AIM:To examine the effects of long-term proton pump inhibitor (PPI) therapy on body weight (BW) and body mass index (BMI) in patients with gastroesophageal reflux disease (GERD).METHODS: The subjects were 52 patients ...AIM:To examine the effects of long-term proton pump inhibitor (PPI) therapy on body weight (BW) and body mass index (BMI) in patients with gastroesophageal reflux disease (GERD).METHODS: The subjects were 52 patients with GERD and 58 sex-and age-matched healthy controls. GERD patients were treated with PPI for a mean of 2.2 years (range, 0.8-5.7 years), and also advised on lifestyle modifications (e.g. selective diet, weight management). BW, BMI and other parameters were measured at baseline and end of study.RESULTS: Twenty-four GERD patients were treated daily with 10 mg omeprazole, 12 with 20 mg omeprazole, 8 with 10 mg rabeprazole, 5 with 15 mg lansoprazole, and 3 patients with 30 mg lansoprazole. At baseline, there were no differences in BW and BMI between reflux patients and controls. Patients with GERD showed increases in BW (baseline: 56.4±10.4 kg, end: 58.6±10.8 kg, mean±SD, P<0.0001) and BMI (baseline: 23.1±3.1 kg/m2, end: 24.0±3.1 kg/m2, P<0.001), but no such changes were noted in the control group. Mean BW increased by 3.5 kg (6.2% of baseline) in 37 (71%) reflux patients but decreased in only 6 (12%) patients during treatment.CONCLUSION: Long-term PPI treatment was associated with BW gain in patients with GERD. Reflux patients receiving PPI should be encouraged to manage BW through lifestyle modifi cations.展开更多
AIM： To meta-analyse the European abstracts presented between 1997-2004 at the European Hpylori Study Group, United European Gastroenterology Week meetings and World Congresses of Gastroenterology. METHODS： The abst...AIM： To meta-analyse the European abstracts presented between 1997-2004 at the European Hpylori Study Group, United European Gastroenterology Week meetings and World Congresses of Gastroenterology. METHODS： The abstracts of randomized/controlled prospective studies were classified into groups based on first-line eradication schedules. The quality of the abstracts was checked by a validated score system. The pooled eradication rates （PER） and combined odds ratios （OR） were calculated and compared with the published meta-analyses. RESULTS： The PER of proton pump inhibitor-based （PPI） one week triple therapies was 81.4% （confidence interval, 95% CI： 78.5-84.5）. Ranitidine bismuth citratebased （RBC） triple regimens have an efficiency rate of 78.5% （95% CI： 70.5%-84.3%） （P = 0.28 vs PPI）. The OR for PPI effect vs RBC regimens was 1.1 （95% CI： 0.92-1.30）. H2 receptor antagonist-based triple therapies achieved 64.1% （95% CI： 52.6-75.6） （P = 0.02 〈 0.05 vs PPI）, the OR vs PPI regimens was 1.55 （95% CI： 0.72-3.78）. PPI-based double combinations were less efficient than triple regimens （PER： 55.0%, OR： 4.90, 95% CI： 2.36-9.70）. Quadruple regimens were successful in 82.6% （95% CI： 76.0-89.7）, the OR vs triple therapies was 0.80 （0.62-1.03）. Clarithromycin ＋ amoxicillin or nitroimidazole combinations were efficient in 80.5% （95% CI： 77.2-84.2） and 83.8% （95% CI： 81.7-85.9）, respectively. Amoxicillin ＋ nitromidazole therapies eradicated the infection in 73.5% （66.6-78.5） （P = 0.01 〈 0.05 vs clarithromycin-based regimens）. CONCLUSION： PPI/RBC-based triple therapies achieved comparable results with the meta-analyses. H2-receptor antagonists and PPI-based double combinations were less efficient. Triple and quadruple regimens were equally effective. Clarithmmycin ＋ either amoxicillin or nitroimidazole containing regimens were more effective than amoxicillin ＋ nitroimidazole combinations. High quality congress abstracts constitutes a valuable pool of data which is suitable for meta-analytical workup.展开更多
