bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV‐infected patients
Authors: Carroccio A. , Guarino A. , Zuin G. , Verghi F. , Berni Canani R. , Fontana M. , Bruzzese E. , Montalto G. , Notarbartolo A. 
Published: March 2003

Background:Nutrient malabsorption is a negative prognostic factor in acquired immunodeficiency syndrome and recent studies have shown that pancreatic insufficiency is a codetermining factor of malabsorption.Aims:To evaluate the effectiveness of open‐label oral pancreatic enzyme supplementation therapy in acquired immunodeficiency syndrome patients with fat malabsorption.Patients and methods:Twenty‐four consecutive patients with human immunodeficiency virus infection and fat malabsorption were recruited (11 males, 13 females; median age, 9.1 years). Faecal fat loss was evaluated by steatocrit assay at entry to the study (T‐0), after 2 weeks (T‐1) without pancreatic enzyme treatment and after a further 2 weeks (T‐2) of treatment with pancreatic extracts (Creon 10 000 at a dose of 1000 units of lipase per gram of ingested dietary fat). Faecal elastase‐1 and chymotrypsin were assayed at entry.Results:Six patients (25%) had abnormally low elastase‐1 and/or chymotrypsin faecal concentration. In all patients, steatocrit values were elevated at both T‐0 and T‐1. Five patients proved intolerant to pancreatic enzyme treatment because of the onset of abdominal pain, and therapy was discontinued. In the 19 patients who concluded the study, steatocrit values during pancreatic enzyme treatment (T‐2) were significantly lower than at entry (P < 0.0001). At T‐2, in eight of 19 patients, steatocrit values were within the normal limit and the frequency of cases cured or improved on pancreatic enzyme therapy (at T‐2) was significantly higher than that observed during the previous study period without enzyme treatment (T‐1) (P < 0.01). A positive significant correlation was found between steatocrit values at entry and the Centers for Disease Control class (P < 0.0005); also, the decrease in steatocrit values during pancreatic enzyme therapy (difference between steatocrit value at T‐2 and steatocrit value at T‐0) positively correlated with the Centers for Disease Control class (P < 0.05).Conclusions:This pilot, open‐label study showed that pancreatic enzyme supplementation therapy is highly effective in reducing faecal fat loss in human immunodeficiency virus‐infected patients with nutrient malabsorption. Further double‐blind studies must be undertaken to verify these results and, if they are confirmed, pancreatic enzymes can be added to our weapons in the fight against human immunodeficiency virus‐associated nutrient malabsorption.
Heparin and low‐molecular‐weight heparin (enoxaparin) significantly ameliorate experimental colitis in rats
Authors: Dotan I. , Hershkoviz R. , Karmeli F. , Brazowski E. , Peled Y. , Rachmilewitz D. , Halpern Z. 
Published: March 2003

Background and aims:The anticoagulants, unfractionated heparin and low‐molecular‐weight heparin, demonstrated anti‐inflammatory effects in animal models and in humans. Because of its dual effects, high‐dose heparin was proposed as a therapeutic modality for ulcerative colitis. We investigated whether a low dose of low‐molecular‐weight heparin—enoxaparin (Clexane, Rhône‐Poulenc Rorer, France)—ameliorates the inflammatory response in two models of experimental colitis.Methods:Colitis was induced in rats by intrarectal administration of dinitrobenzene sulphonic acid. Enoxaparin (40, 80 and 200 μg/kg) or unfractionated heparin (100, 200 and 400 U/kg) were administered subcutaneously immediately after the induction of damage. Enoxaparin, 80 μg/kg, was also administered after induction of colitis by intrarectal administration of iodoacetamide. Rats were sacrificed 1, 3 or 7 days after induction of injury. Colonic damage was assessed macroscopically and histologically. Mucosal prostaglandin E2 generation, myeloperoxidase and nitric oxide synthase activities and tumour necrosis factor‐α levels in blood were determined.Results:Enoxaparin and heparin significantly ameliorated the severity of dinitrobenzene sulphonic acid‐ and iodoacetamide‐induced colitis as demonstrated by a decrease in mucosal lesion area, colonic weight and mucosal myeloperoxidase and nitric oxide synthase activities. The dose–response curve had a bell‐shaped configuration: enoxaparin, 80 μg/kg, and unfractionated heparin, 200 U/kg, were the optimal doses.Conclusions:Low‐dose enoxaparin and unfractionated heparin ameliorate the severity of experimental colitis. This effect is related to their anti‐inflammatory rather than anticoagulant properties.
Acid suppression in healthy subjects following lansoprazole or pantoprazole
Authors: Huang J.‐Q. , Goldwater D. R. , Thomson A. B. R. , Appelman S. A. , Sridhar S. , James C. F. , Chiu Y.‐L. , Pilmer B. L. , Keith R. G. , Hunt R. H. 
Published: March 2003

