Eduardo Ott

Clinical outcomes of eradication of Helicobacter pylori in nonulcer dyspepsia in a population with a high prevalence of infection : results of a 12-month randomized, double blind, placebo-controlled study

Ninety-one Helicobacter pylori-positive patients with nonulcer dyspepsia were randomized to receive either lansoprazole, amoxicillin, and clarithromycin or lansoprazole and placebo. A validated questionnaire assessed dyspeptic symptoms at baseline and at 3, 6, and 12 months. Endoscopies and biopsies were performed at baseline and at 3 and 12 months. There was an overall trend, although not statistically significant, for a benefit of H. pylori eradication. Of the patients in the antibiotics group, 16 of 46 (35%) had symptomatic improvement, versus 9 of 43 (21%) in the control group (P = 0.164). In a secondary analysis, it was found that of the patients without endoscopic gastric erosions, 15 of 34 (44%) in the antibiotics group and 5 of 33 (15%) of controls had symptomatic improvement (P = 0.015). Helicobacter pylori eradication did not prove to be clinically beneficial, although a tendency to symptomatic benefit was detected. Further studies are necessary to confirm the implications of endoscopic gastric erosions in these patients.

Development and validation of a cross-cultural questionnaire to evaluate nonulcer dyspepsia: the Porto Alegre Dyspeptic Symptoms Questionnaire (PADYQ).

Despite its high prevalence, nonulcer dyspepsia is still difficult to study, due to the lack of adequate tools to measure significant outcomes. The objective of this study was to develop and validate a symptom-focused, disease-specific questionnaire to evaluate patients with nonulcer dyspepsia. For that, the questionnaire was carefully written following widely accepted terminology, so as to facilitate translation and validation in other languages and cultures. The questionnaire was developed using Rome I terminology for symptoms, which were evaluated according to their intensity, duration, and frequency when applicable. Thirty-one patients with nonulcer dyspepsia, as well as 31 sex-and age-matched volunteers without digestive problems were used to assess the internal consistency, reproducibility, responsiveness, content validity, and discriminant validity of the questionnaire. Another 31 functional dyspeptic patients were enrolled for assessment of criterion validity. Cronbach’s α coefficient was 0.82. The intraclass correlation coefficient for the scores obtained 7 days apart was 0.86. The mean score obtained after 3 months of treatment was 16.4, vs. 23.03 at baseline (P=0.001). Two blinded gastroenterologists agreed that the questionnaire adequately evaluated nonulcer dyspepsia. The median symptoms score for controls was 0, vs. 22.5 for dyspeptic patients (P=0.001). An inverse correlation was observed between quality of life and dyspeptic symptoms (R = −0.28, P = 0.026). The proposed questionnaire has high degrees of both reproducibility and responsiveness. As this questionnaire was based on Rome I International Consensus terminology, it is expected that it will be easy to translate and validate.

Acidentes de trânsito em área metropolitana da região sul do Brasil: caracterização da vítima e das lesões

Por meio de estudo retrospectivo, descreve-se a casuistica referente aos atendimentos prestados a acidentados de trânsito, em 1988, em hospital de Pronto Socorro de Porto Alegre, RS - Brasil. Os dados utilizados foram fornecidos pelo Setor de Documentacao e Estatistica do hospital estudado (n=6.099). Os resultados encontrados, similares aqueles descritos na literatura, chama especial atencao pela predominância do sexo masculino (69,2% do total de atendimentos), pela concentracao dos acidentados na faixa etaria dos 20 aos 39 anos (52%) e pela frequencia com que a cabeca e acometida (49,6% dos pacientes). Lesoes severas como contusoes e fraturas foram encontradas, respectivamente, em 61,5% e 24,2% dos pacientes. Os dados revelam, ainda, o elevado numero e a gravidade das lesoes resultantes de atropelamentos, os quais foram responsaveis por 32,7% do total de atendimentos por acidentes de trânsito, 57,2% das internacoes hospitalares, 54,6% dos atendimentos de menores de 9 anos e 42,8% dos acima de 60 anos.Casualties treated in a Emergency Hospital of Porto Alegre, Brazil, during the year 1988, for injuries received as a result of traffic accidents, are described by means of a retrospective study of the data provided by the Documentation and Statistics Sector of the hospital (n = 6.099). The results, similar to those described in the literature, draw special attention to the predominance of the male sex (69.2%), to the concentration of accidents involving individuals of between 20 and 39 years of age, inclusive, (52%) and to the frequency which the head is injured (49.6%) of the patients. Severe injuries such as bruises and fractures were found, respectively, in 61.5% and 24.2% of the patients. The data reveal, further, the large number and the seriousness of the injuries caused by accidents involving pedestrians which accounted for 32.7% of the total number of attendances related to traffic accidents, 57.2% of hospital internments; 54.6% of the victims of this kind of accident were under 9 years of age and 42.8% were over 60.Por meio de estudo retrospectivo, descreve-se a casuistica referente aos atendimentos prestados a acidentados de trânsito, em 1988, em hospital de Pronto Socorro de Porto Alegre, RS - Brasil. Os dados utilizados foram fornecidos pelo Setor de Documentacao e Estatistica do hospital estudado (n=6.099). Os resultados encontrados, similares aqueles descritos na literatura, chama especial atencao pela predominância do sexo masculino (69,2% do total de atendimentos), pela concentracao dos acidentados na faixa etaria dos 20 aos 39 anos (52%) e pela frequencia com que a cabeca e acometida (49,6% dos pacientes). Lesoes severas como contusoes e fraturas foram encontradas, respectivamente, em 61,5% e 24,2% dos pacientes. Os dados revelam, ainda, o elevado numero e a gravidade das lesoes resultantes de atropelamentos, os quais foram responsaveis por 32,7% do total de atendimentos por acidentes de trânsito, 57,2% das internacoes hospitalares, 54,6% dos atendimentos de menores de 9 anos e 42,8% dos acima de 60 anos.

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.