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Semwal P, Bolia R, Bhat NK, Patnaik I, Durgapal P, Sharma R. UTILITY OF ENDOSCOPIC NARROW-BAND IMAGING FOR IDENTIFYING H. PYLORI-ASSOCIATED GASTRITIS IN CHILDREN. ARQUIVOS DE GASTROENTEROLOGIA 2024; 61:e24067. [PMID: 39776125 DOI: 10.1590/s0004-2803.24612024-067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Accepted: 09/23/2024] [Indexed: 01/06/2025]
Abstract
BACKGROUND Conventional white light endoscopic (WLE) findings of H. pylori-associated gastritis are often non-specific and may not correlate with histology. Narrow band imaging (NBI), an optical digital technique employed for the visualization of vessels and patterns of gastric mucosa may improve identification. We evaluated the role of NBI in detecting H. pylori-associated gastritis and classifying its severity. METHODS Institution-based prospective observational study conducted between May 2021-October 2022. Children presenting with chronic abdominal pain (>1-month duration) were evaluated. Eligible children underwent gastroscopy with NBI and gastric biopsies for rapid urease test and histopathology. NBI gastroscopic findings were classified into five grades as per the classification by Alboudy et al. The association of NBI grade with the presence and severity of H. pylori gastritis on histopathology was analysed. RESULTS Ninety children (mean age 12.65±3.91 years), 52 (57.7%) males with median duration of symptoms of 4.5 (3-12) months underwent gastroscopy. H. pylori was detected on histopathology in 29 (32%) patients. NBI findings suggested a mucosal abnormality in 27/29 (93.1%) children with H. pylori on histopathology. H. pylori positive gastritis was significantly more common among those with higher (≥3) NBI grades as compared to those with lower NBI grades (61% vs10%, P<0.001). No significant association was found between NBI grade and the severity of H. pylori gastritis (P=0.75). NBI exhibited better sensitivity (0.82) compared to WLE (0.55) in identifying H. pylori-associated gastritis. On receiver operating characteristic curve analysis, NBI had higher area under curve (0.79 vs 0.65) as compared to WLE. CONCLUSION NBI morphological pattern is a useful tool in identifying patients with H. pylori-associated gastritis.
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Affiliation(s)
- Pooja Semwal
- Division of Paediatric Gastroenterology, Department of Paediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishi Bolia
- Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
| | - Nowneet Kumar Bhat
- Division of Paediatric Gastroenterology, Department of Paediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Itish Patnaik
- Department of Gastroenterology, All India Institute of Medical Sciences, Rishikesh, India
| | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Rahul Sharma
- Department of Community Medicine, University College of Medical Sciences, New Delhi , India
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Singh SP, Ahuja V, Ghoshal UC, Makharia G, Dutta U, Zargar SA, Venkataraman J, Dutta AK, Mukhopadhyay AK, Singh A, Thapa BR, Vaiphei K, Sathiyasekaran M, Sahu MK, Rout N, Abraham P, Dalai PC, Rathi P, Sinha SK, Bhatia S, Patra S, Ghoshal U, Poddar U, Mouli VP, Kate V. Management of Helicobacter pylori infection: The Bhubaneswar Consensus Report of the Indian Society of Gastroenterology. Indian J Gastroenterol 2021; 40:420-444. [PMID: 34219211 DOI: 10.1007/s12664-021-01186-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/20/2021] [Indexed: 02/04/2023]
Abstract
The Indian Society of Gastroenterology (ISG) felt the need to organize a consensus on Helicobacter pylori (H. pylori) infection and to update the current management of H. pylori infection; hence, ISG constituted the ISG's Task Force on Helicobacter pylori. The Task Force on H. pylori undertook an exercise to produce consensus statements on H. pylori infection. Twenty-five experts from different parts of India, including gastroenterologists, pathologists, surgeons, epidemiologists, pediatricians, and microbiologists participated in the meeting. The participants were allocated to one of following sections for the meeting: Epidemiology of H. pylori infection in India and H. pylori associated conditions; diagnosis; treatment and retreatment; H. pylori and gastric cancer, and H. pylori prevention/public health. Each group reviewed all published literature on H. pylori infection with special reference to the Indian scenario and prepared appropriate statements on different aspects for voting and consensus development. This consensus, which was produced through a modified Delphi process including two rounds of face-to-face meetings, reflects our current understanding and recommendations for the diagnosis and management of H. pylori infection. These consensus should serve as a reference for not only guiding treatment of H. pylori infection but also to guide future research on the subject.
