bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori eradication reduced the incidence of gastric cancer, especially of the intestinal type
Authors: TAKENAKA R. , OKADA H. , KATO J. , MAKIDONO C. , HORI S. , KAWAHARA Y. , MIYOSHI M. , YUMOTO E. , IMAGAWA A. , TOYOKAWA T. , SAKAGUCHI K. , SHIRATORI Y. 
Published: July 2010

SummaryBackgroundAlthough Helicobacter pylori infection is closely associated with gastric cancer development, follow‐up studies after H. pylori eradication are still scarce.AimTo clarify the cancer preventive effect of H. pylori eradication, with special attention to differences in effect according to histology.MethodsPatients who underwent H. pylori eradication therapy and were followed‐up endoscopically for at least 1 year were analysed. The incidence of gastric cancer and factors associated with cancer development were investigated.ResultsA total of 1807 patients were enrolled. Six of 1519 H. pylori eradicated and five of 288 persistent subjects developed gastric cancer. Four of the eradicated subjects developed the intestinal type and two the diffuse type, while four of the persistent subjects developed the intestinal type and one the diffuse type. Kaplan–Meier analysis indicated a significantly lower incidence in eradicated patients than in persistent patients. The incidence of intestinal type was significantly lower than in eradicated patients, while the diffuse type could not be evaluated because of the low incidence.Conclusions Helicobacter pylori‐eradicated patients had a reduced incidence of gastric cancer compared with H. pylori‐persistent patients, particularly the intestinal type, suggesting that H. pylori is strongly associated with intestinal‐type gastric cancer.
Thiopurine metabolite monitoring in paediatric inflammatory bowel disease
Authors: OOI C. Y. , BOHANE T. D. , LEE D. , NAIDOO D , DAY A. S 
Published: July 2010

SummaryBackground Measurement of thiopurine metabolite levels may be useful as a clinical tool to optimize thiopurine treatment of paediatric inflammatory bowel disease (IBD).Aim The authors evaluated correlations between 6‐thioguanine nucleotide (6‐TGN) and therapeutic response, metabolite levels and drug toxicity.Methods Fifty‐six paediatric IBD patients treated with thiopurines had 326 metabolite level measurements and were retrospectively reviewed. Clinical status and laboratory parameters were compared with metabolite levels.Results There was significant correlation between 6‐TGN levels and therapeutic response, with higher median 6‐TGN levels among patients with therapeutic response than those with non‐therapeutic response (194 vs. 146 pmol/8 × 108 RBC; P = 0.0004). Patients with 6‐TGN levels >235 pmol/8 × 108 RBC were more likely to achieve therapeutic response than those below the cut‐off (odds ratio, 2.5; 95% CI, 1.5–4.1). Patients who developed leukopenia tended to have higher median 6‐TGN levels than those without leukopenia (261 vs. 160 pmol/8 × 108 RBC) but the difference was not statistically significant. There was no correlation between 6‐methylmercaptopurine levels and hepatotoxicity. Two patients developed acute pancreatitis. Metabolite level measurements were helpful in identifying non‐compliance in nine patients.Conclusions Monitoring of thiopurine metabolite levels is useful to guide and optimize dosing, as an adjunct to clinical judgement, blood count and liver biochemistry measurements to minimize the risk of drug toxicity and to confirm non‐compliance.
Double stenting of oesophagus and airways in palliative treatment of patients with oesophageal cancer is efficient but associated with a high morbidity
Authors: LECLEIRE S. , ANTONIETTI M. , DI FIORE F. , BEN‐SOUSSAN E. , BOTA S. , HELLOT M.‐F. , THIBERVILLE L. , MICHEL P. , LEREBOURS E. , DUCROTTÉ P. 
Published: July 2010

SUMMARYBackground Double stenting of oesophagus and airways may be required in palliative treatment of patients with locally advanced oesophageal cancer.Aim To assess feasibility, efficacy and complications occurring in patients with locally advanced oesophageal cancer receiving both oesophagus and airways stenting.Methods In one single centre between 1997 and 2005, among 180 patients with locally advanced oesophageal cancer treated by the palliative placement of a self‐expanding metal stent, patients requiring double stenting of oesophagus and airways were identified. Clinical efficacy, complications and survival were retrospectively collected.Results Fifteen patients (8.3% of 180) required a double stenting at follow‐up. Symptomatic efficacy of oesophagus and airways stenting was 86.7% for dysphagia and 100% for dyspnoea. Median survival after the second stent insertion was 99 days. Life‐threatening early complications occurred in three patients after double stenting (20%), including two deaths following oesophageal perforation and massive haemoptysis, respectively. Procedure‐related mortality was 13.3%.Conclusions Double stenting of oesophagus and airways is feasible in patients with locally advanced oesophageal cancer, with a relevant clinical efficacy. However, early major complications including procedure‐related death may occur in as many as 20% of patients. This treatment should be reserved to very selected patients with severe symptoms and end‐stage disease.
Does body mass index differ between patients with Barrett’s oesophagus and patients with chronic gastro‐oesophageal reflux disease?
Authors: GERSON L. B. , ULLAH N. , FASS R. , GREEN C. , SHETLER K. , SINGH G. 
Published: July 2010

