bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral rehydration therapy without bicarbonate for prevention and treatment of dehydration: a double‐blind controlled trial
Authors: ELLIOTT E. J. , ARMITSTEAD J. C. M. , FARTHING M. J. G. , WALKER‐SMITH J. A. 
Published: July 2010

SUMMARYForty children (≤ 2 years of age) were admitted to hospital with acute gastroenteritis and were randomly assigned to receive either an oral rehydration solution (ORS) containing bicarbonate (Na 35, K 20, CI 37, HCO3 18, glucose 202 mmol litre−3) or an identical solution in which bicarbonate was replaced by chloride ions. Groups were matched for age, sex, ethnic origin, duration of diarrhoea and nutritional status. On admission, degree of dehydration, biochemical and haematological parameters were similar. The majority had minimal or no dehydration and only 30% had moderate to severe dehydration. All children were treated successfully with no complications. Oral rehydration solution intake by each group was similar. Clinical outcome, as judged by speed of rehydration or maintenance of hydration, duration of diarrhoea, stool frequency and length of hospital stay, was the same in both groups. After 24 h of ORS there was no difference between groups in venous pH, serum bicarbonate, urea and electrolytes. In hospitalized children with acute gastroenteritis in the United Kingdom an ORS without bicarbonate is a safe, effective means to prevent dehydration and maintain hydration and acid—base status where dehydration is not severe. Exclusion of bicarbonate would simplify production, increase stability and reduce the cost of ORS without apparent impairment of efficacy.
Two different dose regimens of cisapride in the treatment of reflux oesophagitis: a double‐blind comparison with ranitidine
Authors: GELDOF H. , HAZELHOFF B. , OTTEN M. H. 
Published: July 2010

SUMMARYWe conducted a double‐blind study comparing two dosage regimens of a prokinetic drug, cisapride (10 mg q.d.s. and 20 mg b.d.), with a low dose of a H2 receptor antagonist (150 mg ranitidine b.d.) in the treatment of 155 patients with reflux oesophagitis as determined by endoscopy. The active treatment took 8 to 12 weeks depending on whether complete healing was found at endoscopy. Improvement in oesophagitis grades from baseline to endpoint was observed in 68% of patients in the 10 mg cisapride q.d.s. group, 83 % in the cisapride 20 mg b.d. group and 81% in the ranitidine group (N.S.). At endpoint, the percentages of endoscopically cured patients with initial grades I or II were 52% for 10 mg cisapride q.d.s., 71% for 20 mg cisapride b.d. and 80% for ranitidine (N.S.). The proportional improvement of the overall reflux symptom score (60%) also showed no significant difference between the three groups. In the treatment of mild reflux oesophagitis (grades I and II) similar results can be expected from 20 mg cisapride b.d. and 150 mg ranitidine b.d. As the results of the two dosage regimens of cisapride were not different, the 20 mg twice daily regimen is preferred because it will improve patient compliance. It is concluded that in reflux oesophagitis grades I and II, the efficacy of 20 mg cisapride b.d. and 150 mg ranitidine b.d. are broadly similar.
Infliximab regulates lamina propria T lymphocytes in patients with Crohn's disease
Authors: WATANABE O. , ANDO T. , FURUTA R. , MAEDA O. , ISHIGURO K. , TAKAHASHI H. , INA K. , KUSUGAMI K. , GOTO H. 
Published: July 2010

SummaryBackground and AimsThe immune system is a major determinant of the pathophysiological inflammation, which may lead to gastrointestinal mucosal injury in patients with Crohn's disease. Cytokines such as tumour necrosis factor‐alpha are well‐known mediators of the immune system, and treatment with a chimeric anti‐tumour necrosis factor‐alpha antibody (infliximab) has been shown to be highly effective in patients with Crohn's disease. Recent evidence indicates that infliximab induces apoptosis in lamina propria T lymphocytes in these patients. To better understand the mechanisms of infliximab's effect on gastrointestinal inflammation, we investigated changes in the serum level of cytokines after treatment in these patients, and the effect of infliximab in inducing the apoptosis of T lymphocytes.MethodsThirteen patients with Crohn's disease were treated with infliximab at a dosage of 5‐mg/kg body weight. Clinical response was evaluated using the Crohn's Disease Activity Index, and serum soluble interleukin‐2 receptor, interleukin‐6, tumour necrosis factor‐alpha levels were analysed by enzyme‐linked immunosorbent assay at 0 and 2 weeks after treatment. Apoptosis of peripheral and lamina propria T lymphocytes after culture with infliximab was detected by flow cytometry.ResultsCrohn's Disease Activity Index decreased in 12 of 13 patients, and serum soluble interleukin‐2 receptor, interleukin‐6 and tumour necrosis factor‐alpha levels decreased in most patients after treatment with infliximab. Tumour necrosis factor‐alpha level before treatment in the six patients in whom Crohn's Disease Activity Index decreased by more than 70 was <5 ng/mL. Infliximab induced the apoptosis of lamina propria but not of peripheral T lymphocytes.ConclusionThese findings suggest that a low level of serum tumour necrosis factor‐alpha is an indicator for infliximab treatment. The induction of apoptosis of lamina propria T lymphocytes by infliximab may be an important mechanism of its anti‐inflammatory effect in patients with Crohn's disease.
Helicobacter pylori‐induced atrophic gastritis progressing to gastric cancer exhibits sonic hedgehog loss and aberrant CDX2 expression
Authors: SHIOTANI A. , IISHI H. , UEDO N. , ISHIHARA R. , ISHIGURO S. , TATSUTA M. , NAKAE Y. , KUMAMOTO M. , HINOI T. , MERCHANT J. L. 
Published: July 2010

