bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect ofLactobacillusingestion on the gastrointestinal mucosal barrier alterations induced by indometacin in humans
Authors: Gotteland M. , Cruchet S. , Verbeke S. 
Published: March 2003

Background:Chronic nonsteroidal anti‐inflammatory drug (NSAID) ingestion strongly affects the gastrointestinal mucosa as a first stage before ulceration. SomeLactobacillusstrains may stabilize the mucosal barrier by increasing mucin expression, reducing bacterial overgrowth, stimulating mucosal immunity and synthetizing antioxidant substances; these events are altered in NSAID‐associated gastroenteropathy.Aim:To determine whether ingestion of the probioticLactobacillusGG (LGG) protects the gastrointestinal mucosa against indometacin‐induced alterations of permeability.Subjects and methods:Four gastrointestinal permeability tests were carried out in random order in 16 healthy volunteers: (i) basal; (ii) after indometacin; (iii) after 5 days of living LGG ingestion before indometacin administration; (iv) after 5 days of heat‐killed LGG ingestion before indometacin administration.Results:Indometacin significantly increased basal sucrose urinary excretion (29.6 mg [17.1–42.1] vs. 108.5 mg [68.2–148.7],P=0.0030) (means [95% CI]) and lactulose/mannitol urinary excretion (1.03% [0.73–1.32] vs. 2.93% [1.96–3.90],P=0.00012). Heat‐killed LGG did not modify the indometacin‐induced increase of gastrointestinal permeability, while live bacteria significantly reduced the alteration of gastric (47.8 mg [31.1–64.6],P=0.012) but not intestinal permeability induced by NSAID.Conclusions:Regular ingestion of LGG protects the integrity of the gastric mucosal barrier against indometacin, but has no effect at the intestinal level.
Validation of a new immunoblot assay for the diagnosis of Helicobacter pylori in the Asian population
Authors: Leung W. K. , Chow T. P. , Ng E. K. W. , Chan F. K. L. , Chung S. C. S. , Sung J. J. Y. 
Published: March 2003

Background:Performance of commercial serological tests for Helicobacter pylori varies in different populations, largely due to strain heterogeneity and variations in antigenic preparations. Currently available serology tests often show sub‐optimal accuracy when used for Asian patients.Aim:This study evaluated a recombinant antigen‐based immunoblot for the diagnosis of H. pylori infection in Chinese patients, and compared it with a conventional ELISA test.Methods:Dyspeptic patients referred for diagnostic endoscopy were recruited. The gold standard for H. pylori infection was based on two or more positive results among rapid urease test, histology and 13C‐urea breath test. Serological diagnosis of H. pylori infection was conducted by an ELISA test (pylori DTect; Diagnostic Technology) and an immunoblotting against a novel recombinant antigen (C1S; Genelab), which was constructed by immunological screening of the genomic DNA library of H. pylori.Results:A total of 87 patients were evaluated and H. pylori infection was diagnosed in 40 (46%) by the reference tests. The sensitivities of the ELISA and immunoblot were 80% (95% CI: 64–91%) and 90% (95% CI: 76–97%), whilst the specificities were 96% (95% CI: 86–96%) and 87% (95% CI: 74–95%), respectively. The respective likelihood ratios of the two tests were 18.6 and 7.0.Conclusions:Satisfactory performance is obtained by the use of the new recombinant antigen‐based immunoblot for diagnosing H. pylori infection in Chinese patients.
Effect of food on the pharmacokinetics of budesonide controlled ileal release capsules in patients with active Crohn’s disease
Authors: Lundin P. , Naber T. , Nilsson M. , Edsbäcker S. 
Published: March 2003

