Newsgroup: it.salute
Titolo: helicobacter pylori e reazione antibiotico

Salve, mia madre donna di 65 anni ha fatto una gastroscopia e le hanno
riscontrato l' HP.
Le hanno dato una cura a base di Lucen e due antibiotici Velamox e Zimox.
Al secondo giorno perï¿œ ha avuto una reazione allergica (gonfiore al
volto) e ha interrotto la terapia.
Oggi ï¿œ tornata dal medico (lo stesso che le gli fatto la gastroscopia e
le dato la cura) e questi ha detto che non sa che fare lasciandole solo
il Lucen da prendere.
Mia madre ï¿œ diabetica.
Le domande sono :
1. Puï¿œ essere stato il fatto che mia madre gli antibiotici li ha presi
assieme (a poca distanza di tempo l'uno dall'altro) invece che separati
a causarle la reazione ?
2. Possibile che non c'ï¿œ una alternativa ? Se uno ï¿œ allergico allo zimox
o al velamox non puï¿œ curarsi dall' HP ?
3. Cosa puï¿œ fare mia madre ? Come comportarsi ?
Grazie

 Le hanno dato una cura a base di Lucen e due antibiotici Velamox e Zimox.
Scusate non Velamox ma VECLAM.
Grazie

 riscontrato l' HP.
l'HP ce l'hanno tutti. Le hanno riscontrato anche un'ulcera?
Leggevo un articolo che lamentava l'eradicazione dell'HP che, generalmente,
ha funzioni benefiche sulla (se ben ricordo) regolazione dell'acidit�
durante la digestione.

luca ha scritto:
 > Le hanno dato una cura a base di Lucen e due antibiotici
 > Velamox e Zimox.
 > Al secondo giorno però ha avuto una reazione allergica
 > 1. Può essere stato il fatto che mia madre gli antibiotici
 > li ha presi assieme (a poca distanza di tempo l'uno dall'altro)
Imho, c'è sicuramente qualcosa che non va, perché Zimox e Velamox
sono lo stesso identico antibiotico (amoxicillina, uno dei più sicuri)
e mi pare molto strano che lo stesso antibiotico sia stato prescritto
simultaneamente due volte: se è così, il dosaggio di amoxicillina
sarà risultato doppio del dovuto, con ovvi effetti collaterali.
Ma forse tu non hai descritto correttamente la vicenda, oppure
ti sei sbagliato sul nome di uno dei due antibiotici...
Bye,
   *GB*

luca ha scritto:
 > Scusate non Velamox ma VECLAM.
Ah, volevo ben dire... il Veclam è claritromicina. Cito al riguardo:
  "Essendo la claritromicina metabolizzata ed escreta principalmente
  a livello epatico, particolare cautela dovrà essere posta nella
  somministrazione del farmaco a pazienti con funzionalità epatica
  ridotta, nei soggetti con insufficienza renale di grado moderato
  o severo e negli anziani (oltre i 65 anni)."
Per il resto, vedi la risposta che ti ha dato Ignazio.
Bye,
   *GB*

