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      Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Helicobacter pylori Infection


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          Objective: It is currently unclear whether the Helicobacter pylori (H. pylori) infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period.

          Design: A case retrospective study.

          Methods: A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and H. pylori infection status determined by 13C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology.

          Results: 356 male subjects with mean age 78.5 ± 9.8 years were included. Active H. pylori infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between H. pylori positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the H. pylori positive group compared to the negative group (17.1 vs. 5.6%, P = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, H. pylori status still has significant interrelationship with NTIS (OR = 3.497, P = 0.003).

          Conclusions: There is a positive association between chronic active H. pylori infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of H. pylori infection on NTIS in elderly male patients.

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          Most cited references 44

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          A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

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            APACHE II: a severity of disease classification system.

            This paper presents the form and validation results of APACHE II, a severity of disease classification system. APACHE II uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status to provide a general measure of severity of disease. An increasing score (range 0 to 71) was closely correlated with the subsequent risk of hospital death for 5815 intensive care admissions from 13 hospitals. This relationship was also found for many common diseases. When APACHE II scores are combined with an accurate description of disease, they can prognostically stratify acutely ill patients and assist investigators comparing the success of new or differing forms of therapy. This scoring index can be used to evaluate the use of hospital resources and compare the efficacy of intensive care in different hospitals or over time.
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              Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report.

              Important progress has been made in the management of Helicobacter pylori infection and in this fifth edition of the Maastricht Consensus Report, key aspects related to the clinical role of H. pylori were re-evaluated in 2015. In the Maastricht V/Florence Consensus Conference, 43 experts from 24 countries examined new data related to H. pylori in five subdivided workshops: (1) Indications/Associations, (2) Diagnosis, (3) Treatment, (4) Prevention/Public Health, (5) H. pylori and the Gastric Microbiota. The results of the individual workshops were presented to a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in the various clinical scenarios.

                Author and article information

                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                08 July 2021
                : 8
                1Department of Endocrinology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases , Beijing, China
                2School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast , Belfast, United Kingdom
                3Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases , Beijing, China
                4Department of Statistics and Epidemiology, Graduate School of Chinese People's Liberation Army General Hospital , Beijing, China
                5Office of Information Management, Second Medical Center, Chinese People's Liberation Army General Hospital , Beijing, China
                Author notes

                Edited by: Giuseppe Losurdo, University of Bari Medical School, Italy

                Reviewed by: Edith Lahner, Sapienza University of Rome, Italy; Fabrizio Bossa, Casa Sollievo della Sofferenza (IRCCS), Italy

                This article was submitted to Gastroenterology, a section of the journal Frontiers in Medicine

                Copyright © 2021 Sun, Wang, McLarnon, Ding, Liu, Dai and Wang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 44, Pages: 9, Words: 6356
                Original Research


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