bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Immunization with Helicobacter pylori‐Loaded Poly(	d,	l‐Lactide‐Co‐Glycolide) Nanoparticles
Authors: Kim Seong‐Youl , Doh Hyun‐Joo , Jang Myoung‐Ho , Ha Young‐Ju , Chung Soo‐Il , Park Hae‐Joon 
Published: March 2003

Background. Helicobacter pylori is a major cause of chronic antral gastritis and peptic ulcer diseases. Many researchers have examined the possibility of immunologically‐mediated prevention of H. pylori infection using an oral vaccine. The purpose of this study is to investigate whether mucosal and systemic immune responses are induced by oral immunization with H. pylori lysate‐loaded poly(
d,
l‐lactide‐coglycolide)[PLG] nanoparticles, and if so, how the distribution of serum IgG subclasses are produced.Methods.PLG nanoparticles (H. pylori‐PLG) with encapsulated H. pylori lysates were prepared by the solvent evaporation method, and the physical properties of the nanoparticles were investigated. Following the oral immunization of the H. pylori‐PLG nanoparticles into mice, antibody induction was assayed in serum and gut washings, and the pattern of serum IgG subclasses was determined by ELISA.Results.The prepared H. pylori‐PLG nanoparticles were spherical, nonporous particles with a mean diameter of less than 1 μm. The multiple oral immunization with H. pylori‐PLG nanoparticles induced significantly H. pylori‐specific mucosal IgA response as well as serum IgG responses. The serum antibody subclasses elicited were predominantly IgG1 and IgG2b.Conclusion.Our results suggested that oral immunization of H. pylori‐PLG nanoparticles induced the H. pylori‐specific mucosal and systemic responses in mice and enhanced Th2‐type responses.
Helicobacter pyloriand Gastric Cancer: What Are the Benefits of Screening Only for the CagA Phenotype ofH. pylori?
Authors: Harris Ryan A. , Owens Douglas K. , Witherell Heidi , Parsonnet Julie 
Published: March 2003

Background.Strains ofHelicobacter pylorithat express the CagA protein are associated with a threefold increased gastric cancer risk as compared toH. pyloristrains that do not express CagA. Screening and treatment only for CagA antibodies should target those individuals at highest gastric cancer risk while reducing the number of patients requiring antibiotics. We compared the costs and benefits of screening asymptomatic 50‐year‐old individuals for CagA, screening for allH. pyloristrains, and no screening, both in the United States and abroad.Materials and Methods.We employed Markov cost‐effectiveness analysis using data from randomized, case‐control, and cohort studies.Results.In the United States, CagA screening would result in 1.5 million fewer antibiotic treatments but would prevent 1,400 fewer gastric cancers than would screening for allH. pylori.The incremental cost‐effectiveness of CagA screening is $23,900 per life‐year gained; forH. pyloriscreening, it is $25,100. Screening in countries with epidemiological characteristics similar to those of Colombia, Finland, and Japan costs less than $5,000 per life‐year gained, and the difference between CagA andH. pyloriscreening is smaller than that in the United States.Conclusions.Screening only for CagA‐positiveH. pyloriis not substantially better than is screening for allH. pylori, either in the United States nor abroad. Screening is substantially more cost‐effective outside the United States. Whether population screening is justified, however, is uncertain pending conclusive data regarding the reduction in gastric cancer risk from antibiotics.
Relation between Cytokines and Helicobacter pylori in Gastric Cancer
Authors: Yamaoka Yoshio , Kodama Tadashi , Kita Masakazu , Imanishi Jiro , Kashima Kei , Graham David Y. 
Published: March 2003

