bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: the abdominal compartment syndrome
Authors: LERNER S. M. 
Published: October 2008

SummaryBackground  The term abdominal compartment syndrome refers to hypoperfusion and ischaemia of intra‐abdominal viscera and structures caused by raised intra‐abdominal pressure. It occurs most commonly following major trauma and complex surgical procedures, but can also occur in their absence. Definitive treatment is decompression at laparotomy. Prevention and recognition of abdominal compartment syndrome are crucial to avoid additional morbidity and mortality. Postinjury abdominal compartment syndrome continues to complicate current resuscitation methods and new strategies for resuscitating critically ill patients need to be explored in addition to more accurate monitoring of intra‐abdominal pressure.Aim  To examine the published literature regarding the pathogenesis, diagnosis and management of the abdominal compartment syndrome.Methods  A comprehensive review of the literature was undertaken.Results  This syndrome is an important complication of major trauma and surgery as well as being recognized in critically‐ill medical patients. It requires prompt recognition with a view to decompression at laparotomy.Conclusions  The abdominal compartment syndrome is an important complication of trauma, surgery and resuscitation. Key to its management are its prompt recognition and abdominal decompression.
Review article: probiotics and prebiotics in irritable bowel syndrome
Authors: SPILLER R. 
Published: October 2008

SummaryBackground  The human gut harbours a complex community of bacteria whose relationship with their host is normally mutually beneficial. Recent studies suggest a disturbance of this relationship in irritable bowel syndrome (IBS) and the potential to correct this using prebiotics and probiotics.Aim  To review the mechanisms of action of probiotics and prebiotics in IBS and to assess their performance in clinical trials.Methods  Articles relating to modes of action and randomized control trials of treatment were reviewed by searching PubMed using terms ‘probiotic’, ‘prebiotic’ and ‘irritable bowel’. Small uncontrolled studies in IBS were excluded.Results  Probiotics can enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response. They can also reduce visceral hypersensitivity associated with both inflammation and psychological stress. Probiotics can alter colonic fermentation and stabilize the colonic microbiota. Several large randomized, placebo‐controlled trials of adequate design have shown an improvement in flatulence and abdominal distension with a reduction in composite IBS symptoms scores.Conclusions  Each probiotic has unique features and IBS patients are heterogeneous. Future efforts should be directed to identifying biomarkers of responsiveness to facilitate better targeting of treatment and hence improved efficacy.
Review article: diagnosis and treatment of non‐alcoholic fatty liver disease
Authors: OH M. K. , WINN J. , POORDAD F. 
Published: October 2008

SummaryBackground Non‐alcoholic fatty liver disease (NAFLD) is an increasingly prevalent condition affecting adults and children, leading to significant morbidity. It is often associated with the metabolic syndrome, although multiple pathogenetic mechanisms have been suggested. In the coming decades, it promises to be the leading cause of liver disease in industrial countries.Aim To provide a comprehensive, updated review of diagnosis and management of NAFLD and to appraise the evolution of new modalities in these areas.Methods An Ovid MEDLINE search was performed to identify pertinent original research and review articles. Selected references in these articles were also evaluated.Results The diagnosis of hepatic steatosis and steatohepatitis or non‐alcoholic steatohepatitis (NASH) is not yet possible without liver biopsy. This is impractical given the large numbers affected by the condition. Current therapy has focused on improving insulin resistance and mediators of inflammation, factors probably associated with disease progression.Conclusions There are no proven non‐invasive diagnostic modalities to distinguish NAFLD and NASH, but new biomarker panels are approximating the liver biopsy in accuracy. Therapeutic targets of drug development are in early stages, but a multifaceted approach will probably yield several treatment options in the years to come.
Review article: treatment algorithms to maximize remission and minimize corticosteroid dependence in patients with inflammatory bowel disease
Authors: PANACCIONE R. , RUTGEERTS P. , SANDBORN W. J. , FEAGAN B. , SCHREIBER S. , GHOSH S. 
Published: October 2008

