bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical trial: the effect of amitriptyline in patients with diarrhoea‐predominant irritable bowel syndrome
Authors: VAHEDI H. , MERAT S. , MOMTAHEN S. , KAZZAZI A. S. , GHAFFARI N. , OLFATI G. , MALEKZADEH R. 
Published: July 2010

SummaryBackground  Irritable bowel syndrome is the most common disorder diagnosed by gastroenterologists. Although several randomized‐controlled trials have assessed the therapeutic role of antidepressant drugs, there is insufficient evidence to support their use.Aim  To compare the effects of low‐dose amitriptyline in the treatment of diarrhoea‐predominant irritable bowel syndrome in a double‐blind randomized‐controlled trial.Methods  Fifty‐four patients who fulfilled Rome II criteria for diarrhoea‐predominant irritable bowel syndrome were included in this study. Organic causes were ruled out by standard laboratory and radiological tests, and rectosigmoidoscopy. Patients were randomly assigned to receive either 10 mg amitriptyline daily or placebo. Subjects were followed up for 2 months and symptoms were assessed using a questionnaire. Intention‐to‐treat and per‐protocol analysis was performed.Results  Fifty patients completed the study. At 2 months, the amitriptyline group showed greater (P < 0.05) reduction in the incidence of loose stool and feeling of incomplete defecation. Patients receiving amitriptyline showed greater complete response, defined as loss of all symptoms, compared with those receiving placebo (68% vs. 28%, P = 0.01). Adverse effects were similar between the two groups.Conclusion  Amitriptyline may be effective in the treatment of diarrhoea‐predominant irritable bowel syndrome and at low dose is well tolerated.
Review article: RNA interference – potential therapeutic applications for the gastroenterologist
Authors: PELLISH R. S. , NASIR A. , RAMRATNAM B. , MOSS S. F. 
Published: July 2010

SummaryBackground  A new technique of gene regulation, termed RNA interference, has emerged recently. RNA interference utilizes short double‐stranded RNA to inhibit selectively gene expression of complementary RNA nucleotide sequences after transcription, but prior to translation. Gastrointestinal and hepatic disorders may be particularly amenable to therapeutic RNA interference intervention because of the relative ease of delivery of drugs to the gastrointestinal tract and liver.Aim  To examine the published literature for potential clinical uses of RNA interference in gastroenterology and speculate on future therapies for luminal disease.Methods  Reports were identified using PubMed and the search term ‘RNA interference’, focusing on therapeutic uses related to gastrointestinal and liver disease.Results  Cellular and animal models demonstrate the potential application of short‐interfering RNA‐based therapies for viral hepatitis and inflammatory bowel disease. With validation of specific targets and better in vivo delivery of short‐interfering RNA, RNA interference may represent a new frontier for molecular‐targeted therapy in gastroenterology and hepatology.Conclusions  Short‐interfering RNA provides a novel and specific means to inhibit gene expression. Translation to the clinical arena will require further definition of side‐effects, off‐target effects and delivery systems. Ultimately, mucosally applied or endoscopically delivered short‐interfering RNA could be one of the earliest clinical uses of short‐interfering RNA therapy.
Review article: psychological aspects of home parenteral nutrition, abnormal illness behaviour and risk of self‐harm in patients with central venous catheters
Authors: STERN J. M. , JACYNA N. , LLOYD D. A. J. 
Published: July 2010

SummaryBackground  Home parenteral nutrition is established as standard management for patients with chronic severe intestinal failure. Although the treatment is welcomed by many patients, there are psychological consequences of living with a central venous catheter and there are associated restrictions to the lives of patients on home parenteral nutrition. A subgroup of home parenteral nutrition patients may use their central venous catheter for self‐harm.Aims  To review existing literature relating to abnormal psychological responses to central venous catheters in patients receiving home parenteral nutrition and the psychological meaning of living with a central venous catheter. It also attempts to alert professionals to ways in which patients may self‐harm using their central venous catheters.Methods  A literature review was performed. Data were obtained both from literature searches and from personal experience at a Psychological Medicine Unit attached to a large home parenteral nutrition centre.Results  Patients receiving home parenteral nutrition may use their central venous catheter in various ways to self‐harm. Motivation may be conscious or unconscious. Sequelae of such self‐harm may be life‐threatening.Conclusion  This paper concludes with recommendations for best practice with respect to the psychological management of home parenteral nutrition patients in whom central venous catheter abuse is suspected.
Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia
Authors: KATAGIRI A. , FU K.‐I. , SANO Y. , IKEMATSU H. , HORIMATSU T. , KANEKO K. , MUTO M. , YOSHIDA S. 
Published: July 2010

