Helicobacter pylori eradication does not cause reflux oesophagitis in functional dyspeptic patients: a randomized, investigator-blinded, placebo-controlled trial.

BACKGROUND: The protective role of Helicobacter pylori in gastro-oesophageal reflux disease has been widely discussed. AIM: To assess the risk of reflux oesophagitis in patients with functional dyspepsia after treatment for H. pylori infection. METHODS: A randomized, placebo-controlled, investigator-blinded trial was carried out on 157 functional dyspeptic patients. Patients were randomized to receive lansoprazole, amoxicillin and clarithromycin (antibiotic group) or lansoprazole and identical antibiotic placebos (control group). Upper gastrointestinal endoscopy was performed at baseline, 3 and 12 months after randomization. The primary aim was to detect the presence of reflux oesophagitis. Analyses were performed on an intention-to-treat basis. RESULTS: A total of 147 patients (94%) and 133 (85%) completed 3 months and 12 months follow-up, respectively. The eradication rate of H. pylori was 90% in the antibiotic group (74 of 82) and 1% (one of 75) in the control group. At 3 months, reflux oesophagitis was diagnosed in 3.7% (three of 82) in the antibiotic group and 4% (three of 75) in the control group (P > 0.2). At 12 months, diagnosis was established in five new cases within the first group and in four within the second (P > 0.2). No difference was found in heartburn symptoms. CONCLUSIONS: H. pylori eradication does not cause reflux oesophagitis in this western population of functional dyspeptic patients.

Consumo de benzodiazepínicos em Porto Alegre / Benzodiazepinics comsumption in Porto Alegre

Os benzodiazepínicos (BDZ) vêm sendo utilizados em larga escala para o controle da ansiedade e outras condiçöes clínicas desde que foi introduzida sua comercializaçäo na década de 60. Nos últimos anos, diversos estudos têm apontando seu uso indiscriminado, contribuindo para aumentar a morbidade associada, bem como a busca por outras substâncias calmamente de acesso mais fácil. OBJETIVO. Estimar a prevalência do uso de benzodiazepínicos e calmantes caseiros na populaçäo adulta de Porto Alegre, TS. MÉTODOS. 480 habitantes do município de Porto Alegre, RS, com idade igual ou superior a 18 anos, selecionados através de amostragem aleatória por conglomerados (setores censitários do IBGE), foram entrevistados em seus domicílios durante o mês de junho de 1991. RESULTADOS. As prevalências do uso de BDZ na vida, no último ano e no último mês, foram, respectivamente, 46,7 por cento, 21,3 por cento e 13,1 por cento. Entre as mulheres e os viúvos ou separados a prevalência foi significativamente maior. A maioria dos indivíduos que usaram BDZ no último mês o fizeram, no mínimo, 2 a 3 dias por semana. Mais de 40 por cento dos entrevistados relataram uso freqüente de substâncias caseiras para "acalmar", sendo 28,8 por cento a prevalência do uso no último mês. CONCLUSAO. O uso de substâncias químicas para aliviar a ansiedade e outros sintomas está difundido entre a populaçäo. A legislaçäo, nem sempre respeitada, tem sido insuficiente para disciplinar o uso. É necessário compreender a complexidade de razöes para que a situ-açäo se mantenha e investir em medidas para educar médicos e populaçäo quanto ao uso adequado dos BDZ, além de buscar reguladoras ao nível da lei que sejam mais eficientes

[Benzodiazepine consumption in Porto Alegre]. / Consumo de benzodiazepínicos em Porto Alegre.

Benzodiazepines has been largely used to control anxiety and other clinical pictures since it began to be traded in the 60's. In recent years, many studies have shown that they are used indiscriminately, contributing to increase associated morbidity, and to search for other more accessible tranquilizers. PURPOSE--To estimate the prevalence of benzoadiazepine and over-the-counter tranquilizers use in adults living in Porto Alergre-RS, Brazil. METHODS--480 inhabitants of Porto Alegre, aged 18 or older, selected through a random cluster sampling procedure (sectors of the Brazilian Census), were interviewed in their homes during June, 1991. RESULTS--The prevalence for BDZ use during life, in the past year and in the past month was, respectively, 46.7%, 21.3% and 13.11%. Prevalence was significantly higher among women and widowers or divorced. The majority of those who used BDZ during the past month did so at least 2 or 3 days per week. More than 40% reported frequent over-the-counter substances use to "tranquilize", with a 28.8% prevalence for past month use. CONCLUSION--Chemical substance use to alleviate anxiety and other symptoms is generally spread. Legislation, not always respected, has been insufficient to discipline its use. Understanding the complexity of reasons for the situation to be unchanged is needed. Also necessary is the investment in education on adequate use of BDZ, both for physicians and population, and the search for legal measures that should be more efficient.