bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disease progression in Chinese chronic hepatitis C patients with persistently normal alanine aminotransaminase levels
Authors: HUI C.‐K. , ZHANG H.‐Y. , SHEK T. , YAO H. , YUENG Y.‐H. , LEUNG K.‐W. , LAI S.‐T. , LAI J.‐Y. , LEUNG N. , LAU G. K. ,   FOR THE HONG KONG LIVER FIBROSIS STUDY GROUP
Published: July 2010

SummaryBackgroundAlthough chronic hepatitis C virus‐infected patients with persistently normal alanine aminotransaminase levels usually have mild liver disease, disease progression can still occur. However, it is uncertain which group of patients is at risk of disease progression.AimTo examine the severity of liver disease on liver biopsy in Chinese patients with persistently normal alanine aminotransaminase levels, and their disease progression over time.MethodsEighty‐two patients with persistently normal alanine aminotransaminase levels were followed up longitudinally. The median time of follow‐up was 8.1 years. Forty‐seven of the 82 patients (57.3%) had a second liver biopsy.ResultsAt the time of analysis, six of the 82 patients (7.3%) developed decompensated liver cirrhosis. Patients with an initial fibrosis stage F2 or F3 [6/23 (26.1%) vs. 0/59 (0%), P < 0.0001] or inflammatory grade A2 or A3 [5/40 (12.5%) vs. 1/42 (2.4%), P = 0.04] were more likely to develop decompensated liver cirrhosis. On multivariate analysis, initial fibrosis stage F2 or F3 was independently associated with progression to decompensated liver cirrhosis (relative risk 2.3, 95% confidence interval 0.03–2.5, P = 0.02).ConclusionChinese chronic hepatitis C virus patients with persistently normal alanine aminotransaminase levels with moderate to severe fibrosis at initial evaluation are more likely to develop decompensated liver cirrhosis.
Systematic review: the potential influence of mesalazine formulation on maintenance of remission in Crohn’s disease
Authors: STEINHART A. H. , FORBES A. , MILLS E. C. , RODGERS‐GRAY B. S. , TRAVIS S. P. L. 
Published: July 2010

SummaryAim To evaluate the effectiveness of pH 6‐/pH 7‐dependent and controlled‐release mesalazines in maintaining medically and surgically induced Crohn’s disease remission.Methods A systematic search identified 13 randomized controlled trials (RCTs). The rate of symptomatic relapse (Crohn’s disease activity index >150, or an increase in baseline by at least 60–100 points) was extracted from each randomized controlled trial. Pooled odds ratios (OR), the number needed to treat (NNT), and percentage therapeutic benefit (absolute risk reduction) were calculated.Results Treatment with pH 7‐dependent mesalazine significantly reduced the risk of relapse in patients with either surgically [OR 0.28; 95% confidence interval (CI) 0.12–0.65;P = 0.0032] or medically induced remission (OR 0.38; 95% CI 0.17–0.85;P = 0.0113). However, treatment with controlled‐release mesalazine and pH 6‐dependent mesalazine failed to show any significant advantage over placebo. The NNT to maintain surgically or medically induced remission was lowest for pH 7‐dependent mesalazine (NNT = 4 and 5, respectively; NNT = 15 and 16 for controlled‐release mesalazine and NNT = 11 and 23 for pH 6‐dependent mesalazine). Therapeutic benefit was highest for pH 7‐dependent mesalazine (surgical = 30.6%, medical = 22.8%). This compared with 6.9% (surgical) and 6.4% (medical) for controlled‐release mesalazine, and 9.8% and 4.4%, respectively, for pH 6‐dependent mesalazine.Conclusion Further trials of pH 7‐dependent mesalazine formulations are warranted in the maintenance of remission in Crohn’s disease.
Irritable bowel syndrome: patients’ attitudes, concerns and level of knowledge
Authors: LACY B. E. , WEISER K. , NODDIN L. , ROBERTSON D. J. , CROWELL M. D. , PARRATT‐ENGSTROM C. , GRAU M. V. 
Published: July 2010

