bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between intragastric acid control and healing status in the treatment of moderate to severe erosive oesophagitis
Authors: KATZ P. O. , GINSBERG G. G. , HOYLE P. E. , SOSTEK M. B. , MONYAK J. T. , SILBERG D. G. 
Published: July 2010

SummaryAim  To assess the relationship between the percentage of time intragastric pH >4.0 and healing of erosive oesophagitis.Methods  In this proof‐of‐concept study, adults with endoscopically verified Los Angeles grade C or grade D erosive oesophagitis were randomly assigned to oral esomeprazole 10 or 40 mg once daily for 4 weeks. On day 5, patients underwent 24‐h pH monitoring. At 4 weeks, erosive oesophagitis healing status was endoscopically assessed. Investigators scored gastro‐oesophageal reflux disease symptoms on a 4‐point scale [none to severe (0–3)] before and 4 weeks after treatment. The percentage of time intragastric pH was >4.0 and healing status were correlated and tested for significance using a Spearman rank correlation (r).Results  103 patients had evaluable data (mean age, 48.7 years; 65% men). Mean percentages of time with intragastric pH >4.0 on day 5 in patients with healed and unhealed erosive oesophagitis were 61% and 42%, respectively (P = 0.0002), indicating that erosive oesophagitis healing rates were positively related to the percentage of time intragastric pH was >4.0. Greater intragastric acid control correlated with lower final daytime and night‐time heartburn and acid regurgitation symptom scores (r = −0.029, −0.029 and −0.021; P = 0.003, 0.003 and 0.032, respectively).Conclusion  A positive relationship between intragastric acid control and erosive oesophagitis healing was demonstrated.
Meta‐analysis: randomized controlled trials of clindamycin/aminoglycoside vs. β‐lactam monotherapy for the treatment of intra‐abdominal infections
Authors: FALAGAS M. E. , MATTHAIOU D. K. , KARVELI E. A. , PEPPAS G. 
Published: July 2010

SummaryAim  To compare the effectiveness and safety of clindamycin/aminoglycoside with broad‐spectrum β‐lactam monotherapy in patients with intra‐abdominal infections by performing a meta‐analysis of randomized controlled trials (RCTs).Methods  The relevant 28 RCTS were retrieved from PubMed searches and reviewed by two reviewers independently.Results  β‐lactam monotherapy was more effective regarding cure of the infection than clindamycin/aminoglycoside (3177 clinically evaluable patients, fixed effects model, OR = 0.67, 95% CI: 0.55–0.81). The same result was found in several subset analyses. There was no difference in all‐cause mortality and attributable‐to‐infection mortality [2382 intention‐to‐treat (ITT) patients, fixed effects model, OR = 1.25, 95% CI: 0.74–2.11 and 1976 ITT patients, OR = 1.19, 95% CI: 0.59–2.41, respectively]. There was no difference regarding overall adverse events and ototoxicity (1460 ITT patients, OR = 1.05, 95% CI: 0.80–1.37, and 1404 ITT patients, OR = 3.22, 95% CI: 0.72–14.45, respectively). However, treatment with clindamycin/aminoglycoside was more likely to be associated with nephrotoxicity compared to β‐lactam (3065 ITT patients, OR = 3.7, 95% CI: 2.09–6.57). Clindamycin/aminoglycoside was less likely to be associated with antibiotic‐associated diarrhoea compared to β‐lactam (3050 ITT patients, OR = 0.68, 95% CI: 0.46–1.00).Conclusion  The results of our meta‐analysis suggest that β‐lactams are more effective in the treatment of intra‐abdominal infections compared with clindamycin/aminoglycoside.
Cell proliferation of squamous epithelium in gastro‐oesophageal reflux disease: correlations with clinical, endoscopic and morphological data
Authors: MASTRACCI L. , GRILLO F. , ZENTILIN P. , SPAGGIARI P. , DULBECCO P. , PIGOZZI S. , SAVARINO V. , FIOCCA R. 
Published: July 2010

