SUMMARY`4C-urea breath test was used to detect Campylobacter pylorn colonisation in 129 consecutive non-ulcer There is increasing interest in the presence of Campylobacter pylori in gastric biopsies and their possible role in the aetiology of gastritis and peptic ulcer.'`This spiral organism colonises the gastric antrum in 90-100% of patients with duodenal or gastric ulcer and in 50-70% of patients with non-ulcer dyspepsia.7-" C pylori is also present in 20% of asymptomatic individuals.7 C pylori colonisation can be established by culture or histological examination of antral mucosal biopsies. The use of endoscopy to obtain biopsies precludes large scale epidemiologic studies of this organism. We have previously reported that Cpylori has a very high urease activity.7 Intragastric hydrolysis of urea will result in the production of carbon dioxide and the generation of ammonia. We have utilised this urease activity to
AimThe purpose of this study was to determine the incidence of reintubation due to upper airway obstruction in a homogeneous group of ventilated infants with Respiratory Syncytial Virus bronchiolitis. Our secondary objective was to determine whether prophylactic administration of dexamethasone prior to extubation was associated with decreased risk of reintubation.MethodsThis retrospective observational study in two Pediatric Intensive Care Units in 2 university hospitals in The Netherlands included two hundred patients younger than 13 months admitted with respiratory insufficiency caused by Respiratory Syncytial Virus bronchiolitis, requiring invasive mechanical ventilation. A logistic regression analysis with propensity score method was used to adjust for possible confounding.ResultsReintubation due to post-extubation stridor occurred in 17 (8.5%) of 200 patients. After propensity score matching, administration of dexamethasone prior to extubation was associated with a significantly (p = 0.0011) decreased risk of reintubation due to post-extubation stridor compared to patients not receiving prophylactic dexamethasone (absolute risk reduction 13%, 95% CI 5.3–21%).ConclusionReintubation due to post-extubation stridor is an important complication of ventilation for Respiratory Syncytial Virus bronchiolitis. Dexamethasone administered prior to extubation probably reduces the risk of post-extubation stridor necessitating reintubation in these infants. The results of this study support initiation of a placebo-controlled trial to confirm the beneficial effect of prophylactic dexamethasone.
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