bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oesophageal and gastric pH profiles in patients with gastro‐oesophageal reflux disease and Barrett's oesophagus treated with proton pump inhibitors
Authors: Gerson L. B. , Boparai V. , Ullah N. , Triadafilopoulos G. 
Published: December 2004

SummaryBackground : Acid plays a significant role in the development of gastro‐oesophageal reflux symptoms and tissue damage. It is generally assumed that acid suppressive therapy with proton pump inhibitors improves or eliminates symptoms of gastro‐oesophageal reflux disease by normalizing intra‐oesophageal pH. However, the degree of acid suppression induced by proton pump inhibitor therapy in patients with gastro‐oesophageal reflux disease and/or Barrett's oesophagus has not been adequately studied.Aim : To assess the efficacy of proton pump inhibitors in normalizing intra‐oesophageal and intra‐gastric pH in patients with gastro‐oesophageal reflux disease with and without Barrett's oesophagus who have been rendered symptom‐free by acid‐suppressive therapy.Methods : Patients with gastro‐oesophageal reflux disease and Barrett's oesophagus were prospectively evaluated by dual sensor 24‐h pH monitoring while receiving proton pump inhibitor therapy for complete control of gastro‐oesophageal reflux disease symptoms. Analyses and comparisons of intra‐oesophageal and intra‐gastric pH profiles on therapy were then made.Results : One hundred and ten patients, 98 men and 12 women, with gastro‐oesophageal reflux disease (n = 62) and/or Barrett's oesophagus (n = 48), were studied. All tolerated proton pump inhibitors well and were asymptomatic at the time of the study. Thirty‐six (58%) patients with gastro‐oesophageal reflux disease and 24 (50%) patients with Barrett's oesophagus (P = 0.4) normalized their intra‐oesophageal pH profiles on proton pump inhibitors. Compared with patients with gastro‐oesophageal reflux disease, patients with Barrett's oesophagus were more likely to have higher degree of pathologic acid reflux despite proton pump inhibitor therapy (DeMeester score 50.5 ± 8.2 vs. 31.4 ± 4.6, P = 0.03) and exhibited less intra‐gastric acid suppression (% total pH<4.0: 53.9 ± 2.7 vs. 39.9 ± 2.6, P =0.0004), particularly supine (% pH<4.0: 62.1 ± 3.4 vs. 44.8 ± 3.4, P =0.0006).Conclusions : Gastro‐oesophageal reflux disease patients with or without Barrett's oesophagus continue to exhibit pathologic gastro‐oesophageal reflux disease and low intra‐gastric pH despite proton pump inhibitor therapy that accomplishes complete reflux symptom control. Further, intra‐oesophageal and intra‐gastric pH control is significantly more difficult to achieve in patients with Barrett's oesophagus. These findings may have significant therapeutic implications.
Diagnostic accuracy of faecal calprotectin estimation in prediction of abnormal small bowel radiology
Authors: Dolwani S. , Metzner M. , Wassell J. J. , Yong A. , Hawthorne A. B. 
Published: December 2004

SummaryBackgound : Patients being investigated for symptoms of abdominal pain, diarrhoea and or weight loss often undergo small bowel radiology as part of their diagnostic workup mainly to exclude inflammatory bowel disease.Aim : To assess and compare the utility of a single faecal calprotectin estimation to barium follow through as well as conventional inflammatory markers such as erythrocyte sedimentation rate and C‐reactive protein in exclusion of intestinal inflammation.Methods : Seventy‐three consecutive cases undergoing barium follow through for investigation of symptoms of diarrhoea and or abdominal pain with or without weight loss were studied. The control group comprised 25 cases with known active Crohn's disease (positive controls), 26 normal healthy volunteers (negative controls) and 25 cases of irritable bowel syndrome diagnosed by Rome II criteria. Symptoms, erythrocyte sedimentation rate and C‐reactive protein were recorded at recruitment and a single stool sample assayed for calprotectin within 7 days prior to or after barium follow through.Results : The median calprotectin value in the active Crohn's group, irritable bowel syndrome group and normal volunteers was 227 μg/g of stool, 19 and 10 μg/g respectively (P < 0.0001). A faecal calprotectin above a cut‐off value of 60 μg/g was able to predict all nine cases with an abnormal barium follow through as well as all six cases with a normal barium follow through but with organic intestinal disease. The negative predictive value of a single calprotectin result below 60 μg/g of stool was 100% compared with 91% each for erythrocyte sedimentation rate > 10 mm and C‐reactive protein > 6 mg/L and 84% for a combination of erythrocyte sedimentation rate and C‐reactive protein in predicting absence of organic intestinal disease.Conclusion : A single stool calprotectin value < 60 μg/g of stool obviates the need for further barium radiology of the small bowel, is more accurate than measurement of erythrocyte sedimentation rate or C‐reactive protein and effectively excludes Crohn's disease or non‐functional gastrointestinal disease.
A pilot study of orlistat treatment in obese, non‐alcoholic steatohepatitis patients
Authors: Harrison S. A. , Fincke C. , Helinski D. , Torgerson S. , Hayashi P. 
Published: December 2004

