BACKGROUND:Faecal occult blood testing is an established method of colorectal neoplasia screening. Guaiac-based tests are limited by poor patient compliance, low sensitivity, specificity and positive predictive value. Newer immunochemical-based tests, accurate but tedious, require a well-established laboratory set up. There is need for simpler immunochemical tests that can be performed at the out-patient clinic.AIM:To compare the performance characteristics of a new bedside immunological test strip device with a sensitive Guaiac-based and established immunochemical test for detection of faecal occult blood in patients undergoing colonoscopy.METHODS:A total of 389 consecutive patients from four centres who were referred for colonoscopy also provided the stool samples for detection of occult blood without dietary restrictions. Stool tests performed were (i) Guaiac-based, (ii) immunochemical enzyme-linked immunosorbent assay and (iii) bedside immunochemical strip test.RESULTS:At the optimal threshold level, the sensitivity and specificity of the beside immunochemical strip test for detection of significant colorectal neoplasia (adenomas >1.0 cm and carcinomas) were 60% and 95%, respectively.CONCLUSIONS:This bedside immunochemical strip test proved to be a simple, convenient, non-cumbersome and accurate tool with similar performance characteristics for detection of any bleeding lesion including colorectal neoplasia when compared with an established immunochemical faecal occult blood test.

Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

Methodik: Ergebnisse: Schlussfolgerung:

BACKGROUND:Despite a long-standing use of herbal drugs with dyspeptic symptoms, little attention has been paid to their clinical evaluation.AIM:To assess efficacy and safety of the herbal drug preparation STW 5 (containing, e.g. Iberis, peppermint, chamomile) in the treatment of functional dyspepsia.METHODS:Research in electronic databases, consultation of experts and of the producer identified STW 5 (Iberogast) as descriptor in six randomized-controlled trials. The raw data of three placebo-controlled studies which met the selection criteria, were reanalysed and pooled for meta-analysis; one reference-controlled study supported the safety analysis (STW 5: n = 199, control: n = 198).RESULTS:Pooled data showed verum (n = 138) to be more effective than placebo (n = 135) with regard to the severity of the most bothersome gastrointestinal symptom (P-value: 0.001, odds ratio: 0.22, 95% CI: 0.11-0.47). A fourth randomized-controlled trial showed no significant difference between STW 5 and cisapride. As to safety, adverse events were similar with verum and placebo; no serious adverse events occurred.DISCUSSIONS:From the point of view of efficacy and safety, the herbal medicinal product STW 5 appears to be a valid therapeutic option for patients seeking phytotherapy for their symptoms of functional dyspepsia.

Background: Pantoprazole is claimed to have a lower potential for drug interaction than other proton pump inhibitors.Aim: To estimate the frequency of adverse events and drug interactions reported to the Food and Drug Administration in patients receiving omeprazole, lansoprazole or pantoprazole.Methods: The study involved a search of the Food and Drug Administration's database for adverse events and drug interactions with omeprazole, lansoprazole or pantoprazole as primary or secondary suspect drug. An estimate of the amount of drug dispensed during the adverse event collection period (from US drug launch) was obtained from the International Medical Statistics health database.Results: Of the suspected drug interactions recorded, vitamin K antagonist interactions, although rare, were the most common. The frequency of vitamin K antagonist interactions was 0.09 per million packages for omeprazole and 0.11 per million packages for lansoprazole and pantoprazole. Interactions with benzodiazepines or phenytoin were even rarer, being reported in less than 10 patients on each proton pump inhibitor.Conclusion: The frequency of reported drug interactions was low for omeprazole, lansoprazole and pantoprazole and vitamin K antagonist interactions were by far the most common. These potentially important drug interactions, although rare, were no less frequent on pantoprazole than on omeprazole or lansoprazole, suggesting a class effect.

