bluuebunny/crossref_metadata_2025_split huggingface dataset:
The validity of a symptom diary in ratings of dyspepsia measured against a detailed interview: do patients and clinicians agree in their assessment of symptoms?
Authors: MADSEN L. G. , HANSEN J. M. , GRØNVOLD M. , BYTZER P. 
Published: July 2010

SummaryBackgroundPatients’ self‐assessment of symptoms is central in drug treatment trials of functional dyspepsia. The validity of such ratings is important.AimTo validate a diary for monitoring severity and duration of dyspepsia.MethodWe compared the diary‐cards with two clinicians’ ratings of the patient’s open‐ended responses to the same questions administered by interview. Agreements were evaluated by estimation of the overall agreement and weighted kappa values (Kw).ResultsForty‐six patients were evaluated. The Kw between the two clinicians rating severity and duration of symptoms were 0.59 and 0.86, respectively. Overall agreement between patients’ diary rating and clinicians’ consensus rating of severity were 52%, and a moderate agreement with Kw of 0.49 was found. For duration of symptoms the overall agreement and Kw were 67% and 0.59, respectively. Qualitative data revealed useful insight in the possible causes of suboptimal agreement between patients and clinicians.ConclusionsWe found a moderate to good agreement between patient and observer ratings, indicating that patients to a reasonable extent interpret severity and duration of dyspeptic symptoms in the same way as do investigators. A ceiling effect of the duration scale indicates suboptimal response categories, which should be adjusted before further use.
Clinical trial: short‐ and long‐term benefit of relaxation training for irritable bowel syndrome
Authors: VAN DER VEEK P. P. J. , VAN ROOD Y. R. , MASCLEE A. A. M. 
Published: July 2010

SummaryBackgroundPsychotherapy is effective in treating irritable bowel syndrome, but the effect of relaxation training, a brief psychological group intervention, is not known.AimTo determine the efficacy of relaxation training in a large cohort of irritable bowel syndrome patients.MethodsNinety‐eight irritable bowel syndrome patients were included in this randomized controlled trial. Forty‐six patients received standard medical care (CON) and 52 received four 90‐min sessions of relaxation training in small groups in addition to standard medical care. Irritable bowel syndrome symptom severity, medical consumption and quality of life were assessed at baseline in patients and in 38 healthy controls and evaluated in patients at 3, 6 and 12 months after intervention.ResultsIrritable bowel syndrome symptom severity was significantly reduced in the relaxation training group compared to CON at 3, 6 and 12 months after treatment (time‐by‐treatment interaction, P = 0.002). The number needed to treat for long‐term improvement was 5. Quality of life had improved (general health, P = 0.017; health change, P = 0.05). Frequency of doctor visits was reduced (P = 0.039).ConclusionsRelaxation training is a brief group intervention that significantly improves symptom severity, general health perception and medical consumption in irritable bowel syndrome patients immediately after, as well as 6 and 12 months after intervention.
Recurrence of peptic ulcer in uraemic and non‐uraemic patients after Helicobacter pylori eradication: a 2‐year study
Authors: TSENG G.‐Y. , LIN H.‐J. , FANG C.‐T. , YANG H.‐B. , TSENG G.‐C. , WANG P.‐C. , HUNG T.‐L. , DENG Y.‐C. , CHENG Y.‐T. , HUANG C.‐H. 
Published: July 2010

SummaryBackgroundThe role of Helicobacter pylori in the pathogenesis of peptic ulcer disease in patients with uraemia remains unclear.AimTo evaluate the long‐term effect of H. pylori eradication in these patients.MethodsUraemic and non‐uraemic patients with peptic ulcer were enrolled in this study. Patients having history of non‐steroidal anti‐inflammatory drugs use or cardiovascular disease that need aspirin use were excluded. After confirmation of H. pylori infection, they received a triple therapy and were followed up for 2 years.ResultsBetween September 1999 and December 2005, 34 patients (41%) of the end‐stage renal disease [H. pylori (+) group] and 67 (84%) of the non‐uraemic patients with peptic ulcer disease (PU group) received anti‐H. pylori therapy. After triple therapy, 32 (94%) from the end‐stage renal disease group and 64 (96%) from the peptic ulcer group obtained successful eradication. During the 2‐year follow‐up, three patients in the end‐stage renal disease group were excluded because of the presence of cardiovascular disease and aspirin use in two cases and died of heart failure in one case; two patients in peptic ulcer group refused follow‐up. Finally, 29 uraemic and 62 non‐uraemic patients had achieved the follow‐up. Recurrence of peptic ulcer was more in the end‐stage renal disease group than in the peptic ulcer group with intention‐to‐treat analysis (eight of 32, 25% vs. two of 64, 3%, P = 0.001, OR: 10.0, 95% CI: 1.979–50.540) or per‐protocol analysis (eight of 29, 28% vs. two of 62, 3%, P < 0.001, OR: 11.4, 95% CI: 2.245–58.168).ConclusionsPeptic ulcer recurrence after H. pylori eradication is higher in end‐stage renal disease patients with peptic ulcer than in peptic ulcer patients without renal disease. Factors aside from H. pylori play an important role in peptic ulcer recurrence in end‐stage renal disease patients.
Review article: yeast as probiotics –Saccharomyces boulardii
Authors: CZERUCKA D. , PICHE T. , RAMPAL P. 
Published: July 2010

