Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
Peter Malfertheiner,Francis Mégraud,Colm O'Morain,Javier P. Gisbert,Ernst J. Kuipers,A. T. R. Axon,Franco Bazzoli,Antonio Gasbarrini,John Atherton,David Y. Graham,Richard H. Hunt,Paul Moayyedi,Theodore Rokkas,Massimo Rugge,Michael Selgrad,Sebastian Suerbaum,Kentaro Sugano,Emad M. El-Omar +17 more
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TLDR
This fifth edition of the Maastricht Consensus Report describes how experts from 24 countries examined new data related to H. pylori infection in the various clinical scenarios and provided recommendations on the basis of the best available evidence and relevance.Abstract:
Important progress has been made in the management of Helicobacter pylori infection and in this fifth edition of the Maastricht Consensus Report, key aspects related to the clinical role of H. pylori were re-evaluated in 2015. In the Maastricht V/Florence Consensus Conference, 43 experts from 24 countries examined new data related to H. pylori in five subdivided workshops: (1) Indications/Associations, (2) Diagnosis, (3) Treatment, (4) Prevention/Public Health, (5) H. pylori and the Gastric Microbiota. The results of the individual workshops were presented to a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in the various clinical scenarios.read more
Citations
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Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions.
Alessia Savoldi,Elena Carrara,David Y. Graham,Michela Conti,Evelina Tacconelli,Evelina Tacconelli +5 more
TL;DR: Resistance of H pylori to antibiotics has reached alarming levels worldwide, which has a great effect on efficacy of treatment, and local surveillance networks are required to select appropriate eradication regimens for each region.
Journal ArticleDOI
Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis
Yi-Chia Lee,Tsung-Hsien Chiang,Chu-Kuang Chou,Yu-Kang Tu,Wei-Chih Liao,Ming-Shiang Wu,David Y. Graham +6 more
TL;DR: In a systematic review and meta-analysis of randomized controlled trials and observational studies, eradication of H pylori infection is associated with a reduced incidence of gastric cancer.
Journal ArticleDOI
Review article: the global emergence of Helicobacter pylori antibiotic resistance.
Irene Thung,H. Aramin,Vera Vavinskaya,Samir Gupta,Jason Y. Park,Sheila E. Crowe,Mark A. Valasek +6 more
TL;DR: This study highlights the importance of knowing the carrier and removal status of canine coronavirus, as a source of infection for other animals, not necessarily belonging to the same breeds.
Journal ArticleDOI
Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019.
Pedro Pimentel-Nunes,Diogo Libânio,Ricardo Marcos-Pinto,Miguel Areia,Marcis Leja,Gianluca Esposito,Mónica Garrido,Ilze Kikuste,Francis Mégraud,Tamara Matysiak-Budnik,Bruno Annibale,Jean-Marc Dumonceau,Rita Barros,Jean-François Fléjou,Fátima Carneiro,Jeanin E. van Hooft,Ernst J. Kuipers,Mário Dinis-Ribeiro +17 more
TL;DR: Patients with chronic atrophic gastritis or intestinal metaplasia (IM) are at risk for gastric adenocarcinoma, and identification and surveillance of patients with precancerous gastric conditions is cost-effective.
Gastric cancer risk in patients with premalignant gastric lesions
Abstract: BACKGROUND & AIMS
A cascade of precursor lesions (eg, atrophic gastritis, intestinal metaplasia, and dysplasia) precedes most gastric adenocarcinomas. Quantification of gastric cancer risk in patients with premalignant gastric lesions is unclear, however. Consequently, endoscopic surveillance is controversial, especially in Western populations.
METHODS
To analyze current surveillance practice and gastric cancer risk in patients with premalignant gastric lesions, all patients with a first diagnosis between 1991 and 2004 were identified in the Dutch nationwide histopathology registry (PALGA); follow-up data were evaluated until December 2005.
RESULTS
In total, 22,365 (24%) patients were diagnosed with atrophic gastritis, 61,707 (67%) with intestinal metaplasia, 7616 (8%) with mild-to-moderate dysplasia, and 562 (0.6%) with severe dysplasia. Patients with a diagnosis of atrophic gastritis, intestinal metaplasia, or mild-to-moderate dysplasia received re-evaluation in 26%, 28%, and 38% of cases, respectively, compared with 61% after a diagnosis of severe dysplasia (P < .001). The annual incidence of gastric cancer was 0.1% for patients with atrophic gastritis, 0.25% for intestinal metaplasia, 0.6% for mild-to-moderate dysplasia, and 6% for severe dysplasia within 5 years after diagnosis. Risk factors for gastric cancer development were increasing severity of premalignant gastric lesions at initial diagnosis (eg, severe dysplasia, hazard ratio 40.14, 95% confidence interval 32.2-50.1), increased age (eg, 75-84 years, hazard ratio 3.75, 95% confidence interval 2.8-5.1), and male gender (hazard ratio 1.50, 95% CI 1.3-1.7).
CONCLUSIONS
Patients with premalignant gastric lesions are at considerable risk of gastric cancer. As current surveillance of these patients is inconsistent with their cancer risk, development of guidelines is indicated.
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