Effectiveness of ranitidine bismuth citrate and proton pump inhibitor based triple therapies of Helicobacter pylori in Turkey

Background : Helicobacter pylori infection is the main cause of gastritis, gastroduodenal ulcer disease, MALT lymphoma, and adenocarcinoma of the stomach. The reported prevalence of H. pylori in the adult population in Turkey is 67.6%–81.3%. A national meta-analysis showed that the average H. pylori eradication rate with proton pump inhibitor-based triple regimens in Turkey had decreased from 84% in 1997 to 55.3% in 2004, suggesting a need to evaluate alternative regimens. Materials and methods : The study was a prospective, single-center trial with a parallel group design. After the selection procedure, consecutive out-patients were assigned to one of six study groups using random sampling numbers. All patients received amoxicillin 1,000 mg b.i.d. and clarithromycin 500 mg b.i.d. along with ranitidine bismuth citrate 400 mg b.i.d., or omeprazole 20 mg b.i.d., or lansoprazole 30 mg b.i.d., or rabeprazole 20 mg b.i.d., or pantoprazole 40 mg b.i.d., or esomeprazole 40 mg b.i.d. for 14 days. Results : When we look at the eradication rates of the treatment groups, only two groups (ranitidine bismuth citrate and rabeprazole groups) had eradication rates greater than 80%, both at intention to treat and per protocol analyses. The other four groups (omeprazole, lansoprazole, pantoprazole, and esomeprazole groups) showed statistically significant lower eradication rates both at intention to treat (between 57.6 and 66.7%) and per protocol (between 60.3 and 72.1%) analyses when compared with ranitidine bismuth citrate and rabeprazole groups (p<.05). Conclusion : Ranitidine bismuth citrate and/or rabeprazole based triple therapies must be preferred for the first-line treatment of H. pylori infection

Evaluating elbow osteoarthritis within the prehistoric Tiwanaku state using generalized estimating equations (GEE).

OBJECTIVES:Studies of osteoarthritis (OA) in human skeletal remains can come with scalar problems. If OA measurement is noted as present or absent in one joint, like the elbow, results may not identify specific articular pathology data and the sample size may be insufficient to address research questions. If calculated on a per data point basis (i.e., each articular surface within a joint), results may prove too data heavy to comprehensively understand arthritic changes, or one individual with multiple positive scores may skew results and violate the data independence required for statistical tests. The objective of this article is to show that the statistical methodology Generalized Estimating Equations (GEE) can solve scalar issues in bioarchaeological studies. MATERIALS AND METHODS:Using GEE, a population-averaged statistical model, 1,195 adults from the core and one colony of the prehistoric Tiwanaku state (AD 500-1,100) were evaluated bilaterally for OA on the seven articular surfaces of the elbow joint. RESULTS:GEE linked the articular surfaces within each individual specimen, permitting the largest possible unbiased dataset, and showed significant differences between core and colony Tiwanaku peoples in the overall elbow joint, while also pinpointing specific articular surfaces with OA. Data groupings by sex and age at death also demonstrated significant variation. A pattern of elbow rotation noted for core Tiwanaku people may indicate a specific pattern of movement. DISCUSSION:GEE is effective and should be encouraged in bioarchaeological studies as a way to address scalar issues and to retain all pathology information

Metabolic inactivation of estrogens in breast tissue by UDP-glucuronosyltransferase enzymes: an overview

The breast tissue is the site of major metabolic conversions of estradiol (E(2)) mediated by specific cytochromes P450 hydroxylations and methylation by catechol-O-methytransferase. In addition to E(2 )itself, recent findings highlight the significance of 4-hydroxylated estrogen metabolites as chemical mediators and their link to breast cancer development and progression, whereas, in opposition, 2-methoxylated estrogens appear to be protective. Recent data also indicate that breast tissue possesses enzymatic machinery to inactivate and eliminate E(2 )and its oxidized and methoxylated metabolites through conjugation catalyzed by UDP-glucuronosyltransferases (UGTs), which involves the covalent addition of glucuronic acid. In opposition to other metabolic pathways of estrogen, the UGT-mediated process leads to the formation of glucuronides that are devoid of biologic activity and are readily excreted from the tissue into the circulation. This review addresses the most recent findings on the identification of UGT enzymes that are responsible for the glucuronidation of E(2 )and its metabolites, and evidence regarding their potential role in breast cancer

Metric sex determination from the pelvis in modern Greeks

The ability to determine sex from unknown skeletal remains is vital, and methods to do this on the various bones of the human skeleton have been researched extensively. Many researchers have emphasized the need for population specific data for methods which are based on measurements, as there are vast differences in body size in various populations. The pelvis is known to be the most sexually dimorphic part of the human body, and no discriminant function formulae for this bone are available for Greek or other Mediterranean groups. The purpose of this study was therefore to develop discriminant functions which can be used for sex determination on measurements of the pelvis of modern Greeks. A sample of 97 male and 95 female pelves in a skeletal collection housed in Heraklion, Crete, was used. Measurements were taken from the articulated pelvis, single os coxae and the sacrum. Discriminant function formulae for all measurements and various combinations were used in order to assess the degree of sexual dimorphism in various parts of the pelvis, and to make the formulae usable on fragmented remains. For the single os coxae, average accuracies of 79.7-95.4% (79.1-93.5% on cross-validation) were found. However, it was found that measurements of the sciatic notch were unreliable and yielded poor results, and it is advisable that this characteristic must only be used as a last resort. Dimensions of the sacrum were not very dimorphic (average accuracy 60.9%), while measurements from the articulated pelvis yielded poorer results than that from single innominate bones. The diameter of the acetabulum was the single most dimorphic characteristic, providing on average 83.9% accuracy when used in isolation. (C) 2008 Elsevier Ireland Ltd. All rights reserved

Early results of comparison of polypropylene mesh and 75% resorbable mesh (monofilament polypropylene and poly-L-lactic acid (PLLA) mesh) for laparoscopic total extraperitoneal (TEP) inguinal hernia repair.