SummaryBackgroundIrritable bowel syndrome (IBS) is a common, chronic disorder that reduces patients’ quality‐of‐life. Although highly prevalent, little is known about patients’ understanding of this disorder.AimTo evaluate the knowledge, fears and concerns of IBS patients.MethodsSeven hundred thirty‐six IBS patients (Rome II criteria) were eligible for inclusion in this prospective study. Each patient received a validated questionnaire to evaluate knowledge, attitudes and fears regarding IBS.ResultsA total of 261 of 664 potential respondents completed the questionnaire (39.3%). 83% of respondents were women, with a mean age of 53.7 years, and mean duration of symptoms of 14.2 years. Patients frequently believed that IBS develops because of anxiety (80.5%), dietary factors (75.1%) and depression (63.2%). Few respondents (28.7%) recognized that abdominal pain is the cardinal symptom of IBS, and 40.6% stated that colonoscopy can diagnose IBS. One in seven patients stated that IBS turns into cancer, and 29.9% noted that IBS increases the risk of inflammatory bowel disease.ConclusionsMany IBS patients have significant misconceptions regarding the nature of their disease and its prognosis. An overwhelming majority of IBS patients believe that anxiety, dietary factors and depression cause IBS. These findings are discordant with physicians’ views and practices and highlight the need for patient‐oriented educational programs.
Primary antibiotic resistance in Helicobacter pylori strains isolated in northern and central Italy
Authors: ZULLO A. , PERNA F. , HASSAN C. , RICCI C. , SARACINO I. , MORINI S. , VAIRA D. 
Published: July 2010

SummaryBackground  Helicobacter pylori resistance to antibiotics is increasing worldwide, and it reduces the efficacy of therapy.Aim  To assess current primary antibiotic resistance in H. pylori strains isolated in Italy.Methods  Between June 2004 and June 2006, H. pylori strains were isolated consecutively in the two participating centres (Bologna, northern Italy; Rome, central Italy) from patients never previously treated for the infection. Isolated strains were tested for primary clarithromycin, metronidazole and levofloxacin resistance using as break point the minimal inhibitory concentration ≥1, ≥8 and ≥1 mg/L for the three antibiotics, respectively.Results  Overall, 255 H. pylori strains were evaluated. The resistance rate was 16.9% for clarithromycin, 29.4% for metronidazole and 19.1% for levofloxacin. Clarithromycin resistance was significantly higher in non‐ulcer dyspepsia than in peptic ulcer patients (19.1% vs. 0%, P = 0.02), metronidazole resistance was higher in foreign than Italian patients (50% vs. 22.9%, P = 0.0004) and levofloxacin resistance was higher in old than younger patients (28.4% vs. 14.4%, P = 0.048). Levofloxacin resistance was also more frequent in those strains with either clarithromycin or metronidazole resistance.Conclusion  A very high rate of primary resistance towards the tested antibiotics was detected in our study.
Review article: the role of surgery in gastro‐oesophageal reflux disease
Authors: VAKIL N. 
Published: July 2010

SummaryBackground  Rates for laparoscopic fundoplication are declining in the United States and there is no consensus on the indications for referral to surgery in gastro‐oesophageal reflux disease.Aim  To highlight recent studies on the outcomes of laparoscopic fundoplication in adults that cast doubt on the traditional indications for surgery in reflux disease.Results  Patients who are well maintained on medical therapy have more to lose with surgical intervention than to gain, and should not be offered surgery. Likewise, the notion that surgery prevents oesophageal cancer is a hypothesis that is not supported by current evidence, therefore surgical intervention should not be offered to these patients.The only clear‐cut candidates for surgery include: patients with anatomic abnormalities such as a large hiatus hernia, or those with persistent regurgitation that causes troublesome symptoms despite medical therapy; and carefully selected patients with extra‐oesophageal disorders who have symptoms of reflux disease such as heartburn and regurgitation, an incomplete response to medical therapy and persistent plus demonstrable reflux on pH or impedance testing that is associated with their symptoms.Patients should be aware of the high likelihood of needing continued acid inhibitory therapy following surgery and the possibility of side‐effects.Conclusion  Only a few carefully selected patients should undergo fundoplication for reflux disease.
Risk of acute liver injury associated with the use of drugs: a multicentre population survey
Authors: SABATÉ M. , IBÁÑEZ L. , PÉREZ E. , VIDAL X. , BUTI M. , XIOL X. , MAS A. , GUARNER C. , FORNÉ M. , SOLÀ R. , CASTELLOTE J. , RIGAU J. , LAPORTE J.‐R. 
Published: July 2010

