bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction between Helicobacter pylori and immune response to CagA: CagA antibody may down‐regulate bacterial colonization and tyrosine phosphorylation
Authors: DEGUCHI R. , WATANABE K. , KOGA Y. , KIJIMA H. , TAKAGI A. 
Published: July 2010

SummaryBackgroundCagA+Helicobacter pylori strains are associated with the development of gastroduodenal diseases. H. pylori possess a type IV secretion system that is responsible for the translocation of CagA into host cells.AimTo investigate the correlation between the CagA status and the severity of histological gastritis and to analyse the tyrosine phosphorylation of CagA.MethodsA total of 149 H. pylori status was determined via urine antibody to H. pylori, histological examination and serum antibody against CagA. Histological gastritis was evaluated using the updated Sydney system and scored from 0 to 3. Tyrosine phosphorylation was analysed using immunoprecipitation and immunoblotting.ResultsAnti‐CagA titres were correlated with the severity of mononuclear cell infiltration. In contrast, mean anti‐CagA in patients with grade 2 bacterial density was significantly higher than those with grade 0 (P < 0.01). Mean anti‐titre in patients with grade 3 tended to be lower than that seen with grade 2. CagA tyrosine phosphorylation was significantly more common in bacteria isolated from CagA‐antibody‐negative patients (93%;13/14) than from CagA‐antibody‐positive patients (29%; 4/14, P = 0.0007).ConclusionsHost–bacteria interaction is regarded as one of the important factors in the development of gastroduodenal diseases.
Neurokinin‐1 receptor antagonism in a human model of visceral hypersensitivity
Authors: WILLERT R. P. , HOBSON A. R. , DELANEY C. , HICKS K. J. , DEWIT O. E. , AZIZ Q. 
Published: July 2010

SummaryBackgroundSubstance P acting via the neurokinin‐1 receptor is involved in the development of hyperalgesia, although studies using neurokinin‐1 receptor antagonists (NK‐1RA) in human somatic pain have been disappointing.AimTo evaluate whether Substance P is involved in the development of human visceral pain/hyperalgesia using a selective NK‐1RA.MethodsUsing a validated human model of acid‐induced oesophageal allodynia, pain thresholds to electrical stimulation (mA) were measured in the proximal oesophagus and the foot (somatic control), pre‐ and for 4 h postdistal oesophageal acid in 14 healthy subjects, using a double‐blind, randomized, two‐period, crossover study. Measurements were taken on the third day of dosing with either an oral NK‐1RA or matching placebo, with 2 weeks washout between periods.ResultsBaseline pain threshold did not differ between treatments (proximal oesophagus 37 ± 7.4 mA NK‐1RA vs. 38 ± 10.1 placeboP = 0.81, foot 40 ± 15 mA NK‐1RA vs. 38 ± 14 placeboP = 0.68). NK‐1RA did not attenuate the reduction in pain threshold in the proximal oesophagus postacid infusion (AUC−394 ± 279 NK‐1RA vs. −262 ± 397 placeboP = 0.54).ConclusionsThe lack of effect of NK‐1RA on oesophageal pain threshold in our model does not support a role for Substance P in the development of acid‐induced oesophageal allodynia.
Predictors of inappropriate utilization of intravenous proton pump inhibitors
Authors: AFIF W. , ALSULAIMAN R. , MARTEL M. , BARKUN A. N. 
Published: July 2010

