Showing papers by "Dubai Healthcare City published in 2007"

One week of esomeprazole triple therapy vs 1 week of omeprazole triple therapy plus 3 weeks of omeprazole for duodenal ulcer healding in Helicobacter pylori-positive patients

Abstract: In this randomized, double-blind, multicenter study, H. pylori-positive patients with an active duodenal ulcer (DU) received esomeprazole, 20 mg twice daily (bid), or omeprazole, 20 mg bid, with amoxicillin, 1000 mg bid, and clarithromycin, 500 mg bid, for 1 week (EAC and OAC, respectively). Patients received an additional 3 weeks of either placebo or omeprazole, 20 mg once daily (od), in the EAC and OAC groups, respectively. The intent-to-treat population included 374 patients (EAC, 186; OAC, 188). Four-week DU healing rates were similar in the EAC+placebo and OAC+omeprazole groups: 74% and 76%, respectively. DU healing rates at 8 weeks were 87% for EAC+placebo and 88% for OAC+omeprazole. H. pylori eradication rates were 75% and 79% for EAC and OAC, respectively. Both regimens were well tolerated. A 1-week regimen of esomeprazole-based H. pylori eradication triple therapy was as effective for DU healing and eradication of H. pylori as omeprazole-based triple therapy followed by an additional 3 weeks of monotherapy.

The use of TNF-alpha blockers in Cogan's syndrome.

Abstract: A 37-year-old woman, previously healthy, who in September 2001 noted sudden onset of erythema in both eyes, followed by vertigo, vomiting, tinnitus in both ears, and hearing loss in the left ear then in the right over 1-week period. Slit lamp examination revealed bilateral interstitial keratitis. Her physical examination was essentially unremarkable except for decreased hearing bilaterally, more so on the right. An audiogram conWrmed the presence of severe bilateral sensorineural hearing loss (SNHL), more so on the right. Brainstem auditory evoked response testing revealed delay of all waves on the left and no waves on the right. A gadolinium enhanced MRI of the brain conWrmed the presence of inXammation around the cochlea bilaterally. Her laboratory tests at that time showed a sedimentation rate of 26 mm/h, with a negative ANA, rheumatoid factor, anti-SSA and anti-SSB, anticardiolipins (IgG, IgM), c-ANCA and p-ANCA, and VDRL. A lumbar puncture was normal. Her chest X-ray, electrocardiogram and echocardiography were also normal. Accordingly, the diagnosis of Cogan’s syndrome was made. Therapy was initiated with topical steroid eye drops and oral prednisone at 1 mg/kg/day. The ocular symptoms improved within few days but after 3 weeks, the patient denied any clinical improvement in her hearing and audiogram conWrmed worsening of the SNHL on the left. After 3 weeks from the diagnosis of Cogan’s syndrome the Wrst dose of inXiximab was initiated at 3 mg/kg for three doses at 0, 2 and 6 weeks. After the Wrst dose of inXiximab, the patient reported decrease in the sensation of aural fullness and vertigo and subjective improvement in hearing, associated with improvement on the audiogram in the left ear. Methotrexate as 12.5 mg/week was added after the second dose of inXiximab. Because the hearing conditions remained stable oral prednisone was reduced gradually. Patient was lost of follow up after the third dose of inXiximab and returned after 2 years. She has stopped her medications since then and found to have subjective and objective deterioration for which she underwent left cochlear implant.