bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesalazine downregulates c‐Myc in human colon cancer cells. A key to its chemopreventive action?
Authors: CHU E. C. , CHAI J. , AHLUWALIA A. , TARNAWSKI A. S. 
Published: July 2010

SummaryBackground  Dysplasia and malignant transformation of colonocytes in ulcerative colitis are associated with overexpression of c‐Myc and genes regulating cell survival. 5‐Aminosalicylates such as mesalazine may reduce the development of colorectal cancer in ulcerative colitis, but the mechanisms of its chemopreventive action are not clear.Aims  To examine whether mesalazine affects the expression of c‐Myc in human colon cancer cell lines.Methods  Human colon cancer cells were treated with vehicle or mesalazine (4 mm or 40 mm). We examined: (i) mRNA expression by gene array, (ii) protein expression by Western blotting and immunohistochemistry and (iii) apoptosis by Annexin V labelling.Results  Mesalazine significantly reduced expression of c‐Myc mRNA and protein.Conclusions  Mesalazine downregulates gene and protein expression of c‐Myc. The apoptotic and growth inhibitory effects of mesalazine are dose‐dependent. Expression of c‐Myc is significantly reduced by mesalazine 40 mm.
A clinical trial comparing pantoprazole and esomeprazole to explore the concept of achieving ‘complete remission’ in gastro‐oesophageal reflux disease
Authors: BARDHAN K. D. , ACHIM A. , RIDDERMANN T. , PFAFFENBERGER B. 
Published: July 2010

SummaryBackground and Aim  The outcome of gastro‐oesophageal reflux disease treatment is traditionally assessed by measuring endoscopically confirmed healing and symptom relief separately. Both terms together, indicating complete remission, are intuitively a more realistic clinical endpoint but are assessed less often.Aim  To explore this concept, we formally compared the efficacy of the proton pump inhibitors (PPIs) pantoprazole and esomeprazole using rates of complete remission judged against rates of healing and symptom relief separately.Methods  Five hundred and eighty‐two patients with erosive gastro‐oesophageal reflux disease were randomized to treatment for 4, 8, or 12 weeks with either pantoprazole or esomeprazole 40 mg daily. Symptom relief was assessed with the validated ReQuest™‐GI subscale.Results  Approximately 75% of patients were free of symptoms or had no oesophageal lesions after 4 weeks’ treatment, rising to about 93% and 96%, respectively, at 12 weeks. Complete remission rates were, however, lower at these time points; approximately 60% and about 90%, respectively. Both PPIs had similar efficacy.Conclusions  Endoscopically confirmed healing and symptom relief assessed separately over‐estimated the benefits of both drugs. In contrast, complete remission indicates that patients may be treated inadequately when given the standard 4‐ to 8‐week treatment. We suggest that complete remission is a more reliable and clinically relevant endpoint of treatment.
The best candidates for transarterial chemotherapy in patients with hepatocellular carcinoma awaiting liver transplantation: a cohort‐based characterization of dropout times
Authors: JANG J. W. , CHOI J. Y. , BAE S. H. , KIM C. W. , CHO S. H. , YOON S. K. , YANG J. M. , HAN J. Y. , LEE Y. S. , KIM D. G. 
Published: July 2010

SummaryBackground Although transarterial chemotherapy is used to retard tumour progression for hepatocellular carcinoma (HCC) patients awaiting orthotopic liver transplantation (OLT), information regarding the acceptable waiting time and appropriate patient selection for the therapy is lacking.Aim To examine dropout times and determine the best candidates for pre‐transplant transarterial therapy in a cohort study.Methods In total, 180 consecutive HCC candidates receiving pre‐transplant chemo‐lipiodolization were included in the study.Results Overall, 70 (38.9%) patients dropped off the waiting list during the median follow‐up of 19 months. According to the Child–Pugh (C–P) classification, the estimated dropout rates at 1 and 2 years were 17.2% and 44.8% for the C–P A group and 33.4% and 81.3% for the C–P B/C group, respectively. C–P B/C patients experienced more frequent dropouts than C–P A patients (P < 0.001). Risk factor analysis identified C–P classification to be the strongest predictor of dropout (P < 0.001). On multivariate analysis, alpha‐fetoprotein (AFP) >100 ng/mL, tumour size >3 cm and multiple nodules remained independently predictive of dropout for C–P A group (all P < 0.05). Candidates with none of these factors were found to be at the lowest risk of dropout, with only a 22.5% dropout rate up to 41 months.Conclusions This study suggests that Child–Pugh A patients with one nodule <3 cm and AFP < 100 ng/mL may be the best candidates for pre‐transplant chemo‐lipiodolization, with the lowest dropout rate. However, comparative studies with other therapeutic options are needed to assess the definitive role of transarterial therapy in this setting.
Efficacy of rabeprazole on heartburn symptom resolution in patients with non‐erosive and erosive gastro‐oesophageal reflux disease: a multicenter study from Japan
Authors: MIWA H. , SASAKI M. , FURUTA T. , KOIKE T. , HABU Y. , ITO M. , FUJIWARA Y. , WADA T. , NAGAHARA A. , HONGO M. , CHIBA T. , KINOSHITA Y. ,   THE ACID‐RELATED SYMPTOM (ARS) RESEARCH GROUP
Published: July 2010

