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Biomedical subjects

R Gabriel

Publications and source records attributed to R Gabriel.

At least 55 records · Page 3Linked to original sources
PubMed2001

Prevalence of appendectomy among ulcerative colitis patients and their relatives.

BACKGROUND: It has been suggested that appendectomy may protect against ulcerative colitis (UC). However, the incidences of appendectomy and UC in developed countries have diverged over the last 50 years, possibly as a consequence of environmental factors. AIM: To determine whether the incidence of appendectomy is lower in patients with UC than in the general population. METHODS: Patients with UC (153), their relatives (116) and members of the general population (306) that had been matched for age, sex and educational status were studied. RESULTS: Six per cent of UC patients had undergone appendectomy. The corresponding figure for non-family controls was 20% (P < 0.0001; OR = 0.27; 95% CI = 0.15-0.45). The rate of appendectomy within families (cases plus siblings) was 17/269 (6.3%) and was similar to that for UC patients alone(P < 0.001). CONCLUSIONS: A negative association between appendectomy and UC exists in our patients with UC. In addition, the appendectomy rate in families of UC patients was lower than that in the general population, possibly implying that common environmental and genetic factors could play an important role in the divergent incidences of appendicitis and UC over the last 50 years.

Adolescent↗
PubMed2001

The burden of musculoskeletal diseases in the general population of Spain: results from a national survey.

OBJECTIVE: The objective of the EPISER study was to estimate the prevalence of rheumatoid arthritis (RA), low back pain, hand and knee osteoarthritis (OA), and fibromyalgia in the adult Spanish population, and to assess the impact of these diseases on function and quality of life, and use of health and social resources. METHODS: 2998 subjects aged 20 years or above were randomly selected by stratified multistage cluster sampling from the censuses of 20 municipalities. Trained rheumatologists carried out structured visits at which subjects were asked about rheumatic symptoms and sociodemographic characteristics, completed validated instruments for measuring function (HAQ) and quality of life (SF-12), and underwent a standardised physical examination. Cases were defined by previously validated criteria. RESULTS: The estimated prevalences with 95% confidence intervals were as follows: RA lifetime cumulative: 0.5% (0.3 to 0.9); low back pain: 14.8% (12.2 to 17.4); symptomatic knee OA: 10.2% (8.5 to 11.9); hand OA: 6.2% (5.9 to 6.5); fibromyalgia: 2.4% (1.5 to 3.2). Most conditions significantly impaired function and quality of life. CONCLUSIONS: The EPISER study has internal and external validity for application of the results to the adult Spanish population. The diseases studied affect a significant proportion of the population, with various degrees of impact on disability and quality of life resulting in a significant number of physician visits, work disability, and medication use.

Adult↗
PubMed2001

Clinical findings of the second 1000 UK Gulf War veterans who attended the Ministry of Defence's Medical Assessment Programme.

OBJECTIVE: To review the diagnoses made in the second 1000 veterans of the Gulf conflict 1990-91 seen in the Ministry of Defence's Gulf Veterans' Medical Assessment Programme and to determine the main conditions related to Gulf service. DESIGN: Case series of 1000 consecutive Gulf veterans who presented to the programme between 25 February 1997 and 19 February 1998. SUBJECTS: Gulf War veterans. MAIN OUTCOME MEASURES: Assessment of the patient's health status. Diagnosis of medical and psychiatric conditions using ICD-10. RESULTS: 204 patients were unwell. 309 patients had organic disease, of whom 248 were well, 252 had psychiatric conditions which remained active in 173. The remaining 79, now well, had had psychiatric disorders following Gulf service. The principal psychiatric diagnosis was post traumatic stress disorder and the majority arose as a result of Gulf service. CONCLUSION: 796 (80%) veterans were well. There were 309 (31%) patients with organic disease. 252 (25%) veterans had psychiatric conditions of which 173 (69%) had an active diagnosed disorder and post traumatic stress disorder was the predominant condition. The pattern of disease is similar to that seen in NHS practice. We found, like others, no evidence to support a unique Gulf War syndrome. Post conflict illnesses have many common features.

