bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspirin chemoprevention in patients with increased risk for colorectal cancer: a cost‐effectiveness analysis
Authors: DUPONT A. W. , ARGUEDAS M. R. , WILCOX C. M. 
Published: July 2010

SummaryBackground  Aspirin chemoprevention combined with colonoscopy screening is not cost‐effective for the general population. However, the cost‐effectiveness of aspirin in individuals with prior adenoma resection has not been evaluated.Aim  To evaluate the cost‐effectiveness of aspirin chemoprevention alone and in combination with colonoscopy surveillance in patients with prior adenoma resection.Methods  A model of the natural history of individuals with a history of endoscopic polypectomy was constructed. Four strategies were compared: (i) no intervention, (ii) routine colonoscopy surveillance, (iii) aspirin chemoprevention alone, and (iv) aspirin therapy combined with colonoscopy.Results  Compared with no intervention, all other strategies were more costly but were associated with gains in years of life saved. Aspirin chemoprevention alone was associated with a gain of 0.0092 years, whereas routine colonoscopic surveillance and combination strategy were associated with further gains in years of life saved (0.0124 and 0.0138 years, respectively). Compared with no intervention, the incremental cost‐effectiveness ratio of routine colonoscopy surveillance was $78 226 per year of life saved, and the incremental cost‐effectiveness ratio of combination aspirin and colonoscopy was $60 942 per year of life saved.Conclusion  Aspirin chemoprevention combined with colonoscopic surveillance in post‐polypectomy patients may be considered a cost‐effective strategy.
A randomized, double‐blind, placebo‐controlled trial of lenalidomide in the treatment of moderately severe active Crohn’s disease
Authors: MANSFIELD J. C. , PARKES M. , HAWTHORNE A. B. , FORBES A. , PROBERT C. S. J. , PEROWNE R.C. , COOPER A. , ZELDIS J. B. , MANNING D. C. , HAWKEY C. J. 
Published: July 2010

SummaryBackground  Therapy targeted at tumour necrosis factor‐α has an established role in Crohn’s disease. Lenalidomide, an analogue of thalidomide, is an oral immunomodulatory agent with powerful antitumour necrosis factor‐α properties. It is licensed for myeloma and myelodysplastic syndrome. Based upon reports of thalidomide efficacy, lenalidomide was evaluated in Crohn’s disease.Aim  To evaluate the efficacy and safety of lenalidomide in subjects with moderately severe active Crohn’s disease.Methods  In a multicentre, double‐blind, placebo‐controlled parallel group study 89 subjects were randomized to lenalidomide 25 mg daily, 5 mg daily or placebo. Subjects were treated for 12 weeks. The primary end point was a 70‐point reduction in Crohn’s Disease Activity Index.Results  The overall clinical response rate was not significantly different between the three groups: lenalidomide 25 mg 26%, lenalidomide 5 mg 48% and placebo 39%. Lenalidomide was generally well tolerated with only one serious adverse event, a deep vein thrombosis, being attributed to treatment.Conclusion  Lenalidomide, an oral agent with antitumour necrosis factor‐α properties, was not effective in active Crohn’s disease in contrast to reports of benefit from thalidomide. The reasons for this lack of efficacy are speculative, other physiological activities may offset its action on inflammatory cytokines, or its antitumour necrosis factor‐α action without apoptosis may be insufficient for activity in Crohn’s disease.
Effects of multispecies probiotic supplementation on intestinal microbiota in irritable bowel syndrome
Authors: KAJANDER K. , KROGIUS‐KURIKKA L. , RINTTILÄ T. , KARJALAINEN H. , PALVA A. , KORPELA R. 
Published: July 2010

