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Helicobacter pylori:High dose amoxicillin does not improve primary or secondary eradication rates in an Irish cohort

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World Journal of Clinical Cases 2024年第16期12卷 2773-2779页

作者： Conor Costigan Aoife M O'Sullivan Jim O'Connell Shreyashee Sengupta Thomas Butler Stephen Molloy Fintan John O'hara Barbara Ryan niall Breslin Sarah O'Donnell Anthony O'Connor Sinead Smith deirdre Mcnamara Trinity Academic Gastroenterology Group School of Medicine-Trinity College DublinDublin D2Ireland Department of Gastroenterology Tallaght University HospitalDublin D24 NR0AIreland

BACKGROUnD Helicobacter pylori(***)eradication rates have fallen globally,likely in large part due to increasing antibiotic resistance to traditional *** areas of high clarithromycin and metronidazole resistance such as ours,Maastricht VI guidelines suggest high dose amoxicillin dual therapy(HDADT)can be considered,subject to evidence for local *** this study we assess efficacy of HDADT therapy for *** eradication in an Irish *** To assess the efficacy of HDADT therapy for *** eradication in an Irish cohort as both first line,and subsequent therapy for patients diagnosed with *** All patients testing positive for *** in a tertiary centre were treated prospectively with HDADT(amoxicillin 1 g tid and esomeprazole 40 mg bid×14 d)over a period of 8 *** was confirmed with Urea Breath Test at least 4 wk after cessation of therapy.A delta-over-baseline>4%was considered *** demographics and treatment outcomes were recorded,analysed and controlled for basic demographics and prior *** *** One hundred and ninety-eight patients were identified with *** infection,10 patients were excluded due to penicillin allergy and 38 patients refused follow up *** all 139 were included in the analysis,55%(n=76)were female,mean age was 46.6 ***,93(67%)of patients were treatment-naïve and 46(33%)had received at least one previous course of *** groups were statistically ***-reported compliance with HDADT was 97%,mild side-effects occurred in 7%.There were no serious adverse drug *** the eradication rate for our cohort was 56%(78/139).Eradication rates were worse for those with previous treatment[43%(20/46)vs 62%(58/93),P=0.0458,odds ratio=2.15].Age and Gender had no effect on eradication *** Overall eradication rates with HDADT were *** being a simple and possibly better tolerated regime,these results do not

关键词： Helicobacter pylori eradication Helicobacter pylori High dose amoxicillin High dose amoxicillin dual therapy Triple therapy

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Effects of obesity on breast size,thoracic spine structure and function,upper torso musculoskeletal pain and physical activity in women

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Journal of Sport and Health Science 2020年第2期9卷 140-148页

作者： Julie R.Steele Celeste E.Coltman deirdre E.McGhee Biomechanics Research Laboratory School of MedicineUniversity of WollongongWollongongNSW 2522Australia Research Institute for Sport and Exercise Faculty of HealthUniversity of CanberraCanberraACT 2601Australia

Purpose:This study investigated the effects of obesity on breast size,thoracic spine structure and function,upper torso musculoskeletal pain and physical activity participation in women living independently in the ***:A total of 378 women were divided into 3 groups(not Overweight:body mass index(BMI)=22.5±0.2 kg/m^2(mean±SE);Overweight:BMI=27.4±0.3 kg/m^2;Obese:BMI=35.4±0.3 kg/m^2).Outcome variables of breast volume(mL),thoracic flexion torque(n·m),thoracic kyphosis(degrees),upper torso musculoskeletal pain(score) and time spent in physical activity(min) were calculated and compared among the 3 groups,adjusting for between-group differences in ***:There was a significant main effect of BMI on all outcome *** classified as Obese displayed significantly larger breasts,had greater thoracic flexion torques and reported less time participating in physical activity relative to the participants who were classified as not Overweight and *** in the Obese group also displayed significantly more thoracic kyphosis and reported significantly more upper torso musculoskeletal pain compared to their counterparts who were classified as not ***:This study is the first to demonstrate that increased obesity levels were associated with compromised kyphosis and loading of the thoracic spine,as well as increased symptoms of upper torso musculoskeletal pain and reduced time spent in physical activity in women living in the *** recommend further research to determine whether evidence-based interventions designed to reduce the flexion torque generated on the thoracic spine can improve these symptoms of upper torso musculoskeletal pain and the ability of women with obesity to participate in physical activity.