Aim:To study the influence of food on the systemic availability of budesonide in patients with active Crohn’s disease.Methods:Eight patients with an established diagnosis of Crohn’s disease each received 9 mg budesonide controlled ileal release (CIR) capsules (Entocort capsules) orally on two separate occasions: once in a fasting state and once after a heavy breakfast. For reference, deuterium‐labelled (2H8) budesonide, 0.5 mg, was given intravenously. Plasma concentrations of budesonide and 2H8‐budesonide were determined for 12 h, and their pharmacokinetic parameters were calculated.Results:Average systemic availability of budesonide during fasting conditions was 10.7%, area under the curve was 27.5 nmol/L × h and peak plasma concentration was 4.1 nmol/L. Corresponding postprandial values were 13.2%, 27.0 nmol/L × h and 3.8 nmol/L. Food increased the mean absorption time from 4.5 to 6.8 h (P=0.0012). Body clearance of budesonide was about 25% higher after eating (P=0.0015).Conclusions:Food had little influence on systemic availability and peak plasma concentrations of budesonide administered in CIR capsules. Absorption was retarded postprandially, likely due to delayed gastric emptying. Budesonide in CIR capsules can be administered at the same dose regardless of prandial status in patients with Crohn’s disease.
Changing patterns of sedation use for routine out‐patient diagnostic gastroscopy between 1989 and 1998
Authors: Mulcahy H. E. , Hennessy E. , Connor P. , Rhodes B. , Patchett S. E. , Farthing M. J. G. , Fairclough P. D. 
Published: March 2003

Background:Knowledge of sedation trends for upper gastrointestinal endoscopy is important for health service planning, particularly in view of rapidly increasing demands on endoscopy services. However, no data are available on sedation trends in Britain over the past 10 years.Aim:To determine sedation use for routine gastroscopy in a single endoscopy unit between 1989 and 1998.Methods:This was a retrospective study of 9795 consecutive adults (mean age 56 years, range 18–100 years; 4512 females) who had undergone a gastroscopy between 1989 and 1998. Clinical, pharmacological and endoscopic data were retrieved from a computerized database.Results:Over the 10‐year study period, the sedation rate remained constant for patients undergoing therapeutic endoscopy (P=0.99) and those undergoing in‐patient diagnostic examinations (P=0.63). In contrast, the sedation rate for out‐patient diagnostic endoscopy decreased by 54%, from a high of 70% in 1990 to 32% in 1998 (P < 0.0001). Logistic regression analysis showed that the decline in sedation use was greater in females (P < 0.0001) than males and in procedures performed by non‐consultant compared to consultant staff (P=0.01).Conclusions:If our results form part of a national trend, they will have important implications for cardiopulmonary monitoring strategies, recovery room practices and for complication rates due to the use of sedation for upper gastrointestinal endoscopy.
Sildenafil inhibits gastroduodenal motility
Authors: Bortolotti M. , Mari C. , Lopilato C. , La Rovere L. , Miglioli M. 
Published: March 2003

Background:Sildenafil shows an intense and prolonged inhibitory effect on the smooth muscle cells of corpus cavernosum arterioles by blocking phosphodiesterase‐type 5, which inactivates the nitric oxide‐stimulated cyclic guanosine monophosphate.Aim:To investigate whether this inhibitory effect is also displayed on the musculature of the gastroduodenal tract.Methods:In 16 normal subjects, antroduodenal motility was recorded by means of a low‐compliance manometric system. Ten minutes after the appearance of a phase III of the migrating motor complex, a tablet of sildenafil 50 mg, dissolved in 20 mL of water, was infused in the gut of eight patients, or a placebo in the other eight patients, randomly and in a double‐blind manner, continuing the recording for 90 min. The frequency and amplitude of antral and duodenal waves, measured during the first 60 min after infusion in the two groups, were compared statistically. In addition, the duration of antral and duodenal phases I, and the number of phases III occurring during the whole 90 min after infusion, were compared in the two groups.Results:Antral and duodenal wave frequency and amplitude were significantly lower during the first 60 min after sildenafil administration. Both antral and duodenal phases I were significantly longer after sildenafil than after placebo, and the number of phases III which occurred during the 90 min after sildenafil was significantly lower than after placebo.Conclusions:Sildenafil inhibits interdigestive motor activity of the antrum and duodenum.
Five‐day proton pump inhibitor‐based quadruple therapy regimen is more effective than 7‐day triple therapy regimen for Helicobacter pylori infection
Authors: Nagahara A. , Miwa H. , Yamada T. , Kurosawa A. , Ohkura R. , Sato N. 
Published: March 2003

