No abstract

on Helicobacfer pylovi (H. pylori) recommended that, in suitable patients, the bacterium should be eradicated using a therapeutic regimen comprising a bismuth salt, tetracycline and metronidazole for two weeks.We have treated 40 patients infected with H. pylori with 'triple' therapy consisting of 120 mg tripotassium dicitrato bismuthate 4.d.s.. 500 mg tetracycline q.d.s. and 400 mg metronidazole t.d.s. for two weeks.The success rate, in terms of bacterial eradication, was 19/21 (90.5 %) in patients with metronidazole-sensitive organisms, compared with only 6/19 (31.6%) in patients whose H. pylori were resistant to metronidazole (P < 0.01). Side effects, particularly diarrhoea and vomiting/nausea, were common: 23/40 patients reported such symptoms during the 14-day course of therapy. Fifteen of these 23 patients completed the entire 14day course, although suffering from significant side effects, while the

Summary. Biotypes, ribosomal RNA gene restriction patterns (ribopatterns), whole-cell protein patterns and plasmid profiles of paired Helicobacter pylori isolates from 17 patients were examined. Each pair comprised a pre-and a post-treatment isolate; nine of the I7 posttreatment isolates were obtained after treatment with tripotassium dicitrate bismuthate (DeNo]) and nietronidazole. All strains of H . p1,lot-i had identical biotypes, but exhibited diversity between pairs in their molecular fingerprints. Each of the 17 strain pairs had unique ribopatterns; the pre-and post-treatment isolates in most pairs (16 of 17) were similar or identical. irrespective of metronidazole susceptibility. DNA subtype variants were detected in three patient sets. Although nine post-treatment isolates had acquired resistance to metronidazole, most (six of nine) resembled the pre-treatment isolates in their ribopattern, protein and plasmid profiles. No significant correlation was observed between metronidazole resistance and piasmid content in these H . pj-lori isolates. Emergence of post-treatment nietrunidazole-resistant isolates of H . pjtlori was associated only rarely with colonisation by ii novel ctrain or acquisition of a plasmid and, in most patients, probably resulted from spontaneous emergence of resistance in the original infecting strain.

BackgroundA validated method for assessing the visual characteristics of body condition from photographs (vBCS), would be a useful initial screening tool for client-owned dogs.MethodsIn this retrospective study, photographs taken before and after weight loss from 155 overweight and obese dogs attending a weight management referral clinic were used in designing and testing the feasibility of vBCS. Observers with a range of experience examined the photographs, and estimated body condition indirectly (vBCS) using three different methods. In the first method (vBCSmeasured), the ratio of abdominal width to thoracic width (A:T) was measured, and cut-points used to determine body condition; the second method (iBCSsubjective) involved semi-quantitative examination using visual descriptors of BCS; the third (vBCSadjusted) was a combined approach whereby A:T ratio was first determined, and the final score modified if necessary after assessing photographs.ResultsWhen an experienced observer performed vBCS, there were moderate-to-good associations between body fat (measured by dual-energy X-ray absorptiometry) and the three vBCS methods (median Rs: 0.51-0.75; P < 0.001), and also moderate-to-substantial agreement with actual BCS (median kappa 0.51–0.63; P < 0.001). For operators with a range of experience, moderate-to-substantial agreement was generally seen between actual BCS and the scores determined by all three methods (median Kappa 0.55–0.70, P < 0.001), but the strength of agreement varied amongst observers. Age, sex, breed, coat length, and coat colour had no significant effect on vBCS (P > 0.05 for all). Compared with ideal weight and obese dogs, errors in assessing body condition were more common for overweight dogs (e.g. BCS 6–7/9, P < 0.001) by vBCSadjusted (P = 0.008), and vBCSsubjective (P = 0.021), but not by vBCSmeasured (P = 0.150). For vBCSadjusted, body condition was most often overestimated whilst, for vBCSsubjective, body condition was most often under-estimated.ConclusionsAn estimate of body condition can be obtained from an indirect assessment of photographs, but performance varies amongst observers.