SummaryBackground  Inappropriate use of intravenous proton pump inhibitors is prevalent.Aim  To assess appropriateness of intravenous proton pump inhibitor prescribing.Methods  Retrospective review of in‐patient prescribing of intravenous pantoprazole over a 2‐month period in 2004, in an academic centre. Prescribing was deemed appropriate before and after endoscopic haemostasis, and in fasting individuals requiring a proton pump inhibitor.Results  Amongst 107 patients, 49 (46%) had upper gastrointestinal bleeding. Overall, 33 (31%, 95% CI: 22–41%) received appropriate therapy (indication, dose and duration), 61 (57%, 95% CI: 47–67%) had an inappropriate indication, and 13 (12%, 95% CI: 7–20%) had an incorrect treatment dose or duration. Therapy was appropriate in 20 (41%, 95% CI: 27–55%) with upper gastrointestinal bleeding, and 13 (22%, 95% CI: 12–33%) in the non‐upper gastrointestinal bleeding group. Appropriate prescribing rates decreased (from 41% to 16%, 95% on difference CI: 14–38%) when considering intravenous proton pump inhibitor use while awaiting endoscopy as inappropriate. Significant predictors of inappropriate use were increasing age and decreasing mean daily dose, with a trend for prescriptions written during evening shifts.Conclusion  Inappropriate intravenous proton pump inhibitor utilization was most frequent in the non‐upper gastrointestinal bleeding group, mostly for unrecognized indications. Educational interventions to optimize utilization should target prescribing in older patients, those receiving lower mean daily doses, and, perhaps, prescribing outside regular hours.
Sustained virological response to interferon reduces cirrhosis in chronic hepatitis C: a 1386‐patient study from Taiwan
Authors: HUANG J.‐F. , YU M.‐L. , LEE C.‐M. , DAI C.‐Y. , HOU N.‐J. , HSIEH M.‐Y. , WANG J.‐H. , LU S.‐N. , SHEEN I.‐S. , LIN S.‐M. , CHUANG W.‐L. , LIAW Y.‐F. 
Published: July 2010

SummaryBackground The long‐term benefits of interferon‐based therapy on preventing cirrhosis at non‐cirrhotic stage in chronic hepatitis C patients are not fully clarified.Aim To evaluate the effectiveness of interferon‐based therapy regarding to cirrhosis prevention in non‐cirrhotic chronic hepatitis C patients.Methods A total of 1386 biopsy‐proven, non‐cirrhotic chronic hepatitis C patients (892 received interferon‐based therapy and 494 untreated) were enrolled.Results Fifty‐six untreated and 51 treated (24 sustained virologic responders and 27 non‐responders) patients developed cirrhosis during a mean follow‐up period of 5.0 (1–16) and 5.1 (1–15.3) years, respectively. The annual incidences of cirrhosis in untreated and treated groups were 2.26 and 1.11% (non‐responders: 1.99%, sustained responders: 0.74%), respectively. The 15‐year cumulative incidence of cirrhosis was significantly lower in treated (9.9%) than untreated patients (39.8%, P = 0.0008, log‐rank test). The 14.5‐year cumulative incidence of cirrhosis was significantly lower in sustained responders (4.8%) compared with non‐responders (21.6%, P = 0.0007) and untreated patients (36.6%, P < 0.0001). The difference was not significant between non‐responders and untreated controls. Cox proportional hazards regression showed sustained virologic responders and younger age were independent negative factors for cirrhosis development.Conclusion A sustained virologic response secondary to IFN‐based therapy could reduce cirrhosis development in chronic hepatitis C patients.
Review article: drug hepatotoxicity
Authors: CHANG C. Y. , SCHIANO T. D. 
Published: July 2010

