bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric symptoms during interferon treatment for hepatitis C:experiences from a tertiary care hepatology centre
Authors: EVON D. M. , VERMA A. , SIMPSON K. , GALANKO J. A. , DOUGHERTY K. A. , FRIED M. W. 
Published: October 2008

SummaryBackground Most research on the psychiatric symptoms of peginterferon/ribavirin for the treatment of hepatitis C comes from VA centres and clinical trials with rigid entry criteria that often excluded patients with markers of mental health and substance use disturbance (MH/SUD). The findings from these lines of research may not be generalizable to patients treated under standard of care in a tertiary care setting.Aim To investigate the incidence and outcomes of psychiatric symptoms in patients treated under standard of care protocol, not enrolled in clinical trials.Methods This is a retrospective analysis of 215 patients who underwent therapy from 2002 to 2006 at a university‐based tertiary care centre. Survival curves explored the relationship between history of MH/SUD and the development of psychiatric symptoms on treatment.Results The cumulative history of MH/SUD was 67%. Of these, 39% had taken psychotropic medications previously, and 80% continued on them during therapy. On therapy, 46% developed depressive symptoms, 19% and 46% endorsed anxiety and irritability respectively. Cumulatively, 64% of patients indicated mood disturbance on therapy. Most symptoms developed between weeks 2 and 18, and rarely after week 20. Of those who developed mood symptoms, 66% required an intervention. Treatment discontinuation was infrequent.Conclusions This large observational study provides important insights into the incidence and course of psychiatric symptoms in an unselected sample of patients treated in a tertiary care setting. Patients had higher rates of MH/SUD comorbidity, psychotropic medication use and exhibit higher rates of mood disturbance on therapy compared with previous reports, although a majority completed the prescribed treatment regimen.
Vitamin B12 deficiency in hypersecretors during long‐term acid suppression with proton pump inhibitors
Authors: HIRSCHOWITZ B. I. , WORTHINGTON J. , MOHNEN J. 
Published: October 2008

SummaryBackground  Proton pump inhibitors (PPIs) may cause cyanocobalamin (vitamin B12) malabsorption, but measuring serum B12 alone may underestimate the prevalence. However, B12 deficiency elevates methylmalonic acid and homocysteine, both additional markers of B12 deficiency.Aim  To determine the true prevalence of B12 deficiency and whether acid suppression by PPI caused it.Methods  Sixty‐one acid hypersecretors (basal acid output >15 mmol/h), 46 with gastrinoma [Zollinger–Ellison (ZE) syndrome] and 15 without [acid hypersecretor without gastrinoma (pseudo‐ZE)], were treated with lansoprazole to determine its long‐term (up to 18 years) pharmacological and clinical efficacy and safety, particularly as regards malabsorption of B12.Results  Of 61 patients, six (10%) had low serum B12. Additional tests uncovered B12 deficiency in 13 (31%) of 41 still‐available patients, despite normal serum B12. B12 replacement reduced elevated homocysteine and methylmalonic acid, supporting the diagnosis. Also, measuring both basal and stimulated gastric secretion, we found that acid suppression was neither prolonged nor profound enough to explain the B12 deficiency.Conclusions  In long‐term recipients of PPIs, B12 deficiency was more frequent (29%) than detected by measuring only serum B12, and there was not enough acid suppression to explain this deficiency.
Clinical trial: normal diet vs. partial replacement with oral E028 formula for the prevention of gastrointestinal toxicity in cancer patients undergoing pelvic radiotherapy
Authors: MCGOUGH C. , WEDLAKE L. , BALDWIN C. , HACKETT C. , NORMAN A. R. , BLAKE P. , HARRINGTON K. , TAIT D. , KHOO V. , FROST G. , ANDREYEV H. J. N. 
Published: October 2008

SummaryBackground  Acute gastrointestinal symptoms affect 90% of patients during pelvic radiotherapy. Elemental diet is protective in animal models. A nonrandomized study suggested benefit from a partial elemental diet. A pilot study suggested that radiotherapy patients only tolerate oral elemental diet comprising one‐third of total calories for 3 weeks.Aim  To assess the feasibility and efficacy of replacing one‐third of normal diet with elemental diet during the first 3 weeks of pelvic radiotherapy in reducing acute gastrointestinal toxicity.Methods  Patients were randomized to elemental diet or no intervention. Toxicity was assessed using the Inflammatory Bowel Disease Questionnaire, Vaizey Incontinence scale and Radiation Therapy Oncology Group tool. Faecal calprotectin measured intestinal mucosal inflammation.Results  Twenty‐nine women and 21 men, median age 61.5 years were randomized. Patients taking elemental diet did not have lower gastrointestinal toxicity ratings or inflammatory markers (P > 0.2). The mean dose taken was 21% (2–36%) of total caloric requirements.Conclusions  Patients cannot tolerate large volumes of oral elemental diet. The quantities consumed in this study produced no therapeutic benefit. Future studies should aim to replace a higher proportion of nutritional intake for a longer duration of radiotherapy treatment.
Functional heartburn vs. non‐erosive reflux disease: similarities and differences
Authors: HERSHCOVICI T. , ZIMMERMAN J. 
Published: October 2008