SummaryBackgroundThe loss of sonic hedgehog is an early change that occurs in the mucosa prior to neoplastic transformation and correlates with the type of intestinal metaplasia. Aberrant expression of CDX has also been shown to correlate with the development of intestinal metaplasia.AimTo examine CDX2 expression in the non‐cancerous mucosa of patients with gastric cancer and compared it to CDX2 expression in controls with intestinal metaplasia.MethodsSixty patients who had undergone endoscopic mucosal resection for early gastric cancer and 60 gender‐ and age‐matched controls were studied. Two specimens each were obtained from the greater and lesser curves of the corpus and from the greater curve of the antrum. Expression of CDX2 and sonic hedgehog were evaluated by immunostaining.ResultsGastric cancer was associated with a higher frequency of incomplete intestinal metaplasia (OR = 8.3; 95%CI, 3.7–18.9, P < 0.001). CDX2 negatively correlated with sonic hedgehog expression, however, multivariate analysis revealed that CDX2 correlated with the intestinal metaplasia scores. Sonic hedgehog indices were lower and CDX2 staining in the corpus lesser curve was higher in the cancer group than in the controls. Sonic hedgehog indices in the corpus decreased and CDX2 indices in both areas increased in patients in the ascending order of those without intestinal metaplasia, those with complete intestinal metaplasia and those with incomplete intestinal metaplasia (P < 0.001).ConclusionsLoss of sonic hedgehog expression and aberrant expression of CDX2 correlates with the type of intestinal metaplasia and may play a role in carcinogenesis.
Efficacy and endoscopic prediction of cytapheresis therapy in patients with refractory and steroid‐dependent ulcerative colitis
Authors: WATANABE K. , OSHITANI N. , KAMATA N. , INAGAWA M. , YAMAGAMI H. , HIGUCHI K. , ARAKAWA T. 
Published: July 2010

SummaryBackgroundRecently, it has been proved in Japan that granulocyte and monocyte adsorption apheresis (GCAP) and leukocytapheresis (LCAP) are effective and safe for patients with moderate to severe ulcerative colitis (UC).AimTo investigate the efficacy of GCAP and LCAP in patients with active UC, and the use of endoscopic findings in predicting efficacy, especially in refractory and steroid‐dependent cases.Subjects and methodsThirty‐four patients with active UC (24 refractory to conventional therapy and 10 steroid‐dependent) were treated with GCAP (n = 21) or LCAP (n = 13). The patients received one or two GCAP or LCAP sessions per week for 5 consecutive weeks, with colonoscopy before and after each session.ResultsAbout 70% of the patients achieved a clinical response, and no severe adverse effects were observed. Most steroid‐dependent patients or patients who had side effects due to steroids were controlled successfully. Endoscopically, 14 of 16 cases with shallow ulcers and erosion throughout the colon and 10 of 15 with deep ulcerations responded to treatment. However, three with massive ulceration of the whole mucosa did not respond.ConclusionsGCAP or LCAP are valuable therapies for refractory or steroid‐dependent UC, and endoscopic findings are helpful in predicting clinical effectiveness.
Evaluation of alcohol metabolism in humans using the non‐invasive [13C]‐ethanol breath test – influence of gender, Helicobacter pylori infection and polymorphism of alcohol‐oxidizing enzymes
Authors: SUZUKI M. , TANAKA S. , KOMATSU H. , NAKANE T. , SASAKI N. , MARUYAMA K. , SUZUKI H. , ISHII H. , SUEMATSU M. , HIBI T. 
Published: July 2010

