bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of ursodeoxycholic acid on cancer, dysplasia and mortality in ulcerative colitis patients with primary sclerosing cholangitis
Authors: WOLF J. M. , RYBICKI L. A. , LASHNER B. A. 
Published: October 2005

SummaryBackground : Colorectal cancer in primary sclerosing cholangitis patients with ulcerative colitis is mostly right‐sided where concentrations of carcinogenic secondary bile acids are highest.Aim : To investigate whether ursodeoxycholic acid could be chemopreventive for colorectal cancer.Methods : A historical cohort study was performed on primary sclerosing cholangitis patients with ulcerative colitis where the 28 patients (cases) who were treated with ursodeoxycholic acid for at least 6 months (mean 3.4 ± 2.7 years) were compared with the 92 patients (controls) who were not treated with ursodeoxycholic acid. The primary outcomes were colorectal cancer and dysplasia. The secondary outcome was overall mortality.Results : The cumulative incidence of dysplasia or cancer was not significantly different between cases and controls (P = 0.17 by log‐rank test). The adjusted relative risk for cases of developing dysplasia or cancer was 0.59 (95% CI 0.26–1.36). The cumulative mortality was significantly different between groups (P = 0.02 by log‐rank test). The adjusted relative risk for cases of death was 0.44 (95% CI 0.22–0.90).Conclusion : In ulcerative colitis patients with primary sclerosing cholangitis, ursodeoxycholic acid did not reduce the risk of developing cancer or dysplasia. However, ursodeoxycholic acid may reduce mortality.
Aerophagia in adults: a comparison with functional dyspepsia
Authors: CHITKARA D. K. , BREDENOORD A. J. , RUCKER M. J. , TALLEY N. J. 
Published: October 2005

SummaryBackground : Aerophagia is a functional upper gastrointestinal disorder that has not previously been well described in a large patient group.Aims : To describe the initial evaluation of patients who presented with symptoms of aerophagia at a tertiary medical centre.Methods : A computerized search was used to identify all patients who were diagnosed with aerophagia at the Mayo Clinic, Rochester between 1996 and 2003 (n = 79). Individual medical charts were abstracted for information on the demographics, clinical features, co‐morbid diagnoses, diagnostic workup and treatment. Information on presenting symptoms was also collected for a group of patients who were classified as having functional dyspepsia for comparison (n = 121).Results : The median duration of symptoms in patients with aerophagia was 24 months. The most common symptoms were belching (56%), abdominal pain (19%), bloating (27%) and abdominal distension (19%). Patients with functional dyspepsia had a higher prevalence of reporting nausea, vomiting, early satiety, weight loss and abdominal pain (all P < 0.01, adjusting for age, gender and body mass index). Significantly more patients with aerophagia had anxiety (19%) than those with functional dyspepsia (6%, P < 0.01).Conclusions : Individuals with aerophagia experience prolonged upper gastrointestinal symptoms. Initial presenting symptoms appear to be distinctly different from those who have functional dyspepsia.
Review article: the management of heartburn in pregnancy
Authors: RICHTER J. E. 
Published: October 2005

SummaryHeartburn is a normal consequence of pregnancy. The predominant aetiology is a decrease in lower oesophageal sphincter pressure caused by female sex hormones, especially progesterone. Serious reflux complications during pregnancy are rare; hence upper endoscopy and other diagnostic tests are infrequently needed. Gastro‐oesophageal reflux disease during pregnancy should be managed with a step‐up algorithm beginning with lifestyle modifications and dietary changes. Antacids or sucralfate are considered the first‐line drug therapy. If symptoms persist, any of the histamine2‐receptor antagonists can be used. Proton pump inhibitors are reserved for women with intractable symptoms or complicated reflux disease. All but omeprazole are FDA category B drugs during pregnancy. Most drugs are excreted in breast milk. Of systemic agents, only the histamine2‐receptor antagonists, with the exception of nizatidine, are safe to use during lactation.
Helicobacter pylori eradication in childhood after failure of initial treatment: advantage of quadruple therapy with nifuratel to furazolidone
Authors: NIJEVITCH A. A. , SHCHERBAKOV P. L. , SATAEV V. U. , KHASANOV R. SH. , AL KHASHASH R. , TUYGUNOV M. M. 
Published: October 2005

