RESUMEN
Regression of precancerous lesions after H. pylori eradication remains controversial. This study evaluates the change and topography in first degree relatives [FOR] of gastric cancer [GC] patients following H. pylori eradication. Participants underwent endoscopy with antrum and corpus histological examinations. Subjects with pangastritis were randomly allocated to placebo or eradication therapy and followed over 41/2 years. Among 989 evaluated FDR, we excluded 468 patients as follows: 108 had macroscopic lesions, 243 had no evidence of any H. pylori infection, and 117 were excluded for other reasons. The remaining subjects [n = 521] were allocated to therapy [group A, n = 261] or placebo [group B, n = 260] groups. Interim analysis of 403 subjects [201 placebo, 202 therapy] showed regression of atrophy [60 out of 97 in the antrum and 37 out of 104 in the corpus] in H. pylori-eradicated versus regression of atrophy [57 out of 184 in the antrum and 23 out of 173 in the corpus] in non-H. pylori-eradicated cases over 21/2 years [P < 0.0001]. No regression of intestinal metaplasia [IM] occurred in the antrum and corpus of treated subjects over 41/2 years. However, progression of IM occurred in the antrum in 17 out of 90 patients in the non-H. pylori-eradicated versus 4 out of 68 H. pylori-eradicated subjects after 41/2 years [P < 0.05]. Eradication of H. pylori is associated with regression of gastric atrophy but not IM, even in its early stages. Gastric atrophy and IM in the antrum have shown more rapid progression in cases not treated for H. pylori infection [over 41/2 years follow-up] compared to H. pylori-eradicated cases
RESUMEN
Deep Vein Thrombosis [DVT] and Pulmonary Thromboembolism [PTE] are one of the frequently missed and lethal complications in admitted patients. Unfortunately, in spite of the presence of consensus about prevention of DVT, these guidelines are not applied in most hospitals. Death rates from DVT and PTE are more than those of road accidents and breast cancer. Our study aimed to analyze the situation of DVT/PTE prevention in hospitals of Tabriz. Based on 75000/ year admission, we studied the records of 17 teaching wards in 7 hospitals systematically. At least 50 records from each ward were reviewed. Records with insufficient data; admissions of less than 3 days; heparin treated cases; uremic and cirrhotic patients; those with bleeding tendencies, and ENT, ophthalmology, pediatric wards were excluded. 1557 records were collected, and risk of DVT [low-moderate-high-very high] along with appropriate prevention method was stratified according to ACCP 1998 guideline for surgical ward. For stratification of risk factors in medical wards, comparable rate of prevalence of DVT/PTE was used for every medical condition. Highest rate of DVT prevention was related to cardiology unit [63.4%] and lowest rate to thoracic surgery unit [2.7%]. Appropriate prevention methods were related to cardiology [73.1%], pulmonary ICU [51.4%], and gynecology [42.3%]. Inappropriate methods were related to neurology ICU, neurosurgery, and orthopedic wards [0%]. This study shows that in spite of the presence of guidelines for prevention of DVT, and the importance of this in decreasing costs and mortalities, application of appropriate method in most wards is far from reality, and continuous learning of physicians about prevention of DVT and regular control of medical records by medicare is strongly recommended in order to reach a good endpoint