AbstractBackground Obesity has been demonstrated to be a risk factor for the development of gastro‐oesophageal reflux disease (GERD).Aim To perform a prospective cohort study to determine whether there was a difference in body mass index (BMI) between patients with GERD and patients with Barrett’s oesophagus (BE).Methods We prospectively enrolled patients undergoing endoscopic evaluation for GERD and collected information regarding BMI, tobacco and/or alcohol use, and family history of GERD. Patients with non‐erosive reflux disease underwent confirmatory 24‐h pH testing.Results Seven hundred and fifty one patients with GERD (mean ± s.d. age of 55.4 ± 14.2 years, 74% male) entered the study, and BE was present in 165 (22%, 90% male, 79% Caucasian) patients. The mean GERD symptom duration was 10.3 ± 0.4 years (range 1–62 years) with a mean body mass index of 27.8 ± 0.2 kg/m2 (range 15–55) Compared with patients having GERD alone, patients with BE were more likely to be older (P = 0.001), male (P < 0.001), current or prior tobacco users (P = 0.002), and with greater duration of GERD symptoms (P < 0.001). There was no significant difference in the BMI for patients with and without BE.Conclusions While obesity is a risk factor for both GERD and BMI, patients with BE did not demonstrate increased BMI compared with patients having chronic GERD.
Assessment of thiopurine methyltransferase enzyme activity is superior to genotype in predicting myelosuppression following azathioprine therapy in patients with inflammatory bowel disease
Authors: WINTER J. W. , GAFFNEY D. , SHAPIRO D , SPOONER R. J. , MARINAKI A. M. , SANDERSON J. D. , MILLS P. R. 
Published: July 2010

SummaryBackground Myelosuppression occurs in 2–7% of inflammatory bowel disease (IBD) patients treated with azathioprine, and can be associated with reduced activity of thiopurine methyltransferase (TPMT) in some patients. It has been proposed that pretreatment assessment of TPMT status reduces the incidence of toxicity and is cost‐effective.Aims To determine if screening for TPMT status predicts side‐effects to azathioprine in patients with IBD and to ascertain whether screening by TPMT enzyme activity or genotype is superior.Methods Sequential IBD patients were identified and azathioprine tolerance recorded. Blood was collected for measurement of TPMT activity and TPMT*3C, TPMT*3A and TPMT*2 genotypes.Results Of 130 patients, 25% stopped azathioprine because of toxicity. Four patients experienced severe myelosuppression (WCC < 2). Eleven of 17 patients with reduced TPMT activity were heterozygotes, including one patient with marked TPMT deficiency who experienced severe myelosuppression. There was no association between intermediate TPMT deficiency and any side‐effect.Conclusions Moderate reduction of TPMT activity in heterozygotes was not associated with toxicity, but very low TPMT activity caused severe myelosuppression in one patient. This would have been predicted by measuring TPMT activity but not by genotyping. Measurement of TPMT activity may therefore be superior to genotype in predicting severe myelosuppression.
Positive association between gastro‐oesophageal reflux disease and irritable bowel syndrome in a Chinese population
Authors: CHEUNG T. K. , LAM K. F. , HU W. H. C. , LAM C. L. K. , WONG W. M. , HUI W. M. , LAI K. C. , LAM S. K. , WONG B. C. Y 
Published: July 2010

