RESUMEN
OBJECTIVE: To evaluate the use, effectiveness and safety of Helicobacter pylori empirical rescue therapy in third and subsequent treatment lines in Europe. DESIGN: International, prospective, non-interventional registry of the clinical practice of European gastroenterologists. Data were collected and quality reviewed until October 2021 at Asociación Española de Gastroenterología-Research Electronic Data Capture. All cases with three or more empirical eradication attempts were assessed for effectiveness by modified intention-to-treat and per-protocol analysis. RESULTS: Overall, 2144 treatments were included: 1519, 439, 145 and 41 cases from third, fourth, fifth and sixth treatment lines, respectively. Sixty different therapies were used; the 15 most frequently prescribed encompassed >90% of cases. Overall effectiveness remained <90% in all therapies. Optimised treatments achieved a higher eradication rate than non-optimised (78% vs 67%, p<0.0001). From 2017 to 2021, only 44% of treatments other than 10-day single-capsule therapy used high proton-pump inhibitor doses and lasted ≥14 days. Quadruple therapy containing metronidazole, tetracycline and bismuth achieved optimal eradication rates only when prescribed as third-line treatment, either as 10-day single-capsule therapy (87%) or as 14-day traditional therapy with tetracycline hydrochloride (95%). Triple amoxicillin-levofloxacin therapy achieved 90% effectiveness in Eastern Europe only or when optimised. The overall incidence of adverse events was 31%. CONCLUSION: Empirical rescue treatment in third and subsequent lines achieved suboptimal effectiveness in most European regions. Only quadruple bismuth-metronidazole-tetracycline (10-day single-capsule or 14-day traditional scheme) and triple amoxicillin-levofloxacin therapies reached acceptable outcomes in some settings. Compliance with empirical therapy optimisation principles is still poor 5 years after clinical practice guidelines update. TRIAL REGISTRATION NUMBER: NCT02328131.
RESUMEN
Regarding our article "Daño pancreático: pancreatitis aguda en pacientes COVID-19", we would like to clarify that the case previously described met the diagnostic criteria for acute pancreatitis, defined in the Atlanta classification and mentioned in several guidelines.
Asunto(s)
Traumatismos Abdominales , COVID-19 , Pancreatitis , Enfermedad Aguda , Humanos , Pancreatitis/inducido químicamente , SARS-CoV-2RESUMEN
We read with great interest the two letters published in November regarding SARS-CoV-2 infection and acute pancreatitis (AP). We report our only case of AP related to such infection.
Asunto(s)
COVID-19 , Pancreatitis , Síndrome de Dificultad Respiratoria , Enfermedad Aguda , Humanos , Pancreatitis/complicaciones , Síndrome de Dificultad Respiratoria/etiología , SARS-CoV-2RESUMEN
According to some series, 0.3-1.5% of all cases of acute pancreatitis are drug induced. Acute pancreatitis due to levofloxacin is included in its safety data sheet as an adverse effect.
Asunto(s)
Levofloxacino , Pancreatitis , Enfermedad Aguda , Humanos , Levofloxacino/efectos adversos , Pancreatitis/inducido químicamenteRESUMEN
Actinomycosis is an uncommon granulomatous infection by Gram-positive anaerobic bacteria of the genus Actinomyces. A. israelii is a major human pathogen. The most frequent locations for colonization are cervicofacial (50%), abdominal (20%) and thoracic (15-20%). The abdominal actinomycosis predisposing factors include recent surgery, trauma and neoplasias. Certain cases have been associated with the intrauterine contraception device (IUD).
Asunto(s)
Actinomicosis/complicaciones , Enfermedades del Colon/etiología , Obstrucción Intestinal/etiología , Actinomicosis/diagnóstico por imagen , Adulto , Enfermedad Crónica , Enfermedades del Colon/diagnóstico por imagen , Femenino , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Dispositivos Intrauterinos/efectos adversos , Neoplasias Pélvicas/complicaciones , Neoplasias Pélvicas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
An 81-year-old man with mild iron deficiency anemia (Hb 12 g/dl) and a positive fecal occult blood test was referred for a colonoscopy. The patient was asymptomatic and not undergoing any treatment. A foreign body that crossed the colonic lumen and prevented the colonoscope progression was identified at 40 cm from the anal verge via colonoscopy. The object seemed to be hard and fixed when manipulated with biopsy forceps.
Asunto(s)
Colon/diagnóstico por imagen , Cuerpos Extraños/diagnóstico por imagen , Cuernos , Anciano de 80 o más Años , Anemia Ferropénica/complicaciones , Animales , Bovinos , Colonoscopía , Humanos , Masculino , Sangre OcultaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Granuloma/tratamiento farmacológico , Granuloma/patología , Actinomyces , Actinomicosis/tratamiento farmacológico , Actinomicosis/patología , Penicilinas/uso terapéutico , Amoxicilina/uso terapéutico , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias , Patología/métodos , Actinomyces/aislamiento & purificación , Actinomicosis/diagnósticoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Cuerpos Extraños/complicaciones , Anemia Ferropénica/etiología , Colon , ColonoscopíaRESUMEN
No disponible