bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: complementary and alternative therapies for inflammatory bowel disease
Authors: LANGMEAD L. , RAMPTON D. S. 
Published: January 2006

SummaryComplementary and alternative medicine includes a wide range of practices and therapies outside the realms of conventional western medicine. Despite a lack of scientific data in the form of controlled trials for either efficacy or safety of complementary and alternative medicine, use by patients with inflammatory bowel disease, particularly of herbal therapies, is widespread and increasing.There is limited controlled evidence indicating efficacy of traditional Chinese medicines, aloe vera gel, wheat grass juice, Boswellia serrata and bovine colostrum enemas in ulcerative colitis. Encouraging results have also been reported in small studies of acupuncture for Crohn's disease and ulcerative colitis. Contrary to popular belief, natural therapies are not necessarily safe: fatal hepatic and irreversible renal failure have occurred with some preparations and interactions with conventional drugs are potentially dangerous.There is a need for further controlled clinical trials of the potential efficacy of complementary and alternative approaches in inflammatory bowel disease, together with enhanced legislation to maximize their quality and safety.
Three‐year oral pantoprazole administration is effective for patients with Zollinger–Ellison syndrome and other hypersecretory conditions
Authors: METZ D. C. , COMER G. M. , SOFFER E. , FORSMARK C. E. , CRYER B. , CHEY W. , PISEGNA J. R. 
Published: January 2006

SummaryBackgroundZollinger–Ellison syndrome and idiopathic hypersecretion are gastrointestinal hypersecretory conditions requiring long‐term maintenance.AimsThe safety and efficacy data for short‐term (6‐month) treatment of Zollinger–Ellison syndrome and idiopathic hypersecretion with oral pantoprazole were previously published. This study extends the initial observations to 3 years.MethodsThe primary efficacy end point for this report was the control of gastric acid secretion in the last hour before the next dose of oral pantoprazole (acid output of <10 mmol/h; <5 mmol/h in subjects with prior acid‐reducing surgery). Dose titration was permitted to a maximum of 240 mg per 24 h.ResultsTwenty‐four subjects completed the study. The acid output of 28 of 34 subjects was controlled at initial enrolment. The mean acid output rates were <10 mmol/h throughout the 36 months of treatment for 90–100% of the patients. The majority of the patients were controlled with b.d. doses of 40 or 80 mg pantoprazole at 36 months (acid output was controlled in 24 of 24 subjects). Pantoprazole was generally well tolerated with minimal adverse events reported.ConclusionsMaintenance oral pantoprazole therapy up to 3 years at dosages of 40–120 mg b.d. was effective and well tolerated in patients with Zollinger–Ellison syndrome and other hypersecretory conditions.
Review article: non‐biological liver support in liver failure
Authors: LALEMAN W. , WILMER A. , EVENEPOEL P. , VERSLYPE C. , FEVERY J. , NEVENS F. 
Published: January 2006

SummaryLiver failure, whether acute or acute‐on‐chronic, remains an important cause of morbidity and mortality. The lack of liver detoxification, metabolic and regulatory functions of the liver leads to life‐threatening complications, such as renal failure, altered immune response, hepatic coma and systemic haemodynamic dysfunction, eventually culminating in multiorgan failure.Current medical therapy involves the management of the precipitating event and treatment of complications until the liver eventually recovers, leaving us with no other treatment options than transplantation if these attempts fail. However, the shortage in cadaveric organs and other transplant‐related problems, have prompted the need for alternative methods to provide liver support.As liver failure is often potentially reversible, considerable effort has been invested in the development of liver support systems. Currently, most of the experience is available for non‐biological support systems. They represent the focus of this review, which aims to define the goals of liver support, to describe the design of the different existing devices and to analyse the available data to determine their current status in the management of patients with liver failure.
Cost‐effectiveness analysis of lamivudine and adefovir dipivoxil in the treatment of patients with HBeAg‐negative chronic hepatitis B
Authors: BUTI M. , CASADO M. A. , CALLEJA J. L. , SALMERÓN J. , AGUILAR J. , RUEDA M. , ESTEBAN R. 
Published: January 2006

