Terapia triple de corto tiempo con azitromicina, amoxicilina y omeprazol para la erradicación del helicobacter pylori / Short-term therapy with azithromycin, amoxycilin and omeprazole for the eradication of helicobacter pylori

Background: the high cost and complexity of therapeutic schemes for the eradication of Helicobacter pylori has stimulated the search of simpler and cheaper treatment options. Aim: To evaluate the efficacy of 3 days of azithromycin 500 mg od, 7 days of amoxycilin 750 mg tid and omeprazole, 20 (Group A) or 40 mg (Group B) on randomization, as a treatment for Helicobacter pylori infection in patients with endoscopically diagnosed peptic ulcer. Methods: H. pylori status of peptic ulcer patients was pathologically confirmed by the examination of five gastric biopsies using the Giemsa stain and by rapid urease testing in two gastric biopsies. H. pylori status was reassessed not less than 28 days after completing treatment. Adverse events and compliance were evaluated. Results: Fifty four patients (29 men, 25 women, mean age 48 years) were enrolled, 28 in Group A and 27 in Group B. Per protocol the infection was cured in 58,8 percent of patients (30/51; 95 percent CI: 45-73 percent). On an intention to treat basis, H pylori infection was cured in 55 percent. Minor side effects including diarrhea and nausea were reported by 32 percent of patients. Ninety five per cent of patients consumed more than 95 percent of prescribed medications. H. pylori was successfully erradicated in 61 percent of group A and 57 percent of group B patients (p= NS). Conclusion: Short term therapy with azithromycin was poorly effective in curing H. pylori infection. The compliance was excellent. Increasing Omeprazole from 20 to 40 mg/day did not improve treatment effectiveness

Efecto del clebopride y metaclopramida en la presión del esfínter esófagico inferior y actividad peristáltica esofagica / The effect of clebopride and metoclopramide on lower esophageal sphincter pressure, and on esophageal peristaltic activity

Se investiga en 73 pacientes adultos el efecto de dos Ortopramidas (metoclorpramida y Clebopride) administradas por vía endovenosa, en dos poblaciones de pacientes; un grupo con reflujo Gastro Esofágico Patológico (56 pacientes) y otro grupo sin reflujo Gastro Esofágico Patológico (17 pacientes), en un estudio prospectivo y doble ciego. Se analiza el efecto de ambas drogas sobre el tono del Esfínter Esofágico Inferior (EEI), Intensidad de las Ondas Peristálticas (OP) y Fracción de las Ondas Peristálticas Eficaces (OPE), comparando estos parámetros en condiciones basales y después de la administración de 2 mgs. de Clebopride o 10 mgs de Metoclopramida, con registro a los 5-15 minutos post-inyección. No hubo reacciones adversas con ninguna de las dos drogas. Sólo encontramos pequeñas diferencias en algunos parámetros, que no permiten atribuir a éstos efectos importantes, por lo menos en las dosis usadas en esta experimentación. Nos parece necesario ampliar los estudios al respecto, con casuísticas mayores y dosis más altas