bluuebunny/crossref_metadata_2025_split huggingface dataset:
The safety of endoscopic sphincterotomy in patients receiving antiplatelet agents – a case–control study
Authors: HUSSAIN N. , ALSULAIMAN R. , BURTIN P. , TOUBOUTI Y. , RAHME E. , BOIVIN J. ‐F. , BARKUN A. N. 
Published: July 2010

SummaryObjective  To determine whether antiplatelet agents are associated with endoscopic sphincterotomy‐related haemorrhage as few well‐controlled data exist on this controversial issue.Methods  A case–control study in a tertiary care setting included cases with bleeding following endoscopic sphincterotomy, matched with 2–3 controls selected according to age ± 15 years, sex, and procedural date± 2 years. Cases and controls were compared for possible risk factors of postendoscopic sphincterotomy bleeding (presence of a coagulopathy and cholangitis). The main outcome measurement was the association between the use of antiplatelet medications and postendoscopic sphincterotomy bleeding after adjustment for possible confounding.Results  The 40 cases [mean age 68 ± 17 (s.d.) years, 50% female] and 86 controls [68 ± 16 years, 50% female] were comparable except for differences noted in International Normalized Ratio (INR) (>2 in four cases vs. two controls), and pre‐endoscopic sphincterotomy cholangitis (45% vs. 20%). Amongst cases, 13% were on aspirin and 3% on clopidogrel; 17% of controls took aspirin, and 4% a non‐steroidal anti‐inflammatory drug. 53% of cases bled immediately; the remainder haemorrhaged at 2 ± 3 days. After adjustment for an elevated INR and cholangitis, exposure to antiplatelet agents was not significantly associated with procedure‐related bleeding (odds ratio = 0.41, 95% CI [ 0.13; 1.31]).Conclusion  This case–control study provides controlled data suggesting that antiplatelet agents do not significantly increase the risk of clinically‐important bleeding related to endoscopic sphincterotomy. The low prevalences of non‐steroidal anti‐inflammatory drugs and clopidogrel use limit any definite conclusion on their elective use before endoscopic sphincterotomy.
Predictors of reduced health‐related quality of life in adults with coeliac disease
Authors: HÄUSER W. , STALLMACH A. , CASPARY W. F. , STEIN J. 
Published: July 2010

SummaryBackground  Data available on predictors of reduced health‐related quality of life in coeliac disease are not consistent.Aim  To test predictors of reduced health‐related quality of life, described in the literature, by a multivariate approach.Methods  1000 adult coeliacs of the German Coeliac Society completed a medical and a sociodemographic questionnaire, the Short‐Form Health Survey (SF‐36), the Coeliac Disease Questionnaire and the Hospital Anxiety and Depression Scale within a postal survey. Predictors of reduced health‐related quality of life were tested for by logistic regression analysis.Results  Physical comorbidities (β = −0.41; OR = 0.66, P < 0.001) and mental disorder (β = 0.88; OR = 2.4, P = 0.03) were associated with a reduced physical summary score of the SF‐36. Mental disorder (β = 2.5; OR = 11.9, P < 0.001), physical comorbidities (β = −0.26; OR = 0.77, P = 0.004) and younger age at diagnosis (β = −0.10; OR = 0.91, P = 0.05) predicted a reduced mental summary score of the SF‐36. Mental disorder (β = 0.90; OR = 2.5, P = 0.03), non‐compliance with gluten‐free diet (β = 0.44; OR = 1.6, P = 0.009), active medical comorbidities (β = −0.28; OR = 0.76, P = 0.007) and dissatisfaction with doctor–patient communication (β = 0.55; OR = 1.7, P = 0.03) were associated with reduced Coeliac Disease Questionnaire scores.Conclusions  Reduced health‐related quality of life in coeliac disease is associated not only with physical and mental comorbidities, but also with non‐compliance with gluten‐free diet and dissatisfaction with doctor–patient communication.
An open‐label study of chronic polyethylene glycol laxative use in chronic constipation
Authors: DI PALMA J. A. , CLEVELAND M. VB. , MCGOWAN J. , HERRERA J. L. 
Published: July 2010