关键词： Breast volume Obesity Thoracic kyphosis Upper torso loading

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Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?

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World Journal of Gastroenterology 2018年第9期24卷 971-981页

作者： Denise E Brennan Colin Dowd Colm O'Morain deirdre Mcnamara Sinéad M Smith Department of Clinical Medicine School of Medicine Trinity College Dublin

AIM To evaluate the association between virulence factor status and antibiotic resistance in Helicobacter pylori(H. pylori)-infected patients in Ireland. METHODS DnA was extracted from antral and corpus biopsies obtained from 165 H. pylori-infected patients. Genotyping for clarithromycin and fluoroquinolone-mediating mutations was performed using the Genotype Helico DR assay. cag A and vac A genotypes were investigated using PCR. RESULTS Primary, secondary and overall resistance rates for clarithromycin were 50.5%(n = 53/105), 78.3%(n = 47/60) and 60.6%(n = 100/165), respectively. Primary, secondary and overall resistance rates for fluoroquinolones were 15.2%(n = 16/105) and 28.3%(n = 17/60) and 20%(n = 33/165), respectively. Resistance to both antibiotics was 12.4%(n = 13/105) in treatment-na?ve patients, 25%(n = 15/60) in those previously treated and 17%(n = 28/165) overall. A cag A-positive genotype was detected in 22.4%(n = 37/165) of patient samples. The dominant vac A genotype was S1/M2 at 44.8%(n = 74/165), followed by S2/M2 at 26.7%(n = 44/165), S1/M1 at 23.6%(n = 39/165) and S2/M1 at 4.8%(n = 8/165). Primary clarithromycin resistance was significantly lower in cag A-positive strains than in cag A-negative strains [32%(n = 8/25) vs 56.3%(n = 45/80); P = 0.03]. Similarly, in patients infected with more virulent H. pylori strains bearing the vac A s1 genotype, primary clarithromycin resistance was significantly lower than in those infected with less virulent strains bearing the vac A s2 genotype, [41%(n = 32/78) vs 77.8%(n = 21/27); P = 0.0001]. no statistically significant association was found between primary fluoroquinolone resistance and virulence factor *** Genotypic H. pylori clarithromycin resistance is high and cag A-negative strains are dominant in our population. Less virulent(cag A-negative and vac A S2-containing) strains of H. pylori are associated with primary clarithromycin resistance.

关键词： Helicobacter pylori Antibiotic resistance Fluoroquinolone Clarithromycin Virulence factor VacA CagA

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Molecular detection of Helicobacter pylori antibiotic resistance in stool vs biopsy samples

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World Journal of Gastroenterology 2016年第41期22卷 9214-9221页

作者： Denise E Brennan Joseph Omorogbe Mary Hussey Donal Tighe Grainne Holleran Colm O'Morain Sinéad M Smith deirdre Mcnamara Department of Clinical Medicine School of Medicine Trinity College Dublin School of Pharmacy and Pharmaceutical Sciences Trinity College Dublin

AIM To compare(1) demographics in urea breath test(UBT) vs endoscopy patients; and(2) the molecular detection of antibiotic resistance in stool vs biopsy *** Six hundred and sixteen adult patients undergoing endoscopy or a UBT were prospectively recruited to the study. The Geno Type Helico DR assay was used to detect Helicobacter pylori(H. pylori) and antibiotic resistance using biopsy and/or stool samples from CLOpositive endoscopy patients and stool samples from UBT-positive patients. RESULTS Infection rates were significantly higher in patients referred for a UBT than endoscopy(overall rates: 33% vs 19%; treatment-na?ve patients: 33% vs 14.7%, respectively). H. pylori-infected UBT patients were younger than H. pylori-infected endoscopy patients(41.4 vs 48.4 years, respectively, P ntage of H. pylori-infected males in the endoscopy-compared to the UBT-cohort(52.6% vs 33.3%, P = 0.03). The Geno Type Helico DR assay was more accurate at detecting H. pylori infection using biopsy samples than stool samples [98.2%(n = 54/55) vs 80.3%(n =53/66), P nalysis using stool and biopsy samples from CLO-positive endoscopy patients revealed a higher detection rate ofresistance-associated mutations using stool samples compared to biopsies. The concordance rates between stool and biopsy samples for the detection of H. pylori DnA, clarithromycin and fluoroquinolone resistance were just 85%, 53% and 35%, respectively. COnCLUSIOn Differences between endoscopy and UBT patients provide a rationale for non-invasive detection of H. pylori antibiotic resistance. However, the Geno Type Helico DR assay is an unsuitable approach.