SummaryBackground  The microscopic assessment of squamous epithelium lesions in gastro‐oesophageal reflux disease (GERD) is subjective. The Ki67 nuclear antigen expressed by proliferating cells provides an objective measure of regeneration in the squamous epithelium.Aim  To evaluate Ki67 expression in GERD patients and controls, in comparison with histological lesions, pH‐metry and endoscopic data.Methods  Eighty‐seven patients with GERD symptoms and 20 symptom‐free controls underwent endoscopy and 24‐h pH monitoring. Oesophageal biopsies (4 cm, 2 cm and Z‐line) were stained with Ki67/MIB‐1 antibodies; the Ki67‐positive nuclear area was assessed with an image analysis system and expressed as percentage of the whole epithelial area (Ki67‐%).Results  Ki67‐% was significantly higher in 32 patients with erosive oesophagitis, 44 endoscopy‐negative GERD and 11 patients with functional heartburn than in controls (P = 0.0001). Both controls and patients showed a progressive increase in Ki67‐% from 4 cm to the Z‐line (P < 0.0001). Ki67‐% showed a significant correlation with other conventional histological lesions (P ranged between 0.0151 and <0.0001).Conclusions  Ki67 evaluation provides quantitative and objective data on squamous epithelium proliferative activity. This marker can be applied in the distinction of endoscopy‐negative GERD from healthy controls.
Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow‐up
Authors: MORAIS E. O. , RESENDE M. R. , OLIVEIRA A. M. , SINKOC V. M. , GARCIA M. T. , ANGERAMI R. N. , DA SILVA L. J. 
Published: July 2010

SummaryBackgroundPatients undergoing dialysis usually have a poor response to conventional hepatitis B vaccination.AimTo observe the effects of intradermal hepatitis B (HB) vaccination in a 13‐month prospective study of adult patients with end‐stage renal failure. The patients were with or without previous hepatitis B vaccination, but all had antibody titres <10 mUI/mL.MethodsPatients were allotted to two groups: previous hepatitis B virus vaccination and no previous hepatitis B virus vaccination or anti‐HBs titres <10 mUI/mL. Patients in both groups received 16 i.d. injections of 0.1 mL of hepatitis B virus vaccine over an eight‐week period. Patients had antibody titres assessed before vaccination, 1 month after and every 3 months for a year. Antibody titres ≥10 mUI/mL were considered protective.ResultsSeventy patients completed the protocol. Protective titres were elicited in 82% of each group. Age, time under dialysis, diabetes, smoking and body‐mass index were not associated with seroconversion. Persistent protective titres >12 months occurred in 27 (58.7%). Adverse events were trivial.ConclusionIntradermal hepatitis B virus vaccination is an alternative in end‐stage renal failure.
GI Epidemiology: nutritional epidemiology
Authors: KELEMEN L. E. 
Published: July 2010

SummaryBackgroundNutritional epidemiology is the assessment of diet and its relationship to disease aetiology in populations. The choice of dietary assessment method depends on the disease pathology. Events such as cancer that are chronic and complicated by exposure time require methods that capture consumption patterns of populations over a period of years. Although several methods of dietary assessment exist for collecting information on groups of individuals, their application to epidemiologic studies requires an understanding of the effect of variability in nutrient intake, sources of measurement error, and statistical issues unique to the study of nutritional epidemiology.AimThis review provides an overview of commonly‐used methods of dietary assessments in epidemiologic studies, and identifies their strengths and limitations and application to epidemiologic study designs. It concludes with a brief discussion of assumptions of nutrient databases and objectives of energy‐adjustment and measurement error correction models.ConclusionsNutritional epidemiology has contributed significantly to our understanding of the relationships between diet and disease. Ongoing investigations that further characterize important exposure periods (early life, in utero) and clarify associations within the context of genetic susceptibility will continue to elucidate our understanding of the pathophysiology of complex diseases, and support future recommendations for disease prevention.Key points• The choice of dietary assessment depends on the research question and the pathophysiology of the disease.• Long‐term dietary patterns are most relevant to estimate chronic disease risk.• Most risk models will need to adjust for total energy.• Knowledge of potential sources of error in nutritional assessment is essential.• Statistical methods exist to estimate and correct measurement error.
Meta‐analysis: antibiotic prophylaxis to prevent peristomal infection following percutaneous endoscopic gastrostomy
Authors: JAFRI N. S. , MAHID S. S. , MINOR K. S. , IDSTEIN S. R. , HORNUNG C. A. , GALANDIUK S. 
Published: July 2010