SummaryAimTo estimate the cost‐effectiveness over a 4‐year duration of lamivudine and adefovir dipivoxil for patients with hepatitis B ‘e’ antigen‐negative chronic hepatitis B.MethodsA decision analysis model has been used to perform a cost‐effectiveness analysis of lamivudine and adefovir dipivoxil from the perspective of the Spanish Public Health System. Data were obtained from clinical trials.ResultsFor the base‐case, the total estimated cost per patient treated with lamivudine or adefovir dipivoxil for 4 years was €11 457 and €21 939 respectively. Virological response at year 4 for the lamivudine arm was 40.4% and 78.0% for the adefovir dipivoxil arm. The average cost‐effectiveness ratio (cost per responding patient at year 4) was €28 375 for the lamivudine arm and €28 132 for the adefovir dipivoxil arm. The incremental cost‐effectiveness ratio of adefovir dipivoxil vs. lamivudine (cost per additional responding patient with adefovir dipivoxil) was €27 872, demonstrating that this cost was slightly lower than the average cost‐effectiveness ratios of adefovir dipivoxil or lamivudine. The sensitivity analysis demonstrated that the factors that most influence the cost‐effectiveness were the response to adefovir dipivoxil and lamivudine at year 4.ConclusionLong‐term treatment with adefovir dipivoxil is a cost‐effective strategy in patients with chronic hepatitis B ‘e’ antigen‐negative hepatitis.
Primary clarithromycin resistance in Italy assessed on Helicobacter pylori DNA sequences by TaqMan real‐time polymerase chain reaction
Authors: DE FRANCESCO V. , MARGIOTTA M. , ZULLO A. , HASSAN C. , VALLE N. D. , BURATTINI O. , CEA U. , STOPPINO G. , AMORUSO A. , STELLA F. , MORINI S. , PANELLA C. , IERARDI E. 
Published: January 2006

SummaryBackground Helicobacter pylori clarithromycin resistance is increasing worldwide and different mutations are involved in its mechanisms. Recently, molecular methods have been proposed to assess these mutations.AimTo assess prevalence of primary clarithromycin resistance in two Italian areas, and the distribution of involved mutations, by using a novel method for real‐time polymerase chain reaction.MethodsTwo hundred and thirty‐two H. pylori‐positive patients undergoing oesophagogastroduodenoscopy in two Italian towns (Rome, centre Italy; Foggia, south Italy) were enrolled. Helicobacter pylori infection was detected by histology, rapid urease and urea breath tests. Clarithromycin resistance was assessed by TaqMan real‐time polymerase chain reaction on paraffin‐embedded antral biopsies.ResultsPrimary clarithromycin resistance was detected in 62 (26.7%) patients. Its prevalence did not differ between the two areas (31.5%, centre vs. 23.3%, south; P = 0.17) and between non‐ulcer dyspepsia and peptic ulcer patients (28.4% vs. 20.7%, P = 0.2). The A2143G point mutation was detected in 35 (56.4%) patients, A2142G in 14 (22.6%), A2142C in eight (12.9%), whilst a double mutation (A2143G plus A2142C or A2142G) was present in the remaining five (8.1%) cases.ConclusionsOur study found that primary clarithromycin resistance is highly prevalent in both central and southern Italy, and that A2143G is the most frequent point mutation involved in these areas.
A comparison of sirolimus vs. calcineurin inhibitor‐based immunosuppressive therapies in liver transplantation
Authors: ZAGHLA H. , SELBY R. R. , CHAN L. S. , KAHN J. A. , DONOVAN J. A. , JABBOUR N. , GENYK Y. , MATEO R. , GAGANDEEP S. , SHER L. S. , RAMICONE E. , FONG T.‐L. 
Published: January 2006

SummaryBackground  Sirolimus is a potent immunosuppressive agent whose role in liver transplantation has not been well‐described.Aim  To evaluate the efficacy and side‐effects of sirolimus‐based immunosuppression in liver transplant patients.Methods  Retrospective analysis of 185 patients who underwent orthotopic liver transplantation. Patients were divided into three groups: group SA, sirolimus alone (n = 28); group SC, sirolimus with calcineurin inhibitors (n =56) and group CNI, calcineurin inhibitors without sirolimus (n = 101).Results  One‐year patient and graft survival rates were 86.5% and 82.1% in group SA, 94.6% and 92.9% in group SC, and 83.2% and 75.2% in group CNI (P = N.S.). The rates of acute cellular rejection at 12 months were comparable among the three groups. At the time of transplantation, serum creatinine levels were significantly higher in group SA, but mean creatinine among the three groups at 1 month was similar. More patients in group SA required dialysis before orthotopic liver transplantation (group SA, 25%; group SC, 9%; group CNI, 5%; P = 0.008), but at 1 year, post‐orthotopic liver transplantation dialysis rates were similar.Conclusions  Sirolimus given alone or in conjunction with calcineurin inhibitors appears to be an effective primary immunosuppressant regimen for orthotopic liver transplantation patients. Further studies to evaluate the efficacy and side‐effect profile of sirolimus in liver transplant patients are warranted.
Pharmacokinetics and pharmacodynamic action of budesonide in children with Crohn's disease
Authors: DILGER K. , ALBERER M. , BUSCH A. , ENNINGER A. , BEHRENS R. , KOLETZKO S. , STERN M. , BECKMANN C. , GLEITER C. H. 
Published: January 2006

