Concordance and interchangeability of biometric measurements of ocular axial length in patients awaiting cataract surgery.

PURPOSE: To estimate in patients awaiting cataract surgery the concordance and interchangeability of axial eye length measurements performed with the aid of various biometric methods (optical or ultrasonic) by different operators (nurses) at different times during the period prior to surgery. METHODS: We selected 182 consecutive eyes from 91 patients.Ocular axial length was measured with the aid of 2 methods (IOLMaster® and Ocuscan®) by 9 randomly allocated technicians at 2 different times during the waiting period. The concordance between measurements was evaluated by means of the intraclass correlation coefficient (ICC); the interchangeability of the results was assessed with Bland Altman plots and Passing and Bablok regression. RESULTS: The measurements were consistent between biometric methods (ICC 0.975, 95% confidence interval [CI] 0.968 to 0.980) and measurement dates (ICC 0.996, 95% CI 0.995 to 0.997). Interobserver agreement was more heterogeneous (ICC range 0.844 to 0.998). No systematic errors were observed among the various biometric methods and measurement dates. CONCLUSIONS: Because measurement of axial length in phakic patients may be technician-dependent, the technician's experience should be noted in the protocols of ophthalmology services.

Efficacy of rifabutin-based triple therapy in Helicobacter pylori infected patients after two standard treatments.

BACKGROUND AND AIM: Even with the current most effective treatment regimens for Helicobacter pylori infection, a considerable number of patients will be resistant to eradication. The aim of the present study was to evaluate the H. pylori eradication rate in patients resistant to standard therapies when treated with a triple therapy of pantoprazole, rifabutin and amoxicillin. METHODS: Ninety-two consecutive patients diagnosed with H. pylori infection resistant to two previous treatment regimens were treated with pantoprazole, rifabutin and amoxicillin for 10 days. The persistence or eradication of H. pylori was determined by a 13C-urea breath test performed 4 weeks after the treatment. RESULTS: Per protocol eradication was achieved in 62.2% of patients and the intention-to-treat eradication was 60.8%. Only two patients were excluded for adverse events related to the treatment. CONCLUSIONS: The eradication rate is acceptable as a third-line therapy, particularly in centers with high cure rate for first line therapy. Another important value of this study is the good tolerance for the treatment observed in our patients. It is possible that rifabutin-based triple therapy may be of use in hospital centers that do not have disposable culture and susceptibility methods against H. pylori.

[Efficacy of Helicobacter pylori eradication in non-ulcer dyspepsia]. / Eficacia de la erradicación de Helicobacter pylori en la dispepsia no ulcerosa.

BACKGROUND AND OBJECTIVE: The relationship between Helicobacter pylori infection and functional dyspepsia (FD) is disputed. Although there is a greater prevalence of infection by H. pylori in subjects with non-ulcer dyspepsia than in healthy subjects, results regarding the eradication of infection have been inconclusive so far in terms of disease improvement. In this study, we administered eradicating treatment to a group of patients with both FD and infection by H. pylori to determine the possible beneficial effect of such a treatment. Thus, our objective was to study the effectiveness of eradication therapy for H. pylori in the clinical course of FD. PATIENTS AND METHOD: This was a randomized, double-blind study in 93 consecutive patients diagnosed with FD and infection by H. pylori who received eradicating treatment with omeprazol, amoxicillin and clarythromicin for 7 days (group A, n = 47) vs. placebo, amoxicillin and clarythromicin for 7 days (group B, n = 46). We analyzed the clinical evolution of the disease within the following 9 months. RESULTS: Both groups of treatment were comparable concerning all the variables studied except for the consumption of alcohol, with a greater prevalence in group A, yet no patient consumed more than 40 g per day. The average age of patients was 42 (18-65). Eradication of H. pylori occurred in 65.9% of patients in group A and 4.3% of patients in group B. 40% of all patients included in the study had improved symptoms. In 60.6% of patients whose infection was eradicated, their symptoms improved, as opposed to 25% of patients whose infection was not eradicated (p = 0.001). Among patients whose symptoms improved following eradication, 70% had had an FD duration of less than 3 years and in 30% FD had lasted for more than 3 years (p < 0.05). CONCLUSIONS: The eradication of H. pylori in patients with short-lasting FD may lead to a significant clinical benefit, especially in those whose duration of symptoms is below 3 years.

Eficacia de la erradicación de Helicobacter pylori en la dispepsia no ulcerosa / Efficacy of Helicobacter pylori eradication in nonulcer dyspepsia

FUNDAMENTO Y OBJETIVO: La relación de la infección por Helicobacter pylori y la dispepsia funcional (DF) constituye un tema controvertido. Si bien existe mayor prevalencia de infección por H. pylori en sujetos con DF que en sujetos sanos, los resultados de la erradicación de la infección no parecen concluyentes, en términos de mejoría de la enfermedad, en los diversos estudios publicados. En el presente trabajo se realiza tratamiento erradicador a un grupo de pacientes con DF e infección por H. pylori para determinar el posible efecto beneficioso de la erradicación. PACIENTES Y MÉTODO: Se realizó un estudio aleatorizado y doble ciego en 93 pacientes consecutivos diagnosticados de DF e infección por H. pylori que recibieron tratamiento erradicador con omeprazol, amoxicilina y claritromicina durante 7 días (grupo A, n = 47), frente a tratamiento con placebo de omeprazol, amoxicilina y claritromicina durante 7 días (grupo B, n = 46); durante los 9 meses posteriores se analizó la evolución clínica de la enfermedad. RESULTADOS: Los dos grupos de tratamiento fueron homogéneos en todas la variables estudiadas excepto en el uso de alcohol con una mayor prevalencia en el grupo A, aunque ningún paciente consumía más de 40 g/día. La edad media de los pacientes incluidos fue de 42 años (18,65 años). La erradicación de H. pylori se produjo en el 65,9 por ciento de pacientes del grupo A y en el 4,3 por ciento de pacientes del Grupo B. El 40 por ciento de todos los pacientes incluidos en el estudio mejoraron sus síntomas. En el grupo A, el 53,2 por ciento de los pacientes mejoraron sus síntomas al final del estudio mientras que sólo lo hizo el 32,6 por ciento de los del grupo B. El 60,6 por ciento de los pacientes con erradicación de la infección mejoraron la sintomatología frente al 25 por ciento de los pacientes en que la erradicación no se produjo (p = 0,001). De los pacientes que mejoraron los síntomas tras la erradicación se observó que el 70 por ciento tenía una duración de la DF inferior a 3 años y el 30 por ciento superior (p < 0,05), fenómeno no observado en los pacientes que mejoraban sus síntomas y no presentaban erradicación de la infección. CONCLUSIONES: En nuestra serie, la erradicación de H. pylori en pacientes con DF mejora el curso evolutivo de la enfermedad, especialmente el grupo de pacientes con una duración de los síntomas inferior a los 3 años (AU)