AbstractBackgroundPolyethylene glycol 3350 (MiraLAX, Braintree Laboratories Inc., Braintree, MA, USA) is approved for the short‐term treatment of occasional constipation.AimTo extend the safety data of polyethylene glycol used for chronic treatment of chronic constipation.MethodsStudy subjects who met defined criteria for chronic constipation were enrolled in this open‐labelled, single‐treatment multi‐centre study to receive polyethylene glycol laxative as a single daily dose of 17 g for 12 months. Subjects returned to their study centres after 2, 4, 6, 9 and 12 months of treatment where blood and urine samples were collected and adverse events were reviewed. At each visit, subjects were queried for ROME constipation criteria and they rated their overall improvement using a global efficacy scale.Results311 patients including 117, age 65 and older, were enrolled and received treatment at one of 50 centres. One hundred and eighty‐four completed all 12 months of treatment. With respect to the ‘Global Efficacy Assessment’, depending on the month of observation, 80–88% of enrolled patients, and 84–94% of the elderly, were treated successfully. Similar results were obtained from secondary efficacy measures that assessed individual ROME constipation criteria at each visit. The response to treatment was durable over time. Over the 1‐year course of study representing 218 patient‐years at the labelled dose, medication‐associated adverse effects were gastrointestinal complaints of diarrhoea, loose stool, flatulence and nausea. These effects were generally mild or moderate in severity. There were no clinically significant changes in haematology or blood chemistry, particularly electrolytes, for the study population as a whole or the elderly group.ConclusionsPolyethylene glycol laxative is safe and effective for treating constipation in adult and elderly patients for periods up to 12 months, with no evidence of tachyphylaxis.
The changing incidence of oesophageal and gastric adenocarcinoma by anatomic sub‐site
Authors: CRANE S. J. , RICHARD LOCKE G. , HARMSEN W. S. , DIEHL N. N. , ZINSMEISTER A. R. , JOSEPH MELTON L. , ROMERO Y. , TALLEY N. J. 
Published: July 2010

SummaryBackgroundThe incidence rates of gastric and oesophageal adenocarcinoma are changing significantly, but little is known about specific sub‐sites.AimTo use a population‐based approach to describe the trends in the site‐specific incidence of oesophageal and gastric adenocarcinoma.MethodsUsing the Rochester Epidemiology Project, all cases of gastric and oesophageal adenocarcinoma among Olmsted County, Minnesota, residents first diagnosed between 1971 and 2000 were identified (n = 186). Complete in‐patient and out‐patient records were reviewed and site determined from pathological, surgical, endoscopic and radiological reports.ResultsBetween the decades of 1971–1980 and 1991–2000, the incidence of oesophageal adenocarcinoma increased significantly from 0.4 to 2.5 per 100 000 person‐years. The incidence of adenocarcinoma of the oesophagogastric junction also increased from a rate of 0.6 to 2.2 per 100 000 person‐years. The incidence rate of cancer involving the gastric cardia was stable but the incidence of adenocarcinoma involving distal gastric sites declined. Combined oesophageal and oesophagogastric junction adenocarcinoma (4.7 per 1 000 000 person‐years) was as common as gastric adenocarcinoma (3.4 per 100 000 person‐years) in 1991–2000.ConclusionsThe incidence rates of adenocarcinoma involving proximal gastric sub‐sites do not appear to be increasing in a manner similar to those involving oesophageal sub‐sites.
The Short‐Form Leeds Dyspepsia Questionnaire validation study
Authors: FRASER A. , DELANEY B. C. , FORD A. C. , QUME M. , MOAYYEDI P. 
Published: July 2010

