bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibodies to SS‐A/Ro‐52kD and centromere in autoimmune liver disease: a clue to diagnosis and prognosis of primary biliary cirrhosis
Authors: GRANITO A. , MURATORI P. , MURATORI L. , PAPPAS G. , CASSANI F. , WORTHINGTON J. , FERRI S. , QUARNETI C. , CIPRIANO V. , DE MOLO C. , LENZI M. , CHAPMAN R. W. , BIANCHI F. B. 
Published: July 2010

SummaryBackground Primary biliary cirrhosis (PBC) may be associated with various rheumatological disorders.AimTo investigate the frequency and significance of ‘rheumatological’ antinuclear antibodies in the field of autoimmune chronic liver disease, with special regard to PBC.MethodsWe studied 105 patients with PBC, 162 autoimmune liver disease controls (type 1 and 2 autoimmune hepatitis, primary sclerosing cholangitis), 30 systemic lupus erythematosus and 50 blood donors. Sera were tested for the presence of antibodies to extractable nuclear antigens (anti‐ENA) by counterimmunoelectrophoresis, enzyme‐linked and immunoblot (IB) assay, and for the presence of anti‐centromere antibodies (ACA) by indirect immunofluorescence on HEp‐2 cells and IB.ResultsThe overall prevalence of IB‐detected anti‐ENA in PBC (30%) was higher than in type 1 autoimmune hepatitis (2.5%, P < 0.0001), type 2 autoimmune hepatitis (0%, P < 0.0001) and primary sclerosing cholangitis (11.5%, P = 0.006) and lower than in systemic lupus erythematosus (53%, P = 0.03). The most frequent anti‐ENA reactivity in PBC was anti‐SSA/Ro‐52kD (28%). ACA were detected by IB in 21% PBC patients and never in the other subjects (P < 0.0001). Anti‐SS‐A/Ro/52kD positive PBC patients had at the time of diagnosis a more advanced histological stage (P = 0.01) and higher serum levels of bilirubin (P = 0.01) and IgM (P = 0.03) compared with negative ones.ConclusionsIn the autoimmune liver disease setting, anti‐SS‐A/Ro‐52kD and ACA have a high specificity for PBC and can thus be of diagnostic relevance in anti‐mitochondrial antibodies negative cases. If confirmed in further studies with adequate follow‐up, anti‐SS‐A/Ro‐52kD antibodies might identify PBC patients with a more advanced and active disease.
Long‐acting octreotide as rescue therapy in chronic bleeding from gastrointestinal angiodysplasia
Authors: SCAGLIONE G. , PIETRINI L. , RUSSO F. , FRANCO M. R. , SORRENTINI I. 
Published: July 2010

SummaryBackgroundOctreotide has shown to be effective against rebleeding from gastrointestinal angiodysplasias, but a long‐term daily parenteral administration is recommended. Long‐acting octreotide (LAR‐OCT) could overcome such a limitation, but it has not been studied extensively.AimTo investigate the usefulness of long‐acting octreotide in the control of chronic bleeding from gastrointestinal angiodysplasias.MethodsThirteen patients with chronic gastrointestinal bleeding because of angiodysplasias were enrolled. Diagnosis was made by endoscopy and wireless video capsule. Long‐acting octreotide was administered intramuscularly at a dosage of 10 mg/monthly for 1 year. Patients were followed up for a minimum period of 1 year, and haemoglobin levels, blood transfusions, iron supplementation and hospitalizations were recorded 1 year before and after starting long‐acting octreotide therapy.ResultsFollow‐up ranged from 12 to 60 months. Nine of 13 patients (69%) did not need blood transfusions and iron supplementation any longer; a partial improvement was observed in one patient; no effect was found in the others. No side effect was recorded in any patient.ConclusionsLong‐acting octreotide for 1 year may be beneficial as a rescue therapy for controlling chronic bleeding from gastrointestinal angiodysplasias in patients not eligible for surgery. Its monthly administration represents an advantage, which makes such a formulation the choice when a long‐term treatment is mandatory.
Review article: renal function assessment in cirrhosis – difficulties and alternative measurements
Authors: CHOLONGITAS E. , SHUSANG V. , MARELLI L. , NAIR D. , THOMAS M. , PATCH D. , BURNS A. , SWENY P. , BURROUGHS A. K. 
Published: July 2010

