bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐steroidal anti‐inflammatory drugs, aspirin and newly diagnosed colitis: a case–control study
Authors: Gleeson M. H. , Davis A. J. M. 
Published: December 2004

SummaryBackground : There have been a number of reports of colitis following exposure to non‐steroidal anti‐inflammatory drugs (NSAIDs) and salicylates.Aim : To conduct a case–control analysis of new cases of colitis, with particular reference to the usage of NSAIDs and salicylates prior to the development of the disease.Methods : One hundred and five consecutive new cases of colitis presenting to a single gastroenterologist were questioned about their recent usage of NSAIDs and salicylates. For comparison, the frequency of usage of these compounds was studied in two groups of 105 age‐ and sex‐matched controls taken from hospitalin‐patients and community cases attending the Accident and Emergency Department.Results : Of the 105 cases of colitis studied, 78 patients (74%) had been taking NSAIDs or salicylates prior to or during the development of their disease. By comparison, 20% of community controls were using NSAIDs or salicylates (P < 0.001) and 30% of hospital in‐patients were taking these compounds (P < 0.001). Comparison of these frequencies with those of the colitis group gave odds ratios of 9.1 (4.5, 21.9) with the community controls and 6.2 (3.2, 13.5) with the hospital controls.Conclusions : In new patients presenting with colitis, there is a significantly high frequency of antecedent exposure to NSAIDs or salicylates, supporting the concept that these agents may be important in the pathogenesis of colitis.
Trends in oesophageal and gastric cancer incidence, mortality and survival in England and Wales 1971–1998/1999
Authors: Newnham A. , Quinn M. J. , Babb P. , Kang J. Y. , Majeed A. 
Published: December 2004

SummaryBackground : In England and Wales, 7% of cancers diagnosed in 1997 were oesophageal or gastric cancer.Aim : To review the epidemiology of these cancers in England and Wales using cancer registration data from 1971 to 1998 and mortality data from 1971 to 1999.Methods : We calculated age‐specific and age‐standardised incidence and mortality rates; crude and relative survival by age group; age‐standardised relative survival; and relative survival by socio‐economic status.Results : The age‐standardised incidence of oesophageal cancer increased from 7.6 to 12.8 per 100 000 men and from 4.2 to 5.7 per 100 000 women. The incidence of gastric cancer decreased from 31.8 to 18.9 per 100 000 men and from 15.1 to 7.3 per 100 000 women. For both cancers, the 1‐ and 5‐year age‐standardised relative survival improved for men and women from 1971–1975 to 1992–1994; the 5‐year age‐standardised relative survival was significantly higher in women than in men diagnosed in 1992–1994; for some periods from 1971–1975 to 1986–1990, the 1‐year relative survival was significantly higher in the least deprived men than in the most deprived men.Conclusions : Survival improved for both cancers over the study period, but there were unexplained differences related to sex and deprivation.
Trends in the subsite and morphology of oesophageal and gastric cancer in England and Wales 1971–1998
Authors: Newnham A. , Quinn M. J. , Babb P. , Kang J. Y. , Majeed A. 
Published: December 2004

SummaryBackground : The incidence of adenocarcinoma of the oesophagus and gastric cardia has increased in many countries.Aim : To describe the trends in the subsite and morphology of oesophageal and gastric cancer using cancer registry data from 1971 to 1998.Methods : We calculated the overall age‐standardised incidence in each year; the age‐standardised incidence by subsite, by morphology and by subsite and morphology; and the ratio of the rates in men and women in 1971 and 1998.Results : The incidence of oesophageal adenocarcinoma increased from 1.5 to 7.0 per 100 000 men and from 0.4 to 1.5 per 100 000 women. The incidence of cancer at the cardia also increased, from 2.0 to 5.4 per 100 000 men and from 0.6 to 1.4 per 100 000 women, but the incidence of gastric cancer without a specified subsite decreased markedly from 21.3 to 9.3 per 100 000 men and from 10.7 to 4.2 per 100 000 women.Conclusions : Although some of the increase in the incidence of adenocarcinoma of the gastric cardia is probably real, this interpretation is limited by the proportion of cancers without specified subsites or morphologies.
Clinical and pathological implications of IgG antibody responses toHelicobacter pyloriand its virulence factors in non‐ulcer dyspepsia
Authors: Xia H. H.‐X. , Talley N. J. , Blum A. L. , O'Morain C. A. , Stolte M. , Bolling‐Sternevald E. , Mitchell H. M. 
Published: December 2004