SummaryBackground  The presence of abnormal microcapillaries detected by narrow band imaging (NBI) with magnifying colonoscopy has been reported to be a marker of colorectal neoplasia.Aim  To investigate prospectively if NBI with magnification could help predict the histology of early colorectal neoplasia.Methods  A series of 104 consecutive patients with 139 colorectal lesions were studied. All lesions were detected by conventional colonoscopy and subsequently evaluated by NBI with magnification. During NBI with magnification, the microvascular architecture observed on the surface of the detected lesions, capillary patterns (CP), was divided into non‐neoplastic (CP I) and neoplastic (CP II and CP III) types. Only lesions endoscopically diagnosed as CP II or CP III were included in the study. All of the lesions were resected endoscopically or surgically and examined histologically for comparison.Results Ninety‐seven per cent (n = 103) of colorectal neoplastic lesions with CP II were histologically diagnosed as low‐grade dysplasia. Eighty‐seven per cent (n = 31) of the colorectal neoplastic lesions with CP III were high‐grade dysplasia or invasive cancer.Conclusion  Capillary patterns observed by NBI with magnification could be used to assess the degree of atypia in early colorectal neoplasia.
Diagnostic value of duodenal antitissue transglutaminase antibodies in gluten‐sensitive enteropathy
Authors: SANTAOLALLA R. , FERNÁNDEZ‐BAÑARES F. , RODRÍGUEZ R. , ALSINA M. , ROSINACH M. , MARINÉ M. , FARRÉ C. , SALAS A. , FORNÉ M. , LORAS C. , ESPINÓS J. , VIVER J. M. , ESTEVE M. 
Published: July 2010

SummaryBackground  In gluten‐sensitive enteropathy, antitissue transglutaminase antibodies are synthesized in the duodenum.Aim  To compare the diagnostic yield of these autoantibodies in cultured duodenal biopsies, duodenal aspirate and serum.Methods  Patients (n = 315, 135 female, 180 male; age: 37.3 ± 1.1 years) referred for duodenal biopsies, were recruited and HLA‐DQ2/DQ8 haplotyped. Histological measurements were made from duodenal biopsies and cultured duodenal biopsies were used for antitissue transglutaminase antibodies analysis by enzyme‐linked immunosorbent assay. Duodenal aspirate was collected in a subgroup of 81 patients. Patients were classified, according to their histology, response to a gluten‐free diet and DQ2/DQ8 status, as definite, likely or nongluten‐sensitive enteropathy.Results  Histology was normal in 59% of patients; 28% had lymphocytic enteritis, 1% had crypt hyperplasia and 13% showed atrophy. In Marsh III patients, there was complete agreement between duodenal and serological antitissue transglutaminase antibodies measurements. Marsh I patients showed a slight antitissue transglutaminase antibodies sensitivity improvement in cultured duodenal biopsy compared to serum in definite (22% vs. 19%) and likely gluten‐sensitive enteropathy (20% vs. 14%) patients. Combined serum and cultured duodenal biopsy antitissue transglutaminase antibodies assessment increased serological sensitivity from 19% to 30% in Marsh I patients.Conclusion  Duodenal antitissue transglutaminase antibodies detection improves serological determination sensitivity in Marsh I patients, providing diagnostic value and therapeutic impact.
Histological subclassification of cirrhosis based on histological–haemodynamic correlation
Authors: KUMAR M. , SAKHUJA P. , KUMAR A. , MANGLIK N. , CHOUDHURY A. , HISSAR S. , RASTOGI A. , SARIN S. K. 
Published: July 2010

SummaryBackground  Determining a relationship between specific histological parameters in cirrhosis and hepatic venous pressure gradient can be used to subclassify cirrhosis.Aim  To determine the relationship between hepatic venous pressure gradient and specific histological parameters in cirrhosis.Methods  Forty‐seven patients (mean age: 46.2 ± 13.6 years; 36 male) with biopsy‐proven cirrhosis and hepatic venous pressure gradient measurements within 1 month of biopsy were studied. The following histological parameters were scored semiquantitatively: nodule size, loss of portal tracts and central veins, portal inflammation, periportal inflammation, bile duct proliferation, lobular inflammation, ballooning, fatty change, cholestasis and septal thickness.Results  On multiple ordinal regression analysis, small nodule size (odds ratio: 21.0; 95% confidence interval: 2.1–208.2, P = 0.009) and thick septa (OR: 42.6; CI: 2.3–783.7, P = 0.011) were significantly associated with the presence of clinically significant portal hypertension. A score was assigned to each of the two parameters (nodule size: large = 1, medium = 2, small = 3 and septal thickness: thin = 1, medium = 2, thick = 3). Two subcategories were devised based on the composite score: category A (n = 12): score 1–3 and category B (n = 35): score 4–6. On ordinal regression, subcategory B (OR: 15.5; CI: 3.3–74.2, P = 0.001) was significantly associated with clinically significant portal hypertension.Conclusion  Small nodularity and thick septa are independent predictors of the presence of clinically significant portal hypertension.
Dysphagia: epidemiology, risk factors and impact on quality of life – a population‐based study
Authors: ESLICK G. D. , TALLEY N. J. 
Published: July 2010