SummaryBackgroundThe [13C]‐ethanol breath test (EBT) has been proposed as a novel non‐invasive laboratory test to detect the degradation of ethanol into CO2. However, this method has not yet been evaluated clinically.AimTo investigate the factors that influence [13C]‐EBT.MethodsTwenty‐six healthy volunteers were instructed to drink 100 mL of beer (4 g ethanol) containing 100 μL of [13C]‐ethanol. Breath samples were collected every 15 min before and after the intake of ethanol solution and 13CO2‐enrichment was measured using mass spectrometry. CO2 excretion was then calculated, and the results were evaluated using kinetic parameters (Tmax, Cmax, AUC).Results T
max (min) was significantly shorter in men than in women but not Cmax and AUC. Infection with H. pylori had no impact on all kinetic parameters. Genetic alcohol dehydrogenase (ADH) polymorphisms did not affect 13CO2 excretion, but Cmax (11.1 ± 3.4% dose/h, n = 16) and AUC (10.5 ± 3.4% dose) were slightly increased in aldehyde dehydrogenase (ALDH)‐deficient individuals (heterozygote of ALDH2*2) (13.2 ± 3.2 and 12.9 ± 4.5, respectively; n = 10).Conclusions[13C]‐EBT is capable of assessing the metabolic processing of 100 mL beer in a non‐invasive way. Kinetic parameters are partially influenced by ALDH polymorphism but not by gender, H. pylori infection or ADH polymorphism.
Review article: bacterial translocation in the critically ill – evidence and methods of prevention
Authors: GATT M. , REDDY B. S. , MACFIE J. 
Published: July 2010

SummaryBackgroundDelayed sepsis, systemic inflammatory response syndrome (SIRS) and multiorgan failure remain major causes of morbidity and mortality on intensive care units. One factor thought to be important in the aetiology of SIRS is failure of the intestinal barrier resulting in bacterial translocation and subsequent sepsis.AimThis review summarizes the current knowledge about bacterial translocation and methods to prevent it.MethodsRelevant studies during 1966–2006 were identified from a literature search. Factors, which detrimentally affect intestinal barrier function, are discussed, as are methods that may attenuate bacterial translocation in the critically ill patient.ResultsMethodological problems in confirming bacterial translocation have restricted investigations to patients undergoing laparotomy. There are only limited data available relating to specific interventions that might preserve intestinal barrier function or limit bacterial translocation in the intensive care setting. These can be categorized broadly into pre‐epithelial, epithelial and post‐epithelial interventions.ConclusionsA better understanding of factors that influence translocation could result in the implementation of interventions which contribute to improved patient outcomes. Glutamine supplementation, targeted nutritional intervention, maintaining splanchnic flow, the judicious use of antibiotics and directed selective gut decontamination regimens hold some promise of limiting bacterial translocation. Further research is required.
Oral oligofructose‐enriched inulin supplementation in acute ulcerative colitis is well tolerated and associated with lowered faecal calprotectin
Authors: CASELLAS F. , BORRUEL N. , TORREJÓN A. , VARELA E. , ANTOLIN M. , GUARNER F. , MALAGELADA J.‐R. 
Published: July 2010

SummaryBackground Inulin and oligofructose promote selective growth of saccharolytic bacteria with low inflammatory potential.Objective To test the effect of oligofructose‐enriched inulin in patients with active ulcerative colitis.Design Prospective, randomized, placebo controlled pilot trial. Eligible patients had been previously in remission with mesalazine as maintenance therapy or no drug, and presented with a relapse of mild to moderate activity. They were treated with mesalazine (3 g/day) and randomly allocated to receive either oligofructose‐enriched inulin (12 g/day, p.o., n = 10) or placebo (12 g/day of maltodextrin, p.o., n = 9) for 2 week. Primary endpoint was the anti‐inflammatory effect as determined by reduction of calprotectin and human DNA in faeces.Results Rachmilewitz score decreased in both groups, reaching statistical significance at day 14 (P < 0.05). Oligofructose‐enriched inulin was well‐tolerated and dyspeptic symptoms scale decreased significantly with active treatment but not with placebo. At day 7, an early significant reduction of calprotectin was observed in the group receiving oligofructose‐enriched inulin (day 0: 4377 ± 659 µg/g; day 7: 1033 ± 393 µg/g, P < 0.05) but not in the placebo group (day 0: 5834 ± 1563 µg/g; day 7: 4084 ± 1395 µg/g, n.s.). Changes in faecal concentration of human DNA were not significant.Conclusion In active ulcerative colitis, dietary supplementation with oligofructose‐enriched inulin is well tolerated and is associated with early reduction in faecal calprotectin.
Review article: management of ascites and associated complications in patients with cirrhosis
Authors: KUIPER J. J. , DE MAN R. A. , VAN BUUREN H. R. 
Published: July 2010

