bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐Helicobacter pylori Related Duodenal Ulcer Disease in Children
Authors: Elitsur Yoram , Lawrence Zandra 
Published: March 2003

ABSTRACTBackground.In spite of the worldwide distribution of Helicobacter pylori infection, recent data have reported an increased rate of non‐H. pylori, non‐NSAIDs‐duodenal ulcer disease in adults. The estimated rate of these ulcers in children is unknown. We aimed to investigate the prevalence of non‐H. pylori, non‐NSAIDs‐peptic ulcer disease in our pediatric patients who undergo upper endoscopic procedures.Methods.A retrospective analysis of 622 upper endoscopic reports was performed. Reports that documented mucosal ulcerations were included in our study. The demographic, clinical, endoscopic, and histological data were retrieved. The H. pylori‐negative, duodenal/gastric ulcer‐positive patients were compared with H. pylori‐positive, duodenal/gastric ulcer‐positive patients.Results.Out of the 622 upper endoscopy reports, a total of 11 (1.8%) children with mucosal ulceration were studied. Mucosal ulceration was distributed in the following locations: stomach‐3 (27%), and duodenal bulb‐10 (91%) (two children had ulcers in both the stomach and duodenal bulb). Helicobacter pylori infection was only detected in three (27%) children with duodenal ulcer. Gastritis was more severe in patients with H. pylori infection/duodenal ulcer compared with H. pylori‐negative/duodenal ulcer group. No statistical difference in clinical symptoms or endoscopic appearance was observed between the H. pylori‐negative and H. pylori‐positive groups.Conclusion.‘Idiopathic’ (H. pylori‐negative, NSAIDs‐negative) duodenal/gastric ulcers are present in symptomatic children. Clinical or endoscopic characteristics are insufficient markers to identify those ‘idiopathic’ ulcers. Investigating the ‘risk factors’ for those ulcers will be helpful in reducing the morbidity in these children.
Production of Chemokines and Reactive Oxygen Species by Human Neutrophils Stimulated by Helicobacter pylori
Authors: Shimoyama Tadashi , Fukuda Shinsaku , Liu Qiang , Nakaji Shigeyuki , Fukuda Yoshihiro , Sugawara Kazuo 
Published: March 2003

AbstractBackground. Bacteria have different characteristics in stimulation of human neutrophils to produce reactive oxygen species (ROS) and chemokines. This study examined the ability of Helicobacter pylori to induce production of ROS and chemokines by human neutrophils.Methods. H. pylori strains (1.5 × 108 CFU/ml) were cocultured with 5 × 104 neutrophils isolated from healthy subjects. Samples were incubated with human serum with or without IgG antibodies to H. pylori. ROS production was measured using luminol‐dependent chemiluminescence (LmCL), and the concentrations of chemokines (IL‐8, RANTES, MIP‐1α and MCP‐1) were measured by ELISA.Results. The mean of the highest LmCL (peak height; PH) value stimulated by H. pylori was 3318 in the absence of serum. PH increased to 4687 when incubated with anti‐H. pylori antibody‐positive sera (p < .001) but antibody‐negative sera did not affect LmCL response. The mean final concentration of IL‐8 produced in the absence of serum was 142.6 pg/ml. Increased IL‐8 production was seen by addition of antibody positive serum (p < .01). IL‐8 production was not significantly correlated with production of ROS. On the other hand, H. pylori stimulation did not induce neutrophil production of RANTES, MIP‐1α or MCP‐1.Conclusions. H. pylori was capable of inducing IL‐8 production by human neutrophils, but not C‐C chemokines. Production of C‐X‐C dominant chemokine by neutrophils is consistent with the pathological characteristics of H. pylori‐induced gastritis, where persistent neutrophil infiltration is present.
Stool Antigen Assay to Screen H. pylori Infection and to Assess the Success of 3‐Day and 7‐Day Eradication Therapy in the Patients with Partial Gastrectomy
Authors: Sheu Bor‐Shyang , Yang Hsiao‐Bai , Wang Yen‐Lin , Kao Ai‐Wen , Chuang Chiao‐Hsiung , Lin Pin‐Wen , Chang Yuh‐Chung 
Published: March 2003