SUMMARYBackgroundDrug toxicity is the leading cause of acute liver failure in the United States. Further understanding of hepatotoxicity is becoming increasingly important as more drugs come to market.Aims(i) To provide an update on recent advances in our understanding of hepatotoxicity of select commonly used drug classes. (ii) To assess the safety of these medications in patients with pre‐existing liver disease and in the post‐liver transplant setting. (iii) To review relevant advances in toxicogenomics which contribute to the current understanding of hepatotoxic drugs.MethodsA Medline search was performed to identify relevant literature using search terms including ‘drug toxicity, hepatotoxicity, statins, thiazolidinediones, antibiotics, antiretroviral drugs and toxicogenomics’.ResultsAmoxicillin‐clavulanic acid is one of the most frequently implicated causes of drug‐induced liver injury worldwide. Statins rarely cause clinically significant liver injury, even in patients with underlying liver disease. Newer thiazolidinediones are not associated with the degree of liver toxicity observed with troglitazone. Careful monitoring for liver toxicity is warranted in patients who are taking antiretrovirals, especially patients who are co‐infected with hepatitis B and C. Genetic polymorphisms among enzymes involved in drug metabolism and HLA types may account for some of the differences in individual susceptibility to drug hepatotoxicity.ConclusionsDrug‐induced hepatotoxicity will remain a problem that carries both clinical and regulatory significance as long as new drugs continue to enter the market. Future results from ongoing multicentre collaborative efforts may help contribute to our current understanding of hepatotoxicity associated with drugs.
First‐line triple therapy with levofloxacin for Helicobacter pylori eradication
Authors: GISBERT J. P. , FERNÁNDEZ‐BERMEJO M. , MOLINA‐INFANTE J. , PÉREZ‐GALLARDO B. , PRIETO‐BERMEJO A.‐B. , MATEOS‐RODRÍGUEZ J.‐M. , ROBLEDO‐ANDRÉS P. , GONZÁLEZ‐GARCÍA G. 
Published: July 2010

SummaryBackground At present, the efficacy of proton pump inhibitor‐clarithromycin‐amoxicillin regimen is relatively low.Aim To evaluate the efficacy and tolerability of a first‐line triple clarithromycin‐free regimen including ranitidine bismuth citrate, levofloxacin and amoxicillin.Methods Design: Prospective study. Patients: Helicobacter pylori‐positive patients complaining of dyspeptic symptoms referred for gastroscopy. Intervention: Levofloxacin (500 mg b.d.), amoxicillin (1 g b.d.) and ranitidine bismuth citrate (400 mg b.d.) was prescribed for 10 days. Outcome: Eradication was confirmed by a 13C‐urea breath test 8 weeks after therapy. Compliance with therapy was determined by questioning and the recovery of empty envelopes of medications. Incidence of adverse effects was evaluated by means of a specific questionnaire.Results Sixty‐four patients were included (30% peptic ulcer, 70% functional dyspepsia). Almost all (97%) patients took all the medications correctly. Per‐protocol and intention‐to‐treat eradication rates were 88.5% (95% CI =78–95%) and 84.4 (74–91%). Adverse effects were reported in 9.5% of the patients, mainly including diarrhoea (7.9%); none of them were severe.Conclusion This new 10‐day levofloxacin‐based combination represents an alternative to clarithromycin‐based therapy, as it meets the criteria set for regimens used as primary H. pylori treatment: effectiveness (>80%), simplicity (twice‐daily dosing and excellent compliance) and safety (low incidence of adverse effects).
Eosinophilic oesophagitis and coeliac disease: is there an association?
Authors: QUAGLIETTA L. , COCCORULLO P. , MIELE E. , PASCARELLA F. , TRONCONE R. , STAIANO A. 
Published: July 2010

AbstractAim  To report a series of 17 children affected by eosinophilic oesophagitis. Six of them also received a diagnosis of coeliac disease.Methods  Seventeen children with history of dyspeptic symptoms were investigated.Results  Six patients (M/F:2/4; mean age ± s.d.: 5.6 ± 1.3 years, range: 4–7 years; Group A) affected by eosinophilic oesophagitis also received a diagnosis of coeliac disease. The other 11 children (M/F:10/1, mean age ± s.d.:7.5 ± 2.3 years, range: 4–10 years, Group B) were affected solely by eosinophilic oesophagitis. All children underwent a change in dietary regimen. Group A received a gluten‐free diet. Group B attempted dietary restriction based on the allergy testing results. After 6 months follow‐up, all patients in Group A showed a complete disappearance of symptoms and three of them, who underwent upper gastrointestinal endoscopy, showed histologic remission. Patients from Group B had moderate clinical improvement and in seven of them (64%) a repeated upper gastrointestinal endoscopy showed a statistically significant reduction in eosinophilic infiltration.Conclusions  This is the first reported group of patients with an association between coeliac disease and eosinophilic oesophagitis. To date, it is not possible to exclude that in a subgroup of children with coeliac disease the oesophageal eosinophilic infiltration could be caused by coeliac disease itself.
Acute systemic, splanchnic and renal haemodynamic changes induced by molecular adsorbent recirculating system (MARS) treatment in patients with end‐stage cirrhosis
Authors: DONATI G. , PISCAGLIA F. , COLÌ L. , SILVAGNI E. , RIGHINI R. , DONATI G. , PINI P. , STEFONI S. , BOLONDI L. 
Published: July 2010

