bluuebunny/crossref_metadata_2025_split huggingface dataset:
Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: a Danish nationwide cohort study
Authors: LANGAGERGAARD V. , PEDERSEN L. , GISLUM M. , NØRGARD B. , SØRENSEN H. T. 
Published: July 2010

SummaryBackgroundData on birth outcome after exposure to azathioprine or mercaptopurine during pregnancy is sparse.AimTo examine the risk of adverse birth outcome among newborns of women exposed to azathioprine or mercaptopurine during pregnancy.MethodsData on drug use and births were obtained from Danish population registries. We included 76 exposed pregnancies in 69 women. Of these, we used 64 pregnancies exposed 30 days before conception or during the first trimester to examine the risk of congenital abnormalities, and 65 pregnancies exposed during the entire pregnancy to examine preterm birth and low birth weight at term. Their birth outcomes were compared with outcomes among women who did not fill prescriptions for azathioprine or mercaptopurine during pregnancy.ResultsAzathioprine‐ or mercaptopurine‐exposed women had a higher risk of adverse birth outcomes than unexposed controls. However, when the comparison was limited to newborns of women with the same types of underlying disease, relative risks for spontaneous and induced preterm birth, low birth weight at term, and congenital abnormalities were 1.1 (95% CI: 0.5–2.4), 4.0 (95% CI: 1.5–10.8), 1.7 (95% CI: 0.3–8.7) and 1.1 (95% CI: 0.5–2.9), respectively.ConclusionOur results suggest that adverse birth outcomes were caused by the underlying disease rather than by use of azathioprine or mercaptopurine.
Meta‐analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy
Authors: TONG J. L. , RAN Z. H. , SHEN J. , ZHANG C. X. , XIAO S. D. 
Published: July 2010

SummaryBackgroundRecent evidence found probiotics could inhibit Helicobacter pylori colonization from both in vitro and in vivo studies.AimTo systematically evaluate whether adding probiotics to anti‐H. pylori regimens could improve eradication rates and reduce side effects during anti‐H. pylori treatment.MethodsEligible articles were identified by searches of electronic databases. We included all randomized trials comparing probiotics supplementation to placebo or no treatment during anti‐H. pylori regimens. Statistical analysis was performed with Review Manager 4.2.8. Subanalysis/Sensitivity analysis was also performed.ResultsWe identified 14 randomized trials (n = 1671). Pooled H. pylori eradication rates were 83.6% (95% CI = 80.5–86.7%) and 74.8% (95% CI = 71.1–78.5%) for patients with or without probiotics by intention‐to‐treat analysis, respectively, the odds ratio (OR) was 1.84 (95% CI = 1.34–2.54); the occurrence of total side effects were 24.7% (95% CI = 20.0–29.4%) and 38.5% (95% CI = 33.0–44.1%) for groups with or without probiotics, especially for diarrhoea, the summary OR was 0.44 (95% CI = 0.30–0.66).ConclusionsOur review suggests that supplementation with probiotics could be effective in increasing eradication rates of anti‐H. pylori therapy, and could be considered helpful for patients with eradication failure. Furthermore, probiotics show a positive impact on H. pylori therapy‐related side effects.
Gastro‐oesophageal reflux disease in chronic laryngitis: prevalence and response to acid‐suppressive therapy
Authors: QUA C. S. , WONG C. H. , GOPALA K. , GOH K. L. 
Published: July 2010

SummaryBackgroundGastro‐oesophageal reflux is thought to cause chronic laryngitis through laryngopharyngeal reflux. Response of laryngitis to treatment with acid‐suppressive therapy supports this causal link.AimTo determine the prevalence of gastro‐oesophageal reflux disease in patients with chronic laryngitis and response to proton‐pump inhibitor therapy.MethodsPatients with chronic laryngitis were recruited. The frequency and severity of reflux and laryngeal symptoms were scored and laryngitis graded by laryngoscopy. All patients underwent esophagogastroduodenoscopy and 24‐h ambulatory pH monitoring before receiving lansoprazole 30 mg b.d. for 8 weeks.ResultsThe prevalence of gastro‐oesophageal reflux disease was 65.6% (21 of 32). Based on positive pH test, the prevalence was 25% (eight of 32). The change in laryngeal symptom score and laryngitis grade was significantly higher in GERD compared with non‐GERD patients (P = 0.010 for both). The proportion of patients with marked/moderate improvement in laryngeal symptoms were significantly higher in patients with reflux (14 of 21, 67%) compared to those without reflux (two of 11, 18%; P = 0.026).ConclusionsThe prevalence of gastro‐oesophageal reflux disease amongst our patients with chronic laryngitis was high. The response to treatment with proton‐pump inhibitors in patients with reflux disease compared to those without underlined the critical role of acid reflux in a subset of patients with chronic laryngitis.
Comparison of the effects of immediate‐release omeprazole oral suspension, delayed‐release lansoprazole capsules and delayed‐release esomeprazole capsules on nocturnal gastric acidity after bedtime dosing in patients with night‐time GERD symptoms
Authors: KATZ P. O. , KOCH F. K. , BALLARD E. D. , BAGIN R. G. , GAUTILLE T. C. , CHECANI G. C. , HOGAN D. L. , PRATHA V. S. V. 
Published: July 2010