SummaryBackgroundProbiotics are defined as live micro‐organisms which confer a health benefit on the host. Although most probiotics are bacteria, one strain of yeast, Saccharomyces boulardii, has been found to be an effective probiotic in double‐blind clinical studies.AimsTo compare the main properties that differentiates yeast from bacteria and to review the properties of S. boulardii explaining its potential benefits as a probiotic.MethodsThe PubMed and Medline databases were searched using the keywords ‘probiotics’, ‘yeast’, ‘antibiotic associated diarrhea’, ‘Saccharomyces boulardii’,‘bacterial diarrhea’ and ‘inflammatory bowel disease’ in various combinations.ResultsSeveral clinical studies have been conducted with S. boulardii in the treatment and prevention of various forms of diarrhoea. Promising research perspectives have been opened in terms of maintenance treatment of inflammatory bowel diseases. The mechanism of S. boulardii’s action has been partially elucidated.Conclusion Saccharomyces boulardii is a strain of yeast which has been extensively studied for its probiotic effects. The clinical activity of S. boulardii is especially relevant to antibiotic‐associated diarrhoea and recurrent Clostridium difficile intestinal infections. Experimental studies clearly demonstrate that S. boulardii has specific probiotic properties, and recent data has opened the door for new therapeutic uses of this yeast as an ‘immunobiotic’.
Clinical trial: levofloxacin‐based quadruple therapy was inferior to traditional quadruple therapy in the treatment of resistant Helicobacter pylori infection
Authors: YEE Y. K. , CHEUNG T. K. , CHU K.‐M. , CHAN C. K. , FUNG J. , CHAN P. , BUT D. , HUNG I. , CHAN A. O. O. , YUEN M. F. , HSU A. , WONG B. C. Y. 
Published: July 2010

SummaryBackground  The efficacy of levofloxacin‐based quadruple therapy in resistant Helicobacter pylori infection is not known.Aim  To test the efficacy of levofloxacin‐based quadruple therapy and traditional quadruple therapy in resistant H. pylori infection.Methods  One hundred and two patients with resistant H. pylori infection were randomized to 1 week of either EBAL (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., amoxicillin 1 g b.d. and levofloxacin 500 mg b.d.) or EBMT (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., metronidazole 400 mg t.d.s. and tetracycline 500 mg q.d.s.). 13C‐urea breath test was performed at week 12 to assess post‐treatment H. pylori status.Results  In intention‐to‐treat analysis H. pylori eradication was achieved in 37 of 51 (73%) subjects in EBAL and 45 of 51 (88%) subjects in EBMT groups, respectively (P = 0.046). Per‐protocol eradication rates of EBAL and EMBT groups were 78% and 94%, respectively (P = 0.030). The intention‐to‐treat eradication rate was statistically lower for EBAL than EMBT (56% vs. 90%, P = 0.013) among those who had failed more than one course of eradication therapy. Previous levofloxacin triple therapy did not affect the efficacy of either protocol significantly.Conclusions  Levofloxacin‐based quadruple therapy was inferior to traditional quadruple therapy for resistant H. pylori infection.
Epidemiology of slow and fast colonic transit using a scale of stool form in a community
Authors: CHOUNG R. S. , LOCKE G. R. , ZINSMEISTER A. R. , SCHLECK C. D. , TALLEY N. J. 
Published: July 2010

