bluuebunny/crossref_metadata_2025_split huggingface dataset:
Swedish Women's Interest in Home Birth and In‐Hospital Birth Center Care
Authors: Hildingsson Ingegerd , Waldenström Ulla , Rådestad Ingela 
Published: March 2003

ABSTRACT:Background: In Sweden, few alternatives to a hospital birth are available, and little is known about consumer interest in alternative birth care. The aim of this study was to determine women's interest in home birth and in‐hospital birth center care in Sweden, and to describe the characteristics of these women.Methods: All Swedish‐speaking women booked for antenatal care during 3 weeks during 1 year were invited to participate in the study. Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options and a wide range of possible explanatory variables.Results: Consent to participate in the study was given by 3283 women (71% of all women eligible). The rates of response to the three questionnaires were 94, 88, and 88 percent, respectively. One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2–66.5) and a female friend (OR 15.2; 95% CI 6.2–37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4–15.3), low level of education (OR 4.5; 95% CI 1.8–11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4–9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2–21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3–4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6–2.9).Conclusion: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered. (BIRTH 30:1 March 2003)
Relationship of vacA Genotypes of Helicobacter pylori to cagA Status, Cytotoxin Production, and Clinical Outcome
Authors: Yamaoka Yoshio , Kodama Tadashi , Kita Masakazu , Imanishi Jiro , Kashima Kei , Graham David Y. 
Published: March 2003

Background.Mosaicism in vacA alleles with three distinct families of vacA signal sequences (s1a, s1b and s2) and two distinct families of middle region alleles (m1 and m2) has been reported. It was suggested that the vacA s1a genotype was closely associated with duodenal ulcer disease and with high cytotoxin production. The aim of this study was to evaluate the role of vacA genotyping with respect to gastric inflammation and injury, cytotoxin activity, and clinical presentation.Methods. H. pylori from patients with gastritis, peptic ulcer disease, or gastric cancer were characterized by vacA typing by polymerase chain reaction (PCR) and DNA sequencing. In vitro cytotoxin activity was assessed by vacuolation assay using Vero cells as well as with Hela cells.Results.Four hundred ninety‐one strains were tested. vacA genotype s1a/m1 was present in more than 95% of strains independent of presentation with gastritis, peptic ulcer, or gastric cancer. No vacA genotype was associated with high average cytotoxin activity. The s2/m2 isolates had low or absent cytotoxin activity. All cagA negative strains (n = 18) were s1a strains and both s2/m2 strains were cagA positive. One strain that was a recombinant of m1 and m2 strains was identified and had low cytotoxin activity. The nucleotide and amino acid sequences between original m1 strains and Japanese m1 strains (new m1 strains) were about 85% and 81%, respectively. Strains with the new m1 genotype had nucleotide and amino acid sequences similarity of more than 96%. There was no difference in cytotoxin activity between strains with the Western type m1 and the new type m1 genotype.Conclusion.In this as in other reported studies (≈ 1500 patients overall) vacA genotype was strongly but not exclusively associated with the presence of cagA. Overall, the studies did not support a role for vacA genotyping in relation to cytotoxin activity, virulence, histologic finding, or risk of a particular H. pylori disease. vacA genotype s1 is likely to be a surrogate marker for the presence of the cag pathogenicity island.
Heterogeneity of Protein Profiles of Helicobacter pylori Isolated from Individual Patients
Authors: Kitamoto Noritoshi , Nakamoto Hiromichi , Katai Atsuo , Takahara Nobuaki , Nakata Hiroya , Tamaki Hidehito , Tanaka Tomoyuki 
Published: March 2003