SummaryBackground  Data on the population epidemiology of dysphagia are scarce. Little is known about the prevalence, risk factors and impact on quality of life of dysphagia in the general community.Aim  To determine the magnitude and impact of dysphagia in the general community.Methods  A random sample of 1000 individuals of Sydney, Australia, were mailed a validated self‐report questionnaire to assess dysphagia. Measured were dysphagia symptoms, potential mechanisms, risk factors, psychological disorders, quality of life and demographics.Results  The response rate of included subjects (n = 926) was 73% (n = 672). Dysphagia ever was reported by 16% (n = 110). Multiple logistic regression analysis found that odynophagia was independently associated with gastro‐oesophageal reflux disease (GERD) (OR = 3.41, 95% CI: 1.16–10.04). Intermittent dysphagia was independently associated with GERD (OR = 2.96, 95% CI: 1.76–4.98) and anxiety (OR = 1.09, 95% CI: 1.01–1.19). The presence of progressive dysphagia was independently associated with depression (OR = 1.34, 95% CI: 1.07–1.67). Progressive dysphagia was independently associated with reduced ‘general health’ (OR = 0.95, 95% CI: 0.90–0.99), while intermittent dysphagia was associated with a reduction in the ‘role physical’ subscale (OR = 0.98, 95% CI: 0.97–0.99).Conclusions  Dysphagia is remarkably common in the general population. GERD is a risk factor for dysphagia as well as odynophagia. Intermittent dysphagia was associated with anxiety, while progressive dysphagia was associated with depression.
Relationship between symptom load of gastro‐oesophageal reflux disease and health‐related quality of life, work productivity, resource utilization and concomitant diseases: survey of a US cohort
Authors: WAHLQVIST P. , KARLSSON M. , JOHNSON D. , CARLSSON J. , BOLGE S. C. , WALLANDER M.‐A. 
Published: July 2010

SummaryBackground  Analysis of the burden of gastro‐oesophageal reflux disease (GERD) in relation to the severity and frequency of symptoms is essential to identify individuals and groups in whom targeted management is justified.Aim  To describe the relationship between symptoms of GERD and self‐reported health‐related quality of life (HRQL), work productivity, healthcare utilization and concomitant diseases.Methods  US respondents to the Internet‐based 2004 National Health and Wellness Survey who had self‐reported GERD (n = 10 028, mean age: 52 years, 58% female) were age‐ and gender‐matched to a control group without GERD (n = 10 028). Respondents with GERD were classified according to symptom severity and frequency. HRQL and productivity were assessed using the Short‐Form 8 survey (SF‐8) and Work Productivity and Activity Impairment questionnaire, respectively.Results  Symptom frequency increased with increasing symptom severity. Compared with controls, respondents with GERD had more concomitant diseases [mean difference (MD): 1.6], lower SF‐8 physical and mental health scores (MD: 4.1 units and 3.1 units, respectively), increased absenteeism (MD: 0.9 h/week), reduced percent productivity at work (MD: 7.5%) and increased healthcare utilization. All tested variables deteriorated with increasing symptom severity and/or frequency.Conclusions  Increasing severity and frequency of GERD symptoms is associated with more concomitant diseases, lower HRQL, lower work productivity and increased healthcare utilization, suggesting that patients with moderate or severe GERD should receive targeted management with the most effective treatment strategies.
Proton pump inhibitor therapy in gastro‐oesophageal reflux disease decreases the oesophageal immune response but does not reduce the formation of DNA adducts
Authors: DE JONGE P. J. F. , SIERSEMA P. D. , VAN BREDA S. G. J. , VAN ZOEST K. P. M. , BAC D. J. , LEEUWENBURGH I. , OUWENDIJK R. J. TH. , VAN DEKKEN H. , KUSTERS J. G. , KUIPERS E. J. 
Published: July 2010

