bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacodynamic effects of single doses of rabeprazole 20 mg and pantoprazole 40 mg in patients with GERD and nocturnal heartburn
Authors: WARRINGTON S. , BAISLEY K. , LEE D. , LOMAX K. , DELEMOS B. , BOYCE M. , MOROCUTTI A. 
Published: July 2010

SummaryBackgroundRabeprazole and pantoprazole are both used for symptomatic treatment of gastro‐oesophageal reflux disease (GERD). Speed and duration of acid suppression and intensity of effect after a single dose may be important pharmacodynamic properties in clinical use.AimTo compare antisecretory effects of single doses of rabeprazole and pantoprazole in patients with GERD and a history of nocturnal heartburn.MethodsAn open‐label, randomized, two‐way crossover, clinical pharmacology study was conducted. Twenty‐nine Helicobacter pylori‐negative GERD patients (17 men, mean age 44 years), with a history of nocturnal heartburn (mean frequency 4.7 episodes/week), received a single dose of rabeprazole 20 mg or pantoprazole 40 mg, with a 14‐day ‘washout’. Intragastric pH was recorded continuously from 24 h before to 24 h after dosing.ResultsMean area under the intragastric pH–time curve (AUC) was significantly higher after dosing with rabeprazole 20 mg than with pantoprazole 40 mg in all time intervals analysed, including night (P ≤ 0.02). Mean percentage time with pH > 3 and >4 was significantly greater after rabeprazole than pantoprazole in all time intervals (P ≤ 0.004).ConclusionIn GERD patients with nocturnal heartburn, a single oral dose of rabeprazole 20 mg increased intragastric pH more than pantoprazole 40 mg did throughout the 24 h after dosing.
Change over time of bowel habit in irritable bowel syndrome: a prospective, observational, 1‐year follow‐up study (RITMO study)
Authors: GARRIGUES V. , MEARIN F. , BADÍA X. , BALBOA A. , BENAVENT J. , CABALLERO A. , DOMÍNGUEZ E. , DÍAZ‐RUBIO M. , ROSET M. , FIGUERAS M. , CUCALA M. ,   RITMO GROUP
Published: July 2010

SummaryBackgroundEvolution of bowel habit in irritable bowel syndrome (IBS) is not well known.AimTo evaluate the change over time of bowel habit in IBS patients followed‐up during 1 year.MethodsFive hundred and seventeen patients with IBS were prospectively included in an observational study with five evaluations over a 1‐year period. Symptoms were recorded daily in diary cards during four 4‐week periods along the study. Bristol Stool Scale (BSS) was used to define bowel habit.ResultsFour‐hundred patients completed the study. Rome II showed low–moderate agreement (42%) with BSS to define bowel habit. Frequency of constipation and diarrhoea showed little changes throughout the study. Over 50% of the patients had the same bowel habit when each diary was compared with the next one. A third of patients maintained the same habit throughout the study. Most changes occurred from/to mixed or unsubtyped IBS. Only 14% of cases changed from constipation to diarrhoea or vice versa. This change was associated to female gender (OR: 2.65).ConclusionsThe frequency of constipation and diarrhoea remains relatively stable over time. Changes in IBS subtypes are common, but changes between constipation and diarrhoea are rare. Alternating IBS is more frequent in women.
Is exocrine pancreatic insufficiency in adult coeliac disease a cause of persisting symptoms?
Authors: LEEDS J. S. , HOPPER A. D. , HURLSTONE D. P. , EDWARDS S. J. , MCALINDON M. E. , LOBO A. J. , DONNELLY M. T. , MORLEY S. , SANDERS D. S. 
Published: July 2010

