bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced eradication of Helicobacter pylori by pre‐ versus post‐prandial amoxycillin suspension with omeprazole: implications for antibiotic delivery
Authors: ATHERTON J. C. , CULLEN D. J. E. , KIRK G. E. , HAWKEY C. J. , SPILLER R. C. 
Published: October 2003

Background: Strategies to improve antibiotic treatment of Helicobacter pylori infection are hampered by lack of knowledge about the route of antibiotic delivery. Post‐prandial dosing with antibiotics prolongs their gastric residence time and improves their intragastric distribution, leading to improved local delivery compared with pre‐prandial dosing. We aimed to assess whether pre‐ or post‐prandial dosing with amoxycillin suspension was more effective for H. pylori eradication in an amoxycillin/omeprazole regimen. Methods: Seventy‐nine patients with H. pylori infection were treated with omeprazole 40 mg o.m. for 28 days and amoxycillin suspension 500 mg q.d.s. for days 15–28, the amoxycillin being randomized to either 1 h before or immediately after food. Results: The H. pylori eradication rate, for those completing the trial, was 67% (22/33) when amoxycillin suspension was given pre‐prandially, compared with 39% (15/38) when it was given post‐prandially (P<0.05). Good compliance was achieved, with H. pylori eradication in 59% (28/46) of good compliers compared with 36% (9/25) of others completing the protocol (P<0.05). Conclusion: When given with omeprazole, pre‐prandial dosing with amoxycillin suspension is more effective for H. pylori eradication than post‐prandial dosing. This is consistent with the hypothesis that systemic rather than local delivery of amoxycillin is important for H. pylori eradication.
Long‐term follow‐up after cure of Helicobacter pylori infection with 4 days of quadruple therapy
Authors: LAI J. Y. L. , DE BOER W. A. , DRIESSEN W. M. M. , GEUSKENS L. M. 
Published: October 2003

Background: We have shown that 4 days of quadruple therapy after omeprazole pre‐treatment is an effective therapy for curing H. pylori infection. In this study we investigated whether this regimen would maintain the high cure rate during long‐term follow‐up. Some recent studies have reported high recurrence rates after apparent cure. Apparently not all methods to test for cure have sufficient sensitivity to pick up small numbers of residual bacteria. This study also served to investigate whether our methods to test for cure 5–6 weeks post‐treatment were reliable. Methods: All patients from a previous study were invited to return for a 14C‐urea breath test and serology. A representative group of 37 patients (76%) returned for a urea breath test and serology. The mean follow‐up was 14.7 months (range 11.4–23.6 months). Results: None of the 37 patients had a positive urea breath test result. IgG antibody titres fell steadily in all patients, showing a mean decrease of 83% at the end of the follow‐up. None of the patients showed an increase in titre. Reinfection was therefore 0% (0 of 37). Conclusion: Four days of quadruple therapy seems to be an effective therapy for the eradication of H. pylori as evidenced after long‐term follow‐up. Our biopsy methodology is reliable in identifying treatment failures 5–6 weeks post‐treatment.
Reflux symptom relief with omeprazole in patients without unequivocal oesophagitis
Authors: BATE C. M. , GRIFFIN S. M. , KEELING P. W. N. , AXON A. T. R. , DRONFIELD M. W. , CHAPMAN R. W. G. , O'DONOGHUE D. , CALAM J. , CROWE J. , MOUNTFORD R. A. , WATTS D. A. , TAYLOR M. D. , RICHARDSON P. D. I. 
Published: October 2003

Background: As many as 50% of patients with reflux symptoms have no endoscopic evidence of oesophagitis. This multicentre study was designed to assess symptom relief after omeprazole 20 mg once daily in patients with symptoms typical of gastro‐oesophageal reflux disease but without endoscopic evidence of oesophagitis. Methods: Patients (n=209) were randomized in a double‐blind study to receive either omeprazole 20 mg once daily (n=98) or placebo (n=111) for 4 weeks. Symptoms were assessed at clinic visits and using daily diary cards, with patient‐completed questionnaires providing additional data on symptoms and on psychological disturbance. Results: On completion, symptom relief favoured omeprazole: 57% of patients on omeprazole were free of heartburn (vs. 19% on placebo), 75% were free of regurgitation (47%) and 43% were completely asymptomatic (14%), each with P<0.0001. Fewer patients in the omeprazole group required alginate/antacid relief medication (P<0.05). Symptom relief (time to first heartburn‐free day) was more rapid with omeprazole (2 vs. 5 days on placebo; P<0.01). A greater reduction in anxiety occurred in the omeprazole group (P<0.05). Conclusion: Omeprazole 20 mg once daily is effective in providing relief of the symptoms typical of gastro‐oesophageal reflux disease in patients with essentially normal oesophageal mucosa.
Subcutaneously administered recombinant human β‐interferon in the treatment of chronic hepatitis B virus infection
Authors: GUAN R. , YEOH K. G. , YAP I. , KANG J. Y. , WEE A. , SMITH R. 
Published: October 2003

