Zeitschrift für Gastroenterologie
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Comment Meta Analysis Comparative Study
[Are proton pump inhibitors superior to H2 receptor antagonists within the scope of H. pylori eradication therapy? Meta analysis of current parallel group comparisons].
The combined treatment with acid lowering drugs and antibiotics is widely accepted for H. pylori-eradication therapy. There are, however, controversies regarding the influence of the acid lowering drug on H. pylori-eradication rates. Therefore, this meta-analysis aimed to assess the available parallel-group eradication studies with proton pump inhibitors and H2-receptor antagonists and to compare H. pylori-eradication rates for both classes of acid lowering drugs. ⋯ CONCLUSION. H. pylori-eradication rates for treatment protocols with one or two antibiotics in combination with an acid lowering drug are not different for the proton pump inhibitors or h2-receptor antagonists. Therefore, the question whether H2-receptor antagonists or proton pump inhibitors should be used in combination with antibiotics for H. pylori eradication therapy is without clinical relevance.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Acceptability of high colonoscopy using different premedication--a comparison of the effect of midazolam versus midazolam and pethidine from the viewpoint of the patient and the physician].
Invasive endoscopic procedures such as total colonoscopy result in a better patient acceptance, the less discomfort they cause. Therefore a premedication for total colonoscopy is often required. In a prospective, double-blind, placebo-controlled clinical study of 132 patients examined by one experienced endoscopist we compared two premedication schedules: midazolam (mean 5.2 mg i.v.) versus midazolam (mean 4.8 mg) plus pethidin (50 mg). ⋯ It was also shown, that the endoscopist scored a higher degree of patient's pain during the examination than the patient did himself. No more negative side-effects such as decrease of arterial partial pressure of oxygen or cardiopulmonary complications were found using the combination of both drugs; they provided to be safe without added risk of hypoxia. Thus, the combination of both drugs can be given as premedication for total colonoscopy.
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Randomized Controlled Trial Clinical Trial
Polyethylene glycol 4000 for slow transit constipation.
Slow transit constipation is notoriously difficult to treat. We tested whether polyethylene glycole 4000 (PEG) improves slow transit constipation. Eight female outpatients with symptoms of constipation and a colonic marker transit of more than 60 h were included (age 46 +/- 4y, duration of complaints 17 +/- 3y) in a randomised controlled cross-over study. ⋯ Visual analog scale ratings improved from -4.65, [-8; 0.5] to 4.65, [-8; 7.5]cm (median, range) (p = 0.028), the self-administered dose of sodium picosulfate decreased from 4, [0; 37] to 0, [0; 11] drops per day (p = 0.028), stool frequency increased from 3.1, [1; 30] to 11, [2; 33] defeacations per week (p = 0.017), and total colonic transit decreased from 91, [67; 116] to 43 h, [17; 76]h (p = 0.017). In conclusion, PEG improves colonic function in patients with slow transit constipation subjectively and objectively. PEG should be considered as an additional option in patients refractory to established forms of treatment.