bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: novel therapeutic options for chronic hepatitis C
Authors: CHOLONGITAS E. , PAPATHEODORIDIS G. V. 
Published: July 2010

SummaryBackground  The efficacy of treatment against hepatitis C virus has improved, but it is still far from ideal. Thus, new antihepatitis C virus therapies are required.Aim  To evaluate the data on antihepatitis C virus approaches beyond the current standard combination of pegylated interferon‐alpha and ribavirin.Method  We reviewed the available literature regarding novel antihepatitis C virus options, given alone or in combination with existing agents.Results  New interferons and ribavirin alternatives have been tried aiming to improve the efficacy and the safety/tolerability profile of standard agents. The hepatitis C virus polymerase and NS3/4A protease have been rather popular targets for new antihepatitis C virus agents. The combination of such inhibitors with pegylated interferon‐alpha and ribavirin seems to act synergistically and to prevent viral resistance, compared to monotherapies. Several novel immunomodulators are currently evaluated and may be useful in combination therapies. Alternative strategies (inhibition of hepatitis C virus protein translation, assembly/release or binding) or agents with different modes of action (statins, S‐adenosylmethionine and herbs) need further evaluation.Conclusions  Many novel promising antihepatitis C virus agents are being developed, offering hope for future therapies that may target multiple points of the viral life cycle and/or host immune response. Newer approaches should ideally provide safe, effective and more tolerable therapy to all chronic hepatitis C virus patients.
Systematic review: prevention of travellers’ diarrhoea
Authors: DUPONT H. L. 
Published: July 2010

SummaryBackground  Renewed interest in the use of antibiotics to prevent travellers’ diarrhoea has occurred with the availability of non‐absorbed (<0.4%) rifaximin, and with evidence that a subgroup of travellers with diarrhoea have progression of their illnesses to postinfectious irritable bowel syndrome.Aim  To summarize recently published information and make recommendations on travellers' diarrhoea prevention.Methods  PubMed was reviewed on 2 January 2008 for 255 articles on the topic of ‘travellers diarrhoea’ published beginning with 2000 along with the author’s extensive file on prevention of travellers’ diarrhoea.Results  Exercising care in food and beverage selection, while of unproven value, is recommended during travel to high‐risk areas of Latin America, Southern Asia or Africa. An algorithm is presented to identify future travellers, for which chemoprophylaxis is appropriate. The preferred drug for prevention of travellers’ diarrhoea is rifaximin, with bismuth subsalicylate or a fluoroquinolone also being effective. Vaccines against the principal cause of travellers’ diarrhoea, enterotoxigenic Escherichia coli, are being developed.Conclusions  Research is needed to determine the relative effectiveness of exercising care on food and beverage selection and chemoprophylaxis in preventing travellers’ diarrhoea and postinfectious irritable bowel syndrome during high‐risk travel. Enterotoxigenic E. coli vaccines appear to be a promising addition to travel medicine.
The citrulline generation test: proposal for a new enterocyte function test
Authors: PETERS J. H. C. , WIERDSMA N. J. , TEERLINK T. , VAN LEEUWEN P. A. M. , MULDER C. J. J. , VAN BODEGRAVEN A. A. 
Published: July 2010

SummaryBackground The amino acid citrulline is mainly produced by enterocytes from conversion of glutamine. As fasting plasma citrulline proved disappointing as a biomarker for enterocyte dysfunction in clinical practice, we propose a citrulline generation test (CGT) to assess enterocyte function.Aim To assess the feasibility of a CGT in healthy subjects and patients with decreased enterocyte mass.Methods Nineteen healthy subjects, 16 patients with intestinal villous atrophy and nine patients with short bowel syndrome (SBS) were given an oral bolus of 20 g of the dipeptide alanine–glutamine. Subsequent changes in plasma citrulline and other amino acid concentrations were determined using reverse‐phase high‐performance liquid chromatography.Results Following the oral bolus of alanine–glutamine, plasma citrulline concentrations showed a time dependent rise in healthy subjects of 44 ± 13% (38–55 μmol/L,P < 0.0001). The slope from baseline plasma citrulline to peak concentrations was 0.22 ± 0.08, 0.13 ± 0.04 and 0.09 ± 0.04 μmol/L/min in healthy subjects, patients with coeliac disease (CeD) and refractory CeD, respectively (healthy subjects vs. CeDP < 0.05, healthy subjects vs. refractory CeDP < 0.001). In patients with SBS, the CGT was able to distinguish between non‐adapted and adapted SBS by means of the incremental area under the CGT curve till 90 min (iAUC T90). The iAUC T90 was 447 ± 179 and 1039 ± 178 μmol/L/min in non‐adapted and adapted SBS, respectively (P = 0.04).Conclusion An oral bolus of alanine–glutamine induces a time‐dependent rise in plasma citrulline concentration to an extent dependent on the existence of villous atrophy or enterocyte hyperplasia in CeD, and adapted SBS, respectively.
Evaluating anti‐viral drug selection and treatment duration in HBeAg‐negative chronic hepatitis B: a cost‐effectiveness analysis
Authors: VEENSTRA D. L. , SPACKMAN D. E. , BISCEGLIE A. , KOWDLEY K. V. , GISH R. G. 
Published: July 2010

