bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quadruple antimycobacterial chemotherapy in Crohn's disease: results at 9 months of a pilot study in 20 patients
Authors: HAMPSON S. J. , PARKER M. C. , SAVERYMUTTU S. H. , JOSEPH A. E. , MCFADDEN J.‐J. P. , HERMON‐TAYLOR J. 
Published: July 2010

SUMMARYTwenty patients with active Crohn's disease, the majority refractory to conventional therapy, were treated with rifampicin, ethambutol, isoniazid, and pyrazinamide or clofazamine for 9 months. After this period, 10 were in remission (Crohn's disease activity index < 150). Of the 10 not in remission, three had been at 6 months, but had relapsed on treatment. Nine of 10 patients on steroids at the beginning were off steroids at 9 months. Six patients came to surgery during the period, five for stricture formation without evidence of florid Crohn's disease outside the strictured segment. Three young patients with severe Crohn's disease facing total colectomy were spared surgery. No serious drug‐related side‐effects were encountered. The results of this pilot study suggest that controlled trials of antimycobacterial chemotherapy, using four or more of the best agents available, are worthy of assessment in Crohn's disease.
Repeated high oral doses of omeprazole do not affect intrinsic factor secretion: proof of a selective mode of action*
Authors: FESTEN H. P. M. , TUYNMAN H. A. R. E. , DEN HOLLANDER W. , MEUWISSEN S. G. M. 
Published: July 2010

SUMMARYThe effect of 60 mg oral omeprazole daily for 9 days on intrinsic factor and gastric acid secretion was studied in eight healthy volunteers. Gastric secretion studies were performed during saline and 0.1 M HCl perfusion before and after omeprazole administration. During dosing with omeprazole, basal gastric acid output diminished by 94%, and pentagastrin‐stimulated acid output by 97%. Basal, peak and steady‐state stimulated intrinsic factor output were unaffected by omeprazole. It is concluded that high oral doses of omeprazole suppress gastric acid secretion to very low levels but they do not affect intrinsic factor secretion. Intrinsic factor secretion was also unaffected by profound hypochlorhydria.
Omeprazole (20 mg o.m.) versus ranitidine (150 mg b.d.) in duodenal ulcer healing and pain relief
Authors: MULDER C J. J. , TIJTGAT G. N. J. , CLUYSENAER O. J. J. , NICOLAI J. J. , MEYER W. W. , HAZENBERG B. P. , VOGTEN A. J. M. , GERRITS C. , STUIFBERGEN W. H. N. N. 
Published: July 2010

SUMMARYThe object of this double‐blind, multicentre study was to compare duodenal ulcer healing rates after 2 and 4 weeks of treatment with either 20 mg omeprazole o.m. or 150 mg ranitidine b.d. One hundred and eighty‐one patients were randomized: 91 received omeprazole and 90 received ranitidine.In a per protocol analysis at 2 weeks, 63% of the patients were healed on omeprazole and 65% of the patients were healed on ranitidine (N.S.); at 4 weeks 91% were healed in the omeprazole group and 96% were healed in the ranitidine group. There were no differences in ulcer symptom relief between the two groups. There were no significant changes in laboratory values in either of the groups. Adverse events were few and mainly mild and transient.We conclude that both omeprazole (20 mg o.m.) and ranitidine (150 mg b.d.) result in rapid, ulcer healing rates.
Effects of the glucosidase inhibitor acarbose in patients with liver cirrhosis
Authors: ZILLIKENS M. C. , SWART G. R. , VAN DEN BERG J. W. O. , WILSON J. H. P. 
Published: July 2010