SummaryBackground  Ascites is the most common complication of cirrhosis, associated with an expected survival below 50% after 5 years. Prognosis is particularly poor for patients with refractory ascites and for those developing complications, including spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS).Aim  To provide an evidence‐based overview of the pathophysiology, diagnosis and clinical management of ascites secondary to liver cirrhosis.Methods  Review based on relevant medical literature.Results  Portal hypertension, splanchnic vasodilatation and renal sodium retention are fundamental in the pathophysiology of ascites formation. The SAAG (serum‐ascites albumin gradient) allows reliable assessment of the cause of ascites. The majority of cirrhotic patients with ascites can be managed with dietary sodium restriction in combination with diuretic agents. Large volume paracentesis with albumin suppletion and TIPS are therapeutic options in patients with refractory ascites. Prophylactic antibiotics for SBP should be given in certain patient populations.Conclusions  Recent advances in the diagnosis and treatment of ascites and associated complications have improved the medical management and poor prognosis of patients with these manifestations of advanced liver disease. Early diagnosis, adequate treatment and focus on prevention of complications remain essential as well as timely referral for liver transplantation.
Introduction: thrombocytopenia in chronic liver disease – treatment implications and novel approaches
Authors: AFDHAL N.H. , ESTEBAN R. 
Published: July 2010

SummaryBackground  Thrombocytopenia is a common hematologic toxicity among patients with chronic liver disease.Aim  To give a brief overview of thrombocytopenia and its effects on patients with chronic liver disease.Results  Thrombocytopenia is generally mild to moderate in severity and can thus be managed relatively easily. Severe thrombocytopenia (platelet count <50,000 /μL), however, may present significant challenges to patient management. Thrombocytopenia can increase the risk of bleeding associated with invasive or surgical procedures. Therefore, while perhaps less widely appreciated than the impact of anemia or neutropenia, effective prevention and management of thrombocytopenia is also critical for patients with liver disease.Conclusions  This supplement to Alimentary Pharmacology & Therapeutics provides a comprehensive review of the significance of thrombocytopenia in patients with chronic liver disease, its pathophysiology and relationship to coagulation disorders, impact on clinical care and resource utilization, and novel therapies that may be able to supplant platelet transfusions.
A controlled study of dental erosion in 2‐ to 4‐year‐old twins
Authors: TAJI SUE S. , KIM SEOW W. , TOWNSEND GRANT C. , HOLCOMBE TREVOR 
Published: July 2010

International Journal of Paediatric Dentistry 2010; 20: 400–409 Background.  Dental erosion (DE) in children is a significant oral health issue and has become a focus for research in clinical paediatric dentistry.Aim.  This study investigated DE in the primary dentition of 2‐ to 4‐year‐old twin and singleton children with regard to the genetic, medical and dietary factors associated with the condition.Design.  The 128 subjects consisted of 88 twin children (31 monozygous, 50 dizygous, 7 unknown zygosity) and singletons (n = 40) aged 2–4 years. Medical, dental, and dietary histories were obtained. The children were examined for DE using a modified index.Results.  The prevalence of DE by subject affected was 77% in monozygotic twins (MZ), 74% in dizygotic twins (DZ), and 75% in singleton controls (P > 0.1). Of the teeth scored, 12% had mild, 10% moderate, and 1% severe lesions, and DE was more severe in the older age group (P < 0.05). Concordance rates for erosion lesions in MZ and DZ co‐twins were not statistically significant.Conclusions.  The prevalence of DE and the concordance of erosion lesions were similar between MZ and DZ twins and singleton children, suggesting that the contribution of genetic factors to DE is negligible.
Medical aspects of ageing in a population with intellectual disability: I. Visual impairment
Authors: Evenhuis H. M. 
Published: July 2010