Adult↗
PubMed2001

Problems and issues with door-to-door, two-phase surveys: an illustration from central Spain.

In 1994-1995, a screening and examination survey was conducted to ascertain the prevalence of dementia, Parkinson's disease and stroke in two urban communities and one rural community of central Spain. We use this survey to illustrate many nonclinical aspects of conducting two-phase prevalence surveys. Special emphasis is given to two common weaknesses in such surveys: screening nonparticipation and screening validation.

Aged↗
PubMed2001

Smoking characteristics: differences in attitudes and dependence between healthy smokers and smokers with COPD.

OBJECTIVE: To ascertain the differences in smoking characteristics between a group of smokers with COPD and another group of healthy smokers, both of which were identified in a population-based epidemiologic study. DESIGN AND PARTICIPANTS: This is an epidemiologic, multicenter, population-based study conducted in seven areas of SPAIN: A total of 4,035 individuals, men and women aged 40 to 69 years, who were selected randomly from a target population of 236,412 subjects, participated in the study. INTERVENTIONS: Eligible subjects answered the European Commission for Steel and Coal questionnaire. Spirometry was performed followed by a bronchodilator test when bronchial obstruction was present. The Fagerström questionnaire was used for study of the degree of physical nicotine dependence, and the Prochazka model was followed for analysis of the smoking cessation phase. RESULTS: Of 1,023 active smokers, 153 (15%) met the criteria for COPD. Smokers with COPD were more frequently men (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.21 to 3.95), were > or = 46 years of age (OR, 1.97; 95% CI, 1.18 to 3.31), had a lower educational level (OR, 1.96; 95% CI, 1.23 to 3.14), and had smoked > 30 pack-years (OR, 3.70; 95% CI, 2.42 to 5.65). Smokers with COPD showed a higher dependence on nicotine than healthy smokers (mean [+/- SD] Fagerström test score, 4.77 +/- 2.45 vs 3.15 +/- 2.38, respectively; p < 0.001) and higher concentrations of CO in exhaled air (mean concentration, 19.7 +/- 16.3 vs 15.4 +/- 12.1 ppm, respectively; p < 0.0001). Thirty-four percent of smokers with COPD and 38.5% of smokers without COPD had never tried to stop smoking. CONCLUSIONS: Smokers with COPD have higher tobacco consumption, higher dependence on nicotine, and higher concentrations of CO in exhaled air, suggesting a different pattern of cigarette smoking. Cases of COPD among smokers predominate in men and in individuals with lower educational levels. A significant proportion of smokers have never tried to stop smoking; thus, advice on cessation should be reinforced in both groups of smokers.

Adult↗
PubMed2001

Was the historic contribution of Spain to the Mexican gene pool partially responsible for the higher prevalence of type 2 diabetes in mexican-origin populations? The Spanish Insulin Resistance Study Group, the San Antonio Heart Study, and the Mexico City Diabetes Study.

OBJECTIVE: Mexican-American populations in San Antonio, Texas (SA-MA) and Mexico have a higher prevalence of type 2 diabetes than non-Hispanic whites in San Antonio (SA-NHW). However, the higher prevalence of type 2 diabetes in Mexican-origin populations might be related, in part, not to Native American genetic admixture but to Spanish genetic admixture. RESEARCH DESIGN AND METHODS: Four population-based epidemiological surveys conducted with Mexican-origin and European-origin samples provided data relevant to this question. In all four surveys, type 2 diabetes was defined as fasting plasma glucose > or =7.0 mmol/l or 2-h glucose > or =11.1 mmol/l or use of antidiabetic agents. RESULTS: A comparison of the two Mexican-origin populations showed that the age- and sex-adjusted prevalence of type 2 diabetes was lower in Mexico than in SA-MA (15.1 vs. 17.9%, P = 0.032). Between the two European-origin populations, the prevalence of type 2 diabetes was lower in SA-NHW than in Spain (6.2 vs. 9.1%, P < 0.0001), but differences were attenuated by adjustment for BMI or after stratification by education. In logistic regression analyses, type 2 diabetes was associated with Mexican ethnic origin after adjusting for age, education, BMI, and waist-to-hip ratio. CONCLUSIONS: The prevalence of type 2 diabetes in Spain was intermediate between that in Mexican-origin populations and SA-NHW. Although the higher degree of Native American admixture is a major contributor to the higher rates of type 2 diabetes, we cannot completely rule out a partial contribution of Spanish admixture to diabetes susceptibility among Mexican- origin populations.

