• Title/Summary/Keyword: quadruple therapy

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High Efficacy of Levofloxacin-Dexlansoprazole-Based Quadruple Therapy as a First Line Treatment for Helicobacter pylori Eradication in Thailand

  • Prapitpaiboon, Hatainuch;Mahachai, Varocha;Vilaichone, Ratha-Korn
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4353-4356
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    • 2015
  • Background: Levofloxacin is an effective medication for second line Helicobacter pylori (H. pylori) eradication. However, limited studies have approved its use as an effective antibiotic in first line therapy. Dexlansoprazole is a new PPI and lacks of evidence in support of a role in H. pylori eradication. This study was designed to evaluate efficacy of levofloxacin-dexlansoprazole-based quadruple therapy for H. pylori eradication in Thailand. Materials and Methods: This prospective randomized control study was performed during June 2014 to December 2014. H. pylori infected gastritis patients were randomized to receive 7- or 14-day levofloxacin-dexlansoprazole based on quadruple therapy (levofloxacin 500 mg OD, dexlansoprazole 60 mg bid, clarithromycin MR 1000 mg OD, bismuth subsalicylate 1048 mg bid). CYP2C19 genotyping and antibiotic susceptibility tests were conducted for all patients. A 13C urea breath test was performed to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients were enrolled, comprising 44 males and 56 females (mean age of 52.6 years). Eradication rate by PP analysis was 85.7% (42/49) with the 7-day regimen and 98% (48/49) with the 14-day regimen (85.7% vs 98%; p-value=0.059). ITT analysis was 84% and 96% with 7- and 14-day regimens, respectively (84% vs 96%; p-value=0.092). Antibiotic susceptibility testing demonstrated 35.1% resistance to metronidazole, 18.3% to clarithromycin, and 13.5% to levofloxacin. CYP2C19 genotyping revealed 54.1% RM, 34.7% IM and 11.2% PM. The 14-day regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and metronidazole H. pylori resistant strains. Moreover, the eradication rate was 96.6% in patients with CYP2C19 genotype RM. Conclusions: The 14-day levofloxacin-dexlansoprazole based quadruple therapy provides high H. pylori eradication regardless of CYP2C19 genotype, clarithromycin or dual clarithromycin and metronidazole resistant strains. This regimen could be use as an alternative first line therapy for H. pylori eradication in Thailand.

Seven-Day Bismuth-based Quadruple Therapy as an Initial Treatment for Helicobacter pylori Infection in a High Metronidazole Resistant Area

  • Vilaichone, Ratha-korn;Prapitpaiboon, Hatainuch;Gamnarai, Pornpen;Namtanee, Juraiwan;Wongcha-um, Arti;Chaithongrat, Supakarn;Mahachai, Varocha
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6089-6092
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    • 2015
  • Background: The prevalence of metronidazole-resistant H. pylori is almost 50% in Thailand which severely limits the use of this drug for eradication therapy. The aims of this study were to evaluate the efficacy and safety profiles of 7-day bismuth-based quadruple therapy including metronidazole as an initial treatment for H. pylori infection in a high metronidazole resistance area. Materials and Methods: This study was performed at Thammasat University Hospital and King Chulalongkorn Memorial Hospital during January 2009 to October 2010. Patients with non-ulcer dyspepsia (NUD) with active H. pylori infection were assigned to receive seven days of quadruple therapy (pantoprazole 40 mg bid, bismuth subsalicylate 1,048 mg bid, amoxicillin 1 gm bid and metronidazole 400 mg tid). H. pylori infection was defined as positive H. pylori culture or two positive tests (rapid urease test and histology). Antibiotic susceptibility test for metronidazole by Epsilometer test (E-test) was performed in all positive cultures. At least four weeks after treatment, $^{13}C$ urea breath test ($^{13}C-UBT$) was performed to confirm H. pylori eradication. Results: A total of 114 patients were enrolled in this study, 50 males and 64 females with a mean age of 49.8 years. All 114 patients had a diagnosis of NUD. Overall eradication as confirmed by negative $^{13}C-UBT$ was achieved in 94 out of 114 patients (82.5%). 44 patients had positive cultures and success for E-test. In vitro metronidazole resistance was observed in 22/44 (50%) patients. Eradication rate in patients with metronidazole resistant strains was 16/22 (72.7%) and 20/22 (90.1%) with metronidazole sensitive strains (72.7% vs 90.1%, p-value=0.12; OR=3.75 [95%CI=0.6-31.5]). Minor adverse reactions included nausea, bitter taste, diarrhea and black stools but none of the patients dropped out from the study. Conclusions: Initial treatment with 7-day bismuth-based quadruple therapy including metronidazole, amoxycillin and pantoprazole is highly effective and well tolerated for metronidazole-sensitive H. pylori infections. However, the efficacy markedly decline with metronidazole resistance. Longer duration of this regimen might be required to improve the eradication rate and larger multi-center studies are needed to confirm this hypothesis.