 Non esageriamo adesso.
Ok, non è neanche vero che tutti abbiano l'herpes simplex. Ma l'80% sì.
Sperando di farvi cosa gradita, ho recuperato questo articolo.
Symbiosis
The twists and turns of fate
Aug 21st 2008
From The Economist print edition
Helicobacter pylori has a reputation for causing ulcers and cancer. Hunting
it to extinction, however, may be a mistake
MOST people feel a twinge of regret at reports that an animal or plant is
becoming rare. Should they feel the same pangs for a bacterium? With
Helicobacter pylori, so-called because of its twisty-turny shape, and
famous for causing stomach ulcers and gastric cancer, the reaction would
probably be “good riddance”. And H. pylori is, indeed, endangered in many
parts of the planet. It is fast vanishing from the rich world, thanks to
antibiotics and improved hygiene. Yet, as conservationists of larger
organisms are quick to remind you, extinctions can have unexpected
consequences. And that may prove to be the case with H. pylori.
Martin Blaser, a microbiologist at the New York University School of
Medicine, and his team have already linked the bug’s disappearance with
increased levels of obesity and with the rise of cancer of the oesophagus.
Last month they added asthma to the list by publishing a study showing that
children who had not been infected by H. pylori were more likely to suffer
from the condition than those who had.
It is a mistake, according to Dr Blaser, to think of H. pylori as just
another pathogen. He reckons that it is better perceived as a symbiont that
is sometimes helpful and sometimes harmful. The evidence suggests that its
relatives have been living in mammalian stomachs since the mammals began,
some 150m years ago. It, itself, has been around for at least 60,000 years
and until about 50 years ago it infected 70-80% of the human population.
Now, as a consequence of the routine use of antibiotics for such things as
ear infections, only 5% of American children have it. That change, he
thinks, is having consequences.
Give and take
Dr Blaser has discovered, for example, that H. pylori helps to regulate
stomach-acid levels in a way that is usually helpful to both itself and its
host. If the human side of the loop gets too strong, and the stomach
becomes too acid, the bug may produce a substance called cag. The intended
effect of this, Dr Blaser thinks, is to say “turn down the acid level”.
However, cag also has a side-effect. It is toxic to the stomach lining, and
it is this toxicity that provokes the ulcers and cancers for which H.
pylori is notorious.
The obvious medical temptation—and, indeed, what has happened in
practice—is to annihilate the bacterium with antibiotics. That works as an
anti-ulcer treatment, but when H. pylori goes its homeostatic effect goes
with it, allowing the strength of the stomach acid to rise chronically.
This acid has a tendency to spill out of the top of the stomach and into
the oesophagus. That has unpleasant consequences. In fact the recent drop
in H. pylori infections has almost exactly matched the rise in
gastroesophageal reflux disease (which feels like bad heartburn). Over
time, the damage the excess acid does to the walls of the oesophagus may
cause cancer.
The link with asthma has a different mechanism. When Dr Blaser and his
colleague Yu Chen analysed a health and nutrition database called the
National Health and Nutrition Examination Survey, they found that American
children between the ages of three and 13 who are infected with H. pylori
are 60% less likely to have asthma than their uninfected contemporaries.
They believe this is because H. pylori makes the immune system more robust.
The lack of it lowers the threshold for responding to a foreign protein
that might come from a pathogen. As a result, things like pollen and mites
trigger responses even though they are not, actually, dangerous. This idea
is similar to the “hygiene hypothesis” that the super-clean environment of
the modern world fails to challenge children’s immune systems enough for
their own good, and thus opens the way for conditions such as asthma. It
differs, however, in that Dr Blaser thinks humanity has co-evolved with the
bugs that prime the immune system, rather than picking them up at random.
Moreover, even the link between H. pylori and gastric cancer and ulcers is
complicated. Just having the bacterium does not automatically mean you will
get an ulcer. In the past, most people were infected with H. pylori from
their childhoods until they died. Ulcers, however, generally emerge when a
patient is in his 30s or 40s. In addition, they are three times more common
in men than in women. H. pylori-infection rates, however, are the same in
both sexes.
H. pylori also has an effect on two of the hormones that control
appetite—ghrelin, which makes you feel hungry, and leptin, which does the
opposite. People without H. pylori produce more ghrelin than those with.
Though the connection has not been established for sure, Dr Blaser suspects
the bacterium’s disappearance could thus be contributing to the epidemic of
obesity that is sweeping the rich world.
What all this suggests is that rather than trying to eradicate H. pylori, a
better strategy would be to manage its relationship with humanity in a more
sophisticated way. Some people are, genetically, more susceptible to ulcers
and gastric cancer than others. For these unfortunates eradication may be
the best option. However, if your genes predispose you to asthma or
obesity, eradication may be unwise.
Moreover, people are not born with H. pylori in their stomachs. Rather,
they get infected when they are young. That means a parent or doctor could
choose which strain of the bacterium a child ends up carrying, rather than
leaving the matter to chance. H. pylori is genetically variable (not all
strains, for example, make cag). Dr Blaser envisages a future in which
doctors run routine checks on babies’ genes to find out their
susceptibilities, and then colonise those babies’ stomachs with the strain
or strains that are best for them. If that happens, H. pylori can come off
the endangered species list for good.

 alla terapia il trattamento IMHO va fatto.
Senza ombra di dubbio. Resta solo da vedere se l'idea di inoculare HP
"benigni" ai bambini (e quindi anche ai "trattati") non sia cos� balzana.

 della cosa e sulla "benignit�" di queste varianti
Pi� che altro la "benignit�", come per molti farmaci mai entrati in
commercio o subito ritirati (Vioxx), potrebbe dipendere anche dai geni del
paziente.

 abbiamo un chiaro esempio con la grande quantit� di carenti di G6PDH.
La loro abbondanza (di deficienti G6quaccosa) mi pare sia la cosa migliore
di questo NG. Senza offesa per i piacevolissimi normodotati, eh.