Age Factors↗
PubMed2001

Association of MALTectomy (appendectomy and tonsillectomy) and inflammatory bowel disease: a familial case-control study.

UNLABELLED: There is some controversy regarding the prevalence of tonsillectomy and appendectomy among patients with Crohn's disease (CD) and a lower rate of appendectomy among patients with ulcerative colitis (UC). However, some environmental and familial factors that could alter those figures have not been studied. OBJECTIVE: To explore the prevalence of MALTectomy (appendectomy and tonsillectomy) among patients with IBD, stressing those factors that may be significantly associated to it. METHOD: Age-and-sex matched case-control study in patients with IBD, their relatives and the general population. Two hundred and eighty seven cases were IBD patients (153 UC, and 134 CD), the "family control" group included 203 siblings and the population-based control group included 570 individuals. Potential confounding factors, such as smoking, educational level, oral contraceptive use, place of birth and residence up to the age of 15 years, were ruled out. RESULTS: Appendectomy and UC: 7% of UC patients had undergone appendectomy versus 20% (OR: 0.23; 95% CI: 0.11-0.5; p < 0.0001) of controls. Appendectomy rates in families with at least one case of UC were 17/153 (6.3%) and 61/306 (20%) in the control group (p < 0.001). Appendectomy and CD: Twelve per cent of CD patients had undergone appendectomy six months before the onset of the disease versus 17% among the control population (OR: 0.43; 95% CI: 0.29-0.95; p < 0.01). The frequency of appendectomy in families with at least one case of CD was 22/221 (10%), which was significantly lower (p < 0.05) than among the control group 45/264 (17%). No differences were found between IBD patients and familial controls. Tonsillectomy and CD: Forty six per cent of CD patients had undergone tonsillectomy versus 39% of control patients (OR: 1.77; 95% CI: 0.92-2.05; p = ns). Tonsillectomy and UC: Twenty eight per cent of UC patients had undergone tonsillectomy versus 39% of the population control group (OR: 1.07; 95 CI: 0.57-1.25: p = ns). In fact, no differences were found regarding the prevalence of tonsillectomies within families with IBD cases as compared to population controls. CONCLUSIONS: Appendectomy is not only less frequent among CD and UC patients, but also among their relatives, thus suggesting the existence of environmental and genetic factors with opposed etiological roles in IBD and appendicitis.

Adolescent↗
PubMed2000

[Orthostatic hypotension in the aged and its association with antihypertensive treatment].

BACKGROUND: To assess the prevalence of orthostatic hypotension (OH) in an elderly population and to evaluate the influence of hypertension control and of the type of antihypertensive drug used. METHODS: 2,700 elderly patients (> 65 years) from the EPICARDIAN study were included. Blood pressure (BP) was measured twice with the patient seated and once again 1 to 3 minutes afterwards with the patient standing. Hypertension is defined as BP > or = 140/90 mmHg or if the patient received antihypertensive treatment. Orthostatic hypotension was defined as a fall of SBP > or = 20 mmHg and/or DBP > or = 10 mmHg 1 to 3 minutes after the postural change. RESULTS: 71.6% of the patients were classified as hypertensive and 57.1% were receiving pharmacological treatment. The overall prevalence of OH was 6.8% among hypertensive patients, 8.1% and 3.4% in normotensives patients (p < 0.05). No significant difference was found in the prevalence of OH between those receiving (7.7%) or not (8.6%) antihypertensive medication. No association was found either between the prevalence of OH and the type or number of antihypertensive drugs used. 17.6% of the patients reached hypertension optimal control (SBP < 140 and DBP < 90 mmHg), the prevalence of OH in these patients was 5.3%, among the uncontrolled the prevalence was 8.9% (p < 0.05). The adjusted OR was 1.91 (1.1-3.3) for the prevalence of OH in the uncontrolled patients versus the controlled. CONCLUSIONS: The prevalence of OH in the elderly is not very high, being greater among hypertensive than normotensive patients. No association was found between the prevalence of OH and the number of drugs received. Reaching hypertension control reduces the prevalence of OH.