SummaryAimTo evaluate the acute effect of treatment with the molecular adsorbent recirculating system (MARS) on splanchnic, renal and systemic haemodynamics in patients with end‐stage cirrhosis.MethodsTwelve patients with end‐stage cirrhosis, undergoing MARS treatment, were enrolled. The following haemodynamic parameters were measured by means of Doppler ultrasonography and thoracic electrical bioimpedance, before and after each session: portal velocity, renal and splenic resistance indices, cardiac output, cardiac stroke volume, heart rate, mean arterial pressure, systemic vascular resistance.ResultsMedian portal velocity increased significantly after treatment (23.7 vs. 20.3 cm/s,P < 0.05) while renal resistance index (0.72 vs. 0.75,P < 0.05) and splenic resistance index (0.60 vs. 0.65,P < 0.05) decreased significantly. Mean arterial pressure (83 vs. 81 mmHg,P < 0.05) and vascular resistance (899 vs. 749 dyne. s/cm5,P < 0.05) increased significantly, while cardiac output and stroke volume showed no significant changes.ConclusionsData emerging from this investigation suggest that MARS treatment improves significantly various haemodynamic alterations in cirrhotic patients in the short term. The observed decrease in renal vascular resistance and improvement in splenic resistance index, a parameter related to portal resistance, which leads us to hypothesize that these haemodynamic effects are probably mediated by clearance of vasoactive substances during MARS treatment.
Meta‐analysis: a functional polymorphism in the gene encoding for activity of the serotonin transporter protein is not associated with the irritable bowel syndrome
Authors: VAN KERKHOVEN L. A. S. , LAHEIJ R. J. F. , JANSEN J. B. M. J. 
Published: July 2010

SummaryBackground  Serotonin is associated with symptoms of the irritable bowel syndrome, its action is terminated by the serotonin transporter protein.Aim  To assess the association between a functional polymorphism in the gene encoding for activity of the serotonin transporter protein and the irritable bowel syndrome.Methods  Meta‐analysis of studies identified through a Medline, PubMed and Web of Science search, describing the prevalence of a polymorphism in the serotonin transporter gene creating long and short alleles.Results  Eight eligible studies described a total of 1034 patients with the irritable bowel syndrome, and 1377 healthy controls. Presence of the short allele is not associated with an increased risk for the irritable bowel syndrome: OR 1.0; 95% CI: 0.7–1.4 for homozygous subjects, and OR 1.0; 95% CI: 0.8–1.2 for homozygous subjects and heterozygotes together. Although Caucasians and Asians had diverging genotypic frequencies, no association with the shot allele and irritable bowel syndrome was observed in subgroups: Asians OR 1.2; 95% CI: 0.9–1.6 and OR 1.1; 95% CI: 0.2–5.9; Caucasians OR 0.9; 95% CI: 0.5–1.7 and OR 0.9; 95% CI: 0.7–1.2, respectively, for homozygous subjects alone and for homozygous subjects and heterozygotes together.Conclusion  A genetic polymorphism in the gene encoding for activity of the serotonin transporter protein is not associated with the irritable bowel.
Clinical trial: switch to combined mycophenolate mofetil and minimal dose calcineurin inhibitor in stable liver transplant patients – assessment of renal and allograft function, cardiovascular risk factors and immune monitoring
Authors: CICINNATI V. R. , YU Z. , KLEIN C. G. , SOTIROPOULOS G. C. , SANER F. , MALAGÓ M. , FRILLING A. , GERKEN G. , BROELSCH C. E. , BECKEBAUM S. 
Published: July 2010

