bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic classifications as diagnostic factors of peptic ulcer and early gastric cancer – a possible reason why Helicobacter pylori infection causes gastric ulcers along lesser curvature
Authors: YOSHIDA M. , SAIKAWA Y. , HOSODA S. , KUMAI K. , KUBOTA T. , ISHIKAWA H. , NAKAMURA T. , NAKAMURA R. , KAMEYAMA K. , TAKAHASHI S. , KURIHARA N. , KITAJIMA M. 
Published: July 2010

SummaryBackgroundEndoscopic classifications were reported to reflect the pathophysiology of gastric mucosa. However, relationship between gastric lesions and classifications has not been examined well.AimTo investigate the relationship between endoscopic classifications and cancers or ulcers.MethodsIn this study, 487 patients undergoing upper gastrointestinal endoscopy in Takahashi Clinic and 257 patients with early gastric cancer in Keio University Hospital were enrolled.ResultsIncidence of reflux oesophagitis was higher in Helicobacter pylori‐negative patients. K‐form was better in the H. pylori‐positive patients. Most cancers in the patients with the closed‐type or reflux oesophagitis were of undifferentiated types. Incidences of ulcers were highest in C‐2 and C‐3 in which the borders of atrophy cross the medial oblique muscle bundle, the border circular muscle bundle or both, and 94% of ulcers in C‐2 and C‐3 stomach were located along the lesser curvature.ConclusionThe predominant existence of undifferentiated types in patients with reflux oesophagitis or closed‐type stomach can be useful information for early diagnosis of cancers. The relationship between the Kimura–Takemoto classification and ulcer location may explain why H. pylori infection is related to ulcer formation along the lesser curvature.
Review article: the nature of oesophageal injury in gastro‐oesophageal reflux disease
Authors: DE HERTOGH G. , ECTORS N. , VAN EYKEN P. , GEBOES K. 
Published: July 2010

SummaryThe purpose of this review was to explore issues relating to the nature of oesophageal injury in gastro‐oesophageal reflux disease. Several structural and functional elements of the oesophageal epithelium provide for an inherent resistance against refluxed material. It is only when this defence is overcome that reflux‐induced damage ensues.The light microscopic changes in reflux oesophagitis are manifold. Early changes are confined to the epithelium and consist of reactive changes and inflammatory cell infiltration. When the epithelial integrity can no longer be maintained, erosions and ulcers develop.Recently, dilatation of the intercellular spaces was described as a sensitive early marker for gastro‐oesophageal reflux disease. This parameter was first identified by electron microscopy but can also be assessed by light microscopy in routinely stained tissue sections.Some of the changes occurring in early gastro‐oesophageal reflux disease can be reproduced by incubating oesophageal mucosal biopsies in gastrointestinal fluids or their components. Activated pepsin, trypsin and conjugated bile acids at an acidic pH have been identified as probable causes of reflux‐induced damage.
Review article: complete gastro‐oesophageal reflux monitoring – combined pH and impedance
Authors: TUTUIAN R. , CASTELL D. O. 
Published: July 2010

SummaryGastroesophagel reflux disease (GERD) is a common condition encountered in clinical practice. Over the years there has been a continuous interaction between the understanding of the disease, the diagnostic tools and treatments of GERD. The use of proton pump inhibitor (PPI) trials by primary care physicians as diagnostic tool in patients with symptoms suspected to be due to GERD has led to a shift in the type of patients referred to specialists. Currently, gastrointestinal specialists are frequently asked to evaluate patients with persistent reflux symptoms despite acid suppressive therapy. In these patients symptoms can be associated with reflux (both acid and non‐acid) or not associated with reflux.While conventional pH monitoring can quantify esophageal acid exposure and evaluate the association between symptoms and acid reflux, it cannot reliably detect reflux episodes with a pH >4 (i.e. non‐acid reflux). Detecting reflux episodes by changes in intraluminal resistance to alternating current (i.e. impedance), combined multichannel intraluminal impedance and pH (MII‐pH) monitoring offers the opportunity to detect both acid and non‐acid reflux episodes and to evaluate the relationship between symptoms and reflux. We believe that MII‐pH monitoring has become the new ‘‘gold standard’’ for clarifying the mechanisms of persistent symptom on PPI therapy.
Systematic review: fluoroquinolones for the treatment of intra‐abdominal surgical infections
Authors: FALAGAS M. E. , MATTHAIOU D. K. , BLIZIOTIS I. A. 
Published: July 2010