SummaryBackground : Failures of Helicobacter pylori eradication in children are common.Aim : To evaluate the efficacy of amoxicillin, bismuth subcitrate and omeprazole and nifuratel or furazolidone for H. pylori eradication in children who failed initial treatment with a standard triple therapy.Methods : Seventy‐six consecutive H. pylori‐positive paediatric out‐patients (aged 12–16 years; mean age 13.7 ± 1.4) with chronic abdominal complaints who had failed one attempt of eradication of H. pylori using metronidazole‐containing triple therapy were enrolled. It was an open prospective study. Patients were randomized to receive a 2‐week course of bismuth subcitrate (8 mg/kg/day, q.d.s.), amoxicillin (50 mg/kg/day, q.d.s.), with either nifuratel (15 mg/kg/day, q.d.s.) or furazolidone (10 mg/kg/day, q.d.s.), plus omeprazole (0.5 mg/kg, once daily).Results : There were 37 patients in the nifuratel group and 39 in the furazolidone group. Helicobacter pylori was eradicated in 33 of 37 (89%; 95% CI: 74.5–96.9; intention‐to‐treat) in nifuratel group and in 34 of 39 (87%; 95% CI: 72.5–95.7) in furazolidone group, respectively. Frequency of severe side‐effects was greater with furazolidone (21%) than with nifuratel (3%; P = 0.0289).Conclusions : Nitrofuran‐containing therapies consisting of a proton‐pump inhibitor, amoxicillin and bismuth citrate plus either nifuratel or furazolidone produced good cure rates even among those who had failed prior therapy. Nifuratel is preferred because of the lower frequency of side‐effects.
Increased carotid intima–media thickness in patients with inflammatory bowel disease
Authors: PAPA A. , SANTOLIQUIDO A. , DANESE S. , COVINO M. , CAMPLI C. Di , URGESI R. , GRILLO A. , GUGLIELMO S. , TONDI P. , GUIDI L. , VITIS I. DE , FEDELI G. , GASBARRINI G. , GASBARRINI A. 
Published: October 2005

SummaryBackground : Patients with inflammatory bowel disease have an increased risk of thrombotic complications; moreover, mesenteric microvascular thrombosis has been hypothesized as a contributing factor in the pathogenesis of inflammatory bowel disease.Aim : To assess the extent of subclinical atherosclerosis in inflammatory bowel disease by measuring the intima–media thickness of the common carotid artery.Methods : Fifty‐two patients were enrolled in the study. Patients aged >45 years, with a history of cardiovascular disease and known risk factors for atherosclerosis were excluded from the study. Twenty healthy subjects were studied as controls. Carotid ultrasonography was performed in all patients and controls. intima–media thickness was measured proximal to the carotid bifurcation over both right and left common carotid arteries. The clinical characteristics and the laboratory parameters relevant to disease activity were recorded for all inflammatory bowel disease patients. In particular, plasma homocysteine, a well‐known risk factor for thrombosis, was assessed.Results : Common carotid artery intima–media thickness was significantly higher in inflammatory bowel disease patients (0.63 ± 0.15 mm) compared with controls (0.53 ± 0.08 mm). Multiple regression analysis revealed a significant association of carotid intima–media thickness with homocysteine levels and age.Conclusions : Inflammatory bowel disease patients have an increased risk of early atherosclerosis than healthy controls as showed by greater values of carotid intima–media thickness. Homocysteine levels and age resulted independently associated with the increased arterial wall thickness.
Influence of ghrelin on gastric emptying and meal‐related symptoms in idiopathic gastroparesis
Authors: TACK J. , DEPOORTERE I. , BISSCHOPS R. , VERBEKE K. , JANSSENS J. , PEETERS T. 
Published: October 2005

