Multi-trait association mapping for phosphorous efficiency reveals flexible root architectures in sorghum.

BACKGROUND: On tropical regions, phosphorus (P) fixation onto aluminum and iron oxides in soil clays restricts P diffusion from the soil to the root surface, limiting crop yields. While increased root surface area favors P uptake under low-P availability, the relationship between the three-dimensional arrangement of the root system and P efficiency remains elusive. Here, we simultaneously assessed allelic effects of loci associated with a variety of root and P efficiency traits, in addition to grain yield under low-P availability, using multi-trait genome-wide association. We also set out to establish the relationship between root architectural traits assessed in hydroponics and in a low-P soil. Our goal was to better understand the influence of root morphology and architecture in sorghum performance under low-P availability. RESULT: In general, the same alleles of associated SNPs increased root and P efficiency traits including grain yield in a low-P soil. We found that sorghum P efficiency relies on pleiotropic loci affecting root traits, which enhance grain yield under low-P availability. Root systems with enhanced surface area stemming from lateral root proliferation mostly up to 40 cm soil depth are important for sorghum adaptation to low-P soils, indicating that differences in root morphology leading to enhanced P uptake occur exactly in the soil layer where P is found at the highest concentration. CONCLUSION: Integrated QTLs detected in different mapping populations now provide a comprehensive molecular genetic framework for P efficiency studies in sorghum. This indicated extensive conservation of P efficiency QTL across populations and emphasized the terminal portion of chromosome 3 as an important region for P efficiency in sorghum. Increases in root surface area via enhancement of lateral root development is a relevant trait for sorghum low-P soil adaptation, impacting the overall architecture of the sorghum root system. In turn, particularly concerning the critical trait for water and nutrient uptake, root surface area, root system development in deeper soil layers does not occur at the expense of shallow rooting, which may be a key reason leading to the distinctive sorghum adaptation to tropical soils with multiple abiotic stresses including low P availability and drought.

Irradiance-regulated biomass allocation in Raphanus sativus plants depends on gibberellin biosynthesis.

Gibberellin has been proposed to increase leaf elongation in radish (Raphanus sativus L.) plants, which is associated with decreased tuber growth. Since light intensity can control growth through interaction with gibberellin, investigation of the effect of gibberellin levels on the growth of radish plants would be a step forward towards unraveling factors that underlie biomass accumulation and allocation in response to irradiance levels. Here, we report that the gibberellin biosynthesis inhibitor paclobutrazol (PAC) decreased petiole elongation, but not lamina growth of radish plants grown under full sunlight. However, shading promoted an increase in shoot elongation, while in plants treated with PAC the petiole and leaf lamina fail to elongate. Plants treated with PAC allocated proportionally more biomass to their tubers and less to shoot compared to control under shade. Moreover, PAC decreased the abundance of transcripts encoding cell wall expansion proteins in leaf lamina and petiole of plants grown under shade, which was positively correlated with sugar consumption by the tuber, thereby increasing the mass fraction and concentrations of minerals for tuber. Thus, allocation of biomass during the growth of radish plants and nutritional quality of tubers depend on gibberellin and light intensity.

Selenium uptake and grain nutritional quality are affected by nitrogen fertilization in rice (Oryza sativa L.).

KEY MESSAGE: The effects of selenium in rice grain composition depend on the soil nitrogen supply. Selenium and nitrogen have the potential to modify rice grain composition; however, it is unclear how the combined effect of Se and nitrogen affects the grain nutritional quality of rice. In our study, grain Se concentration was positively associated with the increased availability of nitrogen in soil. The accumulation of Se in grain of rice plants treated with Se combined with nitrogen was accompanied by an increase in expression of NRT1.1B, a rice nitrate transporter and sensor, in root. Moreover, Se potentiates the response of nitrogen supply in expression of sulfate transporter OsSULTR1.2, phosphate transporter OsPT2 and silicon transporter OsNIP2.1 in root, thereby increasing root Se uptake capacity. The combination of Se with high nitrogen increased the concentrations of protein, carbohydrates, Se, Mo and Mg, but decreased concentrations of Fe, Mn, Cu and Zn in grain. Overall, our results revealed that many of the effects of Se in rice grain composition are due to a shift in the nitrogen status of the plant.