The Effects of Pelvic Floor Stabilization exercise on Pain, Function, Psychosocial, EMG Activity on the Lower Back Pain with Postpartum Women (골반 안정화운동이 산후 요통 여성에게 통증, 기능장애, 심리사회적수준, 근활성도에 미치는 영향)

  • Lee, Min-ji;Kwon, O-kook;Song, Hyun-seung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.17-27
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    • 2018
  • Background: This study investigated the effects of pelvic floor stabilization exercise of pain, disfunction, psychosocial, electromyography (EMG) activity on the lower back pain with postpartum. Methods: The study included 20 postpartum women who were randomly assigned to a sling exercise group (SEG, n=10) or a general physical therapy group (GPTG, n=10). Outcomes were assessed using to lower back pain with postpartum the quadruple visual analogue scale (QVAS), the Korean version of the Oswestry disability index (KODI), the fear avoidance belief questionnaire (FABQ), the inventory of functional status after childbirth (IFSAC), the edinburgh postnatal depression scale-Korean (EPDS-K), and trunk muscle activity before and after a 4-week exercise intervention. Statistical analysis were performed using a mean, standard deviation, crosstab test, paired t-test, independent t-test. Kolmogorove-Smirnov test was used for test of normality. Results: Compared to the GPTG, the SEG showed significant improvement in the QVAS, KODI, FABQ, IFSAC, and EPDK-K scores (p<.05) after 4 weeks. Conclusion: Postpartum pelvic strengthening exercise proved to have a positive effect.

New Helicobacter pylori Eradication Therapies (새로운 헬리코박터 제균 요법)

  • Park, Jae Yong;Kim, Jae Gyu
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.237-244
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    • 2018
  • While the prevalence of Helicobacter pylori (H. pylori) infection is decreasing in Korea, the incidence of gastric cancer remains high, emphasizing the importance of H. pylori eradication. A new treatment strategy is needed as the eradication rate with standard triple therapy, which is currently the standard first-line regimen for H. pylori infection, has decreased below the optimum level. The major cause of eradication failure is increased antibiotic resistance. Sequential, concurrent, and hybrid therapies that include clarithromycin produce higher eradication rates than conventional standard triple therapy. However, the effectiveness of these treatments is limited in regions where the resistance rate to various antibiotics is high. Bismuth quadruple therapy is another alternative therapy, but again the eradication rate is not sufficiently high. Tailored therapy based on individual characteristics, including antibiotic susceptibility, may be ideal, but there are several limitations for clinical application and further research is needed. New potassium-competitive acid blocker-based therapies could emerge as effective alternatives in the near future. A consensus is needed to establish a strategy for applying new eradication therapies in Korea.

