bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between ghrelin and Helicobacter pylori infection in Polish adult shepherds and their children
Authors: PLONKA M. , KONTUREK P. C. , BIELANSKI W. , PAWLIK T. , BRZOZOWSKI T. , KONTUREK S. J. 
Published: July 2010

SummaryBackgroundGhrelin stimulates food intake and body weight gain. The stomach is the major source of circulating ghrelin, but controversy exists over the relationship between ghrelin release and Helicobacter pylori infection.AimTo assess the relationship between H. pylori infection and ghrelin, leptin and gastrin release in adult shepherds and their children, and to measure the effect of H. pylori eradication on gastric ghrelin content.Methods H. pylori prevalence was compared in 42 shepherds with full contact with sheep, 148 farmers without sheep contact and in 61 age‐matched urban adult controls as well as in 58 shepherd children with sheep contact, 88 mountain children without contact and 141 urban children controls. Serum levels of ghrelin, leptin and gastrin in adult shepherds and their children with and without H. pylori infection were measured.ResultsThe major source of circulating ghrelin was gastric corpus mucosa, as ghrelin content was severalfold higher than that in antral mucosa and was significantly higher in the H. pylori‐eradicated than that in H. pylori‐infected mucosa. Serum levels of ghrelin were greatly increased, while gastrin levels were significantly decreased in H. pylori‐negative as compared with H. pylori‐positive subjects. In mountain children, serum levels of ghrelin and leptin were about twofold higher in H. pylori‐negative than in H. pylori‐positive children, whereas gastrin levels were significantly reduced in H. pylori‐negative children.ConclusionsThe high incidence of H. pylori infection in shepherds and their children seems to contribute to the decreased serum levels of ghrelin and increased levels of gastrin in H. pylori‐infected mountain children and to their decreased appetite and dyspeptic symptoms.
Helicobacter pylori eradication prevents the development of gastric cancer – results of a long‐term retrospective study in Japan
Authors: KATO M. , ASAKA M. , NAKAMURA T. , AZUMA T. , TOMITA E. , KAMOSHIDA T. , SATO K. , INABA T. , SHIRASAKA D. , OKAMOTO S. , TAKAHASHI S. , TERAO S. , SUWAKI K. , ISOMOTO H. , YAMAGATA H. , NOMURA H. , YAGI K. , SONE Y. , URABE T. , AKAMATSU T. , OHARA S. , TAKAGI A. , MIWA J. , INATSUCHI S. 
Published: July 2010

SummaryAimThis large‐scale study was designed to investigate the incidence of gastric cancer after Helicobacter pylori (H. pylori) eradication in Japan.MethodsThis study was a retrospective multicentre study performed at 23 centres in Japan. Patients in whom H. pylori had been successfully eradicated and those in whom the infection persisted were entered into the study if they had undergone an upper endoscopic examination at least once a year for five consecutive years. The incidence rates of gastric cancer during follow‐up were compared between those whose infections had been successfully eradicated and those with persistent H. pylori infection.ResultsThree‐thousand twenty‐one patients were enrolled. The median follow‐up was 7.7 years for the infected group and 5.9 years for the eradicated group. Gastric cancer developed in 23 (1%) of those in whom H. pylori was successfully eradicated compared with 44 (4%) of those with persistent H. pylori infection (OR = 0.36; 95% CI = 0.22–0.62).ConclusionThis large‐scale retrospective clinical study in Japan, which has a high mortality rate for gastric cancer, indicates that H. pylori eradication may prevent the development of gastric cancer.
Host serological response to Helicobacter pylori after successful eradication: long‐term follow‐up in patients with cured and persistent infection
Authors: TANAKA J. , OHKUSA T. , YOKOYAMA T. , MATSUHISA T. , KAWAI T. , HASHIMOTO H. , TOMITA T. , HORI K. , NAKAJIMA K. , MATSUMOTO T. , MIWA H. 
Published: July 2010