SummaryBackgroundAssessment of symptoms should be the primary outcome measure in dyspepsia clinical trials. This requires a reliable, valid and responsive questionnaire that measures the frequency and severity of dyspepsia. The Leeds Dyspepsia Questionnaire fulfils these characteristics, but is long and was not designed for self‐completion, so a shorter questionnaire was developed (the Short‐Form Leeds Dyspepsia Questionnaire).AimTo assess the acceptability, interpretability, internal consistency, reliability, validity and responsiveness of the Short‐Form Leeds Dyspepsia Questionnaire in primary and secondary care.MethodsUnselected primary and secondary care patients completed the Short‐Form Leeds Dyspepsia Questionnaire. Test–retest reliability was assessed after 2 days. Validity was measured by comparison with general practitioners’ diagnosis. Sensitivity analysis and logistic regression were employed to determine the most valid scoring system. Responsiveness was determined before and after treatment for endoscopically proven disease.ResultsThe Short‐Form Leeds Dyspepsia Questionnaire was administered to 388 primary care and 204 secondary care patients. The Pearson coefficient for test–retest reliability was 0.93. The Short‐Form Leeds Dyspepsia Questionnaire had a sensitivity of 77% and a specificity of 75%. A highly significant response to change was observed (P < 0.005).ConclusionsThe Short‐Form Leeds Dyspepsia Questionnaire is a reliable, valid and responsive self‐completed outcome measure for quantifying the frequency and severity of dyspepsia symptoms, which is shorter and more convenient than the Leeds Dyspepsia Questionnaire.
Meta‐analysis: cancer risk of low‐grade dysplasia in chronic ulcerative colitis
Authors: THOMAS T. , ABRAMS K. A. , ROBINSON R. J. , MAYBERRY J. F. 
Published: July 2010

SummaryBackgroundThe cancer risk of low‐grade dysplasia (LGD) in chronic ulcerative colitis is variable and its management remain contentious.AimTo determine the risk of cancer or any advanced lesion once LGD is diagnosed.MethodsA MEDLINE, EMBASE and Pub Med search was conducted using the key words ‘surveillance’, ‘colorectal cancer’, ‘low‐grade dysplasia’ and ‘ulcerative colitis’. A random effects model of meta‐analysis was used.ResultsTwenty surveillance studies had 508 flat LGD or LGD with dysplasia‐associated lesion or mass. An average of 4.3 colonoscopies was performed/patient post‐LGD diagnosis (range: 3–7.6). An average of 18 biopsies taken per colonoscopy (range: 9–24) detected 73 advanced lesions (cancer or high‐grade dysplasia) pre‐operatively. The cancer incidence was 14 of 1000 (95% CI: 5.0–34) person years duration (pyd) and the incidence of any advanced lesion was 30 of 1000 pyd (95% CI: 12–76). When LGD is detected on surveillance there is a ninefold risk of developing cancer (OR: 9.0, 95% CI: 4.0–20.5) and 12‐fold risk of developing any advanced lesion (OR: 11.9, 95% CI: 5.2–27).ConclusionsThe risk of developing cancer in patients with LGD is high. These estimates are valuable for decision‐making when LGD is encountered on surveillance.
Variability of the area under the receiver operating characteristic curves in the diagnostic evaluation of liver fibrosis markers: impact of biopsy length and fragmentation
Authors: POYNARD T. , HALFON P. , CASTERA L. , CHARLOTTE F. , BAIL B. LE , MUNTEANU M. , MESSOUS D. , RATZIU V. , BENHAMOU Y. , BOURLIÈRE M. , LEDINGHEN V. DE ,   THE FIBROPACA GROUP
Published: July 2010

