1.Success rate of helicobacter pylori eradication using vonoprazan-based triple therapy as first-line treatment at a tertiary hospital in Baguio City
Tristan John B. Guston, MD ; Maria Elizabeth T. Espiritu, MD
Philippine Journal of Internal Medicine 2023;61(2):36-44
Background:
Helicobacter pylori is acknowledged to cause chronic gastritis and peptic ulcer disease and is also implicated
in gastric carcinoma and B cell mucosa-associated lymphoid tissue (MALT) lymphoma development. It has infected at least
half of the world’s population. Proton Pump Inhibitors (PPIs) have been the conventional antacid of choice for H. pylori
eradication triple therapy, while vonoprazan is a novel drug of its class that was recently studied but is limited to an oral
form which makes it less feasible in cases of acute gastrointestinal bleeding. According to several systematic reviews and
meta-analyses, the vonoprazan-based triple therapy regimen for H. pylori eradication is a non-inferior treatment to
traditional PPI-based treatment when given in 1 week for patients having no active gastrointestinal bleeding. Likewise, a
safety profile has been established with its use, offering an alternative treatment option.
Objectives:
The research aims to identify the H. pylori eradication rate among H. pylori-positive patients who received a
vonoprazan-based triple therapy regimen as outpatients, describe their clinicodemographic profile, and identify potential
side effects associated with the treatment.
Methods:
This study utilized a cross-sectional study design in a single tertiary institution from January 2018 to December
2020. Descriptive and inferential statistics were used in data analysis. Frequency and percentage were utilized to determine
the success and failure rates of H. pylori eradication, describe the clinicodemographic profile of patients who underwent
vonoprazan-based triple therapy, and the potential side effects with treatment. The chi-square test of independence was
applied to assess the significant difference in the successful and failed eradication rates across the clinicodemographic
profile. A P-value of <0.05 was considered statistically significant, and statistical analyses were conducted using SPSS
version 20.0.
Results:
32 (91%) had successful H. pylori eradication, with the majority of them determined by a negative 13C-UBT result
(62.8%) and the rest with a negative H. pylori stool antigen test (28.6%). The majority of patients undergoing H. pylori
eradication using a vonoprazan-based regimen with documented successful eradication belonged to the 19 to 39 years
old group (50%), clerical support workers (40.63%), with a chief complaint of abdominal pain (46.88%), with no known co-
morbid illness (75%), and with endoscopic finding limited to antral gastritis alone (46.88%). This study described only two
documented side effects of treatment: diarrhea and abdominal pain (2.9%).
Conclusion
Vonoprazan-based triple therapy, given at 20 mg twice daily for 7 days, has shown a high H. pylori eradication
rate among hemodynamically stable patients, without active bleeding, and treated on an outpatient basis. There was a
significant difference in eradication success and failure across co-morbidities, with a higher success rate in those without
co-morbid illness. A high success rate was also seen in patients <40 years of age, with a single chief complaint, and with
antral gastritis as the sole endoscopic finding.
Helicobacter pylori
2.Developing a coordinate-based strategy to support cognitive targeted prostate biopsies and correlative spatial-histopathological outcome analysis.
Keiran D CLEMENT ; Lizzy DAY ; Helen ROONEY ; Matt NEILSON ; Fiona BIRRELL ; Mark SALJI ; Elizabeth NORMAN ; Ross CLARK ; Amit PATEL ; John MORRISON ; Hing Y LEUNG
Asian Journal of Andrology 2021;23(3):231-235
Lack of investment for magnetic resonance (MR) fusion systems is an obstacle to deliver targeted prostate biopsies within the prostate cancer diagnostic pathway. We developed a coordinate-based method to support cognitive targeted prostate biopsies and then performed an audit on cancer detection and the location of lesions. In each patient, the prostate is considered as two separate hemiprostates, and each hemiprostate is divided into 4 × 4 × 4 units. Each unit is therefore defined by a three-dimensional coordinate. We prospectively applied our coordinates approach to target 106 prostatic lesions in 93 men. Among 45 (of 106; 42.5%) lesions positive for cancer, 27 lesions (60.0%) harbored clinically significant disease. PSA density was significantly higher in patients with proven cancer (median: 0.264 ng ml
3.Superior Specimen and Diagnostic Accuracy with Endoscopic Ultrasound-Guided Liver Biopsies Using 19-Gauge versus 22-Gauge Core Needles
Rucha M. SHAH ; Jason SCHMIDT ; Elizabeth JOHN ; Sheila RASTEGARI ; Priyanka ACHARYA ; Prashant KEDIA
Clinical Endoscopy 2021;54(5):739-744
Background/Aims:
Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB.