SummaryBackgroundPatients with coeliac disease may have diarrhoea despite being on a gluten‐free diet.AimTo assess whether exocrine pancreatic insufficiency causes persisting symptoms compared with controls, we determined whether pancreatic enzyme supplementation provided symptomatic benefit in coeliac patients with chronic diarrhoea.MethodsPatients (n = 259) were subdivided into four groups: (a) new coeliac disease (n = 57), (b) coeliac disease patients on a gluten‐free diet without gastrointestinal symptoms (n = 86), (c) coeliac disease patients on a gluten‐free diet with chronic diarrhoea (n = 66) and (d) patients with chronic diarrhoea without coeliac disease (n = 50). Stool frequency and weight, before and after treatment with pancreatic enzyme supplementation were recorded.ResultsThe prevalence of a low faecal elastase‐1 within the groups was: group (A) six of 57 (11%), group (B) five of 86 (6%), group (C) 20 of 66 (30%) and group (D) two of 50 (4%). Low faecal elastase‐1 was more frequent in coeliac disease patients with chronic diarrhoea vs. other subgroups of coeliac disease (P ≤ 0.0001) and controls (P ≤ 0.0003). In 18 of 20 stool frequency reduced following pancreatic enzyme supplementation from four per day to one (P ≤ 0.001). No weight increase (P = 0.3) was observed.ConclusionsLow faecal elastase is common in patients with coeliac disease and chronic diarrhoea, suggesting exocrine pancreatic insufficiency. In this group of patients, pancreatic enzyme supplementation may provide symptomatic benefit.
Determining the proximal extent of ulcerative colitis: white cell scan correlates well with histological assessment
Authors: SUBRAMANIAN V. , BANERJEE A. , BEHARRY N. , FARTHING M. J. G. , POLLOK R. C. G. 
Published: July 2010

SummaryBackgroundAssessing the extent of ulcerative colitis determines therapeutic strategies and provides prognostic information. Colonoscopy with mucosal biopsy is considered unsafe in patients with severe disease.AimTo assess the correlation between proximal extent of ulcerative colitis as determined by Technitium‐99‐m hexamethylpropylene amine oxime labelled leucocyte scan (white cell scan) with that determined by histological assessment.MethodsOne hundred and thirty‐five patients, with histologically‐confirmed ulcerative colitis, who had a white cell scan and histological assessment of colonic inflammation within 6 months of each other, during the years 1991–2004, were included. Overall agreement, quadratic‐weighted kappa (κ) and polychoric correlations (ρ) were calculated to estimate the inter‐rater reliability.ResultsThe correlation between white cell scan and histological extent was excellent (κ = 0.7 ρ = 0.8). Macroscopic appearance on colonoscopy did not correlate as well with histological extent (κ = 0.62 and ρ = 0.67). White cell scans correlated significantly better in patients with extensive disease (P = 0.02). Colonoscopy predicted disease extent more accurately in patients with limited colitis (P = 0.002).ConclusionsProximal extent of ulcerative colitis determined by white cell scans correlates well with histological assessment especially in patients with more extensive disease. White cell scans offer a reasonable alternative to colonoscopy with mucosal biopsies in determining the proximal extent of colitis.
Efficacy and safety of short‐term adalimumab treatment in patients with active Crohn's disease who lost response or showed intolerance to infliximab: a prospective, open‐label, multicentre trial
Authors: HINOJOSA J. , GOMOLLÓN F. , GARCÍA S. , BASTIDA G. , CABRIADA J. L. , SARO C. , CEBALLOS D. , PEÑATE M. , GASSULL M. A. ,   ON BEHALF OF GETECCU GRUPO ESPAÑOL DE TRABAJO PARA EL ESTUDIO DE E. CROHN Y COLITIS ULCEROSA (SPANISH SCIENTIFIC GROUP ON CROHN'S DISEASE AND ULCERATIVE COLITIS)
Published: July 2010