SummaryBackground  Bowel symptoms have been associated with non‐erosive reflux disease (NERD). However, their role in functional heartburn (FH) has not been established.Aims  To characterize bowel symptoms in FH and NERD patients, and investigate their role as predictors of severity of reflux symptoms.Methods  A prospective study of patients with normal upper endoscopy undergoing a 24‐h oesophageal pH monitoring for the evaluation of reflux symptoms. Patients with oesophageal acid exposure <3.1% and a symptom index <50% were classified as FH (n = 60), while those with oesophageal acid exposure >4% were defined as NERD (n = 160). Symptom severity was scored on validated scales.Results  In FH, a female predominance was noted (P < 0.001). Reflux symptoms were scored higher in NERD patients (P < 0.001) while bowel symptoms were similarly scored in the two groups. In both groups, severity of reflux symptoms was independently associated with a composite score on the bowel scales (P < 0.001) and was not predicted by oesophageal acid exposure. In FH, reflux symptom severity was inversely related to age (P = 0.03), while in NERD, the opposite was true (P = 0.01).Conclusions  In both FH and NERD, bowel symptoms were the strongest predictors of reflux symptoms severity. A female preponderance, and an opposite relationship between reflux symptom severity and age, indicate that FH and NERD may be distinct entities.
Review article: future research on coeliac disease – a position report from the European multistakeholder platform on coeliac disease (CDEUSSA)
Authors: TRONCONE R. , IVARSSON A. , SZAJEWSKA H. , MEARIN M. L. ,   ALSO ON BEHALF OF THE MEMBERS OF THE EUROPEAN MULTISTAKEHOLDER PLATFORM ON CD (CDEUSSA)
Published: October 2008

SummaryBackground  CDEUSSA is a Specific Support Action project from the Sixth Framework Programme Priority of the European Union (EU). Its aim is to bring together basic and applied research in the area of coeliac disease (CD). This paper reviews the main issues that are a result of the CDEUSSA initiative.Aim  To identify the major issues in need of investigation in the areas of clinical aspects, treatment, prevention and public health.Methods  Key stakeholders, representing a wide range of knowledge with crucial importance for CD research and practice, have participated in two workshops aimed at identifying and proposing to the EU, as high priority research, topics in the areas of clinical aspects, treatment, prevention and public health.Results  In public health, the overall goal should be to improve quality of life of the European population by implementing primary prevention strategies, early diagnosis and improved treatments for CD. New treatment strategies need to be developed. The option of primary prevention should be fully explored, which requires combined epidemiological, clinical and basic scientific research efforts. Such studies should also consider the importance of gene–environment interactions in the development of CD. Increased knowledge is needed on the natural history of CD. Diagnostic criteria need to be revised.Conclusions  To achieve these goals, a collaboration of the stakeholders is fundamental, including research and patient organizations, as well as industries within both diagnostics and food production.
Review article: blood platelet number and function in chronic liver disease and cirrhosis
Authors: WITTERS P. , FRESON K. , VERSLYPE C. , PEERLINCK K. , HOYLAERTS M. , NEVENS F. , VAN GEET C. , CASSIMAN D. 
Published: October 2008

SummaryBackground  The liver plays a central role in coagulation and fibrinolysis but is also closely intertwined with the function and number of blood platelets.Aim  To describe and integrate all literature concerning blood platelets and liver disease by performing a thorough literature research.Methods  A thorough literature research on ‘blood platelets’ and ‘liver disease’ was performed.Results  Thrombocytopenia is a marked feature of chronic liver disease and cirrhosis. Traditionally, this thrombocytopenia was attributed to passive platelet sequestration in the spleen. More recent insights suggest an increased platelet breakdown and to a lesser extent decreased platelet production plays a more important role. Besides the reduction in number, other studies suggest functional platelet defects. This platelet dysfunction is probably both intrinsic to the platelets and secondary to soluble plasma factors. It reflects not only a decrease in aggregability, but also an activation of the intrinsic inhibitory pathways. The net effect, finally, is a decreased platelet function in the various types of chronic liver diseases and cirrhosis. Finally, recent data suggest that platelets are not only affected by but can also contribute to the liver disease process, as for instance, in viral hepatitis and cholestatic liver disease.Conclusion  Platelet research in liver disease is a growing area of investigation and could provide new pathophysiological insights.
Asimadoline, a kappa‐opioid agonist, and satiation in functional dyspepsia
Authors: TALLEY N. J. , CHOUNG R. S. , CAMILLERI M. , DIERKHISING R. A. , ZINSMEISTER A. R. 
Published: October 2008

