Comparison of omeprazole, metronidazole and clarithromycin with omeprazole/amoxicillin dual-therapy for the cure of Helicobacter pylori infection

In this randomized, multicenter trial, we evaluated the effectiveness and side effect profile of a modified omeprazole-based triple therapy to cure Helicobacter pylori infection. The control group consisted of patients treated with standard dual therapy comprising omeprazole and amoxicillin. One hundred and fifty-seven H. pylori infected patients with duodenal ulcers were randomly assigned to receive either a combination of omeprazole 10 mg, clarithromycin 250 mg and metronidazole 400 mg (OCM) given three times daily for 10 days (n = 81),or a combination of omeprazole 20 mg and amoxicillin 1 g (OA) given twice daily for 14 days (n = 76). Prior to treatment and after 2 and 6 weeks, gastric biopsies from the antrum and corpus were obtained for histology and H. pylori culture. H. pylori infection was cured in 97.4% after OCM and in 65.8% after OA in the per-protocol analysis (p < 0.001) (intention-to-treat analysis: 93.4% and 63.2%, respectively). H. pylori was successfully cultured in 122 patients (77%). The overall rate of metronidazole resistance was 19.7% (24/122), no primary resistance to clarithromycin or amoxicillin was found. In the OCM group, all patients infected with metronidazole-sensitive H. pylori strains (n = 51) and those infected with strains of unknown susceptibility to metronidazole (n = 14)were cured (100%), while 77% (10/13) of those harboring metronidazole-resistant. strains were cured of the infection (p = 0.36). Side effects leading to premature termination of treatment occurred in 2.5% of the patients in the OCM group and in 1.4 % of the OA group. We conclude that combined treatment with omeprazole, clarithromycin and a higher dose of metronidazole is highly effective in curing H, pylori infection, Helicobacter pylori omeprazole and that this regimen remains very effective in the presence of metronidazole resistant strains

Indications of suppressed high p_T hadron production in nucleus-nucleus collisions at CERN-SPS

Inclusive pion production at high transverse momenta (p_T > 2 GeV/c) in nucleus-nucleus (A+A) collisions at CERN SPS (sqrt(s_NN)~20 GeV) is revisited and systematically compared to all existing proton-proton data in the same range of center-of-mass energies. The ratio of A+A to p+p pion cross-sections (nuclear modification factor) for 0-8% central Pb+Pb, Pb+Au and S+Au reactions does not show a strong enhancement as a function of p_T as previously found, but is consistent with scaling with the number of nucleon-nucleon (NN) collisions. Neutral pion yields per NN collision in head-on Pb+Pb reactions are suppressed, whereas peripheral yields are enhanced. These results together indicate that some amount of ``jet quenching'' may already be present in central heavy-ion reactions at sqrt(s_NN)~20 GeV.Comment: Updated versions of Figs. 1,2 and 4. Minor text modification

Brown bowel syndrome: A rare complication in diseases associated with long-standing malabsorption

BACKGROUND/AIMS Longtime chronic malabsorption may among other things cause a lack of liposoluble vitamins. Vitamin E deficiency can lead to formation of lipofuscin aggregates. Its deficiency is also associated with an increased lipofuscinosis of the bowel, i.e. brown bowel syndrome. METHODS Systematic research via Medline on brown bowel syndrome, lipofuscinosis, and vitamin E deficiency was performed. We combined our own clinical experience and a review of the literature for this paper. Its goal is to inform about the possible consequences of severe malabsorption and brown bowel syndrome. RESULTS Systematic data about the occurrence of severe malabsorption and brown bowel syndrome are rare. Only about 27 scientific reports can be found on this subject. Brown bowel syndrome is found mostly in conjunction with vitamin E deficiency and lipofuscinosis of the bowel. The clinical findings are caused by both malabsorption and lipofuscinosis. Case reports show a therapeutic effect of vitamin E. CONCLUSION Vitamin deficiency caused by longtime chronic malabsorption can lead to the development of brown bowel syndrome, which is seen as the expression of lipofuscinosis of the bowel, and can cause further clinical disorders. Patients with malabsorption should therefore be monitored regarding their vitamin E levels

Autorenverzeichnis

Die hier dokumentierten Reden wurden auf einer akademischen Gedenkfeier an der Universität Hamburg am 6. Februar 2003 zu Ehren von Prof. Eberhard Schmidhäuser gehalten.The speeches documented here were held at an academic commemoration ceremony at the University of Hamburg on 6 February 2003 in honour of Prof. Eberhard Schmidhäuser

Fine and ultrafine particles from indoor sources – Effects on healthy humans in a controlled exposure study and on lung epithelial cells in vitro

In recent years increasing concern has been expressed about the potential adverse health effects of particles from indoor sources. The aims of the EPIA project were: (1) to characterize potentially relevant indoor sources of (ultra)fine particles with respect to their emission levels and composition and (2) to investigate their adverse health effects. We investigated the effects of emissions from candle burning (CB), toasting of bread (TB) and sausage frying (FS) in a randomized, cross-over sham-controlled exposure study in healthy adults as well as in vitro in A549 human lung epithelial cells. Participants were exposed for 2 h to each of these sources at two different exposure levels, and examined before, during and after the exposures at defined time-intervals. We found transient associations between exposures and several respiratory and cardiovascular effects as well as inflammatory changes (e.g. lung function, blood pressure, arterial stiffness, interleukin-8 in nasal lavage/blood). Specific effects were found to depend strongly on the emission source and the selected exposure metric (e.g. size-specific particle mass concentration, size-specific particle number concentration, lung deposited surface area concentration). Evaluation of PM2.5 samples in the A549 cells, revealed an increased interleukin-8 release and DNA strand breakage induction for toasting, whereas candle burning only resulted in DNA damage. The results from our project demonstrate that elevated concentrations from certain indoor emission sources may lead to changes in the lung and cardiovascular systems as well as possibly induce inflammation