bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: improving adherence to medication in patients with inflammatory bowel disease
Authors: ROBINSON A. 
Published: July 2010

SummaryBackground  Adherence to medications in inflammatory bowel disease is associated with a reduced risk of both relapse and colorectal cancer development in the long term. However, many patients are non‐adherent to their prescribed treatment regimen.Aim  To review and discuss the extent of medication non‐adherence in inflammatory bowel disease patients, the predictors of non‐adherence, and strategies for optimizing patient adherence.Results  More than 40% of inflammatory bowel disease patients do not adhere to their medication and thus a significant number of patients are not receiving the full benefits from their treatment – that is, remission and disease maintenance. The causes of medication non‐adherence are multi‐factorial. Improving medication adherence in patients is an important challenge for physicians; understanding the different patient types, the reasons given by patients for non‐adherence and the predictors of non‐adherence will help devise suitable plans to optimize patient adherence. Approaches such as improving the physician–patient relationship, individualized therapy, providing patient information and support, self‐management programmes and practical aide memoires can be beneficial.Conclusions  Implementation of strategies to improve medication adherence in inflammatory bowel disease patients increases the likelihood of patients achieving disease remission and maintaining remission in the long term, thereby improving symptom control and quality of life.
Systematic review: ulcer definition in NSAID ulcer prevention trials
Authors: YEOMANS N. D. , NÆSDAL J. 
Published: July 2010

SummaryBackground  In clinical trials of peptic ulcer prevention, the most appropriate definition of an ulcer remains challenging.Aims  To evaluate the ulcer definitions used in clinical trials of ulcer prevention among non‐steroidal anti‐inflammatory drug users and to determine whether any specific definition is preferred.Methods  A systematic literature search of the PubMed, Medline and EMBASE databases was conducted. Results were limited to full papers published in English from June 1987 to June 2007 that met the following criteria: randomized, controlled non‐steroidal anti‐inflammatory drug trials of ≥8 weeks’ duration, with a primary end point of ulcer upon endoscopy.Results  Forty five publications met the inclusion criteria and were reviewed. Overall, an ulcer diameter of ≥3 mm was used in 25 publications and most included a description of ulcer depth. Of the remainder, ulcer was defined as any lesion with unequivocal/observable depth (with no lower limit for ulcer diameter; five publications) or an excavated mucosal break >3 mm (one publication), whereas nine defined a minimum ulcer size of ≥5 or >5 mm. Ulcer definition was unclear in the remaining five publications.Conclusion  In clinical trials of ulcer prevention among non‐steroidal anti‐inflammatory drug users, a gastric or duodenal lesion ≥3 mm in diameter with significant depth is the preferred definition.
Review article: respiratory manifestations of gastro‐oesophageal reflux disease
Authors: GALMICHE J. P. , ZERBIB F. , BRULEY DES VARANNES S. 
Published: July 2010

SummaryBackground  Respiratory manifestations represent one of the most prevalent and difficult‐to‐manage extra‐oesophageal syndromes of gastro‐oesophageal reflux disease.Aims  To review the epidemiology, pathophysiological mechanisms and therapeutic outcomes of reflux‐related respiratory disorders.Methods  Search of the literature published in English using PubMed database.Results  There is a discrepancy between the high prevalence of reflux in asthmatics and the limited efficacy of antireflux therapies. Asthma per se may cause reflux. Patients with difficult‐to‐treat asthma and/or nocturnal symptoms should be screened for reflux. Reflux can induce chronic cough through different mechanisms including micro‐aspiration and both local and central reflexes. Cough and reflux may precipitate each other. A meta‐analysis found no significant difference between placebo and proton pump inhibitors in the resolution of cough. Encouraging results have been reported, following antireflux surgery in patients selected on the basis of pH‐impedance monitoring. Attention has been drawn to obstructive sleep apnoea syndrome.Conclusions  The role of gastro‐oesophageal reflux disease in the pathogenesis of miscellaneous respiratory disorders has been discussed for decades and established in asthma and cough. However, no major therapeutic advances have been reported recently. Future trials should concentrate on patient selection and the control of efficacy using recently developed technologies, such as pH‐impedance monitoring.
Review article: nitric oxide from dysbiotic bacterial respiration of nitrate in the pathogenesis and as a target for therapy of ulcerative colitis
Authors: ROEDIGER W. E. W. 
Published: July 2010