ABSTRACTBackground. Helicobacter pylori is etiologically involved in the development of gastric cancer and infected gastric mucosa has been shown to possess elevated levels of cytokines [for example interleukin (IL)‐1β, IL‐6 and IL‐8]. Because specific cytokines have also been shown to enhance the development of certain cancers, we examined the relationship between the levels of cytokines, the type and stage of gastric cancers, and the H. pylori infection.Materials and Methods. Cytokines were measured from gastric cancer tissues, adjacent normal appearing mucosa, and the serum in 66 patients with early or advanced gastric cancer and from controls using semiquantitative RT‐PCR and ELISA.Results. IL‐6 and IL‐8 levels were more than 10‐fold increased in cancer tissues as compared with normal gastric tissues. IL‐8 levels in cancer tissues were more than 2‐fold higher in advanced gastric cancer as compared with early gastric cancer irrespective of H. pylori status. IL‐6 levels were significantly higher in early gastric cancer with active H. pylori infection as compared with early cancer without H. pylori infection (8.7 + 1.4 vs. 1.2 + 0.3 pg/mg protein, p < .001) and decreased significantly after the cure of H. pylori (11.1 + 2.9–8.2 + 2.3 pg/mg protein, p < .05).Conclusions. IL‐8 levels in gastric cancer tissue are largely independent of H. pylori infection. In contrast, tissue IL‐6 levels were high in H. pylori infected early gastric cancer and fell significantly after the cure of H. pylori suggesting a relationship between H. pylori infection and early gastric cancer.
A Pilot Study to Determine the Effectiveness of Garlic Oil Capsules in the Treatment of Dyspeptic Patients with Helicobacter pylori
Authors: McNulty Cliodna A.M. , Wilson Melanie P. , Havinga Wouter , Johnston Belinda , O'Gara Elizabeth A. , Maslin David J. 
Published: March 2003

AbstractBackground.Resistance of Helicobacter pylori to clarithromycin and metronidazole is now found worldwide. Steam‐distilled garlic oil has in vitro activity against H. pylori and may be a useful alternative treatment strategy.Materials and methods.In this pilot study dyspeptic patients with positive serology for H. pylori confirmed by 13C urea breath test (UBT), at 0 and 2 weeks, were enrolled. Treatment consisted of one 4 mg garlic oil capsule with a meal four times per day for 14 days. H. pylori eradication was defined as a negative UBT at both follow‐up appointments. Suppression was defined as a 50% fall in 13C excess between baseline and follow‐up 1.Results.Five patients completed the study. There was no evidence of either eradication or suppression of H. pylori or symptom improvement whilst taking garlic oil.Conclusion.These negative results show that, within the gastric milieu, garlic oil at this dose does not inhibit H. pylori. A higher dose administered for a longer time‐period may be effective. Antibiotics are usually combined with a proton‐pump inhibitor or bismuth salt, as the only antibiotic with any in vivo activity against H. pylori in monotherapy is clarithromycin. A proton pump inhibitor raises gastric pH and, by increasing bacterial division, may increase the in vivo activity of garlic oil. This may be worth pursuing in a future trial.
A Multicenter, Double‐Blind Study on Triple Therapy with Lansoprazole, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori in Japanese Peptic Ulcer Patients
Authors: Asaka Masahiro , Sugiyama Toshiro , Kato Mototsugu , Satoh Kiichi , Kuwayama Hajime , Fukuda Yoshihiro , Fujioka Toshio , Takemoto Tadayoshi , Kimura Ken , Shimoyama Takashi , Shimizu Kihachiro , Kobayashi Shinichi 
Published: March 2003

