bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral or intravenous erythromycin has no effect on human distal colonic motility
Authors: JAMESON J. S. , ROGERS J. , MISIEWICZ J. J. , RAIMUNDO A. H. , HENRY M. M. 
Published: July 2010

SUMMARYErythromycin is a prokinetic agent for the lower oesophageal sphincter, the stomach, the gallbladder and the small bowel, acting directly on motilin receptors. Its effect on pressure activity of the human colon has not been investigated. Eight healthy volunteers were studied on 2 occasions and given intravenous or oral erythromycin, or placebo in a single‐blind, randomized crossover study. Sigmoid pressure activity was measured using a 4‐lumen water perfused system placed sigmoidoscopically at 50, 45, 30 and 15 cm from the anal verge. The pressures were analysed for activity index (mmHg.min) for the 35 cm colonic study segment using dedicated software. No significant difference was found in the activity index following oral erythromycin (500 mg) or placebo, or following intravenous erythromycin 1.8 mg/kg or placebo. A further 8 subjects were studied in a single‐blind crossover study to determine the effect of oral erythromycin (500 mg) b.d. on colonic transit, measured with radio‐opaque markers and a single abdominal X‐ray. Mean or segmental colonic transit times were not statistically significantly different (Student's paired t‐test) in the subjects on placebo or erythromycin. This lack of effect of erythromycin on the distal large intestine may indicate the absence of receptors for motilin in that part of the gut.
Ranitidine for erosive oesophagitis: a double‐blind, placebo‐controlled study
Authors: ROUFAIL W. , BELSITO A. , ROBINSON M. , BARISH C. , RUBIN A. 
Published: July 2010

SUMMARYA multicentre, randomized, double‐blind, placebo‐controlled study was conducted to evaluate the efficacy and safety of ranitidine 150 mg and 300 mg in 342 patients with erosive oesophagitis. Treatment was given four times daily, and continued for 12 weeks or until healing (that is, normal or only erythematous mucosa). Erosive oesophagitis healing rates, as determined by endoscopy, were significantly greater in ranitidine‐treated patients by 4 weeks compared with those of placebo‐treated patients. By 12 weeks, erosive oesophagitis healing rates were 83 and 81% for ranitidine‐treated patients (150 and 300 mg, respectively) and 58% for placebo‐treated patients (P± 0.001, ranitidine vs. placebo). Symptomatic relief was achieved within 24 hours after starting either dosage of ranitidine. Heartburn frequency (P < 0.001) and severity (P < 0.001), as well as antacid consumed per week (P < 0.001), were reduced in both ranitidine groups in comparison with placebo. Healing rates and symptom relief were similar in the two ranitidine groups. Both dosages of ranitidine were well tolerated. Ranitidine (150 mg) given four times daily appears to be as effective as 300 mg ranitidine given four times daily in patients with moderate to severe oesophageal erosions.
Short report: comparison of two doses of balsalazide in maintaining ulcerative colitis in remission over 12 months
Authors: GREEN J. R. B. , SWAN C. H. J. , ROWLINSON A. , GIBSON J. A. , BROWN P. , KERR G. D. , SWARBRICK E. T. , THORNTON P. 
Published: July 2010

SUMMARYIn a four‐centre prospective double‐blind trial, 108 patients with ulcerative colitis in remission were randomized to receive balsalazide in doses of 3 g or 6 g/day for 12 months. The patients were assessed at 3‐monthly intervals clinically, sigmoidoscopically and with routine haematology and biochemistry. Remission rates of 77% (3 g/day) and 68% (6 g/day) at 12 months were not significantly different. Intolerance reactions leading to withdrawal from the study occurred in only 9 patients (8%), all occurring in the first 7 weeks of the study. Balsalazide is therefore both highly effective in maintaining remission in ulcerative colitis and well tolerated in both conventional and high dosage (the latter equivalent to 5.5 g/day of sulphasalazine). In this study no distinct advantage in maintenance of remission has been found for the higher dose of balsalazide.
The effects of flumazenil on alertness and hypoxia in elderly patients after ERCP
Authors: HAINES D. J. , BIBBEY D. , GREEN J. R. B. 
Published: July 2010