SUMMARYIn this preliminary study, we examined the effects of acarbose and placebo together with a standardized breakfast on blood glucose levels, on breath hydrogen excretion and on plasma insulin and glucagon levels, in addition, the effects on fasting blood levels of metabolites were studied following an evening meal with acarbose or placebo. Acarbose significantly reduced blood glucose levels in 10 patients with alcoholic cirrhosis following a meal containing 100 g of carbohydrate. There were no significant changes in plasma insulin after breakfast but glucagon levels were increased at 1 h after the meal. Breath hydrogen excretion did not change significantly. Acarbose given with a late evening snack reduced fasting β‐hydroxybutyrate levels the next morning in these cirrhotic patients.
The effect of cisapride on defaecation in normal human subjects—lack of effect on faecal excretion of water, fat, and bile acids
Authors: BERGER V. , ARMBRECHT U. , HEUSINGER A. , WIENBECK M. , STOCKBRÜGGER R. 
Published: July 2010

SUMMARYIn order to elucidate whether or not the increased stool frequency that occurs during cisapride treatment is a result of malabsorption of water, fat, and bile acids, 12 healthy volunteers were dosed with either tablets of placebo q.d.s. or tablets of 10 mg cisapride q.d.s. during two periods of 5 days in a double‐blind, crossover study.Stool frequency, stool consistency, and side‐effects were recorded each day. Total faecal mass, faecal water content, and faecal excretion of fat and bile acids were determined during the last 72 h of each study period.Mean daily stool frequency was 18.8% higher during cisapride [1.68 ± 0.12 (S.E.M.)] administration than during placebo (1.42 ± 0.12); P= 0.038. The stool consistency score increased by 11.8% towards softer stools during cisapride dosing (N.S.). There were no significant differences in total faecal mass (placebo 399.4 g/72 h; cisapride; 414.5 g/72 h), faecal water content (placebo; 75.6%: cisapride 76.2%), or faecal excretion of fat (placebo; 12.7 g/72 h: cisapride; 11.6 g/72 h) and total bile acids (placebo; 2212 μmol/72 h: cisapride; 2261 μmol/72 h). The side‐effects reported during placebo were constipation (n = 3), and during cisapride meteorism (n = 4) and increased appetite (n = 2).The increased stool frequency during cisapride treatment is not caused by malabsorption of water, fat, or bile acids, but seems to be the consequence of a direct motor effect.
Safety and efficacy of acetarsol suppositories in unresponsive proctitis
Authors: FORBES A. , BRITTON T. C. , HOUSE I. M. , GAZZARD B. G. 
Published: July 2010

SUMMARYIn a prospective open study, 10 patients with intractable proctitis were treated with acetarsol suppositories (250 mg b.d. for 4 weeks) and were monitored clinically, biochemically and toxicologically.Proctitis resolved symptomatically and sigmoidoscopically within 2 weeks in nine patients; one patient was unaffected. The only side‐effect was of transient thrombocytosis in a single patient. Maximal blood and urinary arsenic concentrations occurred after 1 week's treatment with a total inorganic arsenic in the hazardous range in six patients; subsequent concentrations fell despite continuing therapy and at 4 weeks potentially hazardous values persisted in only two patients. Continued renal excretion and diminished absorption across an improved rectal mucosa is thought to be responsible for this paradox. Arsenic levels fell rapidly when acetarsol was withdrawn and were indistinguishable from pretreatment values within 4 weeks.Short‐term acetarsol therapy offers a useful additional measure when local steroids have failed to control ulcerative proctitis; it appears to be safe and formal controlled comparisons with other therapeutic options are therefore legitimate.
The effect of SK&F 94482 (BMY‐25368) on 24‐hour intragastric acidity and plasma gastrin concentration in healthy subjects
Authors: GAVEY C. J. , SMITH J. T. L. , NWOKOLO C. U. , POUNDER R. E. 
Published: July 2010