Adrenergic alpha-Antagonists↗
PubMed2000

Somatostatin modulates voltage-gated K(+) and Ca(2+) currents in rod and cone photoreceptors of the salamander retina.

We investigated the cellular localization in the salamander retina of one of the somatostatin [or somatotropin release-inhibiting factor (SRIF)] receptors, sst(2A), and studied the modulatory action of SRIF on voltage-gated K(+) and Ca(2+) currents in rod and cone photoreceptors. SRIF immunostaining was observed in widely spaced amacrine cells, whose perikarya are at the border of the inner nuclear layer and inner plexiform layer. sst(2A) immunostaining was seen in the inner segments and terminals of rod and cone photoreceptors. Additional sst(2A) immunoreactivity was expressed by presumed bipolar and amacrine cells. SRIF, at concentrations of 100-500 nM, enhanced a delayed outwardly rectifying K(+) current (I(K)) in both rod and cone photoreceptors. SRIF action was blocked in cells pretreated with pertussis toxin (PTX) and was substantially reduced by intracellular GDP(beta)S. Voltage-gated L-type Ca(2+) currents in rods and cones were differently modulated by SRIF. SRIF reduced Ca(2+) current in rods by 33% but increased it in cones by 40%, on average. Both effects were mediated via G-protein activation and blocked by PTX. Ca(2+)-imaging experiments supported these results by showing that 500 nM SRIF reduced a K(+)-induced increase in intracellular Ca(2+) in rod photoreceptor terminals but increased it in those of cones. Our results suggest that SRIF may play a role in the regulation of glutamate transmitter release from photoreceptors via modulation of voltage-gated K(+) and Ca(2+) currents.

Ambystoma↗
PubMed2000

[Prostatic benign hypertrophy: review of effectiveness, tolerance, and impact on quality of life of prolonged treatment with alfuzosin].

OBJECTIVES: To evaluate the effectiveness of Alfuzosin in terms of long term effect in BHP patients. To analyze the effectiveness according to the observer, the treatment compliance and the tolerance of alfuzosin, and specifically, cardiovascular and sexually adverse events. Also, to define the clinical profile of the BPH patients that spontaneously seek medical treatment in Spain. DESIGN OF THE STUDY: Observational, descriptive, multicentric and 6-month retrospective study. DATA SOURCES AND COLLECTION: From the patient reports of BPH patients treated with alfuzosin during more than 6 months, data gathered were, along with usually anamnesic data and physical exploration (age, symptoms, blood pressure, e.g.), those related to treatment response, effectiveness, compliance and tolerance of Alfuzosin in the first and second quarter. Data of the 1635 patients initially recruited were considered to define the clinical profile of this population. Effectiveness and tolerance analysis were undertaken with the 911 patients who followed the treatment during the 6-month study. RESULTS: After 6 months of treatment an improvement of the mean intensity of each of the urinary symptoms were statistically significant (p < 0.005). Also, the mean score of each of the analyzed variables and of the I-PSS global score were reduced significantly (p < 0.005). After 6 months of treatment the effectiveness evaluated by the observer was good or very good for the 88.5% of the patients. Treatment compliance was very good; from the 911 patients finishing the study, 96.4% continued with the initially prescribed treatment. Just 16 patients (3%) developed adverse events; measures undertaken were to modify the dosage or to interrupt the treatment (2 cases). The specific study of cardiovascular adverse events showed a mild reduction in the systolic (142 mmHg versus 137.86 mmHg) and diastolic blood pressure (83.53 mmHg) versus 80.72 mmHg), and the heart rate (76.80 l/m versus 76.04 l/m). The mean score of sexual life showed an improvement in all the items studied, although very slight. CONCLUSIONS: The usefulness, effectiveness and tolerance of a long term treatment with alfuzosin in HPB patients was confirmed. Alfuzosin is considered a first choice treatment in patients with the clinical profile described.

