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Helicobacter pylori in primary care physician

Viviana Laredo, Carlos Sostres, Enrique Alfaro, Maria Teresa Arroyo, Ángel Lanas
BACKGROUND: Management of Helicobacter pylori infection has been expanded from the gastroenterology specialist (GS) to primary care physicians (PCPs), with a large increase in requests for urea breath tests (UBT). Due to the lack of evidence at this level, we evaluated the appropriateness of UBT indications and treatment for H pylori infections between PCPs and GSs and the effect of introducing specific counseling to PCPs. MATERIALS AND METHODS: This was a quasi-experimental study...
April 5, 2019: Helicobacter
Doron Boltin, Iris Dotan, Shlomo Birkenfeld
Background: Consensus guidelines recommend that in regions with a high rate of clarithromycin resistance, Helicobacter pylori ( H. pylori ) infection be treated with 4 drugs. Compliance with this recommendation among primary care physicians (PCPs) is low. We aimed to examine whether PCP compliance with H. pylori treatment recommendations increased following a targeted educational intervention. Methods: A questionnaire assessing H. pylori treatment was sent to >2000 PCPs in June 2015 and June 2018...
January 2019: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
F J Bosques-Padilla, J M Remes-Troche, M S González-Huezo, G Pérez-Pérez, J Torres-López, J M Abdo-Francis, M V Bielsa-Fernandez, M C Camargo, F Esquivel-Ayanegui, E Garza-González, A I Hernández-Guerrero, R Herrera-Goepfert, F M Huerta-Iga, Y Leal-Herrera, A Lopéz-Colombo, N X Ortiz-Olvera, A Riquelme-Pérez, C L Sampieri, L F Uscanga-Domínguez, J A Velarde-Ruiz Velasco
Important advances have been made since the last Mexican consensus on the diagnosis and treatment of Helicobacter pylori (H. pylori) infection was published in 2007. Therefore, the Asociación Mexicana de Gastroenterología summoned 20 experts to produce "The Fourth Mexican Consensus on Helicobacter pylori". From February to June 2017, 4 working groups were organized, a literature review was performed, and 3 voting rounds were carried out, resulting in the formulation of 32 statements for discussion and consensus...
July 2018: Revista de Gastroenterología de México
Zekeriya Akturk, Ali Bilal Ulas, Atila Eroglu
INTRODUCTION: Zenker's diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle. It occurs commonly in elderly patients (over 70 years) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss. CASE: We are reporting dysphagia in a 49-years old man who was treated as having Helicobacter Pylori gastritis for three years. Being a family physician himself, the patient applied to specialists in gastroenterology, bypassing primary care...
December 2018: European Journal of General Practice
Maxwell D Mirande, Raul A Mirande
Introduction: Peptic ulcer disease has significantly decreased over the past several decades making the need for definitive surgical intervention an infrequent occurrence. Presentation of Case: A 44-year-old Caucasian female was sent to the emergency department by her primary care physician for right upper quadrant abdominal pain which had been intermittent for the past two months but acutely worsened over the last five days. During this time, she was unable to tolerate oral intake with intractable nausea and vomiting...
May 2018: Annals of Medicine and Surgery
Osama Siddique, Anais Ovalle, Ayesha S Siddique, Steven F Moss
Helicobacter pylori infects approximately half the world's population and is especially prevalent in the developing world. H. pylori is an important cause of global ill health due to its known etiological role in peptic ulcer disease, dyspepsia, gastric cancer, lymphoma, and more recently, recognized in iron deficiency anemia and idiopathic thrombocytopenic purpura. Increased antibiotic usage worldwide has led to antibiotic resistance among many bacteria, including H. pylori, resulting in falling success rates of first-line anti-H...
May 2018: American Journal of Medicine
Shailja C Shah, Steven H Itzkowitz, Lina Jandorf
Background/Aims: Although gastric cancer (GC) prevalence in the United States overall is low, there is significantly elevated risk in certain racial/ethnic groups. Providers caring for high-risk populations may not be fully aware of GC risk factors and may underestimate the potential for selective screening. Our aim was to identify knowledge gaps among healthcare providers with respect to GC. Methods: An Internet-based survey was distributed to primary care providers (PCPs) and gastroenterologists in New York City, which included questions regarding provider demographics, practice environment, GC risk factors, Helicobacter pylori , and screening practices...
January 15, 2018: Gut and Liver
Wolfgang Fischbach, Annemarie Zerl, Christine Klassert
Background The German S3 guideline "H. pylori and gastroduodenal ulcer disease" clearly recommends how to diagnose H. pylori infection. It also states when and how eradication therapy should be done. However, there are only few data available on the management of these patients in daily routine. With this survey, we wanted to gather information on how primary care physicians are involved in the management of H. pylori infection and how they follow the guideline recommendations. From this, consequences for the update of the new S2k guideline 2016 and their communication should be derived...
February 2017: Zeitschrift Für Gastroenterologie
Vincenzo Savarino, Pietro Dulbecco, Nicola de Bortoli, Andrea Ottonello, Edoardo Savarino
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions...
January 2017: European Journal of Internal Medicine
Maria Pina Dore, Giovanni Mario Pes, Gabrio Bassotti, Paolo Usai-Satta
Dyspepsia is defined as symptoms related to the upper gastrointestinal tract. Approximately 25% of western populations complain of dyspeptic symptoms each year. 70% of them do not have an organic cause and symptoms are related to the so-called functional dyspepsia, characterized by epigastric pain, early satiety, and/or fullness during or after a meal occurring at least weekly and for at least 6 months according to ROME III criteria. In order to avoid invasive procedures and adverse effects, to minimize costs, to speed up diagnosis, and to provide the most appropriate treatments, primary care physicians need to recognize functional dyspepsia...