SummaryBackgroundIntra‐abdominal infections result in substantial morbidity and mortality. Fluoroquinolones are among the various regimens that are used for the treatment of these infections.AimTo evaluate the available data from laboratory and clinical studies regarding the use of fluoroquinolones for the treatment of patients with intra‐abdominal infections.MethodsWe searched for relevant laboratory and clinical studies in the PubMed and the Cochrane Library databases.ResultsGood pharmacokinetic and pharmacodynamic properties of fluoroquinolones in inflamed abdominal tissue are reported in several laboratory studies. In six prospective non‐randomized clinical studies of patients with intra‐abdominal infections, the clinical success achieved with the use of fluoroquinolones ranged from 77% to 94%. In 10 randomized‐controlled trials fluoroquinolone‐based regimens were compared with other commonly used (mainly β‐lactam‐based) regimens. Clinical success, bacterial eradication, withdrawal because of toxicity and mortality were similar between the compared treatment arms except from two randomized‐controlled trials, in which clinical success was statistically higher in the fluoroquinolone treatment arm.ConclusionsFluoroquinolones seem to be an effective and relatively safe option for the treatment of patients with intra‐abdominal infections.
Impact of long‐term enteral nutrition on clinical and endoscopic recurrence after resection for Crohn's disease: a prospective, non‐randomized, parallel, controlled study
Authors: YAMAMOTO T. , NAKAHIGASHI M. , UMEGAE S. , KITAGAWA T. , MATSUMOTO K. 
Published: July 2010

SummaryBackgroundThe impact of enteral nutrition on post‐operative recurrence has not been properly examined.AimTo investigate the impact of enteral nutrition using an elemental diet on clinical and endoscopic recurrence after resection for Crohn's disease.MethodsForty consecutive patients who underwent resection for ileal or ileocolonic Crohn's disease were studied. After operation, 20 patients continuously received enteral nutritional therapy (EN group), and 20 had neither nutritional therapy nor food restriction (non‐EN group). In the EN group, enteral formula (Elental) was infused through a nasogastric tube in the night‐time, and low fat foods were taken in the daytime. All patients were followed up regularly for 1 year after operation. Ileocolonoscopy was performed at 6 and 12 months after operation.ResultsOne patient (5%) in the EN group and seven (35%) in the non‐EN group developed clinical recurrence during 1‐year follow‐up (P = 0.048). Six months after operation, five patients (25%) in the EN group and eight (40%) in the non‐EN group developed endoscopic recurrence (P = 0.50). Twelve months after operation, endoscopic recurrence was observed in six patients (30%) in the EN group and 14 (70%) in the non‐EN group (P = 0.027).ConclusionsOur long‐term enteral nutritional therapy significantly reduced clinical and endoscopic recurrence after resection for Crohn's disease.
Assessment of dietary nutrients that influence perception of intra‐oesophageal acid reflux events in patients with gastro‐oesophageal reflux disease
Authors: SHAPIRO M. , GREEN C. , BAUTISTA J. M. , DEKEL R. , RISNER‐ADLER S. , WHITACRE R. , GRAVER E. , FASS R. 
Published: July 2010

SummaryBackgroundGastro‐oesophageal reflux disease symptoms are most commonly reported postprandially, suggesting that some diet components are likely to induce symptoms more than others.AimsTo determine which of the various dietary nutrients is a strong predictive factor for symptom generation in association with an acid reflux event.MethodsSubjects with typical heartburn symptoms were evaluated by the gastro‐oesophageal reflux disease Symptom Checklist, demographics questionnaire, upper endoscopy and pH testing. During the pH study, patients completed a detailed 24‐h dietary intake record. This included time of meals, description of food components and the amount and type of food preparation.ResultsFifty gastro‐oesophageal reflux disease patients completed all stages of the study. A total of 112 (78%) symptoms were considered as sensed reflux event. Body mass index did not correlate with having perceived reflux. Patients who consumed more cholesterol, saturated fatty acids and had more percentage calories from fat were significantly more likely to experience a perceived reflux event. Regression analysis and β‐coefficient were specifically significant for cholesterol.ConclusionOf all dietary nutrients, cholesterol enhances the most the perception of intra‐oesophageal acid reflux events in patients with gastro‐oesophageal reflux disease.
Systematic review: rebound acid hypersecretion after therapy with proton pump inhibitors
Authors: HUNFELD N. G. M. , GEUS W. P. , KUIPERS E. J. 
Published: July 2010