关键词： Helicobacter pylori Antibiotic resistance Clarithromycin Fluoroquinolone Molecular methods

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Fucoidan and topography modification improved in situ endothelialization on acellular synthetic vascular grafts

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生物活性材料(英文) 2023年第4期22卷 535-550页

作者： Yuan Yao Aung Moe Zaw deirdre E.J.Anderson YeJin Jeong Joshua Kunihiro Monica T.Hinds Evelyn K.F.Yim Department of Chemical Engineering University of Waterloo200 University Avenue WestWaterlooONN2L 3G1Canada Department of Biomedical Engineering Oregon Health&Science UniversityPortlandOR97239USA Waterloo Institute for nanotechnology University of Waterloo200 University Avenue WestWaterlooONN2L 3G1Canada Center for Biotechnology and Bioengineering University of Waterloo200 University Avenue WestWaterlooONN2L 3G1Canada

Thrombogenesis remains the primary failure of synthetic vascular *** coverage is crucial to provide an antithrombogenic ***,most synthetic materials do not support cell adhesion,and transanastomotic endothelial migration is ***,a surface modification strategy using fucoidan and topography was developed to enable fast in situ endothelialization of polyvinyl alcohol,which is not endothelial *** three different immobilization approaches compared,conjugation of aminated-fucoidan promoted endothelial monolayer formation while minimizing thrombogenicity in both in vitro platelet rich plasma testing and ex vivo non-human primate shunt *** of six topographical patterns showed that 2μm gratings increased endothelial cell migration without inducing inflammation responses of endothelial *** studies demonstrated that fucoidan could attract fibronectin,enabling integrin binding and focal adhesion formation and activating focal adhesion kinase(FAK)signaling,and 2μm gratings further enhanced FAK-mediated cell *** a clinically relevant rabbit carotid artery end-to-side anastomosis model,60%in situ endothelialization was observed throughout the entire lumen of 1.7 mm inner diameter modified grafts,compared to 0%of unmodified graft,and the four-week graft patency also *** work presents a promising strategy to stimulate in situ endothelialization on synthetic materials for improving long-term performance.

关键词： Blood-contacting devices Small diameter vascular graft Endothelialization Topography Fucoidan

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Treatment and survival in a population-based sample of patients diagnosed with gastroesophageal adenocarcinoma

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World Journal of Gastroenterology 2008年第20期14卷 3165-3173页

作者： deirdre P Cronin-Fenton Margaret M Mooney Limin X Clegg Linda C harlan Surveillance Research Program DCCPS National Cancer Institute CTEP DCTD National Cancer Institute Applied Research Program DCCPS National Cancer Institute

AIM： TO examine the extent of use of specific therapies in clinical practice, and their relationship to therapies validated in clinical trials. METHODS： The US national Cancer Institutes＇ Patterns of Care study was used to examine therapies and survival of patients diagnosed in 2001 with histologically-confirmed gastroesophageal adenocarcinoma （/7 = 1356）. The study re-abstracted data and verified therapy with treating physicians for a population-based stratified random sample. RESULTS： Approximately 62% of patients had stomach adenocarcinoma （SAC）, while 22% had gastric-cardia adenocarcinoma （GCA）, and 16% lower esophageal adenocarcinoma （EAC）. Stage 1V/ unstaged esophageal cancer patients were most likely and stage Ⅰ -Ⅲ stomach cancer patients least likely to receive chemotherapy as all or part of their therapy; gastric-cardia patients received chemotherapy at a rate between these two. In multivariable analysis by anatomic site, patients 70 years and older were significantly less likely than younger patients to receive chemotherapy alone or chemoradiation for all three anatomic sites. Among esophageal and stomach cancer patients, receipt of chemotherapy was associated with lower mortality; but no association was found among gastric-cardia patients. COnCLUSIOn： This study highlights the relatively low use of clinical trials-validated anti-cancer therapies in community practice. Use of chemotherapy-based treatment was associated with lower mortality, dependent on anatomic site. Findings suggest that physicians treat lower esophageal and SAC as two distinct entities, while gastric-cardia patients receive a mix of the treatment strategies employed for the two other sites.