SummaryAim : To determine whether pre‐treatment antibody response to Helicobacter pylori virulence factors predicts eradication success and symptom relief 12 months after triple therapy in non‐ulcer dyspepsia.Methods : H. pylori‐positive patients with non‐ulcer dyspepsia received 1‐week omeprazole‐based triple therapy, or omeprazole plus placebos. Symptoms were assessed using a validated Likert scale. Gastric biopsies taken before and 12 months after treatment were used for histological examination. Pre‐treatment blood samples were used for the detection of anti‐H. pylori immunoglobulin G (IgG) antibodies, and specific IgG antibodies to 19.5‐, 26.5‐, 30‐, 35‐, 89‐ (VacA) and 116‐kDa (CagA) antigens of H. pylori.Results : IgG antibodies to the six antigens were detected in 62%, 96%, 88%, 47%, 54% and 78% of patients, respectively. The presence of antibody to 19.5‐, 26.5‐ or 30‐kDa antigen was associated with an increased anti‐H. pylori IgG absorbance index. IgG absorbance indices were greater in those with H. pylori eradication (vs. persistent infection). The prevalence of antibodies to the six antigens was not significantly different between those with symptom relief vs. those without. The 19.5‐kDa antigen (P = 0.018) and VacA (P = 0.001) were independent risk factors for body gastritis.Conclusions : An increased pre‐treatment anti‐H. pylori IgG absorbance index may be a useful predictor of the success of eradication therapy. Although the 19.5‐kDa antigen and VacA were associated with body gastritis, none of the six antigens tested predicted symptom relief after triple therapy.
Low‐dose or standard‐dose proton pump inhibitors for maintenance therapy of gastro‐oesophageal reflux disease: a cost‐effectiveness analysis
Authors: You J. H. S. , Lee A. C. M. , Wong S. C. Y. , Chan F. K. L. 
Published: December 2004

SummaryBackground : Studies on the use of low‐dose proton pump inhibitor for the maintenance therapy of gastro‐oesophageal reflux disease have shown that it might be comparable with standard‐dose proton pump inhibitor treatment and superior to standard‐dose histamine‐2 receptor antagonist therapy.Aim : To compare the impact of standard‐dose histamine‐2 receptor antagonist, low‐dose proton pump inhibitor and standard‐dose proton pump inhibitor treatment for the maintenance therapy of gastro‐oesophageal reflux disease on symptom control and health care resource utilization from the perspective of a public health organization in Hong Kong.Methods : A Markov model was designed to simulate, over 12 months, the economic and clinical outcomes of gastro‐oesophageal reflux disease patients treated with standard‐dose histamine‐2 receptor antagonist, low‐dose proton pump inhibitor and standard‐dose proton pump inhibitor. The transition probabilities were derived from the literature. Resource utilization was retrieved from a group of gastro‐oesophageal reflux disease patients in Hong Kong. Sensitivity analysis was conducted to examine the robustness of the model.Results : The standard‐dose proton pump inhibitor strategy was associated with the highest numbers of symptom‐free patient‐years (0.954 years) and quality‐adjusted life‐years gained (0.999 years), followed by low‐dose proton pump inhibitor and standard‐dose histamine‐2 receptor antagonist. The direct medical cost per patient in the standard‐dose proton pump inhibitor group (US$904) was lower than those of the low‐dose proton pump inhibitor and standard‐dose histamine‐2 receptor antagonist groups.Conclusions : The standard‐dose proton pump inhibitor strategy appears to be the most effective and least costly for the maintenance management of patients with gastro‐oesophageal reflux disease in Hong Kong.
Impact of carbohydrate and fat intake on weight‐reducing efficacy of orlistat
Authors: Ullrich A. , Erdmann J. , Margraf J. , Schusdziarra V. 
Published: December 2004

SummaryBackground : Orlistat treatment of obesity results in a poor long‐term weight loss (< 5%) in about 30% of patients.Aim : Total energy and macronutrient intake were examined to assess the effect of a change in eating habits on weight loss.Methods : Sixty‐two patients consumed a hypocaloric diet, together with orlistat (3 × 120 mg/day), for 72 weeks, with a maximal fat allowance of 30% of the energy intake. At regular intervals, food diaries were recorded.Results : Fifty‐six patients completed the study and lost 8.5 ± 0.88 kg (P < 0.001). Energy intake was ≈ 1500 kcal/day during the entire study period. In three sub‐groups established according to weight loss (1, < 5%; 2, > 5% and < 10%; 3, > 10%), fat intake was within the recommended range in all groups during the first 6 months, but thereafter only in group 3. All groups increased their carbohydrate consumption, with the greatest increase in group 1, which could account for the rapid regain of initially lost body weight in this group.Conclusion : At the beginning of a weight management programme in conjunction with orlistat, a low fat intake is advised for an efficient reduction in body weight. Subsequently, in patients with poor long‐term weight loss, dietary recommendations must also consider carbohydrate restriction to ensure an adequate hypocaloric diet.
The effects of lansoprazole on erosive reflux oesophagitis are influenced by CYP2C19 polymorphism
Authors: Kawamura M. , Ohara S. , Koike T. , Iijima K. , Suzuki J. , Kayaba S. , Noguchi K. , Hamada S. , Noguchi M. , Shimosegawa T. 
Published: December 2004