SummaryBackground Asimadoline, a kappa‐opioid agonist, reduces visceral sensitivity in experimental animal models and may decrease satiation and postprandial fullness in healthy individuals. However, its effect on satiation in functional dyspepsia is unclear, and any symptom benefit has not been explored.Aim To evaluate the effects of asimadoline on satiation volume and postchallenge symptoms in functional dyspepsia.Methods A randomized, double‐blind trial evaluated gastric satiation and symptoms before and after 8 weeks of asimadoline 0.5 mg (n = 13) or 1.0 mg (n = 13) or placebo (n = 14) b.d. in patients with functional dyspepsia (Rome II). Gastrointestinal Symptom Rating Scale and Nepean Dyspepsia Index were used to assess symptoms during the 8‐week treatment.Results Over 8 weeks of treatment, asimadoline had no significant effect on maximum‐tolerated volume or aggregate symptom score with nutrient drink challenge, and on the mean of the total daily symptom severity score compared to placebo. In apost hocanalysis, asimadoline 0.5 mg significantly increased the maximum‐tolerated volume (1217 mL ± 90.2) compared to placebo (807 mL ± 111.8) in patients with higher postprandial fullness scores (P = 0.01).Conclusion Asimadoline overall did not significantly alter maximum‐tolerated volume, symptoms postnutrient challenge or symptoms over 8 weeks in functional dyspepsia.
Longitudinal effects of hepatitis C virus treatment on hepatic mitochondrial dysfunction assessed by 13C‐methionine breath test
Authors: BANASCH M. , EMMINGHAUS R. , ELLRICHMANN M. , SCHMIDT W. E. , GOETZE O. 
Published: October 2008

SummaryBackground  Hepatitis C virus (HCV) infection is characterized by remarkable levels of oxidative stress induced by virus interactions with hepatic mitochondria.Aim  To examine hepatic mitochondrial function in HCV‐infected patients assessed by a non‐invasive 13C‐methionine breath test (MeBT) and to explore longitudinal effects of antiviral treatment.Methods  Twenty‐one patients with chronic hepatitis C undergoing antiviral treatment with pegIFNα and ribavirin and 20 healthy controls were studied. MeBT was performed at baseline, week 12, end‐of‐treatment and after 24 weeks of follow‐up in all patients with early virological response (n = 15).Results  Twelve patients achieved sustained virological response (SVR); three patients relapsed for HCV‐RNA replication. Cumulative percentage 13C‐exhalation (cPDR1.5h) was significantly decreased in HCV‐infected individuals compared to controls irrespective of genotype and fibrosis stage (P < 0.001). Antiviral treatment induced a further decay in cPDR1.5h (P < 0.01). After treatment cessation, 13C‐exhalation returned at least to baseline values in all patients. SVR was even associated with a mean cPDR1.5h increase of 70% compared to baseline.Conclusions  Hepatitis C virus infection and antiviral treatment synergistically impair hepatic mitochondrial function, which may return to normal after sustained virus elimination. MeBT may be a valuable diagnostic instrument for monitoring hepatic mitochondrial function in particular in patients with mitochondrial comorbidities.
Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine‐induced pancreatitis
Authors: BERMEJO F. , LOPEZ‐SANROMAN A. , TAXONERA C. , GISBERT J. P. , PÉREZ‐CALLE J. L. , VERA I. , MENCHÉN L. , MARTÍN‐ARRANZ M. D. , OPIO V. , CARNEROS J. A. , VAN‐DOMSELAAR M. , MENDOZA J. L. , LUNA M. , LÓPEZ P. , CALVO M. , ALGABA A. 
Published: October 2008