SummaryBackground  Few studies have compared the efficacy of proton pump inhibitors in resolving the symptoms of non‐erosive reflux disease (NERD) and of erosive gastro‐oesophageal reflux disease (GERD) in Japan.Aim  To investigate and compare the efficacy of 4‐week course of rabeprazole 10 mg/day on symptom resolution in NERD and erosive GERD in Japan.Methods  The modified Los Angeles classification was used to grade endoscopically GERD in patients with heartburn (Grades N and M: NERD, Grades A and B: mild reflux oesophagitis (RO), and Grades C and D: severe RO). Rabeprazole 10 mg/day was administered for 4 weeks to 180 patients who kept symptom diaries.Results  Complete relief of the symptoms was achieved in 35.8% of the NERD group and 55.4% of the erosive GERD group (mild RO: 51.1% and severe RO: 77.8%). Rabeprazole was significantly more effective in erosive GERD than in NERD patients. Among the NERD subgroups (Grades N and M), no difference in symptom improvement was observed.Conclusions  Four‐week, rabeprazole 10 mg/day acid suppression therapy was effective in resolving symptoms in Japanese GERD patients. This therapy was more effective in erosive GERD than in NERD patients, and in those with severe RO than in those with mild RO.
Enbucrilate for gastric varices: extended experience in 92 patients
Authors: CALDWELL S. H. , HESPENHEIDE E. E. , GREENWALD B. D. , NORTHUP P. G. , PATRIE J. T. 
Published: July 2010

SummaryAim We assessed N‐2‐butyl‐cyanoacrylate (enbucrilate) in 92 patients with gastric variceal bleeding under an FDA‐approved investigation. These results extend our prior report of the first 44 patients.Method Injection was performed with enbucrilate and ethiodol (1:1). Eighty patients had portal hypertension and 12 had splenic vein thrombosis.Results In the portal hypertensive group, re‐bleeding from gastric varices was seen in 4 of 80 (5%) from 0 to 72 h, 5 of 76 (6.5%) from > 72 h to 3 months and 9 of 51 (17%) from > 3 months to 1 year. Re‐bleeding and survival were significantly related to the Child‐Pugh class. In the splenic vein thrombosis group (n = 12), there was early rebleeding in 2 (17%) patients from 0 to 72 h, 1 (8%) from > 72 h to 3 months and none in the chronic phase (> 3 months to 1 year) although 1‐year survival in this group was only 6 (50%) due to the underlying malignancy in most. Serious embolization was suspected in 2 patients (2%).Conclusion Enbucrilate offers an important intervention in gastric variceal bleeding which should be further studied in the US. A randomized trial is warranted to compare this intervention to radiological therapy.
Effect of a fermented milk containing Bifidobacterium animalis DN‐173 010 on the health‐related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double‐blind, controlled trial
Authors: GUYONNET D. , CHASSANY O. , DUCROTTE P. , PICARD C. , MOURET M. , MERCIER C.‐H. , MATUCHANSKY C. 
Published: July 2010

