bluuebunny/crossref_metadata_2025_split huggingface dataset:
A model of an ‘artificial stomach’ for assessing the characteristics of an antacid
Authors: VATIER J. , LIONNET F. , VITRÉ M. T. , MIGNON M. 
Published: July 2010

SUMMARYA model of an ‘artificial stomach’ has been constructed in order to take into account some of the parameters lacking in conventional in vitro antacid evaluation, namely the interaction between secretory flux and variation in emptying fluxes, the presence of proteins, and the use of human gastric juice instead of an aqueous solution of hydrochloric acid.The ‘artificial stomach’ has two elements, the ‘stomach’ and the pH recording system. The ‘stomach’ includes a ‘gastric’ reservoir receiving secretory flux and is emptied by variable fluxes.Aluminium phosphate gel has been studied in 100 ml of 0.1 n HCl, without and with 1 or 5% meat extracts and also in 100 ml of human gastric juice. The antacid effect of 1 or 5% meat extracts has also been assessed.The antacid effect of aluminium phosphate was characterized by the pH rise of the ‘gastric’ contents, the buffering capacity, and the dilution of gastric contents. These factors were modulated by emptying fluxes. The same characteristics were found when antacid was studied in gastric juice. Proteins exerted a neutralizing effect and modified aluminium phosphate's antacid capacity. A mechanism for buffering capacity by cation aluminium is suggested.
The effect of food on ranitidine‐induced inhibition of nocturnal gastric secretion
Authors: JOHNSTON D. A. , WORMSLEY K. G. 
Published: July 2010

SUMMARYOvernight gastric secretion of acid and pepsin was studied in nine, healthy, male volunteers on two separate occasions, in randomized order. On one day, each individual received a standard meal at 18.00 hours, followed by an oral dose of 300 mg ranitidine at 18.15 hours. During the second study, 300 mg ranitidine was again taken at 18.15 hours, but the meal was consumed at 22.00 hours.Gastric juice was sampled hourly from 19.00 to 24.00 hours and then aspirated completely and continuously until 08.00 hours the next morning. Median pH values were significantly lower and median acidity was significantly higher, when the meal was eaten at 22.00 hours. The outputs of acid and pepsin after midnight were also significantly greater following the late night meal.It seems that food interferes with the gastric inhibitory effects of the currently used H2‐receptor antagonists, such as ranitidine. We conclude that H2‐receptor antagonists must be taken after the last meal of the day in order to ensure maximal therapeutic efficacy.
Double‐blind study of an α2agonist in the treatment of irritable bowel syndrome
Authors: PRIOR A. , WILSON K. M. , WHORWELL P. J. 
Published: July 2010

SUMMARYA double‐blind crossover trial of the α2agonist lidamidine hydrochloride in 72 patients with irritable bowel syndrome is reported. Lidamidine was found to have no significant effect on frequency and severity of abdominal pain or abdominal bloating. It did cause a statistically significant reduction in frequency of defaecation (P= 0.005), but this was of a degree unlikely to be of clinical importance. Although α2agonists inhibit gastrointestinal motility in animals this study suggests that lidamidine hydrochloride does not have a useful therapeutic role in irritable bowel syndrome.
Diagnosis of gastrointestinal lesions during treatment with non‐steroidal anti‐inflammatory drugs
Authors: FESTEN H. P. M. 
Published: July 2010

SUMMARYProbably all non‐steroidal anti‐inflammatory drugs (NSAIDs) increase the risk of gastrointestinal (GI) mucosal injury. The most frequent lesions are gastric erosions in the pre‐pyloric region. Non‐steroidal anti‐inflammatory drugs also increase the incidence of peptic ulcers, although it is not yet clear whether more gastric ulcers or more duodenal ulcers are produced. Gastrointestinal symptoms are prevalent during NSAID treatment, but there is no correlation between symptoms and lesions. Clinical presentation may therefore vary considerably: many symptomatic patients will have no lesions, whereas others will present with complications but no symptoms. Blood loss is the most frequent complication of NSAID‐induced GI lesions. Bleeding is usually 'silent’and occult. Overt haemorrhage, though rare, is more frequent in patients taking NSAIDs. Other complications, such as penetration and perforation, may also occur. Endoscopy is the diagnostic method of choice, as this method can detect even superficial mucosal lesions. However, because of the lack of correlation between symptoms and lesions, it is difficult to ascertain which patients are at risk and thus to avoid unnecessary diagnostic procedures. Future efforts should therefore be directed towards the prevention of NSAID‐induced GI lesions.
The effect of secretin on sodium ion absorption by the isolated human gallbladder
Authors: JACYNA M. R. , ROSS P. E. , HOPWOOD D. , BOUCHIER I. A. D. 
Published: July 2010