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Affiliation(s)
- Shivaram Prasad Singh
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, 753 007, India.
| | - Vineet Ahuja
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Govind Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Usha Dutta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Showkat Ali Zargar
- Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, 190 011, India
| | - Jayanthi Venkataraman
- Department of Hepatology, Sri Ramachandra Medical Centre, No. 1 Ramachandra Nagar, Porur, Chennai, 600 116, India
| | - Amit Kumar Dutta
- Department of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Asish K Mukhopadhyay
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, 700 010, India
| | - Ayaskanta Singh
- Department of Gastroenterology, IMS and Sum Hospital, Bhubaneswar, 756 001, India
| | - Babu Ram Thapa
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Superspeciality of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Kim Vaiphei
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160 012, India
| | - Malathi Sathiyasekaran
- Department of Pediatric Gastroenterology, Kanchi Kamakoti Childs Trust Hospital, Chennai, 600 034, India
| | - Manoj K Sahu
- Department of Gastroenterology, IMS and Sum Hospital, Bhubaneswar, 756 001, India
| | - Niranjan Rout
- Department of Pathology, Acharya Harihar Post Graduate Institute of Cancer, Manglabag, Cuttack, 753 007, India
| | - Philip Abraham
- P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Cadel Road, Mahim, Mumbai, 400 016, India
| | - Prakash Chandra Dalai
- Gastro and Kidney Care Hospital, IRC Village, Nayapalli, Bhubaneswar, 751 015, India
| | - Pravin Rathi
- Department of Gastroenterology, Topiwala National Medical College and B Y L Nair Charitable Hospital, Dr Anandrao Laxman Nair Marg, Mumbai, 400 008, India
| | - Saroj K Sinha
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Shobna Bhatia
- Department of Gastroenterology and Hepatobiliary Sciences, Sir HN Reliance Foundation Hospital and Research Centre, Raja Rammohan Roy Road, Prarthana Samaj, Girgaon, Mumbai, 400 004, India
| | - Susama Patra
- Department of Pathology, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, 751 019, India
| | - Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Ujjal Poddar
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India
| | | | - Vikram Kate
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605 006, India
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ERDAL H, SAKİN YS, ÇETİN M, ÇELİK B, ÖNMEZ A, UYGUN A, GÜLŞEN M. The Relationship Between Hyperplastic Gastric Polyps And Helicobacter Pylori. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.834666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shava U, Srivastava A, Mathias A, Kumar N, Yachha SK, Gambhir S, Poddar U. Functional dyspepsia in children: A study of pathophysiological factors. J Gastroenterol Hepatol 2021; 36:680-686. [PMID: 32710649 DOI: 10.1111/jgh.15193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Functional dyspepsia (FD) is common in children, and treatment targeted towards the altered pathophysiology can improve outcome. We evaluated FD children for abnormality of gastric accommodation and emptying, psychological stressors (PS), Helicobacter pylori (HP) infection, and post-infectious FD. METHODS Diagnosis of FD was based on ROME III criteria. Clinical evaluation including dyspeptic symptom scoring and assessment for PS was performed. Satiety drink test for gastric accommodation, gastroscopy with biopsy for HP infection, and solid meal gastric emptying were performed. Sixty-seven healthy children were enrolled for assessing PS and satiety drink test. RESULTS Fifty-five FD children (33 boys, age 12 [6-18] years) with symptoms for 4 (2-48) months and dyspeptic score of 5 (1-13) were enrolled. PS were more common in FD than in controls (46/55 vs 9/67; P < 0.001). Median satiety drink volume was 360 mL (180-1320 mL); no patients had satiety drink volume of < 5th centile of healthy children. The frequency (98% vs 85%; P = 0.01) and severity (65 [10-175] vs 50 [5-130]; P < 0.001) of postprandial symptoms were higher in FD than in controls. Of the postprandial symptoms, pain (20.3% vs 0%; P = 0.000) was present only in FD. Delayed gastric emptying was present in 6.5%, HP infection in 11%, and post-infectious FD in 13% cases. Etiological factor was identified in 87% children, with 20% having multiple factors. CONCLUSIONS Abnormality of gastric sensorimotor function is seen in one-fourth of FD cases. HP infection and post-infectious FD are present in 11% and 13% cases, respectively.