SummaryBackground  Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the intestine, which frequently require surgery for complications or failure of medical therapy.Aim  To seek evidence and provide direction for clinicians on optimal strategies to enable steroid free remission in inflammatory bowel disease.Methods  Scientific literature was reviewed using MEDLINE with a specific focus on medical therapies for inducing and maintaining remission of CD and UC. The results were discussed at a roundtable meeting to reach a consensus on key issues.Results  Several therapies have demonstrated efficacy for the treatment of active, moderate‐to‐severe CD and UC. These include agents, which induce remission [corticosteroids, infliximab and adalimumab (CD only)] or maintain remission and spare corticosteroids [azathioprine, mercaptopurine, methotrexate (CD only), infliximab and adalimumab (CD only)]. Wide variability exists in the use of these agents.Conclusion  Treatment strategy algorithms are developed for use of these therapies that maximize remission and minimize corticosteroid dependence in patients with moderate‐to‐severe CD and UC.
The effect of functional gastrointestinal disorders on psychological comorbidity and quality of life in patients with inflammatory bowel disease
Authors: MIKOCKA‐WALUS A. A. , TURNBULL D. A. , ANDREWS J. M. , MOULDING N. T. , HOLTMANN G. J. 
Published: October 2008

SummaryBackground  Symptoms of functional gastrointestinal disorders (FGIDs) are common in patients with inflammatory bowel disease (IBD). Psychological comorbidities of anxiety and depression are also highly prevalent in IBD.Aim  To quantify the burden of FGIDs in a hospital‐based cohort of patients with IBD and to determine whether there is any inter‐relationship between the presence and number of FGIDs and patients’ quality of life or psychological status.Methods  A cross‐sectional survey of 61 out‐patients was performed. Data on psychological status, quality of life, disease activity and functional symptoms according to Rome III criteria were collected.Results  Overall, 49 (80%) participants met Rome III criteria for a functional bowel disorder and 52% of participants met criteria for more than one FGID. Participants with no FGID had significantly better physical quality of life than those with more than two FGIDs (P = 0.025). However, there was no relationship among the number of FGIDs, mental quality of life, anxiety or depression.Conclusions  Functional gastrointestinal disorders are highly prevalent in out‐patients with IBD. Somewhat unexpectedly, the presence of anxiety and/or depression did not appear to correlate with either the presence or the number of FGIDs.
Meta‐analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis
Authors: BAI Y. , GAO J. , ZHANG W. , ZOU D. , LI Z. 
Published: October 2008

SummaryBackground  Several clinical trials evaluating the prophylactic effect of allopurinol on postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis have been published; however, there is no consensus on whether prophylactic allopurinol can reduce the incidence of post‐ERCP pancreatitis.Aim  To compare prophylactic allopurinol with placebo on post‐ERCP pancreatitis reduction by performing a meta‐analysis in randomized controlled trials.Methods  Databases including MEDLINE, EMBASE and the Cochrane Library, Science Citation Index were searched to find relevant trials. Two reviewers independently identified relevant randomized controlled trials assessing the effect of prophylactic allopurinol on the incidence of post‐ERCP pancreatitis. Outcome measures were the incidence of post‐ERCP pancreatitis.Results  Four trials involving 1730 patients were included. Analysis suggested that post‐ERCP pancreatitis rates were not significantly different (allopurinol 8.9%, placebo 9.7%, P = 0.68), RR 0.86 (95% CI: 0.42, 1.77). Subsequent subgroup analysis confirmed that allopurinol was not statistically superior to placebo in reducing post‐ERCP pancreatitis.Conclusion  Based on current best evidence, prophylactic allopurinol may not be useful for post‐ERCP pancreatitis reduction.
Oral, colonic‐release low‐molecular‐weight heparin: an initial open study of Parnaparin‐MMX for the treatment of mild‐to‐moderate left‐sided ulcerative colitis
Authors: PASTORELLI L. , SAIBENI S. , SPINA L. , SIGNORELLI C. , CELASCO G. , DE FRANCHIS R. , VECCHI M. 
Published: October 2008

SummaryBackground  Efficacy of heparin and low‐molecular‐weight heparins (LMWHs) in inflammatory bowel disease (IBD) treatment has been suggested. The multimatrix oral formulation MMX releases active drugs in the colon, avoiding systemic absorption. Parnaparin sodium is the LMWH chosen to be carried in the MMX formulation.Aim  To assess the safety of three different oral dosages (70, 140 and 210 mg once daily) of Parnaparin‐MMX (CB‐01‐05) in left‐sided ulcerative colitis (UC).Methods  Left‐sided UC patients, with a mild‐to‐moderate relapse were enrolled. All patients received Parnaparin‐MMX for 8 weeks. Clinical Activity Index (CAI), Disease Activity Index (DAI), Endoscopic Activity Index and IBD‐QoL were assessed throughout the study. A strict clinical and laboratory follow‐up, including assessment of anti‐factor Xa activity, was performed. Clinical remission was defined as CAI <4.Results  Ten UC patients were enrolled. One patient retired for clinical deterioration. No relevant side effects, including either interference with haemostasis parameters or increased bleeding, were observed. At the end of the treatment, seven patients (70%) were in clinical remission, only one achieving endoscopic healing. Mean final CAI, DAI and IBD‐QoL scores were significantly improved from baseline.Conclusions  Parnaparin‐MMX appears to be a safe treatment option in mild‐to‐moderate UC. Controlled studies are warranted.
Meta‐analysis: tumour invasion‐related genetic polymorphisms and gastric cancer susceptibility
Authors: GAO L. , NIETERS A. , BRENNER H. 
Published: October 2008