SummaryBackgroundGastro‐oesophageal reflux disease (GERD) patients on proton pump inhibitors before breakfast or dinner have acid recovery at night. Bedtime immediate‐release omeprazole (IR‐OME) demonstrated better control of nocturnal pH than pantoprazole before dinner.AimTo compare repeated once daily bedtime dosing of IR‐OME, lansoprazole and esomeprazole on nocturnal gastric acidity.MethodsOpen‐label, randomized, crossover study enrolling 54 patients with nocturnal GERD symptoms comparing IR‐OME, lansoprazole and esomeprazole at steady state for nocturnal acid breakthrough (NAB), percentage of time with gastric pH > 4 and median gastric pH.ResultsOnset of nocturnal acid control with IR‐OME was rapid. During the first half of the night, percentage of time with gastric pH > 4 and median gastric pH were significantly higher after IR‐OME compared to esomeprazole or lansoprazole (P < 0.001, both comparisons). Over the 8‐h night‐time period, acid control with IR‐OME was significantly better than lansoprazole (P < 0.001), and comparable to esomeprazole. IR‐OME reduced NAB compared with esomeprazole and lansoprazole (61% vs. 92% and 92%; P < 0.001, both comparisons).ConclusionsBedtime IR‐OME provided more rapid control of night‐time gastric pH and decreased NAB compared with esomeprazole and lansoprazole. Nocturnal acid control with IR‐OME was superior to lansoprazole and comparable to esomeprazole. Bedtime dosing with IR‐OME may be effective for patients with night‐time heartburn.
Review article: glucagon‐like peptide 2 – current applications and future directions
Authors: WALLIS K. , WALTERS J. R. F. , FORBES A. 
Published: July 2010

SummaryBackgroundGlucagon‐like peptide 2 (GLP‐2) is an important peptide growth factor secreted from the human intestine. The trophic properties of GLP‐2 are very specific to the gut where it is pivotal in the regulation of mucosal morphology, function and integrity.AimsThis review details the current understanding of the molecular biology of GLP‐2, its mechanisms of action and physiological properties. A major focus is the discussion of recent clinical data evaluating the use of GLP‐2 as a therapeutic agent.MethodsRelevant articles were identified using Medline searches and from the reference lists of key papers.Results and ConclusionsIn the treatment of short bowel syndrome, GLP‐2 has been shown to be highly effective in improving fluid absorption. In Crohn's disease, GLP‐2 is superior to placebo in the induction of remission. Early data also suggest that the effects of GLP‐2 on bone metabolism can provide a new treatment approach for patients with osteoporosis. In the future, the positive effects of GLP‐2 on intestinal barrier function, splanchnic perfusion and mucosal healing could be utilized to expand its therapeutic application to other causes of intestinal injury. However, important safety aspects need to be considered when using this potent growth‐promoting agent for a long term.
Meta‐analysis: Saccharomyces boulardii for treating acute diarrhoea in children
Authors: SZAJEWSKA H. , SKÓRKA A. , DYLAG M. 
Published: July 2010

