Helicobacter pylori eradication has the potential to prevent gastric cancer: A state-of-the-art critique

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.
The American Journal of Gastroenterology (Impact Factor: 9.21). 10/2005; 100(9):2100-15. DOI: 10.1111/j.1572-0241.2005.41688.x
Source: PubMed

ABSTRACT Helicobacter pylori infection continues to play a key role in gastric diseases. Colonization of the gastric mucosa with the bacterium invariably results in the development of chronic gastritis and subsets of patients have a progression of the chronic gastritis to either ulcer or cancer. Epidemiological evidence indicates that the proportion of all gastric cancers attributable to H. pylori infection, and hence potentially preventable upon elimination of this risk factor, is somewhere in the range of 60% to 90%. This portends significant benefit in terms of morbidity and mortality, not least in populations with high prevalence of H. pylori infection coupled with high incidence of gastric cancer. The effect of prophylactic H. pylori eradication on gastric cancer incidence in humans remains unknown, however. Results from randomized trials are eagerly awaited, but availability of strong conclusive results may take many years. A growing number of studies show considerable variation in risk for gastric cancer development, depending on H. pylori strain type and the genetic predisposition of the host. There is also a remote possibility that elimination of the infection may have adverse health implications (e.g., antibiotic resistance), and therefore "simple" risk stratification and targeted chemoprevention is required. Based on "in depth" evidence presented at this workshop, the majority of the scientific task force favored a search-and-treat strategy in first-degree relatives of gastric cancer patients and an overwhelming majority felt that a more general screen-and-treat strategy should be focused in the first instance on a population with a high incidence of H. pylori-associated diseases.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The guideline of the Korean College of Helicobacter and Upper Gastrointestinal Research group for Helicobacter pylori infection was first produced in 1998. Definite indication for H. pylori eradication is early gastric cancer in addition to the previous indications of peptic ulcer (PUD) including scar lesion and marginal zone B cell lymphoma (MALT type). Though treatment regimen was similar, Japan government declared the inclusion of H. pylori eradication in patients with H. pylori-associated chronic gastritis, suggesting the treatment guideline is quite different between Korea and Japan from February 21, 2013. The prime rationale of Japanese extended treatment guideline for H. pylori infection was based on the drastic intention to prevent gastric cancer according to their beliefs that H. pylori eradication can decrease gastric cancer incidence as well as mortality. In this review, the discrepancy in treatment guideline between Korea and Japan will be explained.
    06/2013; 18(2):107-12. DOI:10.15430/JCP.2013.18.2.107
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scheduling mixed-criticality systems that integrate multiple functionalities with different criticality levels into a shared platform appears to be a challenging problem, even on single-processor platforms. Multi-core processors are more and more widely used in embedded systems, which provide great computing capacities for such mixed-criticality systems. In this paper, we propose a partitioned scheduling algorithm MPVD to extend the state-of-the-art single-processor mixed-criticality scheduling algorithm EY to multiprocessor platforms. The key idea of MPVD is to evenly allocate tasks with different criticality levels to different processors, in order to better explore the asymmetry between different criticality levels and improve the system schedulability. Then we propose two enhancements to further improve the schedulability of MPVD. Experiments with randomly generated task sets show significant performance improvement of our proposed approach over existing algorithms.
    Design Automation and Test in Europe; 01/2014
  • Source

Full-text (2 Sources)

Available from
May 19, 2014