AIM:To evaluate the trends in the eradication rate of Helicobacter pylori(H.pylori) over the past 11 years in a single center.METHODS:This retrospective study covered the period from January 2000 to December 2010.We e...AIM:To evaluate the trends in the eradication rate of Helicobacter pylori(H.pylori) over the past 11 years in a single center.METHODS:This retrospective study covered the period from January 2000 to December 2010.We evaluated 5746 patients diagnosed with gastric ulcers(GU),duodenal ulcers(DU),GU + DU,or nonpeptic ulcers associated with an H.pylori infection.We treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor(PPI) + amoxicilin + clarithromycin(PAC;PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day).The follow-up test was performed at least 4 wk after the completion of the 2 wk standard H.pylori eradication using the PAC regimen.We also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen(PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.i.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.) after the failure of the first-line therapy.Statistical analysis was performed with 95%CI for the differences in the annual eradication rates.RESULTS:A total of 5746 patients [2333 males(58.8%),1636 females(41.2%);mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P < 0.05,total mean age 51.9 ± 13.3 years(mean ± SD)] were investigated.Among these patients,1674 patients were excluded:35 patients refused treatment;18 patients ceased H.pylori eradication due to side effects;1211 patients had inappropriate indications for H.pylori eradication,having undergone stomach cancer operation or chemotherapy;and 410 patients did not undergo the follow-up.We also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned above.Finally,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC therapy.The endoscopic and clinical findings in patients who received the 2 wk PAC were as follows:gastric ulcer in 855(21.5%);duodenal ulcer in 878(22.1%);gastric and duodenal ulcer in 124(3.1%),erosive,atrophic gastritis and functional dyspepsia in 2055(51.8%);and other findings(e.g.,MALToma,patients who wanted to receive the therapy even though they had no abnormal endoscopic finding) in 57(0.5%).The overall eradication rate of the 2 wk standard firstline triple regimen was 86.5%.The annual eradication rates from 2000 to 2010 were 86.7%,85.4%,86.5%,83.3%,89.9%,90.5%,88.4%,84.5%,89.1%,85.8%,and 88.3%,sequentially(P = 0.06).No definite evidence of a significant change in the eradication rate was seen during the past eleven years.The eradication rates of second-line therapy were 88.9%,82.4%,85%,83.9%,77.3%,85.7%,84.4%,87.3%,83.3%,88.9%,and 84%(P = 0.77).The overall eradication rate of 1 wk quadruple second-line therapy was 84.7%.There was no significant difference in the eradication rate according to the H.pylori associated diseases.CONCLUSION:This study showed that there was no trend change in the H.pylori eradication rate over the most recent 11 years in our institution.展开更多
文摘AIM:To examine the effects of long-term proton pump inhibitor (PPI) therapy on body weight (BW) and body mass index (BMI) in patients with gastroesophageal reflux disease (GERD).METHODS: The subjects were 52 patients with GERD and 58 sex-and age-matched healthy controls. GERD patients were treated with PPI for a mean of 2.2 years (range, 0.8-5.7 years), and also advised on lifestyle modifications (e.g. selective diet, weight management). BW, BMI and other parameters were measured at baseline and end of study.RESULTS: Twenty-four GERD patients were treated daily with 10 mg omeprazole, 12 with 20 mg omeprazole, 8 with 10 mg rabeprazole, 5 with 15 mg lansoprazole, and 3 patients with 30 mg lansoprazole. At baseline, there were no differences in BW and BMI between reflux patients and controls. Patients with GERD showed increases in BW (baseline: 56.4±10.4 kg, end: 58.6±10.8 kg, mean±SD, P<0.0001) and BMI (baseline: 23.1±3.1 kg/m2, end: 24.0±3.1 kg/m2, P<0.001), but no such changes were noted in the control group. Mean BW increased by 3.5 kg (6.2% of baseline) in 37 (71%) reflux patients but decreased in only 6 (12%) patients during treatment.CONCLUSION: Long-term PPI treatment was associated with BW gain in patients with GERD. Reflux patients receiving PPI should be encouraged to manage BW through lifestyle modifi cations.