SummaryBackground : The acid suppressive effect of lansoprazole is influenced by the P450 2C19 (CYP2C19) polymorphism.Aim : To investigate whether the CYP2C19 genotype is related to the healing of erosive reflux oesophagitis during treatment with lansoprazole.Methods : Eighty‐eight Japanese patients with erosive reflux oesophagitis were treated with a daily oral dose of 30 mg lansoprazole for 8 weeks. The CYP2C19 genotype, Helicobacter pylori infection status and serum pepsinogen I/II ratio were assessed before treatment. At 4 and 8 weeks, the healing of erosive reflux oesophagitis was evaluated endoscopically.Results : The healing rates were 57.1%, 69.2% and 72.7% at 4 weeks and 77.4%, 95.0% and 100% at 8 weeks in homozygous extensive metabolizers, heterozygous extensive metabolizers and poor metabolizers, respectively. At 8 weeks, the healing rate of erosive reflux oesophagitis was significantly lower in homozygous extensive metabolizers than in the other two groups (P < 0.05). The H. pylori status and serum pepsinogen I/II ratio had less influence than CYP2C19 polymorphism on the healing rate of erosive reflux oesophagitis.Conclusions : The therapeutic effect of lansoprazole on erosive reflux oesophagitis is influenced by the CYP2C19 genotype status. Therefore, a test of CYP2C19 genotype may be useful for the medical treatment of reflux oesophagitis with lansoprazole.
Safety, efficacy and costs of pharmacotherapy for functional gastrointestinal disorders: the case of alosetron and its implications
Authors: Ladabaum U. 
Published: December 2004

SummaryBackground: Functional gastrointestinal disorders cause substantial morbidity, but not mortality. Alosetron may achieve ‘adequate relief ’ in diarrhoea‐predominant irritable bowel syndrome, but may cause major complications, including death.Aim: To appraise, quantitatively, the trade‐off between possible symptomatic improvement and serious complications in the treatment of functional gastrointestinal disorders.Methods: A decision analytical model was used to examine alosetron or standard treatment for 6 months in 45‐year‐old women with diarrhoea‐predominant irritable bowel syndrome using the health care system's perspective.Results: Assuming a 14% higher ‘adequate relief’ rate with alosetron compared to standard care, and a complication rate of four per 1000 persons in 6 months, alosetron gained 0.00081 quality‐adjusted life‐years (QALYs) per patient at a cost of $358 700 per QALY gained. Alosetron gained QALYs if ‘adequate relief’ increased the patients' utility by more than 0.01 in the base case. In probabilistic analysis, alosetron gained QALYs in 98.2% of iterations at a median cost of $212 600 per QALY (interquartile range, $138 000–338 900 per QALY). Results were highly sensitive to the utility gain with ‘adequate relief’ and alosetron's response and complication rates.Conclusions: Alosetron's benefit‐to‐risk profile appears to be favourable, but its cost per QALY gained may be substantial. Decision analyses on treatments for functional gastrointestinal disorders are likely to be highly sensitive to the utility estimates used. There is a pressing need for direct utility measurements in functional gastrointestinal disorders.
Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non‐erosive gastro‐oesophageal reflux disease
Authors: Zentilin P. , Iiritano E. , Vignale C. , Bilardi C. , Mele M. R. , Spaggiari P. , Gambaro C. , Dulbecco P. , Tessieri L. , Reglioni S. , Mansi C. , Mastracci L. , Vigneri S. , Fiocca R. , Savarino V. 
Published: December 2004