Background: There is much controversy as to whether or not treatment of Helicobacter pylori reduces the occurrence of peptic ulcers during therapy with a non-steroidal anti-inflammatory drug (NSAID). Aim: To assess the efficacy of triple therapy or omeprazole on the occurrence of diclofenac associated ulcers in H pylori positive patients. Methods: This was a randomised, double blind, placebo controlled, multicentre trial in H pylori positive patients requiring NSAID therapy who had no past or current peptic ulcer. They received diclofenac 50 mg twice daily for five weeks in combination with one of the four randomly assigned treatments: anti-H pylori treatment for one week (omeprazole 20 mg+clarithromycin 500 mg+amoxicillin 1 g, all twice daily) followed by placebo for four weeks (OAC-P); anti-H pylori treatment for one week followed by antisecretory treatment with omeprazole 20 mg once daily for four weeks (OAC-O); omeprazole 20 mg once daily for five weeks (O-O); or placebo for five weeks (P-P). Patients were endoscoped before and after treatment. Results: Data from 660 patients were included in an intention to treat analysis. The occurrence of peptic ulcers in the four treatment groups during the study period was: 1.2% for OAC-P, 1.2% for OAC-O, 0% for O-O, and 5.8% for P-P (p<0.05 between placebo and all active treatment groups). Patients who received active treatment developed therapy requiring dyspeptic symptoms less frequently than those who received placebo (p<0.05 between placebo and all active treatment groups). Conclusions: In H pylori infected patients, all three active therapies reduced the occurrence of NSAID associated peptic ulcer and dyspeptic symptoms requiring therapy.

A large thallium arsenic selenide, Tl3AsSe3 (TAS) crystal was grown by the Bridgman method for acousto-optic imaging application. An as-grown 38mm diameter crystal was cut, polished and fabricated into 4.5cm long acousto-optic tunable filter (AOTF) in a 12.0° orientation of the transducer to the c-axis to achieve the power and resolution requirements. The fabricated AOTF was tested and measurements were obtained using a waveguide CO2 laser at 10.6μm, where the beam was attenuated by diffuse reflection off a rough target placed about 2m from the AOTF. The spectral response showed that the curve basically follows the predicted sinc2 pattern, with a FWHM resolution of 8cm−1, and a peak response at 13.25MHz. The measurements were performed at lower powers, and scaled to an efficiency of 27% at 200mW/cm2. By comparison, the theory gives 33.5% at 200mW/cm2 of acoustic power. If a power of 300mW/cm2 is applied, theoretically 51% efficiency will be achieved at 10μm.

A detailed study on the effect of convection on crystal quality was carried out by growing lead bromide crystals in transparent Bridgman furnace. Direct observations were made on the solid-liquid interface and a new kind of instability was observed. This could be explained on the basis of toroidal flow in the AgBr-doped lead bromide sample. With the increasing translation velocity, the interface changed from flat to depressed, and then formed a cavity in the center of the growth tube. The crystal grown at the lowest thermal Rayleigh number showed the highest quality and crystal grown at the largest thermal Rayleigh number showed the worst quality. Numerical studies were carried out to provide a framework for interpreting the observed convective and morphological instabilities, and to determine the critical (limiting) concentration of dopant for a particular growth velocity and gravity level. Theoretical instability diagrams were compared with data obtained from the experimental studies. These studies provided basic data on convective behavior in doped lead bromide crystals grown by the commercially important Bridgman process.

We have synthesized stoichiometric batches of GaSe by reacting mixtures of the parent components and have grown centimeter-size modified single crystals of GaSe by the vertical Bridgman technique. GaSe crystals doped with silver, indium and silver gallium selenide were fabricated for wavelength conversion. Silver doping produced scattering centers which could be dissolved by annealing at temperatures above 700 degrees C. Crystals cracked extensively during the annealing process and optical quality deteriorated. SHG measurements of In-doped crystals showed a "d" value of 49 pm/V for low concentration In-doped GaSe crystals. The silver gallium selenide doped GaSe crystals showed a "d" value of 75 pm/V which resulted in significant increase in the "d(2)/n(3)". (C) 1999 Published by Elsevier Science B.V. All rights reserved.

We have experimentally demonstrated the physical vapor transport growth of 30 mm diameter and 8 cm long mercurous chloride crystals for birefringence etalon filters. The 〈1 1 0〉 oriented seeded crystals were grown in a two zone vertical transparent furnace by vapor phase transport method. Two 5 mm and 1.5 mm thick filters were fabricated and tested interferometrically and with a spectrometer. The filter exhibited the spectral modulation expected based on the filter thickness. The effect of temperature on filter performance was studied by measuring the filter operation at specific calibrated temperatures. We observed a significant shift in filter wavelength at 25.8°C and 29.8°C.