2016: Gastroenterology Research and Practice
Mark H Ebell, Roland Grad
In 2015, a group of primary care clinicians with expertise in evidence-based practice performed monthly surveillance of more than 110 English-language clinical research journals. They identified 251 studies that addressed a primary care question and had the potential to change practice if valid (patient-oriented evidence that matters, or POEMs). Each study was critically appraised and disseminated to subscribers via e-mail, including members of the Canadian Medical Association who had the option to use a validated tool to assess the clinical relevance of each POEM and the benefits they expect for their practice...
May 1, 2016: American Family Physician
D S Bordin, O B Yanova, R A Abdulkhakov, V V Tsukanov, M A Livzan, S G Burkov, N V Zakharova, E Yu Plotnikova, M F Osipenko, L V Tarasova, I V Maev, Yu A Kucheryavyi, M A Butov, O A Sablin, S V Kolbasnikov, I N Voinovan, S R Abdulkhakov, A V Vasyutin, E A Lyalyukova, N N Golubev, I V Savilova, L V Grigoryeva, A G Kononova, Colm O'Morain, Mercedes Ramas, Adrian G Mcnicholl, Javier P Gisbert
AIM: To assess the clinical practice of diagnosis and treatment in patients with Helicobacter pylori infection and to compare this practice with the international guidelines in the European Registry on the management of Helicobacter pylori infection, Hp-EuReg protocol), a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group. MATERIALs AND METHODS: The data of 813 patients infected with H. pylori and entered in the Hp-EuReg register by the Russian centers in 2013-2015 were analyzed...
2016: Terapevticheskiĭ Arkhiv
Thomas N Wise, Richard Balon
The psychosomatic approach arose in antiquity as mankind looked for explanations for illness and death. With the rise of modern medicine, the links between emotions and medical conditions, such as cardiac disease and diabetes, were described by astute clinical observers, but the mechanisms for these conditions were based on correlation from observations rather than on experimental design. Psychoanalytic theory was often utilized to explain many common diseases. For example, peptic ulcer disease was blamed upon anger and stress, but scientific methodology discovered Helicobacter pylori to be the significant causal factor of this disease and resulted in the development of more effective treatments...
2015: Advances in Psychosomatic Medicine
Nahla A Azzam, Majid A Almadi, Hessah Hamad Alamar, Lamis Atyah Almalki, Rehab Nawaf Alrashedi, Rawabi Saleh Alghamdi, Waleed Al-hamoudi
AIM: To evaluate adherence of primary care physicians (PCPs) to international guidelines when referring patients for upper-gastrointestinal endoscopy (UGE), evaluate the importance of alarm symptoms and the performance of the American Society for Gastrointestinal Endoscopy (ASGE) guidelines in a Saudi population. METHODS: A prospective, observational cross-sectional study on dyspeptic patients undergoing UGE who were referred by PCPs over a 4 mo period. Referrals were classified as appropriate or inappropriate according to adherence to ASGE guidelines...
January 14, 2015: World Journal of Gastroenterology: WJG
Victoria M Taylor, Linda K Ko, Joo Ha Hwang, Mo-Kyung Sin, John M Inadomi
Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
Oh, what an issue! Extra, Extra, Read all about it! Patients deceiving doctors for prescriptions; characteristics of chronic pain seekers in primary care versus specialty settings; potential overuse of antidepressants when depression screening instruments are used; improving smoking quit rates through anger/stress management training; using immunoglobulin G levels to diagnose and follow eradication of Helicobacter pylori; patient- and family-friendly gentle cesarean deliveries; plus the economic impact of family physicians delivering babies … quite a line-up this issue...
September 2014: Journal of the American Board of Family Medicine: JABFM
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Ching-Ju Fang, Horng-Yuan Wang
The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori (H. pylori) in patients with previous gastric neoplasia who have undergone gastric surgery. However, the guidelines do not mention optimal timing, eradication regimens, diagnostic tools, and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of H. pylori reduces the risk of marginal ulcer or stump cancer in the residual stomach after gastrectomy...
May 14, 2014: World Journal of Gastroenterology: WJG
Aristofanis Gikas, John K Triantafillidis
Chronic gastrointestinal disorders are a source of substantial morbidity, mortality, and cost. They are common in general practice, and the primary care physician (PCP) has a central role in the early detection and management of these problems. The need to make cost-effective diagnostic and treatment decisions, avoid unnecessary investigation and referral, provide long-term effective control of symptoms, and minimize the risk of complications constitute the main challenges that PCPs face. The literature review shows that, although best practice standards are available, a considerable number of PCPs do not routinely follow them...
2014: International Journal of General Medicine
P E C Nel Mourad-Baars, Angelika Kindermann, Leonie M A J Venmans, Merit M Tabbers
In 2012, at the request of the Dutch Society of Paediatrics, a multidisciplinary working group developed a guideline entitled 'Helicobacter pylori infection in children aged 0-18 years'. The 2011 international guideline served as the guiding principle for this. The guideline includes recommendations on which children should be tested for H. pylori infection, the diagnostic tests to be used, the type of treatment to be given, and how follow-up should be conducted. Children can be tested and treated in both primary and secondary care...
2013: Nederlands Tijdschrift Voor Geneeskunde
William Seligman, William Selligman, Neil Baum
The healthcare profession has a reputation as a very conservative occupation. As a result, innovation in medicine comes about very slowly. There are numerous examples from medical history where innovators were sanctioned and even ostracized for their new ideas and recommendations to make medical care for patients better. This also applies to the business of medicine. This article will discuss examples from history where doctors have attempted to advance the clinical aspects of medicine, receiving condemnation from their peers and colleagues, and ultimately receiving approval and even the Nobel Prize on several occasions...
July 2013: Journal of Medical Practice Management: MPM
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