SummaryBackground Several anti‐viral treatments are now available for HBeAg‐negative chronic hepatitis B (CHB), but the clinical and economic outcomes of potential treatment strategies and durations are unclear.Aim To examine the clinical and economic outcomes of potential treatment strategies and durations for HBeAg‐negative CHB.Methods We conducted a cost‐utility analysis from a payer perspective over a lifetime time horizon. Disease progression probabilities, costs and quality of life data were derived from the literature. We evaluated 5‐year, 10‐year, lifetime and 5 on–1 off treatment durations. For each of these treatment durations, we evaluated initial therapy with entecavir, lamivudine or adefovir, with addition of adefovir or entecavir for patients who developed virological breakthrough because of resistance (12 strategies total).Results Increasing treatment duration improved quality‐adjusted life‐years (QALYs) and was generally cost‐effective for all three drugs. However, a 5 on–1 off strategy was the most cost‐effective: lifetime vs. 5 on–1 off entecavir had an ICER of $148 200/QALY. In probabilistic sensitivity analyses, entecavir 5 on–1 off was the preferred strategy over the range of commonly reimbursed cost‐effectiveness thresholds. Lifetime treatment was preferred to a 5 on–1 off strategy, if treatment durability was <10%.Conclusion The results of our analysis suggest that in HBeAg‐negative CHB infection, a 5 on–1 off treatment strategy with entecavir improves health outcomes in a cost‐effective manner compared to alternative strategies.
Survival of patients with hepatocellular carcinoma in cirrhosis: a comparison of BCLC, CLIP and GRETCH staging systems
Authors: CAMMÀ C. , MARCO V. DI , CABIBBO G. , LATTERI F. , SANDONATO L. , PARISI P. , ENEA M. , ATTANASIO M. , GALIA M. , ALESSI N. , LICATA A. , LATTERI M. A. , CRAXÌ A. 
Published: July 2010

SummaryBackground  A major problem in assessing the likelihood of survival of patients with hepatocellular carcinoma (HCC) arises from a lack of models capable of predicting outcome accurately.Aim  To compare the ability of the Italian score (CLIP), the French classification (GRETCH) and the Barcelona (BCLC) staging system in predicting survival in patients with HCC.Methods  We included 406 consecutive patients with cirrhosis and HCC. Seventy‐eight per cent of patients had hepatitis C. Independent predictors of survival were identified using the Cox model.Results  One‐hundred and seventy‐eight patients were treated, while 228 were untreated. The observed mortality was 60.1% in treated patients and 84.9% in untreated patients. Among treated patients, albumin, bilirubin and performance status were the only independent variables significantly associated with survival. Mortality was independently predicted by bilirubin, alpha‐fetoprotein and portal vein thrombosis in untreated patients. CLIP achieved the best discriminative capacity in the entire HCC cohort and in the advanced untreatable cases, while BCLC was the ablest in predicting survival in treated patients.Conclusions  Overall predictive ability of BCLC, CLIP and GRETCH staging systems was not satisfactory, and was not uniform for treated patients and untreated patients. None of the scoring systems provided confident prediction of survival in individual patients.
Clinical trial design in adult reflux disease: a methodological workshop
Authors: DENT J. , KAHRILAS P. J. , VAKIL N. , VAN ZANTEN S. VELDHUYZEN , BYTZER P. , DELANEY B. , HARUMA K. , HATLEBAKK J. , MCCOLL E. , MOAYYEDI P. , STANGHELLINI V. , TACK J. , VAEZI M. 
Published: July 2010