AbstractVisual function of an institutionalized population with intellectual disability, consisting of 70 subjects with a mean age of 70.1 (range 60–92) years at initial evaluation, was assessed during a 10‐year prospective longitudinal study. One subject had Down's syndrome and could not be assessed as a result of dementia. Lower visual acuity values were relatively overrepresented as compared to reported data from ageing populations without intellectual disability. In addition, the prevalence of moderate to severe visual impairment was distinctly higher (27.9% in the group studied vs. 0.66% at age 60–69 years to 13% over age 80 in a population without intellectual disability). During follow‐up, visual function improved in three out of 61 subjeas (4.9%) after cataract surgery, and deteriorated in eight out of 61 subjeas (13.1%), even with optimal correction, as a result of cataract and macular degeneration. Causes of excess impairment were congenital or childhood conditions, too‐late diagnosis of glaucoma and suboptimal correction of refractive errors in non‐cooperative individuals. The present author concludes that it should be possible to reduce excess impairment by an active diagnostic and therapeutic attitude to subjects from a young age onwards.
Evidence for an Unlinked Gene Which Modifies HL‐A Antigen Expression
Authors: Bias WILMA B. , Hopkins KATHERINE A. , Hutchinson JUDITH R. , Hsu SUSAN H. 
Published: July 2010

In a sibship of seven, three of four individuals who inherited the haplotype W29‐W10 showed modified expression of W10. Their lymphocytes were non‐reactive in the cytotoxic test with three of four W10 antisera, but strongly reactive with the fourth serum. The fourth sib's cells reacted strongly with all four antisera. Absorption of anti‐W10 sera by the modified cells removed cytotoxic activity, indicating the presence of W10 antigenic determinants on those cells. Absorption with W10 negative cells did not remove cytotoxicity to W10 cells.This observation of the CYNAP (cytotoxic negative‐absorption positive) phenomenon in multiple family members suggests a genetic modifier of HL‐A antigenic expression which is unlinked to the HL‐A chromosomal complex.
Comparative Immunogenicity of HL–A Antigens: A Study in Primiparas
Authors: OH JUNG H. , MACLEAN LLOYD D. 
Published: July 2010

A comparison of immunogenic strength among 23 HL–A antigens was made by studying HL–A antibodies formed in primiparous women. In this setting of single pregnancies, each one of the incompatible fetal antigens would have an equal opportunity (one gestational period) to sensitize the mother. Three hundred pairs of primiparous women and newborns were HL–A typed and the serum of each mother was tested for antibody activity against the child's lymphocytes.The test was positive in 24 instances; 19 sera were reactive with only one antigen of paternal origin, one serum was reactive with both antigens, and in four instances the children's incompatible antigens were not identified. When the frequencies of different antibody specificities were statistically analysed, HL–A5 and W14 were found to be distinctly more immunogenic than the other antigens.
Human Lymphocyte Antigen, HL–A27, in Japanese Patients with Ankylosing Spondylitis
Authors: SONOZAKI HlDEKICHI , SEKI HlROYUKI , CHANG SHAUYANG , OKUYAMA MACHIKO , JUJI TAKEO 
Published: July 2010

A high association of HL–A27 specificity with ankylosing spondylitis was found in Japanese patients in spite of a very low frequency of this specificity in a normal Japanese population. These findings coincide well with those in Caucasian patients, and indicate the strong relationship between the susceptibility to ankylosing spondylitis and HL–A27 specificity beyond racial differences.No particular HL–A patterns were noted in patients with the ossification of the posterior longitudinal ligament of the cervical vertebrae. This observation provides an evidence that this disease is etiologically different from ankylosing spondylitis.
HLA27 and Anterior Uveitis
Authors: WOODROW J. C. , MAPSTONE R. , ANDERSON JEANNETTE , USHER NORMAN 
Published: July 2010

HL‐A types were determined in 90 successive patients with non‐granulomatous uveitis. Fifty‐one were HL‐A27 positive (55.7%) compared to 8.2% of controls. Of 16 patients with ankylosing spondylitis, 13 were HL‐A27 positive, as were two patients with a history of Reiter's syndrome.Twenty‐eight patients were HL‐A27 positive but had no evidence of rheumatic disease. The findings are discussed in relation to the possible pathogenesis of uveitis.
Cross‐Reactions of HLA Antibodies: VII. Rate of Sensitization and Serological Specificity
Authors: Kostyu Donna D. , Bernard Nicole F. , Amos D. Bernard 
Published: July 2010

Varying the sensitization time of the complement‐dependent antibody mediated cytotoxicity test, while carefully controlling other test conditions, has enabled us to characterize the subtle reactivities of several broadly reactive sera. In particular, we can discriminate between classes of cells, e.g., HLA‐B7 from B27; subclasses of cells, e.g., Bw51 from Bw52; and cells carrying new antigens, e.g., Ao79.This manipulation of the cytotoxicity test is discussed in view of its usefulness in separating primary from cross‐reactive specificities and in detecting new specificities.