关键词： Adenocarcinoma Esophageal adeno-carcinoma Gastroesophageal Gastric adenocarcinoma Survival Chemotherapy Radiotherapy

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Combined antrum and corpus biopsy protocol improves Helicobacter pylori culture success

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World Journal of Gastrointestinal Pathophysiology 2022年第1期13卷 34-40页

作者： Denise E Brennan Colm O'Morain deirdre Mcnamara Sinead M Smith Department of Clinical Medicine Trinity College DublinTrinity CentreTallaght University HospitalDublin D24Ireland

BACKGROUnD Helicobacter pylori(***)causes chronic gastritis,peptic ulcer disease,gastric adenocarcinoma and mucosa-associated lymphoid tissue *** rates have fallen,mainly due to antimicrobial *** guidelines recommend that first-line treatment is based on the local prevalence of antimicrobial resistance and that rescue therapies are guided by antimicrobial susceptibility testing(AST).However,*** culture is challenging and culture-based AST is not routinely performed in the majority of *** of *** culture from clinical specimens will enable more widespread AST to determine the most appropriate antimicrobials for *** *** To determine whether dual antrum and corpus biopsy sampling is superior to single antrum biopsy sampling for *** *** The study received ethical approval from the joint research ethics committee of Tallaght University Hospital and ***’s *** referred for upper gastrointestinal endoscopy were invited to *** were collected in tubes containing Dent’s transport medium and patient demographics were *** were used to inoculate Colombia blood agar *** were incubated under microaerobic conditions and evaluated for the presence of *** analyses were performed using Graphpad *** variables were compared using the two-tailed independent *** variables were compared using the two-tailed Fisher exact *** all cases,a P value less than 0.05 was considered *** In all,samples from 219 ***-infected patients were analysed in the *** mean age of recruited patients was 48±14.9 years and 50.7%(n=111)were *** most common endoscopic finding was gastritis(58.9%;n=129).Gastric ulcer was diagnosed in 4.6%(n=10)of patients,while duodenal ulcer was diagnosed in 2.7%(n=6).Single antrum biopsies were collected from 73 patients,whereas combined antrum

关键词： Helicobacter pylori Culture Antimicrobial susceptibility testing Antimicrobial Antrum Corpus

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联合应用沙利度胺和脂质体阿霉素治疗复发性卵巢上皮性癌和腹膜癌的初步研究

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现代妇产科进展 2008年第2期17卷 109-112页

作者：郭红燕 nelson n. Teng John K. Chan Amreen Husain deirdre Stieglitz Jonathon S Bereck 北京大学第三医院妇产科北京100083 美国斯坦福大学肿瘤妇科

目的：评价联合应用沙利度胺与脂质体阿霉素治疗复发性卵巢上皮性癌和腹膜癌的疗效和毒副作用。方法：将9例经手术和术后泰素＋卡铂化疗后复发患者纳入本研究。每4周予以脂质体阿霉素30～50mg／m^2化疗，共3～8个疗程；同时每日予以沙... 详细信息

目的：评价联合应用沙利度胺与脂质体阿霉素治疗复发性卵巢上皮性癌和腹膜癌的疗效和毒副作用。方法：将9例经手术和术后泰素＋卡铂化疗后复发患者纳入本研究。每4周予以脂质体阿霉素30～50mg／m^2化疗，共3～8个疗程；同时每日予以沙利度胺100～300mg，其剂量从100mg／d开始，此后每2周增加50～100mg。通过体检、影像学检查和测定CA125水平评价治疗效果。结果：9例患者的中位年龄为56岁（35～81岁），FIGO分期为ⅢB～Ⅳ期。本次化疗的中位疗程数是6个疗程。中位随访时间为18．5个月。最常见的不良反应为疲劳（55．6％）和神经系统症状（55．6％）。3例患者出现Ⅲ度副反应，1例为无力、1例过敏性皮疹和1例末梢神经感觉异常。根据RECIST标准评价有病灶的6例患者疗效，2例部分缓解，2例治疗中疾病无进展，1例病情进展，1例失访。另有2例CA125升高的患者，在联合化疗3～4个疗程后CA125水平降低50％以上。1例二次肿瘤细胞减灭术后化疗的患者治疗后随访36个月无肿瘤复发迹象。在随访的8例患者中，中位疾病无进展时间为6．5个月（0～36个月）；中位总的生存时间为20．5个月（8～36个月）。结论：联合应用沙利度胺与脂质体阿霉素治疗复发性卵巢上皮性癌具有可接受的毒副作用，同时具有一定的治疗效果。