Selenomethionine induces oxidative stress and modifies growth in rice (Oryza sativa L.) seedlings through effects on hormone biosynthesis and primary metabolism.

Although the chemical characteristics of selenomethionine (SeMet) are similar to those of methionine (Met), the physiological activity of SeMet apparently differs in its ability to stimulate ethylene production in plant tissues. Since selenium alters root architecture of rice seedlings by modifying ethylene production, the investigation of the effect of SeMet and Met on rice growth would be a step forward towards unraveling factors that underlie selenium toxicity. Here, we report that SeMet increased concentrations of reactive oxygen species (ROS), inhibiting auxin and increasing ethylene production in rice seedlings. The effect of SeMet on seedlings was mediated by the inhibition of the abundance of transcripts encoding auxin transport and cell expansion proteins. Moreover, SeMet led to increased seedling respiration, which was positively correlated with organic acids consumption, but negatively with sugars consumption, thereby decreasing seedling growth. In contrast with SeMet treatment, Met did not affect ROS production, hormone biosynthesis and seedling growth, indicating an exclusive selenium effect. The singlet oxygen scavenger, 1,4-diazabicyclooctane, overrode the repressive effect of SeMet in seedling growth. Our results demonstrate a phytotoxic effect of SeMet for rice seedlings and reveal a relationship between reactive oxygen species, hormone homeostasis and carbon availability, which regulates growth responses.

Genomic Prediction of Grain Yield and Drought-Adaptation Capacity in Sorghum Is Enhanced by Multi-Trait Analysis.

Grain yield and stay-green drought adaptation trait are important targets of selection in grain sorghum breeding for broad adaptation to a range of environments. Genomic prediction for these traits may be enhanced by joint multi-trait analysis. The objectives of this study were to assess the capacity of multi-trait models to improve genomic prediction of parental breeding values for grain yield and stay-green in sorghum by using information from correlated auxiliary traits, and to determine the combinations of traits that optimize predictive results in specific scenarios. The dataset included phenotypic performance of 2645 testcross hybrids across 26 environments as well as genomic and pedigree information on their female parental lines. The traits considered were grain yield (GY), stay-green (SG), plant height (PH), and flowering time (FT). We evaluated the improvement in predictive performance of multi-trait G-BLUP models relative to single-trait G-BLUP. The use of a blended kinship matrix exploiting pedigree and genomic information was also explored to optimize multi-trait predictions. Predictive ability for GY increased up to 16% when PH information on the training population was exploited through multi-trait genomic analysis. For SG prediction, full advantage from multi-trait G-BLUP was obtained only when GY information was also available on the predicted lines per se, with predictive ability improvements of up to 19%. Predictive ability, unbiasedness and accuracy of predictions from conventional multi-trait G-BLUP were further optimized by using a combined pedigree-genomic relationship matrix. Results of this study suggest that multi-trait genomic evaluation combining routinely measured traits may be used to improve prediction of crop productivity and drought adaptability in grain sorghum.

Elevated CO2 induces age-dependent restoration of growth and metabolism in gibberellin-deficient plants.

MAIN CONCLUSION: The effect of elevated [CO2] on the growth of tomato plants with reduced gibberellin content is influenced by developmental stage. The impact of increased atmospheric carbon dioxide (CO2) on plants has aroused interest in the last decades. Signaling molecules known as plant hormones are fundamental controllers of plant growth and development. Elevated CO2 concentration ([CO2]) increases plant growth; however, whether plant hormones act as mediators of this effect is still an open question. Here, we show the response to elevated [CO2] in tomato does not require a functional gibberellin (GA) biosynthesis pathway. We compared growth and primary metabolism between wild-type (WT) and GA-deficient mutant (gib-1) plants transferred from ambient (400 ppm) to elevated (750 ppm) [CO2] at two different growth stages (either 21 or 35 days after germination, DAG). Growth, photosynthetic parameters and primary metabolism in the stunted gib-1 plants were restored when they were transferred to elevated [CO2] at 21 DAG. Elevated [CO2] also stimulated growth and photosynthetic parameters in WT plants at 21 DAG; however, only minor changes were observed in the level of primary metabolites. At 35 DAG, on the other hand, elevated [CO2] did not stimulate growth in WT plants and gib-1 mutants showed their characteristic stunted growth phenotype. Taken together, our results reveal that elevated [CO2] enhances growth only within a narrow developmental window, in which GA biosynthesis is dispensable. This finding could be relevant for breeding crops in the face of the expected increases in atmospheric CO2 over the next century.