Background.In order to characterize the diversity of Helicobacter pylori (H. pylori) in infected individuals, 10 colonies of H. pylori were isolated from the gastric juice of 25 patients with gastroduodenal diseases (total 250 isolates).Methods.Protein profiles of isolates were compared by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE). Results were confirmed by Western blotting (immunoblotting) test using rabbit antisera against three different strains of H. pylori.Results.The protein profiles of 18 of 25 cases (72%) showed a single type of H. pylori with the same polypeptide pattern. In contrast, heterogeneity in the protein profiles was seen in isolates from seven cases (28%). Two differing H. pylori types with two very different polypeptide patterns were found in 10 isolates from one case. In six patients, the protein profiles of isolates were found to have variations in their polypeptides between molecular weights of 30,000 (30K) and 14K, which are thought to be associated with bacterial membrane protein. In some isolates, a polypeptide band of the 16K was missing. Each of three different antisera confirmed differences among the distinct isolates from individual patients.Conclusions.These findings suggest that more than one antigenically different strain of H. pylori may exist in same infected individuals.
CagA and Cytotoxicity of Helicobacter pylori Are Not Markers of Peptic Ulcer in Japanese Patients
Authors: Tokumaru Kenkichi , Kimura Ken , Saifuku Kouji , Kojima Toshichika , Satoh Kiichi , Kihira Ken , Ido Kenichi 
Published: March 2003

Background.The infection with cagA‐positive Helicobacter pylori strains is reported to be associated with peptic ulcer disease in developed countries, but it is controversial in Asia. To investigate the relationship between the virulence factors of H. pylori and peptic ulcer disease in Japan, we compared these between ulcer and nonulcer patients.Materials and Methods.Seventy‐four strains of clinically isolated H. pylori obtained from 22 gastric ulcer (GU), 23 duodenal ulcer (DU), and 29 chronic gastritis (CG) patients were studied. The presence of vacA and cagA gene was examined by polymerase chain reaction method using two different primer sets. We evaluated the proliferation‐inhibiting and lethal cytotoxicity of culture supernatants using the alamarBlue assay.Results.The vacA gene was identified in all strains by the original primers. S1 strains were found in 90.9% (20/22) from GU, 95.7% (22/23) from DU, and 96.6% (28/29) from CG patients. The prevalence of cagA gene determined by the first, and second primers was 90.9% (20/22), 90.9% (20/22) in strains from GU, 87.0% (20/23), 91.3% (21/23) from DU, and 86.2% (25/29), 89.7% (26/29) from CG patients, respectively. The supernatant showed cytolethal effect in 95.5% (21/22) of strains from GU, in 100% (23/23) from DU, and in 93.1% (27/29) from CG patients. There was no significant difference in the prevalence of the virulence factors between H. pylori strains isolated from patients with peptic ulcers and those with chronic gastritis.Conclusions.These results indicate that cagA gene status and the proliferation‐inhibiting and lethal cytotoxicity of supernatant are not reliable markers of ulcerogenicity of H. pylori in Japanese patients.
Twice‐Daily Versus Thrice‐Daily Clarithromycin in Combination with Ranitidine Bismuth Citrate in the Eradication of Helicobacter pylori
Authors: Schwartz Howard I. , Perschy Teresa B. , McSorley David J. , Sorrells Susan C. 
Published: March 2003

Background. Ranitidine bismuth citrate (RBC), 400 mg bid for 4 weeks, plus clarithromycin, 500 mg tid, is a regimen approved by the US Food and Drug Administration for the eradication of Helicobacter pylori in patients with duodenal ulcers. Proof that the clarithromycin portion of the regimen could be given twice daily without loss of efficacy would reduce cost and improve patient compliance. The objective of this study was to compare the H. pylori eradication rates in patients who had duodenal ulcer and were randomly assigned to 4 weeks of treatment with RBC, 400 mg bid, in conjunction with 2 weeks of therapy with either clarithromycin, 500 mg tid, or clarithromycin, 500 mg bid.Patients and Methods. Patients who had a duodenal ulcer and were H. pylori–positive by at least two tests were randomly assigned to (1) RBC, 400 mg bid for 4 weeks, plus clarithromycin, 500 mg tid for 2 weeks, or (2) RBC, 400 mg bid for 4 weeks, plus clarithromycin, 500 mg bid for 2 weeks. H. pylori eradication was assessed 4 weeks after completion of RBC plus clarithromycin.Results. Three hundred eighty‐three patients from 78 centers had a duodenal ulcer and were H. pylori–positive. The modified intent‐to‐treat (MITT) and the per‐protocol (PP) eradication rates were statistically equivalent between the twice‐daily (65% MITT, 74% PP) and thrice‐daily (63% MITT, 73% PP) clarithromycin treatment regimens. Incidence and types of adverse events did not differ between the two groups.Conclusions. For eradicating H. pylori in patients with duodenal ulcer, clarithromycin, 500 mg bid for 2 weeks, with RBC, 400 mg bid for 4 weeks, is equivalent to clarithromycin, 500 mg tid with RBC. The potential enhancement of patient compliance, reduced cost of clarithromycin, and equivalent efficacy would support the use of twice‐daily clarithromycin in triple‐therapy regimens with RBC.
Efficacy of Conventional Endoscopic Disinfection and Sterilization Methods Against Helicobacter pylori Contamination
Authors: Cronmiller James R. , Nelson Daniel K. , Jackson Dana K. , Kim Chung H. 
Published: March 2003