SUMMARYSodium ion (Na+) transport, a principal function of the gallbladder epithelium, was studied by measuring the flux of22Na across isolated human gallbladder mucosa maintained in a modified‘Ussing’flux chamber. Tissue was obtained from cholecystectomy specimens in symptomatic patients with cholelithiasis. Out of 26 gallbladders studied, 13 had a net Na+flux from mucosa to serosa which indicated active Na+absorption. The hormone secretin, when added to the serosal fluid, reversed the direction of net flux in these gallbladders and caused a secretion of Na+from serosa to mucosa. These results suggest that secretin may be involved in the physiological regulation of fluid transport in the human gallbladder, and also suggest a possible role for this hormone in gallbladder emptying.
The effect of a new selective a2‐adrenoreceptor antagonist, idazoxan, and the agonist, clonidine, on fasting antroduodenal motility in healthy volunteers
Authors: GREGERSEN H. , KRAGLUND K. , RITTIG S. , TØTTRUP A. 
Published: July 2010

SUMMARYStudies were carried out on 16 healthy male volunteers to investigate whether intravenous administration of the α2‐adrenoreceptor antagonist, idazoxan, could affect fasting antroduodenal motility with and without administration of the agonist, clonidine. Contractile activity was recorded using an oral tube with perfused side holes positioned in the stomach and duodenum.Clonidine decreased antral contractile activity, an effect that idazoxan did not restore. Idazoxan alone did not affect antral motility. In the duodenum, clonidine decreased the number of contractions significantly and idazoxan restored them. Idazoxan alone did not increase duodenal motility but clonidine induced phase‐III activity within the first 15 min after administration.The observations indicate that regulation of antroduodenal motility is influenced by α2‐adrenoreceptor drugs. Idazoxan may have potential as a motility restoring drug, for example, in postoperative ileus.
Mesalazine in childhood inflammatory bowel disease
Authors: BARDEN L. , LIPSON A. , PERT P. , WALKER‐SMITH J. A. 
Published: July 2010

SUMMARYA study was undertaken in paediatric patients suffering from ulcerative, Crohn's or indeterminate colitis. This aimed to compare the occurrence and tolerance of side‐effects arising during treatment with position‐release mesalazine (Asacol) with those occurring during previous treatment with sulphasalazine (Salazopyrin). The drugs were used to maintain remission from colitis. The occurrence of adverse reactions was also monitored.Sixty‐seven children were assessed for a period of 6 months; 45 of these children received mesalazine after previous treatment with sulphasalazine.The results show that the majority of patients were maintained in remission with either drug, but they reported a preference for position‐release mesalazine with respect to ease and frequency of administration when compared to sulphasalazine.No serious adverse reactions arose during mesalazine treatment, compared with three such events during previous sulphasalazine treatment.
Review article: hypoxia and hepatic drug metabolism—clinical implications
Authors: ANGUS P. W. , MORGAN D. J. , SMALLWOOD R. A. 
Published: July 2010

SUMMARYMost major pathways of hepatic drug metabolism are dependent on oxygen. Hepatic mixed‐function oxidases use oxygen directly as a substrate, while many other enzyme systems are indirectly dependent on oxygen for the generation of essential co‐factors, such as NAD‐and ATP. Studiesin vitroshow that many of these oxygen‐dependent reactions are impaired by relatively minor reductions in oxygen supply, of a magnitude likely to be encounteredin vivo.Phase I metabolism by mixed‐function oxidases appears to be more sensitive to hypoxia than phase II drug conjugation, although the oxygen requirements of conjugation reactions, such as glucuronidation, may be greatly enhanced by poor nutrition or fasting. Studies in humans are few, but in general they affirm the potential importance of the effects of hypoxaemic states on hepatic drug elimination. On present evidence, special care should be taken in hypoxic patients with drugs extensively metabolized by the liver, particularly those which have a low therapeutic ratio.
Effect of propranolol on secretin‐induced gastrin release and secretin‐induced tachycardia in patients with the Zollinger‐Ellison syndrome
Authors: GOLDSCHMIEDT M. , REDFERN J. S. , FELDMAN M. 
Published: July 2010