SummaryBackgroundThe occurrence and the clinical relevance of rebound acid hypersecretion after discontinuation of proton pump inhibitors is unclear.AimTo perform a systematic review of rebound acid hypersecretion after discontinuation of proton pump inhibitors.MethodsPubMed, Embase and Central were searched up to October 2005 with indexed terms.ResultsEight studies were included, sample size was 6–32. The studies used both basal and stimulated acid output as parameters to study rebound acid hypersecretion and assessed these at different time points and with variable methods. Five studies (including four randomized studies) did not find any evidence for rebound acid hypersecretion after proton pump inhibitor therapy. Of the remaining three studies, the duration of proton pump inhibitor therapy was the longest and two of these studies were the only to assessHelicobacter pyloristatus of their study subjects. These two studies suggested that rebound acid hypersecretion may occur inH. pylori‐negatives after 8 weeks of proton pump inhibitors.ConclusionsStudies that have investigated rebound acid hypersecretion after cessation of proton pump inhibitor treatment are heterogenic in design, methods and outcome. There is some evidence from uncontrolled trials for an increased capacity to secrete acid inH. pylori‐negative subjects after 8 weeks of treatment. There is no strong evidence for a clinically relevant increased acid production after withdrawal of proton pump inhibitor therapy.
A randomized double‐blind placebo‐controlled trial of Lactobacillus GG for abdominal pain disorders in children
Authors: GAWROŃSKA A. , DZIECHCIARZ P. , HORVATH A. , SZAJEWSKA H. 
Published: July 2010

SummaryBackgroundFunctional abdominal pain disorders (FAPD) are common in school‐aged children; however, there is no reliable treatment.AimTo determine the efficacy of Lactobacillus rhamnosus GG (LGG) for treating FAPD in children.MethodsA total of 104 children who fulfilled the Rome II criteria for functional dyspepsia (FD), or irritable bowel syndrome (IBS), or functional abdominal pain (FAP) were enrolled in a double‐blind, randomized controlled trial in which they received LGG (n = 52), or placebo (n = 52) for 4 weeks.ResultsFor the overall study population, those in the LGG group were more likely to have treatment success (no pain) than those in the placebo group (25% vs. 9.6%, relative benefit (RB) 2.6, 95% confidence interval (CI): 1.05–6.6, number needed to treat (NNT) 7, 95% CI: 4–123). For children with IBS (n = 37), those in the LGG group were more likely to have treatment success than those in the placebo group (33% vs. 5%, RB 6.3, 95% CI: 1.2–38, NNT 4, 95% CI: 2–36) and reduced frequency of pain (P = 0.02), but not pain severity (P = 0.10). For the FD group (n = 20) and FAP group (n = 47), no differences were found.ConclusionThe LGG appears to moderately increase treatment success, particularly among children with IBS.
Review article: biological activity markers in inflammatory bowel disease
Authors: DESAI D. , FAUBION W. A. , SANDBORN W. J. 
Published: July 2010

SummaryBackgroundTraditionally, inflammatory bowel disease activity is assessed by clinical activity indices that measure clinical symptoms and endoscopic indices that measure endoscopic inflammation. Biological markers are a non‐invasive way of objectively measuring inflammation and can play an adjunctive or primary role in the assessment of disease activity.AimTo review the data on biological markers for assessment of disease activity and prediction of relapse in inflammatory bowel disease.MethodsTo collect relevant articles, a PubMed search was performed from 1980 to 2006 using following search terms in combination: inflammatory bowel disease, biomarkers, inflammation, disease activity, relapse, acute phase reactants cytokines, interleukins, adhesion molecules, integrins, calprotectin and lactoferrin.ResultsBiological activity markers can be classified into serological, faecal and miscellaneous categories. Acute phase reactants levels correlate with disease activity and some can be used to help predict relapse. Cytokines and adhesion molecules are elevated in active disease inconsistently. Faecal markers are useful in assessment of disease activity and relapse.ConclusionsAcute phase reactants and faecal markers are useful to assess the disease activity in clinical practice. More data are required on cytokines and adhesion molecules. C‐reactive protein, erythrocyte sedimentation rate, interleukins and faecal markers may be useful in predicting a relapse.
Consequences of frequent nocturnal gastro‐oesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity
Authors: DUBOIS R. W. , AGUILAR D. , FASS R. , ORR W. C. , ELFANT A. B. , DEAN B. B. , HARPER A. S. , YU H.‐T. , MELMED G. Y. , LYNN R. , SINGH A. , TEDESCHI M. 
Published: July 2010