SummaryBackground  Chronic oesophageal inflammation and related oxidative stress are important in the pathogenesis of erosive oesophagitis (EO) and its malignant progression.Aim  To study the effect of proton pump inhibitors (PPIs) on oesophageal cellular immune response and oxidative damage in EO patients.Methods  Forty gastro‐oesophageal reflux disease (GERD) patients [non‐erosive reflux disease (NERD): 15, EO: 25] were included, after 7 days off antisuppressive drugs. EO patients were randomized to 20‐mg rabeprazole once daily for either 4 or 8 weeks with baseline and follow‐up endoscopy with distal oesophageal biopsies. T lymphocytes, macrophages and mast cells were quantified by immunohistochemistry. DNA adducts were measured by analysis of 8‐oxo‐deoxyguanosine levels.Results  Erosive oesophagitis patients had more T lymphocytes and CD8+ T lymphocytes in squamous epithelium than NERD patients (P = 0.001, P = 0.002, respectively). Levels of DNA adducts between both groups were, however, not different (P = 0.99). Four‐ and eight‐week rabeprazole treatment in EO patients resulted in a significant decrease in number of T lymphocytes and CD8+ T lymphocytes (all P < 0.05). PPIs did not, however, affect levels of DNA adducts.Conclusions  Short‐term PPI therapy in EO patients reduces the oesophageal cellular immune response, but does not change oxidative damage. PPI therapy may therefore not be effective in reducing the risk of oesophageal cancer in GERD patients.
National mortality following upper gastrointestinal or cardiovascular events in older veterans with recent nonsteroidal anti‐inflammatory drug use
Authors: ABRAHAM N. S. , CASTILLO D. L. , HARTMAN C. 
Published: July 2010

SummaryBackground  Upper gastrointestinal events (UGIE), myocardial infarction (MI) and cerebrovascular accident (CVA) are known morbities among recent NSAID users.Aim  To assess all‐cause mortality following UGIE, MI or CVA among recent NSAID users.Methods  Veterans >65 prescribed an NSAID at any Veterans Affairs (VA) facility were identified using prescription fill data and their records linked to a merged VA‐Medicare database. Each person‐day was assessed for NSAID, coxib or proton pump inhibitor (PPI) exposure. Incidence density ratios and hazard rates of death were calculated following UGIE, MI and CVA adjusting for demographics, co‐morbidity, prescription channeling, geographic location and pharmacological covariates.Results  Among 474 495 patients [97.8% male; 85.3% white; 73.9 years (s.d. 5.6)], death followed at a rate of 5.5 per 1000 person‐years (95% CI: 5.4–5.6) post‐UGIE, 17.7 per 1000 person‐years (95% CI: 17.5–17.9) post‐MI and 21.8 per 1000 person‐years (95% CI: 21.6–22.0) post‐CVA. CVA was associated with greatest risk of death [hazard ratio (HR) 12.4; 95% CI: 10.9–14.3] followed by MI (HR 10.7; 95% CI: 9.2–11.6) and UGIE (HR 3.3; 95% CI: 2.8–3.9). Predictors of mortality were advancing age and co‐morbidity, increased use of coxibs and failure to ensure adequate gastroprotection.Conclusion  Among elderly veterans with recent NSAID use, an UGIE, MI or CVA is a clinically relevant premorbid event.
A new co‐axial breathing system
Authors: BURCHETT K. R. , BENNETT J. A. 
Published: July 2010

SummaryA new, simple, versatile co‐axial breathing system combining the features of Mapleson A, D and E type systems is described. The change from an A system to a D/E system is effected by a single switch and without reversal of the gas flow. Fresh gas flows in the order of 70 ml/kg/min are required for both spontaneous ventilation in the Mapleson A mode and controlled ventilation in the Mapleson D mode. The co‐axial conjiguration offers the advantages of a single, lightweight breathing system with easy scavenging of anaesthetic gases, while the ability to switch between the A and D or E configurations offers the economic advantages of low fresh gas flows and the need for a single anaesthetic breathing system for all situations.
The prolongation of local anaesthetic action with dextran
Authors: NAVARATNARAJAH M. , DAVENPORT H. T. 
Published: July 2010