Background: Treatment of chronic replicative hepatitis B virus (HBV) infection is aimed at stopping viral replication and preventing the development of chronic liver disease. β‐Interferon treatment has been less well studied than α‐interferon. Methods: The efficacy and tolerability of a 6‐month course of subcutaneously administered human recombinant β‐interferon (rINF‐βser) was studied and the results of a low‐dose regime compared with a high‐dose regime. Twenty patients (17 men and three women), aged 24–54 years, with chronic hepatitis B virus infection (all hepatitis B surface antigen‐positive with detectable HBV‐DNA in their sera for at least 3 months prior to therapy) were randomized into two treatment groups of 10 patients each. The low‐dose group received 6×106 U/dose and the high‐dose group received 30×106 U/dose, both groups receiving their respective doses three times a week initially for 1 month and continuing for a total of 6 months. Results: The treatment was well tolerated in both groups. None of the patients required dosage reduction or cessation of treatment because of side‐effects. HBV‐DNA decreased in all patients during treatment, demonstrating the anti‐viral efficacy of rINF‐βser, and was undetectable in 20 and 40% of patients receiving low‐dose and high‐dose regimes, respectively, at the end of 6 months treatment (P=N.S.). One year after completion of treatment, HBV‐DNA was undetectable in 50 and 30% of patients in the low‐dose and high‐dose groups, respectively (P=N.S.). However, only one patient achieved seroconversion with loss of the hepatitis B surface antigen and appearance of an anti‐hepatitis B ‘e’ antigen at the end of 18 months. Conclusion: This study shows that subcutaneously administered rINF‐βser is well tolerated, but the optimal dose and duration of treatment still needs to be defined by further studies.
Early and late effects of low‐dose famotidine, ranitidine or placebo on pentagastrin‐stimulated gastric acid secretion in man
Authors: GRIMLEY C. E. , WEST J. M. , LOFT D. E. , COTTRELL J. , MANN S. G. , STAUFFER L. , NWOKOLO C. U. 
Published: October 2003

Background: There are no published comparative studies on the effect of low‐dose H2‐antagonists on pentagastrin‐stimulated gastric acid secretion. Methods: Twenty‐four healthy subjects were dosed with either famotidine 10 mg, ranitidine 75 mg or placebo in a balanced three‐period cross‐over design. The subjects were studied in groups of 12, simultaneously, under identical controlled environmental conditions. Gastric juice was aspirated in 15‐min aliquots during sub‐maximal (0.6 μg . h/kg) intravenous pentagastrin stimulation in the third and fourth hours (early period) and the eighth and ninth hours (late period) after oral dosing. The hydrogen ion (H+) content of gastric juice was measured ex vivo, by titrating to pH 7 known volumes of gastric aspirate against 0.1 m sodium hydroxide, using a versatile microprocessor‐controlled auto‐titration unit. Gastric acid output during the period of interest was calculated by adding the hydrogen ion content of 15‐min aliquots collected during that period. The geometric mean of the cumulative pentagastrin‐stimulated gastric acid output during the early and late periods was determined for the subjects dosed with either famotidine, ranitidine or placebo. Comparisons were performed by ANOVA. Results: During the early period (2–4 h post‐dose), when the subjects were given placebo, mean gastric acid output was 46.6 mmol, decreasing by 76% to 11.3 mmol (P<0.001) when treated with famotidine and by 76% to 11.1 mmol (P<0.001) when treated with ranitidine. During the late period (7–9 h post‐dose), when the subjects were dosed with placebo, mean gastric acid output was 41.2 mmol, decreasing by 38% to 25.7 mmol (P<0.001) when treated with famotidine and by 27% to 30.0 mmol (P=0.007) when treated with ranitidine. The difference between the inhibitory effects of famotidine and ranitidine on gastric acid output were non‐significant during either period. Conclusions: Low‐dose famotidine and ranitidine, intended for over‐the‐counter use, inhibit stimulated gastric acid secretion profoundly in the third and fourth hours after an oral dose. Modest effects are still detectable up to 9 h after dosing.
Effects of lansoprazole plus amoxycillin on the cure of Helicobacter pylori infection in Japanese peptic ulcer patients
Authors: KATO M. , ASAKA M. , KUDO M. , SUKEGAWA M. , KATAGIRI M. , KOSHIYAMA T. , KAGAYA H. , NISHIKAWA K. , HOKARI K. , TAKEDA H. , SUGIYAMA T. 
Published: October 2003