SummaryBackground  Host genetic susceptibility has been suggested as one of the most important possible explanations for interindividual difference in gastric cancer (GC) risk.Aim  To evaluate the impact of tumour invasion‐related gene polymorphisms, which may be involved in a variety of processes during GC development, such as cell adhesion and angiogenesis, on the risk of GC.Methods  We reviewed published studies on tumour invasion‐related gene polymorphisms and GC susceptibility until 31 March 2008, and then quantitatively summarized associations of the most widely‐studied polymorphism, CDH1−160C>A, with GC using meta‐analysis.Results  Twenty‐seven eligible studies were included in this review. Fourteen polymorphisms significantly related to GC in at least one study were identified. For several polymorphisms, heterogeneous results were observed and associations in opposite directions were seen among Asian and Caucasian populations. In meta‐analysis, CDH1−160C>A showed an inverse association with GC among Asians (OR, 0.76; 95% CI, 0.55–1.05) and a positive association among Caucasians (OR, 1.40; 95% CI, 0.95–2.04).Conclusions  This review suggests that genetic polymorphisms in tumour invasion could be candidate biomarkers of GC risk. However, differences between populations and stages of cancer need to be taken into account and may explain some of the inconsistencies found in previous studies.
Clinical trial: peg‐interferon alfa‐2b and ribavirin for the treatment of genotype‐1 hepatitis C recurrence after liver transplantation
Authors: LODATO F. , BERARDI S. , GRAMENZI A. , MAZZELLA G. , LENZI M. , MORELLI M. C. , TAME M. R. , PISCAGLIA F. , ANDREONE P. ,   BOLOGNA LIVER TRANSPLANTATION GROUP (BLTG), BALLARDINI G. , BERNARDI M. , BIANCHI F. B. , BISELLI M. , BOLONDI L. , CESCON M. , COLECCHIA A. , D’ERRICO A. , DEL GAUDIO M. , ERCOLANI G. , GRAZI G. L. , GRIGIONI W. , LORENZINI S. , PINNA A. D. , RAVAIOLI M. , RODA E. , SAMA C. , VIVARELLI M. 
Published: October 2008

SummaryBackground  Treatment of hepatitis C virus (HCV) recurrence after liver transplantation (LT) is difficult with low response rates.Aim  To assess the safety and efficacy of pegylated‐interferon (PEG‐IFN) alfa‐2b + ribavirin (RBV) in patients with post‐LT recurrent genotype‐1 HCV and to establish stopping rules according to response.Methods  Fifty‐three patients with post‐LT HCV recurrence were enrolled. Patients received PEG‐IFN alfa‐2b 1.0 μ/kg/week plus RBV 8–10 mg/kg/day for 24 weeks. Those with ‘early virological response at week 24’ (EVR24) continued treatment for 24 weeks (group A). Patients without EVR24 were randomized to continue (group B) or to discontinue (group C).Results  Overall sustained virological response (SVR) was 26% (14/53). Alanine aminotransferase, rapid virological response, EVR12, EVR24, undetectable serum HCV‐RNA at weeks 12 (cEVR12) and 24 (cEVR24) were related to SVR. cEVR12 and cEVR24 (OR: 14.7; 95% CI: 2.02–106.4) were independent predictors of SVR. All patients with SVR, had cEVR12. No patient in groups B and C achieved end‐of‐treatment response. One patient in group B had SVR.Conclusions  Pegylated‐interferon alfa‐2b was effective in one of four of patients with HCV genotype 1 after LT. Treatment should be discontinued in patients with no virological response at week 12. Further studies are needed to evaluate whether a longer treatment period may be beneficial in patients with ≥2 log10 drop in HCV‐RNA at week 24.
Clinical trial: effectiveness of chewing‐gum in accelerating capsule endoscopy transit time – a prospective randomized, controlled pilot study
Authors: APOSTOLOPOULOS P. , KALANTZIS C. , GRALNEK I. M. , LIATSOS C. , TSIRONIS C. , KALANTZIS N. 
Published: October 2008

