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Introduction: Helicobacter pylori is one of the most common causes of human gastritis. Recently, a new agent has been isolated, which also causes a gastritis. It has been initially named Gastrospirillum hominis and renamed Helicobacter heilmannii (Hh). Hh is extremely rare. In spite of the rarity it is important to recognize and diagnose it, as it requires a proper therapy, different from Hp therapy. Clinical presentation and serological results of Hh are superimposable to those of HP. Therefore differential diagnosis resides on histological grounds. PURPOSE of the present paper is to report 14 new cases of Hh gastritis, which constitutes the first italian series., Results: Cases constituted 0.01% of all gastric biopsies seen in the period 1994-1998. Nine patients were male and five were female; age ranged from 32 to 76 years (50 years on average). All patients presented a mild to moderate gastritis. Hh is a spiral bacterium, being about 10 micra in length, localized in single or small groups in the glandular mucus. Two cases were associated with Hp. One case was associated with gastric adenocarcinoma. Two cases were diagnosed during the follow-up of duodenal ulcer. In CONCLUSION, the incidence of Hh gastritis in the present series seems consistent with that from other European countries. In all cases the presence of Hh was associated with features of gastritis. This confirms the pathogenetic role of Hh.

Unlabelled: Helicobacter pylori (Hp) is connected with active/chronic gastritis, gastric gastric and duodenal ulcer. It is not known whether exogenous factors are involved in Hp infection. The aim of this prospective study, performed on 286 consecutive subjects undergoing upper gastrointestinal endoscopy, was to evaluate the influence of smoking and alcohol consumption on Hp infection. For each patient the following parameters were taken into account: sex, age, smoking (no, < 10, > 10 cig/day) and alcohol (no, < 40, > 40 g ethanol/day) intake, antiulcer therapy (no, H2-blockers, omeprazole, sucralfate), presence of gastric or duodenal ulcer (DU). At least two biopsies from both the antrum and the corpus were obtained for histological examination; the gastritis was classified and scored according to the Sydney system., Statistics: chi-squared test (corrected), Fisher's exact test., Results: 43 pts had Hp (27M, 16F; age 57.8 yrs, range 23-91), 47 Hp ++ (25M, 22F; age 61.1, range 19-86), 81 Hp + (48H, 33F; age 56, range 16-84), 115 Hp- (75M, 40F; age 57.8, range 19-84). Hp infection was found to be significantly correlated with presence of ulcer symptoms, gastritis, lymphoid follicles and, among DU patients, with active DU. The other parameters considered did not influence Hp infection. In conclusion smoking habits and alcohol consumption do not affect Hp infection of the stomach.

A multicentre clinical trial was conducted in 114 Italian endoscopy centres in order to evaluate the comparative efficacy of four different ranitidine dosage regimens in the short-term treatment of active duodenal ulcer. Results were analysed in a total of 1745 patients randomly allocated to treatment with ranitidine 150 mg twice daily - morning and 19h30 (440 patients), ranitidine 150 mg twice daily - morning and 22h30 (438 patients), ranitidine 300 mg once daily at 19h30 (434 patients) or ranitidine 300 mg once daily at 22h30 (433 patients). The four groups were well matched for patient characteristics at entry. Initial treatment was for three weeks, with continuation to six weeks in cases with endoscopically unhealed ulcers at three weeks. Efficacy was evaluated in terms of endoscopic ulcer healing and control of pain symptoms in 24 h (daytime, nocturnal, daytime plus nocturnal). No statistically significant differences were found between any of the groups either as regards control of pain symptoms or ulcer healing rates (mean healing rates at three and six weeks were 77% and 98%, respectively). The results in this very large patient sample confirm equivalent efficacy of twice daily and single bedtime dose regimens and provide no evidence for superior efficacy of early evening compared with bedtime administration. In the population as a whole, concomitance of the three main risk factors (more than 20 cigarettes/day, ulcer size greater than 1 cm, deformation of the duodenal cap) was associated with a distinctly lower three-week healing rate (40.9% versus 87.4% in patients presenting none of these factors), though this difference tended to disappear at six weeks.(ABSTRACT TRUNCATED AT 250 WORDS)