Selenium downregulates auxin and ethylene biosynthesis in rice seedlings to modify primary metabolism and root architecture.

MAIN CONCLUSION: Selenium modulates the formation of primary and lateral roots through alterations in auxin and ethylene, leading to new patterns of root architecture in rice seedlings. Selenium (Se) at low concentrations can control root growth through interaction with hormone biosynthesis. Auxin and ethylene have been shown to control the root architecture, with most of the information obtained from the eudicots such Arabidopsis and Nicotiana tabacum. Here, we presented the effects of Se on auxin and ethylene pathways and examined their impact on primary metabolism and root system architecture in rice (Oryza sativa L.) seedlings. Se treatment increased elongation of primary root, but decreased the number and length of lateral roots. Se led to decreased expression of genes associated with the biosynthesis of auxin and ethylene, concomitantly with reduced production of these hormones by the roots. Moreover, Se decreased the abundance of transcripts encoding auxin transport proteins. Indole-3-acetic acid (IAA) treatment overrode the repressive effect of Se on lateral root growth. The ethylene synthesis inhibitor L-α-(2-aminoethoxyvinyl)-glycine (AVG) increased elongation of primary root, whereas the ethylene precursor 1-aminocyclopropane-1-carboxylic acid (ACC) resulted in the opposite effect. Soluble sugars accumulate in roots of rice seedlings under Se treatment. Thus, Se modulates the formation of primary and lateral roots through alterations in auxin and ethylene, leading to new patterns of root architecture in rice seedlings.

Combining pedigree and genomic information to improve prediction quality: an example in sorghum.

KEY MESSAGE: The use of a kinship matrix integrating pedigree- and marker-based relationships optimized the performance of genomic prediction in sorghum, especially for traits of lower heritability. Selection based on genome-wide markers has become an active breeding strategy in crops. Genomic prediction models can make use of pedigree information to account for the residual polygenic effects not captured by markers. Our aim was to evaluate the impact of using pedigree and genomic information on prediction quality of breeding values for different traits in sorghum. We explored BLUP models that use weighted combinations of pedigree and genomic relationship matrices. The optimal weighting factor was empirically determined in order to maximize predictive ability after evaluating a range of candidate weights. The phenotypic data consisted of testcross evaluations of sorghum parental lines across multiple environments. All lines were genotyped, and full pedigree information was available. The performance of the best predictive combined matrix was compared to that of models fitting the component matrices independently. Model performance was assessed using cross-validation technique. Fitting a combined pedigree-genomic matrix with the optimal weight always yielded the largest increases in predictive ability and the largest reductions in prediction bias relative to the simple G-BLUP. However, the weight that optimized prediction varied across traits. The benefits of including pedigree information in the genomic model were more relevant for traits with lower heritability, such as grain yield and stay-green. Our results suggest that the combination of pedigree and genomic relatedness can be used to optimize predictions of complex traits in crops when the additive variation is not fully explained by markers.

Salt stress inhibits germination of Stylosanthes humilis seeds through abscisic acid accumulation and associated changes in ethylene production.

In Stylosanthes humilis, salt stress tolerance is associated with ethylene production by the seeds, however, how salt stress controls seed germination and ethylene production is poorly understood. Here, we studied the hormonal and metabolic changes triggered by salt stress on germination of S. humilis seeds. Salt stress led to decreased seed germination and ethylene production, concomitantly with higher abscisic acid (ABA) production by seeds. Treatment with NaCl and ABA promoted distinct changes in energy metabolism, allowing seeds to adapt to salt stress conditions. Treatment with the ABA biosynthesis inhibitor fluridone or ethylene precursor 1-aminocyclopropane-1-carboxylic acid (ACC) reversed the effects of salt stress on seed germination and ethylene production. Moreover, ethylene concentration was decreased by increasing the pH of the salt solution. High pH, however, did not influence concentration of ABA in seeds under salt stress. We conclude that biosynthesis of ABA and ethylene in response to salt stress constitutes a point of convergence that provides flexibility to regulate energy metabolism and embryo growth potential of S. humilis seeds within a given pH condition.

