In this patient population, the incidence of new GERD-type symptoms or endoscopic esophagitis was greater in patients in whom successful eradication was achieved. This difference does not appear to be attributable to weight gain, habits, or specific H. pylori strains.
change in alcohol use over time lead to underestimation of an elevated relative risk. 4 However, we found a clear association between level of alcohol use at conscription and risk of subsequent hospitalisation or death with a diagnosis of alcoholism, alcohol psychosis, or alcohol intoxication, with a significant relative risk of 5.71 for consumers of >15 g ethanol/day, indicating a stability over time. The results also indicate a cardioprotective effect of alcohol use in relatively young men, in whom myocardial infarction is rare. Possible biological mechanisms include an increase in high density lipoprotein cholesterol, a decrease in platelet coagulability, and a decrease in plasma fibrinogen associated with alcohol intake.
1Calculation of the attributable proportions clearly indicated that alcohol consumption had a negative net effect on the subjects' health up to the age of 45. The results support a restrictive alcohol policy and recommendations for little or no alcohol consumption by young men.
Susceptibility testing was performed at seven Canadian microbiology laboratories and the Helicobacter Reference Laboratory, Halifax, Nova Scotia, Canada, to assess susceptibility testing proficiency and the reproducibility of the results for clarithromycin and metronidazole and to compare the Epsilometer test (E test) method to the agar dilution reference method. Control strain Helicobacter pylori ATCC 43504 (American Type Culture Collection) and 13 clinical isolates (plus duplicates of four of these strains including ATCC 43504) were tested blindly. The National Committee for Clinical Laboratory Standards (NCCLS) guidelines for agar dilution testing were followed, and the same suspension of organisms was used for agar dilution and E test. Antimicrobials and E test strips were provided to the investigators. Methods were provided on a website (www.Helicobactercanada.org). Each center reported MICs within the stated range for strain ATCC 43504. Compared to the average MICs, interlaboratory agreements within 2 log 2 dilutions were 90% (range, 69 to 100%) for clarithromycin by agar dilution, with seven very major errors [VMEs], and 85% (range, 65 to 100%) by E test, with three VMEs. Interlaboratory agreements within 2 log 2 dilutions were 83% (range, 50 to 100%) for metronidazole by agar dilution, with six VMEs and eight major errors (MEs), and 75% (range, 50 to 94%) by E test, with four VMEs and four MEs. At lower and higher concentrations of antibiotic, E test MICs were slightly different from agar dilution MICs, but these differences did not result in errors. When a standardized protocol based on NCCLS guidelines was used, most participants in this study correctly identified clarithromycin-and metronidazole-susceptible and -resistant strains of H. pylori 93% of the time by either the agar dilution or E test method, and the numbers of errors were relatively equivalent by both methods.
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