SummaryAimTo systematically determine the usefulness of Helicobacter pylori IgG antibody titer decline as a predictor of treatment success after H. pylori eradication in large patient samples.Patients and MethodsSerum samples from 258 H. pylori positive patients (52.8 yrs, 65% males) were retrospectively collected from five medical centers, and H. pylori titers were quantitatively determined by ELISA. Serial serum samples were collected at baseline and for up to 4.9 years after treatment. 169 patients underwent successful eradication while 89 remained infected. The median total observation period was 635 days (range, 51 to 1,800 days). Chronological changes in H. pylori titers were analyzed and compared between cured and infection persistent subjects.ResultsThe proportion of infection persistent patients who developed negative H. pylori IgG antibody titers was below 5%. A receiver operating characteristic (ROC) curve for the confirmation of successful eradication according to the percent decline over baseline at each time‐point showed that a 60% decline at 1 year or more after eradication treatment strongly correlated with successful eradication (sensitivity = 90% and specificity = 87%).ConclusionA 60% decline in H. pylori IgG titers (HEL‐p kit) from baseline to one year or greater is a reliable predictor of successful H. pylori eradication.
Review article: anti‐tryptase therapy in inflammatory bowel disease
Authors: YOSHIDA N. , ISOZAKI Y. , TAKAGI T. , TAKENAKA S. , UCHIKAWA R. , ARIZONO N. , YOSHIKAWA T. , OKANOUE T. 
Published: July 2010

SummaryA number of studies have shown that activated mast cells are involved in the pathogenesis of inflammatory and allergic diseases.Tryptase is one of the serine proteases that stored almost exclusively in the secretory granules of mast cells. It acts to induce microvascular leakage, the chemotaxis of inflammatory cells, and stimulates the release of inflammatory cytokines through the mitogen‐activated protein kinase /activator protein‐1 pathway and protease‐activated receptor (PAR) nuclear factor‐κB pathway.Recent studies have strongly indicated that tryptase and PAR are implicated in the pathogenesis of inflammatory bowel disease and experimental colitis.The effect of anti‐tryptase therapy on human inflammatory bowel disease and experimental colitis has been demonstrated. The result of a pilot study has revealed that systemic administration of a specific tryptase inhibitor is safe and there is evidence of activity in the treatment of ulcerative colitis. Recently, we found that nafamostat mesilate, which selectively inhibits tryptase activity at low concentration, could reduce intestinal inflammation in rats. In addition, nafamostat mesilate enema improved clinical and endoscopic findings in ulcerative colitis patients, resistant to conventional therapy such as corticosteroids and sulfasalazine/5‐aminosalicylic acid.These studies suggest that anti‐tryptase therapy may represent a new therapeutic strategy for human inflammatory bowel disease.
Phase I study of paclitaxel plus irinotecan combination therapy for patients with refractory and advanced gastric cancer
Authors: KOBAYASHI T. , SAKAGAMI T. , KOIZUKA H. , YAMAMOTO N. , SASAKI T. , MAEDA Y. , OMURO Y. , OKAMOTO R. , MIKOSHIBA M. , SASAKI E. , MATSUMOTO T. , MIWA H. 
Published: July 2010