AbstractObjective:Laparoscopic totally extraperitoneal (TEP) hernia repair has become increasingly widespread. Faster recovery than conventional open methods shortens the return to work. Polypropylene (PP) mesh is still in use in hernia surgery because it is an inexpensive and easily accessible patch. The post-operative chronic pain and foreign body sensation are the disadvantages of these PP patches. Poly-L-lactic acid and polypropylene (PLLA) were used in this study because of the good biocompatibility and low tissue inflammation response. We compared the early clinical outcomes of PP patch and PLLA patches.Methods:Between January 2013 and April, 2018,469 patients with inguinal hernia underwent TEP procedure. Patients were divided into two groups. PP mesh (n=211) in group 1, PLLA mesh (n=258) in group 2. Patients were compared regarding age, gender, hernia side, ASA scores, the duration of operation, pain, time to return to work, the sensation of foreign body, seroma and hematoma.Results:A total of 469 patients were analyzed retrospectively (426 male, 43 female). The mean age was 52.23±13.66 years. The operative times of the patients were 40.92±8.9 minutes in group 1, and 38.82±8.5 minutes in group 2 (p&lt;0.05). The time to return to work was 10.2±1.47 days in Group 1 and 8.4±1.0 days in Group 2 (p&lt;0.05). Visual Analog Scale (VAS) in group 2 was lower than in group 1 (p&lt;0.005). In group 2, the feeling of the organic body decreased in the early and late period (p&lt;0.005). Seroma and hematoma were less in Group 2 than in Group 1 (p&lt;0.005). The mean follow-up period of the patients was 18 (3-63) months, two patients in Group 1, two patients in Group 2 recurred.Conclusion:The PLLA patch used in the TEP method is thought to be a herniated patch that can be safely used because of its ease of application and less postoperative complication rates and more rapid return to work.Keywords:Laparoscopic hernia repair; mesh; poly-L-lactic acid

A RARE CASE OF IDENTIFICATION AND PRESERVATION OF HUMAN REMAINS. 240 Un raro caso de identificación y preservación de restos humanos

Los estudios de casos son ideales para probar la validez de técnicas antropológicas y los estudios antropológico-forenses de casos suelen funcionar como campo de pruebas en varios tópicos de la Antropología Física. El creciente rol que ha jugado los antropólogos en las ciencias forenses ha ayudado a las disciplinas médico-legales en varios aspectos. Por ejemplo, la identificación restos óseos es ahora más segura que nunca. El propósito de éste artículo es mostrar un raro caso de preservación de tejidos blandos de los restos de una niña color que se han conservado transformándose en un molde compacto y describir las técnicas antropológicas usadas para identificar los restos. Los estudios antropológicos forenses indicaban que se trataba de los restos de una niña de color entre 10 y 12 años de edad al momento de la muerte y de 150 cms de estatura. Basados en esos datos preliminares y en la sospecha de que los restos podrían ser los de Jane Doe, víctima de una violación y posterior asesinato. Una superposición digital fue realizada usando una fotografía de la supuesta víctima y el cráneo desconocido. Los estu-dios indicaron que el cráneo hallado se correspondía de manera consistente con el individuo de la fotografía. Estos resultados fueron luego ratificados por un análisis de ADN. Por lo tanto, la Antropología Forense y sus técnicas pueden ser utilizadas en investigaciones médico-legales concretas de manera muy satisfactoria. Case studies are ideal to test the validity of anthropological techniques and forensic anthropology cases function as a testing ground for this aspect of physical anthropology. The increasing role that anthropologists have played in forensic sciences has aided the medico legal disciplines in a number of ways. For example, identification of skeletal remains is now more accurate than ever before. The purpose of this paper is to show a peculiar case of rare preservation of soft tissue of a black child that formed an unique soft tissue casting and to describe anthropological techniques used to identify the remains. The anthropological analysis indicated that she was black racial affinity, between 10-12-year old and was about150 cmof stature. Based on preliminary evidence that the victim might be Jane Doe, a victim of possible rape and murder, a digital superimposition was made using one victim\u27s photograph and the unknown skull. This examination revealed that the skull corresponded consistently with the individual in the photograph. Results were supported by a DNA analysis. Therefore, forensic anthropology techniques can be successfully used in medico-legal investigations.

Comparison of histopathological features and prognosis of classical and follicular variant papillary thyroid carcinoma.

Purpose To compare the histopathological features and the outcomes of the follicular variant and classical variant of papillary thyroid carcinoma