ABSTRACTBackground.Two triple therapies with lansoprazole (LPZ)/amoxicillin (AMPC)/clarithromycin (CAM) for eradication of Helicobacter pylori were studied in multicenter, double‐blind fashion to evaluate the eradication rate of H. pylori and safety of eradiation treatment in Japanese patients with H. pylori‐positive active gastric ulcers or duodenal ulcers.Methods.Patients were randomly chosen for the control treatment of LPZ 30 mg twice a day (b.i.d.; Group A‐LPZ‐only) or the test treatments of LPZ 30 mg plus AMPC 750 mg and CAM 200 mg b.i.d. (Group B‐LAC200) and LPZ 30 mg, AMPC 750 mg and CAM 400 mg b.i.d. (Group C‐LAC400). All eradication treatments lasted for a period of 7 days. Successful eradication was assessed by culture and gastric histology 1 month after completion of the ulcer treatment.Results.The eradication rates of H. pylori in the full analysis set were 0% in Group A‐LPZ‐only, 87.5% in Group B‐LAC200 and 89.2% in Group C‐LAC400 for gastric ulcer and, 4.4% in Group A‐LPZ‐only, 91.1% in Group B‐LAC200 and 83.7% in Group C‐LAC400 for duodenal ulcer. The eradication rates of Group B‐LAC200 and Group C‐LAC400 were 89.2% (95% CI: 84.8–93.7%) and 86.4% (95%CI: 81.5–91.3%) in total in the full analysis set, 89% (95% CI: 84.3–93.7%) and 85.3% (95%CI: 80.1–90.5%) in the per protocol set. The eradication rates in Groups B‐LAC200 and group C‐LAC400 were statistically significantly higher than the rate in Group A‐LPZ‐only for both gastric ulcer and duodenal ulcer patients (p < .0001 for both).Conclusion.A satisfactorily high H. pylori eradication rate was obtained in Japanese ulcer patients with the triple therapy regimen consisting of LPZ 30 mg, AMPC 750 mg, and CAM 200 mg b.i.d.
The Effect of Helicobacter pylori Infection on Levels of DNA Damage in Gastric Epithelial Cells
Authors: Everett S. M. , White K. L. M. , Drake I. M. , Schorah C. J. , Calvert R. J. , Skinner C. , Stringer M. D. , Miller D. , Dixon M. F. , Chalmers D. M. , Axon A. T. R. 
Published: March 2003

AbstractBackground. Helicobacter pylori infection leads to an increased risk of developing gastric cancer. The mechanism through which this occurs is not known. We aimed to determine the effect of H. pylori and gastritis on levels of DNA damage in gastric epithelial cells.Methods. Epithelial cells were isolated from antral biopsies from 111 patients. DNA damage was determined using single cell gel electrophoresis and the proportion of cells with damage calculated before and 6 weeks after eradication of H. pylori. Cell suspensions generated by sequential digestions of the same biopsies were assayed to determine the effect of cell position within the gastric pit on DNA damage.Results. DNA damage was significantly higher in normal gastric mucosa than in H. pylori gastritis [median (interquartile range) 65% (58.5–75.8), n = 18 and 21% (11.9–29.8), n = 65, respectively, p < .001]. Intermediate levels were found in reactive gastritis [55.5% (41.3–71.7), n = 13] and H. pylori negative chronic gastritis [50.5% (36.3–60.0), n = 15]. DNA damage rose 6 weeks after successful eradication of H. pylori[to 39.5% (26.3–51.0), p = .007] but was still lower than in normal mucosa. Chronic inflammation was the most important histological factor that determined DNA damage. DNA damage fell with increasing digestion times (r = –.92 and –.88 for normal mucosa and H. pylori gastritis, respectively).Conclusions. Lower levels of DNA damage in cells isolated from H. pylori infected gastric biopsies may be a reflection of increased cell turnover in H. pylori gastritis. The investigation of mature gastric epithelial cells for DNA damage is unlikely to elucidate the mechanisms underlying gastric carcinogenesis.
Emergence of Clarithromycin‐Resistant Helicobacter pylori (CRHP) with a High Prevalence in Children Compared with Their Parents
Authors: Taneike Ikue , Goshi Satoshi , Tamura Yukiko , Wakisaka‐Saito Noriko , Matsumori Noriko , Yanase Azusa , Shimizu Toshiaki , Yamashiro Yuichiro , Toyoda Shigeru , Yamamoto Tatsuo 
Published: March 2003

