ABSTRACT
Saccharomyces boulardii es una levadura recomendada para la prevención y el tratamiento de la diarrea. Se presentan los resultados de la comparación de la actividad relativa de varias presentaciones de esta levadura disponibles en Chile. La comparación se realizó midiendo: i) la rapidez de crecimiento en el producto suspendido en un medio de cultivo y ii) el número de células vivas después de re-hidratar los productos. En las diferentes experiencias, la presentación Perenteryl mostró un crecimiento más rápido, alcanzando los valores máximos de concentración de células alrededor de tres a cinco horas antes que los otros productos. Aunque el número total de células fue prácticamente igual en todas las presentaciones, el número de células vivas fue muy superior en las presentaciones Perenteryl.
Subject(s)
Humans , Diarrhea/prevention & control , Diarrhea/therapy , Saccharomyces , Therapeutic Equivalency , Chile , Probiotics/therapeutic useABSTRACT
Background: Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated. Aim: To perform a cost benefit study of different treatment options for H. pylori infection. Patients and methods: One hundred and sixty-seven patients with active duodenal ulcer and H. pylori infection who completed a 2-week treatment with one of the following regimens were included: famotidine plus amoxycillin plus metronidazole (FAM), omeprazole plus amoxycillin plus tinidazole (OAT) or lansoprazole plus clarithromycin plus amoxycillin in 3 (LAC1) or 2 (LAC2) daily doses. We compared efficacy, adverse effects and cost. Results: Eradication rate was 74.6, 72.9, 96.4 y 91.7 percent for FAM, OAT, LAC1 and LAC2 respectively (p<0.05). Direct cost ranged from US$ 50 for FAM to US$ 220 for LAC1. A decision analysis was carried out in a model including direct and indirect costs and considering retreatment with antibiotics after the first treatment failure and one-year treatment with H2-blockers in case of a second failure. FAM was selected as the most cost-effective option, with an estimated cost of about US$ 300 ñ 148 per patient. However, cost associated to LAC2 was very similar (US$ 320 ñ 58) and the lower standard deviation suggests less variation. Sensitivity analyses, considering reasonable fluctuation in parameters such as eradication rate, cost and follow-up period suggest that a regimen containing a proton pump inhibitor, clarithromycin and amoxycillin may be the most cost-effective treatment. Conclusions: These results should be confirmed in other settings, specially in ordinary clinical practice, far from clinical research
Subject(s)
Humans , Male , Female , Helicobacter pylori/drug effects , Helicobacter Infections/drug therapy , Urease , Famotidine/administration & dosage , Follow-Up Studies , Helicobacter Infections/diagnosis , Cost-Benefit Analysis , Proton Pumps/administration & dosage , Clarithromycin/administration & dosage , Drug Therapy, Combination/administration & dosage , Amoxicillin/administration & dosage , Lymphoma/microbiology , Drug Administration Schedule , Peptic Ulcer/microbiologyABSTRACT
Segments of internal mammary arteries and saphenous veins and cultured smooth muscle cells were incubated with and without doxycicline. Metalloproteinases activity was assessed by zymography and Western Blot. Activity of Metalloproteinase-9 in saphenous veins was 217 percent less than in internal mammary arteries. In these vessels doxycicline decreased metalloproteinase-9 activity by 207 percent and metalloproteinase-1 expression. In cultured smooth muscle cells, the median inhibitory concentration of doxycicline for metalloproteinase-2 was 138 uM (r2=0.82). Internal mammary arteries and saphenous veins have different metalloproteinase activities, that are inhibited by doxycicline
Subject(s)
Doxycycline/pharmacokinetics , Metalloproteases , In Vitro Techniques , Saphenous Vein/enzymology , Cells, Cultured/enzymology , Metalloproteases/drug effects , Mammary Arteries/enzymologyABSTRACT
The presence of metalloproteinases in etherosclerotic plaques has been described but their role is not well understood. An increased secretion of these proteolytic enzymes could explain plaque instability and distal embolization. Plaque were divided in 1 segment with and 1 segement without stenosis, the latter being used as control. Both segments were incubated in culture media for 48 h or were fixed for histology. The conditioned medium was studied using gelatin zimography and digital densitometry. Melloproteinases were identified by their molecular weight, inhibition with EDTA or Western blot. Standard histologic study and immunohistochemistry were done. In stenotic areas, metalloproteinase 9 (92kD) secretion was 269 percent higher than in regular plaques (191 and 73 kilopixels/ug protein respectively p<0.02). The histological study of stenotic areas showed macrophage infiltration and neoformation of blood vessels. The increased secretion of cellular matrix degrading enzyme metalloproteinase 9 in stenotic areas of atherosclerotic plaques could axplain plaque instability and subsequent embolization