The Space Shuttle Columbia was launched as STS-75 at 2018 GMT (Greenwich Mean Time) on February 22, 1996. One of the two major experiment packages was the Third United States Microgravity Payload (USMP-3), and one of the principal instruments on the USMP was the Advanced Automated Directional Solidification Furnace (AADSF). The AADSF is a multizone directional solidification furnace, and at the time of the USMP-3 flight was capable of processing only one sample per Shuttle mission which, for that flight, was a lead tin telluride (PbSnTe) crystal growth experiment. In the one year since the flight experiment the sample has been retrieved from the spacecraft and analysis has begun. After presenting introductory material on why PbSnTe was chosen as a test material, why microgravity processing was expected to produce desired results, and what we expected to find in conducting these tests, this report discusses the results to date which are far from complete.

A heat transfer measuring device was developed to help characterize a vertical Bridgman furnace. The actively heated device, the heat transfer sample HTX, measures the temperature difference created between it and the furnace wall as a function of input power. This allows the heat transfer coefficient to be measured without having to know the physical properties of the sample, the ambient gas, or the furnace. However, if some of these physical properties are known, then the HTX can be used to determine others. Heat transfer measurements were made under a variety of conditions. The convective heat loss was varied by making measurements in air, argon, helium, and vacuum environments. The radiative heat loss was varied by using fused silica, oxidized inconel, and platinum foil sleeves placed over the HTX heater. A convection coefficient for air and the emissivities of the different sleeves were determined.

Knowledge of the amount of heat that is conducted, advected and radiated between an ampoule and the furnace is important for understanding vertical Bridgman crystal growth. This heat transfer depends on the temperature, emissivities and geometries of both the furnace and ampoule, as well as the choice of ambient gas inside the furnace. This paper presents a method which directly measures this heat transfer without the need to know any physical properties of the furnace, the ampoule, or the gaseous environment. Data are given for one specific furnace in which this method was used.

Ground-based research conducted in order to prepare a microgravity space flight experiment is presented. The thermophysical properties of a PbSnTe alloy used for semiconductors are investigated, and furnace calibration and fluid-flow measurements are performed. The alloy has a zero energy crossing at approximately 40 percent SnTe in its band-gap vs composition diagram, which facilitates the design of long-wavelength IR detectors and lasers. The uniformity of devices made from this material depends on the ratio of PbTe and SnTe and requires the composition of the crystal growth to be closely controlled. The main obstacle to such control is the fact that liquid of this material is always solutally or thermally unstable, and, in a high-temperature gradient, the double convective instability cannot be made stable by balancing thermal and solutal expansion. In order to extend the science of crystal growth, the limits of suppression of convection have to be tested in low earth orbit.

In einer multizentrisch durchgeführten prospektiven Einfachblind-Studie wurde die Wirksamkeit des H2-Blockers Ranitidin mit der von Cimetidin in der Prophylaxe streßbedingter Blutungen aus dem oberen Gastrointestinaltrakt verglichen. An dieser Studie nahmen insgesamt 380 Patienten teil. In randomisierter Anordnung erhielten 192 Patienten 4 × 50 mg Ranitidin i.v. bzw. 2 × 150 mg oral. 180 Patienten wurde 4 × 400 mg Cimetidin i.v. bzw: 1000 mg oral verabreicht. 5 Patienten unter Ranitidin (2,6%) und 12 Patienten unter Cimetidin (6,4 %) entwickelten eine obere gastrointestinale Blutung, die eindeutig oder möglicherweise auf Streßläsionen zurückzuführen war. Dieser Unterschied war nicht statistisch signifikant. Streßläsionen konnten bei 11,8 % in der Ranitidin- und bei 18,3 % in der Cimetidin-Gruppe endoskopisch nachgewiesen werden (nicht signifikant). Unter Ranitidin wurden Übelkeit, Erbrechen und Tachykardie (n = 4) und unter Cimetidin Cholestase und zentralnervöse Symptome (n = 10) registriert. Ranitidin ist somit in der Prophylaxe der Streßulcus-Blutung vergleichbar wirksam wie Cimetidin.

Out of 100 patients with early gastric carcinoma 4 cases with a combined benign gastric and/or duodenal ulcer were encountered. Even in long-lasting peptic ulcer history and multiple benign biopsies carcinoma may develop at some site in the ulcer stomach. That's why intermittent therapy based on ulcer symptoms in a patient with chronic ulcer disease remains problematic. Carcinoma incidence seems to be identical in patients with gastric and duodenal ulcer and does not differ from a population with an ulcer-free stomach.