SummaryBackground  Renal function in patients with cirrhosis is important prognostically, both before and following liver transplantation. Its prognostic impact is reflected by the inclusion of serum creatinine in the model for end‐stage liver disease score, which is now used for recipient prioritization on liver transplantation waiting lists in the USA.Aim  To review the accuracy of the surrogate markers for the assessment of renal function, i.e. glomerular filtration rate, particularly in patients with cirrhosis.Method  We reviewed the available literature in PubMed regarding the markers for GFR evaluation and the factors which affect their accuracy in cirrhosis.Results  Although creatinine is widely available, it is an unreliable marker of glomerular filtration rate, particularly in patients with cirrhosis. Clearance of exogenous markers is considered the ‘gold standard’, but this methodology has many drawbacks, particularly poor applicability. Several mathematical formulae for estimated glomerular filtration rate are used to overcome some of these limitations: Cockcroft‐Gault and Modification of Diet in Renal Disease formulae are the most frequently applied, but they are based on serum creatinine.Conclusions  Due to the inaccuracy of serum creatinine and its derived formulae in estimating glomerular filtration rate, alternative serum markers, such as cystatin C, and new formulae are desirable. These need formal evaluation in patients with cirrhosis so as to have a reliable surrogate of glomerular filtration rate, and to obviate many problems that are associated with using creatinine and estimated glomerular filtration rate.
Systematic review: racecadotril in the treatment of acute diarrhoea in children
Authors: SZAJEWSKA H. , RUSZCZYŃSKI M. , CHMIELEWSKA A. , WIECZOREK J. 
Published: July 2010

SummaryBackgroundRacecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoeal effects by inhibiting intestinal enkephalinase.AimTo summarize studies testing the efficacy and safety of racecadotril for treating children with acute gastroenteritis.MethodsReports were gathered by searching electronic databases MEDLINE, EMBASE, the Cochrane Library (all up to April 2007), relevant journals, and bibliographies of reviewed articles. Only randomized‐controlled trials were included.ResultsThree randomized‐controlled trials (471 participants) met the inclusion criteria. Two trials reported stool output, and data suggested less stool output in the racecadotril group than in the control group. The duration of diarrhoea was significantly reduced in the three trials reporting this outcome. Achievement of a cure by day 5 was similar in both groups. Adverse effects were similar in both groups.ConclusionsThe small number of included trials provided some evidence in favour of the use of racecadotril over placebo or no intervention, to reduce the stool output and duration of diarrhoea in children with acute gastroenteritis. However, more data in out‐patients are needed. The safety as well as the cost‐effectiveness of the therapy should be explored, before routine therapy with racecadotril is recommended.
Differences in the management of Crohn’s disease among experts and community providers, based on a national survey of sample case vignettes
Authors: ESRAILIAN E. , SPIEGEL B. M. R. , TARGOWNIK L. E. , DUBINSKY M. C. , TARGAN S. R. , GRALNEK I. M. 
Published: July 2010

SummaryBackground  When faced with the same set of facts, healthcare providers often make different diagnoses, employ different tests and prescribe disparate therapies.Aim  To perform a national survey to measure process of care and variations in decision‐making in Crohn’s disease, and the compared results between experts and community providers.Methods  We constructed a survey with five vignettes to elicit provider beliefs regarding the appropriateness of diagnostic tests and therapies in Crohn’s disease. We measured agreement between community gastroenterologists and Crohn’s disease experts, and measured variation within each group using the RAND Disagreement Index (DI), which is a validated measure of provider variation.Results  We received 186 responses (42% response rate). Experts and community providers generally agreed on diagnostic testing decisions in Crohn’s disease. However, there was a significant disagreement between groups for several decisions (use of 5‐aminosalicylate in particular), and there was evidence of ‘extreme variation’ (defined as DI > 1.0) within groups across a range of decisions.Conclusions  Although experts and community providers are in general consensus about diagnostic decision‐making in Crohn’s disease, extreme variation exists both between and within groups for key therapeutic decisions in Crohn’s disease. We must understand and decrease this variation prior to future efforts of creating explicit quality indicators in Crohn’s disease.
Association between reflux oesophagitis and features of the metabolic syndrome in Japan
Authors: MOKI F. , KUSANO M. , MIZUIDE M. , SHIMOYAMA Y. , KAWAMURA O. , TAKAGI H. , IMAI T. , MORI M. 
Published: July 2010