SummaryBackground  Health‐related quality of life (HRQoL) has been rarely evaluated as a primary endpoint in the assessment of the effect of probiotics on the irritable bowel syndrome (IBS).Aim  To study the effects of fermented milk containing Bifidobacterium animalis DN‐173 010 and yoghurt strains on the IBS in a multicentre, double‐blind, controlled trial.Methods  A total of 274 primary care adults with constipation‐predominant IBS (Rome II) were randomized to consume for 6 weeks either the test fermented milk or a heat‐treated yoghurt (control). HRQoL and digestive symptoms were assessed after 3 and 6 weeks on an intention‐to‐treat population of 267 subjects.Results  The HRQoL discomfort score, the primary endpoint, improved (P < 0.001) in both groups at weeks 3 and 6. The responder rate for the HRQoL discomfort score was higher (65.2 vs. 47.7%, P < 0.005), as was the decrease in bloating score [0.56 ± (s.d.)1.01 vs. 0.31 ± 0.87, P = 0.03], at week 3 in the test vs. the control group. In those subjects with <3 stools/week, stool frequency increased (P < 0.001) over 6 weeks in the test vs. control group.Conclusions  This study suggests a beneficial effect of a probiotic food on discomfort HRQoL score and bloating in constipation‐predominant IBS, and on stool frequency in subjects with <3 stools/week.
Cost‐effectiveness of suppressing hepatitis B virus DNA in immune tolerant patients to prevent hepatocellular carcinoma and cirrhosis
Authors: ENRIQUEZ A. D. , CAMPBELL M. S. , REDDY K. R. 
Published: July 2010

SummaryBackground  For patients with hepatitis B virus (HBV) infection in the immune tolerant phase, the current standard of care is to not offer treatment. However, the recent Risk Evaluation of the Viral Load Elevation and Associated Liver Disease/Cancer‐In study results show a striking relationship between high HBV DNA levels and risk for hepatocellular carcinoma and cirrhosis.Aim  In a cost effectiveness analysis, to assess whether immune tolerant patients with high HBV DNA levels should undergo treatment.Methods  We created a lifetime Markov model to evaluate the cost‐effectiveness of two strategies for immune tolerant hepatitis B: (i) HBV DNA suppression with lamivudine, (ii) no treatment. Patients cycled between the following health states: viral suppression, ongoing viremia, seroconversion, hepatocellular carcinoma, cirrhosis and death.Results  Compared with the no treatment strategy, lamivudine therapy was more expensive but more cost‐effective with an additional cost of $5784 and $12 584 per quality adjusted life year gained in males and females, respectively. Treatment resulted in a gain in life expectancy and a decrease in lifetime risk of hepatocellular carcinoma and cirrhosis.Conclusions  Suppressing HBV DNA to prevent hepatocellular carcinoma and cirrhosis in immune tolerant patients is very cost‐effective, and treatment of these patients may be considered. Future prospective clinical trials will need to be undertaken to confirm our findings.
Low serum HBV DNA levels and development of hepatocellular carcinoma in patients with chronic hepatitis B: a case–control study
Authors: FUNG J. , YUEN M.‐F. , YUEN J. C.‐H. , WONG D. K.‐H. , LAI C.‐L. 
Published: July 2010

SummaryAimTo investigate the level of hepatitis B virus (HBV) DNA in Chinese chronic hepatitis B (CHB) patients below which hepatocellular carcinoma (HCC) is unlikely to occur.Methods  A total of 92 CHB patients diagnosed with HCC were recruited; 184 CHB patients without HCC, matched for age, sex and HBeAg status were included as controls. HBV DNA levels were performed at the time of HCC development and at the same age time points for control group.Results  The median HBV DNA level in HCC patients was 1.7 × 106 copies/mL compared with 2.2 × 105 copies/mL in controls (P = 0.006). In HCC patients, 21 (22.8%) were HBeAg(+), with no significant difference in HBV DNA levels compared with controls. Seventy‐one (77%) HCC patients were HBeAg(−) with median HBV DNA level of 3.2 × 105 copies/mL, compared with 6.0 × 104 copies/mL in controls (P = 0.006). In HBeAg(−) patients, the control group had significantly greater proportion of patients having HBV DNA levels <105 and <104 copies/mL compared with HCC patients. Fifteen per cent of all HCC patients had HBV DNA levels <103 copies/mL.Conclusions  In HBeAg(+) patients, HBV DNA levels were high in both HCC and control patients. In HBeAg(−) patients, HCC was more likely to develop in patients with HBV DNA level >104 copies/mL. However, 15% of the patients with HCC had HBV DNA levels <103 copies/mL.
Oesophageal hypersensitivity is associated with features of psychiatric disorders and the irritable bowel syndrome
Authors: RUBENSTEIN J. H. , NOJKOV B. , KORSNES S. , ADLIS S. A. , SHAW M. J. , WEINMAN B. , INADOMI J. M. , SAAD R. , CHEY W. D. 
Published: July 2010