AbstractBackground. Even after partial gastrectomy, Helicobacter pylori may persist in the residual stomach but be less abundant in the bacterial load. H. pylori stool antigen is a reliable noninvasive tool to detect H. pylori infection in patients without gastrectomy. We thus test whether [1] the course of H. pylori eradication therapy could be diminished [2]; stool antigen can effectively detect H. pylori infection for the patients with gastrectomy.Methods. One hundred and eight patients who had undergone partial gastrectomy were enrolled to receive panendoscopy and provided stool samples for H. pylori stool antigen within 3 days after endoscopy. The H. pylori‐infected patients were then randomized to receive either a 3‐ or 7‐day triple therapy for H. pylori eradication. Six weeks later, to evaluate the success of H. pylori eradication, patients received a follow‐up endoscopy and again provided stool samples for H. pylori stool antigen.Results. Seventy out of 108 patients, proven to have H. pylori infection, were evenly randomized into 3‐day and 7‐day therapy groups. The H. pylori eradication rates were similar between the 3‐day and 7‐day triple therapy (90.9 vs. 93.8%, p > .05). Before therapy, the H. pylori stool antigen was 93% sensitive and 100% specific to detect H. pylori. After therapy, H. pylori stool antigen remain 100% sensitive and 88.3% specific to detect the failure of eradication therapy.Conclusion. H. pylori stool antigen is a highly reliable tool to screen H. pylori infection before therapy and to assess the success of eradication therapy in partial gastrectomy patients. To eradicate H. pylori infection for patients with partial gastrectomy, the duration of triple therapy can be shortened.
Evaluation of a Western Blot Test, Helico Blot 2.1, in the Diagnosis of Helicobacter pylori Infection in a Pediatric Population
Authors: Oleastro Mónica , Matos Rita , Cabral José , Barros Rosa , Lopes Ana Isabel , Ramalho Paulo , Monteiro Lurdes 
Published: March 2003

AbstractBackground. Noninvasive diagnostic tests are useful as screening tools for Helicobacter pylori infection in pediatric populations. The aim of this study was to evaluate performance of the immunoblot assay, Helico Blot 2.1, for the diagnosis of H. pylori infection in symptomatic children.Materials and Methods. Immunoblot assay was used for detection of IgG antibodies to specific H. pylori proteins and to a recombinant H. pylori antigen, CIM marker. The study was performed on sera collected from 134 symptomatic, untreated children (mean age, 9.1 ± 3.2 years; range, 1–14 years). H. pylori infection status was determined by culture, histology and rapid urease test.Results. Immunoblot assay yielded a positive result in 71 of the 72 infected patients (sensitivity 98.6%) and in eight of the 62 noninfected ones (specificity 87.1%). The predictive values for a positive and a negative result were 89.9% and 98.2%, respectively. The performance of the CIM band alone, as a marker for H. pylori infection status, was also evaluated. This band was present on the blot of 71 infected patients and on four of the 62 H. pylori‐negative patients. The sensitivity, specificity, PPV and NPV of the CIM antigen were 98.6%, 93.5%, 94.7% and 98.3%, respectively.Conclusions. The immunoblot assay Helico Blot 2.1 is a suitable noninvasive test for the serodiagnosis of H. pylori infection in children. The good level of performance demonstrated by the novel recombinant antigen CIM suggests it may be a useful contribution to the qualitative and quantitative performance of the Helico Blot 2.1 in pediatric populations.
Impact of Furazolidone‐Based Quadruple Therapy for Eradication of Helicobacter pylori after Previous Treatment Failures
Authors: Treiber G. , Ammon S. , Malfertheiner P. , Klotz U. 
Published: March 2003