SummaryBackgroundThe use of tumour necrosis factor antagonists has changed the therapeutic approach to Crohn's disease.AimTo determine response and remission rates associated with the 4‐week induction phase of adalimumab treatment in patients with luminal and/or fistulizing Crohn's disease, who have lost response to or become intolerant of infliximab.MethodsIn this multicentre, prospective, open‐label, observational, 52‐week study, 50 adults received an induction dose of adalimumab (160 mg at baseline followed by 80 mg at week 2).ResultsOf the 36 patients with luminal Crohn's disease, 83% achieved clinical response [≥70‐point reduction in the Crohn's Disease Activity Index (CDAI) score] and 42% achieved clinical remission (CDAI score <150) at week 4. Of the 22 patients with fistulizing disease, five (23%) experienced fistula remission (complete closure of all fistulas that were draining at baseline), and nine (41%) experienced fistula improvement (≥50% decrease in the number of fistulas that were draining at baseline) at week 4. Of the 19 adverse events, most [13 (68%)] were mild, and no serious or infectious adverse events occurred.ConclusionsAdalimumab may be an effective alternative in patients with luminal and/or fistulizing Crohn's disease who have lost response to or become intolerant of infliximab.
Chronic constipation: a survey of the patient perspective
Authors: JOHANSON J. F. , KRALSTEIN J. 
Published: July 2010

SummaryBackground  Constipation is a common, often chronic, gastrointestinal motility disorder characterized by such symptoms as straining, hard stool, and infrequent defecation. Published literature is limited regarding symptom prevalence, healthcare‐seeking behaviour, and patient satisfaction with traditional therapies for chronic constipation.Aim  To assess the prevalence of chronic constipation among a random sample of Americans, to identify the frequency, severity and bothersomeness of their symptoms, and to assess satisfaction levels with traditional treatments.Methods  All members (N = 37 004) of the Knowledge Networks Panel, representative of the US population, participated in a web‐based survey. Eligibility was established using a six‐question screener.Results  Of the 24 090 panellists consenting to participate, 557 met eligibility requirements and took the 45‐question survey. The most prevalent symptom was straining (79%). Hard stool and straining were the top two severe symptoms, and bloating, straining and hard stool were the top three bothersome symptoms. Symptoms affected quality of life of more than half (52%) the respondents. Among those who worked or went to school, 12% experienced reduced productivity and a mean of 2.4 days of absence in the month before the survey. Most respondents had used (96%) or were using (72%) constipation relief therapy; however, nearly half (47%) were not completely satisfied, mainly because of efficacy (82%) and safety (16%) concerns.Conclusions  Chronic constipation is common. Individual symptoms are often severe and bothersome, and many patients are dissatisfied with traditional treatment options, primarily because of lack of efficacy.
The role of screening and antibiotic prophylaxis in the prevention of percutaneous gastrostomy site infection caused by methicillin‐resistant Staphylococcus aureus
Authors: THOMAS S. , CANTRILL S. , WAGHORN D. J. , MCINTYRE A. 
Published: July 2010

SummaryBackground  Peristomal wound infections are common complications of percutaneous endoscopic gastrostomy (PEG), especially in hospitals where methicillin‐resistant Staphylococcus aureus (MRSA) is endemic. Evidence suggests that antibiotic prophylaxis at PEG insertion may reduce infection rates.Aim  To examine rates of peristomal MRSA infection before and after introduction of a screening, decontamination and antibiotic prophylaxis protocol.Methods  Retrospective case analysis detected new peristomal MRSA infections over a 33‐month period. Prospectively from October 2004, patients requiring PEG were screened and, if MRSA positive, received decontamination (5 days) and prophylactic teicoplanin before insertion. Peristomal wound sites were monitored after insertion.Results  Peristomal MRSA infection was identified in 5/42 patients (12%) in 2002, 7/35 (20%) in 2003 and 7/24 (29%) in 2004 – overall infection rate 19%. Of 47 patients undergoing new PEG insertions between October 2004 and August 2006 (four known MRSA and 10 identified by screening), one (2%) developed peristomal MRSA infection 14 days postprocedure. A significant reduction in MRSA peristomal infection has been demonstrated (P < 0.01).Conclusions  Screening for MRSA before PEG insertion identifies MRSA colonization and subsequent decontamination and antibiotic prophylaxis reduces peristomal MRSA infection rates. Where MRSA is endemic, the risk of wound site infection may remain postprocedure unless high standards of wound care are maintained.
GI Epidemiology: infection epidemiology and acute gastrointestinal infections
Authors: O’BRIEN S. J. , HALDER S. L. S. 
Published: July 2010

