PubMed · 7057527
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
R M Soule. 1982-03-12. Straining out gnats.. https://doi.org/10.1001/jama.1982.03320350021013
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: Over-the-counter histamine-2 receptor antagonists, antacids and alginate/antacids are commonly used for gastro-oesophageal reflux disease. AIM: To conduct a systematic review and meta-analysis of related treatment trials. METHODS: We performed a systematic search and abstraction of randomized, placebo-controlled trials conducted during 1972-2005. Study quality was measured by the Jadad score (0-5). Results were pooled using random effects model. RESULTS: Ten trials (n = 3442, placebo = 2940; Jadad score 3.5) showed a higher response with histamine-2 receptor antagonists in regard to complete relief of heartburn, symptomatic improvement, and episodes requiring rescue antacids. The absolute benefit increase was 10-12% and relative benefit increase was 19-41%. Four trials (n = 578, placebo = 577; Jadad score 3.5) showed a trend in favour of antacids in symptomatic improvement (absolute benefit increase 8%, 95% CI: 0-16%; relative benefit increase 0.11) and requirement of rescue antacids (OR 0.70, 95% CI: 0.59-0.84). Four trials (n = 146, placebo = 138; Jadad score 3.8) found alginate/antacid combination superior to placebo in symptomatic improvement (absolute benefit increase 26%, 95% CI: 12%-41%, relative benefit increase 0.60). CONCLUSIONS: Over-the-counter medications are effective in treating symptomatic gastro-oesophageal reflux disease. Compared with the placebo response, which ranged between 37% and 64%, the relative benefit increase was up to 41% with histamine-2 receptor antagonists, 60% with alginate/antacid combinations, and 11% with antacids.
PURPOSE OF REVIEW: To examine recent advancements of the epidemiology, pathophysiology, and treatment of nocturnal asthma. RECENT FINDINGS: In a large cross-sectional survey, the prevalence of nocturnal symptoms was 60%. Forty-two percent of patients who completed the study did not declare nocturnal symptoms that were detected by physicians. A recent study including 47 individuals with nocturnal and nonnocturnal asthma showed that allele genotype Gly16 was significantly higher in the nocturnal asthma group (72%) compared with the nonnocturnal asthma group (54%). A randomized double-blind study of nocturnal asthma with esomeprazole improved the peak expiratory flow rate in individuals with both nocturnal asthma and gastroesophageal reflux disease. Of patients with nocturnal asthma and snoring, 48% had obstructive sleep apnea. After continuous positive airway pressure treatment, there was significant improvement of asthma nighttime symptom scores; however, no significant difference in lung functions was observed. SUMMARY: Nocturnal symptoms in asthma are frequently underdiagnosed. Obstructive sleep apnea may be prevalent in nocturnal asthma. The Gly16 polymorphism of the beta2-receptor is common in nocturnal asthma. Gastric suppression treatment in patients with both gastroesophageal reflux disease and nocturnal asthma improved the peak expiratory flow rate. Continuous positive airway pressure improves nocturnal symptoms but not lung function tests.
Explore the source record for details and available documents.