Adrenergic alpha-Antagonists↗
PubMed2000

[Prevalence of and attitudes towards smoking in a population over 40 years of age].

OBJECTIVES: Smoking is the main cause of preventable death in developed countries. One of the most relevant health care interventions is convincing smokers to quit. To achieve that end, it is important to know, in addition to the prevalence of smoking, the degree of physical addiction to nicotine and smokers' attitudes toward tobacco. MATERIAL AND METHODS: This study collects results from a Spanish national epidemiological study (the IBERPOC study) related to smoking addiction, smokers' degree of addiction to nicotine and smokers attitudes toward their habits. The data has been obtained by surveying 4,035 individuals selected randomly from census data in seven different parts of the country. Information was obtained from questionnaires and CO in expired air was measured. RESULTS: One thousand fifty-nine respondents were smokers (26%) and 968 were ex-smokers (24%). Female smokers were younger (47 versus 51 years old) and had started smoking later (at age 22 versus 17 years), smoked fewer cigarettes per day (15 versus 21) and had lower concentrations of CO in expired air (13.4 versus 17 ppm) (p < 0.001 for all comparisons). Six hundred fifty-nine smokers (62.2%) had tried to quit at least once. The most important reasons given for trying to quit were related to improving health. CONCLUSIONS: The 26% of the surveyed population smoked. Women generally started later, smoked fewer cigarettes and were less physically addicted to nicotine. Most smokers had tried at least once to quit, particularly if motivated to improve health. These results should be considered when proposing strategies for smoking cessation.

Adult↗
PubMed2000

Acardiac fetus in a triplet pregnancy: ultrasound pitfalls. A case report.

This communication aims at illustrating ultrasound diagnostic difficulties in early pregnancy with acardiac fetus. Our case concerns a spontaneously conceived triplet pregnancy. It was diagnosed as a twin pregnancy at 11 weeks of amenorrhea. One and a half months later the patient was referred to our center for spontaneous premature rupture of membranes with the diagnosis of a fetal demise in a triplet pregnancy. The definite diagnosis of acardia was assessed sonographically by the presence of a reverse blood flow through the umbilical cord, reflex movements, limbs anomalies and discordance between femoral and crown-rump length. Two days after admission, the patient developed chorioamnionitis and the three fetuses were expelled.

Adult↗
PubMed2000

Influence of light and neural circuitry on tyrosine hydroxylase phosphorylation in the rat retina.

Light has been shown to increase dopamine synthesis and release in vertebrate retinas, but the retinal circuits mediating the light signal are unknown. We utilized three antibodies which recognize phosphorylated forms of tyrosine hydroxylase (TH) at serines 19, 31, and 40 to study the effects of light and neuroactive drugs on TH phosphorylation in the rat retina. Phosphorylated TH and total TH immunoreactivities were co-localized exclusively in retinal neurons whose shape and location are characteristic of dopaminergic interplexiform cells. Phosphorylated TH was weak to absent in darkness, but light strongly stimulated phosphorylation in all the three serine residues. Light-induced phosphorylation of TH induction by light was uniformly blocked by a combination of NMDA and AMPA glutamate receptor antagonists. In darkness, the combination of NMDA+AMPA induced phosphosphorylation of TH at serines 19 and 40 but it was weak at serine 31. A GABA(A) antagonist had the same effect. An agonist of depolarizing (ON) bipolar cells, L-(+)-2-amino-4-phosphonobutyric acid, did not prevent light-induced phosphorylated TH formation. Carbachol, a non-specific cholinergic agonist, selectively induced phosphorylation of TH at serine 31 in darkness, an effect which was blocked by the nicotinic antagonist, d-tubocurarine. These results show that retinal circuits involving glutamatergic, GABAergic and cholinergic synapses influence phospho-TH formation at different serine residues in this enzyme. Gamma amino butyric acid (GABA) and glutamate influence TH phosphorylation at serines 19 and 40, whereas cholinergic inputs affect its phosphorylation at serine 31.