SummaryBackground : Ghrelin, the endogenous ligand of the growth hormone secretagogue receptor, is released from the stomach. Animal studies suggest that ghrelin stimulates gastrointestinal motor activity.Aim : To investigate the influence of ghrelin on gastric emptying rate and meal‐related symptoms in idiopathic gastroparesis.Methods : In six patients with idiopathic gastroparesis, a breath test was used to measure gastric emptying rates (t1/2) for solids and liquids after administration of saline or ghrelin 40 μg/30 min in a double‐blind, randomized fashion. At each breath sampling, the patient was asked to grade the intensity of six different symptoms (epigastric pain, bloating, postprandial fullness, nausea, belching and epigastric burning) and these were added to obtain meal‐related symptom severity score.Results : Ghrelin significantly enhanced liquid emptying (t1/2: 86 ± 7 vs. 53 ± 6 min, P = 0.02) and tended to enhance solid emptying (144 ± 45 vs. 98 ± 15 min, P = 0.06). Ghrelin pre‐treatment significantly decreased cumulative meal‐related symptom score (196 ± 30 vs. 136 ± 23, P = 0.04) and individual scores for fullness (55 ± 8 vs. 39 ± 8, P = 0.02), and for pain (40 ± 8 vs. 16 ± 5, P < 0.05).Conclusions : In idiopathic gastroparesis, administration of ghrelin enhances gastric emptying and improves meal‐related symptoms. These observations suggest a potential for ghrelin receptor agonists in the treatment of gastroparesis.
Comparison of the effects of intravenously and orally administered esomeprazole on acid output in patients with symptoms of gastro‐oesophageal reflux disease
Authors: METZ D. C. , MINER P. B. , HEUMAN D. M. , CHEN Y. , SOSTEK M. 
Published: October 2005

SummaryBackground : Intravenous esomeprazole may be beneficial for patients who cannot take oral medications.Aim : To compare intravenous esomeprazole with oral esomeprazole for effects on maximal acid output during pentagastrin stimulation in patients with gastro‐oesophageal reflux disease symptoms.Methods : In four separate open‐label, randomized, two‐way crossover studies, adult patients were administered esomeprazole 20 or 40 mg once daily either orally or intravenously (by 15‐min infusion or 3‐min injection) for 10 days and switched to the other formulation with no washout period. Basal acid output and maximal acid output were measured on days 11, 13 and 21.Results : In the four studies (total of 183 patients), least‐squares mean maximal acid output ranged from 3.0 to 4.1 mmol/h after intravenous esomeprazole 40 or 20 mg and from 2.2 to 3.3 mmol/h after oral esomeprazole 20 or 40 mg. Differences between formulations were small and not statistically significant but did not meet the prospectively defined criterion for non‐inferiority of the intravenous formulation. Median basal acid output values ranged from 0.04 to 0.27 mmol/h after intravenous administration and from 0.05 to 0.25 mmol/h after oral esomeprazole.Conclusions : Intravenous esomeprazole is an acceptable alternative to the oral formulation for treatment of up to 10 days of duration.
The effects of an acute serotonergic challenge on brain–gut responses in irritable bowel syndrome patients and controls
Authors: KILKENS T. O. C. , HONIG A. , FEKKES D. , BRUMMER R.‐J. M. 
Published: October 2005

SummaryBackground : Serotonin, a key denominator of the brain–gut axis is involved in the regulation of gastrointestinal function as well as cognition, mood and hypothalamic‐pituitary‐adrenal axis‐mediated neuroendocrine responses.Aim : To assess the effects of an acutely increased serotonergic activity, using a 20 mg intravenous citalopram challenge test on visceral perception, affective memory performance, mood and neuroendocrine responses, respectively, in diarrhoea‐predominant irritable bowel syndrome patients and controls.Methods : In a randomized, double‐blind crossover design, 14 diarrhoea‐predominant irritable bowel syndrome patients and 14 matched controls were studied under citalopram and placebo conditions, respectively. Visceral perception was scored in response to rectal distensions. Affective memory performance, mood, levels of adrenocorticotropic hormone, cortisol, prolactin and biochemical parameters of serotonergic metabolism were simultaneously assessed.Results : Visceral perception did not significantly differ between the citalopram and placebo condition. Citalopram administration enhanced affective memory performance because of a bias towards positive material but no significant changes in mood. Citalopram significantly increased plasma serotonin, adrenocorticotropic hormone and cortisol levels compared with placebo. Citalopram did not differentially affect the patient or control group.Conclusions : We have provided evidence that acutely increased serotonergic activity influences neuroendocrine responses and cognition in diarrhoea‐predominant irritable bowel syndrome and controls without a significant effect on visceral perception.
Systematic review: the chemoprevention of oesophageal adenocarcinoma
Authors: MEHTA S. , JOHNSON I. T. , RHODES M. 
Published: October 2005