SummaryBackground  Measurement of gastrointestinal transit is commonly performed in the clinic, but data on transit in the community are lacking.Aim  To estimate the prevalence of slow and fast colonic transit using stool form, and potential risk factors.Methods  A validated self‐reported gastrointestinal symptom questionnaire was mailed to 4196 randomly selected members of the community (response rate 54%). One question asked the subject to self‐report their stool form using the Bristol Stool Scale.Results  Overall, 18%, 9% and 73% met stool form criteria for slow, fast or normal colonic transit, respectively. Increased odds for slow transit were observed with a higher Somatic Symptom Checklist score (OR = 1.6; 1.3–2.0), while a decreased odds for slow transit was observed in males relative to females (OR = 0.6; 0.5–0.8). An increased odds for fast transit was observed with higher Somatic Symptom Checklist score (OR = 2.3; 1.7–2.9) and a history of cholecystectomy (OR = 1.8; 1.2–2.8). Increasing body mass index (per 5 units) was associated with decreased odds for slow (OR = 0.85; 0.78–0.93), and an increased odds for fast (OR = 1.1; 1.04–1.24) colonic transit.Conclusion  Based on stool form assessment, nearly one in five community members may have slow colonic transit and one in 12 have accelerated colonic transit.
Prospective evaluation of faecal neutrophil‐derived proteins in identifying intestinal inflammation: combination of parameters does not improve diagnostic accuracy of calprotectin
Authors: SCHRÖDER O. , NAUMANN M. , SHASTRI Y. , POVSE N. , STEIN J. 
Published: July 2010

SummaryBackground  Differentiating symptoms of irritable bowel syndrome from those of organic intestinal disease is a common clinical problem. Several neutrophil‐derived proteins have been proposed as a marker of inflammatory bowel disease.Aim  To compare the diagnostic value of faecal calprotectin, lactoferrin and polymorphonuclear neutrophil‐elastase in distinguishing inflammatory bowel disease from irritable bowel syndrome.Methods  Eighty‐eight adult patients with a history of chronic diarrhoea of unknown origin were screened. All patients underwent a complete work‐up to identify the underlying cause. In addition, a single stool sample was assayed for faecal calprotectin, lactoferrin and polymorphonuclear neutrophil‐elastase by enzyme‐linked immunosorbent assay.Results  Within the study cohort inflammatory bowel disease was diagnosed in 45 patients and irritable bowel syndrome in 31 patients. The sensitivity and specificity of calprotectin for inflammatory bowel disease were 93% and 100%, respectively. In contrast, the respective diagnostic values for lactoferrin and polymorphonuclear neutrophil‐elastase were 82% and 100% and 84% and 87%, respectively. Neither combination of markers did improve the diagnostic power compared with calprotectin alone.Conclusions  Although all faecal biomarkers studied provide a reliable and simple non‐invasive means in the differentiation of inflammatory bowel disease and irritable bowel syndrome, calprotectin appears to represent the most accurate marker to discriminate between these two common causes of chronic diarrhoea.
Upper gastrointestinal bleeding and the changing use of COX‐2 non‐steroidal anti‐inflammatory drugs and low‐dose aspirin
Authors: TAHA A. S. , ANGERSON W. J. , PRASAD R. , MCCLOSKEY C. , BLATCHFORD O. 
Published: July 2010

SummaryBackground  Rofecoxib was withdrawn in 2004.Aim  To assess the incidence of upper gastrointestinal bleeding in the context of the changing use of cyclo‐oxygenase‐2 non‐steroidal anti‐inflammatory drugs and low‐dose aspirin.Methods  We examined the characteristics of patients developing upper gastrointestinal bleeding in a defined population in south‐west Scotland. The primary comparisons were made between two calendar years, preceding and following the withdrawal of rofecoxib.Results  The overall incidence of upper gastrointestinal bleeding rose from 98.7 in 2002 to 143 per 105 of the population per annum in 2005 (χ2 = 21.1; P < 0.001). The rise in the incidence was associated with using low‐dose aspirin, from 26.6 to 38.4 per 105 (χ2 = 5.4; P = 0.02), other antithrombotic drugs, from 12.1 to 30.2 per 105 (χ2 = 19.6; P < 0.001), and excess alcohol, from 23.5 to 36.4 per 105 (χ2 = 7.1; P = 0.008), but insignificantly with using non‐steroidal anti‐inflammatory drugs, from 13.3 to 16.1 per 105 (χ2 = 0.64; P = 0.4). After adjustment for the concomitant use of these drugs, there was no significant trend in the incidence of upper gastrointestinal bleeding associated with non‐steroidal anti‐inflammatory drugs over the period of 1996–2005.Conclusion  The rise in the incidence of upper gastrointestinal bleeding was weakly related to the change in use of non‐steroidal anti‐inflammatory drugs. Instead, it probably reflected the increasing use of low‐dose aspirin, other antithrombotic drugs and alcohol.
Endosonography‐ vs. endoscopic retrograde cholangiopancreatography‐based strategies in the evaluation of suspected common bile duct stones in patients with normal transabdominal imaging
Authors: ANG T. L. , TEO E. K. , FOCK K. M. 
Published: July 2010

