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Background: Helicobacter pylori infection is common in Estonia: 87% of adults and 56% of children aged 9-15 years have been found to be H. pylori seropositive. The aim of this study was to evaluate the long-term recurrence rate after treatment in children and adolescents in a setting of high H. pylori prevalence. Methods: All children ( n = 27) who underwent gastroscopy at the Children's Clinic of Tartu University Clinics during 1993-95 and in whom H. pylori infection was verified by histological examination and rapid urease test and who had completed a treatment course against H. pylori infection were invited for a post-treatment follow-up endoscopy 4-6 weeks after completion of therapy (1st follow-up visit) and to the follow-up control by [ 13 C]-urea breath test in 1997 (2nd follow-up visit) and 2002 (3rd follow-up visit). Results: Recurrence of H. pylori infection occurred in 1 patient out of 16 at the 2nd follow-up visit (mean 17.8 ± 7.1 months after treatment), and in 5 patients out of 15 at the 3rd follow-up visit (mean 6.6 ± 0.9 years after treatment). The recurrence rate calculated for the period between the 1st and the 2nd follow-up visits was 4.2% per patient-year, and between the 2nd and the 3rd follow-up visits the rate was 7.6% (95% CI 2.5%-17.6%) per patient-year. The recurrence rate calculated for the whole follow-up period was 6.7% (95% CI 2.5%-14.5%) per patient-year. Conclusion: The post-treatment recurrence rate of H. pylori infection in children and adolescents is higher in Estonia than in low prevalence settings. [ABSTRACT FROM AUTHOR]

Background:The association of apoptosis was analysed in three different compartments (foveolar cells- FC, proliferating zone-PZ and glandular part-GP) of antrum and corpus mucosa specimens with development of atrophy and the extent of apoptosis as depending on grade of chronic inflammation, activity of gastritis and Helicobacter pyloricolonization at two time points of an 18-year follow-up in an adult population from Saaremaa, Estonia, with a high prevalence of H. pyloriinfection were compared. Methods:A total of 68 persons (31 men, 37 women; median age, 39 years in 1979) from a primary sample of 304 subjects, endoscoped in 1979 and reinvestigated by endoscopy and biopsy in 1997, were included in the study. The state of the gastric mucosa and the presence of H. pyloriin the antrum and corpus mucosa were assessed in accordance with the Sydney system. The dynamics of apoptotic index (AI) between two time points in 1979 and 1997 was evaluated in antrum biopsies of 49 persons and in corpus biopsies of 64 persons. Apoptosis was measured using terminal deoxyuridine nucleotide nick end labelling (TUNEL) histochemistry. Results:The antrum as well as the corpus of 2/68 persons were H. pylorinegative at both time points. Atrophy developed in 9/68 persons in the antrum and in 23/68 in the corpus. In PZ and GP of the corpus mucosa as well as in GP of the antrum mucosa, AI decreased significantly during 18 years compared with initial values (P< 0.05), which was not associated with development of atrophy. In all compartments of the antrum and corpus mucosa, studied at the initial and end points of observation, AI did not reveal a difference in persons with and without development of atrophy (P> 0.05). In the samples of 1979 the highest independent effect on the value of AI in the FC compartment for the antrum was exerted by grade of activity of gastritis (P= 0.01) and in GP by degree of chronic inflammation (P= 0.03), while in the samples of 1997 the highest effec... [ABSTRACT FROM AUTHOR]

Evaluates the course of chronic gastritis and its association with Helicobacter pylori and CagA seroposivity. Correlation between intestinal metaplasia and gastritis; Effect of atrophy on epithelial cells; Prevalence of antibodies on CagA.