SummaryBackground Factors initiating human ulcerative colitis (UC) are unknown. Dysbiosis of bacteria has been hypothesized to initiate UC but, to date, neither the nature of the dysbiosis nor mucosal breakdown has been explained.Aim To assess whether a dysbiosis of anaerobic nitrate respiration could explain the microscopic, biochemical and functional changes observed in colonocytes of UC.Methods Published results in the gastroenterological, biochemical and microbiological literature were reviewed concerning colonocytes, nitrate respiration and nitric oxide in the colon in health and UC. A best‐fit explanation of results was made regarding the pathogenesis and new treatments of UC.Results Anaerobic nitrate respiration yields nitrite, nitric oxide (NO) and nitrous oxide. Colonic bacteria produce NO and UC in remission has a higher lumenal NO level than control cases. NO with sulphide, but not NO alone, impairs β‐oxidation, lipid and protein synthesis explaining the membrane, tight junctional and ion channel changes observed in colonocytes of UC. The observations complement therapeutic mechanisms of those probiotics, prebiotics and antibiotics useful in treating UC.Conclusions The prolonged production of bacterial NO with sulphide can explain the initiation and barrier breakdown, which is central to the pathogenesis of UC. Therapies to alter bacterial nitrate respiration and NO production need to evolve. The production of NO by colonic bacteria and that of the mucosa need to be separated to pinpoint the sequential nature of NO damage in UC.
A randomized, placebo‐controlled, crossover, double‐blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans
Authors: MADSEN J. L. , FUGLSANG S. 
Published: July 2010

SummaryBackground Little is known about the role of tachykinins on human gastrointestinal motility and no data exist on the possible effect of an NK1 receptor antagonist.Aim To examine the effect of an antiemetic dose of the selective NK1 receptor antagonist aprepitant on gastrointestinal propulsion in healthy humans.Methods Twelve healthy volunteers participated in a crossover, double‐blind study. In random order, each volunteer had a 125‐mg capsule of aprepitant or placebo on day 1 followed by an 80‐mg capsule of aprepitant or placebo on days 2–5. Gamma camera imaging was used to measure gastric emptying, small intestinal transit and colonic transit of a radiolabelled, 1600‐kJ mixed liquid and solid meal ingested on day 2.Results Aprepitant did not change gastric retention at 15 min, gastric half emptying time, gastric mean transit time, time to small intestinal transit of 10%, small intestinal mean transit time or colonic geometric centre after 24, 48 and 72 h.Conclusion A 125‐mg capsule of aprepitant followed by an 80‐mg capsule of aprepitant each of the next 2–5 days did not induce major changes in the propulsive function of the gastrointestinal tract in the small number of healthy volunteers investigated.
Histological benefits of virological response to peginterferon alfa‐2a monotherapy in patients with hepatitis C and advanced fibrosis or compensated cirrhosis
Authors: EVERSON G. T. , BALART L. , LEE S. S. , REINDOLLAR R. W. , SHIFFMAN M. L. , MINUK G. Y. , POCKROS P. J. , GOVINDARAJAN S. , LENTZ E. , HEATHCOTE E. J. 
Published: July 2010

SummaryBackground  Patients with chronic hepatitis C virus and advanced fibrosis or cirrhosis are at risk for disease progression and hepatic decompensation.Aim  To determine the effects on hepatic histology of treatment with peginterferon alfa‐2a (90 or 180 μg/week) or interferon alfa‐2a (3 million units three times weekly) for 48 weeks in patients with paired biopsies.Methods  Liver biopsies were obtained at baseline and 6 months after end of treatment. Histological and virological responses were compared.Results  Patients attaining sustained virological response (n = 40) demonstrated the greatest improvements in fibrosis (−1.0, P < 0.0001) and inflammation (−0.65, P < 0.0001). Patients who cleared hepatitis C virus during treatment, but later relapsed (n = 59), experienced less improvement in fibrosis (−0.04, P < 0.0001) and inflammation (−0.14, P = 0.0768). Nonresponders (n = 85) showed no significant improvement in inflammation or fibrosis. Multiple regression analysis showed that the only factors contributing to improvement in fibrosis were sustained virological response (vs. nonresponder, P = 0.0005; vs. relapse, P = 0.7525) and body mass index ≤30 kg/m2 (P = 0.0995).Conclusions  These findings indicate that virological response to peginterferon alfa‐2a improves inflammation and fibrosis in hepatitis C virus patients with advanced fibrosis or cirrhosis. Improving virological response and maintaining ideal body weight are critical for achieving optimal histological outcomes in hepatitis C virus patients.
Clinical trial: phase 2 study of lubiprostone for irritable bowel syndrome with constipation
Authors: JOHANSON J. F. , DROSSMAN D. A. , PANAS R. , WAHLE A. , UENO R. 
Published: July 2010