SummaryBackground Calcineurin inhibitor (CNI)‐related nephrotoxicity significantly contributes to chronic renal failure after liver transplantation.Methods In this prospective study, liver transplantation patients with renal dysfunction were randomized either to receive mycophenolate mofetil (MMF) followed by stepwise reduction of CNI with defined minimal CNI‐trough levels (MMF group), or to continue their maintenance CNI dose (control group). Immune monitoring was performed in a subgroup of the patients.Results In the MMF group (n = 50), renal function assessed by serum creatinine improved >10% in 62% of patients, was stable in 36% and deteriorated >10% in 2% after 12 months compared with baseline values. Mean serum creatinine levels (± s.d.) significantly decreased from 1.90 ± 0.44 mg/dL to 1.61 ± 0.39 mg/dL and the corresponding calculated glomerular filtration rate significantly increased from 38.8 ± 9.6 mL/min/1.73 m2to 47.0 ± 11.8 mL/min/1.73 m2over a 12‐month follow‐up period. Blood pressure and levels of liver enzymes significantly decreased. In the control group (n = 25), there were no significant changes with respect to the investigated parameters. The MMF group had significantly lower numbers of circulating cytotoxic T cells compared with the controls; whereas regulatory T cells significantly increased.Conclusion Combined MMF and minimal dose CNI therapy after liver transplantation is nephroprotective and may promote allograft tolerance.
Clinical trial: knowledge of negative Helicobacter pylori status reduces subsequent dyspepsia‐related resource use
Authors: FORD A. C. , FORMAN D. , NATHAN J. , CROCOMBE W. D. , AXON A. T. R. , MOAYYEDI P. 
Published: July 2010

SummaryBackground  Screening for Helicobacter pylori reduces dyspepsia and dyspepsia‐related costs in positive individuals.Aims  To assess effect of knowledge of H. pylori status on healthcare‐seeking in negative individuals.Methods  H. pylori‐negative subjects in a community screening programme were randomized to placebo triple therapy or informed of their negative H. pylori status. Dyspepsia‐related resource data were extracted from primary care records at 2 years, and National Health Service reference costs were applied to calculate the total cost per subject. Proportions of individuals incurring any cost were compared using a relative risk (RR) and 95% confidence interval (CI). Differences in costs were compared using an independent sample t‐test.Results  A total of 1353 H. pylori‐negative individuals were randomized to placebo whilst 1355 were informed of their infection status. In the placebo arm, 212 (16%) subsequently incurred any dyspepsia‐related cost compared to 172 (13%) informed of their infection status (RR of incurring cost = 0.81; 95% CI: 0.67–0.97). Those informed of their infection status incurred lower costs (mean saving per individual = £11.02; 95% CI: −£3.52 to 25.56).Conclusions  H. pylori‐negative individuals informed of infection status sought health care for dyspepsia less often than those who were unaware. Population screening may reduce dyspepsia‐related costs in uninfected, as well as infected individuals.
Review article: thrombocytopenia in chronic liver disease
Authors: POORDAD F. 
Published: July 2010