SUMMARYThe mechanism for secretin‐induced gastrin release in the Zollinger‐Ellison syndrome is uncertain. We evaluated whether the stimulatory effect of intravenous secretin on gastrin release was partly mediated through a beta‐adrenergic stimulatory mechanism. Serum gastrin concentrations and heart rate were monitored in six patients with the Zollinger‐Ellison syndrome. Secretin (2 clinical units/kg) increased mean serum gastrin concentrations from 1558 pg/ml basally to a peak of 3683 pg/ml (136% above baseline). This increase was not altered by pretreatment with 2 mg of propranolol intravenously, a dose which in previous studies blocked terbutaline‐induced gastrin release. Secretin increased heart rate by 14 beats/min (20% above base‐line) and this also was not altered by propranolol pretreatment. Thus, the stimulatory effects of secretin on gastrinoma cells and the heart do not appear to be mediated by beta‐adrenergic receptors.
Long‐term maintenance treatment of gastric ulcers with ranitidine
Authors: PENSTON J. G. , WORMSLEY K. G. 
Published: July 2010

SUMMARYOne hundred and twenty patients with gastric ulcer disease, who had been receiving maintenance treatment with ranitidine (150 or 300 mg/day) for periods up to 7 years, were studied retrospectively. The proportion of patients remaining free from symptomatic recurrence of ulcer during maintenance treatment was 97% after 1 year; 90% after 3 years; and 79% after 5 years. No patient developed haemorrhage or perforation during maintenance treatment. None of the demographic features was shown to be associated with a significantly increased risk of ulcer recurrence during maintenance treatment.Comparison of the recurrence rates during maintenance treatment with those during periods without active anti‐ulcer therapy, using life table and incidence density analysis, showed a significant difference in favour of maintenance treatment.We conclude that maintenance treatment with ranitidine for 5 years significantly reduces the risk of symptomatic ulcer recurrence in patients with gastric ulcer.
Review article: asymptomatic duodenal ulcers—implications of heterogeneity
Authors: PENSTON J. G. , WORMSLEY K. G. 
Published: July 2010

SUMMARYThe present review examines the evidence for the existence of an asymptomatic variant of duodenal ulcer disease, as well as its clinical significance and therapeutic implications. Asymptomatic duodenal ulcers have definitely been shown to occur only in patients treated with nonsteroidal anti‐inflammatory drugs (NSAIDs) and in patients who have previously suffered from ulcer disease, especially if the latter have been subjected to gastric surgery or are receiving long‐term continuous (maintenance) treatment with drugs. It seems likely (although conclusive evidence is not yet available) that NSAID‐associated asymptomatic duodenal ulcers are predisposed to haemorrhage or perforation and should therefore be healed and kept in remission. Asymptomatic duodenal ulcers discovered during maintenance treatment appear to be clinically innocuous and do not therefore indicate therapeutic failure, nor require modification of therapy.
Tripotassium dicitrato bismuthate enemas in the treatment of ulcerative proctitis
Authors: SRIVASTAVA E. D. , SWIFT G. L. , WILKINSON S. , WILLIAMS G. T. , EVANS B. K. , RHODES J. 
Published: July 2010

SUMMARYEleven patients with active proctitis or proctosigmoiditis completed one month's treatment with tripotassium dicitrato bismuthate enemas administered at night. Symptoms, sigmoidoscopic appearances, and the histological grade of acute inflammation were assessed at the commencement of therapy and after one month. An overall score of these features showed improvement in 9 of 11 patients, which encourages further investigation of bismuth in controlled trials for patients with inflammatory bowel disease.
Review article: the pharmacological implications of leucocyte–endothelial cell interactions in Crohn's disease
Authors: SAWYERR A. M. , WAKEFIELD A. J. , HUDSON M. , DHILLON A. P. , POUNDER R.E. 
Published: July 2010

SUMMARYThe importance of leucocyte–endothelial cell interactions in the inflammatory process is now recognized. In Crohn's disease, we have proposed that these interactions mediate not only the development of the parenchymal cell infiltrate, but also initiate a process (multifocal gastrointestinal infarction) that leads to ischaemic damage to the bowel wall. We review data on the actions of drugs in the treatment of Crohn's disease and, where known, we highlight their effects on leucocyte adhesion to the endothelium. Corticosteroids inhibit adhesion by inhibiting production of interleukin‐1, tumour necrosis factor, interferon gamma, leukotrienes and platelet activating factor. Drugs liberating 5‐aminosalicylate inhibit leukotriene production. Cyclosporin inhibits T‐cell activation, and amplification of the immune response. Inhibition of leucocyte–endothelial cell interactions probably accounts for some of the beneficial effects of these drugs in Crohn's disease.
Evaluation of an enteric‐coated naproxen pellet formulation
Authors: HARDY J. G. , LAMONT G. L. , EVANS D. F. , HAGA A. K. , GAMST O. N. 
Published: July 2010