SummaryBackground : Treatment options for non‐alcoholic steatohepatitis (NASH) are limited. Weight loss remains the most recommended therapy. Orlistat is an effective adjunct to dietary weight loss therapy.Aim : To evaluate the efficacy of orlistat, given for 6 months to patients with obesity and biopsy confirmed NASH.Methods : Ten obese patients with biopsy proven NASH were enrolled. Orlistat was given with meals for 6 months. Body Mass Index (BMI), liver enzymes, haemoglobin A1c, fasting lipids and glucose were assessed at baseline and at completion of the study. Paired liver histology was obtained.Results : Six women and four men were enrolled. The mean weight loss was 22.7 lb and ranged from 0 to 24.3%. The following clinical values significantly improved: mean BMI: 43.4–39.8 (P = 0.007); mean haemoglobin A1c (%): 7.14–5.95 (P = 0.021); mean alanine aminotransferase (ALT) (U/L): 93 –54 (P = 0.009); and mean aspartate aminotransferase (AST) (U/L): 79–48 (P = 0.008). Steatosis improved in six patients, and fibrosis improved in three patients.Conclusions : Orlistat therapy and dietary counselling were associated with significant decreases in body weight, haemoglobin A1c, ALT and AST. A 10% or greater reduction in weight improved steatosis and fibrosis as well as haemoglobin A1c levels in the majority of patients treated for 6 months. Controlled trials of longer duration are warranted to assess for histopathologic improvement as well as cost‐efficacy in comparison to diet and exercise alone.
Azathioprine formulation optimizes metabolite profile in inflammatory bowel disease
Authors: Stevens T. , Achkar J. P. , Easley K. , Brzezinski A. , Lashner B. 
Published: December 2004

SummaryBackground : Recent studies have suggested that mercaptopurine metabolism is influenced by drug formulation (mercaptopurine vs. azathioprine) and concomitant use of 5‐aminosalicylic acid medications.Aim : To determine the influence of dose, formulation and 5‐aminosalicylic acid use on mercaptopurine metabolism.Methods : Metabolites from 131 inflammatory bowel disease patients were analysed. Logistic regression was used to analyse correlations between dose and metabolite levels. Multivariate analysis was used to determine the effects of drug formulation and 5‐aminosalicylic acid use.Results : A positive correlation was detected between dose and 6‐tioguanine nucleotides levels for azathioprine/Imuran formulation (P = 0.005) but not for mercaptopurine formulation. Adjusted mean 6‐tioguanine nucleotides levels were similar for both formulations. Adjusted mean 6‐methylmercaptopurine levels were higher for mercaptopurine formulation than for azathioprine formulation (1950 vs. 1056, P = 0.04). 5‐aminosalicylic acid use: 6‐tioguanine nucleotides levels did not differ based on concomitant 5‐aminosalicylic acid use. However, 5‐aminosalicylic acid use did result in higher adjusted mean 6‐methylmercaptopurine levels: 2078 on 5‐aminosalicylic acid vs. 991 off 5‐aminosalicylic acid (P = 0.004).Conclusions : (i) Azathioprine may have metabolic benefits by achieving a correlation of dose with 6‐tioguanine nucleotides levels and by leading to lower mean 6‐methylmercaptopurine levels. (ii) 5‐aminosalicylic acid use does not significantly impact 6‐tioguanine levels and may lead to higher 6‐methylmercaptopurine levels.
Review article: the safety profile of tegaserod
Authors: Schoenfeld P. 
Published: December 2004