SummaryBackgroundThe area under the receiver operating characteristic (ROC) curve is widely used as an estimate of the diagnostic value for fibrosis markers. Biopsy length and fragmentation are known as risk factors of false positive or false negative of biopsy but their quantitative impact on area under the receiver operating characteristic curve variability has not been assessed.AimTo assess these relationships to better compare the fibrosis markers.MethodsThe area under the ROC curves of FibroTest for the diagnosis of fibrosis was estimated in patients with chronic hepatitis C using an integrated database including 1312 patients with FibroTest and biopsy. To take into account the biopsy length, we used two adjustment factors: one in which an observed area under the ROC curve could be adjusted according to the relative area under the receiver operating characteristic curve of a biopsy of a given length vs. the entire liver and one taking into account the prevalence of each fibrosis stage defining advanced and non‐advanced fibrosis.ResultsThe mean biopsy length was smaller for cirrhosis (F4, 16 mm) vs. F3, (18 mm, P = 0.01) and F0 (19 mm, P = 0.01). The mean number of fragments was higher for cirrhosis (F4 = 4.1 fragments) vs. all the other stages (F0 = 1.9, F1 = 1.9, F2 = 1.9, F3 = 2.3; P < 0.001 vs. F4). The FibroTest area under the ROC curves for the diagnosis of advanced fibrosis, adjusted for stages’ prevalence, ranged from 0.80 to 0.98 depending on biopsy length and fragmentation, respectively.ConclusionThe comparison of the area under the ROC curves of fibrosis markers should take into account the biopsy length and fragmentation.
Hyperhomocysteinaemia is associated with osteoporosis in patients with Crohn’s disease
Authors: ROBLIN X. , PHELIP J. M. , GENEVOIS M. , DUCROS V. , BONAZ B. 
Published: July 2010

SummaryBackgroundA high prevalence of osteoporosis is observed in Crohn’s disease. Recent data have shown that homocysteinaemia is an important risk factor in low‐bone mineralization and fracture.AimTo look for an association between homocysteinaemia and low‐bone mineralization in Crohn’s disease patients.Patients and methodsNinety‐two consecutive patients (sex ratio M/F 0.87; mean age: 36.6 ± 13.2 years) were recruited between 2003 and 2005. Bone densitometry was performed on inclusion. The following parameters were analysed: age, sex, Crohn’s Disease Activity Index, duration and extent of Crohn’s disease, smoking status, corticosteroid treatment, immunosuppressive drugs, plasma homocysteine, folate and vitamin B12 concentration.ResultsThe prevalence of a high homocysteine level (>15 µmol/L) was 60%. Osteoporosis and low‐bone mineralization observed in 26 (28%), and 60 (65%) patients, respectively. On a multivariate analysis, associated factors for osteoporosis and low‐bone mineralization were respectively: hyperhomocysteinaemia (OR: 61.4; CI: 95: 23–250; P < 0.001), and ileal Crohn’s disease [OR: 13.8; CI: 95: 2.5–150; P =  0.036] for osteoporosis and hyperhomocysteinaemia [OR: 63.7; CI: 95: 8.5–250; P < 0.001] and disease duration of at least 5 years [OR: 11.4; CI: 95: 1.31–99; P =  0.039] for low‐bone mineralization. Results were similar whichever site osteoporosis was detected.ConclusionHyperhomocysteinaemia was observed in 60% of our Crohn’s disease patients and was strongly associated with low‐bone mineralization and osteoporosis (OR: 61.4).
Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy?
Authors: HAAG S. , SENF W. , TAGAY S. , LANGKAFEL M. , BRAUN‐LANG U. , PIETSCH A. , HEUFT G. , TALLEY N. J. , HOLTMANN G. 
Published: July 2010