SummaryBackground Saccharomyces boulardii is a non‐pathogenic probiotic yeast considered useful against enteropathogens.AimTo assess the effectiveness of S. boulardii in treating acute infectious diarrhoea in children.MethodsThe following electronic databases were searched through August 2006 for studies relevant to acute infectious diarrhoea and S. boulardii: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized‐controlled trials were included.ResultsFive randomized‐controlled trials (619 participants) met the inclusion criteria. Combined data from four randomized‐controlled trials showed that S. boulardii significantly reduced the duration of diarrhoea compared with control. The pooled weighted mean difference was −1.1 days (95% CI: −1.3 to −0.8) with a fixed model and remained significant in a random effect model. Saccharomyces boulardii significantly reduced the risk of diarrhoea on days 3, 6 and 7. Also the risk of diarrhoea lasting >7 days was significantly reduced in the S. boulardii group vs. control group (1 RCT, n = 88, RR 0.25, 95% CI: 0.08–0.83; NNT 5, 95% CI: 3–20).ConclusionsThere exists a moderate clinical benefit of S. boulardii therapy in otherwise healthy infants and children with acute gastroenteritis, mainly a shorter duration of diarrhoea. However, these results should be interpreted with caution due to methodological limitations of the included studies.
The quantitative validation of non‐endoscopic disease activity indices in ulcerative colitis
Authors: HIGGINS P. D. R. , LEUNG J. , SCHWARTZ M. , MAPILI J. , WREN P. A. , ZIMMERMANN E. M. 
Published: July 2010

SummaryBackgroundUlcerative colitis disease activity indices have not been formally validated.AimTo analise quantitatively the psychometric and performance validity of two non‐endoscopic indices for ulcerative colitis, the Simple Clinical Colitis Activity Index and the Seo Index.MethodsIn 66 patients with ulcerative colitis, the measurement of disease activity was repeated with the two non‐endoscopic indices, St Mark's Index, and the Inflammatory Bowel Disease Questionnaire. Psychometric validity was evaluated by measuring the content, construct, criterion‐convergent and criterion‐predictive validity on a 0–1 scale. Performance validity was evaluated by measuring the reproducibility and responsiveness on a 0–1 scale.ResultsThe Simple Clinical Colitis Activity Index had good to excellent psychometric and performance validity, while the Seo Index had moderate to excellent psychometric validity and moderate to good performance validity. The Simple Clinical Colitis Activity Index had weaknesses in content validity and in responsiveness. The Seo Index had weaknesses in content validity, construct validity and responsiveness.ConclusionsThese two non‐endoscopic indices for ulcerative colitis have good psychometric and performance validity, and are now the most rigorously validated disease activity indices for ulcerative colitis. The Simple Clinical Colitis Activity Index appears to have better overall validity. Quantitative evaluation identifies weaknesses in disease activity indices, and can lead to better disease activity indices for ulcerative colitis.
Efficacy and safety of thalidomide in children and young adults with intractable inflammatory bowel disease: long‐term results
Authors: LAZZERINI M. , MARTELOSSI S. , MARCHETTI F. , SCABAR A. , BRADASCHIA F. , RONFANI L. , VENTURA A. 
Published: July 2010

SummaryBackgroundAnti‐tumour necrosis factor‐α antibodies are useful for the treatment of refractory Crohn's disease and ulcerative colitis. Thalidomide is another agent with tumour necrosis factor‐α suppressive properties.AimTo investigate the long‐term efficacy and safety of thalidomide in a group of children and young adults with refractory inflammatory bowel disease.MethodsTwenty‐eight patients with refractory moderate‐severe inflammatory bowel disease (19 Crohn's disease, 9 ulcerative colitis) received thalidomide 1.5–2.5 mg/kg/day. Patients were assessed at baseline, at weeks 2, 4, 8 and 12, and then every 12 weeks by patient's diary, physical examinations, laboratory analyses and scoring on activity indexes. Primary outcomes were: (i) efficacy in inducing remission; and (ii) efficacy in maintaining remission.ResultsRemission was achieved with thalidomide in 21 of 28 (75%) patients (17 with Crohn's disease, 4 with ulcerative colitis). Mean duration of remission was 34.5 months. Sixteen of 20 (80%) patients suspended steroids. Reversible neuropathy occurred in seven of 28 (25%) patients, but only with cumulative doses over 28 g. Other side effects requiring thalidomide suspension were vertigo/somnolence (one of 28), and agitation/hallucinations (one of 28).ConclusionsThalidomide seems to be effective in inducing long‐term remission in children and adolescents with intractable inflammatory bowel disease. Neuropathy is the main adverse effect, but appears to be cumulative dose‐dependent, thus allowing long‐term remission before drug suspension.
Meta‐analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro‐oesophageal reflux disease
Authors: GATTA L. , VAIRA D. , SORRENTI G. , ZUCCHINI S. , SAMA C. , VAKIL N. 
Published: July 2010