SummaryBackgroundGastrointestinal infection is a major cause of morbidity and mortality worldwide. The World Health Organisation estimated that in 2001 diarrheal disease was the third most common cause of mortality from infectious diseases worldwide, accounting for some 1.9 million deaths. Gastrointestinal infection is also linked to chronic diseases, for example Helicobacter pylori infection and gastric cancer.AimTo introduce the features of infection epidemiology that differentiates it from disease epidemiology in general.ConclusionThe epidemiologic study of infection is essential for disease control. Infection epidemiology requires consideration of micro‐organisms (the infection process and transmission pathways) as well as the host (clinical presentation, behavior and immune status). Although infection epidemiologists often draw on methods used in chronic disease epidemiology there are some special features of infection epidemiology that require additional investigative approaches. We have highlighted these unique features and described some of the special methods available to track infection to its source.Key Points• The epidemiologic approach to the investigation of gastrointestinal infection is influenced by the interaction between micro‐organisms and the host.• The infection epidemiologist can draw on “standard” epidemiologic techniques and on special methods.• Collaboration with microbiologists is essential for studying infection epidemiology.The purpose of this chapter is to introduce the features of infection epidemiology that differentiate it from disease epidemiology in general. Epidemiologic concepts covered in other chapters will not be repeated here, but readers should bear in mind that those methods are also available to use in the study of infection.
Programme of stepping down from twice daily proton pump inhibitor therapy for symptomatic gastro‐oesophageal reflux disease associated with a formulary change at a VA medical center
Authors: COTÉ G. A. , FERREIRA M. R. , ROZENBERG‐BEN‐DROR K. , HOWDEN C. W. 
Published: July 2010

SummaryBackgroundIn July 2001, our Veterans’ Affairs hospital changed its formulary proton pump inhibitor (PPI) from lansoprazole to rabeprazole. All patients previously receiving lansoprazole 30 mg twice daily were switched to rabeprazole 20 mg once daily.AimTo determine if patients with gastro‐oesophageal reflux disease (GERD), who were previously managed on lansoprazole 30 mg twice daily, could be maintained on rabeprazole 20 mg once daily.Patients and methodsFour hundred and thirty‐five patients had received lansoprazole 30 mg twice daily for at least 12 months before the formulary change. Medical records were reviewed for 12 months before and after the formulary change.ResultsThere were 432 men and three women with a mean age of 66.7 years (range: 38–91). Two hundred and twelve patients were excluded. Of the remaining 223, 111 (50%) were maintained successfully on rabeprazole 20 mg once daily. Twenty‐three (10%) stayed off all acid suppression during follow‐up. The number of endoscopies and clinic visits did not significantly change during the follow‐up. Fifty‐six percent who had erosive oesophagitis failed a dose taper compared with 31% of those with endoscopy‐negative GERD (P < 0.025).ConclusionsMost patients receiving twice daily PPI therapy for GERD could be maintained on once daily PPI or no acid suppression for 12 months of follow‐up. Dose reduction was more successful in those without erosive oesophagitis.
Long‐term treatment of patients with gastro‐oesophageal reflux disease in routine care – results from the ProGERD study
Authors: NOCON M , LABENZ J , JASPERSEN D , MEYER‐SABELLEK W , STOLTE M , LIND T , MALFERTHEINER P , WILLICH S. N. 
Published: July 2010

