bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastric retention of sucralfate gel and suspension in upper gastrointestinal diseases
Authors: VAIRA D. , CORBELLI C. , BRUNETTI G. , MENEGATTI M. , LEVORATO M. , MULE P. , COLOMBO P. , MIGLIOLI M. , BARBARA L. 
Published: July 2010

SUMMARYThis study was designed to compare by scintigraphy the gastric retention of a new dosage form of sucralfate as gel (Gastrogel) with that of sulcralfate suspension in 25 patients with upper gastrointestinal symptoms referred for routine endoscopy. After endoscopy 4 subgroups were defined: macroscopically normal mucosa (n= 7), antral gastritis and/or erosions (n= 6), gastric ulcer (n= 6) and duodenal ulcer (n= 6). Each patient received either sucralfate gel or sucralfate suspension in equivalent doses (5 ml containing 1 g sucralfate). Both formulations were labelled with 111 MBq 99m Tc‐DTPA before administration. The mean value of t½ in the total group was significantly longer when patients were taking sucralfate gel (61.6 min) compared to sucralfate suspension (33.8 min) (P < 0.001). The mean values of t½ were significantly longer for sucralfate gel compared to sucralfate suspension also among the subgroups (macroscopically normal P < 0.02, antral gastritis P < 0.05, gastric ulcer P < 0.02 and duodenal ulcer P < 0.05). After 2 and 3 hours, the percentage residual activity in the gastric area was significantly higher following administration of sucralfate gel compared to sucralfate suspension. This study has shown that, compared to sucralfate suspension, sucralfate gel persists longer in the stomach of patients with gastritis and peptic ulcer.
Does lansoprazole influence postprandial digestive function?
Authors: VIDON N. , DUTREUIL C. , SCOULE J. C. , DELCHIER J. C. 
Published: July 2010

SUMMARYThe effects of a potent proton pump inhibitor on postprandial digestive functions were compared with those of a placebo in a double‐blind randomized crossover study. Six healthy male volunteers received 30 mg/day of lansoprazole or placebo for 7 days, with a wash‐out period of 14 days. As compared to placebo, lansoprazole induced a marked decrease of mean ± S.E.M. 3‐h gastric acid secretion from 46.8 ± 10.8 mmol to 10.9 ± 2.5 mmol (P < 0.05), and a decrease of the volume of gastric contents emptying into the duodenum from 1043 ± 139 ml to 660 ± 87 ml (P < 0.05). However, gastric emptying remained unchanged with meal gastric emptying half times of 66 ± 5 min and 67 ± 13 min, respectively. During the 3‐h postprandial period, duodenal lipase and chymotrypsin outputs were 366 ± 123 KIU and 56 ± 11 KIU with lansoprazole and 436 ± 119 KIU and 49 ± 8 KIU with placebo (N.S.). Bile acid outputs were 5.3 ± 0.7 mmol and 6.0 ± 1.0 mmol, respectively (N.S.) There was no change in kinetic profiles of biliarypancreatic secretion. We conclude that potent inhibition of gastric secretion by chronic administration of a proton pump inhibitor at usual therapeutic dose alters neither meal gastric emptying nor postprandial biliary‐pancreatic secretion.
Cisapride and ranitidine in the treatment of gastro‐oesophageal reflux disease—a comparative randomized double‐blind trial
Authors: ARVANITAKIS C. , NIKOPOULOS A. , THEOHARIDIS A. , GIANNOULIS E. , VAGIOS I. , ANTHOPOULOU H. , MICHAILIDIS D. , TOURKANTONIS A. 
Published: July 2010

SUMMARYForty patients with gastro‐oesophageal reflux disease and oesophagitis, documented by endoscopy (grades I to III by the Savary‐Miller classification) were randomized to participate in a comparative doubleblind trial to receive cisapride (10 mg q.d.s.) or ranitidine (150 mg b.d.) for an 8‐week period. Upper gastrointestinal endoscopy was performed immediately before the entry to the trial and after the 8‐week period at the completion of the trial. The evaluable cohort included 37 patients who completed the trial, 18 in the cisapride group and 19 in the ranitidine group. Three patients were withdrawn from the trial; one on ranitidine developed severe anaphylactic reaction, one on cisapride severe dizziness and one on cisapride did not wish to continue on the trial. The results of the trial, regarding symptomatic and endoscopic improvement were comparable in the two groups. Both drugs were effective in controlling symptoms, such as acid regurgitation, retrosternal pain, retrosternal burning, epigastric fullness and discomfort (pain, burning, sense of pressure) and resulted in endoscopic healing of oesophagitis. With few exceptions, symptoms remained in remission 1 month after treatment in the majority of patients. Globally, both drugs were tolerated comparably, and adverse effects other than those which resulted in the withdrawal from the trial were minimal in both groups. The results of this trial indicate that cisapride and ranitidine, although of different pharmacological action, are comparable in their therapeutic effect in symptomatic improvement and endoscopic healing in patients with mild to moderate gastro‐oesophageal reflux disease.
Rolling review: gastrointestinal malignancy
Authors: LUK G. D. 
Published: July 2010