The Effects of Scapular Posture Correction Taping in Painful with le Breast Cancer Women (견갑골 자세교정 테이핑이 유방암 절제술을 한 여성의 통증에 미치는 영향)

  • Lee, Min-ji;Jung, Min-keun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.1
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    • pp.31-41
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    • 2017
  • Background: The purpose of this study was investigate the effects of scapular posture correction taping in painful shoulders with breast cancer women. Method: This study was carried out with a total 35 breast cancer survivors. The subjects were randomized into women a breast cancer taping group (BT, n=15), a breast cancer posture group (BP, n=16). Outcomes such as the Quadruple Visual Analogue Scale, the Shoulder Pain and Disability Index, the muscle strength, and the Quality of Life Questionnaire-cancer were measured before the training and at 4 weeks and 12 weeks after intervention. Result: There were significant variations shoulder pain, dysfunction and Range of Motion among the groups and between points in time (p<.05). However, there was no significant difference upper extremity posture between BT and BP. There were significant variations all ROM muscle strength between the groups and between points in time (p<.05). Conclusion: Applying taping treatment to breast cancer patients proved to decrease in pain and significant in dysfunction. There were significant increase in range of motion.

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Comparison of Scapular Position Between Operation and Non-operation Side to the Rotator Cuff Surgery (회전근개 수술 환자의 수술측과 비수술측 간에 견갑골 자세 비교)

  • Jeong, Eui-young;Kim, Suhn-yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.2
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    • pp.15-20
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    • 2016
  • Background: The purpose of this study was to compared of scapular position between operation side and non-operation side to the rotator cuff surgery. Methods: This study was carried out with a total 34 patients: male (n=14), female (n=20). Shoulder range of motion (ROM), the quadruple visual analogue scale (QVAS), the shoulder pain and disability index (SPADI), and the scapular index (SI) were used to assess shoulder posture and function. SI was the resting position of the scapular was determined by measuring the distance from the mid-point of the sternal notch (SN) to the medial aspect of the coracoid process (CP) and the horizontal distance from the posterolateral angle of the acromion (PLA) to the thoracic spine (TS) with a soft tape measure. The SI was calculated using the equation: [(SN to CP/PLA to TS) ${\times}$ 100]. Results: There were no significant difference in ROM, QVAS to rotator repair patients according to SI (p>.05). There were significant differences in SI between the operation side and the non-operation side (p<.01). Conclusions: Scapular position was operation side more internal rotation, protraction, abduction than non-operation side. Therefore, health professionals managing for rotator cuff tear repair patients should consider scapular position.

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Effect of Lower Trapezius Strengthening Exercise Program on Unstable Support Surface for Neck Pain Patients with Forward Head Posture: A Randomized Controlled Trial

  • Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.189-197
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of a lower trapezius strengthening exercise program on an unstable support surface on pain, neck dysfunction, psychosocial factors, and postural alignment in neck pain patients with forward head posture. Design: A randomized controlled trial Methods: A total of 36 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=18) and control group (n=18) using randomization program. Both groups performed the lower trapezius strengthening exercise program. In addition, in the experimental group, an exercise program for lower trapezius muscle strengthening was performed on an unstable support surface. All interventions were performed 3 times a week, for a total of 5 weeks. quadruple visual analogue scale (QVAS), neck disability index (NDI), short form (SF)-12, and postural alignment were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in QVAS, NDI, SF-12, and postural alignment before and after intervention (p<0.05). In addition, the experimental group showed significant differences in NDI and postural alignment compared to the control group (p<0.05). Conclusions: The lower trapezius strengthening exercise program on unstable support surfaces is an effective intervention method with clinical significance in improving neck disability and postural alignment in patients with neck pain with forward head posture.

Effects of Manual Therapy and Theraputic Exercise on Chronic Pain and Body Function in Elder Women with Chronic Low Back Pain (도수치료와 치료적 운동이 만성 요통의 여성 노인의 만성 통증과 신체 기능에 미치는 영향)

  • Shim, Yong-hyun;Park, Jae-myoung;Yu, Seong-hun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.51-57
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    • 2017
  • Background: The purpose of this study is to examine the effects of manual therapy and therapeutic exercise on pain and body function in elder women with chronic low back pain. Methods: The patients with chronic low back pain were randomly divided 2 group. The experiment group (n=11) was taken manual therapy and therapeutic exercise program. The control group (n=10) was taken physical therapy program(hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Both groups intervention performed 3 session during 6 weeks. We measured the quadruple visual analogue scale, flexibility, static balance, leg strength subject of symptom before and after experiment. The significant test pared t-test according to applying the manual therapy and therapeutic exercise group and control group between group used independent t-test. Results: Pain assessment in the experimental group was significantly different between time and group. Flexibility test groups were not significantly different between time and group. The static balance was not significantly different for the time. Strength tests were also not significantly different for the time. Conclusions: According to the results, manual therapy and therapeutic exercise group it was found to be helpful in pain, flexibility, static balance, not strength in elderly patients with chronic low back pain.