SUMMARYIt is not known whether hypoxia, associated with upper gastrointestinal endoscopic procedures when midazolam sedation is used without narcotics, persists into the post‐procedure recovery period. Thirty consecutive patients aged over 60 years, undergoing ERCP using midazolam sedation alone, were monitored clinically and by pulse oximetry before, during and for 2 hours after the procedure. They were randomized prospectively to receive either 0.5 mg flumazenil or normal saline on extubation. Results show that patients were most hypoxic in the first 30 minutes after the procedure and that mean oxygen saturation had not returned to pre‐sedation values by 2 hours. Treatment with flumazenil increased alertness 2 minutes after the procedure, and was associated with a significantly higher arterial oxygen saturation at 15 minutes.
Early evening nizatidine intake with a meal optimizes the antisecretory effect
Authors: DUROUX P. , EMDE C. , BAUERFEIND P. , BIOLLAZ J. , ARMSTRONG D. , BLUM A.‐L. 
Published: July 2010

SUMMARYThe importance of the temporal relationship between meal and nizatidine intake was studied in a six‐armed, double‐blind, placebo‐controlled trial. Eleven healthy volunteers received early (18.00 hours) or late (21.00 hours) supper, with either placebo, early (18.00 hours) nizatidine, or late (21.00 hours) 300 mg nizatidine. Ambulatory 21‐hour gastric pH‐metry was performed and plasma nizatidine concentrations were determined by high pressure liquid chromatography. Early‐nizatidine/early‐supper (median pH 2.50), but not late‐nizatidine/late supper (median pH 2.30), produced significantly higher median 21‐hour pH values than did early‐nizatidine/late‐supper (median pH 1.90). Concomitant food delayed the absorption of nizatidine but did not change the drug's bioavailability. Oral nizatidine should be taken with food, preferably early in the evening, to optimize its anti‐secretory effect.
The effect of trospium chloride on oesophageal motility
Authors: FRIELING T. , ENCK P. , DOHMANN R. , WIENBECK M. , LÜBKE H. J. 
Published: July 2010

SUMMARYTrospium chloride is a muscarinergic antagonist acting on oesophageal smooth muscle and on ganglionic and/or myenteric neurons. The effect of this drug on oesophageal motility was tested in 16 healthy male subjects in a double‐blind randomized cross‐over examination of trospium chloride or placebo following phentolamine or placebo application. Each subject underwent two separate investigations at least one week apart. Trospium chloride was effective in the oesophagus to reduce contractile activity (amplitude and duration of peristalsis) in all parts of the oesophageal body, and this effect was not blocked by phentolamine. Its potent action and its minor side‐effects appear to be promising for clinical use in patients with motility disorders such as the hypercontractile oesophagus.
Oral tobramycin in ulcerative colitis: effect on maintenance of remission
Authors: LOBO A. J. , BURKE D. A. , SOBALA G. M. , AXON A. T. R. 
Published: July 2010

SUMMARYOral tobramycin for 7 days has been shown to be of benefit as an adjunct to conventional medication in acute ulcerative colitis. Eighty‐one patients (40 who had received tobramycin; 41 placebo) who had been enrolled in a double‐blind placebo‐controlled trial of this drug in acute disease were subsequently followed to determine whether this short‐term benefit persisted. Relapse was defined as a liquid stool frequency of three times daily with rectal bleeding. Results were analysed by the log‐rank test on Kaplan‐Meier survival curves. Treatment failure was defined as a lack of response by the end of the acute trial period, or subsequent relapse. In a second analysis, only those entering remission at the end of the acute trial were considered, and followed to relapse. Although at the start of the follow‐up period significantly fewer patients in the tobramycin group had failed (failed: tobramycin 9, placebo 24; not failed tobramycin 31; placebo 17;P= 0.001), the failure‐free survival curves subsequently converged and did not differ significantly. After 1 and 2 years, the failure‐free survival rates were 40% (S.E. = 7.8%) and 20% (S.E. = 6.3%) for the tobramycin group and 24% (S.E. = 6.7%) and 12% (S.E. = 5.1%) for the placebo group. When only those entering remission were considered, there was no significant difference in the relapse rates in the two groups. Benefit from tobramycin is therefore short‐lived and may reflect short‐term changes in the faecal flora.
A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis
Authors: GREENFIELD S. M. , GREEN A. T. , TEARE J. P. , JENKINS A. P. , PUNCHARD N. A. , AINLEY C. C. , H.THOMPSON R. P. 
Published: July 2010