SummaryBackground Thrombocytopenia is a common finding in advanced liver disease. It is predominantly a result of portal hypertension and platelet sequestration in the enlarged spleen, but other mechanisms may contribute. The liver is the site of thrombopoietin (TPO) synthesis, a hormone that leads to proliferation and differentiation of megakaryocytes and platelet formation. Reduced TPO production further reduces measurable serum platelet counts.Aim This paper describes the scope of thrombocytopenia in chronic liver disease and assesses the clinical impact in this patient population.Methods A medline review of the literature was performed pertaining to thrombocytopenia and advanced liver disease. This data is compiled into a review of the impact of low platelets in liver disease.Results The incidence of thrombocytopenia, its impact on clinical decision making and the use of platelet transfusions are addressed. Emerging novel therapeutics for thrombocytopenia is also discussed.Conclusions Thrombocytopenia is a common and challenging clinical disorder in patients with chronic liver disease. New therapeutic options are needed to safely increase platelet counts prior to invasive medical procedures as well as to counteract therapies that further exacerbate low platelets, such as interferon. An ideal compound would be orally available and safe, with rapid onset of action.
Systematic review and meta‐analysis: the clinical and physiological effects of fibre‐containing enteral formulae
Authors: ELIA M. , ENGFER M. B. , GREEN C. J. , SILK D. B. A. 
Published: July 2010

SummaryBackground Enteral nutrition can be associated with gastrointestinal side effects and fibre supplementation has been proposed as a means to normalize bowel function.Aim To evaluate systematically the effects of fibre supplementation of enteral feeds in healthy volunteers and patients both in the hospital and community settings.Methods Electronic and manual bibliographic searches were conducted. Controlled studies in adults or children, comparing fibre‐supplemented vs. fibre‐free formulae given as the sole source of nutrition for at least 3 days, were included.Results Fifty‐one studies (including 43 randomized‐controlled trials), enrolling 1762 subjects (1591 patients and 171 healthy volunteers) met the inclusion criteria. Fibre supplementation was generally well tolerated. In the hospital setting, the incidence of diarrhoea was reduced as a result of fibre administration (OR 0.68, 95% CI: 0.48–0.96; 13 randomized‐controlled trials). Meta‐regression showed a more pronounced effect when the baseline incidence of diarrhoea was high. In both patients and healthy subjects, fibre significantly reduced bowel frequency when baseline frequency was high and increased it when it was low, revealing a significant moderating effect of fibre.Conclusions The review indicates that the fibre‐supplemented enteral formulae have important physiological effects and clinical benefits. There is a need to use a consistent approach to undertake more studies on this issue in the community setting.
The utilization of parenteral nutrition during the in‐patient management of inflammatory bowel disease in the United States: a national survey
Authors: NGUYEN G. C. , LAVEIST T. A. , BRANT S. R. 
Published: July 2010

SummaryBackground Parenteral nutrition has a limited role in the in‐patient management of inflammatory bowel disease.Aim To determine nationwide patterns of in‐patient parenteral nutrition utilization and its demographic determinants and impact on outcomes.Methods We identified inflammatory bowel disease discharges in the Nationwide Inpatient Sample between 1998 and 2003 and determined rates of parenteral nutrition utilization among US census regions, in‐hospital mortality and hospital resource utilization.Results The parenteral nutrition utilization rate among hospitalized inflammatory bowel disease patients was 6%. Only 64% of Crohn’s disease and 55% of ulcerative colitis discharges who received parenteral nutrition had malnutrition, fistulizing or obstructive Crohn’s disease, or surgery as an indication. The adjusted odds ratio of receiving parenteral nutrition were 0.36 (95% CI: 0.26–0.51) for the mid‐west, 0.47 (0.37–0.56) for the south and 0.70 (0.56–0.89) for the west, compared to the north‐east. Use of parenteral nutrition was associated with higher in‐hospital mortality (OR 2.5; 95% CI: 1.93–3.24), length of stay (13.7 vs. 5.7 days, P < 0.001) and hospital charges ($51 729 vs. $19 563, P < 0.001).Conclusions In‐patient utilization of parenteral nutrition for inflammatory bowel disease varies markedly by census region, expends significant resources, and leads to potentially significant adverse outcomes. These findings underscore the need for guidelines for judicious parenteral nutrition use in inflammatory bowel disease.