Aim: The effect of lansoprazole plus amoxycillin on curing Helicobacter pylori infection and peptic ulcer recurrence was evaluated. Method: The study group was composed of 68 patients with gastric ulcers and 51 with duodenal ulcers, all were H. pylori‐positive. The participants were assigned at random to the lansoprazole alone group (lansoprazole 30 mg o.m. for 6 or 8 weeks) or the lansoprazole plus amoxycillin group (lansoprazole alone regimen plus amoxycillin at 500 mg q.d.s. concomitantly for the first 2 weeks). Healed patients were not given maintenance treatment with acid secretion inhibitors. The cure rate for H. pylori infection and the ulcer recurrence rate after 1 year were investigated. Result: The cure rate for H. pylori infection was 4.2% in patients receiving lansoprazole alone and 38.5% in patients receiving lansoprazole plus amoxycillin (P< 0.01) for gastric ulcers, and 0% in patients receiving lansoprazole alone and 61.9% in patients receiving lansoprazole plus amoxycillin (P<0.001) for duodenal ulcers. The recurrence rate was 42.3% in patients receiving lansoprazole alone and 28.6% in patients receiving lansoprazole plus amoxycillin for gastric ulcers, and 66.7% for patients receiving lansoprazole alone and 11.1% for patients receiving lansoprazole plus amoxycillin (P<0.001) for duodenal ulcers. None of the patients with gastric or duodenal ulcers cured of H. pylori infection had a recurrence. Conclusion: Concomitant use of lansoprazole and amoxycillin increased the curative effects on H. pylori infection. However, the cure rates with this regimen remained inadequate.
Treatment of severe Crohn's disease with anti‐CD4 monoclonal antibody
Authors: CANVA‐DELCAMBRE V. , JACQUOT S. , ROBINET E. , LÉMANN M. , DROUET C. , LABALETTE M. , DESSAINT J.‐P. , ENGOUFA D. , RABIAN B, C. , MODIGLIANI R. , WIJDENES J. , REVILLARD J.‐P. , COLOMBEL J.‐F. 
Published: October 2003

Background: Monoclonal CD4 antibodies have been proposed as a new immunosuppressant drug in the treatment of inflammatory bowel disease. We report our experience of treatment with a monoclonal anti‐CD4 (B‐F5) antibody in severe refractory Crohn's disease. Methods: Twelve patients with severe refractory Crohn's disease were treated in an open clinical trial. B‐F5 was given intravenously at a dose of 0.5 mg.day/kg for 7 consecutive days (patients 1–8). For patients 9–12, B‐F5 was given at a dose of 0.5 mg.day/kg on the first day (day 0) and of 1 mg.day/kg on days 1–6. Follow‐up examinations were carried out at days 8, 15, 22 and 30. Endoscopic evaluation was performed on days 0 and 30 in eight of 12 patients. Results: Immediately after the first infusion, one patient had dyspnoea and tachycardia requiring cessation of the treatment. Among the 11 patients who received the complete course of treatment, two had prolonged clinical improvement and two had partial clinical improvement. Significant endoscopic improvement was observed in only one patient. No sustained depletion of CD4+ cells could be observed. Conclusion: In this uncontrolled open trial, monoclonal anti‐CD4 B‐F5 antibody was not successful in severe Crohn's disease.
Mebeverine alters small bowel motility in irritable bowel syndrome
Authors: EVANS P. R. , BAK Y.‐T. , KELLOW J. E. 
Published: October 2003