SummaryGastrointestinal symptoms are the most common side‐effects of tegaserod therapy. In data pooled from Phase III randomized controlled trials in patients with irritable bowel syndrome with constipation, diarrhoea was reported by 8.8% of patients treated with tegaserod 6 mg b.d. vs. 3.8% of patients treated with placebo. Similar rates were observed in international post‐US marketing randomized controlled trials. In most patients, tegaserod‐induced diarrhoea was mild and transient. In randomized controlled trials, it did not elicit fluid or electrolyte disturbances, and fewer than 3% of irritable bowel syndrome patients discontinued tegaserod due to diarrhoea. The incidence of other gastrointestinal symptoms (e.g. abdominal pain, nausea and flatulence) was similar in tegaserod‐treated and placebo‐treated patients. Pooled analysis of Phase III and post‐US marketing randomized controlled trials did not demonstrate significant differences between tegaserod‐treated and placebo‐treated patients in the incidence of abdominal/pelvic surgery. No episodes of ischaemic colitis were reported in tegaserod‐using patients in any Phase III or post‐marketing randomized controlled trials, and post‐marketing surveillance indicated that the rate of ischaemic colitis in tegaserod‐using patients was lower than that in non‐tegaserod‐using patients. Pooled analysis of Phase III randomized controlled trials demonstrated an increase in the incidence of headaches in tegaserod‐treated (6 mg b.d.) vs. placebo‐treated patients (15% vs. 12.3%, respectively; P < 0.05), although post‐US marketing randomized controlled trials did not demonstrate this increase. Other extra‐gastrointestinal adverse events occurred with similar frequency in tegaserod‐treated and placebo‐treated patients. Tegaserod‐treated patients in randomized controlled trials did not demonstrate significant prolongation of the QTc interval or cardiac arrhythmias compared with placebo‐treated patients. In summary, tegaserod exhibits a favourable safety and tolerability profile in irritable bowel syndrome patients based on data from clinical trials.
Review article: epidemiology and quality of life in functional gastrointestinal disorders
Authors: Chang L. 
Published: December 2004

SummaryThe epidemiology and health‐related quality of life associated with functional gastrointestinal disorders are reviewed, with particular emphasis on irritable bowel syndrome and functional dyspepsia. The literature supports the significant world‐wide prevalence of functional gastrointestinal disorders, including irritable bowel syndrome (IBS), functional dyspepsia and chronic constipation. An increased female prevalence has been demonstrated in most studies in patients with IBS and chronic constipation, but not functional dyspepsia. The female to male ratio appears to be greater in the health care‐seeking population than in community populations. However, some differences in the reported general prevalence and gender‐related prevalence of functional gastrointestinal disorders may be due to cultural factors and study methodology. A significant health care burden is associated with IBS, with increased out‐patient services, abdominal and pelvic surgeries, and gastrointestinal‐ and non‐gastrointestinal‐related physician visits and health care costs. Health‐related quality of life is impacted significantly in patients with functional gastrointestinal disorders, such as functional dyspepsia and IBS, compared with the general healthy population, as well as patients with other chronic medical conditions, such as gastro‐oesophageal reflux disease and asthma. Impaired health‐related quality of life has been demonstrated, in particular, in patients with moderate to severe disease seen in referral settings. The health‐related quality of life appears to improve in treatment responders, or correlates with symptom improvement, with at least some treatment modalities studied in functional gastrointestinal disorders, but further studies are needed. Predictors of health‐related quality of life in patients with functional gastrointestinal disorders include psychosocial factors, such as early adverse life events, and symptoms related to visceral perception, e.g. pain and chronic stress. The presence of extra‐intestinal symptoms appears to have a major if not greater impact on health care visits, excess health care costs and health‐related quality of life in patients with functional gastrointestinal disorders.
Quality of life in patients with established inflammatory bowel disease: a UK general practice survey
Authors: Rubin G. P. , Hungin A. P. S. , Chinn D. J. , Dwarakanath D. 
Published: December 2004

