Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen
Autore:
Chan, FKL; Chung, SCS; Suen, BY; Lee, YT; Leung, WK; Leung, VKS; Wu, JCY; Lau, JYW; Hui, Y; Lai, MS; Chan, HLY; Sung, JJY;
Indirizzi:
Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Chinese Univ Hong Kong, Prince Wales Hosp, Dept Surg, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Alice Ho Miu Ling Nethersole Hosp, Med Unit, Hong Kong, Hong Kong, PeoplesR China Alice Ho Miu Ling Nethersole Hosp Hong Kong Hong Kong Peoples R China na
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 13, volume: 344, anno: 2001,
pagine: 967 - 973
SICI:
0028-4793(20010329)344:13<967:PRUGBI>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; GASTRIC-ULCERS; RISK; OMEPRAZOLE; ERADICATION; THERAPY; USERS; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Chan, FKL Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut,30-32 Ngan Shing St, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong 30-32 Ngan Shing St Shatin Hong Kong Peoples R China
Citazione:
F.K.L. Chan et al., "Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen", N ENG J MED, 344(13), 2001, pp. 967-973

Abstract

Background: Many patients who have had upper gastrointestinal bleeding continue to take low-dose aspirin for cardiovascular prophylaxis or other nonsteroidal antiinflammatory drugs (NSAIDs) for musculoskeletal pain. It is uncertain whether infection with Helicobacter pylori is a risk factor for bleeding in such patients. Methods: We studied patients with a history of upper gastrointestinal bleeding who were infected with H. pylori and who were taking low-dose aspirin or other NSAIDs. We evaluated whether eradication of the infection or omeprazole treatment was more effective in preventing recurrent bleeding. We recruited patients who presented with upper gastrointestinal bleeding that wasconfirmed by endoscopy. Their ulcers were healed by daily treatment with 20 mg of omeprazole for eight weeks or longer. Then, those who had been taking aspirin were given 80 mg of aspirin daily, and those who had been takingother NSAIDs were given 500 mg of naproxen twice daily for six months. Thepatients in each group were then randomly assigned separately to receive 20 mg of omeprazole daily for six months or one week of eradication therapy,consisting of 120 mg of bismuth subcitrate, 500 mg of tetracycline, and 400 mg of metronidazole, all given four times daily, followed by placebo for six months. Results: We enrolled 400 patients (250 of whom were taking aspirin and 150of whom were taking other NSAIDs). Among those taking aspirin, the probability of recurrent bleeding during the six-month period was 1.9 percent for patients who received eradication therapy and 0.9 percent for patients who received omeprazole (absolute difference, 1.0 percent; 95 percent confidence interval for the difference, -1.9 to 3.9 percent). Among users of other NSAIDs, the probability of recurrent bleeding was 18.8 percent for patients receiving eradication therapy and 4.4 percent for those treated with omeprazole (absolute difference, 14.4 percent; 95 percent confidence interval forthe difference, 4.4 to 24.4 percent; P=0.005). Conclusions: Among patients with H. pylori infection and a history of upper gastrointestinal bleeding who are taking low-dose aspirin, the eradication of H. pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding. Omeprazole is superior to the eradication of H. pylori in preventing recurrent bleeding in patients who are taking other NSAIDs, suchas naproxen. (N Engl J Med 2001;344:967-73. ) Copyright (C) 2001 Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 11:47:10