SummaryBackground Twenty per cent of patients with heartburn do not respond to proton pump inhibitors (PPIs). Many have normal oesophageal acid exposure. We hypothesized that such PPI non‐responders have heightened oesophageal sensation, and that oesophageal hypersensitivity is associated with psychiatric features including somatization and anxiety.Aim To compare oesophageal sensation in subjects with heartburn categorized by response to PPI, and to correlate oesophageal sensation with psychiatric features.Methods Twenty‐one PPI responders, nine PPI non‐responders and 20 healthy volunteers completed questionnaires of psychiatric disorders and gastrointestinal symptoms. Subjects underwent oesophageal sensory testing with acid perfusion and balloon distension.Results Healthy volunteers displayed higher thresholds for sensation and discomfort from balloon distension than heartburn subjects (sensation P = 0.04, discomfort P = 0.14). Psychiatric disorders were associated with increased intensity of sensation (P = 0.02) and discomfort from acid (P = 0.01). Somatization was associated with increased discomfort from balloon distension (P = 0.006). Features of irritable bowel syndrome were associated with increased sensation and discomfort.Conclusions Heartburn subjects tend to have heightened oesophageal sensation, suggesting that oesophageal hypersensitivity may persist despite therapy with PPI. Oesophageal hypersensitivity is associated with features of psychiatric disease and with the irritable bowel syndrome, which might partly explain the aetiology of heartburn symptoms that are refractory to PPI.
The view of gastroenterologists on non‐cardiac chest pain in Asia
Authors: CHEUNG T. K. , LIM P. W. Y. , WONG B. C. Y. 
Published: July 2010

SummaryBackground  Non‐cardiac chest pain is an important disorder in Asia. The practice and views of gastroenterologists on non‐cardiac chest pain in this region are not known.Aims  To determine the current understanding, diagnostic practice and treatment strategies among gastroenterologists on the management of non‐cardiac chest pain in Asia.Methods  A 24‐item questionnaire was sent to gastroenterologists in Mainland China, Hong Kong, Malaysia, Indonesia, Philippines, Singapore, Taiwan and Thailand.Results  186 gastroenterologists participated with a response rate of 74%. 98% of gastroenterologists managed patients with non‐cardiac chest pain over the last 6 months. 64% felt that the number of non‐cardiac chest pain patients was increasing and 85% believed that the most common cause of non‐cardiac chest pain was GERD. 94% of the gastroenterologists believed that they should manage non‐cardiac chest pain patients, but only 41% were comfortable in diagnosing non‐cardiac chest pain. The average number of investigations performed was four in non‐cardiac chest pain patients, and oesophago‐gastro‐duodenoscopy was the most commonly used initial test. A proton pump inhibitor was considered the first‐line treatment in non‐cardiac chest pain and was reported as the most effective treatment by the gastroenterologists.Conclusion  Most gastroenterologists were practicing evidence‐based medicine, but frequent use of investigations and a lack of awareness of the role of visceral hypersensitivity in non‐cardiac chest pain patients were noted.
Review article: bowel preparation for colonoscopy – the importance of adequate hydration
Authors: LICHTENSTEIN G. R. , COHEN L. B. , URIBARRI J. 
Published: July 2010

SummaryBackgroundPatient compliance with screening recommendations for colorectal cancer remains low, despite a 90% survival rate achieved with early detection. Bowel preparation is a major deterrent for patients undergoing screening colonoscopy. More than half of patients taking polyethylene glycol electrolyte lavage solution and sodium phosphate preparations experience adverse events, such as nausea and abdominal pain. Many adverse events may be associated with dehydration, including rare reports of renal toxicity in patients taking sodium phosphate products. Addressing dehydration‐related safety issues through patient screening and education may improve acceptance of bowel preparations, promote compliance and increase the likelihood of a successful procedure.AimTo evidence safety issues associated with bowel preparation are generally related to inadequate hydration.ResultsDehydration‐related complications may be avoided through proper patient screening, for example, renal function and comorbid conditions should be considered when choosing an appropriate bowel preparation. In addition, patient education regarding the importance of maintaining adequate hydration before, during and after bowel preparation may promote compliance with fluid volume recommendations and reduce the risk of dehydration‐related adverse events.ConclusionsProper patient screening and rigorous attention by patients and healthcare providers to hydration during bowel preparation may provide a safer, more effective screening colonoscopy.
Randomized‐controlled trial of esomeprazole in functional dyspepsia patients with epigastric pain or burning: does a 1‐week trial of acid suppression predict symptom response?
Authors: TALLEY N. J , VAKIL N. , LAURITSEN K. , VAN ZANTEN S. V. , FLOOK N. , BOLLING‐STERNEVALD E. , PERSSON T. , BJÖRCK E. , LIND T. ,   ON BEHALF OF THE STARS I STUDY GROUP
Published: July 2010