SummaryBackgroundEffects of frequent nocturnal symptoms of gastro‐oesophageal reflux disease (GERD‐FNS) on health‐related quality of life (HRQOL) and work productivity are not well documented.AimTo assess symptom severity, production loss, and HRQOL among employed adults with and without GERD‐FNS.MethodsUsing several validated outcome measures in a web survey design, GERD was pre‐specified as GERD Symptom and Medication Questionnaire score >9, and ≥1 episode of heartburn or acid regurgitation during the preceding week. GERD‐FNS patients were those reporting ≥2 symptom‐nights during the previous week; their outcomes were compared with those of patients having minimal or no nocturnal symptoms (GERD‐NNS) and vs. non‐GERD controls.ResultsData were collected from 1002 GERD patients (476 GERD‐FNS, 526 GERD‐NNS) and 513 controls. Severe symptoms were more common, sleep abnormalities were more frequent (P < 0.0001) and SF‐36 scores lower (P < 0.05, all scores) among GERD‐FNS patients vs. GERD‐NNS patients. GERD‐related work loss was greater among those with GERD‐FNS vs. GERD‐NNS (P < 0.0001). Work loss and functional limitations were more pronounced when comparing GERD‐FNS cases vs. non‐GERD controls.ConclusionEmployed adults with frequent nocturnal GERD report more severe symptoms, and are associated with impaired sleep, HRQOL and work productivity compared with controls and patients with minimal or no nocturnal symptoms.
The relationship between dosing of alosetron and discontinuation patterns reported by patients participating in a follow‐up programme
Authors: TENNIS P. , ANDREWS E. , HICKMAN P. , MILLER D. , HOLLIS K. , COOK S. 
Published: July 2010

SummaryBackgroundAlosetron was reintroduced for treatment of irritable bowel syndrome with a risk management programme in November 2002. Recommended starting dosage was 1 mg/day for 4 weeks. If symptoms remained uncontrolled, dosage could be changed to 2 mg/day.AimTo describe alosetron dosages and associated patient characteristics from the Lotronex follow‐up survey programme.MethodsPatients reported dosages of alosetron at start and regular follow‐up intervals. Analyses were limited to patients with the potential to have at least 1 year of follow‐up (enrolled between 9 December 2002 and 31 December 2003).ResultsAt baseline, 75% of 2817 respondents reported starting on 1 mg/day, 17% on 2 mg/day and 8% on other doses. Adherence to recommended starting dosage did not vary by status at end of follow‐up, previous alosetron experience or age. At last reported dose, 50% of respondents were using 1 mg/day; 29% were using 2 mg/day. Discontinuation was not related to baseline doses. Longer times to discontinuation were associated with previous use, symptoms for more than 6 months and dose change throughout follow‐up.ConclusionsHigh adherence to recommended dosing at baseline and follow‐up suggests that the risk management programme is encouraging safe use of alosetron, including adherence to dosing recommendations.
Coeliac disease and the risk of fractures – a general population‐based cohort study
Authors: LUDVIGSSON J. F. , MICHAELSSON K. , EKBOM A. , MONTGOMERY S. M. 
Published: July 2010

SummaryBackgroundEarlier studies have suggested that untreated coeliac disease may be associated with osteoporosis, but results are contradictory for the risk of long‐term fractures.AimTo study the association between coeliac disease and fractures.MethodsWe used Cox regresson to examine the future risk of hip fracture and fracture of any type in more than 13 000 individuals with coeliac disease and 65 000 age‐ and sex‐matched reference individuals in a general population‐based cohort.ResultsDuring follow‐up, 1365 first hip fractures and 4847 fractures of any type occurred. Coeliac disease was positively associated with subsequent hip fracture (hazard ratio = 2.1; 95% CI = 1.8–2.4) (in children: hazard ratio = 2.6; 95% CI = 1.1–6.2) and fractures of any type (hazard ratio = 1.4; 95% CI = 1.3–1.5) (in children: hazard ratio = 1.1; 95% CI = 1.0–1.2). The absolute excess risk of hip fractures in children with coeliac disease was 4/100 000 person‐years. Incidence ratios for hip fracture in individuals with CD were around two both prior to diagnosis of coeliac disease and afterwards; this risk increase remained 20 years after diagnosis of coeliac disease.ConclusionsIndividuals with coeliac disease, including children with coeliac disease, may be at increased risk of hip fracture and fracture of any type. Coeliac disease may be positively associated with long‐term hip fracture risk.
Systematic review: oral bowel preparation for colonoscopy
Authors: BELSEY J. , EPSTEIN O. , HERESBACH D. 
Published: July 2010

