Effect of Helicobacter Pylori Eradication on Extent of Duodenal Gastric Metaplasia and Grade of Gastritis

The extent of the regression of duodenal gastric metaplasia (DGM) after the eradication of Helicobacter pylori infection is controversial. Therefore, we decided to assess the degree of DGM before, sex weeks and one year after H. pylori eradication. 105 consecutive Helicobacter pylori positive patients with endoscopically proven duodenal ulcer, with DGM and Helicobacter pylori infection were recruited for this study. The diagnosis of Helicobacter pylori infection was based on CLO-test and histology, and DGM was assessed on four bulb biopsies taken before, sex weeks and one year after Helicobacter pylori eradication. Histological assessment of Helicobacter pylori associated gastritis was performed according to the Sydney classification. Follow up study on 98 patients before, six weeks and one year after the eradication of Helicobacter pylori showed that the mean extent of DGM did not change significantly after eradication and did not differ when compared with 14 patients with persisting infection. Our results show that the inflammatory process related to Helicobacter pylori does not play the main role in the development of DGM

Slipping Anchor?: Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity

We propose tests of the two assumptions under which anchoring vignettes identify heterogeneity in reporting of categorical evaluations. Systematic variation in the perceived difference between any two vignette states is sufficient to reject vignette equivalence. Response consistency—the respondent uses the same response scale to evaluate the vignette and herself—is testable given sufficiently comprehensive objective indicators that independently identify response scales. Both assumptions are rejected for reporting of cognitive and physical functioning in a sample of older English individuals, although a weaker test resting on less stringent assumptions does not reject response consistency for cognition

Slipping anchor? Testing the vignettes approach to identification and correction of reporting heterogeneity

Anchoring vignettes are increasingly used to identify and correct heterogeneity in the reporting of health, work disability, life satisfaction, political efficacy, etc. with the aim of improving interpersonal comparability of subjective indicators of these constructs. The method relies on two assumptions: vignette equivalence – the vignette description is perceived by all to correspond to the same state; and, response consistency - individuals use the same response scales to rate the vignettes and their own situation. We propose tests of these assumptions. For vignette equivalence, we test a necessary condition of no systematic variation with observed characteristics in the perceived difference in states corresponding to any two vignettes. To test response consistency we rely on the assumption that objective indicators fully capture the covariation between the construct of interest and observed individual characteristics, and so offer an alternative way to identify response scales, which can then be compared with those identified from the vignettes. We also introduce a weaker test that is valid under a less stringent assumption. We apply these tests to cognitive functioning and mobility related health problems using data from the English Longitudinal Survey of Ageing. Response consistency is rejected for both health domains according to the first test, but the weaker test does not reject for cognitive functioning. The necessary condition for vignette equivalence is rejected for both health domains. These results cast some doubt on the validity of the vignettes approach, at least as applied to these health domains

Applicability ofMathematicalModels in Defining the Behaviour Kinetics Distinction Among Microbial Strains

Mathematical models were applied to define the behaviour kinetics distinction among microbial strains. In the first series of experiments the growth kinetics of microbial colonies of several S. rimosus mutant strains cultivated on agar plates were compared. Then, the interest was focused on the chosen two strains, in order to express mathematically their differences with respect to their colony growth and antibiotic biosynthesis kinetics. Finally, the behaviour of selected three S. rimosus derivative strains at different culture conditions was subjected to the study, with an aim to define strain distinction parameters. Mathematical models based on the three-dimensional growth concept and describing the microorganism growth, substrate uptake and antibiotic biosynthesis kinetics were developed. The computer simulation was applied to verify the applicability of mathematical models. The excellent agreement of computer simulation with experimental data confirmed the hypothesis that the kinetics parameters can be successfully applied to define the behaviour distinction among different S. rimosus strains. In the case of selected three strains, S. rimosus R6–500, S. rimosus MV9R-1 and MV9R-2, it was established that they can be distinguished by their growth kinetics parameters, their substrate uptake kinetics parameters and their antibiotic biosynthesis kineticsparameters. The strain S. rimosus R6–500 showed to be superior with respect to all kinetics parameters, the strain S. rimosus MV9R-2 showed to be slightly inferior to it, whereas the strain S. rimosus MV9R-1 showed to be inferior with respect to the both mentioned strains, especially because it showed the pronounced active biomass reduction rate at all investigated culture conditions. Based on these and the corresponding previous results one can conclude that appropriate mathematical models can be recommended for defining parameters of microbial behaviour distinction among different microbial strains of S. rimosus species

Inequality and polarisation in health systems’ responsiveness: a cross-country analysis

The World Health Report 2000 proposed three fundamental goals for health systems encompassing population health, health care finance and health systems responsiveness. The goals incorporate both an efficiency and equity dimension. While inequalities in population health and health care finance have motivated two important strands of research, inequalities in responsiveness have received less attention in health economics. This paper examines inequality and polarisation in responsiveness, bridging this gap in the literature and contributing towards an integrated analysis of health systems performance. It uses data from the World Health Survey to measure and compare inequalities in responsiveness across 25 European countries. In order to respect the inherently ordinal nature of the responsiveness data, median-based measures of inequality and polarisation are employed. The results suggest that, in the face of wide differences in the health systems analysed, there exists large variability in inequality in responsiveness across countries

Does Reporting Heterogeneity Bias The Measurement of Health Disparities?

Heterogeneity in reporting of health by socio-economic and demographic characteristics potentially biases the measurement of health disparities. We use anchoring vignettes to identify reporting heterogeneity in self reports on health for Indonesia, India and China. Correcting for reporting heterogeneity tends to reduce estimated disparities in health by age, sex (not Indonesia), urban/rural and education (not China) and to increase income disparities in health. Overall, while homogeneous reporting by socio-demographic group is significantly rejected, the results suggest that the size of the reporting bias in measures of health disparities is not large

Relationship of Gastric Metaplasia and Age, Sex, Smoking and Helicobacter pylori Infection in Patients with Duodenal Ulcer and Duodenitis

Gastric metaplasia is one of the factors in duodenal ulcer appearance. The aim of this study was to investigate the frequency of gastric metaplasia and its connection with age, sex, cigarette smoking and H. pylori infection. In the study 216 patients were included. There were 98 patients with duodenal ulcer, 60 with duodenitis, and 58 healthy control subjects. There was no statistically significant difference in gastric metaplasia frequency according to age and sex. Gastric metaplasia was statistically more significant in patients with duodenal ulcer (p < 0.01). In all the subjects cigarette smoking did not significantly influence gastric metaplasia. In smokers with duodenal ulcer, and those who besides duodenal ulcer and smoking had H. pylori infection gastric metaplasia was more frequent (p < 0.01). However, in patients with duodenal ulcer, there was no statistically significant difference of gastric metaplasia related to H. pylori presence. It may be suggested that H. pylori infection is not of indispensable significance for gastric metaplasia appearance