bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of cisapride therapy in functional dyspepsia
Authors: KELLOW J. E. , COWAN H. , SHUTER B. , RILEY J. W. , LUNZER M. R. , ECKSTEIN R. P. , HÖSCHL R. , LAM S.‐K. 
Published: July 2010

SUMMARY Aim: To assess the efficacy of cisapride therapy in relieving symptoms of functional dyspepsia. Methods: After a 2‐week placebo run‐in period, 61 out of 74 patients were eligible to enter a 4‐week double‐blind treatment phase, consisting of treatment with cisapride (10 mg) or placebo tablets t.d.s. Gastric emptying was assessed scintigraphically at entry to the study. Patients were stratified before treatment into those with or without active chronic (Helicobacter pylori) gastritis. Patients were also classified retrospectively into those with ‘reflux‐like’ dyspepsia (n= 29) and those with ‘motility‐like’ dyspepsia (n= 32). Results: At the end of the active treatment phase, there was a similar significant (P < 0.001) reduction in total symptom score from baseline in both cisapride (8.9±0.5 to 5.8±0.6) and placebo (9.7±0.6 to 5.5±0.6) groups. Scores for heartburn and continual bloating were significantly reduced in the cisapride but not the placebo group; improvement was attributable to patients with normal, rather than delayed, rates of gastric emptying. For continual bloating, significant improvement also occurred in the cisapride subgroup without gastritis, but not in the subgroup with gastritis (mean symptom score reduction 0.48±0.18, P= 0.03). For global evaluation by the investigator and by the patient, the overall improvement rates were not statistically different between cisapride and placebo groups. In those with normal gastric emptying, however, there was a significant (P= 0.01) improvement in general well‐being in the cisapride but not in the placebo group. Conclusions: We were unable to show major differences in the short‐term efficacy of cisapride and placebo in functional dyspepsia. There were indications, however, of beneficial effects of cisapride over placebo in those with ‘reflux‐like’ dyspepsia, and in those without gastroparesis.
Colonic spreading of a non‐chlorofluorocarbon mesalazine rectal foam enema in patients with quiescent ulcerative colitis
Authors: WILDING I. R. , KENYON C. J. , CHAUHAN S. , HOOPER G. , MARSHALL S. , McCRACKEN J. S. , STAAB H. J. , ARMBRECHT J. 
Published: July 2010

SUMMARY Background: Rectal foam enemas provide for drug delivery to the distal colon for treatment of left sided ulcerative colitis. However, currently available formulations contain chlorofluorocarbons which are due to be phased out in the near future. The objective of this study was therefore to determine the degree of dispersion of a newly developed nonchlorofluorocarbon rectal foam preparation in ulcerative colitis patients. Methods: This was an open label non‐controlled study of a single administration of a mesalazine foam enema (two actuations containing 2 g of mesalazine in approximately 120 mL foam) in 10 patients with quiescent ulcerative colitis. Spreading of the 99mTc‐labelled foam enema was assessed over a 4‐h period by the non‐invasive technique of gamma scintigraphy. Results: All patients retained the enema for the full 4‐h imaging period. In nine out of the 10 patients, the enema was observed to spread as far as the descending colon and on average 23% of the dose was present in the descending colon at 4 h post‐dose. Conclusions: The extent of spreading observed in the study supports the use of the formulation in the treatment of left sided ulcerative colitis.
Treatment of diabetic gastroparesis with oral clonidine
Authors: ROSA‐E‐SILVA L. , TRONCON L. E. A. , OLIVEIRA R. B. , IAZIGI N. , GALLO L. , FOSS M. C. 
Published: July 2010