SummaryBackground Acute liver injury of uncertain aetiology is often drug related and quantitative information about the associated risk is scarce.Aim To estimate the risk of acute liver injury associated with the use of drugs.Methods In a population survey study, 126 cases of acute liver injury were prospectively assembled from January 1993 to December 1999, in patients over 15 years of age, in 12 hospitals in Barcelona (Spain). We estimated the relative risk for each drug as the ratio between the incidence of acute liver injury among the exposed population to the drug and the incidence of acute liver injury among those not exposed to it. Drug consumption data were used to estimate the exposed population.Results Isoniazid, pyrazinamide, rifampicin, amoxicillin with clavulanic acid, erythromicin, chlorpromazine, nimesulide, and ticlopidine presented the highest risk (point relative risk > 25). Amoxicillin, metoclopramide, captopril and enalapril, furosemide, hydrochlorothiazide, fluoxetine, paroxetine, diazepam, alprazolam, lorazepam, metamizole, low‐dose acetylsalicylic acid and salbutamol showed the lowest risk (point relative risk < 5).Conclusions This study provides a risk estimation of serious liver disease for various drugs that will be useful in its diagnosis and management, and when comparing with the drug therapeutic benefit in each indication. Some observed associations would be worth specific studies.
Decreasing prevalence combined with increasing eradication of Helicobacter pylori infection in the United States has not resulted in fewer hospital admissions for peptic ulcer disease‐related complications
Authors: MANUEL D. , CUTLER A. , GOLDSTEIN J. , FENNERTY M. B. , BROWN K. 
Published: July 2010

SummaryBackground  Helicobacter pylori infection is a major cause of peptic ulcer disease, but the prevalence of this infection has been decreasing steadily. Additionally, eradication of H. pylori decreases ulcer recurrence and prevents ulcer complications such as bleeding.Aim  To examine whether the decreased prevalence of H. pylori and increased use of eradication regimens have affected the prevalence of peptic ulcer disease‐related hospitalizations.Methods  We chose to study a period between 1996 and 2005. The number of gastric and duodenal ulcers as primary or secondary hospital discharge diagnoses per year for the 10‐year span was collected from five large US hospitals. Collected data were analysed using Spearman correlation.Results  No statistically significant trend was observed in the number of gastric or duodenal ulcers listed as primary or secondary discharge diagnoses at any of the five healthcare centres.Conclusions  Despite a decreasing prevalence of H. pylori and the increasing use of successful H. pylori eradication regimens, the prevalence of peptic ulcer disease and its complications has not changed. In the US other aetiologies, including non‐steroidal anti‐inflammatory drugs, may be playing a larger role than once thought.
Environmental risk factors in the development of adenocarcinoma of the oesophagus or gastric cardia: a cross‐sectional study in a Dutch cohort
Authors: DE JONGE P. J. F. , WOLTERS L. M. M. , STEYERBERG E. W. , VAN DEKKEN H. , KUSTERS J. G. , KUIPERS E. J. , SIERSEMA P. D. 
Published: July 2010