SummaryBackground  A multispecies probiotic has shown beneficial effects in irritable bowel syndrome. In addition, certain other probiotics have demonstrated advantageous effects, but the mechanisms behind this are poorly understood.Aim  To investigate the mode of action of a multispecies probiotic consisting of Lactobacillus rhamnosus GG, Lactobacillus rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium breve Bb99 by monitoring its effects on intestinal microbiota and markers of microbial activity.Methods  A total of 55 irritable bowel syndrome patients participated in this placebo‐controlled double‐blind trial. Subjects received either multispecies probiotic or placebo supplementation daily during a 6‐month period. The composition of intestinal microbiota was analysed with real‐time polymerase chain reaction, short‐chain fatty acids with gas chromatography and enzymes with spectrophotometer.Results  Each supplemented probiotic strain was detected in faecal samples. Intestinal microbiota remained stable during the trial, except for Bifidobacterium spp., which increased in the placebo group and decreased in the probiotic group (P = 0.028). No changes in short‐chain fatty acids occurred. A decrease in ß‐glucuronidase activity was detected in 67% of the subjects in the probiotic group vs. 38% in the placebo group (P = 0.06).Conclusions  Factors other than the microbial groups and metabolites studied herein seem responsible for the alleviation of irritable bowel syndrome symptoms by the multispecies probiotic.
Pharmacodynamics of peginterferon alfa‐2a and peginterferon alfa‐2b in interferon‐naïve patients with chronic hepatitis C: a randomized, controlled study
Authors: BRUNO R. , SACCHI P. , SCAGNOLARI C. , TORRIANI F. , MAIOCCHI L. , PATRUNO S. , BELLOMI F. , FILICE G. , ANTONELLI G. 
Published: July 2010

SummaryBackground  Peginterferon alfa‐2a and alfa‐2b, the two commercially available pegylated interferons, have different pharmacokinetic properties that produce differing abilities to suppress replication of the hepatitis C virus.Aim  To compare the pharmacodynamics of peginterferon alfa‐2a and peginterferon alfa‐2b in interferon‐naive patients with chronic hepatitis C.Methods  Patients were randomized to receive peginterferon alfa‐2a, 180 μg (n = 10) or peginterferon alfa‐2b 1.0 μg/kg (n = 12) once weekly. The enzymatic activity of 2′5′‐oligoadenylate synthetase and levels of neopterin and β2‐microglobulin were measured at baseline and at 24, 48, 120 and 168 h.Results  Oligoadenylate synthetase activity and serum neopterin and β2‐microglobulin concentrations did not differ significantly between the two patient groups at any time point, nor was there a significant correlation between the serum area under the concentration‐time curve of either peginterferon and the area under the concentration‐time curve for 2′,5′‐oligoadenylate synthetase, neopterin and β2‐microglobulin. The area under the concentration‐time curves calculated for these three markers did not correlate with body mass index stratified at <25 and ≥25 kg/m2 for either peginterferon.Conclusions  Despite pharmacokinetic differences between peginterferon alfa‐2a and peginterferon alfa‐2b, the pharmacodynamic profiles of the two formulations appear to be comparable.
Predictors of outcome in patients with unresectable hepatocellular carcinoma receiving transcatheter arterial chemoembolization
Authors: SHEN H. , AGARWAL D. , QI R. , CHALASANI N. , LIANGPUNSAKUL S. , LUMENG L. , YOO H. , KWO P. 
Published: July 2010