SummaryBackgroundGastro‐oesophageal reflux disease (GERD) is a common condition frequently requiring long‐term pharmacological treatment.AimTo describe the long‐term pattern of GERD medication use in GERD patients receiving routine care.MethodsPatients were recruited as part of the ongoing ProGERD study, a 10‐year‐cohort study including 6215 patients at baseline. GERD medication and symptoms were assessed with patient questionnaires. During follow‐up, medical treatment was prescribed by participating primary care physicians. Associations between patient characteristics and medication were analysed by logistic regression.ResultsThe percentage of patients who reported using any GERD medication remained constant from year 1 to year 4 (74%, 74%, 73% and 71%). Of patients who reported using GERD medication, the majority were taking proton pump inhibitors (PPI) (79%, 84%, 85%, and 87%). Continuous PPI intake was the predominant prescription pattern (53%, 49%, 56% and 56%), followed by on‐demand treatment (26%, 35%, 29% and 29%). Continuous PPI intake was strongly associated with the presence of erosive GERD.ConclusionThree‐quarters of the GERD population in our study reported long‐term treatment with a PPI. Continuous PPI intake was the predominant treatment pattern, and the proportion of patients taking a PPI on a continuous basis remained constant over time.
Barrett’s oesophagus: long‐term follow‐up after complete ablation with argon plasma coagulation and the factors that determine its recurrence
Authors: FERRARIS R. , FRACCHIA M. , FOTI M. , SIDOLI L. , TARAGLIO S. , VIGANO’ L. , GIACCONE C. , REBECCHI F. , MEINERI G. , SENORE C. , PERA A. ,   GRUPPO OPERATIVO STUDIO PRECANCEROSI ESOFAGEE
Published: July 2010

SummaryBackgroundArgon plasma coagulation seems to be a promising technique for ablation of Barrett’s oesophagus, yet few long‐term efficacy data are available.AimTo report on a long‐term follow‐up and the factors that determine the recurrence of intestinal metaplasia in a cohort of patients with non dysplastic, intestinal type Barrett’s oesophagus, after complete ablation of the metaplastic mucosa with argon plasma coagulation.MethodsNinety‐six patients underwent endoscopic argon plasma coagulation with adequate acid suppression obtained through a continuous omeprazole therapy (50 patients) or through laparoscopic fundoplication (46 patients). Complete ablation was achieved in 94 patients who underwent follow‐up. Endoscopic and histological examinations were performed every 12 months.ResultsThe median follow‐up of the patients was 36 months (range 18–98). A recurrence of intestinal metaplasia was found in 17 patients (18%), with an annual recurrence rate of 6.1%. Neither dysplasia, nor adenocarcinoma were found during the follow‐up. Through the use of logistic regression analysis, previous laparoscopic fundoplication was associated with a reduced recurrence rate of intestinal metaplasia (odds ratio 0.30, 95% confidence interval 0.10–0.93).ConclusionsThe long‐term recurrence of intestinal type Barrett’s oesophagus was low after complete ablation with argon plasma coagulation. The control of oesophageal acidity acid exposure with laparoscopic fundoplication seems to reduce the recurrence rate.
Adalimumab maintenance therapy for Crohn’s disease with intolerance or lost response to infliximab: an open‐label study
Authors: PEYRIN‐BIROULET L. , LACLOTTE C. , BIGARD M.‐A. 
Published: July 2010