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Affiliation(s)
- Upender Shava
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Anshu Srivastava
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amrita Mathias
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Narvesh Kumar
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Surender Kumar Yachha
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sanjay Gambhir
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ujjal Poddar
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Quaglia NC, Dambrosio A. Helicobacter pylori: A foodborne pathogen? World J Gastroenterol 2018; 24:3472-3487. [PMID: 30131654 PMCID: PMC6102504 DOI: 10.3748/wjg.v24.i31.3472] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is an organism that is widespread in the human population and is sometimes responsible for some of the most common chronic clinical disorders of the upper gastrointestinal tract in humans, such as chronic-active gastritis, duodenal and gastric ulcer disease, low-grade B-cell mucosa associated lymphoid tissue lymphoma of the stomach, and gastric adenocarcinoma, which is the third leading cause of cancer death worldwide. The routes of infection have not yet been firmly established, and different routes of transmission have been suggested, although the most commonly accepted hypothesis is that infection takes place through the faecal-oral route and that contaminated water and foods might play an important role in transmission of the microorganism to humans. Furthermore, several authors have considered H. pylori to be a foodborne pathogen because of some of its microbiological and epidemiological characteristics. H. pylori has been detected in drinking water, seawater, vegetables and foods of animal origin. H. pylori survives in complex foodstuffs such as milk, vegetables and ready-to-eat foods. This review article presents an overview of the present knowledge on the microbiological aspects in terms of phenotypic characteristics and growth requirements of H. pylori, focusing on the potential role that foodstuffs and water may play in the transmission of the pathogen to humans and the methods successfully used for the detection of this microorganism in foodstuffs and water.
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Affiliation(s)
- Nicoletta C Quaglia
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinic and Animal Production, University of Bari “Aldo Moro”, Valenzano 70010, Italy
| | - Angela Dambrosio
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinic and Animal Production, University of Bari “Aldo Moro”, Valenzano 70010, Italy
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Yalçin M, Yalçin A, Bengi G, Nak SG. Helicobacter pylori Infection among Patients with
Dyspepsia and Intrafamilial Transmission. Euroasian J Hepatogastroenterol 2016; 6:93-96. [PMID: 29201737 PMCID: PMC5578573 DOI: 10.5005/jp-journals-10018-1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/19/2016] [Indexed: 11/24/2022] Open
Abstract
Introduction Recurrence is an important problem after Helicobacter pylori infection, and intrafamilial transmission has an important role in recurrence. In this study, we aimed to investigate the significance of intrafamilial transmission for recurrence development after treatment as well as its usefulness in prevention. Materials and methods Of the 109 patients who had dyspepsia and underwent endoscopy, 74 patients had H. pylori infection and were enrolled in this study. Infected family members were also detected. Patients were randomly divided into groups I and II, with each group containing 37 individuals. In group I, patients and their infected family members were treated together at the same time. In group II, only the patients were treated. Treatment success was evaluated at the 1st month and evaluation for recurrence was carried out at the 6th month. Results Helicobacter pylori infection was detected in 67.8% of the patients with dyspepsia. Two patients in each group did not show up at the 1st month control. Eradication was achieved in 63 of the 70 patients (90.0%) who completed their treatment. After 6 months, patients with successful treatment had no recurrence in any of the 32 patients in group I. There were recurrence in 3 of the 31 patients (9.7%) in group II; however, there was no statistically significant difference between the groups (p = 0.113). Conclusion Our study showed that eradication treatment in patients and family members with H. pylori infection resulted in a decrease in the number of recurrences even though it was not statistically significant. How to cite this article Yalçin M, Yalçin A, Bengi G, Nak SG. Helicobacter pylori Infection among Patients with Dyspepsia and Intrafamilial Transmission. Euroasian J Hepato-Gastroenterol 2016;6(2):93-96.
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Affiliation(s)
- Mustafa Yalçin
- Department of Gastroenterology, Dokuz Eylul University Medical Faculty, Ege, Turkey
| | - Ayla Yalçin
- Department of Gastroenterology, Uludağ University Medical Faculty, Bursa, Turkey
| | - Göksel Bengi
- Department of Gastroenterology, Dokuz Eylul University Medical Faculty, Ege, Turkey
| | - Selim G Nak
- Department of Gastroenterology, Uludağ University Medical Faculty, Bursa, Turkey
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Afifi RAR, Ali DK, Shaheen IAM. A localized case-control study of extra-gastric manifestations of Helicobacter pylori infection in children. Indian J Pediatr 2011; 78:418-22. [PMID: 21165719 DOI: 10.1007/s12098-010-0308-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 11/23/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To study extra- gastric manifestations of H. pylori infection among children in Egypt. METHODS This case-control study in which thirty [corrected] H pylori positive children were compared to thirty [corrected] H pylori negative children was conducted. Full history taking, clinical examination, CBC, serum iron, serum ferritin in addition to H pylori antibody testing were performed. RESULTS Mean hemoglobin, MCV, MCH, serum iron and serum ferritin were all less in seropositive patients but these were statistically non significant. Iron deficiency (ID) was defined as serum ferritin less than 12 ng/ml; and Iron deficiency anemia (IDA) as hemoglobin less than 11 g/dL in addition to ID. Seropositive patients showed increased frequency of ID and IDA and this was statistically significant (0.003 & 0.000 respectively). There was no statistically significant difference as regards the platelet counts of the two groups or the presence of skin disorders or the gender. CONCLUSIONS There is increased incidence of ID and IDA among H pylori positive children. This needs to be confirmed by larger therapeutic randomized controlled trials. The hematological response to eradication therapy needs to be further studied.
