RESUMO
Background and study aims: Standard sequential treatment for Helicobacter pylori [H. pylori] eradication has less success because of increasing clarithromycin resistance. Extended treatment and bismuth containing regimens were, therefore, investigated
Patients and methods: Consecutive H. pylori-positive patients with dyspepsia were randomly allocated to one of the three sequential regimens: The first group was given lansoprazole 30 mg b.i.d. plus amoxicillin 1 g b.i.d. for the first 5 days, followed by lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg t.i.d. for the second 5 days [standard sequential, SS]. The second group was given the same regimen but for 7 + 7 days instead of 5 + 5 days [extended sequential, ES]. In the third group, colloidal bismuth 600 mg b.i.d. was added to the second regimen for 14 days [extended sequential + bismuth subcitrate, ES + B]. Urea breath test or histology was performed before enrolment and 6 weeks after the end of treatment to detect H. pylori
Results: A total of 280 patients were included in the study. Per-protocol eradication rates were 62% [56/90], 72% [56/78], and 75% [54/72] in patients who received SS, ES, and ES + B regimens, respectively. Moreover, intention-to-treat eradication rates were 53% [56/104], 62% [56/90] and 62% [54/86], respectively. The differences in eradication rates between the groups were not statistically significant
Conclusion: Although prolonging of the sequential treatment to 14 days may be considered, addition of bismuth to the regimen is of no avail
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Helicobacter pylori , Lansoprazol/uso terapêutico , Amoxicilina/uso terapêutico , Metronidazol/uso terapêutico , Bismuto/uso terapêutico , ClaritromicinaRESUMO
Although Bochdalek hernia is the most common congenital diaphragmatic hernia in adults, bilateral occurrence is rare. To the best of our knowledge, only case reports on Bochdalek hernia and its associated pathologies have been previously published. Herein, we present the case of a 27-year-old man with bilateral Bochdalek hernias, which were detected incidentally. The bilateral Bochdalek hernias were found to be associated with severe aortic tortuosity and aberrant right subclavian artery.