SummaryBackgroundNo adequate second‐line chemotherapy regimen for advanced gastric cancer is available.AimsTo determine the safety and optimal dose of paclitaxel/irinotecan as a second‐line chemotherapy for patients with advanced and recurrent gastric cancer.Patients and methodsSixteen patients with refractory and advanced measurable gastric cancer who were resistant to 5‐FU plus cis‐diamminedichloroplatinum (CDDP) therapy (FP) were enrolled. Paclitaxel/irinotecan was given intravenously on days 1, 8, and 15 in repeated 4‐week cycles. Paclitaxel/irinotecan doses were escalated in a stepwise fashion as follows: 50/40 mg/m2, 50/50 mg/m2, 50/60 mg/m2, 60/60 mg/m2, 60/70 mg/m2 in levels I, II, III, IV and V, respectively.ResultsBecause of one patient with Grade 3 febrile neutropenia at level I, three more patients were enrolled in level I. Doses were consequently escalated, and in level IV, Grade 3 febrile neutropenia occurred in one patient. Since an additional patient in level IV had grade 4 neutropenia, Level IV was judged as the maximum tolerated dose (MTD). The recommended dose and schedule for phase II study is paclitaxel 50 mg/m2 and irinotecan 60 mg/m2 on days 1, 8, and 15 every 4 weeks. Partial response was observed in 4 of 16 patients.ConclusionPaclitaxel/irinotecan combination regimen at the level III dosage was safe and well tolerated.
Review article: regulation of TFF1 (pS2) expression in gastric epithelial cells
Authors: FUJII Y. , SHIMADA T. , KOIKE T. , HOSAKA K. , TABEI K. , NAMATAME T. , TAJIMA A. , YONEDA M. , TERANO A. , HIRAISHI H. 
Published: July 2010

SummaryTrefoil factor family (TFF) is a group of small peptides secreted by gastrointestinal epithelial cells.Among three known TFF peptides, TFF1 (formerly pS2) is expressed at a high level in gastric epithelial cells and plays an essential and critical role in maintaining the integrity of the gastric mucosa. Recent evidence also suggests that TFF1 acts as a tumour suppressor gene in the stomach. TFF1 was originally discovered as an oestrogen‐inducible gene in MCF‐7 breast cancer cells, and its expression is dependent on oestrogen in MCF‐7 and other hormone‐dependent breast cancer cells. Although gastric epithelial cells express oestrogen receptors (ERs), gastric TFF1 expression appears to be independent of oestrogen signalling. Instead, several cis‐regulatory elements are involved in the regulation of gastric TFF1 expression and balanced signalling from gp130, a common IL‐6 family coreceptor, has been shown to be necessary for the proper expression of TFF1 in the stomach.Epigenetic regulation, such as DNA methylation in the promoter region of the TFF1 gene, may be also important for tissue‐specific expression of TFF1 in the stomach. However, further studies are still needed to fully understand the detailed regulatory mechanisms of TFF1 expression in gastric epithelial cells.
Discrimination between gastric ectopic pancreas and mesenchymal tumours, including GIST – from 12 years‘ surgical experience in one institute
Authors: OTANI Y. , YOSHIDA M. , SAIKAWA Y. , WADA N. , KUBOTA T. , KUMAI K. , SUGINO Y. , MUKAI M. , KAMEYAMA K. , KITAJIMA M. 
Published: July 2010

SummaryBackgroundAlthough recent immunochemical analysis enabled the discrimination of gastrointestinal stromal tumour (GIST) to other mesenchymal tumours, preoperative diagnosis of these tumours is not always easy.AimTo discriminate between ectopic pancreas (EP) and mesenchymal tumours, including GIST, 12 years surgical experience at Keio University Hospital was reviewed.MethodsClinicopathological findings were analysed for 131 patients with gastric submucosal tumours (SMT), including GIST (67 cases), myogenic tumour (21 cases), Schwannoma (11 cases), EP (12 cases) and others (20 cases) surgically treated at Keio University Hospital since 1993.ResultsAnalysis of clinicopathological findings of these tumours showed that GIST, myogenic tumour and Schwannoma mimic each other from the standpoint of size and location of the tumour. In contrast, comparison of mesenchymal tumours showed that, compared with gastrointestinal mesenchymal tumour, EP tends to exist at middle or lower third of the stomach (P = 0.004), and the tumour size was smaller than 3 cm (P = 0.0006). All EPs were laparoscopically resected and no malignant features were evident.ConclusionTo avoid unnecessary surgery for EP, SMT smaller than 3 cm occurring in the middle or lower third of the stomach should be carefully selected as a candidate of surgical resection.
Review article: the role of bile and pepsin in the pathophysiology and treatment of gastro‐oesophageal reflux disease
Authors: TACK J. 
Published: July 2010