Background and Aim: Despite its widespread use in irritable bowel syndrome (IBS), limited clinical data exist on the effects of mebeverine hydrochloride on gastrointestinal motility. Human motor activity in the small bowel is more reproducible than that in the large bowel; therefore the aim of this study was to determine in the small bowel the effects of oral mebeverine in both IBS patients and in healthy controls. Methods: Twelve IBS patients (11 females/ 1 male, 46±13 years old)—predominant constipation (IBS‐C, n=6) and predominant diarrhoea (IBS‐D, n=6)—and six healthy controls, underwent continuous 48 h ambulant recording of small bowel motor activity. One low energy (400 kcal) and one high energy (800 kcal) standard meal were administered in each consecutive 24‐h period. Subjects received, in blinded fashion, placebo tablets in the first 24 h then mebeverine 135 mg q.d.s. in the second 24 h. Results: Mebeverine had no effect on parameters of small bowel motility in controls. In contrast, in both IBS‐C (P=0.01) and IBS‐D (P<0.05) patients, phase 2 motility index was increased during mebeverine administration. Also, after mebeverine the proportion of the migrating motor complex cycle occupied by phase 2 was reduced in IBS‐D (P=0.01), while phase 2 burst frequency was reduced in IBS‐C (P<0.05). For phase 3 motor activity in IBS‐C patients, the propagation velocity was decreased (P<0.01), and the duration increased (P<0.01). Conclusions: These findings suggest that mebeverine, in the initial dosing period, has a normalizing effect in the small bowel in IBS, enhancing contractile activity in a similar fashion to ‘prokinetic’ agents, as well as producing alterations in motor activity consistent with an ‘antispasmodic’ effect.
A randomized, placebo‐controlled trial of calcium supplementation for decreased bone density in corticosteroid‐using patients with inflammatory bowel disease: a pilot study
Authors: BERNSTEIN C. N. , SEEGER L. L. , ANTON P. A. , ARTINIAN L. , GEFFREY S. , GOODMAN W. , BELIN T. R. , SHANAHAN F. 
Published: October 2003

Background: Patients with inflammatory bowel disease (IBD) have a high prevalence of osteoporosis. A number of studies have found that corticosteroid use is associated with the development of osteoporosis in these patients. Calcium supplementation may be of benefit in corticosteroid‐induced osteoporosis and calcium may be a nutrient that patients with IBD lack. Aim: To test the benefit of calcium supplementation on bone density in a pilot study over a 1‐year period, in a group of corticosteroid‐using patients with IBD, in a randomized, double‐blind, placebo‐controlled treatment study. Methods: Corticosteroid‐using patients with IBD including males over the age of 18 years and premenopausal females, were randomized to receive either calcium carbonate 1000 mg plus vitamin D 250 IU (Oscal) or an identically matched placebo. Dual energy X‐ray absorptiometry measurements of bone density were obtained at entry and at 1 year. At entry, and every 3 months thereafter, serum was collected for the measurement of haemoglobin, biochemistry and bone hormones. Simultaneously a 24‐h urine collection was analysed for calcium excretion and creatinine clearance, and a 4‐day food record was collected to document dietary calcium and vitamin D ingestion. Results: We found a high prevalence of moderately severe decreased bone density in corticosteroid‐using patients with IBD. The dose of prednisone in the year prior to study entry was inversely correlated with bone density at the hip (R=‐0.67, P=0.004). At study entry serum osteocalcin was inversely correlated with corticosteroid dose in the year prior to the study (R=‐0.64, P=0.02) and at study end, directly correlated with the percentage change in spine bone density (R=0.59, P=0.01). The dietary calcium intake of these patients was close to the current RDA (recommended daily intake) for premenopausal, post‐adolescent adults. Calcium supplementation with small extra doses of vitamin D conferred no obvious benefit to bone density at the end of 1 year. There was no correlation between oral calcium ingestion and bone mass measurements. Both the treatment and placebo groups' bone density remained relatively stable at 1 year, suggesting that bone loss in corticosteroid‐using patients may peak early into the use of the corticosteroids. Conclusions: Calcium supplementation (1000 mg/day) conferred no significant benefit to bone density at 1 year in patients with corticosteroid‐using IBD patients with osteoporosis. Future investigations should explore other therapeutic avenues that may have greater effects on increasing bone density in patients who already have considerable osteoporosis.
Could oral erythromycin optimize high energy continuous enteral nutrition?
Authors: LANDRY C. , VIDON N. , SOGNI P. , NEPVEUX P. , CHAUMEIL J.‐C. , COUTURIER D. , CHAUSSADE S. 
Published: October 2003