文摘AIM： To meta-analyse the European abstracts presented between 1997-2004 at the European Hpylori Study Group, United European Gastroenterology Week meetings and World Congresses of Gastroenterology. METHODS： The abstracts of randomized/controlled prospective studies were classified into groups based on first-line eradication schedules. The quality of the abstracts was checked by a validated score system. The pooled eradication rates （PER） and combined odds ratios （OR） were calculated and compared with the published meta-analyses. RESULTS： The PER of proton pump inhibitor-based （PPI） one week triple therapies was 81.4% （confidence interval, 95% CI： 78.5-84.5）. Ranitidine bismuth citratebased （RBC） triple regimens have an efficiency rate of 78.5% （95% CI： 70.5%-84.3%） （P = 0.28 vs PPI）. The OR for PPI effect vs RBC regimens was 1.1 （95% CI： 0.92-1.30）. H2 receptor antagonist-based triple therapies achieved 64.1% （95% CI： 52.6-75.6） （P = 0.02 〈 0.05 vs PPI）, the OR vs PPI regimens was 1.55 （95% CI： 0.72-3.78）. PPI-based double combinations were less efficient than triple regimens （PER： 55.0%, OR： 4.90, 95% CI： 2.36-9.70）. Quadruple regimens were successful in 82.6% （95% CI： 76.0-89.7）, the OR vs triple therapies was 0.80 （0.62-1.03）. Clarithromycin ＋ amoxicillin or nitroimidazole combinations were efficient in 80.5% （95% CI： 77.2-84.2） and 83.8% （95% CI： 81.7-85.9）, respectively. Amoxicillin ＋ nitromidazole therapies eradicated the infection in 73.5% （66.6-78.5） （P = 0.01 〈 0.05 vs clarithromycin-based regimens）. CONCLUSION： PPI/RBC-based triple therapies achieved comparable results with the meta-analyses. H2-receptor antagonists and PPI-based double combinations were less efficient. Triple and quadruple regimens were equally effective. Clarithmmycin ＋ either amoxicillin or nitroimidazole containing regimens were more effective than amoxicillin ＋ nitroimidazole combinations. High quality congress abstracts constitutes a valuable pool of data which is suitable for meta-analytical workup.
文摘AIM:To evaluate the trends in the eradication rate of Helicobacter pylori(H.pylori) over the past 11 years in a single center.METHODS:This retrospective study covered the period from January 2000 to December 2010.We evaluated 5746 patients diagnosed with gastric ulcers(GU),duodenal ulcers(DU),GU + DU,or nonpeptic ulcers associated with an H.pylori infection.We treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor(PPI) + amoxicilin + clarithromycin(PAC;PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day).The follow-up test was performed at least 4 wk after the completion of the 2 wk standard H.pylori eradication using the PAC regimen.We also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen(PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.i.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.) after the failure of the first-line therapy.Statistical analysis was performed with 95%CI for the differences in the annual eradication rates.RESULTS:A total of 5746 patients [2333 males(58.8%),1636 females(41.2%);mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P < 0.05,total mean age 51.9 ± 13.3 years(mean ± SD)] were investigated.Among these patients,1674 patients were excluded:35 patients refused treatment;18 patients ceased H.pylori eradication due to side effects;1211 patients had inappropriate indications for H.pylori eradication,having undergone stomach cancer operation or chemotherapy;and 410 patients did not undergo the follow-up.We also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned above.Finally,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC therapy.The endoscopic and clinical findings in patients who received the 2 wk PAC were as follows:gastric ulcer in 855(21.5%);duodenal ulcer in 878(22.1%);gastric and duodenal ulcer in 124(3.1%),erosive,atrophic gastritis and functional dyspepsia in 2055(51.8%);and other findings(e.g.,MALToma,patients who wanted to receive the therapy even though they had no abnormal endoscopic finding) in 57(0.5%).The overall eradication rate of the 2 wk standard firstline triple regimen was 86.5%.The annual eradication rates from 2000 to 2010 were 86.7%,85.4%,86.5%,83.3%,89.9%,90.5%,88.4%,84.5%,89.1%,85.8%,and 88.3%,sequentially(P = 0.06).No definite evidence of a significant change in the eradication rate was seen during the past eleven years.The eradication rates of second-line therapy were 88.9%,82.4%,85%,83.9%,77.3%,85.7%,84.4%,87.3%,83.3%,88.9%,and 84%(P = 0.77).The overall eradication rate of 1 wk quadruple second-line therapy was 84.7%.There was no significant difference in the eradication rate according to the H.pylori associated diseases.CONCLUSION:This study showed that there was no trend change in the H.pylori eradication rate over the most recent 11 years in our institution.
