Short-term triple therapy with azithromycin for Helicobacter pylori eradication: Low cost, high compliance, but low efficacy

<p>Abstract</p> <p>Background</p> <p>The Brazilian consensus recommends a short-term treatment course with clarithromycin, amoxicillin and proton-pump inhibitor for the eradication of <it>Helicobacter pylori </it>(<it>H. pylori)</it>. This treatment course has good efficacy, but cannot be afforded by a large part of the population. Azithromycin, amoxicillin and omeprazole are subsidized, for several aims, by the Brazilian federal government. Therefore, a short-term treatment course that uses these drugs is a low-cost one, but its efficacy regarding the bacterium eradication is yet to be demonstrated. The study's purpose was to verify the efficacy of <it>H. pylori </it>eradication in infected patients who presented peptic ulcer disease, using the association of azithromycin, amoxicillin and omeprazole.</p> <p>Methods</p> <p>Sixty patients with peptic ulcer diagnosed by upper digestive endoscopy and <it>H. pylori </it>infection documented by rapid urease test, histological analysis and urea breath test were treated for six days with a combination of azithromycin 500 mg and omeprazole 20 mg, in a single daily dose, associated with amoxicillin 500 mg 3 times a day. The eradication control was carried out 12 weeks after the treatment by means of the same diagnostic tests. The eradication rates were calculated with 95% confidence interval.</p> <p>Results</p> <p>The eradication rate was 38% per intention to treat and 41% per protocol. Few adverse effects were observed and treatment compliance was high.</p> <p>Conclusion</p> <p>Despite its low cost and high compliance, the low eradication rate does not allow the recommendation of the triple therapy with azithromycin as an adequate treatment for <it>H. pylori </it>infection.</p

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

Questionable accuracy of home blood pressure measurements in the obese population &ndash; Validation of the Microlife WatchBP O3&reg; and Omron RS6&reg; devices according to the European Society of Hypertension-International Protocol

Alaa Azaki,1,* Reem Diab,1,* Aya Harb,1,* Roland Asmar,1,2 Mirna N Chahine1,2 1Faculty of Medical Sciences, Lebanese University, Hadath, 2Foundation‑Medical Research Institutes (F-MRI&reg;), Beirut, Lebanon *These authors contributed equally to this work Objective: Two oscillometric devices, the Microlife WatchBP O3&reg; and the Omron RS6&reg;, designed for self-blood pressure measurement were evaluated according to the European Society of Hypertension (ESH)-International Protocol (IP) Revision 2010 in the obese population. Methods: The Microlife WatchBP O3 measures blood pressure (BP) at the brachial level and the Omron RS6 measures BP at the wrist level. The ESH-IP revision 2010 includes a total of 33 subjects. The difference between observers&rsquo; and device BP values was calculated for each measure. A total of 99 pairs of BP differences were classified into three categories (&le;5, &le;10, and &le;15 mmHg). The protocol procedures were followed precisely in each of the two studies. Results: Microlife WatchBP O3 and Omron RS6 failed to fulfill the criteria of the ESH-IP. The mean differences between the device and the mercury readings were: 0.3&plusmn;7.8 mmHg and &minus;1.9&plusmn;6.4 mmHg for systolic BP and diastolic BP, respectively, for Microlife WatchBP O3, and 2.7&plusmn;9.9 mmHg for SBP and 3.5&plusmn;11.1 mmHg for diastolic BP for Omron RS6. Conclusion: Microlife WatchBP O3 and Omron RS6 readings differing from the mercury standard by more than 5, 10, and 15 mmHg failed to fulfill the ESH-IP revision 2010 requirements in obese subjects. Therefore, the two devices cannot be recommended for use in obese subjects. Keywords: Microlife WatchBP O3, Omron RS6, validation, blood pressure measurement, home blood pressure measurement, obese population, European Society of Hypertension, International Protoco

Prevalence and correlates of coronary heart disease: first population-based study in Lebanon

Rouba Karen Zeidan,1 Rita Farah,2 Mirna N Chahine,3 Roland Asmar,3 Hassan Hosseini,4,5 Pascale Salameh,6,7 Atul Pathak8 1Doctoral School of Biology Health and Biotechnologies, Toulouse III University, Toulouse, 2Doctoral School of Life and Health Sciences, Paris-Est University, Creteil, France; 3Foundation-Medical Research Institutes, F-MRI&reg;, Beirut, Lebanon; 4Department of Neurology, Henri Mondor Hospital AP-HP, 5EA 4391, Nerve Excitability and Therapeutics, Universit&eacute; Paris-Est, Creteil, France; 6School of Pharmacy, Lebanese American University, Byblos, 7Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; 8Department of Cardiovascular Medicine, Hypertension, Risk Factors and Heart Failure Unit, Clinique Pasteur, Toulouse, France Background: Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs), as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. Purpose: To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. Methods: We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs). Results: Our study showed that 13.4% of the Lebanese population aged &ge;40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect mediated by biological RFs. Conclusion: This is the first nationwide endeavor conducted in Lebanon to assess the prevalence of CHD. This study also confirms the relevance of the classic RFs of CHD and their applicability to the Lebanese population, thus allowing for prevention strategies. Keywords: coronary heart disease, correlates, epidemiology, prevalence, risk factor

Validation of four devices: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 for home blood pressure measurement according to the European Society of Hypertension International Protocol