Background. Iatrogenic transmission of Helicobacter pylori via contaminated endoscopic devices is well documented. Despite the prevalence of this infectious agent, few controlled studies have investigated the major factors that impact on reprocessing of endoscopes contaminated with H. pylori.Materials and Methods. An endoscope (Pentax) was contaminated with 108 cfu/ml of H. pylori in 5% bovine calf serum as standardized inoculum. The endoscope then was passed through one of eight arms (five repetitions per arm = 40 total runs), as follows: 1, recovery control (no cleaning or disinfection); 2, manual cleaning alone; 3–5, manual precleaning followed by either 10‐, 20‐, or 45‐minute exposure to 2% glutaraldehyde and ethanol (ETOH) drying; 6, manual cleaning followed by automated reprocessing by STERIS System; 7 and 8, automated reprocessing by STERIS with and without active peracetic acid sterilant (wash‐off control). Suction‐biopsy channels and air‐water channels were harvested for microbiological culture.Results. Control runs recovered more than 1 × 106 cfu per site, confirming the viability of the test organism and the adequacy of the biological burden for challenge. When instruments underwent manual cleaning alone (without subsequent disinfection), test organisms remained in 40% of runs at the air‐water site. Manual cleaning followed by 10‐, 20‐, or 45‐minute glutaraldehyde exposure and ETOH drying removed all test organisms from all sites in all runs (i.e., 100% disinfection). The automated STERIS system with or without active peracetic acid sterilant also removed all test organisms from all sites in all runs, as did manual cleaning followed by STERIS use.Conclusion. Manual cleaning alone does not effectively remove H. pylori from an endoscope. Current joint association recommendations for minimal disinfection (manual cleaning followed by at least 20 minutes of immersion in glutaraldehyde and ETOH drying) are effective in preventing cross‐transmission of H. pylori. Reprocessing using the automated STERIS system according to manufacturer's recommendations also is highly effective in sterilizing endoscopes contaminated with H. pylori.
Different Penicillin‐Binding Protein Profiles in Amoxicillin‐Resistant Helicobacter pylori
Authors: Dore Maria P. , Graham David Y. , Sepulveda Antonia R. 
Published: March 2003

Background. The β‐lactam group of antibiotics kills bacteria by inhibiting the terminal stages of peptidoglycan metabolism. We have recently identified amoxicillin‐resistant Helicobacter pylori, none of which expressed β‐lactamase. Penicillin‐binding proteins (PBPs) represent a group of target enzymes for the β‐lactam antibiotic family, and alterations in PBPs have been described in other penicillin‐resistant bacteria. The amoxicillin‐resistant phenotype characteristically was lost after freezing but could be restored by consecutive transfers into gradient plates.Materials and Methods. To determine whether amoxicillin resistance in H. pylori was related to alterations in any of the H. pylori PBPs, five H. pylori strains resistant to amoxicillin and three amoxicillin‐sensitive strains were tested. PBPs were extracted from bacteria grown to logarithmic phase, labeled in vivo with 3H‐benzylpenicillin, and analyzed by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS‐PAGE) and fluorography. Four main PBPs were separated from all amoxicillin‐sensitive H. pylori strains.Results. Only three of the four main PBPs were found in the amoxicillin‐resistant H. pylori strains. The differentially detectable PBP (PBP D) had an apparent molecular weight of 30 to 32 kD.Conclusion. These results suggest that PBP D might play a role in the amoxicillin‐resistant phenotype of H. pylori strains lacking β‐lactamase activity.
A New Rapid Test for Detecting Anti–Helicobacter pylori Antibody Excreted into Urine
Authors: Yamamoto Soichiro , Uemura Naomi , Okamoto Shiro , Yamaguchi Shuji , Mashiba Hiroto , Tachikawa Tetsuya 
Published: March 2003