SummaryBackground Risk factors for adenocarcinoma of the oesophagus (OAC) and gastric cardia (GCA) are not yet established.Aim To compare environmental risk factors between patients with OAC and GCA.Methods One‐hundred and twenty‐six patients with OAC, 43 with GCA and 57 with squamous cell carcinoma filled out a questionnaire with information on demographic and lifestyle characteristics, physical activity levels, family history, gastro‐oesophageal reflux disease symptoms and medication use.Results OAC and GCA patients were similar with regard to male predominance and age, alcohol intake and smoking, use of fruits and vegetables, body posture and occupational activities (P > 0.05). GCA patients less often had heartburn compared with OAC patients [odds ratio (OR) 0.5, 95% confidence interval (CI) 0.2–0.96] and had these symptoms less frequently and for a shorter period (OR 0.3, CI 0.1–1.0 and OR 0.1, CI 0.03–0.6, respectively). Former and current aspirin use was lower among GCA patients than OAC patients (OR 0.2, CI 0.05–0.7 and OR 0.4, CI 0.1–0.9, respectively), whereas no difference in non‐steroidal anti‐inflammatory drug use was detected.Conclusion Although OAC and GCA share several environmental risk factors, OAC is more frequently associated with a history of gastro‐oesophageal reflux disease, suggesting a more important role for gastro‐oesophageal reflux in OAC compared with GCA.
Efficacy of mitemcinal, a motilin agonist, on gastrointestinal symptoms in patients with symptoms suggesting diabetic gastropathy: a randomized, multi‐center, placebo‐controlled trial
Authors: MCCALLUM R. W. , CYNSHI O. ,   US INVESTIGATIVE TEAM
Published: July 2010

SummaryBackground Mitemcinal, an oral motilin agonist, accelerates gastric emptying.Aim To investigate if mitemcinal was superior to placebo in relief of symptoms attributed to gastroparesis.Methods In a randomized, double‐blind design, 392 insulin‐requiring diabetics with symptoms attributable to gastroparesis were treated for 3 months with placebo, mitemcinal 5 or 10 mg bid. On a weekly basis, patients assessed whether there was adequate relief of their gastroparesis symptoms. Patients were classified as Complete Responders (CR) if there were three consecutive positive monthly responses, which required at least 50% of their weekly responses in a month being positive. An Overall Responder (OR) had at least 75% positive weekly responses for the whole treatment period.Results Mitemcinal 10 mg produced a significantly better response rate than placebo with a 10.6% increase in the OR (P < 0.05 vs. placebo). Mitemcinal 10 mg also produced statistically significant increases in the CR and OR in the subgroup identified by baseline body mass index (<35 kg/m2) and haemoglobin A1c (<10%) (P < 0.01 vs. placebo). Adverse events did not differ from placebo frequency levels.Conclusions Mitemcinal can induce a statistically significant response to treatment in a subset of diabetic gastroparesis where future prokinetic clinical trials should be focused.
Comparisons of the distribution of oesophageal acid exposure throughout the sleep period among the different gastro‐oesophageal reflux disease groups
Authors: DICKMAN R. , PARTHASARATHY S. , MALAGON I. B. , JONES P. , HAN B. , POWERS J. , FASS R. 
Published: July 2010

SummaryBackground Nocturnal gastro‐oesophageal reflux diseases (GERD) can lead to oesophageal mucosal injury and extra‐oesophageal complications.Aim To compare distribution of oesophageal acid exposure during sleep time among patients with non‐erosive reflux disease and abnormal pH test (NERD‐positive), erosive oesophagitis (EO) and Barrett’s oesophagus (BO).Methods Patients underwent endoscopy followed by 24‐h oesophageal pH testing. Oesophageal acid exposure was assessed every 2 h of the sleep period (0–2, 2–4, 4–6 and 6–8 h). Each period of 2 h was evaluated for acid reflux parameters. All groups were matched by age, time from last meal and duration of sleep time.Results Thirty‐eight patients were enrolled (NERD‐positive, 16; EO, 1.4; and BO, 8). All GERD groups demonstrated higher oesophageal acid exposure in the first vs. second half of the sleep period as determined by percent time pH <4 (BO: 34.7 vs.11.6, EO: 13.5 vs. 6.9, NERD‐positive: 8.8 vs. 2.5, allP < 0.01). In general, patients with BO had a significantly higher distribution of oesophageal acid exposure than those with NERD‐positive and EO.Conclusions Oesophageal acid exposure generally declines throughout the sleep period regardless of GERD group, but BO patients demonstrated the greatest decline during the sleep period.
Determinants of the short‐term gastric damage caused by NSAIDs in man
Authors: BJARNASON I. , SCARPIGNATO C. , TAKEUCHI K. , RAINSFORD K. D. 
Published: July 2010