SummaryBackground  Endosonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are highly accurate techniques for evaluating common bile duct stones.Aim  To compare the clinical impact and costs of EUS‐ and ERCP‐based strategies for evaluating patients with suspected common bile duct stones but normal transabdominal imaging.Methods  The costs of EUS‐ vs. ERCP‐based strategies were compared in patients with suspected acute biliary obstruction from common bile duct stones but normal transabdominal imaging.Results  Over a 15‐month period, 110 patients were recruited. EUS detected a common bile duct lesion in 73% (common bile duct stones: 68%; pancreatic cancer: 2%; ampulla tumour: 2%; cholangiocarcinoma: 1%). The sensitivity, specificity, positive predictive value and negative predictive value of EUS were 98%, 100%, 100% and 93%, respectively. EUS prevented 30% unnecessary ERCP. The mean difference in cost per patient between EUS‐ and ERCP‐based strategies was US$166. When stratified according to clinical indications, an EUS‐based strategy was costlier only in suspected biliary sepsis. Costs were similar when the indications were cholestatic jaundice, acute pancreatitis and cholestasis.Conclusion  EUS prior to biliary interventions in patients with suspected common bile duct stones prevented unnecessary ERCP. It allowed a definitive diagnosis to be made prior to more invasive procedures.
Review article: probiotics in gastrointestinal and liver diseases
Authors: JONKERS D. , STOCKBRÜGGER R. 
Published: July 2010

SummaryBackground  Probiotics, defined as live micro‐organisms with beneficial effects for the host, are widely applied in gastrointestinal and liver diseases.Aim and method  To review the available evidence of clinical trials on probiotics in gastrointestinal and liver diseases, with a major focus on irritable bowel syndrome, inflammatory bowel disease, pancreatitis and chronic liver diseases.Results  Evidence for the therapeutic or preventive application of particular probiotic strains is available for antibiotic‐associated diarrhoea, rota‐virus‐associated diarrhoea and pouchitis. Results are encouraging for irritable bowel syndrome, ulcerative colitis and for reducing side effects by Helicobacter pylori eradication therapies, but are less clear for Crohn’s disease, lactose intolerance and constipation. In general, for most of these patient groups, more placebo‐controlled methodologically well‐designed studies that pay attention to both clinical outcome and mechanistic aspects are required. The application in liver disease and pancreatitis is promising, but more human trials have to be awaited. Possible mechanisms of probiotics include modulation of the intestinal microbiota and the immune system, but different bacterial may have different effects.Conclusion  Further insight into disease entities and the functioning of probiotic strains is required to be able to select disease‐specific strains, which have to be tested in well‐designed placebo‐controlled studies.
Review article: the relevance of surveillance endoscopy in long‐lasting inflammatory bowel disease
Authors: VLEGGAAR F. P. , LUTGENS M. W. M. D. , CLAESSEN M. M. H. 
Published: July 2010

SummaryBackground Development of colitis‐associated colorectal cancer is an important clinical problem in patients with colonic inflammatory bowel disease (IBD). British and American guidelines recommend to start surveillance after a disease duration of 8–10 or 15–20 years for patients with extensive or left‐sided colitis, respectively.Aim To assess the evidence level of current surveillance strategies.Methods A PubMed‐based literature search using the search terms inflammatory bowel disease, ulcerative colitis, Crohn’s disease, dysplasia, colorectal cancer and surveillance was performed.Results Low‐grade and high‐grade dysplastic lesions progress to cancer in a high percentage of patients. Furthermore, concurrent cancer is found in approximately one‐third of the patients with colonic dysplasia. Low‐level evidence showing reduced colorectal cancer‐related mortality in patients who were undergoing surveillance is available. Patients with concomittant primary sclerosing cholangitis form a subgroup of IBD patients with an even higher risk of colorectal neoplasia.Conclusions Colonic surveillance prolongs life expectancy of patients with long‐lasting IBD.
Review article: the management of non‐cirrhotic non‐malignant portal vein thrombosis and concurrent portal hypertension in adults
Authors: SPAANDER V. M. C. W. , VAN BUUREN H. R. , JANSSEN H. L. A. 
Published: July 2010