SummaryBackground  Analyses of a trial in constipated patients indicated that lubiprostone may be an effective treatment for irritable bowel syndrome with constipation.Aim  To assess the efficacy and safety of three lubiprostone doses for irritable bowel syndrome with constipation.Methods  195 irritable bowel syndrome with constipation patients received daily doses of 16 [8 μg twice daily (b.d.)], 32 (16 μg b.d.) or 48 μg (24 μg b.d.) lubiprostone or placebo b.d. for 3 months. Gastrointestinal parameters were recorded in diaries daily by patients.Results  After 1 month, lubiprostone showed significantly greater improvements in mean abdominal discomfort/pain scores vs. placebo (P = 0.023). After 2 months, all lubiprostone groups showed significantly greater improvements in mean abdominal discomfort/pain scores (P ≤ 0.039). After 3 months of treatment, the improvement in each lubiprostone arm was greater than placebo, but the test for trend was no longer significant. Treatment with lubiprostone showed significantly higher rates of gastrointestinal adverse events (P = 0.020), especially diarrhoea and nausea.Conclusion  Lubiprostone significantly improved gastrointestinal symptoms of irritable bowel syndrome with constipation at all doses. Higher doses of lubiprostone, especially the 48 μg/day group, were associated with more gastrointestinal adverse events. From these data, the 16 μg/day dose demonstrated the optimal combination of efficacy and safety. These results warrant further study of lubiprostone for treatment of irritable bowel syndrome with constipation patients.
Intravenous esomeprazole for prevention of peptic ulcer re‐bleeding: rationale/design of Peptic Ulcer Bleed study
Authors: SUNG J. J. Y. , MÖSSNER J. , BARKUN A. , KUIPERS E. J. , LAU J. , JENSEN D. , STUART R. , JUNGHARD O. , OLSSON G. ,   ON BEHALF OF THE PUB STUDY GROUP
Published: July 2010

SummaryBackground  A limited number of trials have investigated the efficacy of proton pump inhibitors for peptic ulcer bleeding, and some study design issues have been identified.Aim  To present the design of a large trial evaluating the effects of intravenous esomeprazole on clinical outcomes in high‐risk patients who have undergone endoscopic haemostasis for peptic ulcer bleeding.Methods  The Peptic Ulcer Bleed study is an international, randomized, double‐blind, placebo‐controlled trial comparing either esomeprazole 80 mg intravenous bolus infusion for 30 min followed by esomeprazole 8 mg/h intravenously for 71.5 h, or placebo infusion for 72 h, after successful endoscopic haemostasis in patients with peptic ulcer bleeding and associated high‐risk stigmata. All patients will receive once daily oral esomeprazole 40 mg for 27 days after intravenous therapy. The primary end point is the rate of clinically significant re‐bleeding during the first 72 h after endoscopy. Secondary end points include: rate of re‐bleeding during the first 7 and 30 days after treatment; length of hospitalization; mortality; blood transfusion; endoscopic re‐treatment and surgery.Results  Expected 2008.Conclusions  The carefully designed protocol and quality control measures represent a pragmatic approach to contemporary challenges in peptic ulcer bleeding management and, it is hoped, qualify the Peptic Ulcer Bleed study as a new standard for future interventional studies.
Systematic review: tranexamic acid for upper gastrointestinal bleeding
Authors: GLUUD L. L. , KLINGENBERG S. L. , LANGHOLZ S. E. 
Published: July 2010