SUMMARYAn enteric‐coated, pellet formulation of naproxen has been evaluated in eight healthy subjects. Each volunteer was dosed with 153Sm‐labelled, enteric‐coated pellets on two occasions, once whilst fasted and once after breakfast. Gastrointestinal transit was followed using gamma scintigraphy and drug absorption compared with that from uncoated naproxen pellets dosed on a separate occasion. The pH in the stomach and intestines was monitored using radiotelemetry capsules. Gastric emptying was delayed by dosing after breakfast, but small intestinal transit of the enteric‐coated formulation was the same on both occasions. The highest pH recorded from the stomach was 4.0 and in all subjects the pH rose to at least 7.3 in the small intestine. The onset of drug absorption was fastest from the uncoated formulation and slowest from the coated pellets taken after breakfast. The total amount of drug absorbed was the same on all three occasions.
Ranitidine prevents duodenal ulcers associated with non‐steroidal anti‐inflammatory drug therapy
Authors: ROBINSON M. , MILLS R. J. , EULER A. R. 
Published: July 2010

SUMMARYThe results of four similarly designed, randomized, double‐blind, placebo‐controlled studies conducted to evaluate ranitidine as prophylaxis for NSAID‐associated damage are reviewed. A total of 673 patients receiving therapeutic dosages of NSAIDs for arthritic or musculoskeletal conditions also received either ranitidine 150 mg twice daily (n= 343) or placebo (n= 330) for four weeks (two studies) or eight weeks (two studies). Endoscopic grading of mucosal lesions was based on a modified Lanza scoring system. All patients had normal baseline endoscopies. After four weeks of treatment a significant protective effect against duodenal mucosal lesions including duodenal ulcers (three studies) and gastric mucosal lesions including gastric ulcers (one study) was observed in patients who received ranitidine compared with those who received placebo. A meta‐analysis of the four studies confirmed that significantly fewer patients receiving ranitidine than placebo developed duodenal ulcers (1%vs. 6%, P= 0.01). Endoscopic data at eight weeks from the two longer‐term studies showed that duodenal ulcers occurred in ranitidine‐ and placebo‐treated patients at a rate of 1% (2/137) vs. 8% (10/126) (P= 0.02), respectively, in one trial, and 0% (0/57) vs. 8% (4/49) (P= 0.02), respectively, in the other trial. No protective effect in the stomach was evident at eight weeks. We conclude that ranitidine is effective in preventing NSAID‐associated duodenal ulcers and may be appropriate prophylaxis for certain high‐risk patients.
Cimetidine suspension in patients with Stage 0 gastro‐oesophageal reflux disease
Authors: RIEMANN J. F. , HÖBEL W. 
Published: July 2010

SUMMARYOne hundred and twenty‐five patients with symptoms of heartburn and acid regurgitation but without endoscopic abnormalities were randomized to receive 200 mg cimetidine suspension four times daily or placebo for two weeks. Daily diary cards were kept to evaluate the frequency and degree of symptoms. At two weeks cimetidine was significantly more effective than placebo. It is concluded that placebo suspension has a considerable effect on gastro‐oesophageal reflux disease symptoms, but cimetidine suspension provides significantly better relief.
Fluconazole for oropharyngeal candidiasis in anti‐HIV positive haemophiliacs
Authors: LIM S. G. , LEE C. A. , HALES M. , O'DOHERTY M. , WINTER M. , KERNOFF P. B. A. 
Published: July 2010