SummaryBackground : The current understanding of quality of life impairment in inflammatory bowel disease has largely been derived from selected populations and may not reflect the experience of patients in the community, where fewer than half are likely to be under specialist care.Aim : To describe the health‐related quality of life in a community‐based sample of patients with established inflammatory bowel disease and explore its association with the type and extent of disease, gender, age, material deprivation and other factors.Methods : Adults with established inflammatory bowel disease were identified systematically from the records of 23 family practices in north‐east England. The health‐related quality of life was assessed by self‐completion of the UK Inflammatory Bowel Disease Questionnaire.Results : Five hundred and fifty‐six patients were sent the questionnaire and 409 (74%) gave usable replies. Lower scores (worse quality of life) were significantly associated with female gender, Crohn's disease, more extensive disease (ulcerative colitis) and being under specialist care. The mean health‐related quality of life score was significantly lower in patients resident in more deprived districts, independent of the type and extent of disease.Conclusions : Most patients with established inflammatory bowel disease showed only minor impairment of their health‐related quality of life. On average, women and those with Crohn's disease were relatively more affected. Clinicians responsible for the care of patients with inflammatory bowel disease should be aware of these more vulnerable groups.
The influence of ageing on the insulin signalling system in rat lacrimal and salivary glands
Authors: Rocha Eduardo M. , Carvalho Carla R. O. , Saad Mário J. A. , Velloso Lício A. 
Published: December 2004

Abstract.Purpose:  Ageing adversely affects the structure and function of lacrimal and salivary glands (LG and SG) and leads to marked insulin resistance that correlates with reduced insulin signal transduction. The aim of this study was to investigate whether ageing affects insulin signal transduction in LG and SG in vivo. Methods:  Male Wistar rats aged 20 months and 2 months (control group) were compared (n = 8/group). Samples were removed under anaesthesia after i.v. injection of insulin, homogenized, immunoprecipitated with anti‐insulin receptor (IR), Shc and STAT‐1 antibodies and immunoblotted with antiphosphotyrosine antibody. Results:  The 20‐month‐old rats were significantly hyperinsulinaemic and presented a reduced rate of blood glucose disappearance in response to insulin, compared to the 2‐month‐old rats. The level of phosphorylation determined by densitometry in the older group of rats showed that ageing significantly reduced insulin‐induced IR phosphorylation in LG and SG and STAT‐1 phosphorylation in SG, compared to in the control group, but did not alter Shc phosphorylation. Conclusions:  Ageing influences insulin signal transduction in the LG and SG of rats. Considering the major anabolic actions of insulin, these observations may help to explain the mechanisms of LG and SG dysfunctions observed in ageing.
Topical versus peribulbar anaesthesia for cataract surgery
Authors: Sauder Gangolf , Jonas Jost B. 
Published: December 2004

Abstract.Background:  To assess and compare the efficacy and safety of topical versus peribulbar anaesthesia in patients undergoing routine cataract surgery. Methods:  The unicentre, prospective, randomized, clinical interventional trial included 140 consecutive patients undergoing routine cataract surgery performed by one of two surgeons. The patients were randomly distributed to either peribulbar anaesthesia or topical anaesthesia. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10‐point pain rating scale. Results:  The study groups did not differ significantly in pain score (p = 0.54), duration of surgery (p = 0.52), anaesthesia‐related intraoperative difficulties (p = 0.17), postoperative visual acuity (p = 0.94), overall intraoperative surgical complication rate, blood pressure rise (p = 0.16) or blood oxygen saturation (p = 0.74) Conclusions:  Patient comfort and surgery‐related complications did not differ between topical anaesthesia and peribulbar anaesthesia. As there are no significant differences between the two techniques in terms of subjective pain experienced by patients, intraoperative complications and postoperative visual outcome, and in view of the minimally invasive character of topical anaesthesia compared to peribulbar anaesthesia, the present study suggests the use of topical anaesthesia for routine cataract surgery.
Melanoma‐associated spongiform scleropathy: biochemical changes and possible relation to tumour extension
Authors: Alyahya Ghassan Ayish , Ribel‐Madsen Søren M. , Heegaard Steffen , Prause Jan Ulrik , Trier Klaus 
Published: December 2004