Low soil pH modulates ethylene biosynthesis and germination response of Stylosanthes humilis seeds.

The tropical forage legume Stylosanthes humilis is naturally distributed in the acidic soils of the tropics. However, data concerning the role of low soil pH in the control of S. humilis seed germination remains limited. Recently, we have demonstrated that acidic soil triggers increased ethylene production during germination of S. humilis seeds, concomitantly with higher root penetration into the soil. Our finding points an important role of low soil pH as a signal allowing penetration of root in the soil through interaction with the ethylene signalling pathway. Herein, we discuss how low soil pH induces changes on seed hormonal physiology.

Prevalence of Injuries during Brazilian Jiu-Jitsu Training.

Brazilian jiu-jitsu (BJJ) is a martial art that focuses on groundwork, joint locks, and chokeholds. The purpose of this study is to determine the prevalence of injuries sustained during BJJ training. A 27-question research survey was e-mailed to 166 BJJ gyms in the United States. Demographic information, belt level, weight class, training hours, competition experience, and injury prevalence data were collected. The majority of respondents were Caucasian (n = 96) males (n = 121) with an average age of 30.3 years. Overall, the most common injury locations were to the hand and fingers (n = 70), foot and toes (n = 52), and arm and elbow (n = 51). The most common medically diagnosed conditions were skin infections (n = 38), injuries to the knee (n =26), and foot and toes (n = 19). The most common non-medically diagnosed injuries occurred to the hand and fingers (n = 56), arm and elbow (n = 40), and foot and toes (n = 33). In general, athletes were more likely to sustain distal rather than proximal injuries. Athletes reported more frequent medically diagnosed injuries to the lower extremity and more frequent self-diagnosed injuries to the upper extremity. Upper extremity injuries appear to be more frequent but less severe than lower extremity injuries with the opposite being true for lower extremity injuries.

Kalkipyrone B, a marine cyanobacterial γ-pyrone possessing cytotoxic and anti-fungal activities.

Bioassay-guided fractionation of two marine cyanobacterial extracts using the H-460 human lung cancer cell line and the OVC-5 human ovarian cancer cell line led to the isolation of three related α-methoxy-ß, ß'-dimethyl-γ-pyrones each containing a modified alkyl chain, one of which was identified as the previously reported kalkipyrone and designated kalkipyrone A. The second compound was an analog designated kalkipyrone B. The third was identified as the recently reported yoshinone A, also isolated from a marine cyanobacterium. Kalkipyrone A and B were obtained from a field-collection of the cyanobacterium Leptolyngbya sp. from Fagasa Bay, American Samoa, while yoshinone A was isolated from a field-collection of cyanobacteria (cf. Schizothrix sp.) from Panama. One-dimensional and two-dimensional NMR experiments were used to determine the overall structures and relative configurations of the kalkipyrones, and the absolute configuration of kalkipyrone B was determined by (1)H NMR analysis of diastereomeric Mosher's esters. Kalkipyrone A showed good cytotoxicity to H-460 human lung cancer cells (EC50=0.9µM), while kalkipyrone B and yoshinone A were less active (EC50=9.0µM and >10µM, respectively). Both kalkipyrone A and B showed moderate toxicity to Saccharomyces cerevisiae ABC16-Monster strain (IC50=14.6 and 13.4µM, respectively), whereas yoshinone A was of low toxicity to this yeast strain (IC50=63.8µM).

Feature Level Two -Dimensional Arrays Based Fusion in the Personal Authentication system using Physiological Biometric traits

ABSTRACT The fingerprint, knuckle print and the retina are used to authenticate a person accurately because of the permanence in the features. These three biometric traits are fused for better security. The fingerprint and knuckle print images are pre-processed by morphological techniques and the features are extracted from the normalized image using gabor filter. The retinal image is converted to gray image and pre-processing is done using top hat and bottom hat filtering. Blood vessels are segmented and the features are extracted by locating the optic disk as the centre point. The extracted features from the fingerprint, knuckle print and the retina are fused together as one template and stored in the data base for authentication purpose, thus reducing the space and time complexity.