Background:There have been no reports that describe whether 5‐day quadruple therapy (rabeprazole + amoxicillin + clarithromycin + metronidazole; RACM) could substitute for standard 7‐day triple therapy as a first‐line therapy for Helicobacter pylori.Patients and methods:This study was designed as a randomized prospective single centre study. A total of 160 H. pylori‐positive patients who had not received therapy were given either a 5‐day RACM regimen (n=80, rabeprazole 20 mg b.d., amoxicillin 750 mg b.d., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d.) or a 7‐day RAC regimen (n=80, rabeprazole 20 mg b.d., amoxicillin 750 mg b.d. and clarithromycin 200 mg b.d.). Cure of the infection was assessed by a 13C urea breath test 1 month after the completion of therapy.Results:The eradication rates of the 5‐day RACM regimen and the 7‐day RAC regimen were 93% (95% CI: 84–97%) and 81% (95% CI: 71–89%) by intention‐to‐treat analysis, 94% (95% CI: 86–98%) and 83% (95% CI: 73–91%) by all‐patients‐treated analysis analysis and 95% (95% CI: 87–98%; P < 0.05) and 82% (95% CI: 72–90%) by per protocol analysis, respectively. No serious adverse effect was observed, and 99% of the patients reported complete compliance.Conclusions:The cure rate of the 5‐day RACM regimen was more effective than the 7‐day RAC regimen, suggesting that this regimen could be preferable as a first‐line therapy for H. pylori infection.
Clarithromycin vs. furazolidone in quadruple therapy regimens for the treatment of Helicobacter pylori in a population with a high metronidazole resistance rate
Authors: Fakheri H. , Malekzadeh R. , Merat S. , Khatibian M. , Fazel A. , Alizadeh B. Z. , Massarrat S. 
Published: March 2003

Background:The eradication of Helicobacter pylori plays a pivotal role in the treatment of peptic ulcer disease. Metronidazole resistance, common in Iran, is claimed to be a major reason for the failure of metronidazole‐containing regimens. Both clarithromycin and furazolidone are potential alternatives for metronidazole.Aim:To assess and compare the effectiveness of clarithromycin‐ and furazolidone‐based regimens in eradicating H. pylori in a population with a high metronidazole resistance rate.Methods:Patients with proven duodenal ulcer and H. pylori infection were randomly assigned to one of two groups. The patients received 2 weeks of omeprazole 20 mg b.d., amoxicillin 1000 mg b.d, bismuth subcitrate 240 mg b.d. and either clarithromycin 500 mg b.d. (the OABC group) or furazolidone 200 mg b.d. (the OABF group).Results:A total of 118 patients were randomized, 55 in the OABC group and 63 in the OABF group. The intention‐to‐treat eradication rate was 84% and 85% for the OABF and OABC groups, respectively. The per protocol eradication rates were 90% for both groups.Conclusions:OABC and OABF are both effective in eradicating H. pylori in areas where metronidazole resistance is a problem. OABF is a good alternative in the face of growing resistance to clarithromycin in developed countries, and is attractive for developing countries where clarithromycin is not readily available.
Colonic motility in chronic ulcerative proctosigmoiditis and the effects of nicotine on colonic motility in patients and healthy subjects
Authors: Coulie B. , Camilleri M. , Bharucha A. E. , Sandborn W. J. , Burton D. 
Published: March 2003

Background:Nicotine decreases diarrhoea and pain in ulcerative colitis without reducing inflammation.Aims:(i) To evaluate the effect of ulcerative proctosigmoiditis on motor functions of an uninflamed segment of descending colon; and (ii) to assess nicotine’s effects on colonic motor functions in patients and healthy subjects.Methods:In healthy subjects (n=30) and patients with ulcerative colitis (13; 11 active, two quiescent colitis), we studied the effects of intravenous nicotine on colonic transit of solid residue by scintigraphy (healthy subjects) and on colonic motility in healthy subjects and 11 patients.Results:In ulcerative colitis, fasting colonic motility was increased, whereas motor response to a meal was significantly reduced; compliance was unchanged. In healthy subjects, high‐dose nicotine induced transient high amplitude propagated contractions and relaxation of the descending colon followed by decreased phasic contractions. This dose also accelerated colonic transit. Low‐dose nicotine (mimicking a transdermal nicotine patch) reduced colonic compliance in healthy subjects, but did not affect motor function in ulcerative colitis.Conclusions:Ulcerative proctosigmoiditis increases fasting colonic motility and reduces tone response to a meal in the descending colon without affecting colonic compliance, suggesting changes in physiological responses but not intrinsic wall properties. Nicotine has dose‐dependent effects on colonic motor activity in healthy subjects.
Polaprezinc attenuates the Helicobacter pylori‐induced gastric mucosal leucocyte activation in Mongolian gerbils—a study using intravital videomicroscopy
Authors: Suzuki H. , Mori M. , Seto K. , Miyazawa M. , Kai A. , Suematsu M. , Yoneta T. , Miura S. , Ishii H. 
Published: March 2003