SUMMARYThe chemotherapy of gastrointestinal malignancies remain mostly investigational, although several adjuvant protocols in colorectal cancer and anal cancer are beginning to be accepted as standards against which newer regimens are to be compared. Chemotherapy regimens are best understood and appreciated with a basic understanding of cancer biology, tumour cell kinetics, and drug toxicities. An appreciation of chemotherapy‐induced toxicity and an awareness of their management will help the gastroenterologist be an active participant in the multidisciplinary team caring for the patient with gastrointestinal malignancies.
Proton pump inhibitors, enterochromaffin‐like cell growth and Helicobacter pylori gastritis
Authors: SOLCIA E. , VILLANI L. , LUINETT O. , FIOCCA R. 
Published: July 2010

SUMMARYIn both rodents and humans the development of gastrin‐promoted gastric argyrophil enterochromaffin‐like cell carcinoids requires the involvement of a genetic factor inherent to multiple endocrine neoplasia syndrome or of type A autoimmune chronic atrophic gastritis. Prolonged severe hypergastrinaemia acting on non‐gastritic mucosa, as in Zollinger‐Ellison syndrome patients, results in diffuse argyrophil enterochromaffin‐like cell hyperplasia but, as a rule, does not produce tumours. Combination of chronic atrophic gastritis (mostly related to Helicobacter pylori infection) with hypergastrinaemia frequently causes linear and micronodular hyperplasia of argyrophil cells, whereas carcinoids are exceptional. No tumours or preneoplastic lesions have been observed in patients treated long‐term with proton pump inhibitors, apart from rare cases in patients with combined Zollinger‐Ellison and multiple endocrine neoplasia syndromes. A moderate increase in the incidence of argyrophil cell clustering, with or without hyperplasia, probably results from the parallel evolution of ulcer‐associated Helicobacter gastritis into chronic atrophic gastritis. Eradication of H. pylori with a combination of proton pump inhibitors and antibiotics suppresses gastritis and prevents ulcer recurrence.
Prospective study of the long‐term efficacy and safety of lansoprazole in patients with the Zollinger‐Ellison syndrome
Authors: JENSEN R. T. , METZ D. C. , KOVIACK P. D. , FEIGENBAUM K. M. 
Published: July 2010

SUMMARYThe long‐term safety and efficacy of lansoprazole were studied in 21 patients with Zollinger‐Ellison syndrome. The initial maintenance dose was determined by acid inhibition studies. In all patients lansoprazole controlled gastric acid hypersecretion and peptic symptoms in both the short and long term. Patients were treated for a mean of 31 months (range 1–43 months) with all but 4 patients followed for > 18 months. The mean initial dose was 60 mg/day, with 2 patients requiring a twice daily dose and the others a single daily dose. During long‐term treatment 6 patients required an increased dosage, 5 within the first year. Long‐term maintenance doses were reduced in 5 of the 6 patients in whom this was attempted. No changes in serum gastrin concentration, haematological parameters, liver function studies or other biochemical parameters occurred due to lansoprazole. No patient developed a gastric carcinoid tumour while being treated with lansoprazole. These results demonstrate that long‐term treatment with lansoprazole is both safe and effective in patients with Zollinger‐Ellison syndrome, and suggest that this drug will be useful in such patients. Furthermore, maintenance doses of lansoprazole, determined by the currently recommended method of acute acid titration studies in patients with Zollinger‐Ellison syndrome, are too high.
An open trial of long‐term therapy with lansoprazole in patients with peptic ulceration resistant to extended high‐dose ranitidine treatment
Authors: BRUNNER G. , ARNOLD R. , HENNIG U. , FUCHS W. 
Published: July 2010