SummaryBackground  Capsule endoscopy (CE) fails to reach the caecum in approximately 20% of patients. Data suggest that chewing‐gum, simulating sham feeding, provokes the cephalic phase of gastrointestinal (GI) motor response and may increase GI motility.Aim  To determine whether chewing‐gum increases the ability of CE reaching the caecum.Methods  Prospective, randomized, single‐blinded controlled trial. Ninety‐three consecutive patients were randomized either to use chewing‐gum (n = 47) or not (n = 46). All patients received the identical bowel preparation. Patients chewed one piece of gum for approximately 30 min every 2 h. Two blinded gastroenterologists examined all studies. The number of CE that reached the caecum within 8‐h, gastric transit time (GTT) and small bowel transit time (SBTT) were evaluated in all patients.Results  The CE percentage passed into the caecum was higher in the chewing‐gum group compared with those in the other (83.0% vs. 71.7% respectively, P = 0.19). Both GTT and SBTT were significantly shorter in the chewing‐gum vs. control group [40.8 min (interquartile range: 21–61 min) vs. 56.1 min (interquartile range: 22–78 min) (P = 0.045) and 229.1 min (interquartile range: 158–282 min) vs. 266.2 min (interquartile range: 204–307 min) (P = 0.032) respectively]. Chewing‐gum did not adversely affect CE image quality.Conclusions  Chewing‐gum significantly reduces GTT and SBTT during CE. Its use may improve the likelihood of the capsule reaching the caecum without affecting CE image quality.
Meta‐analysis: the outcome of anti‐viral therapy in HCV genotype 2 and genotype 3 infected patients with chronic hepatitis
Authors: ANDRIULLI A. , MANGIA A. , IACOBELLIS A. , IPPOLITO A. , LEANDRO G. , ZEUZEM S. 
Published: October 2008

SummaryBackground  Anti‐viral therapy seems more successful in HCV genotype 2 than genotype 3‐infected patients.Aim  To report sustained virological response (SVR) rates for HCV‐2 and HCV‐3 infection.Methods  Meta‐analyses were carried out on SVR data on 2275 patients treated for 24 weeks in eight individual trials and on 968 patients with rapid virological response (RVR) treated for 12–16 weeks or 24 weeks in four studies.Results  After 24 weeks of therapy, SVR rates were 74% and 68%, respectively, for HCV‐2 and HCV‐3 genotype patients. Among high viraemics, SVR rate in HCV‐2 infection (75%) differed from the 58% value in HCV‐3 infection. Among low viraemic patients, respective rates were 79% and 75%. In RVR patients treated for 12–16 or 24 weeks, SVR rates in HCV‐2 infection were 83% and 84%, respectively, and in HCV‐3 infection 84% and 86%. In patients without RVR treated for 24 weeks, SVR was higher in HCV‐2, with a 17.8% weighted difference.Conclusions  Twenty‐four weeks of therapy should remain standard duration for HCV‐2 and low viraemic HCV‐3 patients. In RVR patients, HCV‐3 patients respond to short‐treatment as well as HCV‐2 patients, irrespective of basal viraemia. Patients without RVR may need longer treatment than the recommended 24 weeks.
Long‐term effect of tacrolimus therapy in patients with refractory ulcerative colitis
Authors: YAMAMOTO S. , NAKASE H. , MIKAMI S. , INOUE S. , YOSHINO T. , TAKEDA Y. , KASAHARA K. , UENO S. , UZA N. , KITAMURA H. , TAMAKI H. , MATSUURA M. , INUI K. , CHIBA T. 
Published: October 2008

SummaryBackground  Little is known about long‐term outcome of tacrolimus therapy for ulcerative colitis.Aim  To evaluate long‐term efficacy and safety of tacrolimus in Japanese patients with refractory ulcerative colitis.Methods  Twenty‐seven patients with UC refractory to conventional therapy were administered tacrolimus with trough whole‐blood levels of 10–15 ng/mL to induce remission and 5–10 ng/mL to maintain remission. Median treatment duration was 11 months (1–39 months) and median follow‐up duration was 17 months (2–65 months). Evaluation of the clinical response was based on a modified Truelove–Witts severity index (MTWSI).Results  Tacrolimus produced a clinical response in 21 patients (77.8%), and remission was achieved in 19 of these 21 (70.4%) within 30 days. Overall cumulative colectomy‐free survival was estimated as 62.3% at 65 months. In 18 of 19 patients treated with corticosteroids at the initiation of tacrolimus therapy, corticosteroids were discontinued or tapered. Adverse events were tremor (25.9%), renal function impairment (18.5%), infectious disease (14.8%), hot flashes (11.1%), hyperkalaemia (7.4%), headache (7.4%), epigastralgia (7.4%) and nausea (3.7%). No mortality occurred.Conclusion  Long‐term administration of tacrolimus appears to be an effective and well‐tolerated treatment for Japanese patients with refractory ulcerative colitis.
Clinical trial: comparison of ibuprofen‐phosphatidylcholine and ibuprofen on the gastrointestinal safety and analgesic efficacy in osteoarthritic patients
Authors: LANZA F. L. , MARATHI U. K. , ANAND B. S. , LICHTENBERGER L. M. 
Published: October 2008

