AIM To test the hypothesis that Helicobacter pylori eradication alone can reduce the incidence of gastric cancer in a subgroup of individuals with an increased risk for this fatal disease.METHODS It is a prospective, ...AIM To test the hypothesis that Helicobacter pylori eradication alone can reduce the incidence of gastric cancer in a subgroup of individuals with an increased risk for this fatal disease.METHODS It is a prospective, randomized,double-blind, placebo-controlled multinational multicenter trial. Men between 55 and 65 years of age with a gastric cancer phenotype of Helicobacterpylori gastritis are randomized to receive a 7-day course of omeprazole 2 × 20 mg,clarithromycin 2 × 500 mg, and amoxicillin 2 ×lg for 7 days, or omeprazole2 × 20mg plusplacebo. Follow - up endoscopy is scheduled 3months after therapy, and thereafter in one-year intervals. Predefined study endpoints are gastric cancer, precancerous lesions (dysplasia, adenoma), other cancers, anddeath.RESULTS Since March 1998, 1524 target patients have been screened, 279 patients (18.3%) had a corpus-dominant type of H.pylori gastritis, and 167 of those were randomized (58.8%). In the active treatment group (n -- 86), H. pylori infection infection was cured in 88.9% of patients. Currently, thecumulative follow-up time is 3046 months (253.8patient-years, median follow-up 16 months). So far, none of the patients developed gastric cancer or any precancerous lesion. Three(1.8%) patients reached study endpoints other than gastric cancer.CONCLUSION Among men between 55 and 65years of age, the gastric cancer phenotype of H.pylori gastritis appears to be more common than expected. Further follow- up and continuing recruitment are necessary to fulfil the main aim of the study.展开更多
Objective:The conversations in accountability were designed to gain an understanding of the use and changes to accountability in charities over time,including learning how results are measured.Methods:As part of a lar...Objective:The conversations in accountability were designed to gain an understanding of the use and changes to accountability in charities over time,including learning how results are measured.Methods:As part of a larger study which investigated accountability in charities working to reduce mortality of children younger than 5 years in least developed countries,a multiple-case study comprising semistructured in-depth key informant interviews was conducted to investigate the use and effects of accountability in three charities of differing sizes.Results:Smaller charities tend to use fewer accountability mechanisms than larger ones,whereas the variation in their use between small and medium-sized charities is greater than the variation between medium-sized and large charities.Conclusion:Although accountability has changed over time,charities believe that they are providing the correct amount of accountability-that is,enough to satisfy the perceived demands of their stakeholders but not so much that it detracts from the mission or incurs costs in excess of benefits.However,the tools to determine effectiveness and impact are lacking.展开更多
文摘AIM To test the hypothesis that Helicobacter pylori eradication alone can reduce the incidence of gastric cancer in a subgroup of individuals with an increased risk for this fatal disease.METHODS It is a prospective, randomized,double-blind, placebo-controlled multinational multicenter trial. Men between 55 and 65 years of age with a gastric cancer phenotype of Helicobacterpylori gastritis are randomized to receive a 7-day course of omeprazole 2 × 20 mg,clarithromycin 2 × 500 mg, and amoxicillin 2 ×lg for 7 days, or omeprazole2 × 20mg plusplacebo. Follow - up endoscopy is scheduled 3months after therapy, and thereafter in one-year intervals. Predefined study endpoints are gastric cancer, precancerous lesions (dysplasia, adenoma), other cancers, anddeath.RESULTS Since March 1998, 1524 target patients have been screened, 279 patients (18.3%) had a corpus-dominant type of H.pylori gastritis, and 167 of those were randomized (58.8%). In the active treatment group (n -- 86), H. pylori infection infection was cured in 88.9% of patients. Currently, thecumulative follow-up time is 3046 months (253.8patient-years, median follow-up 16 months). So far, none of the patients developed gastric cancer or any precancerous lesion. Three(1.8%) patients reached study endpoints other than gastric cancer.CONCLUSION Among men between 55 and 65years of age, the gastric cancer phenotype of H.pylori gastritis appears to be more common than expected. Further follow- up and continuing recruitment are necessary to fulfil the main aim of the study.
文摘Objective:The conversations in accountability were designed to gain an understanding of the use and changes to accountability in charities over time,including learning how results are measured.Methods:As part of a larger study which investigated accountability in charities working to reduce mortality of children younger than 5 years in least developed countries,a multiple-case study comprising semistructured in-depth key informant interviews was conducted to investigate the use and effects of accountability in three charities of differing sizes.Results:Smaller charities tend to use fewer accountability mechanisms than larger ones,whereas the variation in their use between small and medium-sized charities is greater than the variation between medium-sized and large charities.Conclusion:Although accountability has changed over time,charities believe that they are providing the correct amount of accountability-that is,enough to satisfy the perceived demands of their stakeholders but not so much that it detracts from the mission or incurs costs in excess of benefits.However,the tools to determine effectiveness and impact are lacking.