SummaryBackgroundDespite numerous guidelines recommending prophylactic antibiotics prior to percutaneous endoscopic gastrostomy, their use remains controversial.AimTo conduct a systematic literature review and performed meta‐analyses to determine the benefit of antibiotic prophylaxis for percutaneous endoscopic gastrostomy placement.MethodsWe performed a systematic literature review by searching healthcare databases and grey literature for randomized‐controlled trials of antibiotic prophylaxis against wound infection after percutaneous endoscopic gastrostomy. Relative risks were calculated for individual trials and data pooled using fixed‐effects model. Relative risk reduction, absolute risk reduction and number needed to treat were calculated and are reported with 95% confidence intervals.ResultsTen randomized‐controlled trials met the inclusion criteria and 1059 cases were pooled. Overall findings indicated that antibiotic prophylaxis resulted in a relative risk reduction of 64% and an absolute risk reduction of 15%. Number needed to treat to prevent one wound infection was 8. Cephalosporin prophylaxis was associated with a relative risk reduction of 64%, absolute risk reduction of 10% and number needed to treat of 10, whereas penicillin‐based prophylaxis was associated with a relative risk reduction of 62%, absolute risk reduction of 13% and number needed to treat of 8.ConclusionsAntibiotic prophylaxis prior to percutaneous endoscopic gastrostomy is effective in reducing the incidence of percutaneous endoscopic gastrostomy site wound infection. Based on sensitivity analyses, penicillin‐based prophylaxis should be the prophylaxis of choice.
Adalimumab in patients with Crohn’s disease – safety and efficacy in an open‐label single centre study
Authors: SEIDERER J. , BRAND S. , DAMBACHER J. , PFENNIG S. , JÜRGENS M. , GÖKE B. , OCHSENKÜHN T. 
Published: July 2010

SummaryAimTo evaluate the efficacy and safety of adalimumab, a human antitumour necrosis factor‐α antibody, in induction and maintenance of remission in patients with Crohn’s disease either refractory or intolerant to infliximab in a single centre cohort.MethodsSixteen Crohn’s disease patients received 160 mg adalimumab subcutaneously in week 0, followed by 80 mg every other week. Clinical response was assessed based on Crohn’s disease activity index and laboratory parameters (leukocyte count, C‐reactive protein). In all patients genotyping for CARD15 variants and the +1059G/C polymorphism in the C‐reactive protein gene was performed.ResultsIn 10 of 16 patients (63%) treated with adalimumab, remission (CDAI score <150) was induced for at least 8 weeks independent of CARD15 or +1059G/C CRP status. In six of these 10 patients ongoing remission is observed now for more than 24 weeks. Adalimumab significantly decreased C‐reactive protein serum levels and Crohn’s disease activity index. There was one serious complication (fungal pneumonia). Six patients intermittently developed minor dermatological problems resolving after topical therapy. Otherwise, treatment was generally well tolerated.ConclusionAdalimumab can induce and maintain remission in patients with moderate to severe Crohn’s disease intolerant or refractory to infliximab. Further experience from larger cohorts is required to evaluate dose regimen and safety profiles in Crohn’s disease therapy.
Review article: the history of acute infectious diarrhoea management – from poorly focused empiricism to fluid therapy and modern pharmacotherapy
Authors: MCMAHAN Z. H. , DUPONT H. L. 
Published: July 2010

SummaryBackgroundAcute diarrhoea management has progressed from largely ineffective measures in the early years to a more effective physiologic approach in recent years.AimTo review the history of acute diarrhoea management.MethodsCitations in PubMed were reviewed on ‘acute diarrhoea treatment’ along with an extensive file maintained by the corresponding author.ResultsFreedom from diarrhoea was equated in early military conflicts with bravery and strength where diarrhoea‐free soldiers had the ‘guts’ to fight. Until early 20th century, colonic irrigants, purgatives and emetic drugs were used to help eliminate undesired intestinal contents. Only a few early authorities suggested the need for replacement of fluids and salt, now standard treatment. Drugs aimed at diarrhoea symptom control have been broadly used for more than 100 years. The evolving history of one of those drugs, kaopectate is unappreciated. Once understanding the pathophysiology and infectious aetiology of acute diarrhoea, new oral fluids, pharmacologic agents designed to block specific secretory alterations and anti‐infective drugs have been identified.ConclusionsPhysiologic and antimicrobial approaches to controlling diarrhoea can lead to reduction of stool number and enteric complaints, important in industrialized areas, with the potential for decreasing threat of fatal illness among infants in developing regions.
Interaction between rifaximin and dietary fibre in patients with diverticular disease
Authors: D'INCÀ R. , POMERRI F. , VETTORATO M. G. , DAL PONT E. , DI LEO V. , FERRONATO A. , MEDICI V. , STURNIOLO G. C. 
Published: July 2010

