phenylephrine-hydrochloride and Helicobacter-Infections

The optimal topical anesthesia regimen for unsedated transnasal endoscopy is unknown. The addition of a nasal decongestant, such as xylometazoline (X), to a topical anesthestic may improve patient comfort.. To determine the effectiveness of lidocaine (L) versus L plus X (LX) for anesthesia in unsedated transnasal endoscopy.. Consecutive participants of the Aklavik Helicobacter pylori project were prospectively randomly assigned to receive LX or L for unsedated transnasal 4.9 mm ultrathin endoscopy. The primary outcome was overall procedure discomfort on a validated 10-point visual analogue scale (1 = no discomfort, 10 = severe discomfort). Secondary outcomes included pain, endoscope insertion difficulty, gagging, adverse events and encounter times. Results were presented as mean +/- SD, difference in mean, 95% CI.. A total of 181 patients were randomly assigned to receive LX (n=94) and L (n=87). Baseline characteristics between the two groups were similar (mean age 40 years, 59% women). Overall, patient procedural discomfort with LX and L were 4.2+/-2.4 versus 3.9+/-2.1, respectively (0.29; 95% CI -0.39 to 0.96). Transnasal insertion difficulty was significantly lower with LX than with L (2.4+/-2.1 versus 3.2+/-2.8, respectively [-0.80; 95% CI -1.54 to -0.06]). Compared with L, the use of LX was associated with significantly less time needed to apply anesthesia (2.4+/-1.8 min versus 3.5+/-2.2 min, respectively [-1.10; 95% CI -1.71 min to -0.50 min]) and less time for insertion (3.2+/-1.8 min versus 3.9+/-2.2 min, respectively [-0.70 min; 95% CI -1.30 min to -0.10 min]). Epistaxis was rare but occurred less frequently with LX (1.1%) than with L (4.6%) (P=0.19).. LX did not improve patient comfort for transnasal endoscopy compared with L alone. However, LX was associated with less difficulty with endoscope transnasal insertion and reduced insertion time. Further studies on the optimal regimen and dosing of anesthesia are required.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Child; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Female; Follow-Up Studies; Gastritis; Helicobacter Infections; Humans; Imidazoles; Lidocaine; Male; Middle Aged; Nasal Decongestants; Nose; Pain Management; Pain Measurement; Retrospective Studies; Treatment Outcome; Young Adult

To investigate the frequency of nasal Helicobacter pylori carriage among cooks living in Bolu, Ardahan and Sakarya province of Turkey.. A total of 54 cooks (10 from Bolu, 29 from Ardahan and 15 from Sakarya) were enrolled. Nasal Helicobacter was tested using polymerase chain reaction.. Helicobacter pylori was detected in only one cook.. Nasal Helicobacter pylori colonisation ratio in cooks in Turkey was found to be very low. Presumably hand hygiene compliance lowered the frequency.

Topics: Carrier State; Cooking; Hand Disinfection; Helicobacter Infections; Helicobacter pylori; Humans; Nose; Occupations; Prospective Studies; Turkey

Large-scale chemoprevention of peptic ulcer disease and gastric cancer through eradication of Helicobacter pylori would expose large population groups to antibiotics, which raises concerns about possible dissemination of antibiotic resistance. The objective of this cohort study was to determine whether a triple therapy, containing omeprazole, clarithromycin, and metronidazole, of H. pylori infection increases the prevalence of macrolide resistance in the normal microbiota. 85 patients with a peptic ulcer disease with verified H. pylori infection and 12 dyspeptic patients without positive findings upon endoscopy were included. Minimal inhibitory concentrations of clarithromycin for Staphylococcus, Streptococcus, Enterococcus and Bacteroides spp. were determined from samples taken before and after treatment, and 1 y later. Before treatment, macrolide resistance was observed in 11%, 31%, 9% and 11% of the staphylococci, streptococci, enterococci and Bacteroides, respectively. The number of resistant isolates remained elevated after 1 y, most notably for staphylococci and streptococci. No development of persistent resistance was detected in the untreated control group. Triple therapy including clarithromycin leads to persistent macrolide resistance in the normal microbiota. A prevalent pool of resistance genes in the normal microbiota constitutes an ecological hazard that needs to be considered before global treatment programmes for eradication of H. pylori are implemented.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteroides; Clarithromycin; Drug Resistance, Bacterial; Drug Therapy, Combination; Feces; Female; Gram-Positive Cocci; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Nose; Omeprazole; Pharynx; Prospective Studies

Topics: Adult; Biopsy; Chronic Disease; Esophagoscopy; Gastritis; Gastroesophageal Reflux; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Male; Nose; Polyps; Vocal Cords

Topics: Costs and Cost Analysis; Endoscopes; Endoscopy, Digestive System; Equipment Design; Helicobacter Infections; Helicobacter pylori; Humans; Nose; Patient Acceptance of Health Care; Time Factors