Background-Eradication ofThere was a significant diVerence (p < 0.001) in the proportion of patients in whom eradication was successful between LAC and LCM when compared with LAM, but no significant diVerence (p = 0.15) between LAM and OAM. Metronidazole resistance before treatment was identified as a significant prognostic factor with regard to eradication of H pylori. The regimens which contained metronidazole were significantly less eVective than those without metronidazole in the presence of pretreatment resistant H pylori. There was no diVerence among the treatment groups with regard to the incidence and severity of adverse events reported. Conclusions-All four treatment regimens were safe and eVective in eradicating H pylori in the patient population studied. LAC was the most eYcacious treatment in patients with pretreatment metronidazole resistant H pylori, and was significantly better than LAM and OAM in this group of patients. (Gut 1997; 41: 735-739)

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Barrett's esophagus is thought to be a disease occurring predominantly in White Caucasian males of higher socioeconomic status. There are no published studies simultaneously examining risk of Barrett's esophagus according to ethnicity, gender, and socioeconomic status within a single data set. The authors conducted a retrospective case-control analysis within a cross-sectional study to determine risk of Barrett's esophagus in relation to sociodemographic variables in a large United Kingdom population. All patients undergoing upper gastrointestinal endoscopy at two clinical centers between January 2000 and January 2003 were evaluated. Data on ethnicity, age, gender, socioeconomic status, and the presence of Barrett's esophagus and esophagitis at endoscopy were collected. A total of 20,310 patients were analyzed. Barrett's esophagus was more common in White Caucasians (401/14,095 (2.8%)) than in South Asians (16/5,190 (0.3%)) (adjusted odds ratio (OR)=6.03, 95% confidence interval (CI): 3.56, 10.22), as was esophagitis (2,500/14,095 (17.7%) vs. 557/5,190 (10.7%); adjusted OR=1.76, 95% CI: 1.57, 1.97). Patients with Barrett's esophagus were also more likely to be male (adjusted OR=2.70, 95% CI: 2.18, 3.35) and of higher socioeconomic status (adjusted OR=1.58, 95% CI: 1.16, 2.15 (top tertile vs. bottom tertile)). White Caucasian ethnicity, male gender, and higher socioeconomic status are independent risk factors for Barrett's esophagus.

Bupropion (BW 323U66) has been considered a dopaminergic antidepressant based on its ability to inhibit the uptake of dopamine (DA) somewhat more selectively than it inhibits uptake of norepinephrine (NE) or serotonin (5-HT). This report describes new evidence that bupropion selectively inhibits firing rates of NE cells in the locus coeruleus (LC) at doses significantly lower than those that inhibit activity of midbrain DA cells or dorsal raphe 5-HT cells. The ICso dose (13 mglkg IP) for inhibition of LC firing produced plasma concentrations !hat were not significantly different from those generated by the EDso in the Porsolt test (10 mglkg IP). The fourfold higher dose needed to inhibit DA cell firing (ICso = 42 mglkg IP) was similar to the dose associated with locomotor stimulation in freely moving rats. Bupropion did not change the firing rates of 5-HT cells in the dorsal raphe nucleus at any dose. In both in vitro and in vivo tests, the metabolite 306U73 (hydroxy bupropion), a weak inhibitor of NE uptake, was approximately equipotent to bupropion with regard to inhibition of LC cells. Another metabolite, 494U73, had no effect on LC firing rates over a wide range of doses. Because of species variation in metabolism, 306U73 was not detected in plasma of rats after IV doses of bupropion that inhibited LC firing. Only trace amounts of 306U73 were detected after bupropion dosing for the Porsolt test. Pretreatment with reserpine markedly depleted catecholamines and reduced (by 30-fold) the potency of bupropion to inhibit LC firing. The effects of clonidine, a direct acting U2 agonist, were not significantly changed by reserpine. Likewise, a reduction in the effect of bupropion on LC firing was observed in vitro after depletion of catecholamines with reserpine or tetrabenazine. These results suggest that bupropion preferentially affects NE neurons in locus coeruleus at doses that are active in animal antidepressant tests. The doses of bupropion required to inhibit DA cell firing were associated with inhibition of DA uptake and behavioral stimulation and were significantly higher than those selectively producing behavioral effects in animal antidepressant tests. The acute electrophysiological actions of bupropion on NE cells require a reserpine sensitive store of NE and occur at doses having activity in antidepressant screening tests. [Neuropsychopharmacology 11:133-141, 1994J KEY WORDS: Antidepressive agents; Dopamine; Electrophysiology; Norepinephrine; Rats Bupropion is a novel antidepressant with an undefIned mechanism of action. Studies have shown that it weakly inhibits the uptake of dopamine in vitro (Ferris et al.

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