ISOLATION OF Cryptococcus neoformans FROM ENVIRONMENTAL SAMPLES COLLECTED IN SOUTHEASTERN NIGERIA.

Cryptococcosis caused by Cryptococcus neoformans is the second most common fungal opportunistic pathogen and a life-threatening infection with serious clinical manifestations especially in HIV/AIDS and other immunocompromised patients. In Nigeria, HIV/AIDS infection has reached an alarming level. Despite this, information on the presence of this fungus in clinical and environmental samples is very scanty in Nigeria and many other parts of Africa. We set out to evaluate the presence of Cryptococcus neoformans or C. gattiiin pigeon droppings obtained from Southeastern Nigeria. One hundred and seventy-seven samples of pigeon droppings from six sample types were collected. The area covered comprised of ten cities and other locations spanning across five States in Nigeria. Using established techniques, Cryptococcus neoformans was isolated from 39 of the 177 (22.0%) samples overall. No C. gattiiwas isolated. Most of the isolates (32.4%) were recovered from dovecotes (11 of 34) followed closely by samples taken from markets (31.8%; seven of 22) and least from the church (4.0%; one of 25). The highest isolation rate (38.9%) was found in samples from Enugu-Ezike(seven of 23) while the least came from Afikpo and the other locations each with 9.1% isolation rate. This is the first large-scale screening of Cryptococcus neoformans from pigeon droppings in Nigeria. The ecological and epidemiological significance of these findings are discussed.

Isolation of cryptococcus neoformans from environmental samples collected in Southeastern Nigeria / Isolamento de Cryptococcus neoformans de amostras ambientais coletadas no sudeste da Nigéria

SUMMARYCryptococcosis caused by Cryptococcus neoformansis the second most common fungal opportunistic pathogen and a lifethreatening infection with serious clinical manifestations especially in HIV/AIDS and other immunocompromised patients. In Nigeria, HIV/AIDS infection has reached an alarming level. Despite this, information on the presence of this fungus in clinical and environmental samples is very scanty in Nigeria and many other parts of Africa. We set out to evaluate the presence of Cryptococcus neoformansor C. gattiiin pigeon droppings obtained from Southeastern Nigeria. One hundred and seventy-seven samples of pigeon droppings from six sample types were collected. The area covered comprised of ten cities and other locations spanning across five States in Nigeria. Using established techniques, Cryptococcus neoformanswas isolated from 39 of the 177 (22.0%) samples overall. No C. gattiiwas isolated. Most of the isolates (32.4%) were recovered from dovecotes (11 of 34) followed closely by samples taken from markets (31.8%; seven of 22) and least from the church (4.0%; one of 25). The highest isolation rate (38.9%) was found in samples from Enugu-Ezike(seven of 23) while the least came from Afikpoand the other locations each with 9.1% isolation rate. This is the first large-scale screening of Cryptococcus neoformansfrom pigeon droppings in Nigeria. The ecological and epidemiological significance of these findings are discussed.

RESUMOA criptococose, causada por Cryptococcus neoformans, é o segundo patógeno fúngico oportunista mais comum em infecções com risco de vida e manifestações clínicas graves, especialmente em HIV/AIDS e outros pacientes imunocomprometidos. Na Nigéria, a infecção pelo HIV/AIDS atingiu um nível alarmante. Apesar disso, informações sobre a presença desses fungos em amostras clínicas e ambientais é muito escassa na Nigéria e em muitas outras partes da África. Propusemo-nos a avaliar a presença de Cryptococcus neoformansou C. gattiiem fezes de pombos obtidos do sudeste da Nigéria. Foram coletadas 177 amostras de fezes de pombos de seis localidades. A área coberta foi composta por dez cidades e outras localidades abrangendo cinco Estados na Nigéria. Usando técnicas estabelecidas, Cryptococcus neoformansfoi isolado de 39 do total de 177 (22,0%) amostras. Nenhuma amostra de C. gattiifoi isolada. A maioria dos isolados (32,4%) foi recuperada de pombais (11 de 34), seguido de perto por amostras colhidas em mercados (31,8%; 7 de 22) e por último na igreja (4,0%; 1 de 25). A maior taxa de isolamento (38,9%) foi encontrada em amostras de Enugu-Ezike (7 de 23), enquanto a menor taxa foi de Afikpo e os outros locais, cada um deles com taxa de isolamento de 9,1%. Esta é a primeira triagem em larga escala de Cryptococcus neoformansem fezes de pombos na Nigéria. A importância ecológica e epidemiológica destes achados é discutida.