SummaryBackground  Chronic use of NSAIDs is associated with gastrointestinal (GI) toxicity that increases with age.Aim  To evaluate the GI safety and therapeutic efficacy of ibuprofen chemically associated with phosphatidylcholine (PC) in osteoarthritic (OA) patients.Methods  A randomized, double‐blind trial of 125 patients was performed. A dose of 2400 mg/day of ibuprofen or an equivalent dose of ibuprofen‐PC was administered for 6 weeks. GI safety was assessed by endoscopy. Efficacy was assessed by scores of analgesia and anti‐inflammatory activity. Bioavailability of ibuprofen was pharmacokinetically assessed.Results  Ibuprofen‐PC and ibuprofen provided similar bioavailability/therapeutic efficacy. In the evaluable subjects, a trend for improved GI safety in the ibuprofen‐PC group compared with ibuprofen that did not reach statistical significance was observed. However, in patients aged >55 years, a statistically significant advantage for ibuprofen‐PC treatment vs. ibuprofen in the prevention of NSAID‐induced gut injury was observed with increases in both mean Lanza scores and the risk of developing >2 erosions or an ulcer. Ibuprofen‐PC was well tolerated with no major adverse events observed.Conclusion  Ibuprofen‐PC is an effective osteoarthritic agent with an improved GI safety profile compared with ibuprofen in older OA patients, who are most susceptible to NSAID‐induced gastroduodenal injury.
Clinical trial: a primary‐care‐based model for the delivery of anti‐viral treatment to injecting drug users infected with hepatitis C
Authors: JACK K. , WILLOTT S. , MANNERS J. , VARNAM M. A. , THOMSON B. J. 
Published: October 2008

SummaryBackground  Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary‐care‐based strategies for the management of HCV do not effectively target this vulnerable population.Aims  To evaluate the feasibility, safety and efficacy of a primary‐care‐based model for the delivery of HCV services including anti‐viral therapy to injecting drug users.Methods  A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary‐care‐based hepatitis service and drug workers and general practitioners. Three hundred and fifty‐three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti‐viral treatment, and number of patients treated.Results  174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically‐infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti‐viral treatment and 30 have so far been treated. Outcomes of anti‐viral treatment are comparable with those obtained in secondary care settings.Conclusion  A primary‐care‐based model offers a new paradigm for the treatment of HCV in injecting drug users.
Cyclosporin A increases the pulmonary eosinophilia induced by inhaledAspergillusantigen in mice
Authors: WANG J M , DENIS M , FOURNIER M , LAVIOLETTE M 
Published: October 2008

SUMMARYWe evaluated the effects of anti-inflammatory drugs in a murine model of allergic bronchopulmonary aspergillosis(ABPA). Mice instilled with 100μg of Aspergillus fumigatus antigen (intranasally, 3 days a week for 3 weeks) developed pulmonary lesions, characterized by a perivascular and peribronchial eosinophil infiltration, a bronchoalveolar lavage (BAL) eosinophilia, and elevated levels of total IgE, total IgGI and A. fumigatus–specific IgGl. Under the same conditions, groups of mice receiving a daily dose of 2 mg/kg dexamethasone showed decreased numbers of eosinophils and total cells in BAL, had less numerous eosinophils in their pulmonary infiltrates, and had lower levels of serum and BAL fluid total IgE, total IgGl and A. fumigatus–specific IgGl. Conversely, groups of mice pretreated with an immunosuppressive agent, cyclosporin A (CsA) at a dose of 50 mg/kg, three times per week, developed pulmonary lesions with enhanced lung eosinophilic influx and increased total IgE levels, both in serum and in BAL fluid. These findings show that dexamethasone potently prevents the murine immunopathologic response to A. fumigatus. The effect of CsA on this inflammatory response was paradoxical, insofar as it suggests an activation of the T helper 2 subset, which up–regulates eosinophil recruitment and IgE production.