SUMMARY Background/Aims: Clonidine, a specific alpha‐2‐adrenergic receptor agonist, has been suggested to improve symptoms of gastroparesis in diabetics with diarrhoea. The aim of this study was to investigate the effects of clonidine on gastric emptying and symptoms suggestive of gastroparesis in patients with long‐standing diabetes mellitus and evidence of autonomic neuropathy. Methods: Six diabetics with chronic, refractory symptoms of bloating, nausea and vomiting were studied. Gastric emptying of a liquid nutrient meal (250 mL; 430 kcal) was evaluated by scintigraphy and symptoms were scored. Patients were treated with clonidine (median dose: 0.3 mg/day) for 2–12 weeks (median : 4 weeks), after which symptoms and gastric emptying were re‐evaluated. Treatment was then sustained for a median follow‐up period of 7 weeks (range: 2–56 weeks). Results: Gastric emptying half‐time values in diabetic patients ranged from 16 to 180 min (median: 100 min) and four patients had abnormally delayed emptying before treatment. In all patients, half‐time values decreased during treatment (median : 35 min; range: 14–106 min, P < 0.025 vs. pre‐treatment values) and in three of the four patients with abnormal gastric retention, half‐time values returned to the normal range. During clonidine treatment, a substantial decrease in the score for symptoms was observed (median and range: 7.5; 2–9 vs. 0; 0–9). In four patients, symptoms virtually disappeared, an effect that was maintained throughout follow‐up (6–56 weeks). Conclusions: These findings suggest that impairment of adrenergic influences on gastrointestinal motility control may play a role in the pathophysiology of diabetic gastroparesis and that clonidine may be a useful alternative for treating patients with this condition.
Spiramycin in triple therapy of Helicobacter pylori‐associated peptic ulcer disease. An open pilot study with 12‐month follow‐up
Authors: BERSTAD A. , BERSTAD K. , WILHELMSEN I. , HATLEBAKK J. G. , NESJE L. B. , HAUSKEN T. 
Published: July 2010

SUMMARY Background: Spiramycin (Rovamycin) is a well‐established macrolide antibiotic with good anti‐Helicobacter pylori activity in vitro. It is acid‐stable and found in high concentration in various body fluids and cells after oral administration. Its anti‐H. pylori activity in vivo has not yet been tested. Methods: Twenty‐five consecutive patients with endoscopically verified peptic ulcer and a positive biopsy urease test were given spiramycin tables 1.5 MIU instead of oxytetracycline 500 mg q.d.s. in our triple therapy regimen with bismuth subnitrate suspension 10 mL (150 mg bismuth subnitrate) q.d.s. and metronidazole 400 mg t.d.s. for 10 days. Bismuth was taken between meals and spiramycin and metronidazole with meals. Re‐endoscopy and 14C‐urea breath test were performed 4 weeks after completion of therapy. Those who were H. pylori negative according to the breath test returned for 1‐year follow‐up. Results: Per protocol analysis at 4 weeks showed that 21 out of 23 patients were H. pylori negative and had healed ulcers. These 21 patients were persistingly H. pylori negative and had no ulcers at 1‐year follow‐up. H. pylori eradication and ulcer healing rates were thus 91.3%; 95 % confidence interval from 72.0% to 98.9%. Side‐effects limiting daily activity were significantly less frequent than we have experienced previously using oxytetracycline in triple therapy. Conclusions: Spiramycin appears to be an alternative to tetracycline in the triple therapy of H. pylori infection. Further studies to position spiramycin as an anti‐H. pylori drug are warranted.
A randomized prospective comparison of clarithromycin versus amoxycillin in combination with omeprazole for eradication of Helicobacter pylori
Authors: KATELARIS P. H. , PATCHETT S. E. , ZHANG Z. W. , DOMIZIO P. , FARTHING M. J. G. 
Published: July 2010

SUMMARY Aim: To compare H. pylori eradication rates using omeprazole in conjunction with either amoxycillin or clarithromycin. Background: Omeprazole with amoxycillin is the most widely used dual therapy regimen for eradication of H. pylori. A recent open study suggested a high eradication rate combining omeprazole with the newer macrolide, clarithromycin. Methods: A randomized prospective trial in 54 patients was conducted to compare 2 weeks of treatment with omeprazole 40 mg once daily and either amoxycillin 500 mg three times daily or clarithromycin 500 mg three times daily. H. pylori eradication was assessed using the 13C urea breath test. Results: Eradication was achieved in 18/26 (69.2%) of subjects treated with omeprazole and amoxycillin and 18/25 (72.0%) of those treated with omeprazole and clarithromycin (P= N.S.). Minor side effects, most commonly altered taste, were reported by 16% of patients and were more frequent in those randomized to clarithromycin (P= 0.01). Conclusions: These regimens are similarly effective. However, clarithromycin is more expensive, associated with a greater frequency of side effects and, unlike amoxycillin, resistance by H. pylori has been reported. This suggests that clarithromycin may be a useful alternative when there is penicillin allergy or previous treatment failure, but it should not replace amoxycillin as first choice in omeprazole‐based dual therapy.
quantitative tests of liver function
Authors: JALAN R. , HAYES P. C. 
Published: July 2010