SummaryBackgroundBudesonide is effective as initial therapy of mild to moderate Crohn's disease in adults. Superior tolerability to conventional corticosteroids might be attributed to extensive first‐pass metabolism of budesonide by cytochrome P450 3A.AimTo evaluate biotransformation and pharmacodynamic action of budesonide in children.MethodsDrug disposition and effects on endogenous cortisol were evaluated in 12 children with Crohn's disease (5–15 years) after first intake of 3 mg budesonide (single dose), and again after 1 week of thrice daily dosing (steady‐state). The parent drug and cytochrome P450 3A‐dependent metabolites were analysed in blood and urine.ResultsPharmacokinetic parameters of budesonide following single‐dose administration (e.g. AUC0−∞ 7.7 ± 5.1 h ng/mL, Cmax 1.8 ± 1.2 ng/mL) did not change upon multiple dosing. Overall systemic elimination of budesonide reflected by clearance and half‐life was not different between children and adults. After 1 week of treatment reversible adrenal suppression was observed – most pronounced in children aged below 12 years.ConclusionsDisposition of oral budesonide appears to be similar between children and adults, but the doctor has to be aware of an increased risk for adrenal suppression in paediatric patients.
Validation of a 7‐point Global Overall Symptom scale to measure the severity of dyspepsia symptoms in clinical trials
Authors: VAN ZANTEN S. J. O. VELDHUYZEN , CHIBA N. , ARMSTRONG D. , BARKUN A. N. , THOMSON A. B. R. , MANN V. , ESCOBEDO S. , CHAKRABORTY B. , NEVIN K. 
Published: January 2006

SummaryBackground  Currently there is no consensus on the optimal method to measure the severity of dyspepsia symptoms in clinical trials.Aim  To validate the 7‐point Global Overall Symptom scale.Methods  The Global Overall Symptom scale uses a 7‐point Likert scale ranging from 1 = no problem to 7 = a very severe problem. Validation was performed in two randomized‐controlled trials (n = 1121 and 512). Construct validity: Global Overall Symptom was compared with the Quality of Life in Reflux And Dyspepsia, Gastrointestinal Symptom Rating Scale, Reflux Disease Questionnaire and 10 specific symptoms using Spearman correlation coefficients. Test–retest reliability: The Intraclass Correlation Coefficient was calculated for patients with stable dyspepsia defined by no change in Overall Treatment Effect score over two visits. Responsiveness: effect size and standardized response mean were also calculated.Results  Construct validity: Change in Global Overall Symptom score correlated significantly with Quality of Life for Reflux And Dyspepsia, Gastrointestinal Symptom Rating Scale, Reflux Disease Questionnaire and specific symptoms (all P < 0.0002). Reliability: The Intraclass Correlation Coefficient was 0.62 (n = 205) and 0.42 (n = 270). Responsiveness: There was a positive correlation between change in Global Overall Symptom and change in symptom severity. The effect size and standardized response mean were 1.1 and 2.1, respectively.Conclusion  The Global Overall Symptom scale is a simple, valid outcome measure for dyspepsia treatment trials.
Systematic review: complementary and alternative medicine in the irritable bowel syndrome
Authors: HUSSAIN Z. , QUIGLEY E. M. M. 
Published: January 2006

SummaryBackground  Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome.Aim  To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use.Methods  A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search.Results  A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high‐placebo response rate that is characteristic of irritable bowel syndrome.Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome.Conclusions Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo‐controlled trials for many of these therapies has limited meaningful progress in this area.
A prospective randomized blinded comparison of sodium phosphate and polyethylene glycol‐electrolyte solution for safe bowel cleansing
Authors: MATHUS‐VLIEGEN E. M. H. , KEMBLE U. M. 
Published: January 2006

