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Sixty percent (60%) of the study population was positive for H. pylori infection (mean age of 44 years +/- 13), 70% were males. H. pylori culture showed a sensitivity of 45% (95% CI [29.5-62.1]), specificity of 98% (95%CI [81.5-100%]), positive likelihood ratio of 19.93 (95% CI [1.254-317.04]) and a negative likelihood ratio of 0.56 (95% CI [0.406-0.772]). All H. pylori strains isolated were sensitive to metronidazole, clarithromycin, amoxicillin and tetracycline.
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A randomized, triple-blind, controlled clinical trial was used to determine the effect of systemic administration of M+A, as the sole therapy, in progressive adult periodontitis. Forty-six subjects with moderate to advanced adult periodontitis who showed > or =2 mm attachment loss in at least 2 sites in the previous 2 months were entered in the study. Subjects were randomly distributed to a group who received 21 tablets of metronidazole 250 mg plus amoxicillin 500 mg, or to a group receiving a placebo (1 tablet every 8 hours for 1 week). Patients were examined every 2 months for 12 months. The M+A or placebo regimen was repeated at 4 and 8 months. No effort was made to change the oral habits of patients and they received no additional therapy. Differences between groups were assessed using the Mann-Whitney U test. The differences at every 2-month interval within each group were assessed using the ANOVA test.
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Overall, resistance to metronidazole and clarithromycin was detected in 41.9% and 5.4% of patients, respectively. There was no significant difference in metronidazole and clarithromycin resistance according to age group and sex. Six strains were resistant to both metronidazole and clarithromycin. Six of nine clarithromycin-resistant isolates possessed the A2144G mutation in the gene encoding 23S rRNA. Sequencing of the three non-restricted clarithromycin-resistant strains revealed a T-to-C mutation at position 2182.
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The purpose of present research work was to prepare calcium alginate beads containing water-soluble drug metronidazole using 3(2) factorial design, with drug concentration and curing time as variables. Curing time was kept as low as possible to improve entrapment with increasing drug concentration. Mostly the drugs which had been encapsulated were water insoluble to facilitate drug encapsulation; a characteristic drug release as whole process is aqueous based. Entrapment efficiency was in the range of 81% to 96% wt/wt, which decreased with decrease in polymer concentration and increase in curing time. The beads were spherical with size range between 1.4 and 1.9 mm. Scanning electron microscope (SEM) photomicrographs revealed increase in the leaching of drug crystals with increased curing time and high drug concentrations. In acidic environment, the swelling ratio was 200% in 30 minutes, but in basic medium, it increased to a maximum of 1400% within 120 minutes. In acidic medium, the swelling and drug release properties were influenced by drug solubility, whereas in phosphate buffer these properties were governed by the gelling of polymer and exhibited curvilinear and quadratic functions of both the variables, respectively.
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A series of 56 children, who were operated on for perforated appendicitis during 1996 in Children's Hospital Podgorica and Pediatric Surgery Department of Hospital in Novi Sad, are reviewed. The average age of children in this series was 9.8 years (range, 2-14 years). All children were divided in two groups: patients included in the first group (n = 36) were treated with aggressive fluid resuscitation, preoperative triple antibiotic therapy, peritoneal lavage, avoidance of transperitoneal drains except those used for well-localized abscesses, primary wound closure and postoperative antibiotic therapy for seven to ten days. In the second group, children were managed in the same way, but silicon tube drainage after appendicectomy was included as well. Patients in both groups were given the same antibiotic therapy: intravenous metronidazole combined with gentamicin and ampicillin.
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In a previous study involving patients at the dental clinic of the Detroit Receiving Hospital, 87% of teeth that initially had been recommended for surgery or extraction were spared either treatment through a combination of debridement and short-term usage of antimicrobial agents. The object of the present study was to determine what changes occurred to these teeth after 6.4 years in the maintenance phase of treatment. Patients were scheduled for maintenance therapy at three-month intervals over a period of 6.4 years. They were evaluated "annually" (that is, the patients were scheduled for annual visits) for surgical needs by a clinician who was not aware of the treatment received by the patients. Multivariate statistical models were used to determine which variables predicted subsequent surgical needs. The initial treatment benefits were sustained, as the majority of patients showed no increase in surgical needs after 6.4 years. When relapse occurred, those who were smoking when the study began and an increased number of sessions of debridement were predictors. Surgical needs were reduced when metronidazole was dispensed after the first and second annual examinations.
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We read with interest the recent meta-analysis by Lin et al who evaluated the effectiveness of concomitant regimen for Helicobacter pylori (H. pylori) in Chinese regions. They found that 7-d concomitant regimen is undoubtedly superior to 7-d triple therapy (91.2% vs 77.9%, P < 0.0001). However, it is a common belief that a triple therapy lasting 7 d should be definitively removed from the clinical practice for its ineffectiveness. Only its prolongation to 14 d may give satisfactory success rate. Thus, the assessment of an old and outdated treatment versus a more recent and successful one does not seem to bring novel and useful information. Moreover, a 7-d duration has not been ascertained for concomitant regimen, as main guidelines recommend a 10-d schedule for this scheme. Therefore, only studies comparing 10-d concomitant versus 14-d triple seem to be appropriate according to current Guidelines and would clarify which regimen is the most suitable worldwide. Additionally, in this meta-analysis concomitant and sequential therapy showed similar performances, despite it is common opinion that sequential is more prone than concomitant therapy to fail when metronidazole resistance occurs, and China is characterized by high rate of resistance to this antibiotic. None of the included studies evaluated a priori antibiotic resistances, and the lack of this detail hampers the unveiling of this apparent contradiction. In conclusion, the lack of the evaluation of the quality of included trials as well as their high heterogeneity constitute a burdensome limit to draw solid conclusions in this meta-analysis. On the bases of these considerations and the low number of examined trials, we believe that further studies and the knowledge of antibiotic resistances will support with high quality evidence which is the best regimen and its optimal duration.
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Among 574 patients treated with RFA over 8 years, only 11 patients (with 13 sessions of RFA, 2 patients undergoing two different RFA sessions) presented with an enterobiliary anastomosis or biliary stenting at the time of RFA. This is a retrospective study of patients who were verified prospectively.
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Tissues and epithelial cells of vagina, uterus, fallopian tubes and perianal region were investigated using fluorescence in situ hybridization (FISH) in women with BV and controls.
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The medical records were reviewed for consecutive in-patients with CDI confirmed by positive toxin assay (A or B), C. difficile culture, or the presence of pseudomembrane on endoscopy. Treatment success was defined as the resolution of diarrhoea within 6 days of therapy. The primary end points were assessed by average symptom recovery time and treatment response (success or failure).
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In conclusion, the scientific evidence supports the adjunctive use of local antimicrobials to SRP in deep or recurrent periodontal sites, mostly when the vehicle has shown pharmacodynamic properties assuring the sustained release of the antimicrobial. This evidence must be interpreted with caution, as the reported data were highly heterogeneous and most of the selected studies were categorised with a high degree of bias.
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To compare the rate of wound infection of perforated appendicitis in children between primary wound closure and delayed primary wound closure.