SUMMARYAim In a prospective randomized, controlled trial, to compare the long‐term outcome of intensive medical therapy (with or without cognitive‐behavioural or muscle relaxation therapy) vs. standard medical therapy in patients with refractory functional dyspepsia (FD), referred to a tertiary referral medical center.Methods A total of 100 consecutive FD patients were allocated to a standardized symptom‐oriented 4 month therapy (SMT, n = 24), intensive medical therapy (IMT, medical therapy with testing‐for and targeting‐of abnormalities of motor‐and‐sensory function, n = 28) or IMT plus psychological interventions (either progressive‐muscle relaxation (IMT‐MR, n = 20) or cognitive‐behavioural therapy (IMT‐CBT, n = 28). The symptom intensity (SI) and health‐related quality‐of‐life (HRQoL) after 12 months were prespecified primary outcome parameters.Results After 12 months, significantly greater improvement of SI occurred in patients with IMT‐all (with or without psychological interventions) compared with SMT (P < 0.025 vs. IMT‐all). IMT, IMT‐MR and IMT‐CBT alone also resulted in significantly better improvement of the primary outcome parameters (P all < 0.025 vs. SMT). HRQoL significantly improved in all groups with intensive medical therapy but not standard medical therapy. Differences between intensive medical therapy‐all and standard medical therapy were not significant. Concomitant anxiety and depression was improved significantly by IMT‐CBT (vs. SMT) but not other treatments.Conclusions In FD patients with refractory symptoms, intensified medical management involving function testing and psychological intervention yields superior long‐term‐outcomes. Additional CBT may be effective for the control of concomitant anxiety and depression.
Air swallowing, belching, acid and non‐acid reflux in patients with functional dyspepsia
Authors: CONCHILLO J. M. , SELIMAH M. , BREDENOORD A. J. , SAMSOM M. , SMOUT A. J. P. M. 
Published: July 2010

SUMMARYBackground Frequent belching is a common symptom in patients with functional dyspepsia with a reported incidence up to 80%. We hypothesized that patients with functional dyspepsia possibly have a higher frequency of belching than healthy subjects secondary to frequent air swallowing.Aim To assess air swallowing, belching, acid and non‐acid reflux patterns of patients with functional dyspepsia.Methods Combined 24‐h oesophageal impedance and pH monitoring was performed in 10 functional dyspepsia patients and 10 controls. Analysis of the impedance‐pH signals included incidence of air swallows, belching, acid and non‐acid reflux.Results The incidence of air swallows in functional dyspepsia patients were significantly higher compared with controls (153 ± 15 vs. 79 ± 10, P < 0.001), while the incidence of liquid‐only swallows were not significantly increased. The proportions of gas‐containing reflux episodes (belches) and non‐acid reflux episodes in functional dyspepsia patients were significantly higher when compared with controls (66.4 vs. 44.4%, P = 0.04 and 70.1 vs. 45.9%, P = 0.009, respectively).Conclusion Patients with functional dyspepsia swallow air more frequently than controls and this is associated with an increased incidence of non‐acid gaseous gastro‐oesophageal reflux.
Meta‐analysis: Lactobacillus GG for treating acute diarrhoea in children
Authors: SZAJEWSKA H. , SKÓRKA A. , RUSZCZYŃSKI M. , GIERUSZCZAK‐BIAŁEK D. 
Published: July 2010

SUMMARYAim To review evidence for the effectiveness of Lactobacillus GG (LGG) in treating acute infectious diarrhoea in children.Methods The following electronic databases were searched through August 2006 for studies relevant to acute infectious diarrhoea and LGG: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized‐controlled trials (RCTs) were included.Results Eight RCTs (988 participants) met the inclusion criteria. Compared with controls, LGG had no effect on the total stool volume (two RCTs, n = 303). However, LGG was associated with a significant reduction in diarrhoea duration (seven RCTs, 876 infants, weighted mean difference, WMD −1.1 days (95% confidence interval, CI −1.9 to −0.3), particularly of rotavirus etiology (WMD −2.1 days, 95% CI −3.6 to −0.6), risk of diarrhoea >7 days (one RCT, n = 287, relative risk 0.25, 95% CI 0.09–0.75) and duration of hospitalization (three RCTs, n = 535, WMD −0.58, 95% CI −0.8 to −0.4; significance was lost in the random effect model). There was no reduction in the number of stools at any time interval.Conclusions The use of LGG is associated with moderate clinical benefits in the treatment of acute diarrhoea in children. These findings should be interpreted with caution due to the important methodological limitations and heterogeneity of most of the studies.
Early changes in rectal nitric oxide and mucosal inflammatory mediators in Crohn’s colitis in response to infliximab treatment
Authors: LJUNG T. , AXELSSON L.‐G. , HERULF M. , LUNDBERG J. O. , HELLSTRÖM P. M. 
Published: July 2010