SUMMARYIn a double‐blind, placebo‐controlled study of SK&F 94482 (BMY‐25368) (400‐mg, post‐evening meal, for 7 days in 11 healthy subjects), there was a significant 75% decrease in median integrated 24‐h intragastric acidity during dosing with the drug (218 mmol h/L) compared with placebo (883 mmol h/L; P= 0.003). The single daily dose of 400 mg SK&F 94482 decreased median hourly intragastric acidity until the time of the next dose 24 h later. There was also a sustained and significant 80% rise in median 24‐h integrated plasma‐gastrin concentration during dosing with SK&F 94482 (364 pmol h/L) when compared with placebo (202 pmol h/L; P= 0.003). The study demonstrates a significant inverse correlation between 24‐h integrated intragastric acidity and 24‐h plasma gastrin concentration (rs=−0.484; P < 0.001).The study shows that a single oral daily dose of an H2‐antagonist can provide control of intragastric acidity throughout the day and night, decreased acidity being associated with statistically significantly, but modestly elevated plasma‐gastrin levels.
Efficacy of a standard United Kingdom oral rehydration solution (ORS) and a hypotonic ORS assessed by human intestinal perfusion
Authors: HUNT I. B. , ELLIOTT E. J. , FARTHING M. J. G. 
Published: July 2010

SUMMARYHuman triple‐lumen intestinal perfusion was used to compare water and solute absorption from the oral rehydration solution (ORS) most widely used in the United Kingdom and a new experimental hypotonic ORS (HYPO‐ORS). HYPO‐ORS (osmolality 210 mOsm/kg) promoted significantly greater water absorption than UK‐ORS (7.03 ± 1.1 vs 2.73 ± 1.0 ml cm−1 h−1; P < 0.01). HYPO‐ORS produced net sodium and chloride absorption whereas the low sodium UK‐ORS produced a net secretion of these ions. Bicarbonate absorption was also greater from HYPO‐ORS although potassium and glucose absorption were similar from both solutions. This study suggests that UK‐ORS may not promote optimal water and solute absorption and that clinical studies with HYPO‐ORS are indicated.
Review article: bile acid therapy
Authors: LANZINI A. , NORTHFIELD T. C. 
Published: July 2010

SUMMARYOver the past 3 years there has been a renewed interest in bile acid therapy not only because of the promising results obtained by combining this therapy with extracorporeal shock‐wave lithotripsy for rapid gallstone dissolution, but also because of its novel use as a treatment for primary biliary cirrhosis. This article reviews the use of bile acids for both these indications.
Dosage of colloidal bismuth subcitrate in duodenal ulcer healing and clearance of Campylobacter pylori
Authors: COGHLAN J. , HUTCHINSON L. , GILLIGAN D. , McKENNA D. , KEANE C. , SWEENEY E. , O'MORAIN C. 
Published: July 2010

SUMMARYSixty consecutive patients with endoscopically proven duodenal ulcers were given colloidal bismuth subcitrate tablets either as 120 mg q.d.s. or 240 mg b.d., in a randomized single‐blind study. The efficacy of each regimen was determined by endoscopic examination and antral biopsy at 4 weeks; if the ulcer remained unhealed, treatment was continued and endoscopy repeated at 8 weeks. The ulcer‐healing efficacy of the two regimens was identical; however, in the four times daily group only 27% remained Campylobacter pylori positive after 8 weeks of treatment compared with 58% of the twice‐daily group. Similarly, only 21% of twice daily patients were free of histological gastritis compared with 42% of the four times daily patients.
Omepmazole or high‐dose ranitidine in the treatment of patients with reflux oesophagitis not responding to ‘standard doses’of H2‐receptor antagonists
Authors: LUNDELL L. , BACKMAN L. , EKSTRÖM P. , ENANDER L.‐H. , FAUSA O. , LIND T. , LÖNROTH H. , SANDMARK S. , SANDZÉN B. , UNGE P. , WESTIN I. H. 
Published: July 2010