SUMMARYForty‐two patients with peptic ulceration of the duodenum, stomach or oesophagus, who had not responded to 3 or more months of high‐dose treatment with ranitidine (450 or 600 mg/day), were treated with oral lansoprazole at 30–60 mg daily. In 40 patients (95.2%) the ulcers healed within 2–12 weeks. In the remaining 2 patients healing took several months but eventually all ulcers healed. After healing, 40 patients underwent long‐term maintenance treatment with 30–60 mg lansoprazole daily for 1–3 years (continuing). During maintenance therapy with lansoprazole, no endoscopically verified relapses occurred when the drug was taken regularly. In 1 patient treatment had to be discontinued because of a drug‐related colitis that disappeared soon after treatment had been stopped. There were no significant changes in routine laboratory tests in any patient. Basal serum gastrin concentrations, which were already elevated by the previous high‐dose ranitidine treatment (125 ± 25 pg/ml), rose to four times the normal values after 4 weeks of treatment with lansoprazole (255 ± 65 pg/ml). Thereafter no further increases in basal serum gastrin concentrations were observed, even after 3 years of administration. The volume density of argyrophilic cells in the oxyntic mucosa increased slightly during lansoprazole treatment; until now no dysplasia of the enterochromaffin‐like cells has been observed. In conclusion, 30–60 mg lansoprazole daily healed ranitidine‐resistant peptic ulcers, and subsequent maintenance therapy with 30–60 mg lansoprazole daily was found to be highly effective and safe over the time observed.
Pharmaco‐economic considerations in the long‐term management of peptic ulcer disease
Authors: RUSZNIEWSKI P. 
Published: July 2010

SUMMARYPharmaco‐economic consequences of available therapeutic strategies in the management of duodenal ulcer disease are of increasing importance. Terminology and methodology in economic evaluation need to be clarified : direct and indirect costs of duodenal ulcer disease have to be calculated, and results expressed in terms of efficacy, utility or benefits. The economic analysis then compares costs or cost‐effectiveness ratios of various strategies. Macroeconomic evaluations conducted in France have shown that the overall cost of duodenal ulcer disease was FF 3.5 billion in 1987 in private practice. Several evaluations have shown that indirect costs accounted for more than 50% of the total expense. From a microeconomic point of view, several studies have been conducted with ranitidine and cimetidine. Our own study has shown that one year of treatment with ranitidine 150 mg/day resulted in a decrease in the use of medical resources (clinic visits, endoscopic investigations, duration of hospital stay) and work days lost, when compared with placebo. This resulted in a smaller cost of the ranitidine strategy (FF 2031 per patient for one year for the community, vs. FF 2823 for the placebo strategy). Similar cost‐effectiveness ratios for the ranitidine strategy have been shown in the USA. Costs savings have also been demonstrated during long‐term treatment with cimetidine for up to 3 years. Studies performed according to Markov's chain model have shown that the costs of continuous and intermittent treatments are identical, the expenses related to investigations and mortality being greater with the latter. More studies are warranted to evaluate the efficiency of the different strategies used in the treatment of duodenal ulcer disease. Available studies show that continuous treatment with an H2‐receptor antagonist is a cost‐effective management option.
Review article: controversies in NSAID‐induced gastroduodenal damage‐do they matter?
Authors: FENN G. C. 
Published: July 2010

SUMMARY Background. This article reviews various issues surrounding NSAID‐induced gastroduodenal ulceration, about which there appear to be conflicting views and data in the literature. These issues include the size, clinical relevance and main site of the problem; when complications occur (early or late?); the relevance of non‐ulcer lesions and whether adaptation is a clinically relevant phenomenon. Method. A comprehensive literature search was carried out to identify relevant new data published since 1987. Results. NSAIDs are causally associated with more gastric than duodenal ulcers but their use may be associated with duodenal ulcers or complications. Erosive lesions may progress to more severe damage. The theories of early or late onset of complications during a course of NSAID therapy may not be mutually exclusive. Conclusions. Available data indicate that NSAID ulcers are at least as dangerous as classic peptic ulcers, and result in significant morbidity and mortality which in the patient population does not appear to be significantly reduced by processes such as adaptation.
Famotidine increases plasma alcohol concentration in healthy subjects
Authors: BURNHAM D. B. , MILLER D. , KARLSTADT R. , FRIEDMAN C. J. , PALMER R. H. 
Published: July 2010