SummaryBackground  The development of well‐tolerated acid suppressant drugs has stimulated substantial growth in the number of trials assessing therapy options for gastro‐oesophageal reflux disease (GERD).Aim  To develop consensus statements to inform clinical trial design in adult patients with GERD.Methods  Draft statements were developed employing a systematic literature review. A modified Delphi process including three rounds of voting was used to reach consensus. Between voting, statements were revised based on feedback from the Working Group and additional literature reviews. The final vote was at a face‐to‐face meeting that included discussion time. Voting was conducted using a six‐point scale.Results  At the last vote, 93% of the final 102 statements achieved consensus (defined a priori as being supported by ≥75% of the votes). The Working Group strongly supported the development of validated patient‐reported outcome instruments. Symptom assessments carried out by the investigator were considered unacceptable. There was agreement that exclusion from clinical trials should be minimized to improve generalizability, that prospective evaluation ideally requires electronic timed/dated methods and that endoscopists should be blinded to patient symptom status.Conclusions  Implementation of the consensus statements will improve the quality and comparability of trials, and make them compatible with regulatory requirements.
The haemodynamic response to propranolol in cirrhosis with arterial hypertension: a comparative analysis with normotensive cirrhotic patients
Authors: Sharma P. , Kumar A. , Jha S. , Mishra S. R. , Sharma B. C. , Sarin S. K. 
Published: July 2010

Aliment Pharmacol Ther 2010; 32: 105–112SummaryBackground  Cirrhosis with arterial hypertension is not uncommon. Haemodynamic alterations in these patients and the effects of beta‐blocker on hepatic venous pressure gradient (HVPG) and systemic haemodynamics have not been evaluated.Aims  To compare the systemic haemodynamic alterations in hypertensive and normotensive cirrhotics, and to investigate the effects of propranolol on these parameters.Methods  A retrospective analysis of consecutive hypertensive cirrhotic patients (n = 33) who underwent haemodynamic assessment and paired HVPG measurement was done. Normotensive cirrhotics (n = 50) served as controls.Results  Hypertensive patients had a significantly higher heart rate, systemic (SVRI), and pulmonary vascular resistance. There was a significant reduction in mean arterial pressure (MAP) in the hypertensive cirrhotic group from 112 (107–130) mmHg to 95 (77–114) mmHg (P < 0.01), but no change in the normotensives. SVRI remained the same in the hypertensive cirrhotic group, but it increased in the normotensives. There was no correlation between MAP reduction and HVPG reduction.Conclusions  The frequency of HVPG response with propranolol treatment in hypertensive cirrhotics is similar to normotensive cirrhotics. Propranolol treatment reduces MAP significantly in hypertensive patients with cirrhosis. Treatment with a nonselective beta‐blocker is a good strategy for hypertensive cirrhotic patients.
A comparison of the acceptance of immunochemical faecal occult blood test and colonoscopy in colorectal cancer screening: a prospective study among Chinese
Authors: Wong M. C. S. , Tsoi K. K. F. , Ng S. S. M. , Lou V. W. Q. , Choi S. Y. P. , Ling K. W. K. , Chan F. K. L. , Griffiths S. M. , Sung J. J. Y. 
Published: July 2010

Aliment Pharmacol Ther 2010; 32: 74–82SummaryBackground  Preferences to choose immunochemical faecal occult blood test (FIT) and colonoscopy as colorectal cancer (CRC) screening modalities among asymptomatic Chinese subjects remain unknown.Aim  To evaluate the preference of choosing colonoscopy vs. FIT among CRC screening participants.Methods  From a community‐based CRC screening programme for asymptomatic Hong Kong Chinese aged 50–70 years, participants attended standardized educational sessions and chose the options of annual FIT for 5 years or direct colonoscopy once. Factors associated with choosing colonoscopy were evaluated by multivariate regression analysis.Results  Among 3430 participants [mean age 56.8 years (s.d. 5.0); female 55.1%, male 44.9%], 51.3% chose colonoscopy and 48.7% chose FIT. Older participants (65–70 years) were less likely to choose colonoscopy [adjusted odds ratio (aOR) 0.731, P = 0.041]. Subjects who chose colonoscopy were those disagreed screening would lead to discomfort (aOR 1.356, P < 0.001), had relatives or friends who had CRC (first degree relatives aOR 1.679, P < 0.001; second degree relatives aOR 1.304, P = 0.019; friends or others aOR 1.252, P = 0.026) and those who self‐perceived their health as poor (aOR 1.529, P = 0.025).Conclusions  Faecal occult blood test and direct colonoscopy were equally preferable to Chinese. Colonoscopy was preferred among the younger subjects, those with positive family history of CRC and self‐perceived poor health status.
Buprenorphine versus morphine. A comparison of intra‐operative and postoperative analgesia
Authors: Green D.W. , Sinclair J.R. , Mikhael M.S. 
Published: July 2010

