Fourteen-day, proton pump inhibitor-based triple therapy achieves better results than 7-day schedules. Additional data are necessary to evaluate 10-day therapies.

Aim: To perform a meta‐analysis of studies comparing twice daily, one‐week triple therapy with a proton pump inhibitor, clarithromycin (C) and amoxycillin (A) (PCA) vs. those using proton pump inhibitor, clarithromycin and a nitroimidazole (N) (PCN) for H. pylori eradication. Review methods: Selection criteria: Comparative randomized trials of PCA vs. PCN were included. Data sources: PubMed database and abstracts from congresses until September 1999. Statistics: Meta‐analysis was performed combining the Odds Ratios (OR) of the individual studies in a global OR (Peto method) both on an intention‐to‐treat (ITT) and on a per protocol (PP) basis. Results: Twenty‐two studies fulfilled the inclusion criteria. Eighteen studies reported ITT and 20 PP analysis. Mean H. pylori eradication rates were 81% (95% CI: 79–83%) ITT, and 84% (82–86%) PP with PCA, and 81% (78–83%) ITT and 84% (82–86%) PP with PCN; the odds ratio for the effect of PCA vs. PCN was 1 (0.83–1.22) on an ITT, and 0.98 (0.8–1.2) on a PP basis. Subanalysis showed that mean H. pylori eradication efficacy with PC(250 b.d.)A was 81% (78–85%) ITT, vs. 86% (83–89%) with PC(250 b.d.)N. The odds ratio for this comparison was 0.68 (0.48–0.98). Finally, when comparing PC(500 b.d.)A against PC(250 b.d.)N ITT cure rates were 77% (74–80%), and 75% (72–78%) with an odds ratio of 1.18 (0.93–1.5). Conclusion: Overall, one‐week combination regimens of PCA and PCN present similar H. pylori eradication efficacy. Nevertheless, the PCN regimen obtains significantly better results when using low doses of C (250 mg b.d.).

The World Health Organization has declared the SARS-CoV-2 infection (COVID-19) outbreak as a Public Health Emergency of International Concern and characterized it as a pandemic. 1,2 Since early March, 2020, the Spanish cases curve started to rise, with more than 177 000 people infected in 6 weeks. 3 The reported fatality-rate in the general population with COVID-19 admitted to a large tertiary Spanish Hospital is 20.7%, 34% in the subgroup of age 70-79 years. 4

The function of the kidney in adult subjects with Cooley’s disease has been hitherto inadequately investigated. In 10 patients suffering from thalassemia major, glomerular filtration rate, renal plasma flow, renal blood flow have been studied, together with urine concentration capacity. The authors emphasize certain pathological changes, such as the increase in renal plasma flow and the failure of the urine concentration ability. On the basis of renal biopsies, two pathogenetic theories are discussed: the functional impairment of the countercurrent system and fibrosis of the medullary tissue.

Although triple therapies with a proton pump inhibitor and two antibiotics are the most widely accepted treatment for Helicobacter pylori infection, there is no consensus on how long this treatment should be maintained. Seven-day schedules are preferred in many settings, but in the USA 10 and 14-day therapies are routinely employed. 1±5 Even in Europe, where 7-day therapies are widely used, a recent consensus report recommended 7±10 days treatment, possibly because of increasing evidence that the ef®cacy of 7-day schedules was less than 90%. 6±10 Many studies have reported comparisons of short (7-day) and extended (10±14-day) schedules. 11±22 Most reported a non-signi®cant increase in eradication rates with longer therapies. 11, 13, 15±17, 19, 23±25 The results of a recent meta-analysis on the ef®cacy of different lengths of triple therapy show a moderate increase in eradication rates with longer schedules, although the increase was only signi®cant when comparing 7±14-day treatments. 26 However, the eradication rate of ®rst-line therapy is not the only factor that should be taken into account when choosing between 7-day and 10-or 14-day therapies. Can we justify doubling the costs of drug therapy and increasing discomfort in all our patients to avoid a second treatment in 5±10% of subjects? Could ®rst-line 7-day triple therapy in SUMMARY Background: Triple therapy with a proton pump inhibitor, clarithromycin and amoxicillin is widely used for H. pylori infection. The appropriate length of treatment remains controversial. Aim: To determine whether length of treatment has an impact on the cost-effectiveness of triple therapy. Methods: The study took the form of a cost-effectiveness analysis spanning 2 years. The perspective was societal and the setting, ambulatory care. Subjects were Helicobacter pylori-positive patients with a duodenal ulcer. The triple therapy trials spanned 7, 10 or 14 days and the main outcome measures were cost per patient and marginal cost for additional cured patient calculated for a low cost-of-care setting (Spain), for a high-cost setting