Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974–2002

<p>Abstract</p> <p>Background</p> <p>Despite a decreasing incidence of peptic ulcer disease, most previous studies report a stabile incidence of ulcer complications. We wanted to investigate the incidence of peptic ulcer complications in Sweden before and after the introduction of the proton pump inhibitors (PPI) in 1988 and compare these data to the sales of non-steroid anti-inflammatory drugs (NSAID) and acetylsalicylic acid (ASA).</p> <p>Methods</p> <p>All cases of gastric and duodenal ulcer complications diagnosed in Sweden from 1974 to 2002 were identified using the National hospital discharge register. Information on sales of ASA/NSAID was obtained from the National prescription survey.</p> <p>Results</p> <p>When comparing the time-periods before and after 1988 we found a significantly lower incidence of peptic ulcer complications during the later period for both sexes (p < 0.001). Incidence rates varied from 1.5 to 7.8/100000 inhabitants/year regarding perforated peptic ulcers and from 5.2 to 40.2 regarding peptic ulcer bleeding. The number of sold daily dosages of prescribed NSAID/ASA tripled from 1975 to 2002. The number of prescribed sales to women was higher than to males. Sales of low-dose ASA also increased. The total volume of NSAID and ASA, i.e. over the counter sale and sold on prescription, increased by 28% during the same period.</p> <p>Conclusion</p> <p>When comparing the periods before and after the introduction of the proton pump inhibitors we found a significant decrease in the incidence of peptic ulcer complications in the Swedish population after 1988 when PPI were introduced on the market. The cause of this decrease is most likely multifactorial, including smoking habits, NSAID consumption, prevalence of Helicobacter pylori and the introduction of PPI. Sales of prescribed NSAID/ASA increased, especially in middle-aged and elderly women. This fact seems to have had little effect on the incidence of peptic ulcer complications.</p

Multi-genome identification and characterization of chlamydiae-specific type III secretion substrates: the Inc proteins

<p>Abstract</p> <p>Background</p> <p><it>Chlamydiae </it>are obligate intracellular bacteria that multiply in a vacuolar compartment, the inclusion. Several chlamydial proteins containing a bilobal hydrophobic domain are translocated by a type III secretion (TTS) mechanism into the inclusion membrane. They form the family of Inc proteins, which is specific to this phylum. Based on their localization, Inc proteins likely play important roles in the interactions between the microbe and the host. In this paper we sought to identify and analyze, using bioinformatics tools, all putative Inc proteins in published chlamydial genomes, including an environmental species.</p> <p>Results</p> <p>Inc proteins contain at least one bilobal hydrophobic domain made of two transmembrane helices separated by a loop of less than 30 amino acids. Using bioinformatics tools we identified 537 putative Inc proteins across seven chlamydial proteomes. The amino-terminal segment of the putative Inc proteins was recognized as a functional TTS signal in 90% of the <it>C. trachomatis </it>and <it>C. pneumoniae </it>sequences tested, validating the data obtained <it>in silico</it>. We identified a <it>macro </it>domain in several putative Inc proteins, and observed that Inc proteins are enriched in segments predicted to form coiled coils. A surprisingly large proportion of the putative Inc proteins are not constitutively translocated to the inclusion membrane in culture conditions.</p> <p>Conclusions</p> <p>The Inc proteins represent 7 to 10% of each proteome and show a great degree of sequence diversity between species. The abundance of segments with a high probability for coiled coil conformation in Inc proteins support the hypothesis that they interact with host proteins. While the large majority of Inc proteins possess a functional TTS signal, less than half may be constitutively translocated to the inclusion surface in some species. This suggests the novel finding that translocation of Inc proteins may be regulated by as-yet undetermined mechanisms.</p

Avaliação de dois esquemas de monitorização domiciliar em pacientes com diabetes mellitus do tipo 1 Evaluación de dos esquemas de monitorización domiciliar en pacientes com diabetes mellitus tipo 1 Evaluation of two monitoring schemes in type 1 diabetes mellitus patients

O estudo teve por objetivo avaliar a efetividade de esquemas de monitorização domiciliar sangüíneo e urinário, na obtenção de adequado controle glicêmico, em pacientes com diabetes mellitus do tipo 1, em regime quinzenal de ajuste terapêutico; durante 6 meses de participação em grupos educativos. A amostra foi de 34 pacientes divididos em dois grupos. Os pacientes do grupo A realizaram monitorização domiciliar da glicemia capilar 1 vez ao dia e os do grupo B realizaram monitorização domiciliar da glicosúria 1 vez ao dia, conforme esquemas preconizados. Estes esquemas possibilitaram construção de perfis e de ajustes terapêuticos. Os resultados mostraram que o uso sistemático dos testes domiciliares sangúíneos e urinários da forma prescrita, não proporcionou melhora significante no controle metabólico em nenhum dos dois grupos. Entretanto, favoreceu o processo educativo e possibilitou reflexões sobre a necessidade de intensificação da monitorização glicêmica.<br>Este estudio tiene como objetivo evaluar la efectividad de dos esquemas de monitorización sanguíneo y de orina a nivel domiciliar, para obtener un adecuado control glicémico en pacientes con diabetes mellitus tipo 1. El ajuste terapéutico se realizó a cada quince dias en el plazo de seis meses com la participación en grupos educativos. La muestra stubo formada por 34 pacientes divididos en dos grupos: los pacientes del grupo A realizaron monitorización domiciliar de la glicemia capilar una vez al dia y los del grupo B hicieron monitorización de la glicosuria también una vez al dia según esquemas pre-establecidos. Estos esquemas posibilitaron la construción de los perfiles y ajustes terapéuticos. Los resultados indicaron que el uso de los tests domiciliares sanguíneos y orinarios pre-estabelecidos en los dos grupos, no proporcionaran una mejoría significativa en el control metabólico. Sin embargo, favoreció en el proceso educativo, posibilitando reflexiones sobre la necesidad de intensificar la monitorización glicémica en el domicilio.<br>The goal of this study was to evaluate the effectiveness of two monitoring schemes(blood and urine) in the metabolic control of type l diabetic patients, in biweekly therapeutic adjustments, along 6 months of participation in the educational groups. A sample of 34 patients was divided in two groups. The interventions proposed to group A were daily blood glucose monitoring, during three consecutive days for each period (before breakfast, before lunch, before dinner and before bed) and biweekly in the dawn. For the other group B was proposed daily urine glucose monitoring, during three consecutive days for each period (before breakfast, before lunch, before dinner and before bed). These schemes were used to construct glycemic profile and to determine the therapeutic adjustments. The results evidenced that there was no significant statistical difference in the metabolic control after proposed intervention in each group. In spite of this, the monitoring facilitated the educacional process and the considerations about the use of more intensive monitoring schemes