No abstract

The acceptance and realization of clinical guidelines in daily routine practice is unknown. The aim of this study was to evaluate the behaviour of private gastroenterologists in Germany with respect to the diagnostic and therapeutic management of H. pylori infection in times of increasing antibiotic resistance. Between 12/2014 and 02/2015 a standardized questionnaire with 19 multiple choice questions were sent to 1507 private gastroenterologists in Germany. The data were electronically captured and analyzed using SurveyMonkey. The response rate was 36 % (540 questionnaires). 65 % of responders prescribe first line therapy by themselves and mainly use standard triple therapies. In patients with intolerance to penicillin, 81 % prescribe Italian triple therapy and 19 % prescribe bismuth quadruple therapy. Risk factors for primary clarithromycin resistance (migrational background, previous macrolide exposure) are routinely assessed by only a minority of responders (22 % and 17 %, respectively). Forty-one percent of responders perform eradication control by themselves mainly using a 13C urea breath test (54 %). In second line therapy, 42 % are prescribing bismuth quadruple therapy and 24 % fluoroquinolone triple therapy. After second line therapy, 58 % of responders are performing eradication control by themselves. Of those, 70 % always take biopsies for antibiotic susceptibility testing. The results of our survey suggest that most private gastroenterologists in Germany adhere to current guidelines for H. pylori management; however, some relevant deviations seem to exist. Our data might be useful for further developments of clinical guidelines and their communication among the medical community.

(7) platelets maximum specific binding of J-125-IGF-1 was 1.6% with a n unspec . binding of 0.3%. 1/2 max. binding was shown at 2 0 ng/ml IGF-1,the affinity constant was 0 . 6 7~1 0 (Y)xM(-1). IGF-1 internalisation experiments were performed by preincubation with J-125-IGF -1 and dissociation of labeled hormone after cell placement into IGF-1 free medium o r displacement by inactive IGF-1.Increasingly incomplete dissociation of J125-IGF-1 was demonstrated for preincubation times > lh. These results are confirmed by diminished displacement of cell-bound J-125-IGF-1 by unlabeled hormone after a preincubation period of >lh.Preliminary results indicate that lysed platelets contain remarkable amounts of IGF-1. -I t has to be considered that platelets' serve as a reservoir from which IGF-1,following a local injury,is released after aggregation,and together with PDGF might stimulate fibroblast growth i n wound healing.

No abstract

No abstract