SummaryBackground  Transcatheter arterial chemoembolization (TACE) has been shown to improve survival in patients with unresectable hepatocellular carcinoma (HCC).Aim  To identify pretreatment factors that predicts increased mortality in HCC patients receiving TACE.Methods  Retrospective review of all patients who underwent TACE for HCC from January 1999 to November 2004. Patient demographics, aetiology of liver disease, laboratory and imaging data regarding tumour characteristics were obtained.Results  Eighty‐eight patients (57 ± 1 years age) received 1–4 sessions of TACE (1.4 ± 0.1). Tumour size was 3.3 ± 0.2 cm (range 1–13 cm, median 3 cm) with mean number of lesions 1.9 ± 0.1 (range 1–7). Mean model for the end stage liver disease score: 11 ± 0.4; cancer of the liver Italian program score: 1.3 ± 0.1. Survival post‐TACE (excluding those underwent orthotopic liver transplantation) was 12 ± 0.3 months. By multivariate analysis, tumour size (HR = 1.37, 95% CI: 1.11–1.68, P = 0.003), hypovascularity (HR = 12.62, 95% CI: 1.79–88.92, P = 0.01) and elevated international normalized ratio (HR = 1.46, 95% CI: 1.10–1.92 P = 0.008) are shown to be significant risk factors for increased mortality.Conclusion  TACE therapy leads to a mean survival of 12 months in patients not receiving orthotopic liver transplantation. Tumour size, hypovascularity on imaging, and elevated international normalized ratio are predictors of increased mortality after TACE therapy for HCC.
Effect of long‐term treatment with octreotide on rectal sensitivity in patients with non‐constipated irritable bowel syndrome
Authors: KLOOKER T. K. , KUIKEN S. D. , LEI A. , BOECKXSTAENS G. E. 
Published: July 2010

SummaryBackground Acute administration of octreotide reduces visceral perception and therefore has been suggested as potential treatment for irritable bowel syndrome. Whether prolonged treatment with octreotide also reduces visceral sensitivity and improves gastrointestinal symptoms remains, however, unknown.Aim To investigate the effect of a slow release preparation of octreotide on rectal sensitivity and symptoms in irritable bowel syndrome patients.Methods Forty‐six non‐constipated irritable bowel syndrome patients (52% female, 19–63 years) participated. Before and after 8 weeks of treatment with octreotide (Sandostatin LAR 20 mg i.m.) or placebo, patients underwent a barostat study to assess the rectal sensitivity. During a 2‐week run‐in period and treatment, abdominal pain, defecation frequency, consistency and symptom relief were scored weekly.Results Octreotide, but not placebo, significantly increased the threshold for first sensation. Thresholds for urge to defecate and discomfort/pain and rectal compliance were not altered by either treatment. Octreotide improved stool consistency compared with placebo (loose stools after eight weeks: octreotide: 52%, placebo: 81%,P < 0.05). In contrast, abdominal pain and defecation frequency were not affected.Conclusions Although the threshold of first rectal sensation increased and stool consistency improved, long‐term treatment with octreotide, at least at the current dose used, has no visceral analgesic effect and fails to improve irritable bowel syndrome symptoms.
An open population screening study for HFE gene major mutations proves the low prevalence of C282Y mutation in Central Italy
Authors: FLOREANI A. , RIZZOTTO E. ROSA , BASSO D. , NAVAGLIA F. , ZANINOTTO M. , PETRIDIS I. , DI ANDREA O. , TESTA R. , MARRA M. , BALDO V. , CHIARAMONTE M. ,   ARSITA‐TWO RESEARCH GROUP
Published: July 2010

SummaryBackground  The C282Y mutation in the HFE gene is responsible for most cases of hereditary haemochromatosis.Aim  To investigate the allele frequency of HFE mutations and the associations between mutations and cases of iron overload or liver diseases in an open population of Central Italy.Methods  A total of 502 individuals over 8 years of age, comprising 203 males and 299 females, who were residents in Arsita (a small town in Central Italy), were assayed for: C282Y, H63D and S65C mutations of the HFE gene by TaqMan probes; body mass index, serum ferritin, transferrin saturation, transaminases, GGT, glucose, insulin, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, triglycerides, HBV and HCV serum markers. Information was obtained on alcohol intake. Liver ultrasound was performed in 334 (67%) subjects.Results  The allele frequencies for C282Y, H63D and S65C were 2%, 15%, and 0.01%, respectively. C282Y/wt was found in 19 subjects (4%), H63D/wt in 127 (25%), H63D/H63D in 11 (2%) and S65C/wt in one (2.0‰). No homozygosity for C282Y or compound mutation (C282Y/H63D) was found in the study population, but 27 subjects (5%) had TfSat >45% (including 10 subjects with high serum ferritin). Overall, 49 subjects (9.8%) were HCV‐RNA‐positive. Logistic regression analysis indicated that male gender (P = 0.000) and hepatic steatosis (P = 0.017) were independent variables correlating to a high serum ferritin.Conclusion  C282Y HFE mutation is less frequent in Central Italy than in Northern Italy.
Reverse transcriptase activity in patients with primary biliary cirrhosis and other autoimmune liver disorders
Authors: MCDERMID J. , CHEN M. , LI Y. , WASILENKO S. , BINTNER J. , MCDOUGALL C. , PANG X. , BAIN V. G. , MASON A. L. 
Published: July 2010