SummaryBackground  There have been many reports about the relationship between reflux oesophagitis and obesity, but not the metabolic syndrome.Aim  To review upper gastrointestinal endoscopic findings and screening data obtained in healthy subjects, and assess relations between reflux oesophagitis and features of the metabolic syndrome.Methods  In 3599 men and 1560 women, the prevalence of reflux oesophagitis was assessed in relation to the age, body mass index, blood pressure, triglycerides and fasting blood glucose. Logistic regression analysis was used to calculate odds ratio for risk factors.Results  The overall prevalence of reflux oesophagitis was 4%, and it increased with age in women. Prevalence of reflux oesophagitis increased significantly with an increase of body mass index, blood pressure, triglycerides and fasting blood glucose. On multivariate analysis, male sex (odds ratio: 2.5; 95% confidence interval: 1.6–3.8), obesity (1.9; 1.4–2.5), hyperglycaemia (1.7; 1.2–2.4) and hypertension (1.5; 1.1–2.1) were independent risk factors for reflux oesophagitis. Among both men and women, those with reflux oesophagitis were significantly more likely to have two or more of these risk factors than non‐reflux oesophagitis subjects.Conclusions  Components of the metabolic syndrome are associated with the occurrence of reflux oesophagitis. Therefore, some risk factors may be common to reflux oesophagitis and the metabolic syndrome.
Medical management of mild to moderate Crohn’s disease: evidence‐based treatment algorithms for induction and maintenance of remission
Authors: SANDBORN W. J. , FEAGAN B. G. , LICHTENSTEIN G. R. 
Published: July 2010

SummaryBackground Patients with Crohn’s disease alternate between periods of active, symptomatic disease and periods of remission. The treatment goal for Crohn’s disease is to induce and then maintain remission of symptoms.Aim To review evidence from randomized, controlled, clinical trials on medical therapies for inducing and maintaining remission in patients with mild‐to‐moderate Crohn’s disease, and to suggest the best evidence‐based approaches for induction and maintenance therapies.Methods PubMed search using the following terms: sulfasalazine or salicylazosulfapyridine or aminosalicylate or aminosalicylic acid or mesalamine or mesalazine or corticosteroid or prednisone or prednisolone or methylprednisolone or budesonide or antibiotic or metronidazole or ciprofloxacin or immunosuppressive or azathioprine or mercaptopurine or thiopurine or methotrexate and Crohn’s disease.Results Randomized, controlled trials demonstrated that sulfasalazine, budesonide, and conventional corticosteroids are effective for inducing remission of mild‐to‐moderate Crohn’s disease when administered for a period of 8–16 weeks. An ideal maintenance therapy does not currently exist.Conclusions Selection of maintenance therapy is based on a combination of evidence from controlled trials and patient features including disease severity and location, co‐morbidities, previous response to treatment, and previous surgical resection. The options for maintenance therapy include therapy cessation and patient observation following successful induction, budesonide, or immunosuppressive therapy.
Clinical trial: effect of mitemcinal (a motilin agonist) on gastric emptying in patients with gastroparesis – a randomized, multicentre, placebo‐controlled study
Authors: MCCALLUM R. W. , CYNSHI O. ,   INVESTIGATIVE TEAM
Published: July 2010

SummaryBackground  Mitemcinal is an orally active motilin agonist that could potentially improve gastric emptying.Aim  To investigate the effect of mitemcinal on gastric emptying in patients with idiopathic and diabetic gastroparesis.Methods  In a randomized, double‐blind design, 106 patients were randomized into four dosing regimens (22 to placebo and 21 each to mitemcinal 10 mg, 20 mg, 30 mg bid or 20 mg tid) for 28 days. A standardized scintigraphic gastric emptying test was performed at screening and again after completing the 4‐week protocol.Results  All doses of mitemcinal showed prokinetic activity. A significant improvement in meal retention at 240 min was noted even in the lowest dose group with the greatest improvement observed with 30 mg bid group (75% vs. 10% in placebo group). Diabetic patients responded better than the idiopathic subgroup. In diabetic patients, blood glucose at 1 h after a meal showed dose‐dependent elevation. Although gastroparetic symptoms improved with both mitemcinal and placebo, the prominent placebo effect was not statistically exceeded by mitemcinal. Baseline scintigraphy results exhibited no clear correlation between the severity of gastroparetic symptoms and the status of gastric emptying.Conclusion  Mitemcinal is capable of accelerating gastric emptying in both diabetic and idiopathic patients with gastroparesis.
Clinical trial: modulation of human placental multidrug resistance proteins in cholestasis of pregnancy by ursodeoxycholic acid
Authors: AZZAROLI F. , MENNONE A. , FELETTI V. , SIMONI P. , BAGLIVO E. , MONTAGNANI M. , RIZZO N. , PELUSI G. , DE ALOYSIO D. , LODATO F. , FESTI D. , COLECCHIA A. , RODA E. , BOYER J. L. , MAZZELLA G. 
Published: July 2010