Cholera: something old, something new.

BACKGROUND: In the aftermath of a devastating earthquake in early 2011, Haiti fell victim to an outbreak of cholera that claimed thousands of lives and affected populations in nearby Dominican Republic, Venezuela, and even the United States. This was the first time cholera had been reported in Haiti in more than 100 years. The sudden appearance of cholera, a pathogen with no known non-human host, raised the question of how it was introduced to an island that has long been spared this disease. The purpose of this review is to provide an overview of the history of cholera, its pathophysiology and virulence factors, and current recommendations for treatment. METHODS: Articles published in the past 10 years were identified by a search of the medical literature using PUBMED and reviewed. Bibliographies of each article also were reviewed for additional pertinent articles. RESULTS: The recent epidemic was caused by a strain that has been responsible for disease in South Asia since 1961, the seventh and most recent strain identified since 1900. It is transmitted by the fecal-oral route. Once infected, the patient develops a rapidly dehydrating diarrheal illness caused by the cholera toxin, which activates cytoplasmic adenylate cyclase of the intestinal epithelial cells by adenosine diphosphate (ADP)-ribosylation of the stimulatory G protein. The high cyclic adenosine monophosphate (cAMP) concentrations activate the cystic fibrosis transmembrane conductance regulator, causing a dramatic efflux of ions and water from infected enterocytes and leading to watery diarrhea. The first line of therapy is oral hydration with intravenous fluids; antibiotics are reserved for patients with severe dehydration. Spread of cholera is preventable with simple modifications of hygiene and water preparation. CONCLUSIONS: Cholera has re-emerged as a major infectious disease in the recent past, with a global increase in its incidence. Vaccination should be considered as an adjunct for controlling the epidemics and also for volunteer health care workers who provide services to underdeveloped nations. During an epidemic such as occurred in Haiti, use of antibiotics should be considered for all hospitalized patients. These endeavors should proceed in concert with much-needed improvements in sanitation and accessibility of potable water.

Allowable levels of take for the trade in Nearctic songbirds.

The take of Nearctic songbirds for the caged-bird trade is an important cultural and economic activity in Mexico, but its sustainability has been questioned. We relied on the theta-logistic population model to explore options for setting allowable levels of take for 11 species of passerines that were subject to legal take in Mexico in 2010. Because estimates of population size necessary for making-periodic adjustments to levels of take are not routinely available, we examined the conditions under which a constant level of take might contribute to population depletion (i.e., a population below its level of maximum net productivity). The chance of depleting a population is highest when levels of take are based on population sizes that happen to be much lower or higher than the level of maximum net productivity, when environmental variation is relatively high and serially correlated, and when the interval between estimation of population size is relatively long (> or = 5 years). To estimate demographic rates of songbirds involved in the Mexican trade we relied on published information and allometric relationships to develop probability distributions for key rates, and then sampled from those distributions to characterize the uncertainty in potential levels of take. Estimates of the intrinsic rate of growth (r) were highly variable, but median estimates were consistent with those expected for relatively short-lived, highly fecund species. Allowing for the possibility of nonlinear density dependence generally resulted in allowable levels of take that were lower than would have been the case under an assumption of linearity. Levels of take authorized by the Mexican government in 2010 for the 11 species we examined were small in comparison to relatively conservative allowable levels of take (i.e., those intended to achieve 50% of maximum sustainable yield). However, the actual levels of take in Mexico are unknown and almost certainly exceed the authorized take. Also, the take of Nearctic songbirds in other Latin American and Caribbean countries ultimately must be considered in assessing population-level impacts.