Methods:
We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized.
Results:
The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001).
Conclusions
A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.
4.Superior Specimen and Diagnostic Accuracy with Endoscopic Ultrasound-Guided Liver Biopsies Using 19-Gauge versus 22-Gauge Core Needles
Rucha M. SHAH ; Jason SCHMIDT ; Elizabeth JOHN ; Sheila RASTEGARI ; Priyanka ACHARYA ; Prashant KEDIA
Clinical Endoscopy 2021;54(5):739-744
Background/Aims:
Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB.
Methods:
We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized.
Results:
The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001).
Conclusions
A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.
5.Intratympanic Gentamicin Versus Labyrinthectomy: Inner Ear Sensitivity to Gentamicin and Impact on the Contralateral Labyrinth
Georgios KONTORINIS ; Hiteshkumar TAILOR ; Margaret GAGGINI ; John A CROWTHER
Clinical and Experimental Otorhinolaryngology 2019;12(4):392-398
OBJECTIVES: To investigate the impact of labyrinthectomy and intratympanic (IT) gentamicin injections on the contralateral labyrinth, we also assessed the response of each individual semicircular canal to each IT gentamicin application. METHODS: We performed a pilot observational study on tertiary, referral, academic settings. Thirteen patients with unilateral vestibular pathology were organized into two groups, group I (seven patients) receiving IT gentamicin and group II undergoing labyrinthectomy (six patients). All patients underwent six-canal video-head-impulse test in predetermined time intervals. Patients receiving gentamicin were additionally tested 3 to 5 days after every sequential injection, until all ipsilateral canals were ablated, to determine the order of response to gentamicin. We recorded the vestibular-ocular reflex gains and the presence of covert/overt saccades for each canal. RESULTS: The posttreatment ipsilateral gains were abnormal. No patient from the gentamicin group developed abnormal contralateral responses, while patients undergoing labyrinthectomy had abnormal contralateral responses from at least one canal, even several months posttreatment. Finally, the lateral semicircular canal was the first one to be affected by IT gentamicin followed by the posterior canal: the superior canal was ablated last. CONCLUSION: In our study, labyrinthectomy had an impact on the responses recorded from the contralateral ear, while IT gentamicin ablated the ipsilateral labyrinthine function without affecting the contralateral responses, possibly because of a milder, more gradual impact. We also show for the first time the order that IT gentamicin application affects the semicircular canals, with the lateral being the first to be affected.
Ear
;
Ear, Inner
;
Gentamicins
;
Head Impulse Test
;
Humans
;
Observational Study
;
Pathology
;
Referral and Consultation
;
Reflex
;
Saccades
;
Semicircular Canals
6.Second to Fourth Digit Ratio (2D:4D) as a Predictor of Adult Circulating Sex Hormones and Overweight/Obesity in Ado-Ekiti Nigeria.
Fatai Bolaji OYEYEMI ; John Oluwafemi ADEBAYO ; Adekunle Wahab OYEYEMI ; Iyabo Cecilia ADEOLA ; Elizabeth Tope AYANWOLE ; Febisola Oluwatoyin JEGEDE ; Ruth Oluwakemi OGUNSAKIN
Biomedical and Environmental Sciences 2018;31(7):539-544
7.Theoretical axial wall angulation for rotational resistance form in an experimental-fixed partial denture.