关键词：复发性卵巢上皮性癌沙利度胺脂质体阿霉素药物疗法,联合

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Addition of castor oil as a booster in colon capsule regimens significantly improves completion rates and polyp detection

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2021年第6期12卷 103-112页

作者： Serhiy Semenov Mohd Syafiq Ismail Fintan O'hara Sandeep Sihag Barbara Ryan Anthony O'Connor Sarah O'Donnell deirdre Mcnamara Gastroenterology Department Tallaght University HospitalDublin D 24Ireland Trinity Academic Gastroenterology Group Trinity College DublinDublin D 2Ireland

BACKGROUnD Incomplete excretion rates are problematic for colon capsule endoscopy(CCE).Widely available booster regimens are *** published data on one day preparation CCE protocol using castor oil appeared *** To assess the impact of adding castor oil to a standard split-dose(2-d)preparation in an unselected Western patient *** All patients aged 18 or more referred to our unit for a CCE over a 5-mo period were prospectively *** were retrospectively identified from our CCE *** patients received split bowel preparation with Moviprep■[polyethylene glycol(PEG)-3350,sodium sulphate,sodium chloride,potassium chloride,sodium ascorbate and ascorbic acid for oral solution;norgine B.V,United States],a PEG-based solution used predominantly in our colonoscopy *** booster regimen included Moviprep■with 750 mL of water(booster 1)on reaching the small bowel.A further dose of Moviprep■with 250 mL of water was given 3 h later and a bisacodyl suppository(Dulcolax■)10 mg after 8 h,if the capsule was not *** addition to our standard booster regimen,cases received an additional 15 mL of castor oil given at the time of booster 1.A nested case control design with 2:1 ratio(control:case)was *** demographics,completion rates,image quality,colonic transit time,diagnostic yield and polyp detection were compared between groups,using a student t or chi-square tests as *** One hundred and eighty-six CCEs[mean age 60 years(18-97),56%females,n=104],including 62 cases have been *** breakdown included 96 polyp surveillance(51.6%),42 lower gastrointestinal symptoms(22.6%),28 due to incomplete colonoscopy(15%),18 anaemia(9.7%)and 2 inflammatory bowel disease surveillance(1.1%).Overall,CCE completion was 77%(144/186),image quality was adequate/diagnostic in 91%(170/186),mean colonic transit time was 3.5 h(0.25-13),and the polyp detection rate was 57%(106/186).Completion rates wer

关键词： Castor oil Colon capsule endoscopy Bowel preparation Completion rates Excretion rates

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联合应用口服沙利度胺和脂质体阿霉素治疗复发性卵巢上皮性癌的初步研究

联合应用口服沙利度胺和脂质体阿霉素治疗复发性卵巢上皮性癌的初...

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中华医学会第一届全球华人妇产科学术大会暨第三次全国妇产科中青年医师学术会议

作者：郭红燕 nelson n.Teng Amreen Husain deirdre Stieglitz Jonathon S Bereck M.S. John K. Chan. M. D 北京大学第三医院妇产科 Division of gynecologic ontology department of obstetrics and gynecology stanford university school of medicine 300 pasteur drive HH333 Stanford Cancer Center StanfordCA 94305 M.DPhD Division of gynecologic ontology department of obstetrics and gynecology stanford university school of medicine 300 pasteur drive HH333 Stanford Cancer Center StanfordCA 94305 M. D

目的联合应用多柔比星脂质体与口服沙利度胺治疗卵巢上皮性癌或腹膜癌复发患者,评价和探讨治疗效果和可能存在的毒性。方法 9位主要以泰素为基础方案化疗后复发的患者被选入研究人群。每 4周给予多柔比星脂质体30～50mg/m化疗共6～8个疗...

目的联合应用多柔比星脂质体与口服沙利度胺治疗卵巢上皮性癌或腹膜癌复发患者,评价和探讨治疗效果和可能存在的毒性。方法 9位主要以泰素为基础方案化疗后复发的患者被选入研究人群。每 4周给予多柔比星脂质体30～50mg/m化疗共6～8个疗程;同时每日给予沙利度胺100～300mg。给予沙利度胺的剂量从100mg/天开始,以后每2周增加50～100mg。通过体格检查、影像学检查和测定

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