Helicobacter Pylori infection of the gallbladder and the risk of chronic cholecystitis and cholelithiasis: A systematic review and meta-analysis

Abstract

Background

Helicobacter pylori is coexisted with various diseases, including chronic gastritis, ulcer, and gastric cancer. Besides, chronic cholecystitis and cholelithiasis are extremely widespread over the world, which are considered as high health-care cost burdens of digestive diseases. Epidemiologic evidence on Helicobacter pylori infection in gallbladder increasing the risk of biliary diseases has been contradictory.

Aim

Conduct a meta-analysis of overall studies and investigate an association between Helicobacter pylori infection of the gallbladder with chronic cholecystitis/cholelithiasis.

Methods

We used PubMed, EMBASE, and Cochrane library databases to identify all published studies before August 2017. Pooled odds ratios (OR) and corresponding 95% confidence intervals (CIs) were obtained using the random effects model. Heterogeneity, sensitivity, and stratified analyses were also performed.

Results

Eighteen studies involving 1544 participants and 1061 biliary cases with chronic cholecystitis/cholelithiasis were included. Helicobacter pylori infection of the gallbladder was significantly associated with an increased risk of chronic cholecystitis and cholecystitis (OR = 3.022; 95% CI, 1.897-4.815; I² = 20.1%). In addition, country-based subgroup analysis also showed a positive association between Helicobacter pylori positivity and chronic cholecystitis/cholelithiasis risk. The ORs (95% CIs) for Asian and non-Asian region studies were 3.75 (1.83-7.71) and 2.25 (1.29-3.89), respectively.

Conclusion

This meta-analysis suggests that infection of the gallbladder with Helicobacter pylori is closely related to an increased risk of chronic cholecystitis and cholelithiasis.

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Turbinate reduction with complete preservation of mucosa and submucosa during rhinoplasty

Abstract

Background

Turbinate surgery is an important adjunct to functional and cosmetic rhinoplasty. Many studies have analyzed the effects of various mucosal-sparing techniques, such as radiofrequency, laser, shaver, and others. These techniques, however, result in the destruction of the submucosal tissue of the turbinate. The goal of this study was to determine whether excellent functional outcome could be achieved with techniques sparing both the mucosa and submucosa from destruction when addressing the turbinates in rhinoplasty surgery.

Materials and methods

A prospective single-surgeon clinical study analyzing submucous resection of turbinate bone without destruction of the submucosa or mucosa in patients undergoing functional–esthetic rhinoplasty was performed. In all, 122 patients (47 men, 75 women, average age: 32.1 years, range: 16–69 years) were eligible for the study. The functional outcome was measured prospectively using the Nasal Obstruction Symptom Evaluation (NOSE) score. Occurrence of complications was documented.

Results

Of over 1000 surgical patients, 307 candidates fulfilled multiple selection criteria and were entered in a rhinoplasty database. The surveys sufficient for the present study were completed by 122 of 307 patients (39.7%), of whom 91 patients reported improvement, 14 patients reported no subjective change, and 12 patients reported minimal worsening of nasal breathing. Overall, postoperative function was excellent (preoperative vs. postoperative NOSE score 47.5 vs. 20.1, p < 0.001). A large proportion of patients reporting worsening of symptoms (50%) were diagnosed with decongestant nasal spray abuse. Specific complications such as bleeding, foul drainage, dryness, and crusting were not reported.

Conclusion

All function-bearing structures of the inferior nasal turbinates, mucosa, and submucosa can be fully preserved without impairment of functional outcome during rhinoplasty. The technique of selective submucous bone resection is as an excellent alternative for patients undergoing rhinoplasty for concomitant treatment or prevention of nasal obstruction.

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All you need to know about varicose vein pain

A look at varicose vein pain, a condition where swollen veins become painful. Included is detail on prevention, potential causes, and when to see a doctor.

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Prevention of photosensitivity with action spectrum adjusted protection for erythropoietic protoporphyria

Abstract

Erythropoietic protoporphyria is a genetic disease characterized by sensitivity to sunlight caused by the accumulation of protoporphyrin IX. Photoprotection against ultraviolet A and visible light is necessary for erythropoietic porphyria patients because the absorption spectrum of protoporphyrin IX lies in both ultraviolet A and visible light region. We developed a novel index, in vitro porphyrin protection factor, based on the protoporphyrin IX absorbance spectrum. We also selected appropriate photoprotective products designed according to protoporphyrin IX absorbance. The porphyrin protection factors of a combination of make-up base with a powder as well as with a liquid foundation were significantly higher than those of a conventional sunscreen product, even at a small application dose. An in-use test carried out for 6 months showed that the efficacy of these products was 78.3%, and no adverse reactions were observed. Male subjects preferred liquid foundation, whereas all female subjects used powder foundation. The preference of the subjects could lead to the long-term use of the tested products. In conclusion, this study provided a new approach to improve photoprotection in erythropoietic protoporphyria patients.

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Centrifugal lipodystrophy of the scalp manifesting as centrifugal lipodystrophic alopecia

Summary

Centrifugal lipodystrophy (CLD), characterized by a depressed lesion in the abdominal skin, is a chronic disease occurring more often among younger patients of East Asian descent. We present an extremely unusual case of CLD of the scalp associated with reversible hair loss. The patient demonstrated alopecia in the frontal, temporal and occipital areas of the scalp, which connected to form a ring-shaped area of hair loss. Curiously, the area of hair loss gradually expanded outwards while the central region showed normal hair regrowth. Immunohistochemical analysis demonstrated reduced expression of leptin, an adipokine capable of inducing the anagen phase of the hair cycle, in the adipose tissue, associated with active inflammation. By contrast, recovery of leptin expression was observed at sites of healed inflammatory lesions, suggesting that reversible hair loss might be caused by a change in leptin expression in adipose tissue.

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An unusual onset of agminated Spitz naevi in an adult patient

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Antibiotic resistance rates in cutaneous propionibacteria from UK patients with acne are not falling

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