Rabeprazole 20 mg for erosive esophagitis-associated symptoms in a large, community-based study: additional results.

PURPOSE: To provide additional efficacy data in patients treated with rabeprazole through week 4, and to validate sustained relief of gastroesophageal reflux disease symptoms through week 8 as well as to further analyze rabeprazole safety in patients with wide-ranging demographic and clinical characteristics. RESULTS: Patients in this study (N = 2,449) demonstrated significant overall improvement versus baseline (P < 0.001). Substantial symptom relief was seen throughout 8 weeks of treatment. By week 4, complete relief of daytime and nighttime heartburn, belching, regurgitation, and dysphagia was observed in 87.5, 90.7, 50.7, 77.6, and 75.1% of patients, respectively. Improvements were seen in rabeprazole-treated patients (<65 or >or=65 years) with a range of baseline symptom severities and across different racial groups. Rabeprazole was well tolerated. CONCLUSIONS: In patients with endoscopy-confirmed erosive esophagitis treated with once-daily rabeprazole 20 mg, prompt and continuing improvements were seen in daytime and nighttime heartburn, belching, regurgitation, and dysphagia.

Medical Treatment for Microscopic Colitis: A Community Hospital's Experience.

BACKGROUND: Lymphocytic colitis (LC) is a chronic disorder characterized by watery diarrhea. This study sought to evaluate if LC recurs after therapy, and the time frame in which this occurs. Secondary objectives included length and type of therapy, drug-free intervals, and reasons for drug discontinuation. METHODS: A retrospective chart review between January 1, 2008 and October 30, 2015 of patients with biopsy-confirmed lymphocytic, collagenous, or microscopic colitis was conducted. Patient-reported average bowel movements/day were reviewed. Demographic data, dates of colonoscopy, follow-up, type and dose of medications used, and therapy start/stop dates were reviewed. RESULTS: Patients presenting with colonoscopic documented LC (n = 114) were predominantly female (88%), Caucasian (97%), with mean bowel movements/day of five. A total of 58/114 (51%) patients were placed on a therapy. Patients taking budesonide saw bowel movements/day reduced from 4.7 to 2.4 compared to 5.8 to 2.8 for those given 5-aminosalicylic acid (5-ASA). First-line medications budesonide and 5-aminosalicylic acid failed in 12/58 (21%) of patients, other drugs also resulted in therapy changes. Thirty-five percent required their initial therapy changed and of those 40% required a second change. Symptom exacerbations were documented during therapy for 19% of patients; therapy changes resulted in good response. CONCLUSIONS: Almost half of all LC cases (56/114) gradually improved without requiring therapy. Seventy-six percent of our treated patients responded well to budesonide when used as the first-line therapy. Similarly, 61.5% responded to 5-ASA. Budesonide was the drug of choice for flares. Tailoring drug therapy to meet individual patient's needs appears to be the best current approach to managing LC.

A comparative analysis of nested subset patterns of species composition.

We present a broad comparative assessment of nested subsets in species composition among ecological communities. We assembled presence-absence data from a broad range of taxa, geographic regions, and spatial scales; and subjected this collection of datasets to common analyses, including a variety of metrics for measuring nestedness and null hypotheses against which to evaluate them. Here we identify ecological patterns in the prevalence and strength of nested subset structure, and assess differences and biases among the available methodologies. In all, we compiled 279 presence-absence matrices, of which 163 do not overlap in their coverage of species and sites. The survey includes studies on vertebrates, arthropods, mollusks, plants, and other taxa; from north temperate, tropical, and south temperate latitudes. Our results were as follows. Statistically significant nestedness was common. Assemblages from landbridge archipelagos were strongly nested, and immigration experiments were least nested. This adds further empirical support to the hypothesis that extinction plays a major role in producing nested structure. Nestedness was positively correlated with the ratio of the areas of the largest and smallest sites, suggesting that the range in area of sites affects nestedness. Taxonomic differences in nestedness were weak. Higher taxonomic levels showed stronger nesting than their constituent lower taxa. We observed no effect of distance of isolation on nestedness; nor any effects of latitude. With regard to methodology, the metrics Nc and Ut yielded similar results, although Nc proved slightly more flexible in use, and deals differently with tied sites. Similarities also exist in the behavior of N0 ("N") and Up, and between N1 and Ua. Standardized nestedness metrics were mostly insensitive to matrix size, and were useful in comparative analyses among presence-absence matrices. Most metrics were affected by the proportion of presences in the matrix. All analyses of nestedness, therefore, should test for bias due to matrix fill. We suggest that the factors controlling nested subset structure can be thought of as four filters that species pass to occur at a site: a sampling filter, a distance filter, a habitat filter, and an area filter - and three constraints on community homogeneity: evolutionary history, recent history, and spatial variation in the environment. The scale of examination can also have important effects on the degree of nestedness observed.