SUMMARYBackground Treatment with tumor necrosis factor‐α monoclonal antibody (infliximab) reduces clinical activity and intestinal inflammation in Crohn’s disease.Aim To study the time‐course of the effects of infliximab with reference to mucosal cytokine and inducible nitric oxide synthase expression.Methods Thirty‐two patients with Crohn’s disease were treated with single dose infliximab (5 mg/kg). Disease activity was assessed days 1, 3, 7 and 28 using Harvey–Bradshaw index. Rectal nitric oxide levels were determined and rectal biopsies collected before treatment, 1 h after infusion and on days 3, 7 and 28. Immunohistochemical staining against inducible nitric oxide synthase, tumor necrosis factor‐α, interleukin‐1β and interferon‐γ were performed.Results Clinical response was seen in 14 patients with down‐regulation of global immunohistochemistry expression, reaching nadir day 3. Rectal nitric oxide was increased at baseline (3578 ± 1199 parts per billion, ppb) compared with controls (89 ± 13 ppb) (P < 0.001). In patients with clinical response, rectal nitric oxide decreased from 3926 ± 1687 ppb to 1050 ± 428 ppb day 28 (P < 0.05).Conclusions Down‐regulation of mucosal inflammatory mediators occurs after infliximab. Rectal nitric oxide levels parallel down‐regulation of inducible nitric oxide synthase, tumor necrosis factor‐α, interleukin‐1β and interferon‐γ and may serve as a quantitative biomarker of intestinal inflammation.
Continuous infusion of high‐dose omeprazole is more effective than standard‐dose omeprazole in patients with high‐risk peptic ulcer bleeding: a retrospective study
Authors: SIMON‐RUDLER M. , MASSARD J. , BERNARD‐CHABERT B. , DI MARTINO V. , RATZIU V. , POYNARD T. , THABUT D. 
Published: July 2010

SUMMARYHigh‐dose omeprazole reduces the rate of recurrent bleeding after endoscopic treatment of peptic ulcer bleeding. However, the effectiveness of high‐dose vs. standard‐dose omeprazole in peptic ulcer bleeding has never been shown.Aim To compare the benefits of high‐dose vs. standard‐dose omeprazole in peptic ulcer bleeding.Methods We reviewed the medical files of patients admitted between 1997 and 2004 for high‐risk peptic ulcer bleeding who had undergone successful endoscopic treatment. We distinguished 2 periods: before 2001, standard‐dose omeprazole (40 mg/day intravenously until alimentation was possible, then 40 mg/day orally for 1 week); after 2001, high‐dose omeprazole (80 mg bolus injection, then 8 mg/h continuous infusion for 72 h, then 40 mg/day orally for 1 week). During both periods, patients subsequently received omeprazole, 20 mg/day, orally for 3 weeks.Results We enrolled 114 patients (period 1, n = 45, period 2, n = 69). Therapy with high‐dose omeprazole significantly decreased the occurrence of poor outcome (27 vs. 12%, P = 0.04), rebleeding (24 vs. 7%, P = 0.01), mortality due to haemorrhagic shock (11 vs. 0%, P < 0.001) and need for surgery (9 vs. 1%, P = 0.05).Conclusions In this retrospective study, high‐dose omeprazole reduced the occurrence of rebleeding, need for surgery and mortality due to hemorrhagic shock in patients with high‐risk peptic ulcer bleeding, as compared with standard‐dose omeprazole.