SummaryBackground : The majority of reflux patients have non‐erosive reflux disease.Aim : To evaluate the influence of Helicobacter pylori on oesophageal acid exposure in patients with both non‐erosive and erosive reflux disease and in a group of controls. The pattern and distribution of chronic gastritis were also assessed.Methods : One hundred and twelve consecutive patients with symptoms of gastro‐oesophageal reflux disease agreed to undergo both upper gastrointestinal endoscopy and 24‐h oesophageal pH‐metry. Patients were grouped as H. pylori‐positive or H. pylori‐negative on the basis of both CLO‐test and histology, and as cases with or without oesophagitis on the basis of endoscopy. The controls consisted of 19 subjects without reflux symptoms and with normal endoscopy and oesophageal pH‐metry.Results : H. pylori was positive in 35 patients (31%) and in six controls (31%); oesophagitis was found in 44 patients (39%) and non‐erosive reflux disease in 68 (61%). The prevalence of chronic gastritis in the antrum and corpus was higher in H. pylori‐positive than in H. pylori‐negative patients (P < 0.001), but was more frequently mild (P < 0.001) than moderate or severe. The percentage total time the oesophageal pH < 4.0 was higher in patients than in controls (P < 0.008–0.001), but there was no difference between H. pylori‐positive and H. pylori‐negative patients (12.3% vs. 12%, P = 0.43) or H. pylori‐positive and H. pylori‐negative controls (1.07% vs. 1.47%, P = 0.19).Conclusions : H. pylori infection had the same prevalence in reflux patients and in controls. It did not affect oesophageal acid exposure, as there was no difference between H. pylori‐positive and H. pylori‐negative individuals. The high prevalence of mild body gastritis in H. pylori‐positive patients suggests that H. pylori eradication is unlikely to lead to gastric functional recovery, which might precipitate or worsen symptoms and lesions in patients with gastro‐oesophageal reflux disease.
Antigen stool test for assessment of Helicobacter pylori infection in patients with upper gastrointestinal bleeding
Authors: Peitz U. , Leodolter A. , Kahl S. , Agha‐Amiri K. , Wex T. , Wolle K. , Günther T. , Steinbrink B. , Malfertheiner P. 
Published: December 2004

SummaryBackground : Re‐bleeding of Helicobacter pylori‐associated peptic ulcer disease is reduced by H. pylori eradication.Aim : To validate a non‐invasive test, the Premium Platinum HpSA™ stool test, in patients with upper gastrointestinal bleeding.Methods : Stool samples of consecutive patients with relevant bleeding from gastric or duodenal ulcers or erosions were collected at initial endoscopy and during the following week. Samples were assessed using the HpSA™ test. H. pylori status was defined by three biopsy‐based reference methods: culture, rapid urease test and histology. It was positive if culture was positive or if rapid urease test and histology were positive.Results : One hundred and fourteen patients (mean age, 66 years) were included. In accordance with the definition, 56 (49%) were H. pylori positive. The sensitivity and specificity of the first stool sample were 84% and 90%, respectively. The respective values for two samples from consecutive days were 91% and 86%. In comparison with a serum immunoglobulin G antibody enzyme‐linked immunoabsorbent assay, the HpSA™ test showed superior specificity.Conclusions : The diagnostic accuracy, in particular the sensitivity, of the HpSA™ stool test is reduced by upper gastrointestinal bleeding. The positive predictive value of 89%, however, justifies the initiation of eradication therapy on the basis of a positive stool test. A negative test result should be confirmed by a further diagnostic method.
Diverticular disease of the colon — on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000
Authors: Kang J. Y. , Hoare J. , Tinto A. , Subramanian S. , Ellis C. , Majeed A. , Melville D. , Maxwell J. D. 
Published: December 2004

SummaryBackground:  Diverticular disease emerged as a common problem in Western countries over the course of the 20th century.Aims:  To determine the time trends in diverticular disease for hospital admissions in England between 1989/1990 and 1999/2000 and population mortality rates from 1979 to 1999.Methods:  Hospital Episode Statistics were obtained from the Department of Health and mortality data from the Office for National Statistics.Results:  Between 1989/1990 and 1999/2000, annual age‐standardized hospital admission rates for diverticular disease increased by 16% for males (from 20.1 to 23.2 per 100 000) and 12% for females (from 28.6 to 31.9 per 100 000). Female rates were significantly higher than male rates throughout the study period. The proportions of admissions with an operation increased by 16% for males (from 22.9% to 24.1%) and 14% for females (from 19.7% to 22.3%). Older patients were less likely to undergo operation than younger patients. In‐patient case fatality rates and population mortality rates remained unchanged.Conclusions: Admission rates for diverticular disease increased over the study period. The proportion of patients who underwent operation increased, but in‐patient and population mortality rates remained unchanged. With an ageing population, diverticular disease will become an increasingly important clinical problem in England.
Non‐cardiac chest pain: prevalence, risk factors, impact and consulting — a population‐based study
Authors: Eslick G. D. , Jones M. P. , Talley N. J. 
Published: December 2004