Animals↗
PubMed2000

[Human papillomavirus typing in routine cervical smears. Results from a series of 3778 patients].

AIM: As human papillomavirus (HPV) infection is a significant risk factor for cervical cancer, the aim of this study was to assess the efficacy of HPV detection techniques in predicting the presence or the development of a high-grade squamous intra epithelial lesion. Additional reasons for carrying out this investigation were as follows. It was considered that the clinical value of HPV typing may have been underestimated in certain previous reports, which based their findings on first-generation assays. Moreover, until the present investigation most studies only investigated the cases with abnormal smear findings and did not include long-term follow-up, nor detailed follow-up of women with a normal smear but positive HPV typing, although this patient subgroup is of particular interest. The patient population included 3778 women who underwent routine cytological cervical screening and who gave their informed consent to participate in this study, consisting of a cervical smear, HPV testing via a second-generation Hybrid Capture II assay (which is more sensitive than first-generation tests, and can detect 18 different HPV types, i.e., 13 oncogenic and five non-oncogenic types); and in the case of abnormal smear findings, colposcopic examination and directed biopsies of the sites of suspected lesions. The women with cytomorphologically normal cervical smears but which who HPV-positive were reexamined six months later. RESULTS: HPV findings were positive in 66 cases where the initial smear indicated the presence of a high-grade lesion with the diagnosis confirmed by biopsy in 65 cases; in 155 cases (76.1%) where the initial smear indicated the presence of a low-grade lesion; in 44 (57.1%) out of 77 smears indicating the presence of ASCUS-type (atypical squamous cells of undetermined significance) lesions; and in 366 cases (10.5%) of apparently normal initial smears. After colposcopy and follow-up, a final diagnosis of high-grade lesion was made for 85 patients. All these patients were found to have high-risk (oncogene-positive) HPV at the first examination, but in only 65 cases (76.5%) was the initial smear indicative of a high-grade lesion. Finally, in the patient groups with low-grade or ASCUS-type smear findings or with an apparently normal smear, a high-grade lesion was only found in those patients with persistent high-risk HPV infection. In all, the sensitivity of the Hybrid Capture II assay in detecting high-grade lesions was 100% versus 85.9% for standard cytology. However, its specificity (86.3%) and positive predictive value were not as high as the latter. CONCLUSION: The results of this study indicate that HPV typing via this second-generation assay displays good sensitivity for the detection of at-risk cases, i.e., those involving the presence or development of high-grade cervical lesions. However, a number of issues have to be addressed before HPV typing is adopted in clinical practice, such as the fairly high HPV prevalence in women aged over 60 years, and whether the implications of this are the same as for younger age groups. Also, the present cost of complete typing remains too high for it to be used on a widespread scale. Nevertheless, HPV typing may have a useful role to play in the detection of cervical cancer.

Adult↗
PubMed2000

Helicobacter pylori eradication: proton pump inhibitor vs. ranitidine bismuth citrate plus two antibiotics for 1 week-a meta-analysis of efficacy.

OBJECTIVE: To compare the efficacy of proton pump inhibitor vs. ranitidine bismuth citrate (RBC) with two antibiotics for 1 week in Helicobacter pylori eradication. METHODS: Randomized trials comparing 1-week regimens with (i) proton pump inhibitor plus two antibiotics [clarithromycin (C) and amoxycillin (A) or a nitroimidazole (N)]; or (ii) RBC plus the same antibiotics. Eradication was confirmed by histology or 13C-urea breath test at least 4 weeks after therapy. Data sources included PubMed database and abstracts from congresses until October 1999. Statistical analysis was by meta-analysis combining the odds ratios (OR) of the individual studies in a global OR (Peto method). RESULTS: Twelve studies met the selection criteria. Nine compared proton pump inhibitor vs. RBC plus C and A, and five compared proton pump inhibitor vs. RBC plus C and N. With RBC, C and A, mean H. pylori eradication efficacy by intention-to-treat analysis (pooled data) was 76.6% (95% CI: 72-81%) and 73.7% (95% CI: 69-78%) with proton pump inhibitor, C and A. The OR for the effect of RBC vs. proton pump inhibitor (plus C and A) on H. pylori eradication was 1.15 (95% CI: 0.8-1.64%). Mean H. pylori eradication with RBC, C and N was 87. 2% (95% CI: 83-91%), and 74.9% (95% CI: 74-84%) with proton pump inhibitor plus these two antibiotics. The OR for the effect of RBC vs. proton pump inhibitor (plus C and N) on H. pylori eradication was 1.76 (95% CI: 1.08-2.85%). CONCLUSION: RBC and proton pump inhibitor have similar efficacy for H. pylori eradication when given with C and A for 1 week, but RBC seems to have a higher efficacy than proton pump inhibitor when C and N are the co-prescribed antibiotics.