SummaryBackgroundCyclic administration of rifaximin in association with dietary fibre achieves symptomatic relief in uncomplicated diverticular disease (DD) by means of a still undefined mechanism.AimTo investigate the effects of a combination of rifaximin and fibre on both hydrogen production by intestinal microflora and oro‐anal transit time.MethodsIn a controlled, double‐blind crossover trial, 64 patients with uncomplicated DD were given bran (20 g/day) and randomly treated with rifaximin (1200 mg/day) or a placebo for 14 days. Evaluation was based on clinical status, breath test, oro‐anal transit time and faecal weight.ResultsThe global symptomatic score was significantly reduced after rifaximin (7.1 ± 4.1 to 4.1 ± 3.3; P < 0.005) but not after placebo (6.8 ± 3.8 to 6.1 ± 3.5). Hydrogen production significantly increased after placebo from 198 ± 134 to 267 ± 161 ppm/min, while Rifaximin reduced it from 222 ± 187 to 166 ± 131 ppm/min (P = 0.05). The total oro‐anal transit time decreased from 56.1 ± 28.2 to 51.3 ± 28.0 h in placebo and from 54.4 ± 31.9 to 45.1 ± 32.4 h (P < 0.05) in rifaximin‐treated patients.ConclusionsThe administration of rifamixin improves the benefits of dietary fibre in uncomplicated DD by preventing its bacterial degradation.
Early virological suppression is associated with good maintained response to adefovir dipivoxil in lamivudine resistant chronic hepatitis B
Authors: CHAN H. L.‐Y. , WONG V. W.‐S. , TSE C.‐H. , CHIM A. M.‐L. , CHAN H.‐Y. , WONG G. L.‐H. , SUNG J. J.‐Y. 
Published: July 2010

SUMMARYAim To determine the factors affecting the virological response to adefovir dipivoxil (ADV) among patients with lamivudine resistant chronic hepatitis B.Methods Chronic hepatitis B virus (HBV) infected patients, who had virological relapse to lamivudine, were switched to ADV monotherapy.Results Twenty‐six patients were treated by ADV for 23 (12–41) months. At baseline, the median log HBV DNA was 7.70 (4.88–9.01) copies/mL. Six (23%) and 8 (31%) of patients had HBV DNA suppressed to below 1000 copies/mL at month 12 and the last follow‐up, respectively. On linear regression, patients who had higher HBV DNA at baseline and month 6 have higher HBV DNA at month 12. On Cox proportional hazard model, the hazard ratio for each log step increase in HBV DNA at baseline and month 6 for HBV DNA <1000 copies/mL at the last visit was 0.39 (P = 0.010) and 0.47 (P = 0.027), respectively. Alanine aminotransferase, HBV genotype, rtL80 M mutation and log HBsAg did not affect the HBV DNA response.Conclusions The response of lamivudine‐resistant patients to ADV is suboptimal. Treatment with ADV when HBV DNA is low, and rapid viral suppression at month 6 increases the chance of maintained viral suppression.
Introduction of newer selective cyclo‐oxygenase‐2 inhibitors and rates of hospitalization with bleeding and perforated peptic ulcer
Authors: CHRISTENSEN S. , RIIS A. , NØRGAARD M. , THOMSEN R. W. , SØRENSEN H. T. 
Published: July 2010

SUMMARYBackground Limited data exist on the impact of the introduction of newer selective cyclo‐oxygenase‐2 inhibitors into clinical practice in 1999 on overall non‐steroidal anti‐inflammatory drug use and hospitalization rates of complicated peptic ulcer disease at the population level.Aim To examine these issues, we conducted a population‐based study in western Denmark, within a population of 1.2 million.Methods All patients with perforated (n = 1488) or bleeding peptic ulcer (n = 6017) between 1996 and 2004 were identified in hospital discharge registries. We computed standardized annual hospitalization rates and hospitalization rate ratios using Poisson regression. Data on annual number of prescriptions for non‐steroidal anti‐inflammatory drugs were obtained through population‐based prescription databases.Results Introduction of newer selective cyclo‐oxygenase‐2 inhibitors was followed by a 44% increase in the annual number of prescriptions for non‐steroidal anti‐inflammatory drugs – almost entirely due to increased use of newer selective cyclo‐oxygenase‐2 inhibitors. Annual standardized hospitalization rates for bleeding peptic ulcer remained stable. Standardized hospitalization rates for perforated peptic ulcer decreased from 17 per 100 000 person‐years in 1996 to 12 per 100 000 person‐years in 2004 (HRR 0.71; 95% CI: 0.57–0.88).Conclusion Introduction of newer selective cyclo‐oxygenase‐2 inhibitors was followed by substantial increase in overall non‐steroidal anti‐inflammatory drug use and coincided with stable and decreasing hospitalization rates for bleeding and perforated peptic ulcer, respectively.
Review article: acidity and volume of the refluxate in the genesis of gastro‐oesophageal reflux disease symptoms
Authors: SIFRIM D. , MITTAL R. , FASS R. , SMOUT A. , CASTELL D. , TACK J. , GREGERSEN H. 
Published: July 2010