SummaryBackground  Polyethylene glycol‐electrolyte solution (PEG‐ELS) is routinely prescribed for bowel cleansing. Sodium phosphate (NaP) may be an effective but potentially hazardous alternative.Aim  To investigate the safety of prescription of either agent, without being informed of the patient's medical history.Methods  One hundred consecutive patients were randomly allocated to PEG‐ELS or NaP. Prior to and after the bowel cleansing, blood was sampled for renal function and electrolytes. Patients answered questionnaires about complaints and ease of intake, and endoscopists rated the quality of bowel preparation.Results  Eleven patients were identified with a theoretical contraindication for NaP, of whom nine should have been discovered by taking a detailed clinical history. Actually, six of them received NaP with a doubling of serum phosphate levels or hypokalaemia in four. In subjects without a contraindication to the use of NaP, hyperphosphataemia developed in 39% and hypocalcaemia in 5%. Patients tolerated NaP better and completed the preparation more often. Endoscopists rated the quality of bowel preparation equivalent, except for a better cleansed ascending colon with PEG‐ELS.Conclusions  The 11% potentially hazardous allocation to NaP and the 39% incidence of hyperphosphataemia with NaP do not justify an ‘over‐the‐counter’ prescription. Taking a detailed history and, when in doubt, using PEG‐ELS will safeguard against inappropriate administration of NaP.
Identification of a novel germline MET mutation in dogs
Authors: Liao A.T. , McMahon M. , London C.A. 
Published: January 2006

SummaryThe MET proto‐oncogene encodes a transmembrane tyrosine kinase receptor that mediates multiple functions such as migration, cycling and survival by binding to hepatocyte growth factor (HGF). Dysregulation of MET through inappropriate expression or mutation has been shown to play an important role in human cancers. Furthermore, inherited mutations in MET are known to contribute to the development of gastric and renal cancer in humans. Lastly, mouse models of MET mutations lead to the development of a wide variety of cancers including lymphomas, sarcomas and some forms of carcinoma. In the process of cloning canine MET, a novel germline point mutation was found in the juxtamembrane domain (G966S) in two of the templates used for cloning, both of which were derived from Rottweiler dogs, a breed believed to be at high risk for the development of several cancers. Screening of germline DNA from a variety of breeds revealed that this mutation was present in approximately 70% of Rottweiler dogs and <5% of all other breeds examined, suggesting a breed‐specific heritable mutation. Stable transfection of the G966S mutant form of MET into NIH3T3 cells resulted in enhanced baseline scattering and migration of the cells, which was further increased in the presence of HGF. This study supports the notion that particular dog breeds may carry germline mutations that contribute to high rates of cancer in a manner similar to heritable, cancer‐associated mutations in humans.
The effect of CYP2J2, CYP3A4, CYP3A5 and the MDR1 C3435T polymorphisms and gender on the urinary excretion of the metabolites of the H1‐receptor antihistamine ebastine: a pilot study
Authors: Gervasini Guillermo , Vizcaino Sonia , Carrillo Juan Antonio , Caballero Maria Jesus , Benitez Julio 
Published: January 2006

AimsTo determine the effect of gender and the genetic polymorphisms of CYP2J2, CYP3A4, CYP3A5 and MDR1 on the urinary excretion of the H1 antihistamine ebastine in healthy subjects.MethodsEighty‐nine Caucasians were studied. The presence of polymorphisms in genes known to be involved in ebastine metabolism and transport (CYP2J2*2,*3,*4,*6,*7, CYP3A4*1B, CYP3A5*3, *6 and MDR1(ABCB1)C3435T) was assessed by means of PCR‐restriction fragment length polymorphism and sequencing methods. Genotype was correlated with the urinary excretion of the main ebastine metabolites (desalkylebastine and carebastine) under basal conditions and after administration of grapefruit juice.ResultsWomen excreted statistically greater amounts of desalkylebastine in urine (mean ± SD (95% confidence intervals, 95% CI), 23.0 ± 19.5 (18.1, 27.9) µmol) than men (12.4 ± 11.0 (7.9, 16.9)), (mean difference: 10.6 (2.4, 18.7), P < 0.005). The CYP2J2, CYP3A4 and CYP3A5 analysed polymorphisms did not greatly affect ebastine metabolite excretion. The MDR1C3435T polymorphism was found to affect both the urinary excretion of the active metabolite carebastine (32.3 ± 18.3 (23.1, 41.4), 22.8 ± 14.7 (18.6, 27.0) and 21.5 ± 15.3 (14.7, 28.3) for CC, CT and TT carriers, respectively; P < 0.05) and the grapefruit juice‐induced inhibition of its transport/formation (mean fold‐decrease ± SD (95% CI), 1.5 ± 0.8 (1.0, 2.0), 1.1 ± 0.9 (0.7, 1.4) and 0.9 ± 0.4 (0.6, 1.2) for CC, CT and TT carriers, respectively; P = 0.01).ConclusionsGender and the presence of the MDR1C3435T polymorphism both influence the excretion of ebastine metabolites in urine.
Lineage involvement in chronic myeloid leukaemia: comparison between MBCR/ABL+ and mBCR/ABL+ cases
Authors: Primo Daniel , Sanchez Maria Luz , Espinosa Ana Belén , Tabernero María Dolores , Rasillo Ana , Sayagués Jose Ma , Gonzalez Marcos , Hernandez Jose Ma , Orfao Alberto 
Published: January 2006