SummaryBackground Gastro‐oesophageal reflux disease and irritable bowel syndrome are common diseases which may be related.Aim To examine the association between gastro‐oesophageal reflux disease and irritable bowel syndrome in Chinese population in Hong Kong.Methods Randomly selected ethnic Chinese were invited to participate in a telephone survey in 1996. Gastro‐oesophageal reflux disease was defined as subjects having heartburn and/or acid regurgitation once weekly or more. Irritable bowel syndrome was diagnosed according to the Rome I criteria. The association between gastro‐oesophageal reflux disease and irritable bowel syndrome was calculated using a statistical model which allows the odds ratio to be measured.Results One thousand six hundred and forty‐nine subjects completed the interview (response rate 62%). The population prevalence of gastro‐oesophageal reflux disease and irritable bowel syndrome were 5% and 4%, respectively. Thirteen per cent of subjects with gastro‐oesophageal reflux disease and 11% with irritable bowel syndrome suffered from both gastro‐oesophageal reflux disease and irritable bowel syndrome. The OR of having gastro‐oesophageal reflux disease and irritable bowel syndrome together was estimated to be 3 (95% CI: 1.05, 6.27) indicating a positive association between the two diseases. This association occurred predominantly in male subjects [OR = 9.3, (95% CI: 2.3, 26.2)] but not as strong in females [OR = 1.5, (95% CI: 0.3, 4.3)]. Younger subjects were statistically more prone to the two diseases.Conclusions There is a positive association between gastro‐oesophageal reflux disease and irritable bowel syndrome, and their association occurs predominantly in male subjects.
The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C
Authors: LO IACONO O. , VENEZIA G. , PETTA S. , MINEO C. , DE LISI S. , DI MARCO V. , RODOLICO V. , AMATO M. , FERRARO D. , GIORDANO C. , ALMASIO P.L. , CRAXÍ A. 
Published: July 2010

SUMMARYAims  To assess whether host metabolic factors influence the degree of hepatic steatosis and fibrosis in patients infected with hepatitis C virus, and to evaluate the impact of anti‐viral therapy on insulin resistance and serum levels of adipocytokines.Methods  Clinical and biochemical features, anthropometrical characteristics, and levels of fasting insulin, leptin, adiponectin and resistin were measured in ‘naïve’ patients with chronic hepatitis C, before, during and after therapy with Peg‐Interferon‐alpha 2a plus Ribavirin.Results  Forty‐eight patients were included (M/F 28/20; mean age 50.0 ± 12.6 years; 62.5% genotype‐1). Body mass index was 26.4 ± 4.0 kg/m2, and visceral obesity was present in 24 patients. At multivariate analysis (RR; 95% CI), steatosis was associated to older age (1.08; 1–1.18), necroinflammatory activity (17.67; 1.6–194.46), and raised insulin levels (1.39; 1.1–1.77). Fibrosis was related to necroinflammatory activity (25.73; 2.54–261.11), and steatosis (6.47; 1.09–38.29). Sustained viral response was achieved by 62.5% of patients and was associated with younger age (0.92; 0.85–0.99), genotype non‐1 (10.61; 1.52–73.76) and absence of visceral obesity (13.78; 2.36–80.29). At the end of follow‐up, insulin and the homeostasis model assesment for insulin resistance were reduced and adiponectin increased when compared with baseline, all unrelated to the outcome of treatment.Conclusions  Visceral obesity correlates with the degree of steatosis and fibrosis, and it negatively affects treatment response. Significant changes of insulin resistance and adipocytokines occur under treatment, irrespective of virological outcome.
The role of genomic and antigenomic HCV‐RNA strands as predictive factors of response to pegylated interferon plus ribavirin therapy
Authors: LÓPEZ‐ALCOROCHO J. M. , RODRÍGUEZ‐IÑIGO E. , CASTILLO I. , CASTELLANOS M. E. , PARDO M. , BARTOLOMÉ J. , QUIROGA J. A. , CARREÑO V. 
Published: July 2010

SUMMARYBackground  Hepatitis C virus replicates by the synthesis of an antigenomic HCV‐RNA. As the end point of anti‐viral therapy is to decrease viral replication, the amount of antigenomic HCV‐RNA could influence the response.Aim  To study if amounts of genomic and antigenomic HCV‐RNA in the baseline liver biopsy are predictive factors of response to anti‐viral therapy.Methods  Eighty‐eight patients with chronic HCV infection (anti‐HIV‐negative) treated with pegyltaed‐interferon‐α2b plus ribavirin for 12 months were included. Intrahepatic genomic and antigenomic HCV‐RNA concentrations were determined by real‐time polymerase chain reaction and percentage of infected hepatocytes by in situ hybridization.Results  Of the 88 patients, 31% were responders while 69% were not. Median of antigenomic HCV‐RNA in liver of responders and non‐responders was 120 000 copies/μg RNA (range: 10 000–775 000) vs. 150 000 copies/μg RNA (range: 100–3 200 000; P = 0.38). Median of genomic HCV‐RNA in liver of responders was 1 250 000 copies/μg RNA (range: 5000–9 000 000) and in non‐responders 3 180 000 copies/μg RNA (range: 4600–18 000 000; P = 0.0191). Predictive factors of response in the logistic regression were: intrahepatic amount of genomic HCV‐RNA, percentage of infected hepatocytes and previous therapy.Conclusion  Response to 12 months of therapy with pegylated interferon‐α2b plus ribavirin depends on the amount of genomic HCV‐RNA in the pre‐treatment liver biopsy.
Risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in patients with unexplained chest/epigastric pain and normal upper endoscopy: a 10‐year Danish cohort study
Authors: MUNK E. M. , DREWES A. M. , GORST‐RASMUSSEN A. , GREGERSEN H. , FUNCH‐JENSEN P. , NØRGÅRD B. 
Published: July 2010