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Chiesa C, Pacifico L, Anania C, Poggiogalle E, Chiarelli F, Osborn JF. Helicobacter pylori therapy in children: overview and challenges. Int J Immunopathol Pharmacol 2010; 23:405-16. [PMID: 20646336 DOI: 10.1177/039463201002300203] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Helicobacter pylori is one of the most common infections found in humans. It was first identified in 1982 and by 1989 had been associated with gastric inflammation and ulcers in adults and children. During the 1990's evidence emerged of its etiologic role in stomach cancers in adults. That the infection is common and may have serious consequences, has led to an avalanche of research during the last twenty years. During this time, there have been many studies on children which have sought an effective and safe treatment to eradicate the infection, but as yet, no therapy regimen has been found which is always effective and safe. This article provides information, from a pediatric point of view, on the major developments in the therapeutics and therapy of H. pylori infection. It examines first-line treatment regimens, evaluates the efficacy of the main drugs used in the management of (primary) H. pylori infection in children, assesses the potential for the use of probiotics and sequential therapy, examines therapeutic options after failure of initial treatment, and discusses factors affecting eradication rate, including antibiotic resistance, adherence to therapy, and bacterial factors.
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Saadah OI. Helicobacter pylori infection in Saudi children; clinical, endoscopic and pathological findings. Arab J Gastroenterol 2010. [DOI: 10.1016/j.ajg.2010.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hurduc V, Plesca D, Dragomir D, Sajin M, Vandenplas Y. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatr 2009; 98:127-31. [PMID: 18681892 DOI: 10.1111/j.1651-2227.2008.00977.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM The failure rate of Helicobacter pylori (H. pylori) eradication imposes the assessment of new options. SUBJECTS AND METHODS A prospective open study was performed in 90 symptomatic children (range 3-18 years) with H. pylori infection, randomized in two groups: control (42 patients) and intervention group (48 patients). Both groups were treated with the standard triple eradication therapy (omeprazole/esomeprazole, amoxicillin and clarithromycin) for 7-10 days. The intervention group was also treated with Saccharomyces boulardii (S. boulardii), 250 mg b.i.d., for 4 weeks. The eradication rate of H. pylori was assessed by the same methods (urease test and histology) 4-6 weeks after treatment. Adverse events and compliance were evaluated after 7 and 28 days of treatment. The Chi-square test was used for statistical evaluation (p < 0.05). RESULTS H. pylori infection was identified in 90 of 145 children (62%) and it correlated positively with age (p < 0.002) and inversely with socioeconomic status (p < 0.005). All infected children had chronic gastritis, with antral nodularity in 76.7%. Overall, H. pylori eradication rate was 87.7% (control 80.9%, S. boulardii group 93.3%) (p = 0.750). The incidence of side effects was reduced in the S. boulardii group: 30.9% in the control versus 8.3% in the probiotic group (p = 0.047). CONCLUSION The addition of S. boulardii to the standard eradication treatment confers a 12% nonsignificant enhanced therapeutic benefit on H. pylori eradication and reduces significantly the incidence of side effects.
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Affiliation(s)
- Victoria Hurduc
- Department of Pediatric Gastroenterology, Victor Gomoiu University Children Hospital, Basarabia Street 21, Bucharest, Romania.
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Kandil ME, . AEH, . NAE. Seroprevalence of Helicobacter pylori in Juvenile Rheumatoid Arthritis And its Relation to Disease Severity. JOURNAL OF MEDICAL SCIENCES 2007. [DOI: 10.3923/jms.2007.716.723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
This review summarizes the literature on Helicobacter pylori infection in childhood between April 2005 and March 2006, and includes guidelines of the Canadian Helicobacter Study Group Consensus Conference, noninvasive tests, optimum therapy regimens and problems with resistance, and reviews on immune mechanisms in the gastric mucosa that may lead to the development of an effective vaccine.
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Affiliation(s)
- Petronella Mourad-Baars
- Department of Pediatrics, Leiden University Medical Center, Leiden and Rijnland Hospital, Leiderdorp, the Netherlands.
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