SUMMARYThe effect of famotidine on plasma alcohol concentration was studied in 24 healthy male subjects who demonstrated high apparent ethanol first‐pass metabolism after oral (p.o.) and intravenous (i.v.) ethanol administration (i.e. AUCpo S 40% of AUCiv, where AUC is area under the plasma ethanol concentration‐time curve). Six of the original 30 subjects screened (20%) did not demonstrate high first‐pass metabolism and were excluded. In a randomized open crossover study, oral ethanol pharmacokinetics were assessed after breakfast in the morning following a 3‐day regimen of famotidine, 40 mg/day, and following a no‐drug control period. Famotidine increased the area under the plasma ethanol concentration‐time curve (AUC0‐t) by 29% (7.1 vs 5.5 mg.h/dL, P= 0.006) and maximal plasma concentration (Cmax) by 23% (9.2 vs 7.5 mg/dL, P= 0.013). The changes in ethanol AUC0‐t and Cmax may have been associated with changes in gastric emptying, as they were inversely correlated with changes in the time at which maximal plasma concentration was attained. There was considerable intra‐individual variation in ethanol AUC and Cmax. As a result, regression to the mean is a potentially confounding problem in ethanol pharmacokinetic studies when subjects are selected on the basis of having low AUCpo, and properly controlled randomized studies of substantial size are required to detect modest drug effects. Small effects on ethanol pharmacokinetics have now been demonstrated with all four of the major H2‐receptor antagonists, but these effects are seen only under specific experimental conditions and appear to be unimportant clinically.
Zollinger‐Ellison syndrome and antral G‐cell hyperfunction in patients with resistant duodenal ulcer disease
Authors: ANNIBALE B. , DE MAGISTRIS L. , CORLETO V. , D'AMBRA G. , MARIGNANI M. , IANNONI C. , DELLEFAVE G. 
Published: July 2010

SUMMARYWe measured basal and pentagastrin‐stimulated acid secretion, as well as basal and meal‐stimulated plasma gastrin concentration to determine, in 67 patients affected by resistant duodenal ulcer, whether their condition could be related to gastric acid secretion and/or gastrin‐related syndromes. We then compared them to 46 duodenal ulcer control patients. The outpatients were investigated consecutively. The resistant duodenal ulcer patients differed from the controls only in their higher complication rates (bleeding or perforation, P < 0.05). We identified five patients in the resistant duodenal ulcer group with Zollinger‐Ellison syndrome and 12 with antral G cell hyperfunction, whereas in the control group only one patient was affected by antral G cell hyperfunction. IgG anti‐Helicobacter pylori antibodies were positive for the presence of infection in 7 of the hypergastrinaemic patients. When Zollinger‐Ellison syndrome or antral G cell hyperfunction were excluded, no differences could be found in gastric acid secretion, or basal and meal‐stimulated plasma gastrin levels, between the resistant and control duodenal ulcer patients, except for basal acid hypersecretion (resistant duodenal ulcer 16%vs duodenal ulcer 2%P= 0.0144). In the presence of duodenal ulcer disease resistant to H2‐blockers, it is mandatory to measure basal plasma gastrin concentration since it was possible to diagnose the gastrin‐related syndromes, Zollinger‐Ellison syndrome and antral G cell hyperfunction, in 26% of this group of patients.
Short report: clarithromycin, an alternative to metronidazole in the triple therapy of Helicobacter pylori infection
Authors: THIJS J. C. , VAN ZWET A. A. , MOOLENAAR W. , OOM J. A. J. , DE KORTE H. , RUNHAAR E. A. 
Published: July 2010

SUMMARY Background: Triple therapy for Helicobacter pylori using metronidazole is less effective in patients with a metronidazole resistant strain. Moreover, metronidazole is responsible for many side‐effects. This open study examined the efficacy and side‐effects of a triple treatment regimen substituting clarithromycin for metronidazole. Methods: 36 patients with a H. pylori infection, proven by culture, were treated with tripotassium dicitrato bismuthate 120 mg q.d.s., tetracycline 250 mg q.d.s. and clarithromycin 250 mg q.d.s. for 10 days.Eradication was defined as a negative culture and histological examination of antral biopsy specimens, taken at least 6 weeks after completion of the treatment. Results: Eradication was achieved in 26 patients (72%). The treatment was well tolerated with only 4 (11 %) of the patients having significant side‐effects. Conclusion: Triple therapy with clarithromycin seems to be less effective than standard triple treatment when the prevalence of metronidazole resistance is low. It is suggested, however, that this combination could be a valuable alternative in areas with a high prevalence of metronidazole resistance.
Short report: long‐term management of peptic ulcer disease with ranitidine in Germany
Authors: SIMON B. , SCHÜTZ E. , MÜLLER P. , DIXON J. S. 
Published: July 2010