Jirar Topouchian,1 Davide Agnoletti,1 Jacques Blacher,1 Ahmed Youssef,1 Mirna N Chahine,2,3 Isabel Ibanez,3 Nathalie Assemani,3 Roland Asmar1&ndash;31Centre de Diagnostic, H&ocirc;pital H&ocirc;tel-Dieu, Paris, France; 2Faculty of Medicine of the Lebanese University, 3Foundation-Medical Research Institutes, Beirut, LebanonBackground: Four oscillometric devices, including the Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670, designed for self-blood pressure measurement (SBPM) were evaluated according to the European Society of Hypertension (ESH) International Protocol Revision 2010 in four separate studies.Methods: The four devices measure brachial blood pressure (BP) using the oscillometric method. The Withings BP-800 has to be connected to an Apple&reg; iOS device such as an iPhone&reg;, iPad&reg;, or iPod&reg;. The ESH International Protocol Revision 2010 includes a total number of 33 subjects. The difference between observer and device BP values was calculated for each measure. Ninety-nine pairs of BP differences were classified into three categories (&le;5 mmHg, &le;10 mmHg, &le;15 mmHg). The protocol procedures were followed precisely in each of the four studies.Results: All four tested devices passed the validation process. The mean differences between the device and mercury readings were: &minus;1.8&plusmn;5.1 mmHg and &minus;0.4&plusmn;2.8 mmHg for systolic and diastolic BP, respectively, using the Omron M6 Comfort device; 2.5&plusmn;4.6 mmHg and &minus;1.2&plusmn;4.3 mmHg for the Omron HEM-7420 device; &minus;0.2&plusmn;5.0 mmHg and 0.4&plusmn;4.2 mmHg for the Withings BP-800 device; and 3.0&plusmn;5.3 mmHg and 0.3&plusmn;5.2 mmHg for the Polygreen KP-7670 device.Conclusion: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 readings differing by less than 5 mmHg, 10 mmHg, and 15 mmHg fulfill the ESH International Protocol Revision 2010 requirements, and therefore are suitable for use by patients for SBPM, if used correctly.Keywords: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, Polygreen KP-7670, self-blood pressure measurement, validation, European Society of Hypertension International Protocol Revisio

Validation of BP devices QardioArm&reg; in the general population and Omron M6 Comfort&reg; in type II diabetic patients according to the European Society of Hypertension International Protocol (ESH-IP)

Mirna N Chahine,1,2 Jirar Topouchian,3,4 Parounak Zelveian,3 Zoya Hakobyan,3 Arevik Melkonyan,3 Alaa Azaki,1 Reem Diab,1 Aya Harb,1 Roland Asmar1,2 1Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon; 2Foundation-Medical Research Institutes (F-MRI), Beirut, Lebanon; 3Preventive Cardiology Center, Yerevan, Armenia; 4Diagnostic Center, Hotel-Dieu Hospital, Paris, France Background: Following the European Society of Hypertension International Protocol (ESH-IP) Revision 2010, QardioArm&reg; and Omron M6 Comfort IT&reg; oscillometric devices were evaluated in the general population and in patients with type II diabetes, respectively, for self-blood pressure (BP) measurement. Methods: Both devices, QardioArm&reg; and Omron M6 Comfort&reg;, measure BP at the brachial level. The ESH-IP Revision 2010 includes a total number of 33 subjects. For each measure, the difference between observer and device BP values was calculated. In all, 99 pairs of BP differences are classified into three categories (&le;5, &le;10, and &le;15 mmHg). The protocol procedures were followed precisely. Results: QardioArm&reg; and Omron M6 Comfort&reg; fulfilled the requirements of the ESH-IP and passed the validation process successfully. For QardioArm&reg;, a total of 69 out of 99 comparisons for systolic blood pressure (SBP) showed an absolute difference within 5&thinsp;mmHg and 82 out of 99 for diastolic blood pressure (DBP). As for Omron M6 Comfort&reg;, a total of 83 out of 99 comparisons for SBP showed an absolute difference within 5&thinsp;mmHg and 77 out of 99 for DBP. The mean differences between the device and mercury readings were 0.7&plusmn;5.9 mmHg for SBP and 0.3&plusmn;4.1 mmHg for DBP for QardioArm&reg; and &minus;1.4&plusmn;4.7 mmHg for SBP and &minus;2.1&plusmn;4.3 mmHg for DBP for Omron M6 Comfort&reg;. With regard to part 2 of ESH-IP 2010, 27 out of 33 subjects had a minimum of two out of three measurements within 5&thinsp;mmHg difference for SBP and 31 out of 33 subjects for DBP for the QardioArm&reg;, and 29 out of 33 patients had a minimum of two out of three measurements within 5&thinsp;mmHg difference for SBP and 26 out of 33 patients for DBP for Omron M6 Comfort&reg;.Conclusion: QardioArm&reg; and Omron M6 Comfort&reg; readings differing from the mercury standard by &lt;5, 10, and 15 mmHg fulfill the ESH-IP Revision 2010 requirements. Consequently, these two devices are suitable for use in the general population and non-insulin-dependent type II diabetic patients, respectively. Keywords: QardioArm&reg;, Omron M6 Comfort&reg;, validation, blood pressure measurement, type II diabetes, International Protoco