SUMMARYNinety‐eight patients (26 females), who presented with erosive and/or ulcerative oesophagitis, despite at least a 3‐month period of treatment with standard doses of cimetidine (≥ 1200 mg daily) or ranitidine (≥ 300 mg daily), were included in a double‐blind, randomized trial to compare omeprazole (40 mg o.m.) with a high dose of ranitidine (300 mg b.d.). The treatment was given for 4–12 weeks; endoscopy assessment and laboratory screening were performed on entry to the trial and thereafter every fourth week. Endoscopic healing was defined as complete epithelialization of all macroscopic erosions or ulcers in the squamous epithelium. An ‘intention‐to‐treat’analysis of the clinical datarevealed omeprazole to be superior to ranitidine : 63 % of those patients who were given omeprazole were heaIed endoscopically after a 4‐week period of treatment, compared with only 17 % of those given ranitidine. This difference in healing rate persisted during the 12‐week study period (90% DS 47% after 12 weeks; P < 0.0001). Reflux symptoms were more rapidly and completely relieved with omeprazole : heartburn resolved completely in 86% of patients treated with omeprazole for 4 weeks compared with 32% in the ranitidine group (P < 0.0001). The mean basal gastrin concentrations increased only in those given omeprazole from 18.9 pmol/L at pre‐entry to a mean value of 31.7 pmol/L on the last day of omeprazole administration. In ranitidine‐treated patients no significant increase in basal gastrin concentration was observed. Both drugs were well tolerated with few adverse events, which were mainly mild and transient. These results demonstrate the superiority of omeprazole over a high dose of ranitidine in the treatment of resistant reflux oesophagitis.
The safety and efficacy of tripotassium dicitrato bismuthate (De‐Nol) maintenance therapy in patients with duodenal ulceration
Authors: DUNK A. A. , PRABHU U. , TOBIN A. , O'MORAIN C. , MOWAT N. A. G. 
Published: July 2010

SUMMARYSeventy‐one patients whose duodenal ulcers had healed after a 4‐week treatment period with tripotassium dicitrato bismuthate (TDB) were randomly allocated to receive maintenance treatment with either one TDB swallow tablet nocte (equivalent to 120 mg Bi2 O3) or an identical placebo. During 12 months of follow‐up, no side‐effects were reported by TDB‐treated patients, blood bismuth levels did not rise above discontinuation threshold concentrations (> 50 μg/L in the first 6 months, or > 100 μg/L in the second 6 months), and there were no adverse effects on haematological or biochemical indices. Ulcer relapse was significantly less in TDB‐treated patients (P < 0.025). Cumulative relapse rates at 6 and 12 months were 51% and 66%, respectively, for placebotreated patients and 26% and 31%, respectively, for those who received TDB. It is likely that TDB is a safe and effective maintenance treatment for patients with duodenal ulcer disease.
Effect of ranitidine and indomethacin on nocturnal gastric acidity in normal subjects
Authors: WALT R. P. , DANESHMEND T. K. , PRICHARD P. , LANGMAN M. J. S. 
Published: July 2010

SUMMARYTo assess the effect of indomethacin on gastric acidity and to identify a potential pharmacodynamic interaction between indomethacin and ranitidine, we measured nocturnal acidity on half‐hourly aliquots of gastric contents from 10 volunteers on the seveneth day of four dosing regimens given in a randomized double‐blind manner. These were indomethacin (50 mg t.d.s.) and ranitidine (300 mg in the evening) together or alone with matching placebos. Median nocturnal acidity on placebo was 41.7 mmol/L (range 67.6–25.1 mmol/L) and was 39.8 mmol/L (63.1–24.0 mmol/L) on indomethacin (N.S.). During ranitidine dosing it was 0.4 mmol/L (21.3–0.0 mmol/L) without and 0.8 mmol/L (43.7–0.0 mmol/L) with concurrent indomethacin, representing 99 and 98% decreases in gastric acidity (P< 0.01) compared with placebo. Indomethacin did not increase overnight gastric acidity and did not influence the suppression of acidity produced by ranitidine. It is unlikely that the ulcerogenic potential of indomethacin is explicable by an effect on gastric acidity.
Effect of octreotide on mouth‐to‐caecum transit time in healthy subjects and in the irritable bowel syndrome
Authors: O'DONNELL L. J. D. , WATSON A. J. M. , CAMERON D. , FARTHING M. J. G. 
Published: July 2010