AbstractBackground. One week of quadruple therapy including metronidazole is recommended for Helicobacter pylori treatment failures after first line therapy regardless of resistance status. This study investigated whether a quadruple regimen containing furazolidone could be effective as a third‐line (salvage) therapy.Methods. All patients with previous H. pylori treatment failure after a clarithromycin‐metronidazole ± amoxicillin combination plus acid suppression were given lansoprazole 30 mg twice a day (bid), tripotassiumdicitratobismuthate 240 mg bid, tetracycline 1 g bid, metronidazole 400 mg (PPI‐B‐T‐M) three times a day (tid) for 1 week. In the case of treatment failure with this second‐line therapy, the same regimen was applied for 1 week except for using furazolidone 200 mg bid (PPI‐B‐T‐F) instead of metronidazole (sequential study design).Results. Eighteen consecutive patients were treated with PPI‐B‐T‐M. Eleven of those 18 remained H. pylori positive (38.9% cured). Pretherapeutic metronidazole resistance was associated with a lower probability of eradication success (10% vs. 75%, p= .04). Ten of these 11 patients agreed to be retreated by PPI‐B‐T‐F. Final cure of H. pylori with PPI‐B‐T‐F was achieved in 9/10 patients (90%) nonresponsive to PPI‐B‐T‐M.Conclusions. In the presence of metronidazole resistance, PPI‐B‐T‐M as a recommended second‐line therapy by the Maastricht consensus conference achieved unacceptable low cure rates in our metronidazole pretreated population. In this population, metronidazole based second‐line quadruple therapy may be best suited in case of a metronidazole‐free first line‐regimen (e.g. PPI‐clarithromycin‐amoxicillin) or a low prevalence of metronidazole resistance. Furazolidone in the PPI‐B‐T‐F combination does not have a cross‐resistance potential to metronidazole and is a promising salvage option after a failed PPI‐B‐T‐M regimen.
A Novel Method for Assessing Gastritis in the Murine Model Demonstrates Genetically Determined Variation in Response to Helicobacter felis Infection
Authors: Walker M. M. , Worku M. , Coggle S. , Thursz M. R. 
Published: March 2003

AbstractBackground. In murine Helicobacter infection it has been demonstrated that the degree of gastric mucosal inflammation is determined by mouse strain. This is a valuable tool for investigating genetic, immunological or bacterial determinants for the outcome of human Helicobacter infection. This study aims to devise a robust method to facilitate these investigations.Materials and Methods. C57BL/6, BALB/c and (C57BL/6 × BALB/c) F1 mice were given 108H. felis by gavage on days 1, 3 and 5 of the experiment Sections of the lesser and greater curve of stomach were examined at 12 weeks to assess active gastritis using a semi‐quantitative and a quantitative method by counting neutrophils in glands in four zones of the mucosa.Results. Semi‐quantitative scoring for active inflammation, based on the Sydney System, was inadequate with little discrimination between strains. Quantifying the level of active inflammation, counting the number of neutrophils in inflamed gastric glands and taking the total number of neutrophils in three inflamed pits within each zone (cardia, body, transitional zone and antrum) showed clear differences between the two parental strains for the degree of active gastritis and furthermore, using this system the phenotype of the (C57BL/6 × BALB/c) F1 was found to be between the two parental extremes.Conclusions. This novel method provides a numerical value for active inflammation in the stomach that is accurate, reproducible and discriminatory.
Helicobacter pylori Infection in Connective Tissue Disorders is Associated with High Levels of Antibodies to Mycobacterial hsp65 but not to Human hsp60
Authors: Kalabay László , Fekete Béla , Czirják László , Horváth Laura , Daha Mohamed R. , Veres Amarilla , Fónyad Gábor , Horváth Anna , Viczián Ágnes , Singh Mahavir , Hoffer Izabella , Füst George , Romics László , Prohászka Z. 
Published: March 2003

AbstractBackground. To investigate whether the Helicobacter pylori status influences levels of antibodies against mycobacterial heat shock protein (hsp) 65 and human hsp60 in systemic autoimmune diseases and to study the concentration of anti‐H. pylori antibodies in autoimmune patients and healthy controls.Materials and Methods. Antibodies against human heat‐shock protein hsp60, mycobacterial heat‐shock protein hsp65 were analyzed by ELISA. Anti‐Helicobacter antibodies were determined by enzyme immunoassay.Results. There was a markedly higher prevalence of H. pylori infection in undifferentiated connective tissue disease (82%) (n = 33) and systemic sclerosis (78%) (n = 55) but not in systemic lupus erythematosus (n = 49), polymyositis/dermatomyositis (n = 14), rheumatoid arthritis (n = 21) or primary Raynaud's syndrome (n = 26) compared with controls (59%) (n = 349). In autoimmune diseases H. pylori infection was associated with elevated levels of antihsp65 (p = .008) but not of antihsp60. Anti‐hsp65 levels were significantly higher in H. pylori‐infected (n = 129) than in uninfected patients (n = 69) (p = .0007).Conclusions. These findings indicate that in autoimmune diseases the infection with the H. pylori bacterium is associated with increased concentration of antimycobacterial hsp65.
The Effect of Epoetin alfa on Quality of Life in Anemic Cancer Patients
Authors: Cella David , Bron Dominique 
Published: March 2003