SummaryThe incidence of oesophageal adenocarcinoma is increasing in the UK faster than any other malignancy. Despite its relatively poor prognosis and the limited success of existing treatments, there is enthusiasm that chemopreventive agents might be able to stem the transition from normal squamous epithelium to adenocarcinoma.We discuss gastro‐oesophageal reflux as the main risk factor for the development of Barrett's metaplasia, the only known precursor of oesophageal adenocarcinoma. Treatment options for reflux disease are considered with regard to their effects on cancer risk. Recent advances in the molecular and cell biology of Barrett's are outlined, and potential targets for chemoprevention examined.Available treatments for reflux disease have not convincingly altered the likelihood of cancer development. Epidemiological and animal studies support the use of non‐steroidal anti‐inflammatory drugs as potential chemopreventive agents. Dietary agents, however, have a more favourable side‐effect profile and may prove to be an attractive alternative, although more work is needed to fully explore this prospect.
Windy weather and low humidity are associated with an increased number of hospital admissions for acute pain and sickle cell disease in an urban environment with a maritime temperate climate
Authors: Jones Simon , Duncan Edward R. , Thomas Nikki , Walters Joan , Dick Moira C. , Height Susan E. , Stephens Adrian D. , Thein Swee Lay , Rees David C. 
Published: October 2005

SummarySickle cell disease (SCD) is characterised by intermittent episodes of acute severe pain, related to vaso‐occlusion. Environmental factors are thought to play an important role, and studies in tropical countries have suggested that cold and rainy seasons are associated with increased episodes of acute pain. We have studied retrospectively the number of admissions with acute pain and SCD to King's College Hospital, London, together with daily meteorological records collected locally. Data from 1400 d and 1047 separate admissions were analysed. Increased admissions were significantly associated with increased wind speed and low humidity, but showed no relationship to temperature, rainfall or barometric pressure. The strongest effect was for (maximum wind speed)/humidity, with 464 admissions on days in the lowest two quartiles of this parameter and 582 in the highest quartiles. The effect of high wind and low humidity is likely to be related to skin cooling.
Evaluation of cytomegalovirus‐specific T‐cell reconstitution in patients after various allogeneic haematopoietic stem cell transplantation using interferon‐γ‐enzyme‐linked immunospot and human leucocyte antigen tetramer assays with an immunodominant T‐cell epitope
Authors: Ohnishi Mutsuko , Sakurai Toshiharu , Heike Yuji , Yamazaki Rie , Kanda Yoshinobu , Takaue Yoichi , Mizoguchi Hideaki , Kawakami Yutaka 
Published: October 2005

SummaryCytomegalovirus (CMV) infection is a major complication for patients who received allogeneic haematopoietic stem cell transplantation (HSCT). Accurate monitoring of CMV‐specific T‐cell reconstitution is required for appropriate decision on treatment, such as anti‐viral drugs, which have adverse effects. Although human leucocyte antigen (HLA) tetramer and interferon‐γ‐enzyme‐linked immunospot (IFN‐γ‐ELISPOT) assays have been used to measure CMV‐specific T cells, detailed comparison of these assays and kinetics of anti‐CMV T‐cell reconstitution between reduced‐intensity transplantation (RIST) and conventional HSCT has not yet been performed. In this study, we performed prospective comparative monitoring of CMV‐specific T cells using HLA tetramer and IFN‐γ‐ELISPOT assays with a single immunodominant CMV495 peptide in 28 HLA‐A*0201 and 9 HLA‐A*0206 patients after various allogeneic HSCTs. The IFN‐γ‐ELISPOT assay was more sensitive for evaluation of functional T cells than the HLA tetramer assay, and CMV‐specific T cells were reconstituted earlier in patients who received RIST without anti‐thymocyte globulin (ATG) than those receiving RIST with ATG or conventional HSCT. The threshold level for protection from CMV reactivation was estimated as over 1 × 106 cells/l peripheral blood with the IFN‐γ‐ELISPOT assay. These results demonstrate that the IFN‐γ‐ELISPOT assay with CMV495 provides more accurate evaluation on CMV immunity in HLA‐A*0201 and ‐A*0206 patients, and may be useful for determining timing of various treatments.
Milk–alkali syndrome is a major cause of hypercalcaemia among non‐end‐stage renal disease (non‐ESRD) inpatients
Authors: Picolos Michalis K. , Lavis Victor R. , Orlander Philip R. 
Published: October 2005

