Orv Hetil 2021[Aug]; 162 (32): 1275-1282 PMID34370686show ga
Osszefoglalo. A Helicobacter pylori tovabbra is a vilag legelterjedtebb fertozese: prevalenciaja a fejlodo orszagokban 70-80%, a fejlett orszagokban csokkeno tendenciat mutat. A del-magyarorszagi veradokban a prevalencia 32%-ra csokkent. A migracio a befogado orszag szamara a fertozes fokozott kockazataval jar. A szovettani diagnozisban az immunhisztokemiai vizsgalat pontosabb a hagyomanyos Giemsa-festesnel. A mesterseges intelligencia erzekenysege a hagyomanyos endoszkopiaeval osszehasonlitva 87%, pontossaga 86%. Az ujgeneracios szekvenalassal lehetseges egy biopszias mintabol tobb antibiotikumerzekenyseg meghatarozasa. A Helicobacter pylori kezelesenek europai regisztere kimutatta, hogy 2013 es 2018 kozott a bizmutalapu negyes vagy a 14 napos egyideju negyes kezelesek hatasosabbak, mint a hagyomanyos harmas kezeles, de elterjedesuk igen lassu folyamat, jelentos foldrajzi kulonbsegekkel. Az uj tipusu koronavirus (SARS-CoV-2) fellephet Helicobacter pylori fertozesben is, egymas koros hatasat felerositve. A diagnosztikai modszerek korlatozottak. Protonpumpagatlok szedese noveli a COVID-19-fertozes kockazatat es annak sulyos kimenetelet. Elozetesen ismert peptikus fekely, verzes, illetve antikogulans kezeles elott az eradikacio a virusos fertozes lezajlasa utan indokolt. A probiotikumoknak az eradikaciora gyakorolt hatasarol 20, kozepes minosegu metaanalizis szuletett, igy a konszenzusokban foglalt allaspontok sem egyertelmuek: a jovoben ezt tisztazni kell. Orv Hetil. 2021; 162(32): 1275-1282. Summary. Helicobacter pylori is still the most widespread infection in the world: its overall prevalence is 70-80% in developing regions, but fortunately it is decreasing in the Western world. The prevalence in blood donors from South-Eastern Hungary decreased from 63% in the 1990's to 32% in 2019. Migration constitutes an increased risk of infection for the destination countries. Immunohistochemistry has proven to be more accurate in histological diagnosis than the conventional Giemsa stain. The sensitivity and accuracy of artificial intelligence as compared to videoendoscopy were 87% and 86%, respectively. The European Register on the management of Helicobacter pylori infection revealed that concomitant quadruple and 14-day bismuth-based therapies are more efficient than triple combinations, although their incorporation in practice is a long-lasting process, with large geographical variations. The novel type of coronavirus (SARS-CoV-2) can also occur in Helicobacter pylori-infected patients, mutually enhancing their pathogenetic effects. Diagnostic possibilities are limited in this setting. The use of proton pump inhibitors increases the risk of viral infection and the severity of the disease. Eradication treatment seems justified in patients with previously known peptic ulcers or gastrointestinal bleeding, or before starting anticoagulant treatment, but must be postponed after resolution of viral infection. The effect of probiotics on eradication was addressed by 20, medium-to-low quality meta-analyses and so, the recommendations of the guidelines are equivocal, which must be clarified in the future with higher quality studies. Orv Hetil. 2021; 162(32): 1275-1282.
Orv+Hetil 2021 ; 162 (32): 1275-1282