SummaryBackground A number of mechanisms, other than acid reflux, may be responsible for the symptoms of gastro‐oesophageal reflux disease.Aim To assess the importance of non‐acid reflux mechanisms.Methods This review is based on presentations and discussion at a workshop, where specialists in the field analysed data relating to these mechanisms.Results Weakly acidic reflux, pH (4–7), detected with impedance–pHmetry is associated with regurgitation and atypical gastro‐oesophageal reflux disease symptoms. It is not clear whether pepsin and trypsin can elicit symptoms, but bile can elicit heartburn. The magnitude of reflux‐induced oesophageal distension can be determined by high frequency ultrasonography and is not reduced by proton pump inhibition, suggesting that persisting symptoms ‘on’ a proton pump inhibitor may still be due to oesophageal distension by non‐acidic reflux. Exaggerated longitudinal muscle contraction can induce non‐acid‐related heartburn. Preliminary studies showed a positive effect of baclofen, surgery or endoscopic procedures to reduce weakly acidic reflux.Conclusion Mechanisms other than acid reflux are involved in some of the symptoms of gastro‐oesophageal reflux disease. Controlled outcome studies are needed to clarify their roles and the indications for antireflux procedures in patients with persistent symptoms whilst ‘on’ a proton pump inhibitor.
Prospective randomized trial evaluating ketamine for advanced endoscopic procedures in difficult to sedate patients
Authors: VARADARAJULU S. , ELOUBEIDI M. A. , TAMHANE A. , WILCOX C. M. 
Published: July 2010

SUMMARYBackground Adequate patient sedation is mandatory for advanced endoscopic procedures such as ERCP and EUS.Aim To evaluate the effectiveness and safety of ketamine in difficult to sedate patients undergoing advanced endoscopic procedures.Methods This was a prospective, randomized trial of all patients undergoing ERCP or EUS who were not adequately sedated despite administration of meperidine 50 mg, midazolam 5 mg and diazepam 5 mg. Patients during endoscopy were then randomized to receive either intravenous ketamine (20 mg) every 5 min or continue to receive standard sedation using meperidine and diazepam.Results Of 175 patients, 82 were randomized to receive ketamine and 93 standard sedatives. Compared with standard sedation, qualitative physician rating (P < 0.0001) and depth of sedation (P < 0.001) were superior in the ketamine group with shorter recovery times (P < 0.0001). Both patient discomfort and sedation‐related technical difficulty were significantly less among patients randomized to receive ketamine (P < 0.0001). More patients in the standard sedation group were crossed‐over to the ketamine group due to sedation failure (35.5 vs. 3.7%, P < 0.0001). Nine patients who received ketamine, developed adverse events that were managed conservatively.Conclusions Ketamine is a useful adjunct to conscious sedation in patients who are difficult to sedate. Its use results in better quality and depth of sedation with shorter recovery times than patients sedated using benzodiazepines and meperidine alone. Further prospective studies evaluating the effectiveness and safety of ketamine for endoscopic sedation are needed.
Altered intestinal permeability is predictive of early relapse in children with steroid‐responsive ulcerative colitis
Authors: MIELE E. , PASCARELLA F. , QUAGLIETTA L. , GIANNETTI E. , GRECO L. , TRONCONE R. , STAIANO A. 
Published: July 2010

SUMMARYAim To determine if small bowel involvement at diagnosis could predict early relapse in children with ulcerative colitis.Methods Children with newly diagnosed ulcerative colitis were evaluated prospectively at three time points: within 1 month, 6 months and 1 year after diagnosis. Clinical activity indices were used to measure disease activity. Laboratory studies were performed at each visit and/or at the time of relapse. At diagnosis, all patients underwent colonoscopy and a cellobiose/mannitol small intestinal permeability study. Some children were further investigated with an upper gastrointestinal endoscopy.Results Thirty‐three patients completed the 1‐year study. Overall, nine patients (27.3%) relapsed within 6 months of diagnosis, one patient (3%) within 1 year, whereas 23 patients (69.7%) did not relapse. The mean clinical activity indices, laboratory parameters, extent of colonic involvement, upper and lower gastrointestinal histological features were not predictive of early relapse. Results of the cellobiose/mannitol small intestinal permeability study were significantly higher in children who relapsed within 6 months compared with children who did not relapse (P < 0.013). The cellobiose/mannitol small intestinal permeability study was abnormal in 77.8% of early relapsers compared with only 8.3% of non‐relapsers.Conclusion Abnormal small intestinal permeability in children with ulcerative colitis could predict a more relapsing disease.