SummaryField blocks of the inguinal region were performed in two groups of patients, in one group using a mixture of 0.5% bupivacaine, 1:200 000 adrenaline and dextran 110 and in the second group using a mixture of 0.5% bupivacaine, 1:200 000 adrenaline and dextran 150; the study being performed in a double‐blind fashion. The dextran 150 mixture produced a highly significant increase (p < 0.01) in the duration of the block when compared with the dextran 110 mixture. The authors conclude that the use of dextran of increasing molecular weight increases the duration of action of local anaesthetics correspondingly.
Tracheal compression caused by aneurysms of the aortic arch
Authors: MacGILLIVRAY R. G. 
Published: July 2010

SummaryTwo cases of severe tracheal compression caused by aortic arch aneurysm are reported. There was a marked similarity in the clinical presentation of these patients but the different outcomes of surgical resection appeared to be related to the content of the aneurysms. The first patient had a fixed obstruction due to solid clot, which proved irreversible; while the second had an aneurysm containing fluid blood. The anaesthetic management of this complication is discussed.
Pulmonary function tests before and after laparoscopic cholecystectomy
Authors: FREEMAN J. A. , ARMSTRONG I. R. 
Published: July 2010

SummaryPulmonary function tests were performed in 22 patients undergoing laparoscopic cholecystectomy. Measurements were made before, 24h after, and 6 weeks after operation (12 patients). At 24 h postoperatively there were significant decreases in forced expiratory volume in 1 s, vital capacity, functional residual capacity and total lung capacity to 75% (p < 0.001), 73% (p < 0.001), 92% (p = 0.002) and 83% (p < 0.001) of pre‐operative values respectively. Inspiratory and expiratory mouth pressures decreased to 66% (p < 0.001) of pre‐operative values respectively. Inspiratory and expiratory mouth pressures decreased to 66% (9 < 0.001) adn 63% (p < 0.001) of the pre‐operative pressures respectively. There was a reduction in Pao2 (p < 0.01) and an increase in alveolar‐arterial gradient (p < 0.001) but no change in Paco2 at 24 h. The pulmonary function tests measured in the patients who returned after 6 weeks had returned to pre‐operative values.
Effect of three different surgical prone positions on lung volumes in healthy volunteers
Authors: MAHAJAN R. P. , HENNESSY N. , AITKENHEAD A. R. , JELLINEK D. 
Published: July 2010

SummaryTen healthy volunteers were placed in three different surgical prone positions (knee‐chest, Eschmann frame and two supports, one each for the thorax and pelvis); the normal prone position without any supports was used as a control. Lung volumes using helium dilution and spirometery were calculated for each volunteer in each position. Compared with the control position, functional residual capacity, expiratory reserve volume, residual volume and total lung capacity were significantly higher in the knee‐chest position. Functional residual capacity and expiratory reserve volume were significantly higher in the frame position. No advantage was gained with the use of the two supports position. We conclude that, of these three prone positions in awake volunteers, the knee‐chest position causes least respiratory restriction.
Expression pattern, genomic cloning and RFLP analyses of the swine PIT‐1 gene
Authors: Yu T‐P , Schmitz C B , Rothschild M F , Tuggle C K 
Published: July 2010

SummaryThe swine PIT‐1 POU domain cDNA was used to study PIT‐1 expression and to clone the PIT‐1 genomic region to identify additional PIT‐1 polymorphisms. PIT‐1 was expressed only in the pituitary, confirming the swine cDNA identity. To study the PIT‐1 genomic region, a clone containing 13.7 kb DNA was isolated. EcoRI fragments hybridizing to PIT‐1 were sequenced, and the 3′ portion of PIT‐1 gene identified. Primers for polymerase chain reaction (PCR)‐restriction fragment length polymorphism (RFLP) analysis were then designed. Restriction analysis of PCR products identified a RsaI RFLP. In contrast to other PIT‐1 RFLPs, the RsaI PCR‐RFLP was widely distributed in American breeds. Thus, the RsaI RFLP and the previously reported PIT‐1 RFLPs allow detection of PIT‐1 alleles in most, if not all, breeds currently used in the US and European reference/resource pig mapping families.
Chromosomal assignment of porcine microsatellites by use of a somatic cell hybrid mapping panel
Authors: Rettenberger G. , Fredholm M. , Fries R. 
Published: July 2010

SummaryA well‐established and characterized somatic cell hybrid panel was used to map three polymorphic microsatellites. Microsatellite S0072, representing the linkage group S0007‐S0072, was assigned to porcine chromosome 14. Micro‐satellite S0009, representing the unassigned linkage group EAM‐S0009‐S0071, was assigned tentatively to porcine chromosome 11. Finally, S0062 was tentatively mapped to chromosome 18. S0062 may represent the first marker for porcine chromosome 18.