SUMMARYCandidiasis of the oropharynx and oesophagus is one of the most common problems encountered in patients with HIV disease. Fluconazole is a bis‐triazole antifungal agent with a long serum half‐life. Sixteen anti‐HIV positive patients (15 haemophiliacs and one blood transfusion recipient) with a clinical diagnosis of oropharyngeal candidiasis were treated with 50 mg fluconazole daily for 14–28 days and then either 150 mg fluconazole or placebo weekly for 6 months in a prophylactic phase. Clinical cure occurred in all patients, and mycological cure occurred in 13/16 (81%) patients. In the prophylactic phase, there were 2/5 (40%) relapses in the placebo arm compared with 1/8 (12.5%) in the fluconazole arm, but this was not statistically significant by Fisher's onesided exact test (P= 0.31). It is concluded that fluconazole is an effective treatment of oropharyngeal candidiasis and has potential for prophylactic use.
Dose‐related healing of duodenal ulcer with the proton pump inhibitor lansoprazole
Authors: LONDONG W. , BARTH H. , DAMMANN H. G. , HENGELS K. J. , KLEINERT R. , MÜLLER P. , ROHDE H. , SIMON B. 
Published: July 2010

SUMMARYLansoprazole (AG 1749) is a novel substituted benzimidazole which inhibits gastric acid secretion by blocking H+, K+‐ATPase. This randomized, double‐blind multicentre trial studied the dose–response relationship of lansoprazole on ulcer healing and compared it with ranitidine in 314 out‐patients with endoscopically assessed, symptomatic duodenal ulcer. Cumulative healing rates with Lansoprazole 7.5, 15, and 30 mg o.m. were 48, 59, and 74% at 2 weeks and 75, 84, and 95 % at 4 weeks, respectively (intention‐to‐treat); the difference of the healing rates between 7.5 and 30 mg groups was significant (P< 0.001).Corresponding healing rates for 300 mg ranitidine nocte were 51 and 89 %. Pain relief was similar in all treatment groups. Lansoprazole was well tolerated. During a follow‐up of 6 months relapse rates after lansoprazole 7.5, 15, and 30 mg were 21, 29, and 22%, respectively; the relapse rate after ranitidine 300 mg was 20%. In conclusion, lansoprazole provides faster healing of duodenal ulcer than ranitidine and a similar relapse pattern. For further trials in peptic ulcer disease a daily dose of lansoprazole 30 mg o.m. is recommended.
Review article: new developments in the use of 5‐aminosalicylic acid in patients with inflammatory bowel disease
Authors: THOMSON A. B. R. 
Published: July 2010

SUMMARYSulphasalazine is composed of sulphapyridine and mesalazine (5‐aminosalicylic acid, 5‐ASA or mesalazine) joined by an azo bond. Sulphasalazine has been used clinically for 40 years but less than 10 years ago it was recognized that the active moiety is 5‐ASA. Sulphapyridine appears to act only as a carrier molecule to deliver mesalazine to the bowel, yet it is the sulphapyridine which appears to be responsible for many of the adverse effects observed with sulphasalazine. Normally, mesalazine is rapidly absorbed from the upper gastrointestinal tract. Since the action of mesalazine is thought to be locally at the site of disease in the intestine, the 5‐ASA must be ‘protected’ to ensure its release in the terminal ileum and colon, the site of bowel inflammation in patients with Crohn's disease or ulcerative colitis. Recent clinical studies have confirmed the efficacy of topical (suppositories and enemas) therapy for ulcerative proctitis and left‐sided colitis; oral mesalazine has been proven to be useful for the treatment of acute ulcerative colitis and for the maintenance of remission. There is preliminary evidence for the clinical usefulness of mesalazine in acute Crohn's disease as well as for the maintenance of remission.
Is topical therapy necessary in acute distal colitis? Double‐blind comparison of high‐dose oral mesalazine versus steroid enemas in the treatment of active distal ulcerative colitis
Authors: COBDEN I. , AL‐MARDINI H. , ZAITOUN A. , RECORD C. O. 
Published: July 2010

SUMMARYThirty‐seven patients suffering an attack of acute distal ulcerative colitis of mild or moderate severity were randomized in a double‐blind, doubledummy fashion to receive either 800 mg oral mesalazine four times daily (18 patients) or steroid enemas twice daily (19 patients) for 4 weeks. Both treatments were well tolerated with no adverse effects. Three patients in each group were withdrawn because of clinical deterioration but both treatments produced significant clinical improvement with decreases in stool frequency and scores for urgency, bleeding and tenesmus. There were no significant differences between the treatments although there was a slight trend in favour of the enemas for reduction in rectal bleeding. Activity of the colitis as graded at sigmoidoscopy also decreased significantly with both treatments and there were corresponding improvements in histological parameters of inflammatory activity assessed with the aid of a computerized morphometric system. Little correlation was seen between clinical, sigmoidoscopic and histological changes.