objectives: The purpose of this paper is to review evidence on the use of Epoetin alfa in the treatment of anemia associated with cancer treatment through a discussion of clinical and quality‐of‐life considerations.materials and methods: Cancer patients often experience fatigue, which leads to reduced quality of life. There are few effective treatments available to manage this potentially debilitating symptom, which can lead clinicians to become discouraged about treating fatigue. When cancer‐related fatigue is due to anemia, there are viable treatment options. This paper reviews the current management of anemia in cancer patients, with an emphasis on the use of recombinant human erythropoietin (Epoetin alfa).conclusions: Anemia can contribute to the reduced quality of life experienced by cancer patients. Blood transfusion, the traditional method of treating anemia, is effective and relatively inexpensive, but is associated with certain risks and is subject to limitations in blood supply. Epoetin alfa therapy provides healthcare providers with an effective alternative to blood transfusion, and trial results suggest that this intervention has a positive effect on patients' quality of life. The optimal starting and stopping points for therapy have not yet been determined. In practice, many physicians begin treatment when hemoglobin levels drop below 10 g/dL and stop when they rise above 13 g/dL, with a 75% dose reduction until completion of chemotherapy if hemoglobin again drops below 12 g/dL. Nonresponse (< 1 g/dL rise in hemoglobin) is met with dose increase at 4 weeks and discontinuation after 8 weeks. Controlled studies comparing anemia management via transfusion to the use of Epoetin alfa have not been done to date. Therefore, the relative cost‐effectiveness of Epoetin alfa, an effective but expensive intervention, remains unknown.
Patients' Sensations After Breast Cancer Surgery: A Pilot Study
Authors: Baron Roberta H. , Kelvin Joanne Frankel , Bookbinder Marilyn , Cramer Laura , Borgen Patrick I. , Thaler Howard T. 
Published: March 2003

Purpose: The purpose of this study was to obtain information about the prevalence and characteristics of breast sensations after breast cancer surgery, the impact they had on patients, and aggravating and relieving factors.description of Study: Within 1 month after the date of their surgery, 132 patients with breast cancer completed an instrument rating the prevalence, severity, and level of distress of breast sensations. Information also was obtained on the impact that those sensations had on activities of daily living and factors that triggered and provided relief from sensations.Results: Certain sensations remain prevalent (numb, tender), severe (burning, sharp), and distressing (cramping, painful). Overall these sensations significantly interfered with patients' activities of daily living. Certain activities (movement, position change) triggered sensations, while others (position change, medication) provided relief.clinical Implications: Healthcare professionals can use the information learned from this pilot study to educate patients both preoperatively and postoperatively about prevalent breast sensations after surgery for breast cancer and about the types of activities that may aggravate or relieve these sensations. As patient educators and advocates, oncology professionals must continue to explore the long‐term effects and treatment options to provide optimal care and support to patients who have or are likely to have postsurgical breast sensations. More studies are needed to explore long‐term effects and treatment options.
Clinical Trial Enrollment of Rural Patients with Cancer
Authors: Paskett Electra D. , Cooper M. Robert , Stark Nancy , Ricketts Thomas C. , Tropman Sara , Hatzell Teresa , Aldrich Tim , Atkins James 
Published: March 2003

purpose: The goal of this study was to examine the effect of a rural community clinical oncology program‐based cancer‐care intervention program that was launched to increase the number of rural patients with cancer enrolled in clinical trials.description of study: Five rural counties in eastern North Carolina served as intervention communities, and five rural counties in South Carolina served as the comparison region. The intervention counties used a rapid tumor‐reporting system, a nurse facilitator who identified and prompted oncologists to enter patients into clinical trials, a quarterly newsletter to primary‐care physicians about cancer treatment and clinical trials, and a health educator who focused on community‐wide education regarding cancer prevention, treatment, and clinical trial information. Outcomes included changes in knowledge and attitudes about clinical trials among the primary‐care providers who were surveyed and enrollment in clinical treatment trials for breast and colorectal cancer, as analyzed by comparing practice pattern data from before and after the intervention.results: The results indicate that the intervention was not effective. The proportion of primary‐care physicians who were aware of clinical trials for their patients with cancer rose slightly in comparison counties (26% to 34%) but remained constant (41% to 43%) in intervention counties. Perceived patient and actual physician barriers toward clinical trial participation were reported by the physicians. A minority of potentially eligible patients with breast or colon cancer in both North Carolina and South Carolina were enrolled in clinical trials.clinical implications: These data suggest that different types of interventions may be needed to improve accrual to cancer treatment trials in rural communities. In addition, the role that primary‐care providers play in encouraging patients with cancer to participate in clinical treatment trials needs further exploration.
Modularity, evolvability, and adaptive radiations: a comparison of the hemi‐ and holometabolous insects
Authors: Yang Andrew S. 
Published: March 2003