SummaryBackgroundAdalimumab is effective in inducing remission in patients with active Crohn’s disease who had secondary failure to infliximab therapy.AimTo evaluate the efficacy and safety of adalimumab maintenance therapy in Crohn’s disease patients who previously responded to infliximab and then lost response or became intolerant.MethodsTwenty‐four patients with Crohn’s disease were enrolled in a 52‐week open‐label trial. The patients received a loading dose of adalimumab 80‐mg at week 0, and then 40 mg every other week starting at week 2. The primary efficacy measure was clinical remission defined as Crohn’s Disease Activity Index score < 150 at week 52.ResultsFive patients lost response to adalimumab. None of the patients experienced intolerance to adalimumab. Clinical remission rates were higher at weeks 4 (16/24, 67%) and 52 (14/24, 58%) compared with baseline (8/24, 35%) (P = 0.043 at week 52). This was accompanied by a decrease in mean C‐reactive protein concentration from 31.8 mg/mL at baseline to 9.7 mg/mL at week 52, and 3/4 (75%) patients achieved steroid‐free remission. No serious toxicities occurred in the study.ConclusionsAdalimumab is well tolerated and appears to be effective in maintaining clinical remission in patients with Crohn’s disease and lost response or intolerance to infliximab.
Pharmacological modulation of gut mucosal and large vessel blood flow
Authors: KAMM M. A. , JORDAN C. C. , LEAKER B. R. , NICHOLSON F. B. , MURRAY C. D. R. , TAYLOR S. , MARSHALL M. , GIBBS A. , CARTER E. G. , EMMANUEL A. V. 
Published: July 2010

SummaryBackgroundConstipation, diminished gut blood flow, ischaemic colitis and drug therapy may be associated.AimTo study the effect of constipating medication on, and the regulation of, gut blood flow.Methods24 healthy females (mean age 30) received, in a double‐blind, three‐way crossover study: (i) placebo, (ii) ipratropium 40 μg by inhalation (positive control known to reduce rectal mucosal blood flow) and (iii) oral loperamide 4 mg. Mucosal blood flow was measured at the splenic flexure and rectum using laser Doppler flowmetry. Blood flow in the superior and inferior mesenteric arteries was measured by trans‐abdominal Doppler ultrasound.ResultsIpratropium decreased rectal mucosal blood flow by 16% (P = 0.009) and splenic flexure mucosal blood flow by 8% (P = 0.075). Loperamide caused no change in rectal (P = 0.40) or splenic flexure mucosal blood flow (P = 0.73). Neither treatment changed superior or inferior mesenteric artery blood flow. Splenic flexure mucosal blood flow showed a positive correlation with rectal mucosal blood flow (r = 0.69; P < 0.0001).ConclusionsVasoactive agents may reduce gut mucosal blood flow in the absence of reduced large vessel flow. Constipating drugs do not necessarily reduce gut blood flow. Rectal mucosal blood flow correlates with splenic flexure mucosal flow, and potentially may be used as a more convenient surrogate for studying splenic flexure blood flow.
High dosage rifaximin for the treatment of small intestinal bacterial overgrowth
Authors: SCARPELLINI E. , GABRIELLI M. , LAURITANO C. E. , LUPASCU A. , MERRA G. , CAMMAROTA G. , CAZZATO I. A. , GASBARRINI G. , GASBARRINI A. 
Published: July 2010

SummaryBackgroundRifaximin is a broad spectrum non‐absorbable antibiotic used for treatment of small intestinal bacterial overgrowth. Doses of 1200 mg/day showed a decontamination rate of 60% with low side‐effects incidence.AimsTo assess efficacy, safety and tolerability of rifaximin 1600 mg with respect to 1200 mg/day for small intestinal bacterial overgrowth treatment.MethodsEighty consecutive small intestinal bacterial overgrowth patients were enrolled. Diagnosis of small intestinal bacterial overgrowth based the clinical history and positivity to H2/CH4 glucose breath test. Patients were randomized in two 7‐day treatment groups: rifaximin 1600 mg (group 1); rifaximin 1200 mg (group 2). Glucose breath test was reassessed 1 month after. Compliance and side‐effect incidence were also evaluated.ResultsOne drop‐out was observed in group 1 and two in group 2. Glucose breath test normalization rate was significantly higher in group 1 with respect to group 2 both in intention‐to‐treat (80% vs. 58%; P < 0.05) and per protocol analysis (82% vs. 61%; P < 0.05). No significant differences in patient compliance and incidence of side effects were found between groups.ConclusionsRifaximin 1600 mg/day showed a significantly higher efficacy for small intestinal bacterial overgrowth treatment with respect to 1200 mg with similar compliance and side‐effect profile.