Aim:To compare the effect of lansoprazole, 30 mg once daily, with that of pantoprazole, 40 mg once daily, for the inhibition of gastric acid secretion.Methods:Two randomized, single‐blind, two‐way, crossover studies were conducted in 74 healthy male volunteers. Lansoprazole, 30 mg, or pantoprazole, 40 mg, was administered once daily for five consecutive days with at least a 2‐week washout period between regimens. Ambulatory 24‐h intragastric pH was recorded at baseline and on days 1 and 5 of each crossover treatment period.Results:On day 1 in both studies, lansoprazole, 30 mg, produced significantly higher mean 24‐h intragastric pH values when compared to pantoprazole, 40 mg (3.78 vs. 3.08, P < 0.001, and 3.97 vs. 3.20, P < 0.001, in the first and second studies, respectively). In both studies, lansoprazole, 30 mg, produced significantly greater proportions of time that the intragastric pH was above 3, 4 and 5 when compared with pantoprazole, 40 mg (P < 0.005 in all comparisons). By treatment day 5 in the first study, lansoprazole, 30 mg, continued to produce a higher mean 24‐h intragastric pH (4.15 vs. 3.91, P=0.014) and a significantly greater percentage of time that the intragastric pH was above 4 (63% vs. 56%, P=0.017) and 5 (41% vs. 30%, P < 0.001) when compared with pantoprazole, 40 mg. In the second study, the effects on intragastric pH were comparable between the two treatment groups. Headache was the most commonly reported adverse experience (nine lansoprazole‐treated subjects, seven in the first study and two in the second study; six pantoprazole‐treated subjects, five in the first study and one in the second study).Conclusions:Lansoprazole, 30 mg once daily, produces a faster onset and greater degree of acid inhibition than pantoprazole, 40 mg once daily. The implications for these differences on symptom relief and healing of erosive oesophagitis should be explored.
The cost‐effectiveness of population Helicobacter pylori screening and treatment: a Markov model using economic data from a randomized controlled trial
Authors: Mason J. , Axon A. T. R. , Forman D. , Duffett S. , Drummond M. , Crocombe W. , Feltbower R. , Mason S. , Brown J. , Moayyedi P. ,   (ON BEHALF OF THE LEEDS HELP STUDY GROUP)
Published: March 2003

Background:Economic models have suggested that population Helicobacter pylori screening and treatment may be a cost‐effective method of reducing mortality from gastric cancer. These models are conservative as they do not consider that the programme may reduce health service peptic ulcer and other dyspepsia costs. We have evaluated the economic impact of population H. pylori screening and treatment over 2 years in a randomized controlled trial and have incorporated the results into an economic model exploring the impact of H. pylori eradication on peptic ulcer disease and gastric cancer.Methods:Subjects between the ages of 40 and 49 years were randomly invited to attend their local primary care centre. H. pylori status was evaluated by 13C‐urea breath test and infected individuals were randomized to receive omeprazole, 20 mg b.d., clarithromycin, 250 mg b.d., and tinidazole, 500 mg b.d., for 7 days or identical placebos. Economic data on health service costs for dyspepsia were obtained from a primary care note review for the 2 years following randomization. These data were incorporated into a Markov model comparing population H. pylori screening and treatment with no intervention.Results:A total of 2329 of 8407 subjects were H. pylori positive: 1161 were randomized to receive eradication therapy and 1163 to receive placebo. The cost difference favoured the intervention group 2 years after randomization, but this did not reach statistical significance (£11.42 per subject cost saving; 95% confidence interval, £30.04 to – £7.19; P=0.23). Analysis by gender suggested a statistically significant dyspepsia cost saving in men (£27.17 per subject; 95% confidence interval, £50.01 to £4.32; P=0.02), with no benefit in women (– £4.46 per subject; 95% confidence interval, – £33.85 to £24.93). Modelling of these data suggested that population H. pylori screening and treatment for 1 000 000 45‐year‐olds would save over £6 000 000 and 1300 years of life. The programme would cost £14 200 per life year saved if the health service dyspepsia cost savings were the lower limit of the 95% confidence intervals and H. pylori eradication had only a 10% efficacy in reducing mortality from distal gastric cancer and peptic ulcer disease.Conclusions:Modelling suggests that population H. pylori screening and treatment are likely to be cost‐effective and could be the first cost‐neutral screening programme. This provides a further mandate for clinical trials to evaluate the efficacy of population H. pylori screening and treatment in preventing mortality from gastric cancer and peptic ulcer disease.
Dyspepsia tolerability from the patients' perspective: a comparison of celecoxib with diclofenac
Authors: Goldstein J. L. , Eisen G. M. , Burke T. A. , Peña B. M. , Lefkowith J. , Geis G. S. 
Published: March 2003