SUMMARYIn a placebo‐controlled study, 43 patients with stable ulcerative colitis were randomized to receive either MaxEPA (n= 16), super evening primrose oil (n= 19), or olive oil as placebo (n= 8) for 6 months, in addition to their usual treatment. Treatment with MaxEPA increased red‐cell membrane concentrations of eicosapentaenoic acid (EPA) at 3 months by three‐fold and at 6 months by four‐fold (both P < 0.01), and doubled docosahexaenoic acid (DHA) levels at 6 months (P < 0.05). Treatment with super evening primrose oil increased red‐cell membrane concentrations of dihomogamma‐linolenic acid (DGLA) by 40% at 6 months (P < 0.05), whilst treatment with placebo reduced levels of DGLA and DHA at 6 months (both P < 0.05). Clinical outcome was assessed by patient diary cards, sigmoidoscopy and histology of rectal biopsy specimens. Super evening primrose oil significantly improved stool consistency compared to MaxEPA and placebo at 6 months, and this difference was maintained 3 months after treatment was discontinued (P < 0.05). There was however, no difference in stool frequency, rectal bleeding, disease relapse, sigmoidoscopic appearance or rectal histology in the three treatment groups. Despite manipulation of cell‐membrane fatty acids, fish oils do not exert a therapeutic effect in ulcerative colitis, while evening primrose oil may be of some benefit.
Cisapride in the treatment of gastro‐oesophageal reflux disease
Authors: ROBERTSON C. S. , EVANS D. F. , LEDINGHAM S. J. , ATKINSON M. 
Published: July 2010

SUMMARYProkinetic agents are being used increasingly in medical therapy for gastro‐oesophageal reflux disease (GERD). This study examined the effect of 10 mg q.d.s., oral cisapride, or placebo, taken for 12 weeks, on 48 patients with symptoms and endoscopic evidence of GERD. Objective evaluation of benefit was obtained by endoscopy and biopsy, oesophageal manometry, acid reflux provocation test and 24‐h oesophageal pH monitoring. Cisapride significantly increased lower oesophageal sphincter pressure (P= 0.003) against baseline and also against placebo, in patients (n= 9) with an hypotensive lower oesophageal sphincter pressure (P < 0.01). The frequency of dyspeptic symptoms was significantly improved in the cisapride group (P= 0.03). Antacid intake, global evaluation of symptoms and a VAS score for symptoms were all better than placebo but failed to reach significance (global evaluation by patients, P= 0.07). Overall, there was no significant improvement in oesophagitis at either 6 weeks (P < 0.05 > 0.3) or 12 weeks (P= 0.07). However, if patients with grades I and II oesophagitis at entry were excluded, cisapride had a significantly greater effect than placebo, 6 weeks (P= 0.05), 12 weeks (P= 0.04). In those with oesophageal ulceration, cisapride was significantly more effective than placebo in inducing healing. Gastro‐oesophageal reflux was very variable on both 24‐h pH monitoring and acid reflux provocation test. In spite of a 50% decrease in acid exposure on 24‐h pH monitoring (cisapride group, mean % pH < 4 day: entry 18.9%, 12 weeks 9.6%), there were no significant intra‐ or intergroup differences for percentage of time < pH 4, or frequency and duration of episodes, neither pre‐ or post‐prandially, day or night, except for the number of post‐prandial episodes during acid reflux provocation tests, which decreased significantly more with cisapride than with placebo (P < 0.05). Thus, oral cisapride when taken for 12 weeks promoted healing of oesophagitis and improved symptoms in patients with GERD; although an increase in lower oesophageal sphincter pressure was observed and a reduction in acid reflux was measured, no significant decrease of acid exposure was seen.
Effect of methylprednisolone on small bowel spleen and liver changes in a murine model of inflammatory bowel disease
Authors: BANIĆ M. , BRKIĆ T. , ANIĆ B. , ROTKVIĆ I. , GRABAREVIĆ Z. , DUVNJAK M. , TROSKOT B. , MIHATOV Š. 
Published: July 2010

SUMMARYThe aim of this study was to evaluate the influence of methylprednisolone (1 mg/kg, i.p.) on inflammatory lesions in the small bowel, liver (pericholangitis) and spleen (lymphofollicular proliferation), in a model of inflammatory bowel disease induced by 2,4‐dinitrofluorobenzene in previously sensitized BALB‐c mice. As a parameter of corticosteroid antiinflammatory and immunosuppressive action, we simultaneously investigated its effects on mononuclear cell accumulation within the ileal lamina propria and submucosa during the observed time period (1–30 days). We noted a significant decrease in accumulation of mononuclear cells within the lamina propria (P < 0.001). An effect on mononuclear cell infiltration within the ileal submucosa was also noted but was not statistically significant. In addition, pericholangitis in the liver and lymphofollicular proliferation in the spleen were not observed in the experimental group during treatment with methylprednisolone. The results of this study indicate that the previously described model of intestinal inflammation could be used in further research of present and new therapeutic modalities for inflammatory bowel disease.
The effect of beta‐adrenoreceptor agonists and antagonists on fructose absorption in man
Authors: McINTYRE A. S. , THOMPSON D. G. , BURNHAM W. R. , WALKER E. 
Published: July 2010