SummaryBackground  Pancreatitis is a potentially severe condition. Patients with inflammatory bowel disease (IBD) seem to be at increased risk for acute pancreatitis.Aim  To describe the incidence, main causes and possible predictive factors of acute pancreatitis in inflammatory bowel disease.Methods  Information was retrospectively extracted from the clinical records of patients followed in the IBD Units of nine hospitals in Madrid (n = 5073).Results  A total of 82 acute pancreatitis episodes were diagnosed (cumulative incidence, 1.6%); 98% of them were mild. Recurrent acute pancreatitis developed in 13% of patients. Most cases of acute pancreatitis (63.4%) were attributed to drug exposure [azathioprine/mercaptopurine (AZA/MP) n = 46, mesalazine (mesalamine) n = 6]; 20.7% were idiopathic, and 12.2% were biliary. Incidence of acute pancreatitis in patients treated with AZA/MP was 3.1%. In patients with acute pancreatitis, female gender (OR 3.4 95% CI: 1.3–9.3; P = 0.012) and Crohn’s disease (CD) (OR 5.8 95% CI: 1.6–20.6; P = 0.007) were risk factors for AZA/MP‐associated acute pancreatitis, the latter also when analysed only in patients treated with AZA/MP (n = 1477) (OR 5.2 95% CI: 1.8–14; P = 0.002).Conclusions  The incidence of acute pancreatitis in our IBD patients (1.6%) is similar to that previously described. Drugs, mainly AZA/MP, are the leading cause. AZA‐induced acute pancreatitis is always mild. Patients with CD are at a higher risk for AZA/MP‐associated acute pancreatitis. The frequency of idiopathic acute pancreatitis is higher than expected, suggesting that part of these cases could be extraintestinal manifestations of IBD.
Review article: 5‐aminosalicylate formulations for the treatment of ulcerative colitis – methods of comparing release rates and delivery of 5‐aminosalicylate to the colonic mucosa
Authors: LICHTENSTEIN G. R. , KAMM M. A. 
Published: October 2008

SummaryBackground Many oral 5‐aminosalicylic acid (5‐ASA) formulations are designed to maximize 5‐ASA release in the colon where it acts topically on the colonic mucosa. Delayed‐release formulations and azo‐prodrugs minimize 5‐ASA absorption in the upper gastrointestinal (GI) tract.Aims To review methods for assessing 5‐ASA release and colonic distribution from oral formulations, and the potential use of this information for guiding clinical decisions.Methods PubMed and recent conference abstracts were searched for articles describing techniques used to assess 5‐ASA release from ulcerative colitis (UC) therapies.Results In‐vitro GI models, although unable to simulate more complex aspects of GI physiology, can provide useful data on 5‐ASA release kinetics and bioaccessibility. Gamma‐scintigraphy is useful for investigating GI disintegration of different formulations, but may not accurately reflect 5‐ASA distribution. Plasma pharmacokinetic studies provide data on systemic exposure, but not on colonic distribution or mucosal uptake. Mucosal biopsies provide direct evidence of colonic distribution and may predict clinical efficacy, but must be interpreted cautiously because of considerable inter‐subject variability and other confounding factors.Conclusion While assessment of 5‐ASA release is important, limitations of individual measurement techniques mean that randomized clinical studies in UC patients remain the best guide for dosing and treatment regimen decisions.
Relationship between rectal sensitivity, symptoms intensity and quality of life in patients with irritable bowel syndrome
Authors: SABATE J.‐M. , VEYRAC M. , MION F. , SIPROUDHIS L. , DUCROTTE P. , ZERBIB F. , GRIMAUD J.‐C. , DAPOIGNY M. , DYARD F. , COFFIN B. 
Published: October 2008

SummaryBackground  Relationships between pain threshold during rectal distension and both symptoms intensity and alteration in quality of life (QoL) in irritable bowel syndrome (IBS) patients have been poorly evaluated.Aim  To evaluate relationships between rectal sensitivity, IBS symptom intensity and QoL in a multicentre prospective study.Methods  Rectal threshold for moderate pain was measured during rectal distension in IBS patients (Rome II), while IBS symptoms intensity was assessed by a validated questionnaire and QoL by the Functional Digestive Disorder Quality of Life questionnaire.Results  Sixty‐eight patients (44.2 ± 12.7 years, 48 women) were included. The mean rectal distending volume for moderate pain was 127 ± 35 mL while 45 patients (66%) had rectal hypersensitivity (pain threshold <140 mL). Rectal threshold was not significantly related either to overall IBS intensity score (r = −0.66, P = 0.62) or to its different components, or to FDDQL score (r = 0.30, P = 0.14). Among FDDQL domains, only anxiety (r = 0.30, P = 0.01) and coping (r = 0.31, P = 0.009) were significantly related with pain threshold.Conclusions  In this study, two‐thirds of IBS patients exhibited rectal hypersensitivity. No significant correlation was found between rectal threshold and either symptom intensity or alteration in QoL.
Screening differences and risk of cervical cancer in inflammatory bowel disease
Authors: HUTFLESS S. , FIREMAN B. , KANE S. , HERRINTON L. J. 
Published: October 2008