Aim:To compare celecoxib (800 mg/day, n=1997) with diclofenac (150 mg/day, n=1996) on dyspepsia‐related tolerability.Methods:In one of the two protocols comprising the Celecoxib Long‐Term Arthritis Safety Study, a randomized double‐blind trial, patients completed the Severity of Dyspepsia Assessment Questionnaire at baseline and at weeks 4, 13, 26 and 52 for the following three scales: Pain Intensity, Non‐Pain Symptoms and Satisfaction with Dyspepsia‐Related Health.Results:For the Pain Intensity scale, patients given diclofenac had significantly higher (worsening dyspepsia) mean changes, defined as follow‐up minus baseline, than patients given celecoxib (P < 0.001, at all assessments). The mean changes in the Pain Intensity scale (scale, 2–47; higher score is higher pain intensity) were 0.99 (95% confidence interval (CI): 0.50, 1.48) for celecoxib and 2.76 (95% CI: 2.28, 3.25) for diclofenac at 4 weeks. Satisfaction was superior with celecoxib at all assessments (P < 0.001). At 4 weeks, the mean changes in the Satisfaction scale (scale, 7–35; higher score is higher satisfaction) were 0.02 (95% CI: − 0.26, 0.29) for celecoxib and − 0.72 (95% CI: − 1.00, − 0.45) for diclofenac. Diclofenac patients had significantly higher Non‐Pain Symptoms at 4 weeks (P=0.005).Conclusions:Celecoxib, at two to four times the recommended dose, demonstrated a superior dyspepsia‐related tolerability and satisfaction compared with standard dosages of diclofenac.
Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro‐oesophageal reflux in patients with oesophagitis: a double‐blind, placebo‐controlled study
Authors: Pehlivanov N. , Sarosiek I. , Whitman R. , Olyaee M. , McCallum R. 
Published: March 2003

Aim:To investigate the effect of cisapride, a selective 5‐hydroxytryptamine‐4 receptor agonist, on the frequency of nocturnal transient lower oesophageal sphincter relaxations and oesophageal acid exposure in patients with gastro‐oesophageal reflux disease.Methods:In a double‐blind, placebo‐controlled study, 10 patients with gastro‐oesophageal reflux disease (six male and four female; mean age, 54 ± 10.4 years) were randomly assigned to 5‐day treatments with cisapride, 10 mg q.d.s., or placebo, separated by a 2‐day washout period before the treatment crossover. Sleep stages, lower oesophageal sphincter tone and oesophageal pH were monitored overnight at the end of each treatment regimen. Gastric emptying was assessed before treatment.Results:Cisapride decreased the frequency of transient lower oesophageal sphincter relaxations during sleep (1.2 ± 0.2/h vs. 2.7 ± 0.5/h with placebo; P=0.004) and oesophageal acid exposure (17.2 ± 9.9% with placebo vs. 7.2 ± 4.2% with cisapride; P=0.4). Cisapride increased lower oesophageal sphincter tone from 12.7 ± 2.8 mmHg with placebo to 16.9 ± 3.9 mmHg (P=0.03), and decreased heartburn episodes and antacid consumption. All patients had normal gastric retention data over 4 h.Conclusions:In patients with gastro‐oesophageal reflux disease, cisapride significantly decreased the frequency of transient lower oesophageal sphincter relaxations during sleep and increased lower oesophageal sphincter pressure without changing gastric emptying. We hypothesize, therefore, that 5‐hydroxytryptamine‐4 mechanisms are important in the control of transient lower oesophageal sphincter relaxations in humans.
Does withholding aspirin for one week reduce the risk of post‐sphincterotomy bleeding?
Authors: Hui C.‐K. , Lai K.‐C. , Yuen M.‐F. , Wong W.‐M. , Lam S.‐K. , Lai C.‐L. 
Published: March 2003