SummaryBackground  Patients with biliary disease make retroviral antibodies and the Human Betaretrovirus has been characterized in patients with primary biliary cirrhosis.Aim  To screen patients with autoimmune liver disease for evidence of retroviral infection.Methods  Real‐time reverse transcriptase polymerase chain reaction was used to detect Human Betaretrovirus, and a reverse transcriptase assay to measure reverse transcriptase activity in plasma.Results  Using reverse transcriptase polymerase chain reaction, 24% of primary biliary cirrhosis samples were positive for Human Betaretrovirus when compared to 13% with autoimmune hepatitis, 5% of other liver diseases and 3% of the non‐liver disease control subjects. Reverse transcriptase activity was found in 73% of patients with autoimmune hepatitis, 42% with primary biliary cirrhosis, 22% of liver patients without viral or autoimmune disease and 7% of subjects without liver disease. In patients with autoimmune liver disease, detection of reverse transcriptase activity was related to higher ALT levels, whereas others stabilized on immunosuppressive therapy either preliver or postliver transplantation were less likely to be reverse transcriptase‐positive.Conclusions  Most patients with autoimmune hepatitis have detectable reverse transcriptase activity. Investigations will be required to assess whether this represents the expression of endogenous retroviruses and retrotransposable elements in inflamed tissue, or signifies the presence of exogenous retroviral infection.
One‐week acid suppression trial in uninvestigated dyspepsia patients with epigastric pain or burning to predict response to 8 weeks’ treatment with esomeprazole: a randomized, placebo‐controlled study
Authors: VAN ZANTEN S. V. , FLOOK N. , TALLEY N. J. , VAKIL N. , LAURITSEN K. , BOLLING‐STERNEVALD E. , PERSSON T. , BJÖRCK E. , SVEDBERG L.‐E. ,   ON BEHALF OF THE STARS II STUDY GROUP
Published: July 2010

SummaryBackgroundWhile empiric acid‐suppressive therapy for uninvestigated dyspepsia patients with symptoms of epigastric pain or burning is standard practice, it is unknown whether an early response to therapy predicts outcome.AimTo evaluate whether a 1‐w acid suppression trial is effective for predicting 8‐w response in such patients.Methods Helicobacter pylori‐negative patients (aged 18–50 years) in primary care with uninvestigated epigastric pain or burning were randomized to esomeprazole 40 mg q.d.s. or b.d. for 1w, followed by esomeprazole 40 mg q.d.s. or placebo for 7w. Each day, patients rated the severity of their symptoms.ResultsBased on the last 3d, 1‐w response rates were 39% (231 of 588) and 43% (258 of 596) with esomeprazole 40 mg q.d.s. and b.d., respectively. Based on the last 7d, response rates at 4w were 38% (283 of 738) and 25% (93 of 380) for esomeprazole and placebo, respectively, and 47% (339 of 716) and 34% (124 of 368), respectively, at 8w (both P < 0.001 vs. placebo). The sensitivity and specificity of esomeprazole treatment were 58% and 70%, respectively, at 8w.ConclusionA 1‐w acid suppression trial is of limited clinical value for predicting 8‐w response in patients with symptoms of epigastric pain or burning. Esomeprazole provides greater symptom control than placebo at 4w and 8w.
The safety, tolerance, pharmacokinetic and pharmacodynamic effects of single doses of AT‐1001 in coeliac disease subjects: a proof of concept study
Authors: PATERSON B. M. , LAMMERS K. M. , ARRIETA M. C. , FASANO A. , MEDDINGS J. B. 
Published: July 2010