SummaryBackgroundMany investigators have proposed an association between gastro‐oesophageal reflux disease and laryngo‐pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful.AimTo perform a meta‐analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro‐oesophageal reflux disease.MethodsRandomized controlled trials comparing medical or surgical treatments for gastro‐oesophageal reflux disease against placebo were identified by searching MEDLINE (1966–September 2005), EMBASE (1974–September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random‐effects model.ResultsFive studies using high‐dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta‐analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81–1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub‐group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk.ConclusionsTherapy with a high‐dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo‐pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.
Combined analysis of three crossover clinical pharmacology studies of effects of rabeprazole and esomeprazole on 24‐h intragastric pH in healthy volunteers
Authors: NORRIS V. , BAISLEY K. , DUNN K. , WARRINGTON S. , MOROCUTTI A. 
Published: July 2010

SummaryAimTo compare antisecretory effects of rabeprazole and esomeprazole after single and repeat dosing in Helicobacter pylori‐negative healthy volunteers.MethodsResults were pooled from three smaller, open, crossover, randomized studies to obtain data from 80 subjects. The studies compared: (a) 5 days’ dosing of 20 mg rabeprazole and esomeprazole (n = 24); (b) single doses of rabeprazole 20 mg and esomeprazole 40 mg (n = 27) and (c) 5 days’ dosing of rabeprazole 10 mg and esomeprazole 20 mg (n = 29). Washout periods were ≥14 days. Intragastric pH was recorded continuously for 24 h on days 0, 1 and 5.ResultsSingle doses of rabeprazole 20 mg maintained 24‐h intragastric pH >4 for longer than esomeprazole 20 mg (45% vs. 32%; P < 0.001); rabeprazole 20 mg and esomeprazole 40 mg were equivalent in their effects. After 5 days’ dosing, rabeprazole 20 mg maintained pH >4 for longer than esomeprazole 20 mg (62% vs. 56%; P = 0.046); the reverse was true for esomeprazole 20 mg vs. rabeprazole 10 mg (56% vs. 48%; P = 0.035). In general, intragastric pH AUC during 0–5 h after dosing was higher after esomeprazole than rabeprazole, whereas the reverse was true during the night.ConclusionsThe order of effects on 24‐h pH was: rabeprazole 10 mg ≤ esomeprazole 20 mg < rabeprazole 20 mg = esomeprazole 40 mg. Esomeprazole acts faster, whereas rabeprazole's effect lasts longer.
An open study of modafinil for the treatment of daytime somnolence and fatigue in primary biliary cirrhosis
Authors: JONES D. E. J. , NEWTON J. L. 
Published: July 2010

SummaryBackgroundFatigue is a debilitating symptom which frequently impairs the quality of life of patients with primary biliary cirrhosis (PBC). Although the mechanisms underpinning fatigue in PBC remain unclear, there is an emerging consensus that CNS mechanisms play a key role. It has recently been shown that there is a strong association between abnormalities in sleep regulation, in particular excessive daytime somnolence, and fatigue severity in PBC. The CNS‐acting drug modafinil has an established role in the treatment of excessive daytime somnolence in non‐liver disease states.AimTo explore, in an open label study, the responses of PBC patients suffering from significant daytime somnolence and associated fatigue to modafinil therapy.MethodsAll patients in the series (n = 21) underwent daytime somnolence assessment using the Epworth Sleepiness Scale and PBC symptom assessment using the PBC‐40, a multi‐domain, disease specific, psychometrically robust quality of life measure. Modafinil was started at a dose of 100 mg/day and was titrated according to tolerability and response. Patients underwent repeat Epworth Sleepiness Scale and PBC‐40 assessment after 2 months of treatment.ResultsSignificant improvement was seen in Epworth Sleepiness Scale scores with modafinil therapy [15 ± 3 vs. 8 ± 6, P < 0.0005 (intention‐to‐treat analysis)]. An equally significant improvement in fatigue severity was also seen [PBC‐40 fatigue domain score (46 ± 6 vs. 34 ± 12, P < 0.0001) (intention‐to‐treat analysis)].ConclusionsOpen label modafinil therapy was associated, where tolerated by patients, with improvement in excessive daytime somnolence and associated fatigue in PBC. Further study in placebo‐controlled trials is warranted.
Chronic celecoxib users more often show regression of gastric intestinal metaplasia after Helicobacter pylori eradication
Authors: YANG H.‐B. , CHENG H.‐C. , SHEU B.‐S. , HUNG K.‐H. , LIOU M.‐F. , WU J.‐J. 
Published: July 2010