SummaryGastro‐oesophageal reflux disease is a multifaceted and multifactorial disorder which results from the reflux of gastric contents into the oesophagus. Animal studies suggest that synergism between acid and pepsin and conjugated bile acids have the greatest damaging potential for oesophageal mucosa, although unconjugated bile acids may be caustic at more neutral pH.Human studies are compatible with a synergistic action between acid and duodenogastric reflux in inducing lesions. During prolonged monitoring studies, typical gastro‐oesophageal reflux symptoms are more related to acid reflux events than to non‐acid reflux events.However, symptoms that persist during acid suppressive therapy are often related to non‐acid reflux events. The therapeutic options for the non‐acid component of the refluxate, including acid suppression, prokinetics, baclofen, surgery and mucosal protective agents like alginates, are discussed.
Comparison of gastric pH with omeprazole magnesium 20.6 mg (Prilosec OTC) o.m. famotidine 10 mg (Pepcid AC) b.d. and famotidine 20 mg b.d. over 14 days of treatment
Authors: MINER P. B. , ALLGOOD L. D. , GRENDER J. M. 
Published: July 2010

SummaryBackgroundThe onset of acid inhibition for proton pump inhibitors is slower than with H2RAs and generally considered to be at a steady‐state after 5 days. Thus, little direct comparison data exists between H2RAs and proton pump inhibitors for gastric acid suppression on day 1 of therapy. Furthermore, the durability of their acid suppression has not been systematically compared.AimTo compare the effects of 20.6 mg omeprazole magnesium o.m. (Ome‐Mg 20), famotidine 10 mg b.d. (Fam 10) and famotidine 20 mg b.d. (Fam 20) on intragastric pH on day 1 and throughout 14 days of dosing.MethodsThe study was a randomized, double‐blind, three‐dosing regimens, three‐period crossover. Healthy adults with frequent heartburn (≥2 days/week) underwent 24‐h gastric pH monitoring on days 0 (baseline), 1, 3, 7 and 14.ResultsThirty‐one subjects were included in the per‐protocol analyses. On day 1, the mean percentage time pH > 4 (pH4%) was higher for Ome‐Mg 20, 44.6%, than for Fam 10, 36.7% (P = 0.032), and not different from Fam 20, 46.9% (P = 0.541). The pH4% was higher for Ome‐Mg 20 than either famotidine regimen on all subsequent monitoring days (P < 0.001). The 24‐h area under the mean intragastric pH curve showed a similar pattern. Furthermore, after day 1, Ome‐Mg 20 demonstrated an increasing and sustained effect in contrast to a decreasing effect for famotidine, consistent with H2RA tolerance.ConclusionGastric acid suppression on Ome‐Mg 20 mg o.m. over 14 days was comparable with Fam 10 mg b.d. or Fam 20 mg b.d. on day 1, and superior thereafter.
Review article: medical management of the liver transplant recipient – a primer for non‐transplant doctors
Authors: SETHI A. , STRAVITZ R. T. 
Published: July 2010

SummaryBackgroundSurvival 10 years after orthotopic liver transplantation now approaches 65%. Consequently, community doctors must manage the metabolic and neoplastic complications of orthotopic liver transplantation in an ageing population.AimsTo review common sources of morbidity and mortality in long‐term orthotopic liver transplantation recipients, and to make evidence‐based recommendations regarding their management.MethodsPertinent studies and reviews were identified by literature search through PubMed. Where evidence‐based recommendations could not be gleaned from the literature, expert opinion was obtained from syllabi of national meetings.ResultsThe two most common causes of morbidity and mortality in orthotopic liver transplantation recipients are atherosclerotic vascular disease andde novomalignancy. The pathogenesis of many complications begins before orthotopic liver transplantation, and many are potentially modifiable. Most complications, however, can be directly ascribed to immunosuppressive agents. Despite improvements in our understanding of the pathogenesis and epidemiology of the metabolic and neoplastic complications of orthotopic liver transplantation, remarkably few randomized‐controlled studies exist to define their optimal management.ConclusionsOrthotopic liver transplantation recipients experience and succumb to the same afflictions of old age as non‐transplant patients, but with greater frequency and at an earlier age. Most recommendations regarding surveillance for, and treatment of, medical complications of orthotopic liver transplantation remain based upon expert opinion rather than evidence‐based medicine.
Perioperative acute upper gastrointestinal haemorrhage in older patients with hip fracture: incidence, risk factors and prevention
Authors: FISHER L. , FISHER A. , PAVLI P. , DAVIS M. 
Published: July 2010