SummaryBackground  Extrahepatic portal vein thrombosis is an important cause of non‐cirrhotic portal hypertension.Aim  To provide an update on recent advances in the aetiology and management of acute and chronic non‐cirrhotic non‐malignant extrahepatic portal vein thrombosis.Method  A PubMed search was performed to identify relevant literature using search terms including ‘portal vein thrombosis’, ‘variceal bleeding’ and ‘portal biliopathy’.Results  Myeloproliferative disease is the most common risk factor in patients with non‐cirrhotic non‐malignant extrahepatic portal vein thrombosis. Anticoagulation therapy for at least 3 months is indicated in patients with acute extrahepatic portal vein thrombosis. However, in patients with extrahepatic portal vein thrombosis due to a prothrombotic disorder, permanent anticoagulation therapy can be considered. The most important complication of extrahepatic portal vein thrombosis is oesophagogastric variceal bleeding. Endoscopic treatment is the first‐line treatment for variceal bleeding. In several of the patients with extrahepatic portal vein thrombosis biliopathy changes on endoscopic retrograde cholangiography (ERCP) have been reported. Dependent on the persistence of the biliary obstruction, treatment can vary from ERCP to hepaticojejunostomy.Conclusion  Prothrombotic disorders are the major causes of non‐cirrhotic, non‐malignant extrahepatic portal vein thrombosis and anticoagulation therapy is warranted in these patients. The prognosis of patients with non‐cirrhotic, non‐malignant extrahepatic portal vein thrombosis is good, and is not determined by portal hypertension complications but mainly by the underlying cause of thrombosis.
Review article: gastro‐oesophageal reflux disease – application of the concept of complete remission
Authors: OUDKERK POOL M. 
Published: July 2010

SummaryBackground  Therapeutic success in the treatment of gastro‐oesophageal reflux disease cannot be measured by endoscopic healing or symptomatic relief alone. Assessment of treatment efficacy should be based on symptomatic relief and endoscopic healing. As most questionnaires focus on heartburn, it is important to stress that there is more to gastro‐oesophageal reflux disease than just heartburn. The ‘complete remission’ concept was recently introduced; an approach in which endoscopic appearances and symptomatic relief are integrated, thus allowing the full gastro‐oesophageal reflux disease picture and its changes over time to be described in a simple and accurate manner. Complete remission is defined as the absence of both oesophagitis and symptoms. ReQuest, a relatively new questionnaire acceptable as a clinical endpoint in trials, seems to be of use in daily practice.Aim  To review the utility of the ReQuest questionnaire.Results  This questionnaire assesses the gastro‐oesophageal reflux disease symptom profile using 67 symptom descriptions adapted from patients’ view, doctors’ view, clinical trials and from the literature. Individual symptoms are reduced to seven dimensions by factor analysis and expert consensus. This gives insight into multiple symptoms over time as well as individual patient profiles. ReQuest determines symptom relief using a gastro‐oesophageal reflux disease symptom threshold. This unique concept allows the doctor to measure the time to first symptom relief and also to sustained symptom relief.Conclusions  ReQuest makes it possible to evaluate the complete symptom spectrum in patients with non‐erosive oesophageal reflux disease and gastro‐oesophageal reflux disease. ReQuest is available for daily practice to use for comparability with regard to treatment efficacy.
Review article: new developments in colonic imaging
Authors: VAN DEN BROEK F. J. C. , FOCKENS P. , DEKKER E. 
Published: July 2010

SummaryBackground  Colonoscopic detection and removal of neoplasia from the colorectum prevent the development of colorectal cancer. Sporadic adenomas and neoplasia associated with ulcerative colitis are frequently missed during colonoscopy, as a result of which, interval cancers might develop.Aim  To review new developments in colonoscopic imaging concerning the detection of neoplasia.Methods  Medical databases were searched for relevant publications, dealing with advanced endoscopic imaging techniques during colonoscopy.Results  Pancolonic chromoendoscopy has shown to increase the detection of sporadic adenomas and ulcerative colitis associated neoplasia, at the expense of longer examination times. As chromoendoscopy is labour intensive and time‐consuming, its widespread use has been hampered. Narrow band imaging is a novel endoscopic imaging technique, which enhances mucosal and vascular details. Recent studies indicate that narrow band imaging has a high yield for neoplasia; however, no improvement compared to standard colonoscopy has been demonstrated. Autofluorescence imaging is another new technique for which blue endoscopic light is used to induce mucosal autofluorescence. So far, preliminary results have shown promising results of autofluorescence imaging for neoplasia detection.Conclusion  Whether chromoendoscopy or novel advanced imaging techniques will change current colonoscopic practice depends on results of future studies comparing these different colonoscopic techniques.