SummaryBackgroundThe short‐term gastric damage seen with non‐steroidal anti‐inflammatory drugs (NSAIDs) in man may involve inhibition of cyclooxygenase (COX‐1) and COX‐2 as well as the topical irritancy, which is dependant on the acidity (pKa) and/or lipophilicity (logP7.4).AimTo study the quantitative relationship between NSAID‐induced short‐term gastric damage, their physicochemical properties and contrasting roles of COX‐1 and COX‐2 inhibition.MethodsWe identified studies that allowed a qualitative comparison of the gastric injury (Lanza scores) induced by NSAIDs with their pKa and logP7.4. Damage was correlated with gastric COX inhibition and potency to inhibit COX‐1 and 2 and their COX‐2/COX‐1 selectivity ratio.ResultsThe gastric damage correlates significantly with pKa (r = −0.69;P < 0.01), logP(r = −0.58,P < 0.05) and potency of the NSAIDs to inhibit COX‐1 (r = −0.61,P < 0.02), but not with COX‐2 inhibition or COX‐2/COX‐1 selectivity.ConclusionAgainst a background of COX‐1 and COX‐2 inhibition, the physicochemical properties of NSAID appear to play an important role in short‐term gastric damage.
Meta‐analysis: the efficacy of rectal beclomethasone dipropionate vs. 5‐aminosalicylic acid in mild to moderate distal ulcerative colitis
Authors: MANGUSO F. , BALZANO A. 
Published: July 2010

SummaryBackground Beclomethasone dipropionate (BDP) is a second‐generation steroid with topical effects and minimal systemic activity for patients with ulcerative colitis (UC).Aim To review all available literature to assess the efficacy of enema/foam BDP compared with enema/foam 5‐aminosalicylic acid (5‐ASA) in the control of left‐sided mild–moderate UC.Methods We selected randomized controlled trials of enema/foam BDP compared with enema/foam 5‐ASA treatment in patients with UC. Two reviewers assessed trial quality and extracted data independently.Results Four trials involving 428 UC patients, 209 treated with 5‐ASA (1–4 g o.d.) and 219 with BDP (3 mg o.d.), were included. Intention‐to‐treat analysis showed that 5‐ASA induced improvement/remission of UC in 146 (69.9%) patients, while BDP in 143 (65.3%). The test for heterogeneity (Cochran Q) was not significant and Mantel–Haenszel pooled estimate of odds ratio was 1.23 (95% CI = 0.82–1.85). The results did not change when analysis was performed on a per‐protocol basis.Conclusion The randomized controlled trials identified in this review showed that rectal BDP has equal effect as 5‐ASA to control symptoms in UC.
Systematic review: the adverse effects of sodium phosphate enema
Authors: MENDOZA J. , LEGIDO J. , RUBIO S. , GISBERT J. P. 
Published: July 2010