SummaryBackgroundLifelong adherence to a strict gluten‐free diet is the cornerstone of coeliac disease treatment. Elucidation of disease pathogenesis has created opportunities for novel therapeutic approaches to coeliac disease. AT‐1001 is an inhibitor of paracellular permeability whose structure is derived from a protein secreted by Vibrio cholerae.AimTo determine the safety and tolerability of 12 mg doses of AT‐1001 in coeliac disease subjects challenged with gluten.MethodsAn in‐patient, double‐blind, randomized placebo‐controlled safety study utilizing intestinal permeability, measured via fractional excretions of lactulose and mannitol, as an exploratory measure of drug efficacy.ResultsCompared to placebo, no increase in adverse events occurred in patients exposed to AT‐1001. Following acute gluten exposure, a 70% increase in intestinal permeability was detected in the placebo group, while none was seen in the AT‐1001 group. Interferon‐γ levels increased in four of seven patients (57%) of the placebo group, but only in four of 14 patients (29%) of the AT‐1001 group. Gastrointestinal symptoms were more frequently detected in the placebo group when compared to the AT‐1001 group (P = 0.018).ConclusionsAT‐1001 is well tolerated and appears to reduce intestinal barrier dysfunction, proinflammatory cytokine production, and gastrointestinal symptoms in coeliacs after gluten exposure.
Infliximab in severe ulcerative colitis: short‐term results of different infusion regimens and long‐term follow‐up
Authors: KOHN A. , DAPERNO M. , ARMUZZI A. , CAPPELLO M. , BIANCONE L. , ORLANDO A. , VISCIDO A. , ANNESE V. , RIEGLER G. , MEUCCI G. , MARROLLO M. , SOSTEGNI R. , GASBARRINI A. , PERALTA S. , PRANTERA C. 
Published: July 2010

SummaryBackgroundSevere ulcerative colitis is a life‐threatening disorder, despite i.v. glucocorticoids treatment. Infliximab has been proposed as a safe rescue therapy.AimTo evaluate short‐ and long‐term effectiveness and safety of infliximab in severe refractory ulcerative colitis.MethodsEighty‐three patients with severe ulcerative colitis (i.v. glucocorticoids treatment‐refractory) were treated with infliximab in 10 Italian Gastroenterology Units. Patients underwent one or more infusions according to the choice of treating physicians. Short‐term outcome was colectomy/death 2 months after the first infusion. Long‐term outcome was survival free from colectomy. Safety data were recorded.ResultsTwelve patients (15%) underwent colectomy within 2 months. One died of Legionella pneumophila infection 12 days after infliximab. Early colectomy rates were higher in patients receiving one infusion (9/26), compared with those receiving two/more infusions (3/57, P = 0.001, OR = 9.53).Seventy patients who survived colectomy and did not experience any fatal complications were followed‐up for a median time of 23 months; 58 patients avoided colectomy during the follow‐up. Forty‐two patients were maintained on immunosuppressive drugs. No clinical features were associated with outcomes.ConclusionsInfliximab is an effective and relatively safe therapy to avoid colectomy and maintain long‐term remission for patients with severe refractory ulcerative colitis. In the short term, two or more infusions seem to be more effective than one single infusion.
Long‐term survival of patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoinfusion
Authors: HA B. Y. , AHMED A. , SZE D. Y. , RAZAVI M. K. , SIMPSON N. , KEEFFE E. B. , NGUYEN M. H. 
Published: July 2010

