Modified quadruple therapy or bismuth-containing quadruple therapy in the first-line treatment of Helicobacter pylori in Turkey

Aim: Helicobacter pylori (H. pylori) eradication is still an important issue in countries with high antibiotic resistance. This study aimed to compare the efficacy and safety of two bismuth-containing treatment modalities in H. pylori treatment in Turkey. Material and methods: subjects with H. pylori infection who were treated with either bismuth-containing quadruple therapy (pantoprazole 40 mg bid, tetracycline 500 mg qid, metronidazole 500 mg tid, bismuth subcitrate 262 mg qid daily) (BQT group) or modified quadruple therapy (pantoprazole 40 mg bid, amoxicillin 1g bid, metronidazole 500 mg tid, bismuth subcitrate 262 mg qid daily) (MBQT group) for 14 days were compared, retrospectively. The eradication success rate, adverse events related to the medications and compliance were investigated. Results: a total of 128 patients in the BQT group and 102 patients in the MBQT group completed the treatment. The overall rate of adverse events was significantly higher in the BQT group compared with the MBQT group (39.4 % vs 18.6; p: 0.001). Among the adverse events, nausea-vomiting and abdominal discomfort was significantly more frequent in the BQT group than in the MBQT group (p: 0.001). The adverse events were mild-moderate in both groups and life threatening adverse events were not present in any of the patients. Conclusion: although both regimens were highly effective and safe in H. pylori eradication, both intention-to-treat (ITT) and per-protocol (PP) eradication rates were higher and adverse events were lower in the modified quadruple therapy group. Modified quadruple therapy should be kept in mind for the first-line treatment of H. pylori in regions with high clarithromycin and metronidazole resistance

Social stigmatization in Turkish patients with chronic hepatitis B and C

Background and aim: Viral hepatitis is the most important cause of chronic hepatitis worldwide. Stigmatization is defined as a feeling of rejection and isolation of patients by society due to illness. There are no studies on chronic viral hepatitis in the literature in English, which has its own religious and socio-cultural structure. In our study, we aimed to investigate the presence of social stigmatism and psychosocial effects on patients with different stages of chronic viral hepatitis B and C. Methods: Forty-five patients with chronic hepatitis C and 114 patients with chronic hepatitis B were enrolled in the study. Berger’s scale was used for stigmatization, composed of 40 four-point Likert items that have four subscales: personalized stigma, disclosure, negative self-image, and public attitude. Stigma score ranges between one and four. Stigma is accepted as present if the overall score is above two. Results: Overall the mean stigma scores were 1.97 ± 0.58 and 2.14 ± 0.57 for chronic hepatitis B and C, respectively. There was stigma in 47.4% of the patients with chronic hepatitis B, and 60% of the patients with chronic hepatitis C. Being male was the risk factor on overall stigma, disclosure and public attitude in chronic hepatitis C. Living in an urban setting was the risk factor on negative self-image in chronic hepatitis C and on personalized stigma and disclosure in chronic hepatitis B

Diffüz Büyük B Hücreli Lenfoma’da CD10, BCL-6 ve MUM-1 Markerların Ekspresyonu ve Prognoz Üzerine Etkisi