SummaryBackgroundSodium‐phosphate enemas are widely used to treat constipation, and are rarely associated with side effects.AimA systematic review of the literature was conducted to identify the most common adverse effects of sodium‐phosphate enemas and associated risk factors.MethodsA systematic search was conducted in Internet (MEDLINE), and the Cochrane Library, from January 1957 to March 2007.ResultsA total of 761 references were identified initially, and 39 relevant papers were finally selected. The most common therapeutic indications included constipation (63%). Sixty‐eight per cent of the patients having adverse effects had associated conditions, the most common being gastrointestinal motility disorders, cardiological diseases and renal failure. Virtually, all side effects were due to water and electrolyte disturbances. Most patients were under 18 years of age (66%) or older than 65 years (25%). A total of 12 deaths were found.ConclusionThe main side effects caused by sodium phosphate enemas are water and electrolyte disturbances. The main risk factors are extreme age and associated comorbidity.
Novel endoscopic observation in Barrett’s oesophagus using high resolution magnification endoscopy and narrow band imaging
Authors: ANAGNOSTOPOULOS G. K. , YAO K. , KAYE P. , HAWKEY C. J. , RAGUNATH K. 
Published: July 2010

SummaryBackground High resolution magnification endoscopy with narrow band imaging (NBI) may improve the detection of specialised intestinal metaplasia (SIM) and dysplasia in Barrett’s oesophagus.Aims To describe the magnified endoscopic features with the use of NBI in Barrett’s oesophagus.Methods Three hundred and forty‐four areas from 50 patients with Barrett’s oesophagus were studied using high resolution magnification endoscopy (HRME) with NBI and targeted biopsies were obtained. The sensitivity, specificity, predictive values of the various patterns for the prediction of SIM and dysplasia were calculated.Results The magnified endoscopic features of Barrett’s oesophagus with the use of NBI consist of microstructural/microvascular patterns. The yield of SIM according to the patterns was: (i) Regular microstructural pattern with tubular/linear/villous pattern 90.6% and with circular pattern 0%; and (ii) Absent microstructural pattern 98.9%. The sensitivity, specificity, positive and negative predictive values of the combination of regular microstructural pattern (tubular/villous/linear) and absent microstructural pattern to detect SIM were 100%, 78.8%, 93.5% and 100%, respectively. The sensitivity, specificity, positive and negative predictive values of the irregular microvascular/microstructural pattern for the prediction of high grade dysplasia were 90%, 100%, 99.2% and 100%, respectively.Conclusion High resolution magnification endoscopy with NBI allows clear visualisation of microstructural and microvascular patterns within Barrett’s oesophagus, and allows targeted biopsy with a high yield of SIM and high grade dysplasia.
Relationship between the Fibrotest and portal hypertension in patients with liver disease
Authors: THABUT D. , IMBERT‐BISMUT F. , CAZALS‐HATEM D. , MESSOUS D. , MUNTENAU M. , VALLA D. C. , MOREAU R. , POYNARD T. , LEBREC D. 
Published: July 2010

SummaryBackground  The best technique to estimate portal hypertension (PHT) is to measure the hepatic venous pressure gradient (HVPG), which is an invasive method.Aim  To assess the relationship between the Fibrotest (Biopredictive, Paris, France) and the presence and degree of PHT in patients with liver disease, and to determine if the Fibrotest can diagnose severe PHT, defined by HVPG ≥ 12 mmHg, in cirrhotic patients.Methods  Patients who underwent a transjugular liver biopsy were prospectively included. HVPG was measured, and classification of histological lesions assessed. The same day, blood samples for Fibrotest were performed.Results  A total of 130 patients were included (no or minimal fibrosis: 12%, moderate fibrosis 17%, cirrhosis 71%). There was a significant correlation between Fibrotest and HVPG (Pearson correlation coefficient = 0.58, P < 0.0001), also weaker in cirrhotic patients (Pearson correlation coefficient = 0.24, P = 0.02). In cirrhotic patients, Fibrotest was significantly higher when there was a severe PHT (0.87 ± 0.15 vs. 0.73 ± 0.14, respectively, P = 0.02). The areas under the receiver operating characteristic curves for the diagnosis of severe PHT was 0.79 ± 0.07, not different from that of platelets and Child‐Pugh score.Conclusion  In patients with liver disease or cirrhosis, Fibrotest is correlated with the presence and degree of PHT. Other studies are needed to confirm these results, especially in non‐decompensated cirrhotic patients.