Objective
Few studies have reported the influence of clinical background factors on the outcome of
Helicobacter pylori
eradication therapy in primary care practice. We aimed to determine which clinical background factors influence the outcome of eradication therapy in a primary care setting.
Methods
This was a retrospective study of patients who received
H pylori
eradication therapy at Higashiohmi City Gamo Medical Center, Shiga, Japan, from January 2012 to December 2015. We investigated clinical background factors associated with success, failure, and self‐interruption of
H pylori
eradication therapy: patients’ age, gender, first‐ or second‐line treatment, reasons for receiving gastroenterological endoscopic examination, method of drug administration, and attending physicians’ age and their specialties.
Results
There were 369 patients (208 females, 161 male), with a mean age of 59 years (range 30‐88 years). The middle‐aged group (50‐69 years) was associated with successful eradication therapy compared with the young group (30‐49 years). The elderly group (>70 years) was associated with eradication therapy failure compared with the middle‐aged group. The young group was associated with self‐interruption of eradication therapy. There was a marginally significant association between male patients and self‐interruption. Older attending physicians (>50 years) were also associated with failure compared with younger physicians. There was no difference in outcome of eradication therapy between generalists and gastroenterology specialists.
Conclusion
We have identified clinical factors associated with success, failure, and self‐interruption of
H pylori
eradication therapy in a primary care setting.
IntroductionIn patients with combined lumbar spinal canal stenosis (LSCS), a herniated intervertebral disc (IVD) that compresses the dura mater and nerve roots is surgically treated with discectomy after laminoplasty. However, defects in the IVD after discectomy may lead to inadequate tissue healing and predispose patients to the development of IVD degeneration. Ultrapurified stem cells (rapidly expanding clones (RECs)), combined with an in situ-forming bioresorbable gel (dMD-001), have been developed to fill IVD defects and prevent IVD degeneration after discectomy. We aim to investigate the safety and efficacy of a new treatment method in which a combination of REC and dMD-001 is implanted into the IVD of patients with combined LSCS.Methods and analysisThis is a multicentre, prospective, double-blind randomised controlled trial. Forty-five participants aged 20–75 years diagnosed with combined LSCS will be assessed for eligibility. After performing laminoplasty and discectomy, participants will be randomised 1:1:1 into the combination of REC and dMD-001 (REC-dMD-001) group, the dMD-001 group or the laminoplasty and discectomy alone (control) group. The primary outcomes of the trial will be the safety and effectiveness of the procedure. The effectiveness will be assessed using visual analogue scale scores of back pain and leg pain as well as MRI-based estimations of morphological and compositional quality of the IVD tissue. Secondary outcomes will include self-assessed clinical scores and other MRI-based estimations of compositional quality of the IVD tissue. All evaluations will be performed at baseline and at 1, 4, 12, 24 and 48 weeks after surgery.Ethics and disseminationThis study was approved by the ethics committees of the institutions involved. We plan to conduct dissemination of the outcome data by presenting our data at national and international conferences, as well as through formal publication in a peer-reviewed journal.Trial registration numberjRCT2013210076.
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