SummaryBackgroundThere are many published trials of colon cleansing regimens for colonoscopy but no clear consensus regarding relative performance.AimTo identify high quality controlled trials comparing two or more bowel preparation regimens and to compare efficacy and tolerability.MethodsA comprehensive systematic review was carried out to identify candidate studies. Quality appraisal was carried out on all identified studies. Results were meta‐analysed where possible and qualitatively compared if not.ResultsEighty‐two studies qualified for analysis. Polyethylene glycol and sodium phosphate were the most frequently investigated preparations. There was no significant efficacy difference between the two, but sodium phosphate was better tolerated. Sodium picosulphate/magnesium citrate, a commonly prescribed preparation, was investigated in four studies, with no clear benefit over other regimens demonstrated. Safety was not recognized as a problem in the randomized controlled trials. Published case series demonstrate that sodium phosphate is associated with the highest risk of clinically significant electrolyte disturbances.ConclusionShortcomings in study design limit the value of many of the studies. Based on these results, no single bowel preparation emerges as consistently superior. New preparations are required that combine better efficacy and tolerability, in addition to rigorous new validated study designs, allowing unequivocal comparisons to be made.
Meta‐analysis: ondansetron for vomiting in acute gastroenteritis in children
Authors: SZAJEWSKA H. , GIERUSZCZAK‐BIAŁEK D. , DYLĄG M. 
Published: July 2010

SummaryBackgroundVomiting is a common sympton in children with gastroenteritis, but its treatment remains controversial.AimTo investigate potential beneficial effects of ondansetron, compared with placebo or no intervention, in treating vomiting during acute gastroenteritis in children.MethodsThe following electronic databases were searched through August 2006: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized‐controlled trials (RCTs) were included.ResultsFour RCTs involving 490 patients with vomiting during acute gastroenteritis were included. Combined data from three RCTs (n = 466) showed that ondansetron compared with the control significantly increased the chance for vomiting cessation soon after drug administration [relative risk (RR): 1.3, 95% confidence interval (CI): 1.2–1.5, number needed to treat (NNT): 5, 95% CI: 4–8], but this effect was not observed at 24 h (three RCTs, n = 144, RR 1.2, 95% CI: 0.9–1.7). Ondansetron significantly reduced the risk of intravenous rehydration (two RCTs, n = 359, RR 0.4, 95% CI: 0.3–0.7, NNT 7, 95% CI: 5–14). Outcome measures not significantly different after ondansetron treatment were the need for hospitalization and return emergency department visits.ConclusionsDespite some clinical benefits, there is insufficient evidence to recommend the routine use of ondansetron for vomiting during acute gastroenteritis in children.
Helicobacter pylori eradication in long‐term proton pump inhibitor users in primary care: a randomized‐controlled trial
Authors: RAGHUNATH A. S. , HUNGIN A. P. S. , MASON J. , JACKSON W. 
Published: July 2010

SummaryBackground  Two‐thirds of proton pump inhibitor prescribing in the UK is for long‐term therapy.Aim  To determine the impact of eradication in long‐term proton pump inhibitor users infected with Helicobacter pylori.Methods  A total of 184 H. pylori‐positive patients were randomly assigned to true or placebo eradication therapy. The primary outcome was the change in proton pump inhibitor usage measured by prescriptions; secondary outcomes were changes of proton pump inhibitor doses, dyspepsia symptoms, general practitioner consultations and quality of life measures.Results  In the year following H. pylori eradication proton pump inhibitor prescriptions fell compared with placebo (−1.7, 95% CI: −2.3 to −1.1, P < 0.001); when adjusted to full‐dose equivalent prescriptions the reduction was more marked (−2.2, 95% CI: −3.0 to −1.4, P < 0.001). Both general practitioner consultations (−1.0, 95% CI: −1.8 to −0.1, P = 0.026) and symptoms measured on the Leeds Dyspepsia Questionnaire (−3.1, 95% CI: −5.3 to −0.9, P = 0.005) were reduced. Quality of life and self‐rating measures also favoured eradication (EQ‐5D: 0.09, P = 0.08 and VAS: 5.6, P = 0.002). The Carlsson and Dent Reflux Questionnaire found no difference between groups (−0.3, P = 0.65), possibly balancing decreased overall symptoms with increased prominence of heartburn in the eradication group.Conclusions  Helicobacter pylori eradication in infected, long‐term proton pump inhibitor users in primary care reduced both the overall severity of symptoms and use of health care.