SummaryBackground : Little is known about the prevalence and importance of non‐cardiac chest pain in the general population.Aim : To evaluate the magnitude and impact of this condition.Methods : A validated self‐report questionnaire was mailed to a sample of 1000 residents of Penrith, selected randomly from the electoral rolls. Symptoms, risk factors, psychological distress, quality of life and demographics were measured.Results : The response rate was 73% (n = 672; mean age, 46 years; 52% female). Chest pain ever was reported by 39% of the population; 7% reported a history of myocardial infarction and 8% a history of angina. Two hundred and nineteen (33%) cases were classified as non‐cardiac chest pain; only 23% had consulted a physician about chest pain in the previous year. The only independent risk factor for non‐cardiac chest pain was the frequency of heartburn (odds ratio, 1.74; 95% confidence interval, 1.08–2.79; P = 0.02). None of the gastrointestinal (heartburn, dysphagia, acid regurgitation) or psychological (anxiety, depression, neuroticism) risk factors were significantly associated with consulting for non‐cardiac chest pain.Conclusions : Non‐cardiac chest pain is remarkably common in the general population and negatively impacts on the quality of life. Gastro‐oesophageal reflux disease is a key risk factor for non‐cardiac chest pain in the community. Health care seeking for non‐cardiac chest pain remains unexplained.
The clinical course of fistulating Crohn's disease
Authors: Bell S. J. , Williams A. B. , Wiesel P. , Wilkinson K. , Cohen R. C. G. , Kamm M. A. 
Published: December 2004

SummaryAim : To determine the clinical characteristics, management and outcome of Crohn's fistulas from the time of first presentation.Methods : Patients treated for fistulas 6 years previously were assessed for disease demographics, fistula characteristics and treatment from first presentation to final follow‐up.Results : Eighty‐seven patients with active Crohn's fistulas were evaluated. The median age was 35 years and the median duration of Crohn's disease was 8 years at study entry. Disease was ileo‐colonic or colonic in 85%, and 65% had rectal involvement. A single fistula was present in one‐third and multiple fistulas in two‐thirds; 65% of fistulas were perianal; 80% of fistulas were complex. After a median follow‐up from the last treatment of 5.9 years, 68% of patients showed healing of all fistulas, 18% showed healing of some fistulas and 14% showed no healing of fistulas. The fistula site did not influence healing. Perianal and recto‐vaginal fistulas took a median of 2.6 years to heal. Half of the complex fistulas required a stoma, resection or proctectomy.Conclusions : Healing is usually achieved. However, morbidity is great and healing is slow. Proctectomy is required in one‐fifth of patients, and perineal healing is often slow. Defining the perianal fistula anatomy as complex or simple determines the likelihood of healing and the type of surgical approach required.
Triple vs. quadruple therapy for treating Helicobacter pylori infection: a meta‐analysis
Authors: Gené E. , Calvet X. , Azagra R. , Gisbert J. P. 
Published: December 2004

SummaryBackground: Triple therapy (proton pump inhibitor, clarithromycin and amoxicillin or an imidazole) is the first‐line treatment for Helicobacter pylori infection. However, the effectiveness of triple therapy is decreasing due to the increase in antibiotic resistance. Quadruple therapy (proton pump inhibitor, tetracycline, metronidazole and a bismuth salt) is a very effective regimen even in areas of high prevalence of antibiotic resistance, and may be an alternative first‐line treatment.Aim: To compare triple vs. quadruple therapy for the first‐line treatment of H. pylori infection.Methods: An extensive literature search was performed to identify randomized trials comparing triple vs. quadruple therapy. Selected trials were included in a meta‐analysis using Review Manager 4.1.Results: Four studies met the inclusion criteria. Eradication rates with quadruple therapy were slightly higher in both the intention‐to‐treat (81% vs. 78%; odds ratio, 0.83; 95% confidence interval, 0.61–1.14) and per protocol (88% vs. 85%; odds ratio, 0.81; 95% confidence interval, 0.55–1.20) analysis, although the differences were not statistically significant. Nor were there significant differences in compliance or adverse effects between the therapies.Conclusion: Triple and quadruple therapies seem to be roughly equivalent in terms of effectiveness, compliance and side‐effects profile when administered as first‐line treatment for H. pylori infection.