SUMMARYTo explore the effect of beta‐adrenoreceptor stimulation and blockade on the extraction of monosaccharide from the upper gut, we first established the malabsorption threshold in 26 normal volunteers using a series of test meals containing varying proportions of fructose and glucose. Incomplete small intestinal extraction and consequent arrival of carbohydrate into the caecum was identified by a rise in exhaled breath hydrogen concentration. The malabsorption threshold varied between individuals from 30 to 80 g fructose (median 40 g) but was reproducible within individuals, with 90% agreement of repeat studies. The malabsorption threshold for an individual was unrelated to body height (r= 0.007, P > 0.05) or weight (r= 0.003, P > 0.05) but correlated closely with time to onset of the breath hydrogen rise of a standard meal (r= 0.70, P < 0.001). Administration of the beta‐adrenoreceptor antagonist propranolol (160 mg) reduced the quantity of fructose required to exceed the malabsorption threshold from 45, 30–60 (median and range) to 40, 30–50 g (P= 0.03); administration of the beta‐adrenoreceptor agonist isoprenaline (0.015, μg. kg/min) increased the quantity of fructose required to exceed the malabsorption threshold by 10 g (55 (50–90) g; P < 0.02). The effect of both drugs correlated closely with their transit effect (r= 0.79, P < 0.01). A beta‐adrenoreceptor mediated pathway thus appears to be capable of influencing the extraction of monosaccharide from the small intestine in normal subjects both under resting and stimulated conditions, probably acting via an effect on upper gastrointestinal motility.
Endoscopy‐related infections
Authors: SCHEMBRE D. , BJORKMAN D. J. 
Published: July 2010

SUMMARYEndoscopic procedures generate bacteraemia to different degrees. Under certain conditions, most notably valvular heart disease, clinically significant infections may occur. A large body of literature has grown around recommendations for antibiotic prophylaxis to prevent procedure‐related infections. Most of this literature is in the form of anecdotal reports. Few prospective randomized studies have been performed. In this paper, the literature on endoscopy‐related infections is reviewed. Recommendations for antibiotics from different sources are compared and a rational approach to prophylactic antibiotic therapy is presented.
Effects of indomethacin on intragastric pH and meal‐stimulated serum gastrin secretion in rheumatoid arthritis patients
Authors: JANSSEN M. , BAAK L. C. , JANSEN J. B. M. J. , DIJKMANS B. A. C. , VANDENBROUCKE J. P. , LAMERS C. B. H. W. 
Published: July 2010

SUMMARYThe effects of oral indomethacin on intragastric pH and serum gastrin were investigated in rheumatoid arthritis patients. Nine patients (1 male, 8 female) without a history of peptic ulcer disease and 6 patients with a history of peptic ulcer disease (5 male, 1 female) were studied. To obviate Helicobacter pylori infection as a confounding factor, only patients with positive H. pylori serology were included. After a 5‐day period of placebo treatment and after a 5‐day period of indomethacin (50 mg t.d.s.; total dose 750 mg), 24‐h intragastric pH and basal and meal‐stimulated serum gastrin levels were measured in a double‐blind placebo controlled cross‐over study.There were no differences in the median 24‐h pH values between placebo and indomethacin irrespective of peptic ulcer disease history. Indomethacin resulted in a higher basal and stimulated gastrin response than placebo in patients with a history of peptic ulcer disease. The basal and incremental responses were lower in patients with a history of peptic ulcer disease than in patients without a history of peptic ulcer disease, both during indomethacin and placebo. The same basal and stimulated incremental serum gastrin responses were found during placebo and indomethacin treatment in patients without a history of peptic ulcer disease. No correlation was established between median 2‐h post‐prandial intragastric pH and post‐prandial incremental serum gastrin concentration. We conclude that indomethacin does not influence the intragastric pH of rheumatoid arthritis patients irrespective of history of peptic ulcer disease.
Exocrine pancreatic secretion in man following one week of M1‐muscarinic receptor blockade
Authors: MALFERTHEINER P. , NELSON D. K. , KEMMER T. P. , GLASBRENNER B. , SCHNEIDER A. , DITSCHUNEIT H. 
Published: July 2010