SUMMARY Despite recent attention given to the concept of modularity and its potential contribution to the evolvability of organisms, there has been little mention of how such a contribution may affect rates of diversification or how this would be assessed. A first key prediction is that lineages with relatively greater degrees of modularity in given traits should exhibit higher rates of diversification. Four general conditions for testing this prediction of the modular evolvability hypothesis are outlined here. The potential role of modularity as a deterministic factor in adaptive radiations is best examined by looking at historic patterns of diversification rather than just levels of extant diversity, the focus of most analyses of key innovations.Recent developmental evidence supports the notion that phenotypes of juvenile and adult stages of insects with “complete” metamorphosis (Holometabola) are distinct developmental and evolvable modules compared to the highly correlated life stages of insects with “incomplete” metamorphosis (Hemimetabola). Family‐level rates of diversification for these two groups were calculated from the fossil record. The Holometabola was found to have a significantly and characteristically higher rate of diversification compared to the less modular Hemimetabola, consistent with the idea that intrinsic differences in modularity can influence the long‐term evolvability of organisms.The modular evolvability hypothesis also makes a second key prediction: that characters in more modular clades will exhibit greater levels of variation due to their independence. This provides an independent, phenotypically based test of the hypothesis. We discuss here how this second prediction may be tested in the case of the Hemi‐ and Holometabola.
Ecosystem Health, Landscape Vulnerability, and Environmental Risk Assessment
Authors: Vilchek Gregory E. 
Published: March 2003

ABSTRACTEcosystem health is evaluated as an integrated assessment based on ecosystem stability, resilience, and vulnerability concepts. Special emphasis is focused on two dimensions in the ecosystem health concept: a geocentric approach (i.e., considering any impacts or interactions in terms of their effects on natural geosystems or ecosystems) which deals with assessment of natural ecosystems and their disturbance; and an anthropocentric approach, which concerns effects on human beings and human environment. Analysis of the relevant terminology leads to the development of a conceptual framework for ecosystem health. A suggested method of environmental risk assessment is based on ranking and merging into one criterion a series of individual estimates: bioresources abundance, biodiversity, ecosystem stability and resilience, and feedback effects of a disturbed environment on human beings and their activities.
Modelling the Temperature Sensitivity of Some Physiological Parameters of Epidemiologic Significance
Authors: Massad Eduardo , Forattini Oswaldo Paulo 
Published: March 2003

ABSTRACTAnthropogenic emissions of greenhouse gases are enhancing the natural greenhouse effect. It is almost universally accepted that this will lead to a warming of the earth’s surface. It is also accepted that this warming will lead to a spread of the insects that transmit several infections, currently restricted to the tropics, such as malaria, leishmaniasis, yellow fever, and dengue fever, among others. We calculated the expected increase in the density of female adult forms of anopheline mosquitoes by assuming temperature‐dependent functions on the rates of the mosquitoes life cycles. Other mosquito characteristics, such as the feeding interval, were also calculated as functions of environmental temperature. The resultant increase in the density of adult females as a function of the increase in temperature was related to an increase in malaria risk by the calculations of the basic reproductive ratio and the vectorial capacity, which permitted the application of the mathematical model for malarial transmission.
Gender, Risk, and Scientific Proceduralism
Authors: Boetzkes Elisabeth 
Published: March 2003

ABSTRACTIn this article, I consider the implications of gender differences for determining acceptable risk. Although often unacknowledged, values are ineradicable from risk identification, estimation, and acceptability. Because empirical studies, including some conducted by McMaster University’s Eco‐Research group, show significant gender differences in risk assessment, democratic decisions about acceptable risk must reflect the values of females as well as males. I argue that Kristin Shrader‐Frechette’s model of scientific proceduralism, modified to incorporate findings about gender differences, can contribute to fairness in decision‐making about risk. Furthermore, because females are more environmentally concerned than are males, especially at local levels, ecosystem health would be well‐served by decentralizing environmental decision‐making and ensuring gender representation.