Publisher Correction: Human gastric microbiota analysis of refractory H. pylori infection
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Refractory (planetary science)
Helicobacter Infections
Gastric cancer is estimated to be the fifth most common cancer and the fourth leading cause of cancer deaths worldwide. 1The occurrence of gastric cancer is linked to commonly-occurring Helicobacter pylori infection.Because of difficulties in developing a vaccine, H. pylori eradication treatment has emerged as a key strategy for limiting infection and preventing complications, such as precancerous diseases, in the general population. 2 Antibiotic resistance has increased, albeit with regional differences in rates of resistance, and affects first-line and other rescue treatments.A survey of 16 countries in the Asian-Pacific region found that resistance rates to clarithromycin in 11 countries and to levofloxacin in 13 countries were greater than 15%. 3 To address this, improved detection methods and novel treatment strategies based on a deeper understanding of bacterial resistance mechanisms are needed.In this issue of Gut and Liver, Kim et al. 4 examined the prevalence of resistance to clarithromycin related to point mutations using a dual-priming oligonucleotide (DPO)based multiplex polymerase chain reaction (PCR) assay and assessed the impact of different point mutations on the success of eradication therapy.This retrospective cohort study examined 464 patients by reviewing databases in Korea between June 2014 and October 2019.The authors found that standard triple therapy was effective in more cases in the negative point mutation group compared with the positive point mutation group (p<0.001).The point mutation rate was 37.7% among the study population, with the single mutation A2143G being most frequently identified, followed by A2142G, and double point mutations.
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Resistance to clarithromycin in H. pylori has emerged in a number of countries. We present the first documented case of H. pylori resistance to clarithromycin in Denmark. This follows an increase in the use of clarithromycin as part of the treatment of H. pylori in the most recent years in Denmark. The need for culturing and susceptibility testing in H. pylori is emphasized.
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Objectives
The current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors.Design
Cross-sectional surveys.Setting and participants
Self-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020.Primary and secondary outcome measures
COVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed.Results
The results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald’s χ2=4.36, p=0.04) and distress (Wald’s χ2=25.18, p<0.001), as well as compromised well-being (Wald’s χ2=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic.Conclusions
Our results render the need for regular psychological surveillance in healthcare workers.Registration
Hungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).Helicobacter Infections
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Conflicting data about the link between Helicobacter pylori and dyspepsia provoked lively discussion at this year's meeting of the American Gastroenterological Association (New Orleans, LA, USA; May 17–20).
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