Background:Complications of endoscopic sphincterotomy are closely related to the endoscopic technique. To date, there have been no studies to indicate that aspirin increases the risk of bleeding after endoscopic sphincterotomy.Aim:To compare the incidence of post‐sphincterotomy bleeding in patients with and without prior aspirin therapy.Methods:Eight hundred and four patients were recruited into this retrospective study: 124 patients continued to take aspirin until the day of sphincterotomy (Group 1), 116 patients had their aspirin discontinued for 1 week before sphincterotomy (Group 2) and 564 patients had never taken aspirin (Group 3). The primary outcome analysed was the incidence of post‐sphincterotomy bleeding.Results:Sixty‐seven patients (8.3%) developed post‐sphincterotomy bleeding. The incidences of post‐sphincterotomy bleeding in Groups 1, 2 and 3 were 9.7%, 9.5% and 3.9%, respectively. Group 1 showed significantly increased post‐sphincterotomy bleeding when compared with Group 3 (P=0.01), and the risk was also significantly increased when Group 2 was compared with Group 3 (P=0.01). However, there was no significant difference in post‐sphincterotomy bleeding between Groups 1 and 2 (P=0.96).Conclusions:Aspirin therapy increased the risk of post‐sphincterotomy bleeding. Withholding aspirin for 1 week before endoscopic sphincterotomy did not seem to decrease the risk of post‐sphincterotomy bleeding.
Inguinal hernia is not a sign of colon cancer: results of a prospective screening trial
Authors: Avidan B. , Sonnenberg A. , Bhatia H. , Aranha G. , Schnell T. G. , Sontag S. J. 
Published: March 2003

Background:It has been suggested that patients with an inguinal hernia harbour an increased risk for colorectal cancer.Methods:In a prospective clinical trial, we compared the prevalence of colonic neoplasms in 100 cases with inguinal hernia and 100 controls without inguinal hernia. The number, size, histology type, and the location of all colorectal lesions found during a screening flexible sigmoidoscopy were recorded.Results:Not a single case of colorectal cancer was detected in the patients with inguinal hernia pending surgical repair. In the asymptomatic control subjects, one Dukes A and one Dukes B1 colon cancer were detected. Polypectomy was performed in 15% and 17% of the case and control subjects, respectively. During a 5‐year period following the initial screening procedure, none of the case or control subjects was diagnosed with colon cancer.Conclusions:The decision for or against performing an endoscopic procedure in a patient with inguinal hernia should be guided by the general principles of screening for colorectal cancer. The mere presence of an inguinal hernia does not automatically increase the risk of colorectal cancer.
Eradication of Helicobacter pylori may reduce disease severity in rheumatoid arthritis
Authors: Zentilin P. , Seriolo B. , Dulbecco P. , Caratto E. , Iiritano E. , Fasciolo D. , Bilardi C. , Mansi C. , Testa E. , Savarino V. 
Published: March 2003

SummaryBackground : A triggering infectious agent has long been postulated in rheumatoid arthritis. Data on the possible role of Helicobacter pylori infection are lacking.Aim : To assess the effect of H. pylori eradication in patients with rheumatoid arthritis.Methods : Fifty‐eight adult patients with established rheumatoid arthritis and dyspeptic symptoms were recruited — 28 were H. pylori‐positive and 30 were H. pylori‐negative on the basis of invasive tests. All infected patients were treated successfully. We evaluated the disease activity using clinical and laboratory parameters at baseline and every 4 months during 2 years, and compared the variations in the two subgroups.Results : H. pylori‐eradicated rheumatoid arthritis patients showed progressive improvement over time (P < 0.0001) of all clinical indices compared with baseline, whereas H. pylori‐negative rheumatoid arthritis patients remained substantially unchanged. After 2 years, H. pylori‐eradicated rheumatoid arthritis patients differed significantly (P < 0.04–0.0001) from patients without H. pylori infection in terms of improvement of all clinical parameters. At the same time point, several laboratory indices (erythrocyte sedimentation rate, fibrinogen, α2‐globulins and antinuclear antibody) showed significantly lower values (P < 0.02–0.0003) in the H. pylori‐eradicated subgroup compared to the H. pylori‐negative subgroup.Conclusions : Our data suggest that H. pylori infection is implicated in the pathogenesis of rheumatoid arthritis, in that its eradication may induce a significant improvement of disease activity over 24 months. H. pylori eradication seems to be advantageous in infected rheumatoid arthritis patients, but controlled studies are needed.
Systematic review: the effectiveness of budesonide therapy for Crohn's disease
Authors: Kane S. V. , Schoenfeld P. , Sandborn W. J. , Tremaine W. , Hofer T. , Feagan B. G. 
Published: March 2003

