Ελικοβακτηρίδιο...

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    ...22 31 2017

    *Geen tekst: alleen laten zien

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  • Hp

  • Hp

    OConnor A, et al. Nat Rev Gastroenterol Hepatol 2017 (in press)

  • Peptic ulcer, gastric cancer, MALT lymphoma, coronary artery disease, cerebrovascular diseases, hypertension, Raynaud, migraine, hematologic diseases, chronic urticaria, liver diseases, autoimmune disorders-glaucoma (ocular Alzheimers)- neurodegenerative diseases, GERD-Barretts, esophageal adeno-ca, colon ca or other extraintestinal neoplasia

    Sleisenger & Fordtrans 2010, Helicobacter 2012, World J Gastrointest Pathophysiol 2014

    Hp

  • Ca Correa

  • CaFerlay J. et al. GLOBOCAN 2012

  • 5 , 3 Ca ()10% Hp 25% CaHp (+) 3-6 x CaIARC (1994): Hp, Hp , Ca 2050,

    Ca

    The Eurogast Study Group. Gut 1993;34:1672-6.Yeh JM, et al. Cancer Causes Control 2009;20:2021-9.

  • Rokkas T, et al. Ann Gastroenterol 201726 10 RCTs52363

  • Hp

  • Wilson Jungner Wilson JM & Jungner G. WHO 1968

  • : 90%, : 95-100%

    Hp IgG:

    (PG1 PG1/PG2): / -

    UBT: 96%, 93% ( PPI)

    : 97%, 94% ( PPI)

  • Hp : 6-15 ()

    Ca Hp :

    ( ) PPI ( )

    ()

    Hp

  • Ca (): Ca: - , (US$83.000 Ca) Hp 50 US$25.000 - : US$50.000 UBT

    CaOConnor A, et al. Nat Rev Gastroenterol Hepatol 2017 (in press)

  • / Hp: 2.324 Hp 40-49 , Hp 2 (RR 0,84, 95%CI 0,73-0,97, P=0,015) (Leeds HELP study), placebo 13 4 (P=0,04)10 , Hp / /

    / Moayyedi P, et al. Lancet 2000;355:1665-9.Ford AC, et al. Gastroenterology 2005;129:1910-7.

  • Bristol Helicobacter project ( ): 10.537 20-59 UBT 1.636 Hp (+) (P=0,05) (P=0,02) 2 / 2 , Hp 7

    / Lane JA, et al. BMJ 2006;332:199-202.Harvey RF, et al. Aliment Pharmacol Ther 2010;32:394-400.

  • >?
  • In vitro

    Hp

    (C 0.136 mg/mL) (MBC 0.202 mg/mL)

    total mastic extract without polymer (TMEWP)Paraschos S, et al. Antimicrob Agents Chemother 2007;51:551-559

  • TMEWP :

    ( 30 ) Hp

    In vivo Paraschos S, et al. Antimicrob Agents Chemother 2007;51:551-559 TMEWP Hp ,

  • 52 Hp : Hp in vivo

    Hp ?

    Dabos KJ, et al. Phytomedicine 2010;17:296-299

  • Hp, :

    Ca ( ) ( , )

    Hp: Ca

    :

    Take-home messages (1)

  • / Hp :

    Wilson Jungner cost-effective Ca -

    Hp : PG

    Hp

    Take-home messages (2)

  • :

    Hp >180.000 Hp Ca 2018

    ?

    Pan KF, et al. Gut 2016;65:9-18.

  • *Geen tekst: alleen laten zien

    *Geen tekst: alleen laten zien

    *Geen tekst: alleen laten zien