SUMMARYOne hundred and twenty‐five patients with duodenal ulcer disease were given continuous ranitidine therapy after initial acute healing. Cumulative remission rates indicated that 95 % of patients were ulcer‐free after 1 year, 89% at 2 years, 81% at 3 years, 70% at 4 years and 60% at 5 and 6 years. Nine patients had a second recurrence after healing of the first. No patient developed an ulcer complication. These results support the view that long‐term continuous ranitidine therapy prevents ulcer recurrence and complications.
Comparative effects of H2‐receptor antagonists on subjective and objective assessments of sleep
Authors: ORR W. C. , DUKE J. C. , IMES N. K. , MELLOW M. H. 
Published: July 2010

SUMMARYBackground:Clinically, it is common for patients to experience drowsiness in association with consumption of H2receptor antagonists. Reported side‐effects with H2‐receptor antagonists include insomnia and somnolence. The present study was designed to assess and compare the effects of three H2‐receptor antagonists (cimetidine, famotidine, and ranitidine) on nocturnal and daytime sleepiness.Methods: This is a double‐blind crossover study on 12 normal volunteers. Subjects were studied under conditions of placebo, cimetidine (400 mg b.d.), famotidine (20 mg b.d.), and ranitidine (150 mg b.d.) for one week. Sleep was assessed at the end of each one‐week interval via polysomnographic evaluation conducted on nights 6 and 7 of drug administration. On the day between the two nights in the sleep laboratory, a multiple sleep latency test was conducted.Results: The results revealed a significant reduction in the sleep onset latency with famotidine administration, but since there were no effects of any of the medications in the multiple sleep latency test, this finding is of dubious clinical significance. Cimetidine revealed a small increase in subjective estimates of sleepiness. No effects on sleep‐related respiratory parameters were noted.Conclusions: This study demonstrates the lack of effect of peripheral administration of H2‐receptor antagonists on sleep stages, while subjective or objective assessment of daytime alertness revealed small effects of famotidine and cimetidine.
Short report: the effect of misoprostol on the anaemia of NSAID enteropathy
Authors: MORRIS A. J. , MURRAY L. , STURROCK R. D. , MADHOK R. , CAPELL H. A. , MACKENZIE J. F. 
Published: July 2010

SUMMARY Background: Small bowel ulceration is an increasingly recognised complication of therapy with non‐steroidal anti‐inflammatory drugs (NSAID). The ulceration is a potent site of blood loss contributing to unexplained iron deficiency anaemia in patients with arthritis. No drug is currently available to treat NSAID small bowel ulcers. Methods: We have retrospectively examined the effect of therapy with the prostaglandin El analogue misoprostol on the anaemia of patients with enteroscopically proven NSAID small bowel enteropathy. Results: All of the patients had proven iron deficiency anaemia. Eleven patients received misoprostol and ten received no treatment. Haemoglobin in the misoprostol‐treated group rose significantly from median (range) 9.1 (6.2–10.6) g/dL (95% confidence intervals 8.76, 10.13) to 10.6 (6.5–16.8) g/dL (95% confidence intervals 10.06, 11.82); P= 0.004). Those patients who did not receive misoprostol had no significant change in their haemoglobin: 9.1 (7.5–10.6) g/dL to 8.1 (5.6–14.7) g/dL (P= N.S.). Conclusion: Misoprostol therapy was associated with an improvement in the anaemia in patients with proven NSAID enteropathy.
Review article: orthograde gut lavage for colonoscopy
Authors: BERRY M. A. , DiPALMA J. A. 
Published: July 2010

SUMMARYMost colon cleansing regimens for surgical and diagnostic procedures such as colonoscopy are modifications of older barium enema X‐ray preparations which have evolved in gastrointestinal laboratories influenced by empiric experience. Recent formal study allows for careful comparison of gut lavage, diet and cathartic, and oral sodium phosphate preparations. This review will evaluate oral lavage solutions and address their safety, tolerance and efficacy. Administration options are discussed as well as other diet and cathartic methods previously referred to as ‘standard preps’.