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Impact of Helicobacter pylori virulence markers on clinical outcomes in adult populations

World Journal of Gastroenterology 2023年第1期29卷 190-199页

作者： Halim Roshrosh Hanan Rohana Maya Azrad Tamar Leshem segula masaphy Avi Peretz Applied Mycology and Microbiology MigalKiryat Shemona 1101202Israel Department of Microbiology Padeh Poriya Medical CenterTiberias 111508Israel

BACKGROUND In recent years,associations between specific virulence markers of Helicobacter pylori(***)and gastrointestinal disorders have been *** To investigate the presence of virulence factors including vacuolating cytotoxin A genotypes(s1m1,s1m2,s2m1,and s2m2),cytotoxin-associated gene A(CagA),and urease activity in *** strains isolated from Arab and Jewish populations in northern Israel and to assess associations between these factors and patients’demographics and clinical *** Patients(n=108)who underwent gastroscopy at the Baruch Padeh Medical Center,Poriya due to symptomatic gastroduodenal pathologies as part of *** diagnosis were enrolled in the *** biopsy specimens were collected from the antrum of the *** condition was assessed by clinical pathology *** were isolated on modified BD Helicobacter Agar(BD Diagnostics,Sparks,MD,United States).Bacterial DNA was extracted,and PCR was performed to detect CagA and vacuolating cytotoxin A *** activity was assessed using a rapid urease *** A significant correlation was found between disease severity and patient ethnicity(P=0.002).A significant correlation was found between CagA presence and the s1m1 genotype(P=0.02),which is considered the most virulent ***,a higher level of urease activity was associated with isolates originating from the Jewish ***,higher urease activity levels were measured among CagA-/s1m1 and CagA-/s2m2 *** Our study highlights the importance of incorporating molecular methods for detection of virulence markers of *** in order to tailor optimal treatments for each *** investigation should be performed regarding associations between *** virulence factors and ethnicity.

关键词： Helicobacter pylori Virulence factors Vacuolating cytotoxin A Cytotoxin-associated gene A Urease activity

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Long Term Outcome of Bisphosphonate Therapy in Patients with Primary Hyperparathyroidism

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International Journal of Clinical Medicine 2014年第14期5卷 829-835页

作者： Dalitso segula Tanya Nikolova Eileen Marks Lakshminarayan Ranganath Vinita Mishra Department of Clinical Biochemistry & Metabolic Medicine Royal Liverpool & Broadgreen University Hospital NHS Trust Liverpool UK

Context: Primary hyperparathyroidism (PHPT) is commonly associated with reduced bone mineral density (BMD) presenting with osteoporosis, increasing the risk of bone fragility fractures in these patients. Bisphosphonates, due to their anti-resorptive action, are known to improve the BMD and reduce the risk of bone fragility fractures. Therefore, bisphosphonates are considered as an alternative to surgical treatment in managing osteoporosis in PHPT patients. Aim: The aim of this observational study was to assess the effect of long term bisphosphonate therapy on BMD, bone fragility fracture and biochemical markers of bone metabolism in patients with PHPT. Methodology: Fifty patients (mean age 74 years) with PHPT who were treated with long term bisphosphonate therapy were studied retrospectively. The mean baseline (before commencing bisphosphonate therapy) BMD T-scores for lumbar spine (L2-L4) and left femoral neck were -2.5 and -2.1, respectively. Fourteen patients had bone fragility fractures before initiation of bisphosphonate therapy. Results: After an average of 5 years of bisphosphonate treatment, there was a significant increase in lumbar BMD T-score (-2.5 to -2.1, p = 0.013) and a non-significant change in left femoral neck BMD T-score (-2.1 to -2.2, p = 0.497). There was no increase in bone fragility fracture rate (p = 0.167). Serum corrected calcium reduced from 2.74 mmol/L to 2.60 mmol/L (p 0.001) and urine calcium to creatinine ratio from 0.70 to 0.55 (p 0.0001), both within the reference range. Conclusions: Our study suggests that long term bisphosphonate therapy improves lumbar BMD and prevents increase in bone fragility fracture rate. Additionally it improves hypercalcaemia in PHPT.

关键词： Primary Hyperparathyroidism Bisphosphonates Hypercalcaemia Bone Mineral Density

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