Background:We previously demonstrated that Helicobacter pylori colonization evokes gastric mucosal inflammation and an extensive increase in lipid peroxides and glutathione in Mongolian gerbils. Zinc and its derivative, polaprezinc, have been reported to be potent antioxidants in gastric mucosa.Aim:To examine the effect of polaprezinc on gastric mucosal oxidative inflammation in H. pylori‐colonized Mongolian gerbils.Methods:Sixty‐eight male Mongolian gerbils were orally inoculated with H. pylori (ATCC43504, 5 × 108 CFUs/gerbil; H. pylori group) and 35 gerbils were inoculated with the culture media (control group). Twenty‐two gerbils in the H. pylori and 13 gerbils in the control group were fed with diets containing polaprezinc (0.06%, 100 mg/kg, 10 times the usual clinical dose) (H. pylori + polaprezinc group, polaprezinc group). The remaining gerbils were fed a standard laboratory chow diet. Neutrophil infiltration, assessed histologically and by the activity of myeloperoxidase, the contents of CXC‐chemokine (GRO/CINC‐1‐like protein) and the contents of thiobarbituric acid‐reactive substances, was evaluated in each group 12 weeks after the inoculation. Separately, gastric mucosal leucocyte activation and capillary perfusion were also assessed using intravital microscopy 2, 4, 8 and 12 weeks after the inoculation.Results:In all H. pylori‐inoculated animals, the bacterial infection persisted throughout the experimental period. Gastric mucosal lesion formation in the H. pylori group was significantly inhibited in the H. pylori + polaprezinc group. Elevated levels of myeloperoxidase activity, GRO/CINC‐1 and thiobarbituric acid‐reactive substances in the H. pylori group at 12 weeks were attenuated significantly by polaprezinc treatment. Enhanced levels of venular leucocyte activation observed in the H. pylori group were attenuated significantly in the H. pylori + polaprezinc group during both the early phase (2 weeks) and late phase (12 weeks).Conclusion:Polaprezinc inhibited H. pylori‐associated gastric mucosal oxidative inflammation, including initial micro‐vascular leucocyte activation, in Mongolian gerbils.
Erythromycin as a prokinetic agent in infants and children
Authors: Curry J. I. , Lander T. D. , Stringer M. D. 
Published: March 2003

Erythromycin has been used as an antibiotic for more than four decades, but only in the last 10 years have other therapeutic benefits of this agent been exploited. Animal and human studies have demonstrated a prokinetic effect on the gastrointestinal tract at sub‐antimicrobial doses (typically a quarter or less of the antibiotic dose). A limited number of studies have been performed in children to investigate this action. A review of this literature is particularly pertinent given the frequency of clinical problems related to gastrointestinal dysmotility in children and the limited availability of prokinetic agents in paediatric practice, compounded by the recent withdrawal of cisapride.The prokinetic effects of erythromycin have been investigated in infants with dysmotility associated with prematurity, in low birth‐weight infants recovering from abdominal surgery, and in older children with a variety of other gastrointestinal disorders. Only one randomized placebo‐controlled trial has been conducted. All except one of these studies have shown a beneficial effect of erythromycin in either promoting tolerance of enteral feeds or enhancing a measured index of gastrointestinal motility. Erythromycin appears to be equally effective when given orally (as ethylsuccinate or estolate) or intravenously (as lactobionate). Significantly, no serious adverse effects have been reported in studies in which erythromycin has been used for its prokinetic effects, although fatal reactions have followed the intravenous administration of erythromycin to neonates in antibiotic doses.
Colon cleansing preparation for gastrointestinal procedures
Authors: Toledo T. K. , Dipalma J. A. 
Published: March 2003