SummaryBackground  Tranexamic acid may reduce upper gastrointestinal bleeding and stabilize patients before endoscopic treatments.Aim  To review randomized trials on tranexamic acid for upper gastrointestinal bleeding.Methods  Manual and electronic searches of The Cochrane Library, MEDLINE, EMBASE and Science Citation Index were combined. Intention‐to‐treat random effect meta‐analyses were performed and results presented as RRs with 95% confidence intervals.Results  Seven double‐blind randomized trials on tranexamic acid vs. placebo were included. Of 1754 patients randomized, 21% were excluded. Only one trial included endoscopic treatments or proton pump inhibitors. Five per cent of patients on tranexamic acid and 8% of controls died (RR: 0.61, 95% CI: 0.42–0.89). No significant differences were found on bleeding, bleeding‐related mortality, surgery or transfusion requirements. Adverse events were unclearly reported. Data from three of the included trials suggested that tranexamic acid did not significantly increase the risk of thromboembolic disease.Conclusions  The present review suggests that tranexamic acid may reduce all‐cause mortality. However, because of limitations in the internal and external validity of included trials, additional evidence is needed before treatment recommendations can be made.
Validation of a brief symptom questionnaire (ReQuest in Practice) for patients with gastro‐oesophageal reflux disease
Authors: RUBIN G. , UEBEL P. , BRIMO‐HAYEK A. , HEY K. H. , DOERFLER H. , HEADING R. C. 
Published: July 2010

SummaryBackground  A clinical need exists for a means of assessing symptom control in patients with gastro‐oesophageal reflux disease. The ReQuest questionnaire has been extensively validated for symptom assessment in both erosive and non‐erosive gastro‐oesophageal reflux disease but was designed for research purposes. We derived a shorter version (ReQuest in Practice) that would be more convenient for clinical practice.Aim  To validate ReQuest in Practice in patients suffering from gastro‐oesophageal reflux disease.Methods  Multicentre, non‐interventional, crossover comparison. Patients completed ReQuest in Practice followed by ReQuest or vice versa. Before and after a planned endoscopy, patients completed the health‐related quality of life questionnaire GERDyzer. Internal consistency and the Intraclass Correlation Coefficient were calculated. Construct validity was evaluated by correlation with ReQuest and GERDyzer.Results  There was high internal consistency of ReQuest in Practice (Cronbach’s alpha: 0.9) and a high Intraclass Correlation Coefficient of 0.99. The measurement error of ReQuest in Practice was 4.1. High correlation between ReQuest in Practice and ReQuest (Spearman correlation coefficient: 0.9) and GERDyzer (Spearman correlation coefficient: 0.8) demonstrated construct validity.Conclusions  ReQuest in Practice was proven to be valid and reliable. Its close correlation with ReQuest makes it a promising tool to guide the clinical management of patients across the full spectrum of both erosive and non‐erosive gastro‐oesophageal reflux disease.
Meta‐analysis: ertapenem for complicated intra‐abdominal infections
Authors: FALAGAS M. E. , PEPPAS G. , MAKRIS G. C. , KARAGEORGOPOULOS D. E. , MATTHAIOU D. K. 
Published: July 2010

SummaryBackground  Ertapenem is a new member of the carbapenem class of antibiotics, with a favourable pharmacokinetic profile, but a narrower spectrum of antimicrobial activity, compared with older representatives of this class.Aim  To evaluate the effectiveness and safety of ertapenem for treatment of complicated intra‐abdominal infections.Methods  We performed a meta‐analysis of randomized‐controlled trials identified in PubMed, Cochrane and Scopus that compared ertapenem with other antimicrobial regimens, in patients of all ages, with complicated intra‐abdominal infections. The primary outcomes evaluated were clinical success (cure or improvement) in the modified intention‐to‐treat population and clinical adverse events.Results  Six randomized‐controlled trials involving patients with complicated intra‐abdominal infections, mainly of mild‐to‐moderate severity (three with a double‐blind design; one performed in children) that compared ertapenem treatment (once daily) against piperacillin/tazobactam, ceftriaxone plus metronidazole and ticarcillin/clavulanic acid (in three, two and one randomized‐controlled trials respectively) were included. No difference was found between adult patients with complicated intra‐abdominal infections treated with ertapenem vs. comparators, regarding clinical success (five randomized‐controlled trials, 2002 patients, fixed‐effect model, odds ratio: 1.11, 95% confidence interval (CI): 0.89–1.39); clinical adverse events (four randomized‐controlled trials, 1530 patients, fixed‐effect model, OR: 0.86, 95% CI: 0.61–1.20); microbiological success; mortality and withdrawals because of adverse events. Ertapenem was associated with more laboratory adverse events (four randomized‐controlled trials, 1530 patients, fixed‐effect model, OR: 1.73, 95% CI: 1.14–2.61), but none was reported as serious.Conclusion  This meta‐analysis provides additional evidence that ertapenem can be used as effectively and safely, as other recommended antimicrobial regimens, for the treatment of complicated intra‐abdominal infections, particularly of mild‐to‐moderate severity.
Review article: use of antitumour necrosis factor therapy in inflammatory bowel disease during pregnancy and conception
Authors: O'DONNELL S. , O'MORAIN C. 
Published: July 2010

