One-day Quadruple Therapy Compared With 7-day Triple Therapy For Helicobacter Pylori Infection
clarithromycin; cure; duodenal-ulcer disease; eradication; follow-up; General & Internal Medicine; nonulcer dyspepsia; peptic-ulcer; proton-pump inhibitor; term; united-states; urea breath test
Background: Eradication of Helicobacter pylori infection has had an impact on the treatment and recurrence rates of peptic ulcer disease and malignancies such as mucosa-associated lymphoid tissue lymphoma. Treatment options are cumbersome, expensive, and associated with side effects. Methods: Randomized, prospective, open-labeled equivalence trial with a parallel-group design to compare eradication rates of H pylori with a 1-day, 4-drug regimen with a 7-day, 3-drug regimen. A total of 160 patients with dyspepsia and a Glasgow Dyspepsia Severity Score of at least 3 had a urea breath test labeled with carbon 14. Patients who tested positive were randomized to 1 of the 2 study groups. The study was designed to test the therapeutic equivalence of 1-day and 7-day regimens based on the percentage of H pylori eradication in each group at 5 weeks. Results: The 1-day treatment group (n = 80) had a slightly higher eradication percentage (95%) than the 7-day group (90%). The possible inferiority of the 1-day treatment relative to the 7-day treatment, a 15% difference in the number of patients whose infection was not eradicated at 5 weeks, was rejected (P < .001; 90% confidence interval, 2.7%-11%). Both groups demonstrated a mean decrease of 7.5 points in the Glasgow Dyspepsia Severity Score. The 2 groups showed no significant differences in side effects. Patients whose treatment failed (4 in the 1-day treatment group and 7 in the 7-day treatment group) were retreated for 10 days. One patient from the 7-day treatment group still tested positive after the second treatment. Conclusions: The 1-day treatment proved to be statistically similar to the 7-day treatment for the eradication of H pylori in patients with dyspepsia and a positive urea breath test. Further evaluation will be necessary to determine whether the 1-day regimen is adequate for patients with peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma, or gastric adenocarcinoma.
Lara L F; Cisneros G; Gurney M; Van Ness M; Jarjoura D; Moauro B; Polen A; Rutecki G; Whittier F
Archives of Internal Medicine
2003
2003-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1001/archinte.163.17.2079" target="_blank" rel="noreferrer noopener">10.1001/archinte.163.17.2079</a>
NEPHROLOGISTS PERCEPTIONS ON DEATH AND THEIR IMPACT ON TERMINAL CARE
Urology & Nephrology
Rutecki G; Cugino A; Jarjoura D; Whittier F
Journal of the American Society of Nephrology
1995
1995-09
Journal Article
n/a
Ventricular tachycardia in acute myocardial infarction: the role of hypophosphatemia.
80 and over; Adult; Aged; Cardiac Complexes; Electrolytes/blood; Female; Humans; Hypophosphatemia/*complications; Logistic Models; Male; Middle Aged; Myocardial Infarction/blood/*complications; Premature/etiology; Tachycardia; Ventricular Fibrillation/etiology; Ventricular/blood/*etiology
The relationship between serum concentration of certain electrolytes and the pathogenesis of ventricular arrhythmia in myocardial infarction has been the subject of frequent review. The role of hypophosphatemia in the pathogenesis of arrhythmia in patients with acute myocardial infarction has not been as well studied. In our study group of 325 consecutive patients admitted to the coronary care unit of a community hospital, 111 were confirmed to have had a myocardial infarction. Patients were continuously monitored for ventricular arrhythmia during the first 24 hours, and the electrocardiographic records were reviewed for documentation of arrhythmia. From an admission blood sample, measurement of electrolytes included serum phosphate, calcium, bicarbonate, potassium, and magnesium. Associations between ventricular tachycardia and serum electrolyte abnormalities including magnesium, potassium, phosphate, calcium, and bicarbonate were studied. Low phosphate (less than 2.6 mg/dL) was a significant predictor of ventricular tachycardia in the myocardial infarction group. In the entire group of 325 patients prior to the confirmation of myocardial infarction, both low bicarbonate and low phosphate were significant predictors of ventricular tachycardia during the first 24 hours of hospitalization. Although management of acidosis is considered early in the hospital course, phosphate replacement therapy is usually not as often considered. We recommend further study on the effectiveness of replacement therapy in hypophosphatemic patients with chest pain to reduce the risk of ventricular tachycardia.
Ognibene A; Ciniglio R; Greifenstein A; Jarjoura D; Cugino A; Blend D; Whittier F
Southern medical journal
1994
1994-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/00007611-199401000-00014" target="_blank" rel="noreferrer noopener">10.1097/00007611-199401000-00014</a>
Remission of nephrotic syndrome in type 1 diabetes: long-term follow-up of patients in the Captopril Study.
Adult; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use; Antihypertensive Agents/*therapeutic use; Blood Pressure/drug effects; Captopril/*therapeutic use; Chronic/etiology; Creatinine/blood; Diabetes Mellitus; Diabetic Nephropathies/*drug therapy/physiopathology; Disease Progression; Female; Follow-Up Studies; Humans; Kidney Failure; Male; Middle Aged; Nephrotic Syndrome/complications/*drug therapy/physiopathology; Prospective Studies; Proteinuria; Randomized Controlled Trials as Topic; Remission Induction; Type 1/*complications
In 1994, we reported a 3.4 +/- 0.8 year follow-up of the eight patients who experienced remission of nephrotic syndrome during the Collaborative Study Group-sponsored, multicenter trial of captopril therapy in patients with type 1 diabetes with nephropathy (Captopril Study). Of the 409 patients randomized to treatment on the Captopril Study, 108 had nephrotic syndrome (24-hour proteinuria \textgreater/= 3.5 g of protein) at baseline. Of these 108 patients, 8 experienced remission of nephrotic syndrome (proteinuria
Wilmer W A; Hebert L A; Lewis E J; Rohde R D; Whittier F; Cattran D; Levey A S; Lewis J B; Spitalewitz S; Blumenthal S; Bain R P
American journal of kidney diseases : the official journal of the National Kidney Foundation
1999
1999-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1053/AJKD03400308" target="_blank" rel="noreferrer noopener">10.1053/AJKD03400308</a>