John Francis BOWLEY ; Elizabeth Krall KAYE ; Raul Isidro GARCIA
The Journal of Advanced Prosthodontics 2017;9(4):278-286
PURPOSE: The aim of this study was to determine the influence of long base lengths of a fixed partial denture (FPD) to rotational resistance with variation of vertical wall angulation. MATERIALS AND METHODS: Trigonometric calculations were done to determine the maximum wall angle needed to resist rotational displacement of an experimental-FPD model in 2-dimensional plane. The maximum wall angle calculation determines the greatest taper that resists rotation. Two different axes of rotation were used to test this model with five vertical abutment heights of 3-, 3.5-, 4-, 4.5-, and 5-mm. The two rotational axes were located on the mesial-side of the anterior abutment and the distal-side of the posterior abutment. Rotation of the FPD around the anterior axis was counter-clockwise, Posterior-Anterior (P-A) and clockwise, Anterior-Posterior (A-P) around the distal axis in the sagittal plane. RESULTS: Low levels of vertical wall taper, ≤ 10-degrees, were needed to resist rotational displacement in all wall height categories; 2–to–6–degrees is generally considered ideal, with 7–to–10–degrees as favorable to the long axis of the abutment. Rotation around both axes demonstrated that two axial walls of the FPD resisted rotational displacement in each direction. In addition, uneven abutment height combinations required the lowest wall angulations to achieve resistance in this study. CONCLUSION: The vertical height and angulation of FPD abutments, two rotational axes, and the long base lengths all play a role in FPD resistance form.
Denture, Partial*
;
Denture, Partial, Fixed
9.The prevalence of CYP2D6 Gene Polymorphisms among Filipinos and their use as biomarkers for lung cancer risk
Eva Maria Cutiongco-de la Paz ; Corazon A. Ngelangel ; Aileen David-Wang ; Jose B. Nevado Jr. ; Catherine Lynn T. Silao ; Rosalyn Hernandez-Sebastian ; Richmond B. Ceniza ; Leander Linus Philip P. Simpao ; Lakan U. Beratio ; Eleanor A. Dominguez ; Albert B. Albay Jr ; Rey A. Desales ; Nelia Tan-Liu ; Sullian Sy-Naval ; Roberto M. Montevirgen ; Catalina de Siena Gonda-Dimayacyac ; Pedrito Y. Tagayuna ; Elizabeth A. Nuqui ; Arnold Joseph M. Fernandez ; Andrew D. Dimacali ; Maria Constancia Obrerro-Carrillo ; Virgilio P. Banez ; Oliver G. Florendo G. Florendo ; Ma. Cecilia M. Sison ; Francisco T. Roxas ; Alberto B. Roxas ; Orlino C. Bisquera Jr. ; Luminardo M. Ramos ; John A. Coloma ; Higinio T. Mappala ; Alex C. Tapia ; Emmanuel F. Montana Jr. ; Jonathan M. Asprer ; Reynaldo O. Joson ; Sergio P. Paguio ; Conrado C. Cajucom ; Richard C. Tia ; Tristan Chipongian ; Joselito F. David ; Florentino C. Doble ; Maria Noemi G. Pato ; Hans Francis D. Ferraris ; Benito B. Bionat Jr. ; Adonis A. Guancia ; Eriberto R. Layda ; Frances Maureen C. Rocamora ; Roemel Jeusep Bueno ; Carmencita D. Padilla
Acta Medica Philippina 2017;51(3):207-215
Objectives:
The highly polymorphic nature of the CYP2D6 gene and its central role in the metabolism of commonly used drugs make it an ideal candidate for pharmacogenetic screening. This study aims to determine the prevalence of CYP2D6 polymorphisms among Filipinos and their association to lung cancer.
Method:
Forty seven single nucleotide polymorphisms (SNPs) of the CYP2D6 gene were genotyped from DNA samples of 115 cases with lung cancer and age- and sex-matched 115 controls.
Results:
Results show that 18 out of 47 polymorphisms have significant genotypic variability (>1% for at least 2 genotypes). No variant is associated with lung cancer. However, rs1135840,
rs16947 and rs28360521, were found to be highly variable among Filipinos.