SummaryBackgroundTranscatheter arterial chemoembolization (TACE) has become one of the most common treatments for unresectable hepatocellular carcinoma. Published studies of TACE report a 5–16% risk of serious complications. Compared with TACE, transcatheter arterial chemoinfusion (TACI) may have similar efficacy and fewer side effects.AimTo examine the clinical outcomes of TACI.MethodsWe performed a retrospective cohort study of 345 consecutive TACI cases in 165 patients performed at a single United States medical center between 1998 and 2002. Primary outcomes were tumour response and survival rates.ResultsOnly seven patients were hospitalized for more than 24 h after the procedure, and only three patients had worsening of liver function within 30 days of TACI. Survival was significantly poorer for patients with tumour‐node‐metastasis (TNM) IV compared to those with TNM I–III and also for patients with Child’s class B/C vs. A. Following adjustment for age, gender, ethnicity and aetiology of liver diseases, independent predictors of poor survival were Child’s class B/C [Hazard Ratio (HR) = 1.69, P = 0.024] and TNM IV staging (HR = 1.63, P = 0.014).ConclusionsTACI appears to be safe and effective for unresectable hepatocellular carcinoma with TNM stage I–III; randomized controlled trials are needed to compare TACI to TACE.
Epidemiology of chronic atrophic gastritis: population‐based study among 9444 older adults from Germany
Authors: WECK M. N. , STEGMAIER C. , ROTHENBACHER D. , BRENNER H. 
Published: July 2010

SummaryBackgroundEpidemiological data on chronic atrophic gastritis from general population samples are sparse in Germany.AimTo assess prevalence of chronic atrophic gastritis according to potential risk factors and clinical outcomes in a large‐scale population‐based study.MethodsIn the baseline examination of ESTHER, a population‐based cohort study conducted in Germany, serological measurements of pepsinogen (PG) I and II and Helicobacter pylori antibodies were taken in 9444 women and men aged 50–74 years. Information on potential risk factors and medical history were obtained by questionnaire.ResultsWith the definition used in the EUROGAST study (PG I < 25 ng/mL), prevalence of chronic atrophic gastritis increased from 4.8% in age group 50–54 to 8.7% in age group 70–74. An alternative definition of chronic atrophic gastritis (PG I < 70 ng/mL and PG I/PG II < 3), used in multiple studies from Japan, revealed a greater increase with age (from 2.7% to 9.1%) and a strong association with H. pylori infection (adjusted odds ratio: 2.9, 95% confidence interval: 2.4–3.7). With both definitions, a strong inverse association with heartburn was observed.ConclusionsOverall chronic atrophic gastritis prevalence is low among older adults in Germany, but it strongly increases with age and H. pylori infection.
Meta‐analysis: enteral nutrition in active Crohn’s disease in children
Authors: DZIECHCIARZ P. , HORVATH A. , SHAMIR R. , SZAJEWSKA H. 
Published: July 2010

SummaryBackgroundControversy exists surrounding the optimal treatment for inducing remission in active Crohn’s disease.AimTo review and update evidence on the effectiveness of enteral nutrition (EN) in treating active Crohn’s disease in children.MethodsMEDLINE, EMBASE and The Cochrane Library (up to February 2007) were searched for randomized controlled trials (RCTs) relevant to Crohn’s disease and EN in children.ResultsWe included 11 RCTs (n = 394). Seven RCTs (n = 204) compared EN with corticosteroid therapy. On the basis of pooled results of four RCTs (n = 144), we found no significant difference in the remission rates between groups (relative risk, RR 0.97, 95% CI 0.7–1.4, random effect model). Four RCTs (n = 190) compared two EN regimens. One of the four RCTs (n = 50) revealed a significant increase in the percentage of patients achieving remission in the total EN group compared with the partial EN group (RR 2.7, 95% CI 1–7.4). Because of lack of data, formal pooling of results was not possible for many outcomes (e.g., time until remission, duration of remission, growth data).ConclusionsLimited data suggest similar efficacy for EN and corticosteroids. As the number of patients needed to provide a definite answer is too large, future studies should focus on detailed outcome measurements including growth and quality of life.