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The Effect of Scapular Dynamic Taping on Pain, Disability, Upper Body Posture and Range of Motion in the Postoperative Shoulder (어깨뼈 다이나믹 테이핑이 어깨 수술 환자의 통증과 기능장애 수준, 상지 자세와 관절가동범위에 미치는 영향)

  • Park, Se-Jin;Kim, Suhn-Yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.149-162
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    • 2018
  • PURPOSE: The aim of this study was to investigate the effect of scapular dynamic taping on pain, disability, upper body posture, and range of motion (ROM) in the postoperative shoulder. METHODS: Twenty-two patients who underwent acromioplasty and rotator cuff repair surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n=11) and a control group (CG, n=11). For the EG, exercise therapy, manual therapy, and scapular dynamic taping were applied for 6 weeks; for the CG, only exercise therapy and manual therapy were applied for 6 weeks. Shoulder pain, disability, upper body posture, and ROM were evaluated at baseline, after 3 weeks of intervention, and after 6 weeks of intervention. Assessment tools included quadruple visual analog scale (QVAS) for level of pain; shoulder pain and disability index (SPADI) for functional disability level; forward head angle (FHA), forward shoulder angle (FSA), and pectoralis minor index (PMI) for upper body posture; and ROM testing. RESULTS: Significant differences were observed between the EG and CG in SPADI total scores; internal rotation and external rotation ROM of the glenohumeral joint ; FSA ; and PMI. All groups showed statistically significant improvement in QVAS; SPADI; flexion; abduction; external rotation and internal rotation ROM of the glenohumeral joint; FSA; and PMI. CONCLUSION: These results suggest that, for patients who have undergone acromioplasty and rotator cuff repair surgery, the addition of scapular dynamic taping during therapy is effective for improvement of shoulder disability level, ROM, and upper body posture.

Effects of Abdominal Drawing-in using Pressure Biofeedback Training on Pain, Performance of Transverse Abdominis, Oswestry Disability Index, and Quality of Life in Postpartum Women: Targeted at Women in their 30s Less than One Year Postpartum (압력 생체 되먹임 훈련을 이용한 복부 드로잉 운동이 산후 여성에서 통증, 배가로근 수행력, 요통장애지수, 삶의 질에 미치는 효과: 출산 후 1년 미만의 30대 여성을 대상으로)

  • Hyoung-bong Song;Geun-hong Park;Eun-bi Kim;Tae-won Kim;Sung-doo Park
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.30 no.1
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    • pp.1-13
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    • 2024
  • Background: The purpose of this study was to investigate the effects of stabilization exercise performed after abdominal drawing exercise using pressure biofeedback for 8 weeks on pain level, performance of transverse abdominis, back pain disability index, and quality of life in women in their 30s less than one year after giving birth. Methods: A total of 20 women who voluntarily participated less than one year after giving birth were randomly divided into a control group and an experimental group. The control group was subjected to abdominal drawing exercise before lumbar stabilization exercise, and the experimental group was subjected to abdominal drawing exercise using pressure biofeedback before lumbar stabilization exercise thrice a week for eight weeks. The quadruple visual analog scale (QVAS), the performance of transverse abdominis, the Korean version of the Oswestry disability index (KDOI), the inventory of functional status after childbirth (IFSAC), and the Short Form-12 item (SF-12) were evaluated before and after the intervention. Results: Except for the Physical Components Summary Scale of SF-12, after the intervention, the experimental group showed significant improvement in QVAS, performance of Transverse abdominis , KDOI, and Mental Components Summary Scale of SF-12 compared to the control group. Conclusion: Selective deep muscle activation through abdominal drawing exercises using pressure biofeedback can help rehabilitation for women after postpartum.

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