SUMMARYThe effect of a single subcutaneous injection of octreotide (50 μg) on mouth‐to‐caecum transit time was determined in patients with the irritable bowel syndrome who complained of bowel frequency, and in healthy volunteers. The assessment of mouth‐to‐caecum transit time was performed by monitoring breath hydrogen concentration and noting a sustained 10 p.p.m. rise after ingestion of lactulose 40 ml. Measurements were performed fasting, and on a separate day, after a standard breakfast which included 40 ml lactulose. The studies were performed double‐blind in a pre‐determined random order. Octreotide prolonged mouth‐to‐caecum transit time in irritable bowel syndrome patients and healthy subjects by factors of 2.4 and 2.6 after lactulose when fasting, respectively, and by factors of 2.8 and 2.6 after the breakfast which contained lactulose. The upper gastrointestinal transit rate was similar in irritable bowel syndrome patients and healthy controls.
The interaction between Helicobacter pylori culture filtrate and indomethacin: effects on the integrity of human gastric antral mucosa and its prostaglandin E2 production in vitro
Authors: TAHA A. S. , KELLY R. W. , GEMMELL C. G. , LEE F. D. , RUSSELL R. I. 
Published: July 2010

SUMMARYHistopathological methods and radioimmunoassay were used to assess the microstructure and prostaglandin E2 production by paired specimens of human gastric antral mucosa; the specimens were studied after 48 h of incubation in base‐line tissue culture medium, Helicobacter pylori culture filtrate, H. pylori culture control fluid, indomethacin, and H. pylori culture filtrate plus indomethacin. When applied alone, the filtrate did not affect the structure of the mucosal tissue or its prostaglandin E2 synthesis. In the overall group (n = 21), specimens incubated with the mixture of H. pylori filtrate and indomethacin had a median histological grade of 1 and prostaglandin E2 of 29 pg/mg tissue, compared to 2 pg/mg (P= 0.04) and 60 pg/mg (P= 0.0007) respectively, in specimens incubated with indomethacin alone.These results indicate that an interaction may exist between
Maintenance therapy of duodenal ulcer with H2‐receptor antagonists—a meta‐analysis
Authors: PALMER R. H. , FRANK W. O. , KARLSTADT R. 
Published: July 2010

SUMMARYA theoretical basis for similar recurrence rates among H2‐receptor antagonists exists based on recent concepts of ulcer recurrence, ulcer healing and suppression of nocturnal gastric acidity. In order to compare H2‐receptor antagonists in the maintenance therapy of duodenal ulcer, a meta‐analysis was carried out using 29 studies in the literature that met strict criteria. When the results of the placebo‐controlled studies were expressed as odds ratios, a technique used to minimize differences in protocol design and patient populations among studies, cimetidine, ranitidine, famotidine and nizatidine were all found to be superior to placebo to approximately the same extent. Odds ratios (and 95% confidence limits) for the recurrences in the pooled studies were cimetidine 0.22 (0.18–0.28), ranitidine 0.23 (0.18–0.30), famotidine 0.28–0.31 and nizatidine 0.36. These reflected similar 1‐year recurrence rates of 24.9% (n= 530) for 400 mg cimetidine nocte, 22.4 (n= 508) for 150 mg ranitidine nocte, 28.0% (n= 371) for 20 mg or 40 mg famotidine nocte, and 21.8% (n= 261) for 150 mg nizatidine nocte. In studies to compare cimetidine and ranitidine directly, the odds ratio (and 95% confidence limits) was 0.64 (0.48–0.86). However, for two studies done by a single protocol, the odds ratio of 0.51 (0.35–0.75) tended todiffer from the odds ratio of 0.85 (0.54‐1.33) for six other studies (P = 0.09). These reflected recurrence rates for cimetidine and ranitidine of 28.3% and 16.8% (two studies) and 23.3% and 20.6% (six studies) respectively.
Effect of intra‐colonic nicardipine on colonic motility in irritable bowel syndrome
Authors: MAXTON D. G. , WHORWELL P. J. 
Published: July 2010