Abstract.Purpose:  To investigate biochemical changes of the sclera in eyes with melanoma‐associated spongiform scleropathy (MASS), and to analyse possible relationships between these changes and tumour extension.Methods:  Sections from 364 eyes, enucleated for choroidal and ciliary body melanoma, were examined for MASS and scleral tumour extension. Biochemical analysis was also performed on eight scleral specimens with MASS and eight specimens (controls) from morphologically normal sclera of the same eyes. The scleral thickness of each specimen was measured. Samples were delipidized, dried and weighed. The weight ratios of collagen‐related amino acids were calculated based on quantitation by liquid chromatography. Amounts of glycosaminoglycans (GAGs) were determined by electrophoresis.Results:  Melanoma‐associated spongiform scleropathy was seen in 140 eyes (38.5%). Tumour scleral extension was observed in 82 eyes. Of these 82 eyes, 75 (91.5%) had MASS (p < 0.05). Biochemically, the majority of the main amino acids of the scleral collagen and total proteins were significantly lower in areas with MASS than in the control specimens. Specific GAGs and total GAGs were found in significantly higher concentrations in areas with MASS than in the control specimens. Scleral thickness was also significantly higher in areas with MASS than in the control specimens.Conclusions:  The reduced content of collagen manifested by decreased amino acids and total proteins indicates collagen degradation in the vicinity of the tumour. The concomitant excessive deposition of GAGs accumulates water and may cause loosening of the already degraded collagen bundles, giving a histopathological picture of MASS. These changes could facilitate tumour cell migration and may explain the high incidence of MASS in eyes with scleral tumour extension.
Outcome of zone 1 retinopathy of prematurity
Authors: O'Keefe Michael , Lanigan Bernadette , Long Vernon W. 
Published: December 2004

Abstract.Purpose:  To describe the outcome in a series of patients with pre‐threshold and threshold zone 1 retinopathy of prematurity. Methods:  We performed a retrospective analysis of 12 babies, 24 eyes, with zone 1 retinopathy of prematurity, treated between 1992 and 2002 with diode laser treatment. Results:  Ten out of the 12 babies had an unfavourable outcome. The only patients with successful anatomical outcomes were those treated before threshold disease occurred. All babies had developmental delay or neurological disability. Conclusion:  Zone 1 retinopathy of prematurity has a poor anatomical and visual prognosis and many of the babies in our study had developmental delay and neurological disability. Earlier treatment may improve the visual outcome.
Corneal penetration of levofloxacin into the human aqueous humour: a comparison with ciprofloxacin
Authors: Colin Joseph , Simonpoli Sylvie , Geldsetzer Klaus , Ropo Auli 
Published: December 2004

Abstract.Purpose:  To compare aqueous humour levels of levofloxacin and ciprofloxacin following topical application to patients scheduled for cataract surgery. Methods:  A total of 59 patients undergoing cataract surgery were randomly assigned to topical treatment with either levofloxacin 0.5% or ciprofloxacin 0.3% eye drops, at one drop every 15 min for four doses immediately prior to surgery. Aqueous humour samples were collected by paracentesis and analysed for drug content. Results:  The (geometric) mean aqueous humour concentration of levofloxacin was 0.728 µg/ml; that of ciprofloxacin was 0.080 µg/ml. Conclusions:  Levofloxacin achieves 9.1 times the aqueous humour concentration of ciprofloxacin. It could be considered a better choice than ofloxacin or ciprofloxacin for topical ophthalmic use.
Nordic research in ophthalmology
Authors: Stefánsson Einar , Zetterström Charlotta , Ehlers Niels , Kiilgaard Jens F. , La Cour Morten , Sigurdsson Haraldur , Gudmundsdóttir Elínborg , Prause Jan Ulrik , Heijl Anders 
Published: December 2004

Abstract.Purpose: To provide an overview of some of the current activities in eye research in the Nordic countries.Methods: The presentations at the biannual Nordic Congress of Ophthalmology, held in Tampere, Finland in 2002, were reviewed and the contributions found most noteworthy are included in this article along with a limited discussion of each research field. However, space requirements prevented the inclusion of many interesting scientific contributions.Results: Important contributions in various subfields of eye research and ophthalmology are reviewed. These include cornea, cataract, paediatric ophthalmology, glaucoma, diabetic eye disease, age‐related macular degeneration, physiology and pharmacology and oncology.Conclusions: Eye research is very active in the Nordic countries and significant contributions are being made to ophthalmology in several fields on a world scale. We hope to continue to review Nordic contributions to eye research after each Nordic Congress of Ophthalmology and plan to make the reviews more systematic and comprehensive in the future.