SUMMARYThe search continues for a single reliable test of liver function that provides accurate prognostic information in chronic liver disease, in acute liver failure, and about graft function following orthotopic liver transplantation. Although transaminases, the commonly used markers of hepatocellular injury, have a high sensitivity in screening for liver disease, they do not provide any information about prognosis. Rational assessment of liver function using bilirubin, serum albumin and prothrombin‐time is limited by the relative lack of sensitivity of these measurements and their inability to identify the functional reserve of the liver. Dynamic liver function tests are an improvement on the static tests but are generally cumbersome.The ideal liver function test would be cheap, easy to perform and analyse, safe, have a simple pharmacokinetic profile with minimal drug interactions, have a high predictive value and provide quick results. Numerous quantitative liver function tests have been developed and have shown promise in some studies. The aim of this review is to assess the place of these tests in the practical management of liver disease.
Short‐chain fatty acid topical treatment in distal ulcerative colitis
Authors: VERNIA P. , MARCHEGGIANO A. , CAPRILLI R. , FRIERI G. , CORRAO G. , VALPIANI D. , PAOLO M. C. DI , PAOLUZI P. , TORSOLI A. 
Published: July 2010

SUMMARY Background: Some evidence indicates that short‐chain fatty acid (SCFA) enemas are effective in the treatment of distal ulcerative colitis. Methods: In a randomized, double‐blind, placebo‐controlled study, we tested the efficacy of a 6‐week course of topical SCFA (100 mL, twice daily enemas of sodium acetate 80 mmol/L, sodium propionate 30 mmol/L and sodium butyrate 40 mmol/L) in 40 patients with mild to moderate distal colitis. Clinical, endoscopic and histological data were collected at the beginning and end of the study. Results: Fourteen patients on SCFA improved (overall score 11.3 ± 2.0 vs. 7.4 ± 3.5) as compared to five in the placebo group (overall score 10.0 ± 1.9 vs. 8.9 ± 2.5). In the SCFA‐treated group all parameters significantly improved except the number of bowel motions, whereas no significant changes were recorded in the control group. A statistically significant difference between the two treatment regimens, however, was observed only for intestinal bleeding (P < 0.05), urgency (P < 0.02) and the patient self‐evaluation score (P < 0.05). This was probably due to the random inclusion of more patients with moderate disease into the SCFA‐treated group, thus causing pre‐trial differences between the two groups. Conclusion: the present study confirms that irrigation with SCFA enemas is effective in distal colitis, and may represent an alternative therapeutic tool in the treatment of the disease.
Release of 5‐ASA from Pentasa in patients with Crohn's disease of the small intestine
Authors: LAROUCHE J. , MORAIS J. , PICARD M. , LAMBERT C. , SPÉNARD J. , LANDRIAULT H. , KENNEDY G. , POITRAS P. 
Published: July 2010

SUMMARY Background: Pentasa is a controlled‐release tablet made from semipermeable microspheres and designed to continuously deliver therapeutic quantities of 5‐ASA (5‐aminosalicylic acid) throughout the gastrointestinal tract. Scintigraphic studies in healthy subjects have documented that 5‐ASA release could occur in the small intestine. We tested here the disintegration of Pentasa in the digestive tract of nine patients with Crohn's disease of the small intestine. Materials: Each patient was given, after breakfast, a 250 mg tablet of Pentasa containing samarium‐153 oxide. For 8 h the progression of the isotope in the gastrointestinal tract was followed using gamma camera scintigraphy. Plasma measurement of 5‐ASA and acetylated 5‐ASA was used to verify the liberation and absorption of 5‐ASA. Results: The Pentasa tablet appeared completely dissolved in the stomach by 117 ± 18 min. Samarium oxide was first detected in the small intestine 60 ± 5 min after its ingestion; it reached the colon after 280 ± 13 min and it was completely absent from the small intestine at 360 ± 26 min. Plasma concentrations of 5‐ASA started to rise after 67 ± 7 min and were maximal at 222±25 min. Conclusion: In patients with Crohn's disease of the small intestine, Pentasa microgranules start releasing 5‐ASA in the proximal small intestine, acting locally to exert its beneficial effect.
The continuing development of proton pump inhibitors with particular reference to pantoprazole
Authors: HUBER R. , KOHL B. , SACHS G. , SENN‐BILFINGER J. , SIMON W. A. , STURM E. 
Published: July 2010