Conclusion
This study demonstrated that CYP2D6 polymorphisms are present among Filipinos, which, although not found to be associated with lung cancer, can be useful biomarkers for future pharmacogenetic studies. The SNP rs16947 is found to be associated with cancer and timolol-induced bradycardia; the SNP rs1135840, on the other hand, is only shown to be linked with cancer. The genetic variant rs28360521 is known to be associated with low-dose aspirin-induced lower gastrointestinal bleeding.
Pharmacogenetics
;
Cytochrome P-450 CYP2D6
;
Lung Neoplasms
;
Biomarkers
10.Genetic polymorphisms in NAT1, NAT2, GSTM1, GSTP1 and GSTT1 and susceptibility to colorectal cancer among Filipinos
Eva Maria C. Cutiongco-de la Paz ; Corazon A. Ngelangel ; Virgilio P. Bañ ; ez ; Francisco T. Roxas ; Catherine Lynn T. Silao ; Jose B. Nevado Jr. ; Alberto B. Roxas ; Oliver G. , Florendo ; Ma. Cecilia M. Sison ; Orlino Bisquera, Jr ; Luminardo M. Ramos ; Elizabeth A. Nuqui ; Arnold Joseph M. Fernandez ; Maria Constancia O. Carrillo ; Beatriz J. Tiangco ; Aileen D. Wang ; Rosalyn H. Sebastian ; Richmond B. Ceniza ; Leander Linus Philip P. Simpao ; Lakan U. Beratio ; Eleanor A. Dominguez ; Albert B. Albay Jr. ; Alfredo Y. Pontejos Jr. ; Nathaniel W. Yang ; Arsenio A. Cabungcal ; Rey A. Desales ; Nelia S. Tan-Liu ; Sullian S. Naval ; Roberto M. Montevirge ; Catalina de Siena E. Gonda-Dimayacyac ; Pedrito Y. Tagayuna ; John A. Coloma ; Gil M. Vicente ; Higinio T. Mappala ; Alex C. Tapia ; Emmanuel F. Montana Jr. ; Jonathan M. Asprer ; Reynaldo O. Joson ; Sergio P. Paguio ; Tristan T. Chipongian ; Joselito F. David ; Florentino C. Doble ; Maria Noemi G. Pato ; Benito B. Bionat Jr ; Hans Francis D. Ferraris ; Adonis A. Guancia ; Eriberto R. Layda ; Andrew D. Dimacali ; Conrado C. Cajucom ; Richard C. Tia ; Mark U. Javelosa ; Regie Lyn P. Santos-Cortez ; Frances Maureen C. Rocamora ; Roemel Jeusep Bueno ; Carmencita D. Padilla
Acta Medica Philippina 2017;51(3):216-222
Objectives. Polymorphisms in metabolic genes which alter rates of bioactivation and detoxification have been shown to modulate susceptibility to colorectal cancer. This study sought to evaluate the colorectal cancer risk from environmental factors and to do polymorphism studies on genes that code for Phase I and II xenobiotic metabolic enzymes among Filipino colorectal cancer patients and matched controls. Methods. A total of 224 colorectal cancer cases and 276 controls from the Filipino population were genotyped for selected polymorphisms in GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subject participants.Results. Univariate logistic regression of non-genetic factors identified exposure to UV (sunlight) (OR 1.99, 95% CI: 1.16-3.39) and wood dust (OR 2.66, 95% CI: 1.21-5.83) and moldy food exposure (OR 1.61, 95% CI:1.11-2.35) as risk factors; while the NAT2*6B allele (recessive model OR 1.51, 95% CI :1.06-2.16; dominant model OR 1.87, 95% CI: 1.05-3.33) and homozygous genotype (OR 2.19, 95% CI: 1.19-4.03) were found to be significant among the genetic factors. After multivariate logistic regression of both environmental and genetic factors, only UV radiation exposure (OR 2.08, 95% CI: 1.21-3.58) and wood dust exposure (OR 2.08, 95% CI: 0.95-5.30) remained to be significantly associated with increasing colorectal cancer risk in the study population.Conclusion. This study demonstrated that UV sunlight and wood dust exposure play a greater role in influencing colorectal cancer susceptibility than genotype status from genetic polymorphisms of the GST and the NAT` genes.
Colorectal Neoplasms
;
Polymorphism, Genetic


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