Adequate cleansing is essential for reliable diagnostic and surgical colon procedures. Accuracy and safety depend on good preparation. Patient compliance is enhanced by simplicity and well‐tolerated methods.Several methods are available. Diet and cathartic regimens utilize clear liquids or diets designed to leave a minimal colonic residue. Laxatives, cathartics and enemas are employed. Gut lavage solutions are osmotically balanced electrolyte lavage products. Oral sodium phosphate solutions and tablets are available and are attractive because of good efficacy with a small volume of administration.For colonoscopy and colon surgery preparation, these methods have been proven safe and effective. For barium enema X‐ray, lavage requires an adjunctive agent such as bisacodyl to enhance barium coating. Overall, all regimens are well‐tolerated.This review discusses the development and clinical experience with various colon cleansing regimens.
Control of intragastric pH with omeprazole 20 mg, omeprazole 40 mg and lansoprazole 30 mg
Authors: Katz P. O. , Xue S. , Castell D. O. 
Published: March 2003

Background:Single daily doses of proton pump inhibitors, omeprazole and lansoprazole provide effective acid suppression and equal healing and symptom relief in patients with GERD. Despite this, controversy exists as to the efficacy of available proton pump inhibitors in the control of gastric acidity.Aim:To assess the efficacy of omeprazole 20 mg vs. lansoprazole 30 mg and omeprazole 40 mg vs. lansoprazole 30 mg in intragastric pH control.Methods:Study I: 12 Helicobacter pylori‐negative volunteers (mean age 33 years) were treated with omeprazole 20 mg and lansoprazole 30 mg in random order before breakfast for 7 days. Study II: 24 subjects (mean age 36 years) were similarly treated with omeprazole 40 mg and lansoprazole 30 mg for 7 days after a baseline pH study. One week washout was allowed between studies. Subjects had the same meal on each study day. On day seven, a 24‐h intragastric pH study was performed. The percentage time for which gastric pH > 4 was analysed (Gastrosoft, Synectics Medical Inc.) and expressed as mean ± s.d.Results:(1) Omeprazole 20 mg and lansoprazole 30 mg showed no significant difference in the percentage time for which gastric pH > 4 in the daytime and night‐time periods. (2) The percentage time for which pH > 4 with omeprazole 40 mg was significantly greater than lansoprazole 30 mg in both daytime (61 ± 19% vs. 48 ± 14%, P < 0.001), and night‐time periods (34 ± 21% vs. 26 ± 14%, P < 0.05). (3) A large inter‐subject variation existed in both studies. (4) In 10 subjects who participated in both studies, omeprazole 40 mg showed a significantly higher percentage time for which pH > 4 in the daytime (69 ± 18% vs. 51 ± 15%, P=0.015) than omeprazole 20 mg.Conclusion:These pH data support the therapeutic equivalency of FDA approved doses of omeprazole and lansoprazole.
The effect of Helicobacter pylori eradication therapy on dyspepsia symptoms in industrial workers in Japan
Authors: Azuma T. , Ito Y. , Suto H. , Ohtani M. , Dojo M. , Muramatsu A. , Kuriyama M. , Kato T. 
Published: March 2003

Background:The relationship between Helicobacter pylori infection and non‐ulcer dyspepsia is still controversial. The potential benefits and risks of the treatment could depend on local conditions, such as the prevalence of the infection and the local rates of gastric cancer.Aim:To evaluate the effects of H. pylori eradication therapy on non‐ulcer dyspepsia symptoms in industrial workers in Japan.Methods:A total of 615 employees of an industrial corporation were examined for H. pylori infection and symptom scores; 215 H. pylori‐positive non‐ulcer dyspepsia cases underwent eradication therapy. Symptom scores were also analysed 12 months after the eradication therapy. Serum pepsinogen A and pepsinogen C levels were analysed and chronic atrophic gastritis was serologically diagnosed on the basis of the criteria of a pepsinogen A < 70 ng/mL and pepsinogen A : pepsinogen C ratio < 3.0.Results:The symptom score improved significantly in the cured cases, but not in the non‐cured cases. The effect of the cure of H. pylori infection on symptoms was analysed according to the serological diagnosis of chronic atrophic gastritis. In both groups, cases with atrophic gastritis and cases with chronic gastritis only, the cure of infection was effective in improving symptoms.Conclusion:The cure of H. pylori infection was effective in reducing non‐ulcer dyspepsia symptoms in industrial workers in Japan.