SummaryBackground  The effects of ursodeoxycholic acid on human placental bile acids and bilirubin transporters in intrahepatic cholestasis of pregnancy are still undefined.Aim  To evaluate whether ursodeoxycholic acid affects MRP2, MRP3 and MRP4 expression in the placenta.Materials and methods  Forty‐three pregnant women were enrolled; fourteen subjects had physiological pregnancies. Intrahepatic cholestasis of pregnancy patients were divided into two groups: (i) 13 received ursodeoxycholic acid (20 mg/kg/day) and (ii) 16 untreated. Total bile acid and bilirubin in serum and cord blood were determined in each subject. Multidrug resistance proteins expression (immunoblot, quantitative real‐time PCR) was evaluated in placentas collected at delivery. anova test was used for statistical analysis of data.Results  Ursodeoxycholic acid administration significantly improved maternal serum bile acid and cord blood bilirubin and bile acid levels. MRP2 protein and RNA expression was significantly increased in placentas from treated patients compared to controls (P < 0.001 and P < 0.01, respectively). MRP3 protein expression was not significantly different between the groups while RNA expression was significantly decreased in treated patients (P < 0.01). MRP4 did not show significant differences between the groups.Conclusions  Ursodeoxycholic acid administration induces placental MRP2 expression, and reduces bilirubin and bile acid levels in cord blood.
Clinical trial: a randomized‐controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis
Authors: ARTS J. , HOLVOET L. , CAENEPEEL P. , BISSCHOPS R. , SIFRIM D. , VERBEKE K. , JANSSENS J. , TACK J. 
Published: July 2010

SummaryBackground  Uncontrolled studies suggest benefit of intrapyloric injection of botulinum toxin (botox) for the treatment of gastroparesis, but controlled data are lacking.Aim  To perform a controlled study of botox injection in gastroparesis.Methods  Twenty‐three gastroparesis patients (five men, age 45 ± 3, 19 idiopathic) underwent two upper endoscopies with 4‐week interval, with injection of saline or botox 4 × 25 U in a randomized double‐blind‐controlled crossover fashion. Before the start of the study and 4 weeks after each treatment, they underwent a solid and liquid gastric emptying breath test with measurement of meal‐related symptom scores, and filled out the Gastroparesis Cardinal Symptom Index. Results (mean S.E.M.) were compared using Student’s t‐test.Results  Twelve patients received botox and 11 saline as the first injection. Significant improvement in emptying and Gastroparesis Cardinal Symptom Index was seen after initial injection of saline or botox. No further improvement occurred after the second injection (respectively, botox and saline). Pooled data for both treatment groups showed no significant difference in improvements of solid t1/2 (3.4 ± 7.4 vs. 16.3 ± 8.3, N.S.) and liquid t1/2 (8.2 ± 13.7 vs. 22.5 ± 7.7, N.S.), meal‐related symptom scores or Gastroparesis Cardinal Symptoms Index (GCSI; 6.1 ± 1.5 vs. 3.8 ± 1.5, N.S.).Conclusion  In a cohort of predominantly idiopathic gastroparesis patients, botox is not superior to placebo in improving either symptoms or the rate of gastric emptying.
Clinical trial: randomized‐controlled clinical study comparing the efficacy and safety of a low‐volume vs. a high‐volume mesalazine foam in active distal ulcerative colitis
Authors: ELIAKIM R. , TULASSAY Z. , KUPCINSKAS L. , ADAMONIS K. , POKROTNIEKS J. , BAR‐MEIR S. , LAVY A. , MUELLER R. , GREINWALD R. , CHERMESH I. , GROSS V. ,   ON BEHALF OF THE INTERNATIONAL SALOFALK FOAM STUDY GROUP
Published: July 2010