SummaryThe relationship between different Abelson/breakpoint cluster region (BCR/ABL+) gene rearrangements and the involvement of different haematopoietic cell lineages were investigated in 15 chronic myeloid leukaemia patients. Analysis of purified cell populations confirmed the involvement of the neutrophil (89%), monocytic (89%), eosinophil (88%), erythroid (100%), and CD34+ cells (100%) in virtually all patients, without differences between minor BCR/ABL+ and major BCR/ABL+ cases; BCR/ABL+ B‐ and natural killer (NK)‐cells were detected in 43% and 31% of cases, respectively, whereas BCR/ABL+ T‐cells were rare (7%). All three minor BCR/ABL+ patients showed involvement of both B‐ and NK‐cells, which was infrequent (27%, P = 0·06 and 10%, P = 0·01) among major BCR/ABL+ cases.
FQPD, a novel immunomodulatory drug, has significant in vitro activity in multiple myeloma
Authors: Kumar Shaji , Raje Noopur , Hideshima Teru , Ishitsuka Kenji , Podar Klaus , Gouille Steven Le , Chauhan Dharminder , Richardson Paul , Munshi Nikhil C. , Anderson Kenneth 
Published: January 2006

SummaryMultiple myeloma (MM) is a plasma cell malignancy that claims thousands of lives each year and has considerable morbidity. The disease remains incurable despite recent advances in the understanding of the disease biology and the introduction of more effective drugs is needed. This study evaluated the anti‐MM activity of 3‐(7‐fluoro‐4H‐quinazolin‐3‐yl)‐piperidine‐2,6‐dione, hydrochloride (FQPD), a novel immunomodulatory drug. FQPD inhibited the proliferation of multiple MM cell lines, including those resistant to conventional treatments, such as dexamethasone. It induced apoptosis in MM cell lines, as well as freshly isolated patient MM cells, without cytotoxicity on normal human lymphocytes. Moreover, it induced apoptosis in MM cells adherent to bone marrow (BM) stromal cells or in the presence of cytokines, such as interleukin‐6 and vascular endothelial growth factor, confirming its ability to overcome the protective effects of the BM milieu. Apoptosis in the MM cells was mediated via poly‐ADP ribose polymerase cleavage as well as cleavage of caspase 8 and caspase 9. Our studies therefore demonstrated in vitro anti‐MM activity of FQPD and provide the rationale for its in vivo evaluation in animal models and derived clinical trials.
Optimal haemophilia care versus the reality
Authors: Bolton‐Maggs Paula H. B. 
Published: January 2006

SummaryHaemophilia A and B are inherited bleeding disorders whose diagnosis and management is generally well established and best provided by specialists in a comprehensive care setting. Patients may be put at unnecessary risk if appropriate expertise is not sought for the management of accidents and surgery. The delivery of a high quality comprehensive service to patients with bleeding disorders depends upon defined standards and a network of haemophilia centres in the UK with similar models in other countries. In developing countries, despite a shortage or absence of treatment products, development of local expertise results in an improved outlook and reduction in mortality. Optimal care for severe haemophilia includes accurate diagnosis, early and adequate factor replacement for bleeding episodes and the provision of prophylaxis from an early age to prevent joint bleeding and the consequent arthropathy. Haemophilia treatment is expensive resulting in considerable inequity in provision of care across the world. Despite decades of experience, optimal treatment levels are not robustly defined. Transfusion‐transmitted infections continue to have a significant impact on patient management. The development of inhibitory antibodies seriously complicates the management both in morbidity and cost. While gene therapy has not yet produced the hoped‐for cure, new technologies will produce improved products.