SUMMARYBackground  No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy.Aim  To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients.Methods  This Danish 10‐year cohort study focused on UCEP patients (n = 386), diagnosed in 1992–93. Ten age‐ and gender‐matched controls were selected per patient from Denmark’s Civil Registration System (n = 3860). Kaplan–Meier analysis and Cox’s regression analysis was used to calculate the risk of hospitalization for peptic ulcer, oesophagitis, pancreatitis or gallstone.Results  Compared with controls, the adjusted relative risks among UCEP patients <1 and ≥1 year after upper endoscopy were for peptic ulcer 2.0 [95% confidence interval (CI) 0.2–18.4] and 1.7 (95% CI 0.9–3.4), for oesophagitis 8.2 (95% CI 1.2–59.2) and 1.9 (95% CI 0.7–5.0), for pancreatitis 9.2 (95% CI 2.0–41.8) and 3.9 (95% CI 1.4–10.5), and for gallstone 14.1 (95% CI 5.4–37.2) and 3.3 (95% CI 1.9–5.8).Conclusions  UCEP is positively associated with all study outcomes especially in the first year after upper endoscopy, indicating that peptic ulcer, oesophagitis, pancreatitis or gallstone could be underlying early UCEP symptoms. However, the long‐term association remained strong for pancreatitis and gallstone, suggesting a genuine excess risk.
Paroxetine for prevention of depressive symptoms induced by interferon‐alpha and ribavirin for hepatitis C
Authors: RAISON C. L. , WOOLWINE B. J. , DEMETRASHVILI M. F. , BORISOV A. S. , WEINREIB R. , STAAB J. P. , ZAJECKA J. M. , BRUNO C. J. , HENDERSON M. A. , REINUS J. F. , EVANS D. L. , ASNIS G. M. , MILLER A. H. 
Published: July 2010

SUMMARYBackground Whether antidepressants prevent depression during interferon‐alpha/ribavirin treatment for hepatitis C virus infection has yet to be established.Aim To investigate the use of paroxetine in a prospective, double‐blind, placebo‐controlled study for this indication.Methods Sixty‐one hepatitis C virus‐infected patients were randomly assigned to the antidepressant, paroxetine (n = 28), or placebo (n = 33), begun 2 weeks before and continued for 24 weeks during interferon‐alpha/ribavirin treatment. Primary endpoints included development of major depression and severity of depressive symptoms measured by the Montgomery Asberg Depression Rating Scale (MADRS).Results Rates of major depression during the study were low (17%) and did not differ between groups. Nevertheless, using published MADRS cut‐off scores, the percent of subjects who met criteria for mild, moderate or severe depression during interferon‐alpha/ribavirin therapy was significantly lower in paroxetine‐ vs. placebo‐treated subjects (P = 0.02, Fisher’s exact test). Assignment to paroxetine was also associated with significantly reduced depressive symptom severity. This effect was largely accounted for by participants with depression scores above the median (MADRS > 3) at baseline in whom paroxetine was associated with a maximal reduction in MADRS scores of 10.3 (95% CI: 2.1–18.5) compared with placebo at 20 weeks (P < 0.01). Study limitations included a small sample size and high drop‐out rate.Conclusion This double‐blind, placebo‐controlled trial provides preliminary data in support of antidepressant pre‐treatment in hepatitis C virus patients with elevated depressive symptoms at baseline.
Lubiprostone, a locally acting chloride channel activator, in adult patients with chronic constipation: a double‐blind, placebo‐controlled, dose‐ranging study to evaluate efficacy and safety
Authors: JOHANSON J. F. , UENO R. 
Published: July 2010

