AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:...AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulcer was detected at the follow up endoscopy.There were no significant differences between the H.pylori eradication regimens for the reinfection rate and no significant differences in endoscopic findings between the H.pylorirecurred group and the H.pylori-cured group.CONCLUSION:The reinfection rate in Korea is 9.1% which represents a decreasing trend.There was no relationship between H.pylori infection status and changes in endoscopic findings.There was also no recurrence or aggravation of ulcers.展开更多
Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfecti...Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative 13CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.展开更多
AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chi...AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chinese Bio Medicine Web Base and Chinese Science and Technology Journals were searched from inception to June 2014.Studies examining the association between H.pylori infection and glycemic control and/or the effect of eradication treatment on glycemic control in diabetic humans were eligible for inclusion.Meta-analyses were conducted using the Review Manager software version 5.2.The outcome measures are presented as weighed mean differences(WMDs) with 95% confidence intervals(CIs).Statistical heterogeneity was assessed by the Cochran Q test and the I2 statistic.RESULTS:A total of 21 relevant publications were identified.A meta-analysis of 11 studies with 513 patients with diabetes mellitus(DM) showed significantly lower glycosylated hemoglobin(Hb A1c) levels in the H.pylori-negative than H.pylori-positive DM participants(WMD = 0.43,95%CI:0.07-0.79;P = 0.02).In children and adolescents with type 1 DM(T1DM),there was a positive association between H.pylori infection and Hb A1 c level(WMD = 0.35,95%CI:0.05-0.64;P = 0.02),but there was no difference in those with type 2 DM(T2DM,WMD = 0.51,95%CI:-0.63-1.65;P = 0.38).A meta-analysis of six studies with 325 T2 DM participants showed a significant difference in the fasting plasma glucose levels between H.pylori-positive and H.pylori-negative participants(WMD = 1.20,95%CI:0.17-2.23;P = 0.02).Eradication of H.pylori did not improve glycemic control in the T2 DM participants in a threemonth follow-up period(Hb A1 c decrease:WMD =-0.03,95%CI =-0.14-0.08;P = 0.57;fasting plasma glucose decrease:WMD =-0.06,95%CI:-0.36-0.23;P = 0.68).Glycemic control was significantly better in T1 DM participants who were not reinfected than in those who were reinfected(Hb A1c:WMD = 0.72,95%CI:0.32-1.13:P = 0.00).CONCLUSION:H.pylori infection is associated with poorer glycemic contro展开更多
文摘AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulcer was detected at the follow up endoscopy.There were no significant differences between the H.pylori eradication regimens for the reinfection rate and no significant differences in endoscopic findings between the H.pylorirecurred group and the H.pylori-cured group.CONCLUSION:The reinfection rate in Korea is 9.1% which represents a decreasing trend.There was no relationship between H.pylori infection status and changes in endoscopic findings.There was also no recurrence or aggravation of ulcers.
文摘Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative 13CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.
文摘AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chinese Bio Medicine Web Base and Chinese Science and Technology Journals were searched from inception to June 2014.Studies examining the association between H.pylori infection and glycemic control and/or the effect of eradication treatment on glycemic control in diabetic humans were eligible for inclusion.Meta-analyses were conducted using the Review Manager software version 5.2.The outcome measures are presented as weighed mean differences(WMDs) with 95% confidence intervals(CIs).Statistical heterogeneity was assessed by the Cochran Q test and the I2 statistic.RESULTS:A total of 21 relevant publications were identified.A meta-analysis of 11 studies with 513 patients with diabetes mellitus(DM) showed significantly lower glycosylated hemoglobin(Hb A1c) levels in the H.pylori-negative than H.pylori-positive DM participants(WMD = 0.43,95%CI:0.07-0.79;P = 0.02).In children and adolescents with type 1 DM(T1DM),there was a positive association between H.pylori infection and Hb A1 c level(WMD = 0.35,95%CI:0.05-0.64;P = 0.02),but there was no difference in those with type 2 DM(T2DM,WMD = 0.51,95%CI:-0.63-1.65;P = 0.38).A meta-analysis of six studies with 325 T2 DM participants showed a significant difference in the fasting plasma glucose levels between H.pylori-positive and H.pylori-negative participants(WMD = 1.20,95%CI:0.17-2.23;P = 0.02).Eradication of H.pylori did not improve glycemic control in the T2 DM participants in a threemonth follow-up period(Hb A1 c decrease:WMD =-0.03,95%CI =-0.14-0.08;P = 0.57;fasting plasma glucose decrease:WMD =-0.06,95%CI:-0.36-0.23;P = 0.68).Glycemic control was significantly better in T1 DM participants who were not reinfected than in those who were reinfected(Hb A1c:WMD = 0.72,95%CI:0.32-1.13:P = 0.00).CONCLUSION:H.pylori infection is associated with poorer glycemic contro