Background. Helicobacter pylori infection has been one of the most common infectious diseases in the world, whereas a gold standard for identifying its infection has not yet been established. The specific test will depend on the particular clinical, epidemiological, and scientific requirements. We recently developed a new type of rapid test to detect H. pylori antibody excreted into urine; the test requires only 20 minutes. The purpose of this study was to examine the accuracy of this rapid test.Methods. The performance of the rapid test was compared with those of a histological search through Giemsa staining and of an assay for detecting antibodies in serum by a commercially available ELISA kit. The patients, totaling 117 (male, 62, female, 55; average age, 51.6 years), included those with peptic ulcer endoscopically diagnosed and excluded cases that were subjected to eradication therapy in the past.Results. With respect to the determinations of H. pylori identified by the microscopical test and the serum antibody assay, our kit had a sensitivity of 92.0% and a specificity of 93.1%, and the agreement of determination of H. pylori infection was as high as 91.5% and 92.3%, respectively.Conclusions. The rapid test for antibodies to H. pylori in urine could detect H. pylori infection easily, rapidly, and noninvasively and would be useful in general practice for screening patients with dyspeptic symptoms.
The 26‐Kilodalton, AhpC Homologue, of Helicobacter pylori is also Produced by Other Helicobacter Species
Authors: Lundström Anneli M. , Sundaeus Vivianne , Bölin Ingrid 
Published: March 2003

AbstractBackground.The 26 kDa protein, which is an alkyl hydroperoxide reductase (AhpC) homologue, has earlier been described as specific for Helicobacter pylori. The aims of this study were to analyse whether this protein, or the corresponding gene, could be identified in other Helicobacter species.Materials and Methods.Two different monoclonal antibodies (Mabs), which recognise the 26 kDa protein in H. pylori, were used in immunoblots to determine the presence of the protein in 10 Helicobacter species. PCR was performed in order to analyse whether the gene was detectable and the PCR products were sequenced. Southern and Northern blot analyses were done on chromosomal DNA and total RNA, respectively, isolated from some selected Helicobacter species in order to compare the genes and mRNA transcripts to H. pylori.Results.The 26 kDa protein was identified in H. nemestrinae (primate), H. acinonychis (cheetah), H. bilis (mouse), H. felis (cat) and H.salomonis (dog) but not in H. mustelae (ferret), H. cinaedi (human), H. canis (dog), H. fennelliae (human) or H. pullorum (poultry). By PCR the gene was also recognised in H. mustelae, H. cinaedi and H. pullorum. The PCR products showed high sequence homology (66–98%) compared to H. pylori. The gene was also highly conserved in four H. pylori strains (94–99% homology). Southern blot showed that the H. nemestrinae and H. acinonychis chromosomal DNA contained a single copy of the gene and the Northern blot analyses indicated mono‐cistronic transcription of the gene in these two species, as has been found in H. pylori.Conclusions.A gene similar to ahpC was found in eight out of 10 Helicobacter species analysed.
Is Eradication of Helicobacter pylori With Colloidal Bismuth Subcitrate Quadruple Therapy Safe?
Authors: Phillips Rosemary H. , Whitehead Mark W. , Doig Laura A. , Sieniawska Christine E. , Delves H. Trevor , Thompson Richard P. H. , Powell Jonathan J. 
Published: March 2003