SummaryBackground  Rectally administered mesalazine (mesalamine; 5‐aminosalicylic acid) is the first‐line therapy for treatment of distal ulcerative colitis. Recently, a high‐volume 5‐aminosalicylic acid foam has been shown to be as effective and safe as standard 5‐aminosalicylic acid enema.Aim  To study the efficacy and safety of a low‐volume vs. a high‐volume 5‐aminosalicylic acid foam.Methods  In this investigator‐blinded study, patients with active distal ulcerative colitis [Clinical Activity Index (CAI) > 4, Endoscopic Index ≥ 4] were randomized to receive 2 × 1 g/30 mL low‐volume (n = 163) or 2 × 1 g/60 mL high‐volume 5‐aminosalicylic acid foam (n = 167) for 42 days. Primary end point was clinical remission (CAI ≤ 4) at the final/withdrawal visit (per‐protocol).Results  330 patients were evaluable for efficacy and safety by intention‐to‐treat, 290 for per‐protocol analysis. Clinical remission rates at week 6 (per‐protocol) were 77% on low‐volume foam vs. 77% on high‐volume foam (P = 0.00002 for non‐inferiority). The low‐volume foam was associated with a lower frequency of severe discomfort, pain and retention problems.Conclusions  Low‐volume 5‐aminosalicylic acid foam is as effective and safe as a high‐volume 5‐aminosalicylic acid foam in the treatment of active distal ulcerative colitis, but offers compliance advantages compared to the high‐volume preparation.
Clinical trial: the effects of adding ranitidine at night to twice daily omeprazole therapy on nocturnal acid breakthrough and acid reflux in patients with systemic sclerosis – a randomized controlled, cross‐over trial
Authors: JANIAK P. , THUMSHIRN M. , MENNE D. , FOX M. , HALIM S. , FRIED M. , BRÜHLMANN P. , DISTLER O. , SCHWIZER W. 
Published: July 2010

SummaryBackground  Gastro‐oesophageal reflux disease (GERD) is an important problem in systemic sclerosis due to impaired salivation and oesophageal function.Aim  To determine the efficacy of adding ranitidine at bedtime to control nocturnal acid breakthrough (NAB) and GERD in patients with systemic sclerosis already prescribed high‐dose omeprazole.Methods  Patients with systemic sclerosis and GERD symptoms (n = 14) were treated with omeprazole 20 mg b.d. and either placebo or ranitidine 300 mg at bedtime for 6 weeks in a randomized, cross‐over, placebo controlled study. At the end of each period a 24 h pH‐study with intragastric and oesophageal pH measurement was performed.Results  Pathological acid reflux occurred in eight patients with omeprazole/placebo and in seven with omeprazole/ranitidine (P = ns) with technically adequate oesophageal pH‐studies (n = 13). NAB was present in eight patients with omeprazole/placebo and six with omeprazole/ranitidine (P = ns) in whom technically adequate gastric pH‐studies were obtained (n = 10). The addition of ranitidine had no consistent effect on patient symptoms or quality of life.Conclusion  Many patients with systemic sclerosis experienced NAB and pathological oesophageal acid exposure despite high‐dose acid suppression with omeprazole b.d. Adding ranitidine at bedtime did not improve NAB, GERD or quality of life in this population.
Clinical trial: pharmacodynamics and pharmacokinetics of re‐treatment with fixed‐dose induction of peginterferon α‐2a in hepatitis C virus genotype 1 true non‐responder patients
Authors: DIAGO M. , CRESPO J. , OLVEIRA A. , PÉREZ R. , BÁRCENA R. , SÁNCHEZ‐TAPIAS J. M. , MUÑOZ‐SÁNCHEZ M. , ROMERO‐GÓMEZ M. 
Published: July 2010

SummaryBackground  Patients infected with hepatitis C virus genotype 1 who are true non‐responders to previous therapy suffer from a very difficult‐to‐cure disease. New approaches to treatment are necessary.Aim  To explore the efficacy, pharmacokinetics and safety of fixed‐dose induction with peginterferon α‐2a and ribavirin in this difficult‐to‐cure population.Methods  Seventy‐five hepatitis C virus genotype 1 true non‐responder patients to a previous interferon‐based combination regimen were randomised to receive peginterferon α‐2a 360, 270 or 180 μg/week for 12 weeks, followed by 180 μg/week for 36 weeks, in combination with ribavirin (1000/1200 mg/day). Peginterferon α‐2a concentration was measured throughout the study.Results  Sustained virological response rates were 38%, 30% and 18%, in the 360, 270 and 180 μg/week groups, respectively (relapse rates: 25%, 50% and 64%, respectively). The area under the serum concentration‐time curve of peginterferon α‐2a from 0–12 weeks increased in a dose‐dependent manner (P < 0.0001) and was associated with the sustained virological response (odds ratio: 1.35; 95% CI: 0.89, 2.06). The three regimens were equally well tolerated.Conclusion  Fixed‐dose induction of peginterferon α‐2a resulted in increased drug exposure and improved the likelihood of achieving a cure, without compromising safety in hepatitis C virus genotype 1 true non‐responder patients.