SummaryBackgroundNo specific preventive strategy exists for acute gastrointestinal haemorrhage in hip fracture patients.AimsTo determine the effectiveness of prophylactic use of proton pump inhibitors in patients with risk factors for acute gastrointestinal haemorrhage.MethodsProspective two‐stage study of 822 consecutive older (≥60 years) hip fracture patients.ResultsAcute gastrointestinal haemorrhage occurred in 16 (3.9%) of 407 patients and was associated with increased length of hospital stay (28.7 vs. 15.9; P = 0.0027) and mortality (18.8% vs. 4.3%; P = 0.043). Multiple analysis identified five independent risk factors for acute gastrointestinal haemorrhage: pre‐existing peptic ulcer (OR 4.3; P = 0.043), current smoking (OR 3.1; P = 0.023), post‐operative use of an antiplatelet agent (OR 6.5; P = 0.046), post‐operative use of non‐steroidal anti‐inflammatory drug/cyclo‐oxygenase‐2 inhibitor (OR 4.9; P = 0.06) and blood group O (OR 1.7; P = 0.046). These risk factors were highly sensitive and had a negative predictive value of 99.8%. Prophylactic use of proton pump inhibitors in patients with risk factor for acute gastrointestinal haemorrhage significantly reduced the incidence of this complication (0.72% in treated patients vs. 13.4% in untreated; P < 0.001); the number needed to treat was 7.9.ConclusionsIn older hip fracture patients perioperative acute gastrointestinal haemorrhage occurs in 3.9% and is associated with poor outcome. Preventive proton pump inhibitor therapy in patients at risk of acute gastrointestinal haemorrhage is effective and safe.
GI Epidemiology: databases for epidemiological studies
Authors: DAVILA J. A. , EL‐SERAG H. B. 
Published: July 2010

SummaryBackgroundLarge databases are being increasingly used for examining the epidemiology and outcomes of digestive and liver disorders. The complexity and rigor of the methods used to conduct these studies are often underestimated.AimsFor the most commonly used databases, we provide a brief description of the contents, highlight strengths and weakness, and provide links for more detailed information. We also present a systematic approach to utilizing large databases for addressing research questions, highlighting commonly encountered study design issues, as well as strategies for resolving these issues.Conclusions1. Research using large databases requires the same essential skills needed to conduct research studies using other data sources. These include a rigorous study design, expertise in analytic methods, and relevant research questions.2. The completeness and accuracy of information contained in the database must be assessed. Methods for improving the quality and completeness of this information should be considered.3. Despite similarities among large databases, gaining insight and experience into the structure and content of each database is essential.Key points•Large databases can be a powerful source of information to examine the clinical epidemiology and outcomes of digestive and liver disorders.• Research using large databases requires the same essential skills needed to conduct research studies using other data sources. These include a rigorous study design, expertise in analytic methods, and relevant research questions.• The completeness and accuracy of information contained in the database must be assessed. Methods for improving the quality and completeness of this information should be considered.• Despite similarities among large databases, gaining insight and experience into the structure and content of each database is essential.• Examples of commonly used large databases are presented with a synopsis of information contained in the database, as well as strengths and limitations of using the database for research.
Combined type‐1 plasminogen activator inhibitor and NOD2/CARD15 genotyping predicts complicated Crohn's disease behaviour
Authors: ALVAREZ‐LOBOS M. , AROSTEGUI J. I. , SANS M. , TASSIES D. , PIU J. , REVERTER J. C. , PIQUE J. M. , YAGÜE J. , PANÉS J. 
Published: July 2010