SummaryA randomised double‐blind trial comparing morphine and buprenorphine for intra‐operative and postoperative analgesia combined with droperidol was conducted in 60 patients. Compared with morphine, taken as the standard analgesic, buprenorphine was shown to be a satisfactory analgesic for major surgery, with no difference in the incidence of unwanted effects.
Plasma volume estimation using indocyanine green
Authors: BUSSE M. W. , ZISOWSKY S. , HENSCHEN S. , PANNING B. , PIEPENBROCK S. 
Published: July 2010

SummaryThe validity and reliability of plasma volume estimation using indocyanine green were investigated in five in vitro experiments and in three in vivo series. The in vitro measurements reflected real volumes with an error of about 1%. Comparative measurements in the same patients using indocyanine green or Cr51 labelled red cells differed by 1.7% (r = 0.97). The mean (SD) plasma volume difference between two successive plasma volume measurements using indocyanine green was 38 (43) ml (r = 0.99). Plasma volume measured before and about 7 min after a hyperosmolar saline bolus (100 ml, 1 molar) was increased by 223 (102) ml and 286 (49) ml when determined by indocyanine green and plasma protein changes respectively. Nevertheless, the necessity for central venous injection and arterial sampling restricts the possible application of the method to intra‐operative or emergency care use.
Atelectasis and oxygenation in major surgery with either propofol with or without nitrous oxide or isoflurane anaesthesia
Authors: Jensen A. G. , Kalman S. H. , Eintrei C. , Fransson S.‐G. , Morales O. 
Published: July 2010

SummaryForty‐two patients undergoing major colonic surgery were assigned at random to receive isoflurane‐fentanyl anaesthesia with nitrous oxide in oxygen, propofol‐fentanyl anaesthesia with air in oxygen or propofol‐fentanyl anaesthesia with nitrous oxide in oxygen. The groups were comparable in demographic data. Atelectases were identified, and the area measured by computerised tomography of the chest 203±69 min after extubation. and oxygenation was determined by arterial blood gas samples taken during operation at 30, 60, 90 and 120 min after extubation and on postoperative days 1, 2 and 3. Atelectases were seen in all three groups with no differences in the mean area between groups. After operation, the effect of 4 l.min−1 of oxygen by nasal catheter on Pao2 was similar in all groups. A significant decrease in PaO2 was found during the first 3 days after surgery, and was also the same in all groups. There was no correlation between area of atelectasis and postoperative PaO2. We conclude there is no difference in the incidence of postoperative atelectasis or oxygenation when using propofol, with or without nitrous oxide or isoflurane.
Mortality after spinal and general anaesthesia for surgical fixation of hip fractures
Authors: Sutcliffe A. J. , Parker M. 
Published: July 2010

SummaryOne thousand, three hundred and thirty three patients who underwent anaesthesia for surgical fixation of a hip fracture were studied prospectively to assess the effects on outcome of general and spinal anaesthesia. There were no significant differences between the groups in risk factors, length of hospital stay or mortality rates after 30 days or one year. The data presented may be useful for those wishing to audit anaesthetic services provided to patients with hip fracture.
Cardiovascular changes after achieving constant effect site concentration of propofol*
Authors: Jack E. S. , Shaw M. , Harten J. M. , Anderson K. , Kinsella J. 
Published: July 2010