Background and Aim: Immunohistochemistry may serve as a surrogate to define Diffuse large B-cell lymphoma (DLBCL) cases as germinal center B cell-like (GCB) or non-GCB subtypes and to provide prognostic information. In this study, we aimed to investigate the frequency and prognostic impact of CD10, B-cell lymphoma 2 and 6 (BCL2 and BCL6) and multiple myeloma oncogene 1 (MUM1) expressions in pathology sections of patients with DLBCL to determine the response of these subgroups to the rituximab including chemotherapy regimens. Materials and Method: Patients were grouped into 2 regarding the chemotherapy regimens they were treated, as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or Rituximab-CHOP. The treatment response, follow-up periods and outcomes of patients were recorded. The immunohistochemical panel was stained in pathology sections for CD10, BCL6 and MUM1/IRF 4 biomarkers. The patients were subgrouped as GCB or ABC regarding the immunohistochemical panel. Results: Totally 81 patients, (39 male, 42 female) were included in the study. At the time of diagnosis, CD10 was positive in 31 patients (38.3%); BCL-6 in 53 patients (65.4%); MUM-1 was positive in 47 patients (58%) and BCL-2 was positive in 53 patients (65.4). With these results, 36 patients (44.4%) were in the GCB group and 45 patients (55.6%) were in the ABC group. No significant difference was found between the individual markers and subgroups in survival analyses. Conclusion: We did not determine any significant effect of CD10, BCL-6, MUM-1 or BCL-2 positivity or GCB and non-GCB groups in the survival of patients with DLBCL.Giriş ve Amaç: İmmünohistokimya kullanılarak, Diffüz büyük B hücreli lenfoma (DBBHL) vakaları germinal merkez B hücresi benzeri (GCB) ve ABC grubu olmak üzere prognostik açıdan önemli olan alt tiplere ayrılabilir. Biz bu çalışmada DBBHL’li hastaların patoloji preparatlarında CD10, B hücreli lenfoma 2 ve 6 (BCL2 ve BCL6) ve multipl miyelom onkogen 1 (MUM1) markerlarının sıklığını ve rituksimab içeren kemoterapi gruplarındaki prognostik etkisini araştırmayı amaçladık. Yöntem ve Gereçler: Hastalar, kemoterapi rejimleri açısından, siklofosfamid, doksorubisin, vinkristin ve prednizon (CHOP) veya Rituksimab-CHOP olarak 2'ye ayrıldı. Hastaların tedaviye yanıtı, takip süreleri ve tedavi sonuçları kaydedildi. Tanı anındaki patoloji preparatlarından CD10, BCL6 ve MUM1 / IRF 4 biyomarkerları için boyama yapılarak hastalar immünohistokimyasal panel açısından GCB veya ABC olarak alt gruplara ayrıldı. Bulgular: Toplam 81 hasta (39 erkek, 42 kadın) çalışmaya dahil edildi. Tanı sırasında 31 hastada (% 38,3) CD10; 53 hastada BCL-6 (% 65,4); MUM-1 47 hastada (% 58) ; BCL-2 53 hastada (65,4) pozitifti. Bu sonuçlarla 36 hasta (% 44.4) GCB grubu, 45 hasta (% 55.6) ABC grubu olarak tanımlandı. Sağkalım analizinde gruplar ve biyomarkerlar arasında istatistiksel olarak anlamlı bir farklılık saptanmamıştır. Tartışma ve Sonuç: DLBCL hastalarının sağkalımında CD10, BCL-6, MUM-1 veya BCL-2 pozitifliği veya GCB ve ABC gruplarının anlamlı bir etkisi saptanmamıştır

Long-term proton pump inhibitor use is a risk factor for mortality in patients hospitalized for COVID-19

Background and aim: The aim of this study is to evaluate whether the long-term (?4 weeks) use of proton pump inhibitors (PPIs) is arisk factor for intubation requirement and mortality in patients hospitalized for COVID-19.Materials and methods: In this multicentric retrospective study, a total of 382 adult patients (?18 years of age) with confirmedCOVID-19 who were hospitalized for treatment were enrolled. The patients were divided into two groups according to the periodsduring which they used PPIs: the first group included patients who were not on PPI treatment, and the second group included thosewho have used PPIs for more than 4 weeks.Results: The study participants were grouped according to their PPI usage history over the last 6 months. In total, 291 patients did notuse any type of PPI over the last 6 months, and 91 patients used PPIs for more than 4 weeks. Older age (HR: 1.047, 95% CI: 1.026–1.068),current smoking (HR: 2.590, 95% CI: 1.334–5.025), and PPI therapy for more than 4 weeks (HR: 1.83, 95% CI: 1.06–2.41) were foundto be independent risk factors for mortality.Conclusion: The results obtained in this study show that using PPIs for more than 4 weeks is associated with negative outcomes forpatients with COVID-19. Patients receiving PPI therapy should be evaluated more carefully if they are hospitalized for COVID-19treatment