SUMMARYIntravenous nicardipine has previously been shown to abolish the effect of a 1000‐calorie meal on colonic motility. The purpose of this study was to use the same experimental design to assess the effect of nicardipine instilled directly into the colon. Each patient was studied three times when receiving either placebo, 15 mg or 30 mg nicardipine infused over 2 h. Blood concentrations of nicardipine remained very low, but neither dose of the drug affected either basal or post‐prandial colonic motility. Topical nicardipine does not appear to have therapeutic potential and its activity is probably dependent on systemic absorption.
Antioxidant therapy for recurrent pancreatitis: placebo‐controlled trial
Authors: UDEN S. , BILTON D. , NATHAN L. , HUNT L. P. , MAIN C. , BRAGANZA J. M. 
Published: July 2010

SUMMARYOxidant stress has been proposed as the initiating pathogenetic mechanism in pancreatitis, hence micronutrient antioxidant therapy has been assessed in patients with recurrent attacks and/or constant pancreatic pain. In a 20‐week double‐blind double‐dummy crossover trial active treatment was given as two types of tablets providing daily doses of 600 μg organic selenium, 9000 IU β carotene, 0.54 g vitamin C, 270 IU vitamin E and 2 g methionine. Of 28 patients enrolled, 20 adhered to the full protocol (idiopathic chronic 8, alcoholic chronic 7, idiopathic acute 5). Six patients had an attack whilst on placebo but none whilst on active treatment (P= 0.032). Analysis of visual analogue scoresheets to compare background pain in the 10‐week period before entry and during each phase of the trial, using a 10‐cm scale for each of 11 best descriptors, endorsed the beneficial effect of active treatment (placebo v baseline, P= 0.073; active v baseline, P < 0.001; active v placebo, P= 0.049). The same trend emerged from analysis of pain‐score diaries by conventional and time series methods. Micronutrient antioxidant therapy thus offers a new approach to the treatment of recurrent (non‐gallstone) pancreatitis and/or pancreatic pain.
Duodenal ulcer healing and acid secretory responses to modified sham feeding and pentagastrin stimulation
Authors: JOHNSTON D. A. , MARKS I. N. , YOUNG G. O. , TIGLER‐WYBRANDI N. A. , BRIDGER S. 
Published: July 2010

SUMMARYThe effect of duodenal ulcer healing on the acid secretory responses to modified sham feeding and maximal pentagastrin stimulation has been studied in 17 patients treated successfully with ranitidine (n= 9) and sucralfate (n= 8). Parietal cell sensitivity was calculated as the ratio of the modified sham feeding response to the peak pentagastrin response, expressed as a percentage. Ulcer healing after sucralfate therapy resulted in significant falls in modified sham feeding stimulated acid output (P < 0.02), from 9.4 (1.8–17.0) (median + range) to 3.7 (0.2–9.4) mmol/h; in peak acid output (P < 0.05) from 42.8 (23.0–61.4) to 27.7 (7.2–51.0)mmol/h; and in the parietal cell sensitivity (P < 0.05) from 19.2 (4.4–42.6) to 14.3 (2.8–19.7)%. No significant falls in any of these parameters were noted following ulcer healing with ranitidine. Duodenal ulcer healing with sucralfate results in decreased acid secretory responses to vagal and pentagastrin stimulation.
Efficacy of diltiazem in the treatment of diffuse oesophageal spasm
Authors: DRENTH J. P. H. , BOS L. P. , ENGELS L. G. J. B. 
Published: July 2010

SUMMARYCalcium antagonists relax smooth muscle, a possible useful concept in treatment of diffuse oesophageal spasm. Therefore the effects of oral diltiazem (60 mg t.d.s.) and placebo were compared in eight patients with diffuse oesophageal spasm in a 10‐week double‐blind crossover study. The patients recorded the severity of chest pain and/or dysphagia in daily pain diaries using visual analogue scales. Chest pain index and dysphagia index were calculated by multiplying frequency with daily intensity of each individual symptom. When compared to placebo, diltiazem did not significantly change the overall dysphagia index and chest pain index. An individual sizeable reduction of dysphagia was attained on diltiazem in four out of six patients and in six out of eight patients suffering from chestpain. Side effects were not seen during diltiazem therapy. Diltiazem, in our study, did not yield in a significant improvement of symptoms in diffuse oesophageal spasm. Diltiazem, however, can offer relief in selected individual patients suffering from diffuse oesophageal spasm.