SummaryBackgroundLubiprostone, a locally acting type‐2 chloride channel activator, induces intestinal fluid secretion.AimTo assess efficacy and safety of oral lubiprostone at multiple doses for the treatment of chronic constipation.MethodsA total of 129 patients with chronic constipation were randomized to receive lubiprostone (24, 48 or 72 mcg/day) or placebo for 3 weeks. Spontaneous bowel movement (SBM) frequency, rescue medication use, symptom assessments and adverse events (AEs) were tracked.ResultsOver the double‐blinded period, mean SBM frequencies were higher for lubiprostone groups (5.1–6.1) vs. placebo (3.8) and the overall difference was statistically significant (P = 0.046). SBM frequencies at week 1 were significantly higher in patients taking lubiprostone 48 or 72 mcg/day (P ≤ 0.003) and, at week 2, all three lubiprostone doses yielded significantly higher SBM rates vs. placebo (P ≤ 0.020). Significantly larger proportions of patients taking lubiprostone 48 and 72 mcg/day also experienced a SBM on the first treatment day (P ≤ 0.009). The most common AEs were nausea, headache and diarrhoea.ConclusionsLubiprostone improved SBM rates in a dose‐dependent manner. AEs were tolerable for most patients. Increased AE severity at 72 mcg/day did not provide a clear risk‐to‐benefit advantage compared with lubiprostone 48 mcg/day, the dose chosen for subsequent Phase 3 studies.
Influence of genetics on irritable bowel syndrome, gastro‐oesophageal reflux and dyspepsia: a twin study
Authors: LEMBO A. , ZAMAN M. , JONES M. , TALLEY N. J. 
Published: July 2010

SummaryBackgroundA genetic contribution has been proposed for irritable bowel syndrome (IBS) and gastro‐oesophageal reflux disease (GERD), but is controversial. No twin data exist for dyspepsia.AimTo determine the relative contribution of genetic factors in GERD, dyspepsia (upper abdominal pain) and IBS.MethodsA total of 986 twin pairs (from initial mail‐out response 51%). Both members completed validated symptom and psychological questionnaires; 481 monozygotic pairs [mean (s.d.) age 53 ± 5.8 years] and 505 dizygotic pairs (mean age 54 ± 5.6 years).ResultsPrevalence of IBS, dyspepsia and GERD was 12%, 10% and 20%, respectively. Polychoric correlation for monozygotic twins for IBS (0.47) and GERD (0.44) were both substantially larger than those for dizygotic twins (0.17 and −0.37, respectively). Polychoric correlation was slightly lower in monozygotic than dizygotic twins for dyspepsia. Genetic modelling confirmed the independent additive genetic effects in GERD and IBS but not dyspepsia. Estimates of genetic variance were 22% for IBS, 13% for GERD and 0% for dyspepsia, but adjusting for anxiety and depression removed the statistical significance for IBS and GERD.ConclusionsThere is a genetic contribution to GERD and IBS but not dyspepsia; this may be mediated by the hereditability of anxiety and depression.
Distinct roles of free leptin, bound leptin and soluble leptin receptor during the metabolic‐inflammatory response in patients with liver cirrhosis
Authors: OCKENGA J. , TIETGE U. J. F. , BÖKER K. H. W. , MANNS M. P. , BRABANT G. , BAHR M. J. 
Published: July 2010

SummaryBackgroundAlteration of the leptin system appears to play a role in the inflammatory–metabolic response in catabolic diseases such as chronic liver diseases.AimTo investigate the association between leptin components, inflammatory markers and hepatic energy and substrate metabolism.MethodsWe investigated in vivo hepatic substrate and leptin metabolism in 40 patients employing a combination of arterial and hepatic vein catheterization techniques and hepatic blood flow measurements. In addition to metabolic, inflammatory and neuroendocrine parameters, circulating levels of free leptin, bound leptin and soluble leptin receptor were determined.ResultsCompared with controls, bound leptin and soluble leptin receptor levels were significantly elevated in cirrhosis, while free leptin did not increase. In cirrhosis bound leptin was correlated with soluble leptin receptor (r = 0.70, P < 0.001). Free leptin was positively correlated with metabolic parameters such as energy storage (body fat mass; r = 0.36, P < 0.05), insulin and insulin resistance (r = 0.48; r = 0.46, P < 0.01) as well as with hepatic glucose and energy release (r = 0.35 and r = 0.40, P < 0.05). In contrast, bound leptin and soluble leptin receptor were linked to proinflammatory cytokines and sympathetic activity (r = 0.61 and r = 0.56, P < 0.01).ConclusionThe components of the leptin system (free leptin, bound leptin and soluble leptin receptor) have distinct roles in metabolic and inflammatory processes in patients with liver cirrhosis. The better understanding of this metabolic and inflammatory tissue‐repair response may lead to innovative new therapeutic strategies in liver disease as well as in various other catabolic diseases.