SummaryTarget controlled infusions of propofol use a pharmacokinetic/pharmacodynamic model to calculate an effect site concentration of the drug. We assessed the cardiovascular stability of 10 healthy patients using non‐invasive thoracic bioimpedance and their ‘depth’ of anaesthesia using the Bispectral index after they had been anaesthetised to a constant effect site concentration of propofol (6.5 min from starting). Each patient had no surgical stimulus and received no intravenous fluid during the study period. The patients also received effect site target controlled remifentanil (steady state 2.5 min from starting) and a bolus of vecuronium to facilitate intubation and ventilation. We mathematically calculated when each measured parameter would reach a state of stability (i.e. with 95% certainty). Heart rate levelled off at 20 min, Bispectral index at 32 min, and cardiac index and mean arterial pressure at 47 min after achieving effect site stability, the final levels being, respectively, 21%, 47%, 14% and 28% lower than those at effect site stability. We conclude that cardiovascular parameters continue to change to a clinically significant degree after achieving a constant effect site concentration of propofol via target controlled infusions.
Comparative study of pig‐rodent somatic cell hybrids
Authors: Zijlstra C. , Bosma A. A. , de Haan N. A. 
Published: July 2010

SummaryThe pig chromosome complement of six different types of pig‐rodent hybrid cell lines was examined by means of fluorescence in situ hybridization with a porcine SINE probe. The cell lines were obtained by fusing pig lymphocytes with cells of the Chinese hamster cell lines wg3h, BK14‐150 and E36, and of the mouse cell lines NSO, PU and LMTK‐. The hybrids were analysed with respect to: (1) the number of pig chromosomes, (2) the type of pig chromosomes, (3) the occurrence of pig‐rodent chromosome trans‐locations, and (4) the presence of pig chromsome fragments. The results show that the number of pig chromosomes varied within and among hybrid cell lines. The pig‐hamster hybrids mainly retained nontelocentric pig chromosomes, whereas the pig‐mouse hybrids also retained telocentric pig chromosomes. Pig‐rodent chromosome translocations were found in all types of hybrids, but the incidence was in general low. Chromosome fragments were abundant in BK14‐150 hybrids, and rare in most other hybrid cell lines. It is concluded that the SINE probe is a useful tool to make a preliminary characterization of the porcine chromosome complement of pig‐rodent somatic cell hybrids. The results of this characterization can be used to select hybrids for further cytogenetic analysis. Furthermore, our data show that different rodent cell lines will have to be used as fusion partners for the production of hybrids when constructing a panel informative for all pig chromosomes.
Endotoxin-induced lung injury in α-galactosylceramide-sensitized mice is caused by failure of interleukin-4 production in lung natural killer T cells
Authors: Dagvadorj J , Tumurkhuu G , Naiki Y , Noman A S M , Iftakhar-E-Khuda I , Badamtseren B , Komatsu T , Koide N , Yoshida T , Yokochi T 
Published: July 2010

SummaryAdministration of bacterial lipopolysaccharide (LPS) known as endotoxin into α-galactosylceramide (α-GalCer)-sensitized mice causes severe lung lesions but few hepatic lesions in lethal shock, and interferon (IFN)-γ is suggested to play a pivotal role in preparation of the lung lesions. In order to clarify the mechanism of how α-GalCer sensitization causes lung lesions exclusively in mice, we examined the differential responsiveness of lungs and livers to α-GalCer sensitization. Although lung and liver natural killer T (NK T) cells both produced IFN-γ in response to α-GalCer, IFN-γ signalling was triggered only in the lungs of α-GalCer-sensitized mice. Lung NK T cells did not produce interleukin (IL)-4 in response to α-GalCer and it did not induce the expression of suppressor of cytokine signalling 1 (SOCS1) in the lungs. Conversely, IL-4 produced by liver NK T cells led to the expression of SOCS1 in the livers of the mice. Neutralization of IL-4 reduced SOCS1 expression in the livers and exacerbated LPS-induced hepatic lesions. IL-10 was produced by liver NK T cells but not lung NK T cells. However, IL-10 was produced constitutively by alveolar epithelial cells in normal lung. Lung NK T cells and liver NK T cells might express CD8 and CD4, respectively. Based on the fact that IL-4 inhibited IFN-γ signalling in the livers of α-GalCer-sensitized mice via SOCS1 expression and signal transducer and activator of transcription 1 (STAT-1) activation, no inhibition of the IFN-γ signalling in the lungs caused LPS-induced lung lesions in α-GalCer-sensitized mice. The detailed mechanism of development of the lung lesions in α-GalCer-sensitized mice is discussed.