SummaryBackgroundNOD2/CARD15 gene variants have not been universally associated with stricturing behaviour in Crohn's disease. Other behaviour modifying genes could explain these results.AimTo study the combined influence of NOD2/CARD15 variants and 4G/4G genotype of type‐1 plasminogen activator inhibitor (PAI‐1) gene on Crohn's disease behaviour.MethodsOne hundred and seventy Crohn's disease patients were studied prospectively, with a mean follow‐up of 7± 6 years. Disease behaviour was registered by using two criteria: the Vienna classification and a non‐hierarchical classification based on the behavioural Vienna categories.ResultsIn the multivariate analysis for stricturing behaviour according to the Vienna categories, only absence of colonic disease (OR, 4.0; 95% CI: 1.49–11.1; P = 0.006) was an independent predictive factor. However, in the multivariate analysis for stricturing disease applying a non‐hierarchical criteria, ileal disease (OR, 4.19; 95% CI: 1.30–13.5; P = 0.01), and carrying both NOD2/CARD15 variants and the 4G/4G PAI‐1 genotype (OR, 5.02; 95% CI: 1.44–17.48; P = 0.01) were independent predictive factors. In the multivariate analysis for penetrating behaviour, the 4G/4G PAI‐1 (OR, 3.10; 95% CI: 1.54–6.23; P = 0.001) and male sex (OR, 2.44; 95% CI: 1.30–4.60; P = 0.005) were independent predictive factors irrespective of criteria applied.ConclusionsCombined PAI‐1 and NOD2/CARD15 genotyping predict complicated Crohn's disease. Patients with these variants could benefit from early interventions.
Efficacy of esomeprazole for resolution of symptoms of heartburn and acid regurgitation in continuous users of non‐steroidal anti‐inflammatory drugs
Authors: HAWKEY C. J. , JONES R. H. , YEOMANS N. D. , SCHEIMAN J. M. , TALLEY N. J. , GOLDSTEIN J. L. , AHLBOM H. , NÆSDAL J. 
Published: July 2010

SummaryBackgroundThe use of non‐steroidal anti‐inflammatory drugs (NSAIDs) is often associated with upper gastrointestinal symptoms such as heartburn and acid regurgitation.AimTo assess the efficacy of esomeprazole 20 and 40 mg for resolution of heartburn and acid regurgitation in continuous NSAIDs.MethodsA post hoc analysis of five clinical trials was performed. Two identically designed, placebo‐controlled, 4‐week studies (NASA1, SPACE1) enrolled non‐ulcer, NSAIDs‐treated patients with upper abdominal pain, discomfort or burning. PLUTO and VENUS were identically designed, placebo‐controlled, 6‐month studies that enrolled patients at risk of NSAIDs‐induced ulcers. Study 285 was an 8‐week comparative study with ranitidine (300 mg/day) in patients with NSAIDs‐induced gastric ulcers. Resolution of investigator‐assessed heartburn and acid regurgitation was defined as symptom severity of ‘none’ in the last 7 days.ResultsIn NASA1/SPACE1, heartburn resolved in 61% and 62% of patients taking esomeprazole 20 and 40 mg, respectively (vs. 36% on placebo, P < 0.001), and acid regurgitation resolved in 65% and 67% (vs. 48%, P < 0.001). Resolution of both symptoms was greater with esomeprazole than with placebo in PLUTO/VENUS (P ≤ 0.001), and than with ranitidine in study 285 (P < 0.05 for esomeprazole 20 mg).ConclusionHeartburn and regurgitation are common in patients taking NSAIDs and esomeprazole is efficacious for resolution of these symptoms.