SUMMARYInhibition of the gastric proton pump is gaining acceptance as the treatment of choice for severe gastrooesophageal reflux disease, and for treatment of duodenal and gastric ulceration. Three of these drugs are now available (omeprazole, lansoprazole and pantoprazole) and more are being developed. Proton pump inhibitors share the same core structure, but differ in terms of substituents on this core. The substitutions are able to modify some important chemical properties of the compounds. For example, pantoprazole is significantly more acid‐stable than omeprazole or lansoprazole. E3810 is significantly less stable than the other compounds. We present an explanation for this finding that depends on the relative pK values for the pyridine and benzimidazole nitrogens, especially the former.Pantoprazole formulated in an enteric‐coated tablet displays high bioavailability and linear pharmacokinetics whether on single or multiple dose regimens. Although all three proton pump inhibitors provide a similar chemical conversion to sulphenamides, which are highly reactive cysteine reagents, these reagents derivatize different cysteines in the extracytoplasmic or membrane domain of the pump and inhibit the pump at different rates.Whereas the differences in chemical reactivity can be explained by the solution chemistry of the compounds, selective derivatization of different cysteines on the protein argues for an involvement of pump structure in response to the presence of the proton pump inhibitor on its luminal surface. This suggests that the proton pump inhibitors, which were originally designed to take advantage of only the highly acidic space generated in the parietal cell by the production of the sulphenamide, are made even more selective by the protein they target.Pantoprazole is metabolized by a combination of phase I and phase II metabolism, and has also been shown to have a very low potential for drug interaction. Studies of acid secretion in man have shown this compound to be an effective and long lasting inhibitor of acid secretion. The pharmacodynamics explain the cumulative effect of repeated doses and maximal acid secretory capacity with a once daily dosage.
Low dose famotidine in the prevention of sleep disturbance caused by heartburn after an evening meal
Authors: MANN S. G. , MURAKAMI† A. , McCARROLL† K. , RAO† A. N. , COTTRELL J. , MEHENTEE† J. , MORTON R. 
Published: July 2010

SUMMARY Aim: To determine whether, in a susceptible opulation, dosing with 10 mg famotidine 1 h before an evening meal could decrease the interference with sleep caused by heartburn. Methods: Patients with a history of frequent heartburn (n= 309) were randomized to receive 10 mg famotidine or placebo 1 h before an evening meal likely to induce symptoms. Patients assessed the efficacy of the treatment in preventing heartburn after the meal, at bedtime and during the night. The number of awakenings due to heartburn and the consumption of antacid tablets taken to alleviate symptoms were also recorded. Results: Treatment groups were well matched and data from 302 patients were available for analysis. Compared to placebo, famotidine treated patients had: less heartburn after the meal (P < 0.0001 mean global scores), less interference with getting to sleep (P= 0.0156 mean global scores), fewer awakenings (P= 0.0001 difference in mean number) and better control of heartburn during the night (P < 0.0001 mean global scores). They were also almost three times less likely to need antacid treatment than the placebo group during the night (relative odds for no antacid 2.78 (95% CI: 1.29–5.96). Only four patients in each group suffered adverse events. Conclusion: Taking a 10 mg dose of famotidine 1 h before an evening meal appears to be a successful and well tolerated strategy for preventing post‐prandial heartburn and avoiding the associated interference with sleep.
drug development in gastroenterology—the changing view of industry
Authors: PARSONS M. E. , GARNER A. 
Published: July 2010

SUMMARYRationalization within the pharmaceutical industry to combat escalating costs has included the close examination of research portfolios. Gastroenterology has been one of the casualties of this exercise and few companies currently retain a specific gastrointestinal research programme.Acid‐peptic disease has been the victim of its own success, since the availability of a range of extremely effective drugs largely satisfies current medical needs. A safe, convenient and effective monotherapy able to eradicate Helicobacter pylori would be a commercially viable alternative to antisecretory drugs, leading to further expansion of the anti‐ulcer market. The irritable bowel syndrome is probably too diverse a target for logical research; inflammatory bowel disease is probably too small a market to be attractive.Potentially effective drugs to treat these and other gastrointestinal diseases could emerge from broader research programmes, provided that companies retain the expertise and desire to develop such agents for gastrointestinal indications. Cancer of the gastrointestinal tract and associated organs undoubtedly represents a commercially attractive target, but new anti‐tumour drugs are more likely to arise from generic research rather than programmes specifically directed at tumours of the gastrointestinal tract.The changing view of the pharmaceutical industry towards the development of gastrointestinal drugs is likely to have a negative impact on both fundamental and clinical research in gastroenterology.
artificial nutritional support for improved patient care
Authors: PENNINGTON C. R. , POWELL‐TUCK† J. , SHAFFER J. 
Published: July 2010