SummaryBackgroundEarly identification of true responders to acid suppression in functional dyspepsia patients with symptoms of epigastric pain or burning may enable clinicians to optimally tailor treatment.AimTo evaluate whether a 1‐w acid suppression trial is useful for identifying true responders in this population.MethodsPatients (18–70 years) were randomized to either esomeprazole 40 mg q.d.s., b.d. or placebo for 1w, and then esomeprazole 40 mg q.d.s. or placebo for 7w. Epigastric pain and/or burning were recorded on a 4‐point scale (0 = none, 3 = severe). Trial‐week response was defined as symptom score sum ≤1 on last 3d of therapy; response at 8w was symptom score sum ≤1 over preceding 7d.Results1‐w response rates were 33% (199 of 597), 29% (188 of 629) and 23% (71 of 315) with esomeprazole q.d.s., esomeprazole b.d. and placebo, respectively (P = 0.002 for esomeprazole groups vs. placebo). At 8w, trial week sensitivity and specificity were 46% and 80%, respectively, for esomeprazole (40 or 80 mg), and 33% and 87%, respectively, for placebo. The positive and negative predictive values for esomeprazole were 60% and 69%.ConclusionResponse to a 1‐w acid suppression trial is of limited use for predicting symptom response at 8w in patients with unexplained epigastric pain or burning.
Meta‐analysis: the utility and safety of heparin in the treatment of active ulcerative colitis
Authors: SHEN J. , RAN Z. H. , TONG J. L. , XIAO S. D. 
Published: July 2010

SummaryBackgroundThe use of heparin for the treatment of ulcerative colitis has been evaluated in several open and controlled trials, with varying outcomes.AimTo evaluate the efficacy and safety of heparin as supplemental therapy compared with conventional therapy in patients with ulcerative colitis.MethodsAll randomized trials comparing heparin supplementation to conventional therapy were included from electronic databases. Statistical analysis was performed with review manager 4.2.8 (The Cochrane Collaboration, Oxford, UK). Sub‐analysis and sensitivity analysis were also performed.ResultsEight randomized‐controlled trials, investigating a total of 454 participants, met the inclusion criteria. The odds ratio (OR) for the efficacy of heparin supplementation vs. conventional therapy was 0.78 (95% CI = 0.50–1.21). Few serious adverse events were observed. The OR for the efficacy of unfractionated heparin and low‐molecular‐weight heparin vs. conventional therapy was 0.26 (95% CI = 0.07–0.93) and 0.92 (95% CI = 0.57–1.47), respectively. The OR for the efficacy of heparin vs. conventional therapy with placebo was 0.87 (95% CI = 0.53–1.44).ConclusionsOur meta‐analysis suggests that administration of heparin in patients with ulcerative colitis is safe, but no additive benefit over conventional therapy is indicated.
Histological progression of non‐alcoholic fatty liver disease: a critical reassessment based on liver sampling variability
Authors: RATZIU V. , BUGIANESI E. , DIXON J. , FASSIO E. , EKSTEDT M. , CHARLOTTE F. , KECHAGIAS S. , POYNARD T. , OLSSON R. 
Published: July 2010

SummaryBackgroundIn non‐alcoholic fatty liver disease, histological lesions display a significant sampling variability that is ignored when interpreting histological progression during natural history or therapeutic interventions.AimTo provide a method taking into account sampling variability when interpreting crude histological data, and to investigate how this alters the conclusions of available studies.MethodsNatural history studies detailing histological progression and therapeutic trials were compared with the results of a previously published sampling variability study.ResultsNatural history studies showed an improvement in steatosis, which was significantly higher than expected from sampling variability (47% vs. 8%, P < 0.0001). In contrast, no study showed a change in activity grade or ballooning higher than that of sampling variability. There was only a marginal effect on fibrosis with no convincing demonstration of a worsening of fibrosis, a conclusion contrary to what individual studies have claimed. Some insulin sensitizing drugs and anti‐obesity surgery significantly improved steatosis, while most did not significantly impact on fibrosis or activity.ConclusionsSampling variability of liver biopsy is an overlooked confounding factor that should be considered systematically when interpreting histological progression in patients with non‐alcoholic fatty liver disease.