Amoxicillin↗
PubMed2000

Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta-analysis of eradication of Helicobacter pylori.

AIM: To perform a meta-analysis of studies comparing twice daily, one-week triple therapy with a proton pump inhibitor, clarithromycin (C) and amoxycillin (A) (PCA) vs. those using proton pump inhibitor, clarithromycin and a nitroimidazole (N) (PCN) for H. pylori eradication. REVIEW METHODS SELECTION CRITERIA: Comparative randomized trials of PCA vs. PCN were included. DATA SOURCES: PubMed database and abstracts from congresses until September 1999. STATISTICS: Meta-analysis was performed combining the Odds Ratios (OR) of the individual studies in a global OR (Peto method) both on an intention-to-treat (ITT) and on a per protocol (PP) basis. RESULTS: Twenty-two studies fulfilled the inclusion criteria. Eighteen studies reported ITT and 20 PP analysis. Mean H. pylori eradication rates were 81% (95% CI: 79-83%) ITT, and 84% (82-86%) PP with PCA, and 81% (78-83%) ITT and 84% (82-86%) PP with PCN; the odds ratio for the effect of PCA vs. PCN was 1 (0.83-1.22) on an ITT, and 0.98 (0.8-1.2) on a PP basis. Subanalysis showed that mean H. pylori eradication efficacy with PC(250 b.d.)A was 81% (78-85%) ITT, vs. 86% (83-89%) with PC(250 b.d.)N. The odds ratio for this comparison was 0.68 (0.48-0.98). Finally, when comparing PC(500 b.d. )A against PC(250 b.d.)N ITT cure rates were 77% (74-80%), and 75% (72-78%) with an odds ratio of 1.18 (0.93-1.5). CONCLUSION: Overall, one-week combination regimens of PCA and PCN present similar H. pylori eradication efficacy. Nevertheless, the PCN regimen obtains significantly better results when using low doses of C (250 mg b.d.).

Amoxicillin↗
PubMed2000

Human papillomavirus detection by the hybrid capture II assay: a reliable test to select women with normal cervical smears at risk for developing cervical lesions.

The reliability of the Hybrid Capture II (HC-II; Digene, Silver Spring, MD, U.S.A.) assay was tested in detecting 18 human Papillomavirus (HPV) types for the screening of cervical lesions. Cytology, HPV testing, colposcopy, and biopsy were used to monitor 204 women with normal smears at the first entry. The median follow-up was 15 months (range, 4-27 months). The primary endpoint was clinical progression defined as the presence of a cervical intraepithelial lesion at the biopsy. In the patient population of 204 HPV-infected women, 81 (39.7%) had a persistent HPV infection at two or three examinations with a final histologic diagnosis of 14 high-grade and 13 low-grade squamous intraepithelial lesions (SIL) within 4 to 22 months. Women with regressive HPV infection did not develop any lesion during the same period. The evaluation of the viral load of high-risk HPV by the HC-II did not represent a sensitive approach to predict the persistence or the apparition of high-grade lesions. Thus, persistent high-risk HPV infection detected with HC-II represents a reliable tool to select populations at risk for the development of high-grade cervical lesions.

Adolescent↗