis after <i>H. pylori</i> eradication: assessing the risks

Livzan

Гаус

Мозговой

2022

jour

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Stomach cancer occupies a leading position in oncological morbidity and mortality worldwide. Approximately 800,000 people die from stomach cancer every year. In two-thirds of patients gastric cancer is diagnosed at a late stage, when radical treatment becomes impossible. Helicobacter pylori (H. pylori) infection is considered as the main etiological factor for gastric cancer. To stratify the risk of developing gastric cancer an assessment of morphological changes in the gastric mucosa using the Operative Link for Gastritis Assessment of Atrophic Gastritis (OLGA) system is used. The stage of gastritis plays a key role in determining an individual’s risk of developing stomach cancer. H. pylori eradication therapy is an effective method for preventing gastric cancer. However not in all patients the elimination of the infection can prevent the development of gastric cancer in the future. It is extremely important to identify a group of people with ex-helicobacter gastritis, who have a high risk of developing stomach cancer, and to take timely preventive measures in them. The purpose of this publication is to summarize and systematize the currently available data on the risk of developing gastric cancer in patients with H. pylori-associated gastritis, including those after successful eradication.

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Section: резюмеunclassified

Gastric cancer in a patient with chronic gastritis after <i>H. pylori</i> eradication: assessing the risks

Livzan

Гаус

Мозговой

2022

jour

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Modern opportunities to improve the effectiveness of eradication therapy on a clinical case

Pakhomova

2022

Medicinskij sovet

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Today, one of the significant and urgent problems of gastroenterology is Helicobacter pylori infection, which is one of the most common causative agents of chronic infections in humans. The problems of its diagnosis, and to a greater extent therapy, continue to be the subject of numerous consensuses and recommendations. The effectiveness of Helicobacter pylori eradication therapy is quite acute, taking into account both the characteristics of the microorganism itself, the growing antibiotic resistance and the decrease in patients’ adherence to therapy. The choice of treatment regimen is determined by a number of regional characteristics, including indicators of H. pylori resistance to clarithromycin and nitroimidazole, as a result of which regional recommendations are being developed in a number of countries. At the same time, the summary data on the resistance of H. pylori to clarithromycin in Russia do not allow us to speak about high rates of this problem. Therefore, clarithromycin can be used in first-line therapy as an effective component of eradication therapy. At the same time, an important measure to improve the effectiveness of H. pylori eradication is to increase the adherence of patients to therapy, which consists in talking with the patient, providing complete information about the disease, its complications, the need to follow all recommendations and taking prescribed drugs, keeping a patient diary, and, if necessary, telephone contact with the patient. In addition, it is possible to influence compliance by increasing it by prescribing a fixed combination of drugs in one package. An example of this approach is the drug combination of omeprazole, clarithromycin and amoxicillin. This article presents a small review of the literature on the reasons for unsuccessful H. pylori eradication, considers possible ways to improve it, and analyzes a clinical case with a discussion of rational pharmacocorrection.

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Experience of Chita the program of the Scientific Society of Gastroenterologists of Russia and Russian Scientific Medical Society of Internal Medicine “Physicians without helicobacteriosis”

Luzina

Лазебник

Lareva

et al. 2020

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Objective. To determine the prevalence of Helicobacter pylori (HP) in doctors in Chita, to identify clinical manifestations of infection, endoscopic, ultrasound and morphological changes in the stomach, to conduct eradication treatment with an assessment of its effectiveness, to determine the resistance of HP to clarithromycin and to develop treatment tactics for HP-associated diseases in the region.Material and methods. 70 doctors of Chita were examined, including 55 women and 15 men, average age 47.04±12.76 years (20 persons were 39 years and younger, 33 persons were 40–59 years, 17 people were 60 years and older; 27 persons were gastroenterologists, 17 — therapists, 11 — pediatricians, 5 — surgeons and 10 persons were doctors of other specialties). All doctors underwent antigen (AH) of HP determination in feces, a survey on the original questionnaire to assess clinical manifestations. Ultrasound examination of the stomach was performed in 47 doctors. Endoscopy of the upper gastrointestinal tract (GI) was performed in 35 persons. During endoscopy, in 29 doctors biopsy material of the mucous membrane from 5 points of the stomach were taken. A histological examination of biopsy samples was performed with an assessment using the OLGA system. The resistance of HP to clarithromycin was determined by the molecular genetic method in biopsy samples of gastric biopsy. 44 doctors conducted eradication with different schemes. Adverse events (AE) and treatment tolerance were evaluated. Control of eradication was carried out 6–8 weeks after the end of therapy by determining AH of HP in the feces. Statistical processing was carried out using the method of descriptive statistics, criterion of Student and criterion x2 (Biostatprogramm).Results. A positive AH of HP in feces was registered in 71.4% of the doctors examined: 73.3% of men and 70.9% of women, 75% of people under the age of 39 years, 72.7% of those aged 40–59 years and 64.7% are over 60 years old. Gastroenterologists were infected in 63%, therapists in 70.6%, pediatricians in 72.7%, surgeons in 80%, another specialists in 90% of cases. In the presence of HP, 81.6% of the examined showed symptoms from the digestive organs, 3 times more often a hereditary history of stomach cancer was determined. The wall thickness of the stomach during ultrasound in the infected was recorded 0.21–0.18 mm more than in the group of HP-negative individuals. A histological examination of III–IV degree of activity of inflammation in the stomach was diagnosed in 86.1%, stage III atrophy and colonic metaplasia in 20.7% of the examined doctors. The desire to conduct eradication treatment was expressed by 78% of doctors, 44 people completed the therapy. Non-compliance with the eradication regimen was noted in 9 people. AE were registered in 76.6% of cases. The efficacy of all regimens was 71.4%: when using the regimen with clarithromycin — 73%, with josamycin — 100%, with tetracycline and metronidazole — 33%, with levofloxacin — 100%. HP DNA was detected in 27 samples of gastric. In 10 cases, mutations A2142G and A2143G in the HP genome were detected, providing resistance to clarithromycin, which amounted to 37%.Conclusion1. 71.4% of doctors in Chita are infected with HP, among which the bacterium is most often detected at a young age (39 years and younger).2. Infected doctors are more likely to have gastrointestinal symptoms, a history of gastric damage, and hereditary gastric cancer.3. In 20.7% of doctors, histological examination revealed colonic metaplasia and dysplasia, which confirms the need for treatment and requires further observation.4. Only 78% of Chita doctors expressed their readiness to eradicate HP, and 20.4% of those who started treatment did not comply with the treatment regimen. This fact requires further educational activities.5. The efficacy of eradication by all schemes was 71.4%. Genotypic resistance of HP to clarithromycin was found in 37% of doctors. Further studies are needed to identify the characteristics of the macro- and microorganism (genetic polymorphism of enzymes, HP mutations) in groups, both among doctors and other categories of patients who do not have professional contacts with microorganisms and antibiotics in order to develop recommendations on the use of HP eradication schemes in region.

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Underwater rocks of anti - helicobacter therapy

Cited by 3 publications

References 52 publications

Gastric cancer in a patient with chronic gastritis after <i>H. pylori</i> eradication: assessing the risks

Gastric cancer in a patient with chronic gastritis after <i>H. pylori</i> eradication: assessing the risks

Modern opportunities to improve the effectiveness of eradication therapy on a clinical case

Experience of Chita the program of the Scientific Society of Gastroenterologists of Russia and Russian Scientific Medical Society of Internal Medicine “Physicians without helicobacteriosis”

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