ABSTRACTBackground.When standard triple therapy fails to eradicate Helicobacter pylori, quadruple ‘rescue’ therapy is often used which, in Europe, generally comprises colloidal bismuth subcitrate (CBS) based triple therapy and a proton pump inhibitor. Since hypochlorhydria could greatly increase absorption of the toxic bismuth ion from CBS, we investigated the bismuth status of patients receiving anti‐H. pylori quadruple therapy.Materials and Methods.In a prospective open label study 34 patients with nonulcer dyspepsia or peptic ulcer disease, who had failed to eradicate H. pylori with standard triple therapy, were subsequently treated with CBS, omeprazole, amoxycillin and metronidazole (BOAM). A further 35 patients received triple therapy for the eradication of H. pylori: CBS, amoxycillin and metronidazole (BAM) (n = 18); placebo bismuth, amoxycillin and metronidazole (AM) (n = 9); or omeprazole, amoxycillin and metronidazole (OAM) (n = 8). Whole blood bismuth levels were determined before and within 24 hours of completing treatment. Analysis of bismuth was by inductively coupled plasma mass spectrometry, and concentrations were compared between groups and with the Hillemand ‘alarm level’ for blood bismuth (50–100 µg/l).Results.BOAM gave higher blood bismuth levels than BAM (difference in means 13.1, CI 6.0–20.2, p < .001); three (8.8%) patients taking BOAM had concentrations within the Hillemand alarm level at 54.2, 64.7 and 91.8 µg/l. OAM and AM did not alter baseline blood bismuth levels.Conclusions.Caution should be observed in prescribing CBS with gastric acid suppression, and alternative bismuth preparations should be considered.
Helicobacter pylori Infection Increases Serum Nitrate and Nitrite More Prominently Than Serum Pepsinogens
Authors: Kodama Kanji , Sumii Koji , Kawano Masanori , Kido Tamako , Nojima Keiko , Sumii Masaharu , Haruma Ken , Yoshihara Masaharu , Chayama Kazuaki 
Published: March 2003

AbstractBackground. Helicobacter pylori infection causes chronic gastritis and results in increased serum concentrations of pepsinogens I and II as well as gastrin, while the ratio of pepsinogen I to II (I : II) is decreased. Inducible nitric oxide synthase (iNOS) is induced in H. pylori‐associated gastritis and may modulate inflammation. However serum nitrate and nitrite (NOx) concentrations in patients with H. pylori‐induced chronic gastritis have not been reported. We examined differences in serum NOx between H. pylori‐negative and positive volunteers relative to differences in pepsinogens and gastrin.Materials and methods. Sera from 80 healthy asymptomatic volunteers younger than 36 years were analyzed for anti‐H. pylori antibody, NOx, gastrin and pepsinogens.Results. In H. pylori antibody‐positive subjects serum NOx concentrations were higher than in negative subjects (p < .005). In H. pylori‐negative subjects, NOx correlated with pepsinogen II (r = .405, p < .05). In subjects with low pepsinogen I or II, NOx was higher in H. pylori‐positive than negative subjects (p < .001). In subjects with high pepsinogen I : II (6 or higher), serum NOx was higher in H. pylori‐positive than in negative subjects.Conclusions. H. pylori‐induced gastritis increases serum NOx concentrations more prominently than those of pepsinogen. In H. pylori‐negative subjects, serum correlates with serum pepsinogen II.
Increased Primary Resistance to Recommended Antibiotics Negatively Affects Helicobacter pylori Eradication
Authors: Ecclissato C. , Marchioretto M.A.M. , Mendonça S. , Godoy A.P.O. , Guersoni R.A. , Deguer M. , Piovesan H. , Ferraz J.G.P. , Pedrazzoli J. 
Published: March 2003

AbstractObjective. To evaluate the efficacy of two commonly employed treatments for Helicobacter pylori infection and the impact of bacterial resistance to antibiotics on eradication rate.Methods. Ninety‐two consecutive H. pylori‐positive patients with active peptic ulcer disease were randomly enrolled to receive a 7‐day treatment with either lansoprazole 30 mg plus amoxicillin 1 g and clarithromycin 500 mg [all twice a day (b.i.d.), Group A, n = 46]; or bismuth subcitrate 125 mg four times a day (q.i.d.) plus tetracycline 500 mg q.i.d and furazolidone 200 mg b.i.d. (Group B, n = 46) H. pylori status was reassessed 30 days after completion of the therapy and bacterial resistance to the antibiotics was investigated using an in vitro assay.Results. Five patients from each study group were lost to follow up. Both treatments resulted in similar H. pylori eradication rate: 66–60% (per protocol), 59–52% (intention‐to‐treat) in Groups A and B, respectively (non significant). However, eradication improved to 79% in the absence of H. pylori resistance to clarithromycin or amoxicillin.Conclusion. Primary resistance to clarithromycin or amoxicillin may underscore a potentially serious problem for the eradication of H. pylori infection. Testing for bacterial resistance may become necessary to improve therapeutic efficacy.