Evaluación para comparar dos esquemas de terapia estándar (7 frente a 10 días) contra el Helicobacter pylori, con seguimiento clínico a 1 año / Randomized study of seven days of standard treatment for Helicobacter Pylori vs. ten days of standard treatment for Helicobacter Pylori with one year follow-ups of patients

Antecedentes: la creciente resistencia del Helicobacter pylori a los antibióticos induce el fracaso de la terapia de erradicación, por lo que se pretende modificar no solo la duración de la misma sino el régimen de antibióticos. Materiales y métodos: luego de una asignación aleatorizada se compararon dos esquemas de tratamiento estándar (7 [grupo 1] frente a 10 días [grupo 2]) con omeprazol 20 mg más amoxicilina 1 g y claritromicina 500 mg, todos vía oral (VO) cada 12 horas en pacientes con dispepsia no ulcerosa (DNU) y dispepsia ulcerosa (DU), para evaluar la efectividad de la erradicación con la prueba o test del aliento. Al año se comparó de nuevo la respuesta clínica de cada una de las terapias en los pacientes con DNU y DU. Se evaluó, además, la tolerancia a la terapia en cada grupo. Resultados: se asignaron aleatoriamente 149 pacientes al grupo 1 y 144 pacientes al grupo 2. La tasa de erradicación en el análisis por intención a tratar fue del 67,8% en el grupo 1 y del 74,3% en el grupo 2 (p=0,24), y en el análisis por protocolo fue del 72,1% y 81,1% (p=0,08), respectivamente. La tasa de erradicación fue similar para ambos grupos independiente del grado de infección por H. pylori (p=0,22) y no se encontraron diferencias en el grado de infección y la presencia de DNU o DU (p=0,19). Los efectos adversos fueron más frecuentes en el grupo 2 (27,5% frente a 36,1%), aunque sin relevancia estadística (p=0,4). La tasa de erradicación para ambos grupos fue similar para los pacientes con DNU (73,8% frente a 81,1%) y DU (64,3% frente a 73%). El seguimiento al año mostró que las manifestaciones clínicas no se relacionaron con el hecho de haber erradicado o no la bacteria (p=0,7), pese a que la respuesta clínica de los pacientes con DU fue mejor que la observada para los pacientes con DNU. Conclusiones: la terapia estándar durante 7 o 10 días es insuficiente para la erradicación del H. pylori, independiente del grado de infección por este microorganismo ...

Background: The increasing resistance of H pylori to antibiotics has led to failures of eradication treatment. For this reason we intend to modify both the duration of treatment and the regime of antibiotics. Methods: After random allocation, the standard treatment with omeprazole 20 mg orally every 12 hours, amoxicillin 1 g VO every 12 hours and clarithromycin 500 mg orally every 12 hours for 7 days (group 1) was compared with the same antibiotic regime over 10 days (group 2). Patients had either non-ulcer dyspepsia (NUD) or ulcer dyspepsia (UD). Effectiveness of eradication was evaluated with breathe tests. A year later, clinical responses to each therapy were compared for patients with NUD and DU. The tolerance to therapy was also evaluated for each group. Results: 149 patients were randomly assigned to group 1 and 144 patients to group 2. The eradication rate as measured by ITT analysis was 67.8% in group 1 and 74.3% in group 2 (p = 0.24). It was 72.1% and 81. 1% (p = 0.08) respectively for per protocol analysis. The eradication rate was similar for both groups independently of the degree of H pylori infection (p = 0.22). Differences in the degree of infection and the presence of NUD or DU (p = 0.19) were not found. Adverse effects were more frequent in group 2 (27.5% vs. 36.1%), but without statistical relevance (p = 0.4). The eradication rate was similar for patients with NUD (73.8% vs. 81,1%) and DU (64.3% vs. 73%). Follow up examinations one year later showed that the clinical manifestations were not related to the whether or not bacteria had been eradicated (p = 0.7). Nevertheless, the clinical response of patients with DU was better than for those with NUD. Conclusions: Standard therapy for either 7 or 10 days is insufficient for eradication of H pylori independent of the degree of H pylori infection or the type of endoscopic finding (NUD or DU). Both therapies show suboptimal eradication rates and poor clinical responses at ...