SummaryBackground  Cervical cancer risk is high among immune suppressed women.Aim  To evaluate inflammatory bowel disease (IBD) with medications and risk of cervical cancer.Methods  Members of Kaiser Permanente Northern California (KPNC), 15–68 years from 1996 to 2006 with IBD were compared with age‐matched women without IBD. Cervical cancer was ascertained using the KPNC Cancer Registry. IBD medications of interest were aminosalicylates (ASA), corticosteroids, immune modulators and infliximab. Odds of cervical cancer were analysed with adjusted logistic regression. The prevalence of Pap smear testing was compared using a log binomial model.Results  Ten cervical cancer cases occurred among 1165 women with IBD and 72 cancers among 12 124 controls. The adjusted odds ratio (OR) of IBD with risk of cervical cancer was 1.45 [95% confidence interval (CI) 0.74–2.84]. Medication ORs were 1.65 for ASA, 2.79 for corticosteroids and 3.45 for immune modulators (all P > 0.05). No cancer case used infliximab. The adjusted absolute increase in Pap smears among IBD women compared to women without IBD was 4% (95% CI 2–5%).Conclusions  Although a trend of elevated risk for cervical cancer with IBD and IBD medications was observed, it was not statistically significant. Regular cervical cancer screening for women with IBD is recommended.
Predictive graphical model, network‐based medical tool for the prognosis of chronic hepatitis C patients treated with peg‐interferon plus ribavirin
Authors: TRAPERO‐MARUGAN M. , MARIN M. , PIVEL J. P. , DEL RIO J. M. , NUNEZ O. , CLEMENTE G. , GISBERT J. P. , MORENO‐OTERO R. 
Published: October 2008

SummaryBackground  There are few model networks to predict treatment outcome in viral hepatitis.Aim  To develop an easy bioinformatics platform based on algorithm decisions (Bayesian network) for a more efficient prediction of treatment response.Methods  Totally 385 consecutive chronic hepatitis C (CHC) treated patients were included. More than 40 variables were analysed. Data from 308 patients were used to build the variable model network using DLIFE platform based on predictive graphical models. The prediction accuracy of the bioinformatics network was compared with the true data collected in a retrospective study. The model was then validated twice with external data from CHC patients treated in other hospitals.Results  The accuracy of this bioinformatics network for treatment response in our 308 patients was 83.3%, which is higher than the accuracy obtained by physicians on the basis of study of clinical data and their own experience (50–65%). The receiver operator characteristic curve areas after validation with another cohort of patients were: 0.91 for sustained virological response, one for nonresponse, and 0.81 for relapse. DLIFE offered a diagnostic accuracy of 81.3%, which is a clear improvement compared with unassisted prognosis (50–65%).Conclusions  This bioinformatics platform (DLIFE) accurately predicts the outcome of CHC combination therapy, improving treatment decisions and reducing costs. This bioinformatics platform allows integrating widespread data sources and permits predicting the clinical outcome of a particular patient using a general predictive graphical model.
Perinatal risk factors and coeliac disease in children and young adults: a record linkage study
Authors: ROBERTS S. E. , WILLIAMS J. G. , MEDDINGS D. , DAVIDSON R. , GOLDACRE M. J. 
Published: October 2008

SummaryBackground  Little is known about perinatal risk factors and coeliac disease.Aim  To investigate the relationship between perinatal risk factors and subsequent coeliac disease among offspring.Methods  Record linked abstracts of birth registrations, maternity, in‐patient and day case records in a defined population of southern England.Results  Using univariate analysis, coeliac disease in the child was associated with maternal coeliac disease (odds ratio = 20.6; 95% CI = 5.04–84.0; based on two cases in both mother and child) and with social class, year of birth, maternal smoking and parity. Multivariate analysis confirmed an increased risk of coeliac disease of 3.79 (95% CI = 1.85–7.79) for classes IV and V compared with I and II, an increased risk of 1.92 (1.06–3.49) for births during 1975–1979 compared with 1970–1974 and an increased risk of 1.80 (1.05–3.09) for ‘subsequent’ compared with ‘first’ births. Smoking during pregnancy was no longer associated with coeliac disease. Because numbers were small, maternal coeliac disease was excluded from the multivariate anaylsis.Conclusions  This study shows increased risks of coeliac disease for manual social classes, births during the late 1970s and ‘subsequent’ births. Overall, perinatal risk factors seem to have a limited role in the aetiology of coeliac disease in children and young adults.