AbstractBackground. Clarithromycin‐resistant Helicobacter pylori (CRHP) is increasing worldwide. Clarithromycin resistance in H. pylori from familial members has not been investigated.Materials and Methods. Biopsy specimens were taken from 13 families living in Tokyo, Yokohama, and Niigata between 1998 and 2001. Drug resistance was tested with the replica plating method. The minimum inhibitory concentrations of antimicrobial agents for H. pylori strains were determined by the agar dilution method. Molecular analyses of H. pylori strains were performed by ribosomal RNA gene restriction pattern analysis. The DNA region, associated with clarithromycin resistance, was analyzed by PCR and sequencing.Results. Helicobacter pylori strains isolated from a 5‐year‐old‐son displayed clarithromycin resistance with a mutation (A → G at position 2143) in the 23S ribosomal RNA, whereas H. pylori strains from his parents did not. DNA analyses revealed that the boy was infected with his father's strain. The boy had repeatedly developed otitis media and received clarithromycin since the age of 2 years. Studies on an additional 12 families demonstrated that clarithromycin resistance in the children's strains reached 42.9% and was significantly higher than those of H. pylori strains from their parents (0%) or from adult patients (11.1%) (p < .05).Conclusions. The rate of clarithromycin resistance in H. pylori strains from Japanese children was extremely high, in contrast to those from their parents or adult patients. Prior history of clarithromycin usage in a child suggested development of clarithromycin resistance in resident H. pylori, which was originated from a parent.
Does Helicobacter pylori Eradication Affect Symptoms in Nonulcer Dyspepsia: A 5‐Year Follow‐Up Study
Authors: McNamara D. , Buckley M. , Gilvarry J. , O'Morain C. 
Published: March 2003

AbstractThe role of Helicobacter pylori infection in nonulcer dyspepsia remains controversial. To date studies exploring the effect of H. pylori eradication on symptoms have reported conflicting results. Randomised control trials employing validated outcome measures have also been difficult to interpret because of several important issues such as the large placebo response seen in patients with nonulcer dyspepsia and both the natural variability in symptoms and symptom severity with time. The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient. We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia. In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. For those who remained symptomatic at 5 years, there was no difference in symptom severity based on H. pylori status. The findings of this study support the use of H. pylori eradication in symptomatic patients with nonulcer dyspepsia both to induce symptom resolution and to prevent disease progression.
Helicobacter pylori and gastric malignancies
Authors: Sepulveda Antonia R. , Coelho Luiz Gonzaga V. 
Published: March 2003

AbstractThe epidemiological link of Helicobacter pylori and gastric carcinoma was confirmed and the reported rate of gastric carcinoma development in the Japanese population with H. pylori gastritis was 2.9% during a 7.8‐year period. Studies showed that gastric atrophy and intestinal metaplasia may partially regress after H. pylori eradication, but whether this will result in a decrease in the development of malignant lesions remains to be confirmed in large studies. Little progress was made towards the identification of criteria applicable to individualized populations that would benefit from H. pylori screening and surveillance of gastric malignancy.Studies of low‐grade MALT lymphoma reported clinical and molecular features that may be useful to identify cases that may be responsive to H. pylori eradication therapy, namely evaluation of lymphoma stage by EUS and t(11;18). The role of H. pylori eradication therapy in high‐grade MALT lymphoma needs to be evaluated in larger prospective studies. The application of methods of global analysis of gene expression (microarray studies) resulted in the explosion of information on the molecular pathways activated by H. pylori in gastric epithelial cells. New pathways that may play an important role in H. pylori carcinogenesis have been discovered in several studies.
Helicobacter pylori infection in pediatrics
Authors: Roma‐Giannikou Eleftheria , Shcherbakov Peter L. 
Published: March 2003

AbstractIn the past year the main interest was focused on the role of family for transmission of Helicobacter pylori to children; the evaluation of noninvasive diagnostic tests, especially in young children; extra‐intestinal clinical manifestations; the lack of consensus on treatment; and the problem of high resistance of the microorganism to antibiotics.
Cancer Screening of Older Women A Primary Care Issue
Authors: Blair Kathryn A. 
Published: March 2003