SUMMARYMalnutrition is common and undiagnosed in the majority of affected hospital patients; it is associated with impaired organ function, morbidity, and increased length of hospital stay. Artifical nutritional support in malnourished patients leads to improvement in nutritional status and clinical outcome.Nutritional support is required in malnourished patients, patients who are unable to take normal diet and patients with intestinal failure. Gastroenterologists are required to supervise patients with intestinal failure, to insert endoscopic feeding devices, and increasingly to participate in, or lead, nutritional support teams.Major developments in nutrient delivery have included percutaneous endoscopic feeding devices, the recognition that enteral feeding is possible in patients with gastric stasis, and that nutrient needs can be met by peripheral parenteral nutrition. There is much interest in the use of new substrates, or substrates delivered in pharmacological doses such as glutamine and arginine, to manipulate the response to disease.Many hospitals lack an organized approach to artificial nutritional support. Patients continue to suffer from a lack of treatment or the consequences of inappropriate or inadequate treatment. This article reviews the current status of artificial nutritional support and provides guidelines for patient managment.
The effects of aminosalicylic acid derivatives on nitric oxide in a cell‐free system
Authors: REYNOLDS P. D. , MIDDLETON S. J. , SHORTHOUSE M. , HUNTER J. O. 
Published: July 2010

SUMMARYAims and Methods: To determine the effect of aminosalicylic acid derivatives on the concentration of nitric oxide produced in a cell‐free system, by the use of a sensitive and specific polarographic meter.Results: The aminosalicylic acid derivatives 3‐ASA (IC50100 μm), 4‐ASA (IC50350 μm) and 5‐ASA (IC505 μm) all decreased the nitric oxide signal. These drugs had a similar inhibitory effect on the formationin vitroof nitrite from sodium nitroprusside (IC50200 μm, 500 μmand 100 μm, respectively). Sulphasalazine (31.1 ± 5% decrease in signal at 1 mm) was less effective than 5‐ASA, but sulphapyridine, N‐acetyl 5‐ASA, indomethacin and hydrocortisone produced no decrease in nitric oxide signal at all.Conclusions: Nitric oxide binding may be part of the mechanism by which ASA derivatives exert their therapeutic effect, and this work suggests that it may be an important factor in the pathogenesis of ulcerative colitis.
GR122311X (ranitidine bismuth citrate), a new drug for the treatment of duodenal ulcer
Authors: BARDHAN K. L. D. , DEKKERS C. P. M. , LAM S. K. , NOWAK A. , MUCKADELL O. B. SCHAFFALITZKY DE , SCHUTZE K. , TILDESLEY G. , KLER L. , FORSTER J. K. , LACEY M. F. , ROBERTS P. M. , ISAL J. P. 
Published: July 2010

SUMMARY Background: Ranitidine bismuth citrate (GR122311X) is a new drug which offers potential benefits in healing duodenal ulcers and prevention of relapse. Methods: This randomized, multi‐centre double‐blind study of 1620 patients compared the effect of 4 weeks of treatment with GR122311X 200 mg b.d. (n= 401), 400 mg b.d. (n= 404) or 800 mg b.d. (n= 404) or ranitidine hydrochloride 150 mg b.d. (n= 411) on the rates of duodenal ulcer healing and of overall success (ulcers healed and remaining ulcer free in the 24‐week follow‐up phase). Results: All four treatments were equally effective at ulcer healing (79%, 85%, 84% and 81% of patients, respectively). GR122311X 400 mg b.d. (38%) and 800 mg b.d. (37%) were significantly more effective than ranitidine hydrochloride 150 mg b.d. (32%) with respect to overall success (P = 0.050 and P = 0.030, respectively) but there was no difference with GR122311X 200 mg b.d. (31%). GR122311X caused effective, dose‐related suppression of H. pylori (47%, 61% and 74%); H. pylori eradication rates were 18%, 21% and 22%. GR122311X was safe and well tolerated, with an adverse event profile similar to that of ranitidine hydrochloride 150 mg b.d. Median week 4 trough plasma bismuth levels were 1.3 ng/mL, 2.3 ng/mL and 3.3 ng/mL with GR122311X 200 mg b.d., 400 mg b.d. and 800 mg b.d. respectively. No individual plasma bismuth concentrations were of clinical concern. Conclusions: GR122311X is a safe and effective ulcer healing drug, and provides a platform on which anti‐H. pylori therapy can be based.