SUMMARYA double‐blind, randomized, placebo‐controlled crossover study was performed to assess the influence of one week of selective M1‐muscarinic receptor blockade on pancreatic exocrine secretion in man. Ten healthy subjects received telenzepine (3 mg p.o.) and placebo each for 8 days, with a 6‐day drug‐free washout interval between treatment sequences. On Day 8 of each sequence, pancreatic secretion was stimulated for 2 h by infusion of submaximal secretin (0.2 U.kg/h) followed by maximal stimulation with secretin (1.0 U.kg/h) and ceruletide (120 ng.kg/h). Telenzepine had no significant effect on secretory parameters during submaximal stimulation with secretin. During maximal stimulation, total protein, secretory volume, and output of amylase, trypsin and bicarbonate were unexpectedly increased by telenzepine. These findings might be partially explained by removal of the inhibitory influence of pancreatic polypeptide, which was depressed by telenzepine. Acute studies have shown that M1‐receptor antagonists inhibit exocrine secretion. Our results suggest that adaptation of physiological mechanisms governing the exocrine pancreas may occur after one week of receptor blockade by a therapeutic dosage of telenzepine, to the extent that M1‐blockade no longer inhibits secretion.
Does 40 mg omeprazole daily offer additional benefit over 20 mg daily in patients requiring more than 4 weeks of treatment for symptomatic reflux oesophagitis?
Authors: BATE C. M. , BOOTH S. N. , CROWE J. P. , HEPWORTH‐JONES B. , TAYLOR M. D. , RICHARDSON P. D. I. 
Published: July 2010

SUMMARYThis study was designed to establish whether 40 mg omeprazole once daily exhibits sufficient additional efficacy over that of 20 mg omeprazole once daily in patients with symptomatic reflux oesophagitis requiring more than an initial 4‐week course of 20 mg omeprazole once daily (o.m.) to warrant routine use of the higher dose. Three hundred and thirteen patients were randomized to receive either 20 mg omeprazole (4 weeks) then 20 mg (second 4 weeks if not both healed and symptom‐free after 4 weeks), or 20 mg omeprazole (4 weeks) then 40 mg omeprazole o.m. (second 4 weeks). One hundred and twenty‐seven patients were healed and symptom‐free after 4 weeks and left the study at that point. Taking the second treatment period in isolation, the healing rate (64%vs. 45%, P < 0.02) and relief of heartburn (72%vs. 60%, P < 0.002) were greater among patients receiving 40 mg omeprazole o.m., demonstrating the existence of a dose–response relationship for omeprazole. However, on completion, there were no significant differences between the patients randomized to the 20/20 mg (healed 65%, asymptomatic 69%) or the 20/40 mg (healed 74%, asymptomatic 74%: both not significant differences compared with 20/20 mg) regimens. The magnitude of the difference in efficacy between 20 and 40 mg omeprazole in symptomatic reflux oesophagitis is insufficient to warrant the routine use of 40 mg in patients requiring more than 4 weeks' treatment with 20 mg omeprazole o.m.; continued treatment with 20 mg omeprazole for 4–8 weeks is the preferred option.
The extent and pattern of gastro‐oesophageal reflux in patients with scleroderma oesophagus: the effect of low‐dose omeprazole
Authors: SHOENUT J. P. , WIELER J. A. , MICFLIKIER A. B. 
Published: July 2010

SUMMARYAmbulatory 24‐hour oesophageal pH studies were obtained from 11 patients with scleroderma who expressed either dysphagia (n= 6) or heartburn (n= 5) as their predominant oesophageal symptom. No significant differences were found in the extent of pattern of reflux between these two groups. The pH data of both scleroderma groups were combined and compared to an age‐ and sex‐matched group of control subjects (n= 11). The reflux demonstrated by scleroderma patients was significantly greater than the control group in every category (P < 0.01). The percentage of time the pH was < 4.0 was not significantly different (P > 0.05) upright (29.9 ± 19.8%) vs. supine (44.2 ± 28.5%) in patients with scleroderma. Eight scleroderma patients underwent repeat pH studies while taking low‐dose omeprazole (20 mg daily) and reflux was reduced significantly (P < 0.01) in all patients. The authors believe that 24‐hour ambulatory oesophageal pHmonitoring should be routinely conducted in scleroderma patients to provide quantitative reflux data, even when heartburn is not expressed as a symptom. Omeprazole, 20 mg daily, provides adequate protection from the H+ component of the refluxate.