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Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line

World Journal of Gastroenterology 2012年第40期18卷 5669-5678页

作者： Simona Di Caro Lucia Fini Yayha Daoud Fabio Grizzi Antonio Gasbarrini Antonino De Lorenzo Laura Di Renzo sara mccartney Stuart Bloom Department of Gastroenterology University College HospitalLondon NW1 2PGUnited Kingdom Division of Human Nutrition University of Tor Vergata Department of Gastroenterology and Laboratory of Molecular Gastroenterology Humanitas Clinical and Research Center Baylor Health Care System Institute for Health Care Research and Improvement Department of Internal Medicine Gemelli HospitalCatholic University of Rome

Worldwide prevalence of Helicobacter pylori(***) infection is approximately 50%,with the highest being in developing *** compared cure rates and tolerability(SE) of second-line *** levofloxacin/amoxicillin(LA)-based triple regimens vs standard quadruple therapy(QT).An English language literature search was performed up to October 2010.A meta-analysis was performed including randomized clinical trials comparing 7-or 10-d LA with 7-d *** total,10 articles and four abstracts were *** eradication rate in LA was 76.5%(95% CI:64.4%-97.6%).When only 7-d regimens were included,cure rate was 70.6%(95% CI:40.2%-99.1%),whereas for 10-d combinations,cure rate was significantly higher(88.7%;95% CI:56.1%-109.9%;P < 0.05).Main eradication rate for QT was 67.4%(95% CI:49.7%-67.9%).The 7-d LA and QT showed comparable efficacy [odds ratio(OR):1.09;95% CI:0.63-1.87],whereas the 10-d LA regimen was significantly more effective than QT(OR:5.05;95% CI:2.74-9.31;P < 0.001;I 2 = 75%).No differences were reported in QT eradication rates among Asian and European studies,whereas LA regimens were more effective in European populations(78.3% vs 67.7%;P = 0.05).Incidence of SE was lower in LA therapy than QT(OR:0.39;95% CI:0.18-0.85;P = 0.02).A higher rate of side effects was reported in Asian patients who received *** findings support the use of 10-d LA as a simple second-line treatment for *** eradication with an excellent eradication rate and *** optimal second-line alternative scheme might differ among countries depending on quinolone resistance.

关键词： Helicobacter pylori Second-line treatment Levofloxacin Quadruple regimen

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High resolution colonoscopy in a bowel cancer screening program improves polyp detection

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World Journal of Gastroenterology 2011年第38期17卷 4308-4313页

作者： Matthew R Banks Rehan Haidry M Adil Butt Lisa Whitley Judith Stein Louise Langmead Stuart L Bloom Austin O' Bichere sara mccartney Kalpesh Basherdas Manuel Rodriguez-Justo Laurence B Lovat Department of Gastrointestinal Services University College London Hospitals NHS Foundation Trust Department of Histopathology University College London Hospitals NHS Foundation Trust

AIM： To compare high resolution colonoscopy （Olympus Lucera） with a megapixel high resolution system （Pentax HiLine） as an in-service evaluation. METHODS： Polyp detection rates and measures of performance were collected for 269 colonoscopy procedures. Five colonoscopists conducted the study over a three month period, as part of the United Kingdom bowel cancer screening program. RESULTS：There were no differences in procedure duration （x^2 p = 0.98）, caecal intubation rates （x^2 P = 0.67）, or depth of sedation （x^2 P = 0.64）. Mild discomfort was more common in the Pentax group （x^2 p = 0.036）. Adenoma detection rate was significantly higher in the Pentax group （x^2 test for trend P = 0.01）. Most of the extra polyps detected were flat or sessile adenomas. CONCLUSION： Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope performance. Increased polyp detection rates may improve future outcomes in bowel cancer screening programs.

关键词： High resolution colonoscopy Bowel cancerscreening Polyp detection

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Henoch-Schnlein purpura complicating adalimumab therapy for Crohn's disease

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2010年第5期1卷 119-122页

作者： Farooq Z Rahman Gagandeep K Takhar Ovishek Roy Anna Shepherd Stuart L Bloom sara a mccartney Department of Gastroenterology University College London Hospitals NHS Foundation TrustLondonNW1 2BUUnited Kingdom Department of Histopathology University College London Hospitals NHS Foundation TrustLondonNW1 2BUUnited Kingdom

Anti-tumour necrosis factor-α(TNF) therapy has revolutionised the management of chronic inflammatory *** ever increasing numbers of patients being treated with these agents,uncommon adverse reactions will inevitably occur more *** manifestations are associated with many of these chronic conditions and can complicate anti-TNF therapy in about 20% of *** complications are rarely associated with anti-TNF ***-Schnlein purpura(HSP),a small vessel vasculitis,has been described following infliximab and etanercept therapy but never with adalimumab,a fully humanized TNF *** risk of such immune-mediated reactions is theoretically less with adalimumab compared to infliximab but can still *** we report the f irst case in the literature of HSP that can be attributed to the use of adalimumab in a 19-year-old male with recalcitrant Crohn's disease.

关键词： Henoch-Schnlein purpura Adalimumab Anti-TNF therapy Leukocytoclastic vasculitis Crohn’s disease

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