Background: Intravenous erythromycin has previously been reported to stimulate gastric emptying, to inhibit gastric acid secretion and to stimulate pancreatic secretion during continuous gastric infusion of a liquid diet in healthy volunteers. Aim: The aim of this study was to evaluate the effects of oral erythromycin (160 mg/h) on gastrointestinal function under these conditions in seven healthy subjects. Method: This randomized double‐blind cross‐over study measured the gastric emptying rate of nutrients, gastric acid secretion, gastric pH, jejunal flow rate as well as biliopancreatic secretion and duodeno‐caecal transit time during a 19.9 kJ/min continuous infusion of a nutrient solution (4.18 kJ/mL) in the antrum over a 6‐h period by a perfusion method. Results: The nutrition was well tolerated except by one subject with placebo perfusion. During the 6‐h period, total gastric volume and gastric volume of nutrient decreased during erythromycin administration by 22±8 and 22±6%, respectively. Gastric acid secretion was not modified by erythromycin. Lipase and bile salt outputs were significantly higher with erythromycin. The duodeno‐caecal transit time was not statistically different with drug and placebo (169±15 and 146±19 min, respectively). Conclusion: During continuous gastric infusion of a liquid diet, the effect of oral erythromycin on gastric emptying could be useful to optimize cyclic enteral nutrition or to enhance the tolerance of enteral nutrition.
High‐dose proton pump inhibitor plus amoxycillin for the treatment or retreatment of Helicobacter pylori infection
Authors: MALATY H. , EL‐ZIMAITY H. M. T. , GENTA R. M. , COLE R. A. , GRAHAM D. Y. 
Published: October 2003

Background: The combination of 120 mg of omeprazole (40 mg t.d.s.) and amoxycillin has been reported to be effective for treating H. pylori infections. Methods: Normal volunteers with H. pylori infection received high‐dose omeprazole (40 mg t.d.s.) or lansoprazole (60 mg t.d.s.) plus amoxycillin 750 mg t.d.s. for 14 days. The studies were open label and not randomized as those receiving omeprazole plus amoxycillin had previously failed lower dose omeprazole (20 mg b.d.) plus amoxycillin therapy more than 6 months previously. Those receiving lansoprazole plus amoxycillin had not been previously treated. Four to 6 weeks after ending antimicrobial therapy, H. pylori status was determined by Genta stain of gastric mucosal biopsies. Results: Forty‐three volunteers entered the study and 41 completed it. The overall success with high‐dose proton pump inhibitor plus amoxycillin was 34.9%. For the individual regimens the per‐protocol results were 48% (95% CI=28–69%) with lansoprazole and 12.5% (95% CI=2–38%) with omeprazole. Compliance was >95% for both regimens. Side‐effects were experienced by four lansoprazole and three omeprazole subjects, and caused two omeprazole subjects to withdraw. Cure rates were similar among different races and ethnic groups, between men and women, and between smokers and non‐smokers. The level of the pre‐treatment urea breath test also did not predict outcome. Conclusion: High‐dose proton pump inhibitor plus amoxycillin combinations for treatment of H. pylori infection yielded unacceptable results, as the 95% confidence intervals did not include an 80% cure rate. These combinations do not yield consistent results worldwide and cannot be recommended as primary therapy.
Sucralfate and hydrocortisone enemas in the treatment of active ulcerative proctitis—a randomized single‐blind comparative study
Authors: ARDIZZONE S. , PETRILLO M. , ANTONACCI C. M. , BIANCHI PORRO G. 
Published: October 2003

Background: Sucralfate is a non‐absorbable aluminium salt of sucrose octasulphate which in recent studies has proved to be of possible use in the treatment of active distal ulcerative colitis. Aim: The aim of this randomized, single‐blind, study was to compare 10 g sucralfate with 100 mg hydrocortisone enemas in the treatment of 40 patients (26 male and 14 female; mean age 36.5 years, range 18–65 years) with active ulcerative proctitis, twice daily for 4 weeks. Methods: A clinical, sigmoidoscopic and histological assessment was performed before and 4 weeks after the start of the therapy. Results: Both treatments showed significant within‐treatment improvement in clinical, endoscopic and histological grades (Wilcoxon's matched pair test, P<0.05). Between‐treatment comparisons, using the Mann–Whitney test, showed that hydrocortisone is more effective than sucralfate in improving the clinical score (P<0.05). Conclusions: Sucralfate enema treatment, which was significantly less effective than hydrocortisone enemas in this study, has very limited use in the treatment of active ulcerative proctitis.