SummaryObjective  Milk–alkali syndrome, once a common cause of hypercalcaemia, is now considered rare. Our aim was to estimate the prevalence of milk–alkali syndrome among hypercalcaemic, non‐end‐stage renal disease (non‐ESRD) inpatients of a University Hospital and identify patients’ and syndrome characteristics.Design and patients  In this retrospective chart review study, we identified patients hospitalized with possible hypercalcaemia between November 1998 and October 2003 by a computer search of admission, discharge and consultation diagnoses. Patients with renal transplantation, stage 5 chronic kidney disease (CKD‐5) and those admitted for parathyroidectomy were excluded. The remaining patients’ charts were reviewed for confirmation of hypercalcaemia and identification of the cause. In patients with milk–alkali syndrome, additional historical, clinical, laboratory and imaging data were collected.Results  We identified 125 patients with hypercalcaemia, 11 (8·8%) of whom had milk–alkali syndrome, 42 (33·6%) had malignancy and 37 (29·6%) hyperparathyroidism. Thirty‐five patients had severe hypercalcaemia, defined as corrected serum calcium 3·5 mmol/l. Malignancy accounted for 13 of those patients (37·1%) and milk–alkali for nine (25·7%). Conditions prevalent among the milk–alkali inpatients were female gender, hypertension, chronic kidney disease, osteoporosis, upper gastrointestinal diseases, diuretic treatment and vitamin D derivative supplementation. Five of the patients with milk–alkali syndrome were treated with bisphosphonates and all five developed hypocalcaemia, compared to one of the five who received conventional treatment (P = 0·047).Conclusion  Milk–alkali was the third leading cause of hypercalcaemia of any degree and the second cause of severe hypercalcaemia among inpatients without ESRD. In milk–alkali syndrome, treatment with bisphosphonates contributes to post‐treatment hypocalcaemia.
An unusual distribution of supplemental teeth in the primary dentition
Authors: ROBERTS A. , BARLOW S. T. , COLLARD M. M. , HUNTER M. L. 
Published: October 2005

SummarySupernumerary teeth are more common in the permanent than the primary dentition [1]. In the latter, the majority occur in the maxillary lateral incisor region or as a mesiodens. Indeed, in one study conducted in the USA, all 26 cases of primary supernumerary teeth examined were found to be lateral incisors [2]. This report describes a case presenting with three erupted supernumerary (supplemental) teeth in the primary dentition, including, somewhat unusually, bilateral duplication of maxillary canines.
Cyclosporin‐induced gingival overgrowth in children
Authors: WRIGHT G. , WELBURY R. R. , HOSEY M. T. 
Published: October 2005

SummaryCyclosporin is a potent immunosuppressant drug commonly used to prevent organ transplant rejection. In recent years, there has been a widening of its therapeutic use and an increase in the number of patients undergoing transplantation. Gingival overgrowth is one of several oral side‐effects of cyclosporin, with a quoted prevalence of between 8% and 100%. There is continued debate over the factors which modify the degree of overgrowth, including individual sensitivity, age, dose of drug, duration of drug therapy and the presence of dental plaque. The exact mechanism of gingival overgrowth is still being debated, but appears to be caused by a combination of the proliferation of fibroblasts within the gingival tissue, an increase in the deposition of collagen and extracellular matrix, and a decrease in phagocytosis with a net gain in gingival tissue mass. A number of treatment options are utilized in the treatment of gingival overgrowth, including CO2 laser surgery, improved oral hygiene, the use of antibiotics such as metronidazole and azithromycin, and surgical intervention. In the clinical application of cyclosporin, there is little correlation between cyclosporin dose, serum trough levels and total exposure to the drug, making it difficult to achieve the desired therapeutic response. These problems were previously further complicated by the variability of absorption of the drug via the gastrointestinal tract. The original cyclosporin formulation, Sandimmune®, was replaced by a new formulation, Neoral®, which has a more reliable absorption, and gives a closer correlation between trough concentration levels and individual bioavailability. There is a conflict of opinion over whether or not the side‐effect profile of Neoral varies from its precursor Sandimmune. It has yet to be seen whether the increased bioavailability of Neoral will result in an increased severity and prevalence of gingival overgrowth. An alternative immunosuppressant drug, tacrolimus, which is a macrolide antibiotic with a different side‐effect profile, has emerged as a substitute for cyclosporin in organ transplantation. However, there have been conflicting reports of its side‐effects and its capacity to cause gingival overgrowth.