SummaryBackground  One of the most frequently asked questions during consultation with those affected by inflammatory bowel disease is what are its effects on pregnancy, and how the treatment will impact on conception and pregnancy outcomes.Aim  To review available data regarding the safety of biological therapies during pregnancy, primarily in woman with inflammatory bowel disease.Methods A Medline search was performed and available original research and review articles relating to the use of biological (antitumour necrosis factor‐α) therapies in inflammatory bowel disease were reviewed. Where information regarding the use of a drug in inflammatory bowel disease during pregnancy was limited, articles referring to its use for other indications, such as rheumatoid arthritis, were reviewed.Conclusions Based on available data, biological therapies appear to be safe in pregnancy. Most studies looking at the effects of any one medication on pregnancy in inflammatory bowel disease are confounded by the fact that most patients are on multiple medications and have varying levels of disease activity. Stopping therapy in the third trimester should be considered. Large registries with longer follow‐up periods will be necessary before firm conclusions about the safety of antitumour necrosis factor‐α therapies during conception and pregnancy can be drawn.
Effects of therapeutic doses of lactulose vs. polyethylene glycol on isotopic colonic transit
Authors: JOUËT P. , SABATE J.‐M. , FLOURIE B. , CUILLERIER E. , GAMBINI D. , LEMANN M. , JIAN R. , COFFIN B. 
Published: July 2010

SummaryBackground  Lactulose and polyethylene glycol are osmotic agents used to treat idiopathic chronic constipation.Aim  To compare the effects of low doses of lactulose and PEG 4000 on transit time measured by scintigraphy in normal subjects.Methods  For 5 days, 10 healthy subjects received either 10 g b.d. of lactulose or PEG 4000 in a randomized, double‐blind, crossover study. On the evening of day 4, they took a capsule containing Amberlite resin pellets labelled with 111In. On day 5, after a 1000 kcal test meal labelled with 99Tcm, gastric, small bowel and colonic transits were measured.Results  Gastric emptying and small bowel transit time were not different. Ascending colon emptying curve was significantly accelerated with lactulose in comparison with polyethylene glycol (P = 0.001) and, respectively, 50 ± 18% vs. 35 ± 18% of the radioactivity had left the ascending colon at the end of the study (P < 0.05). The descending colon filling curves, variations in the geometric centre and numbers of scintigraphic movements were not different.Conclusions  In healthy subjects, in comparison to PEG 4000, usual therapeutic doses of lactulose significantly accelerate ascending colon emptying. This result supports a stimulating motor effect of colonic fermentation of lactulose.
Short‐term treatment with infliximab in chronic refractory pouchitis and ileitis
Authors: CALABRESE C. , GIONCHETTI P. , RIZZELLO F. , LIGUORI G. , GABUSI V. , TAMBASCO R. , POGGIOLI G. , PIERANGELI F. , CAMPIERI M. , DI FEBO G. 
Published: July 2010

SummaryBackground  Chronic refractory pouchitis is a long‐term complication after ileal pouch‐anal anastomosis and it may be associated with ileal inflammation.Aim  To determine the efficacy of infliximab in treatment of chronic refractory pouchitis complicated by ileitis, using a wireless capsule endoscopy.Methods  Sixteen patients with chronic refractory pouchitis complicated by ileitis were enrolled. Pouchitis was diagnosed by clinical, endoscopic and histological criteria. Ileitis was documented using wireless capsule endoscopy. Duodenum–jejunum and proximal–middle ileum were evaluated and the presence of small lesions and large lesions were noted. Crohn’s disease, intestinal infections were excluded in all patients. Patients were treated with infliximab and clinical response was recorded. Wireless capsule endoscopy was repeated at week 10 and Pouchitis Disease Activity Index score was determined.Results  Ten patients were enrolled and completed the study. Clinical remission was achieved in nine patients. At wireless capsule endoscopy and pouch endoscopy, a complete recovery of lesions was observed in eight patients. One patient presented four small lesions of the ileum at the 6 weeks of treatment and one patient did not show any modification. Clinical and endoscopic remission was maintained in these eight patients at least 6 months.Conclusion  These preliminary results indicate that infliximab may be recommended for the treatment of chronic refractory pouchitis complicated by ileitis.