SummaryBackground and AimTo test whether the chronic users of celecoxib, a selective cyclo‐oxygenase‐2 inhibitor, had less Helicobacter pylori‐related intestinal metaplasia or if such users’ intestinal metaplasia could be prone to disappear after H. pylori eradication.MethodsThe study enrolled 150 chronic celecoxib users and 216 non‐users who underwent pan‐endoscopy to detect H. pylori infection and its related intestinal metaplasia. One hundred and three H. pylori‐infected patients with intestinal metaplasia (43 chronic celecoxib users and 60 non‐users) received anti‐H. pylori therapy and completed the 12‐month follow‐up to survey the regression of intestinal metaplasia by mean intestinal metaplasia score.ResultsThere were no differences in the prevalence of H. pylori‐related intestinal metaplasia between the chronic celecoxib users and controls (P > 0.05). On the 12th month of follow‐up, chronic celecoxib users had a lower mean intestinal metaplasia score (1.2 vs. 1.8, P < 0.005) and a higher regression rate of intestinal metaplasia (42% vs. 20%, P = 0.027) than non‐users.ConclusionsWith H. pylori infection, chronic celecoxib users still showed limited effects to decrease intestinal metaplasia. Nevertheless, celecoxib should be promising to assist H. pylori eradication for the control of gastric intestinal metaplasia and cancer risk.
Efficacy of tegaserod for functional constipation in Chinese subjects: a randomized double‐blind controlled trial in a single centre
Authors: ON CHAN A. O. , MO HUI W. , LEUNG G. , HU W. H. C. , LAM S. K. , WONG B. C. Y. 
Published: July 2010

SummaryBackgroundTegaserod has been shown to be effective in chronic constipation in Western population.AimWe investigated if tegaserod is equally effective in Chinese population.Materials and methodsTwo hundred and fifty patients were randomized to a double‐blinded 8‐week treatment of tegaserod 6 mg b.d. or placebo. Response during weeks 1–4 was defined as an increase in complete spontaneous bowel motion ≥1/week. Secondary efficacy included response during weeks 1–8, individual symptoms and scores, quality of life and global assessment of bowel habits and constipation.ResultsOne hundred and nine patients from the treatment group and 107 from the placebo group completed the 8‐week treatment. Responder rates was 47.7% vs. 29% for the treatment and placebo groups (P = 0.005). The sustained complete spontaneous bowel motion rate was 29.4% vs. 15.7% in the two groups (P = 0.016). The response rates were higher than that reported previously in the Caucasian studies. There was improvement in the scores for stool form scale, bothersomeness of constipation, abdominal distension/bloating and satisfaction of bowel habit (P < 0.05). The mental score was higher in the treatment group (46.8 ± 9 vs. 43.6 ± 10,P = 0.01).ConclusionsTegaserod is effective in relieving chronic constipation in Chinese population. The efficacy observed may be higher than that in Western population.
Meta‐analysis: Helicobacter pylori eradication treatment efficacy in children
Authors: KHURANA R. , FISCHBACH L. , CHIBA N. , VAN ZANTEN S. V. , SHERMAN P. M. , GEORGE B. A. , GOODMAN K. J. , GOLD B. D. 
Published: July 2010

SummaryBackground  Several meta‐analyses assessing the efficacy of anti‐Helicobacter pylori treatment in adults have been published but a comparable meta‐analysis in children is lacking.Aims  To summarize the efficacy of treatments aimed at eradicating H. pylori in children and to identify sources of variation in treatment efficacy across studies.Methods  We searched Medline, reference lists from published study reports, and conference proceedings for anti‐H. pylori treatment trials in children. Weighted meta‐regression models were used to find sources of variation in efficacy.Results  Eighty studies (127 treatment arms) with 4436 children were included. Overall, methodological quality of these studies was poor with small sample sizes and few randomized‐controlled trials. The efficacy of therapies varied across treatment arms, treatment duration, method of post‐treatment assessment and geographic location. Among the regimens tested, 2–6 weeks of nitroimidazole and amoxicillin, 1–2 weeks of clarithromycin, amoxicillin and a proton pump inhibitor, and 2 weeks of a macrolide, a nitroimidazole and a proton pump inhibitor or bismuth, amoxicillin and metronidazole were the most efficacious in developed countries.Conclusions  Before worldwide treatment recommendations are given for eradication of H. pylori, additional well‐designed randomized placebo‐controlled paediatric trials are needed, especially in developing countries where both drug resistance and disease burden is high.