purpose
: The purpose of this retrospective chart review was to examine whether family practice physicians and residents were screening older women for breast, gynecologic, and colorectal cancers as recommended by the American Cancer Society, the Guide to Clinical Preventive Services, and Healthy People 2000.
methods
: A retrospective chart review of women 60 years and older who were seen at least twice between July 1, 1992, and June 30, 1993, in a midwestern family practice residency program was completed. From the original sample of 660 potential subjects, a systematic random selection of every third chart was identified for review, resulting in a sample of 201. Analysis of the data was performed by descriptive statistics and chi‐square tests. A series of multiple regression models using age, number of visits, type and gender of provider, and personal or family history of cancer as predictor variables was performed.
results
: Breast cancer screening was offered to approximately 70% of the sample, with only about one third of the older women receiving mammography or clinical breast examination. Recommendations for gynecologic cancer screening were given to 63% of the sample, with less than one third receiving Papanicolaou smears. Recommendations for digital rectal examination, fecal occult blood test, and flexible sigmoidoscopy were 58%, 59%, and 30%, respectively. The percentages of patients who actually received these tests were considerably lower.
clinical implications
: Barriers for appropriate cancer screening for older women exist for both the provider and the patient; however, many of these obstacles can be overcome. Improving the resident's exposure to the current recommendations, increasing geriatric content in the training program, and initiating a reminder system may reduce some of the provider barriers. The use of midlevel providers may increase the preventive services offered to older women as well as educate and empower these women to become responsible for their own healthcare. Together, physicians and midlevel providers can become patient advocates through political activism, encouraging legislation that guarantees payment for cancer screening tests. Finally, primary care providers can become actively engaged in research that explores the healthcare concerns of older women.
Cancer‐Related Fatigue
Authors: Holley Sandra 
Published: March 2003

Abstract Purpose: The purpose of this naturalistic inquiry was to understand, from the patient's perspective, the differences between cancer‐related fatigue (CRF) and “typical” fatigue and to describe its impact on their lives. Description of study: The sample consisted of 17 adult patients with cancer who agreed to participate, yielding 23 in‐depth audiotaped interviews. Participants included inpatients and outpatients from a dedicated cancer center and a Veterans Affairs Hospital. Symbolic interactionism was the framework used for the interviews to understand how individuals and groups construct and discover the meaning of events. Transcribed data were coded by distress category to classify the textual information and to reduce the text to more relevant and manageable bits of data. Five to 10 representative excerpts from each coding category were chosen and were coded independently by a second coder to evaluate intercoder reliability. Results: CRF was found to be more rapid in onset, more energy draining, more intense, longer lasting, more severe, and more unrelenting when compared with “typical” fatigue. CRF caused distress in the physical, social, spiritual, psychological, and cognitive domains of the participants' lives. All participants agreed that CRF was different than the typical fatigue of everyday life. Clinical implications: This study's findings indicate that because of this different fatigue, CRF, participants did not just experience the symptom, but they suffered with it. The current oncology literature and texts do not portray the morbidity of the CRF experience as described by the participants in this study. These data can be used as part of an experiential teaching guide to assist healthcare students and practitioners in understanding the CRF experience. This increased awareness will afford clinicians a better foundation for implementing management strategies. A CRF distress instrument is in development based on these data.
Implementing Cancer Pain Education for Medical Students
Authors: Sloan Paul A. , LaFountain Pat , Plymale Margaret , Johnson Mitzi , Montgomery Christopher , Snapp Janet , Sloan David 
Published: March 2003

Purpose: The purpose of this study was to develop and pilot a cancer pain education course for medical students, using a structured home hospice visit.Description of study: A 1‐hour home hospice visit was presented to 57 senior medical students. The content and objective criteria for the structured home hospice visit were developed by a multidisciplinary group of experts. During a 1‐hour interview, students completed a cancer pain history, performed a focused physical examination, and received feedback and teaching regarding the essentials of cancer pain management from the hospice nurse. All students and hospice patients completed a multi‐item evaluation questionnaire with a 5‐point Likert scale (1 = strongly disagree; 5 = strongly agree) regarding the structured home hospice visit.Results: Most students agreed strongly that the home hospice visit was a positive experience (mean ± SD 4.8 ± 0.44) that helped them to understand the management of cancer pain (mean 4.7 ± 0.46) and opioid‐related side effects (mean 4.5 ± 0.57). Most patients enjoyed visiting with the students (mean 4.90 ± 0.30), agreed that the visit was not tiring (mean 4.81 ± 0.51), and felt that they benefited from participating (mean 4.76 ± 0.54).Clinical implications: The authors concluded the following: 1) that medical students benefited from learning about cancer pain assessment and management through the use of a structured home hospice visit; 2) that a structured home hospice visit helped the students to learn the basics of cancer pain management; 3) that patients enjoyed their role as teacher for medical students; and 4) that senior hospice nurses provided excellent instruction for medical students in the management of cancer pain.