Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study.

Objectives: To describe the characteristics of a cohort of patients with microscopic colitis (MC; lymphocytic (LC) or collagenous (CC) colitis) and to compare them with patients with functional bowel disorder with diarrhea (FBD-D).

Methods: Between September 2010 and June 2012, patients fulfilling the following inclusion criteria were prospectively included in 26 centers in France: (i) having at least three bowel movements daily with change in stool consistency; (ii) duration of abnormal bowel habit >4 weeks; and (iii) normal or near-normal colonoscopy. Each patient underwent a colonoscopy and colonic biopsies.

[Follow-up of patients after Helicobacter pylori eradication].

After Helicobacter pylori eradication, the risk of new contamination in adulthood is very low and there is no need for further microbiological surveillance. Helicobacter pylori infection induces alteration of the gastric mucosa, beginning with chronic active gastritis and leading to atrophy, intestinal metaplasia and dysplasia. Chronic active gastritis disappears completely a few months after bacterial eradication while atrophy, intestinal metaplasia or dysplasia remain.

Peptic ulcer disease: one in five is related to neither Helicobacter pylori nor aspirin/NSAID intake.

Background: The proportion (and even the reality) of peptic ulcer disease (PUD) not related to H. pylori or NSAID/aspirin is debated.

Aim: To analyse the current epidemiological and clinical characteristics of peptic ulcer disease in French general hospitals.

Comparative evaluation of 29 commercial Helicobacter pylori serological kits.

Background: Serology is a noninvasive diagnostic method for the detection of Helicobacter pylori infection. Many commercial kits are now on the market. It is necessary to assess their performances to help the user to choose the most appropriate.

From array-based hybridization of Helicobacter pylori isolates to the complete genome sequence of an isolate associated with MALT lymphoma.

Background: Helicobacter pylori infection is associated with several gastro-duodenal inflammatory diseases of various levels of severity. To determine whether certain combinations of genetic markers can be used to predict the clinical source of the infection, we analyzed well documented and geographically homogenous clinical isolates using a comparative genomics approach.

Results: A set of 254 H.

[Treatment of Helicobacter pylori infection].

The eradication rate of H. pylori after an initial course of antibiotic treatment is only 70%. It is therefore essential to inform patients from the onset that a follow-up verification of eradication will be needed 4 to 6 weeks after the first course of treatment and a second or even a third course may be required.

Frequent and rapid progression of atrophy and intestinal metaplasia in gastric mucosa of patients with MALT lymphoma.

Objectives: Association of gastric mucosa-associated lymphoid tissue (MALT) low-grade lymphoma and adenocarcinoma has repeatedly been reported. The aim of this study was to evaluate the frequency and the spreading of atrophy and intestinal metaplasia in gastric mucosa of patients with gastric MALT lymphoma followed after conservative treatment.

Methods: Forty-five patients (mean age 45 +/- 2.

[Helicobacter pylori resistance: who needs what treatment?].

The standard treatment recommended for eradication of Helicobacter pylori is a combination of three drugs for seven days: one proton pump inhibitor at a double dose and two antibiotics. The high risk of failure - on the order of 30% - justifies routine testing to verify eradication after this first treatment. Verification is most often conducted with a urea breath test, more rarely by endoscopy when endoscopy or gastric histology is otherwise necessary.

Second-line treatment for failure to eradicate Helicobacter pylori: a randomized trial comparing four treatment strategies.

Aim: To compare the efficacy of different regimens in patients in whom previous Helicobacter pylori eradication therapy has failed.

Methods: In this study named StratHegy patients (n=287) were randomized to receive one of three empirical triple therapy regimens or a strategy based on antibiotic susceptibility. The empirical regimens were omeprazole, 20 mg b.

[Confirmation of Helicobacter pylori eradication following first line treatment. How and when?].

Helicobacter pylori (H. pylori) eradication treatment should always be thought of as a package which includes first and second line therapies together. So, testing of H.

[Cholangiocarcinoma developing in von Meyenburg complexes in haemochromatosis].

A 63-year-old man with genetic haemochromatosis underwent resection of a cholangiocarcinoma that developed in von Meyenburg complexes; the liver was not cirrhotic. Patients with an association of genetic haemochromatosis and von Meyenburg complexes might have a predisposition to cholangiocarcinoma, even before cirrhosis occurs. Patients with this association should undergo regular and early hepatic surveillance of hemochromatosis.

False-positive somatostatin receptor scintigraphy due to an accessory spleen.

A patient with previous left caudal pancreatectomy and splenectomy presented with Zollinger-Ellison syndrome. Abdominal CT and endoscopic ultrasonography revealed a mass in the splenic area. Somatostatin receptor scintigraphy showed a nodular increase of the uptake corresponding to the lesion detected with conventional imaging.

[Treatment of a hemorrhagic duodenal varice by endoscopic sclerotherapy].

We report the case of a duodenal varix rupture in a 37-year-old man revealing an alcoholic cirrhosis. Endoscopic diagnosis of this duodenal varix was difficult because of its atypical and changing appearance. Endoscopic sclerotherapy was completely successful and there was no recurrent bleeding.

Helicobacter pylori infection: physiopathologic implication of N alpha-methyl histamine.

Background/aims: In the gastric mucosa of Helicobacter pylori-infected subjects, we previously detected N alpha-methyl histamine (N alpha-MeHA), a minor catabolite of histamine and a potent agonist of histamine H3 receptors. The origin of N alpha-MeHA and its effects on gastric histamine and somatostatin in infected subjects were investigated.

Methods: Ten noninfected patients and 13 patients with intense colonization were compared.

Argyrophil cells, mast cells, and histamine in the fundic mucosa of antrectomized patients.

Fasting gastrinemia, fundic argyrophil cell density, mast cell number, basal fundic histamine content and histidine decarboxylase activity were determined in 20 antrectomized patients and 20 control subjects. Fasting gastrinemia and fundic argyrophil cell density were significantly lower in antrectomized patients than in controls, whereas fundic mast cell number, basal histamine content, and histidine decarboxylase activity did not differ significantly between the two groups. In antrectomized patients the basal fundic histamine content appears related to the fundic mast cell number, as a consequence of the reduced effect of gastrin on argyrophil cells.

Seven years of recurrent severe strongyloidiasis in an HTLV-I-infected man who developed adult T-cell leukaemia.

Objective: Human T-cell leukaemia/lymphoma virus type I (HTLV-I) is endemic in Japan, the Caribbean basin and Africa, where it has been aetiologically linked to certain chronic myelopathies and adult T-cell leukamia (ATL). We sought to investigate whether strongyloidiasis, a parasitic disease common in these areas, might be a cofactor in the pathogenesis of ATL, as some reports have suggested.

Patients, Participants: One 35-year-old HTLV-I-seropositive French West Indian man with a 7-year history of recurrent strongyloidiasis associated with episodic hyperinfestation presenting at the Centre Hospitalier Intercommunal, Villeneuve St Georges, France.

Arthritis associated with Strongyloides stercoralis.

A case of reactive arthritis combined with uveitis associated with a longstanding and heavy infestation with Strongyloides stercoralis is reported in a 32-year-old HTLV-1 positive West Indian man. Stool examination revealed numerous adult worms and larvae. Treatment with thiabendazole and ivermectin resulted in prompt improvement.