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Gastro esophageal reflux disease is associated with absence from work: Results from a prospective cohort study

World Journal of Gastroenterology 2005年第45期11卷 7148-7151页

作者： andreas leodolter Marc Nocon Michael Kulig Stefan N Willich Peter Malfertheiner Joachim Labenz Department of Gastroenterology Institute of Social Medicine Ev.Jung-Stilling-Krankenhaus

AIM： To study the association of gastro-esophageal reflux disease （GERD） with the absence from work and to estimate the extent of loss in gross domestic product due to inability to work. METHODS： Analysis was based on the prospectively gathered data of a large European cohort study involving 6 215 symptomatic GERD patients （ProGERD）. Among these patients, 2 871 were initially employed. The calculation of the loss of gross domestic product was based on the assumption that the prevalence of GERD was about 15% in Germany. According to the German Federal Statistical Office, the mean gross wage of employees was 150 E/d in 2002. RESULTS： The data of 2 078 employed patients who were prospectively followed up for over 2 years were analyzed. At study entry, the patients reported a mean of 1.8 d per year of inability to work. During the prospective follow-up under routine clinical care, the proportion of patients reporting days with inability to work decreased from 14% to 6% and the mean number of days per year with inability to work decreased to 0.9 d. Assuming a prevalence of troublesome GERD of 15% in the employed German population, the loss of gross domestic product amounted to 668 million E/year in Germany. CONCLUSION： GERD causes a relevant impairment on the national economics by absence from work. The presented data demonstrate the importance of GERD, not only for patients and health insurance companies, but also for the community at large.

关键词： Gastro-esophageal reflux Sick leave Medicale conomics

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Prevalence of H pylori associated 'high risk gastritis' for development of gastric cancer in patients with normal endoscopic findings

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World Journal of Gastroenterology 2006年第34期12卷 5509-5512页

作者： andreas leodolter Matthias P Ebert Ulrich Peitz Kathlen Wolle Stefan Kahl Michael Vieth Peter Malfertheiner Department of Gastroenterology and Hepatology Otto-von-Guericke University Magdeburg Leipziger Street 44 Magdeburg 39120 Germany Institute of Pathology Otto-von-Guericke University Magdeburg Leipziger Street 44 Magdeburg 39120 Germany

AIM： To investigate the prevalence of H pylori associated corpus-predominant gastritis （CPG） or pangastritis, severe atrophy, and intestinal metaplasia （IM） in patients without any significant abnormal findings during upper- GI endoscopy. METHODS： Gastric biopsies from 3548 patients were obtained during upper GI-endoscopy in a 4-year period. Two biopsies from antrum and corpus were histologically assessed according to the updated Sydney-System. Eight hundred and forty-five patients （mean age 54.8 ± 2.8 years） with H pylori infection and no peptic ulcer or abnormal gross findings in the stomach were identified and analyzed according to gastritis phenotypes using different scodng systems. RESULTS： The prevalence of severe H pylori associated changes like pangastritis, CPG, IN, and severe atrophy increased with age, reaching a level of 20% in patients of the age group over 45 years. No differences in frequencies between genders were observed. The prevalence of IM had the highest increase, being 4-fold higher at the age of 65 years versus in individuals less than 45 years. CONCLUSION： The prevalence of gastritis featuring at risk for cancer development increases with age. These findings reinforce the necessity for the histological assessment, even in subjects with normal endoscopic appearance. The age-dependent increase in prevalence of severe histopathological changes in gastric mucosa, however, does not allow estimating the individual risk for gastric cancer development-only a proper follow-up can provide this information.

关键词： H pylori Gastric cancer Gastritis

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Breath and string test: A diagnostic package for the identification of treatment failure and antibiotic resistance of Helicobacter pylori without the necessity of upper gastrointestinal endoscopy

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World Journal of Gastroenterology 2005年第4期11卷 584-586页

作者： andreas leodolter Kathlen Wolle Ulrike von Arnim Stefan Kahl Gerhard Treiber Matthias P.Ebert Ulrich Peitz Peter Malfertheiner Department of Gastroenterology Hepatology and Infectious Diseases University of MagdeburgGermany

AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13C-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of H pylori. METHODS: The UBT was routinely performed 4 to 6 wk after H pylori eradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed. Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under micro-aerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture. RESULTS: H pylori was successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. H py/oriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%). CONCLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of H pylori with little inconvenience to the patient. Upper Gl-endoscopy can be avoided in several cases by applying consequently this diagnostic package.

关键词： Helicobacter pylorr, Antibiotic resistance 13C-urea breath test Gastric string test

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