SummaryAim : To assess the effectiveness and safety of budesonide in comparison to corticosteroids, 5‐aminosalicylic acid (5‐ASA), or placebo for inducing remission of active Crohn's disease and for maintaining remission.Study selection criteria : Randomized controlled trials comparing budesonide to corticosteroids, 5‐ASA products or placebo were included. Trials had to report on the effectiveness of treatment (defined as decreasing or maintaining Crohn's Disease Activity Index, CDAI, scores ≤ 150) or adverse events.Data analysis : After assessing the validity of study design and independent, duplicate data extraction from selected trials, summary relative risks (RR) were calculated for each outcome. A test of heterogeneity was also calculated for each outcome using a random effects model.Results : Budesonide was more likely to induce remission than placebo (RR=1.82, 95% CI: 1.15–2.88) or 5‐ASA (RR=1.73, 95% CI: 1.26–2.39), although only one trial compared budesonide to 5‐ASA products. Although budesonide induced remission less frequently than conventional corticosteroids (RR=0.87, 95% CI: 0.76–0.995), there was no significant difference between conventional corticosteroids and budesonide for inducing remission among patients with a low disease activity (initial CDAI=200–300). Budesonide was significantly less likely to cause corticosteroid‐associated adverse events than conventional corticosteroids (RR=0.65, 95% CI: 0.53–0.80). No significant difference in total adverse events or corticosteroid‐associated adverse events was demonstrated between budesonide and 5‐ASA or placebo.Conclusion : Budesonide is significantly more effective than placebo or 5‐ASA for inducing remission of active Crohn's disease. Although budesonide is 13% less effective for the induction of remission in active Crohn's disease than conventional corticosteroids, it is less likely to cause corticosteroid‐related adverse effects. Budesonide is ineffective in maintaining remission.
The quality of life in patients with Crohn's disease
Authors: Cohen R. D. 
Published: March 2003

SUMMARYBackground : Health‐related quality of life studies provide insight into the influence of Crohn's disease on patients' lives, and the potential impact on professional and personal productivity.Aim : To compare health‐related quality of life in Crohn's disease patients with that in other patients and healthy controls, and between medically and surgically treated Crohn's disease patients, and to correlate health‐related quality of life with Crohn's disease activity.Methods : An expanded MEDLINE search of full length, English language, adult Crohn's disease studies from January 1966 to September 2000 was performed. The key words utilized were: ‘Quality of Life’, ‘Health Status’ or ‘Health Related Quality of Life’ and ‘Crohn’s' or ‘Inflammatory Bowel Disease’.Results : A total of 258 articles were identified; 236 subsequently were excluded, leaving 22 for analysis. Compared with Crohn's disease patients, the health‐related quality of life was better in healthy controls and in ulcerative colitis patients (except pre‐colectomy), but similar to or worse than that in many other medical conditions. The health‐related quality of life was directly correlated with Crohn's disease activity, and was worse in active disease than in remission. The health‐related quality of life was improved only in the short term in surgically vs. medically treated Crohn's disease patients.Conclusions : Health‐related quality of life analysis provides important insights into the impact of Crohn's disease, and should be included in clinical trials. Researchers, clinicians and other health care providers need to be cognizant of the impact of the health‐related quality of life upon patients' lives.
Efficacy of enzyme immunoassay for the detection of Helicobacter pylori antigens in frozen stool specimens: local validation
Authors: Yee Y. K. , Yip K. T. , Que T. L. , Chang K. K. , Li K. F. , Lee C. K. , Wong S. W. , Lau S. F. , Szeto M.L. 
Published: March 2003

SummaryAim : To investigate the efficacy of measurement of Helicobacter pylori stool antigen (HpSA) using stored frozen stool specimens, and to assess whether there were factors affecting efficacy in Hong Kong.Methods : Patients undergoing upper endoscopy at Tuen Mun Hospital were recruited. Stool samples were saved for HpSA testing and questionnaires were completed. Stool samples were frozen immediately upon receipt and stored at − 70 °C until tested. HpSA results were compared with rapid urease test and histology.Results : One hundred and eighty‐one patients were recruited. One hundred and seventy‐eight patients were suitable for analysis. Eighty‐three were H. pylori positive and 95 were H. pylori negative. The mean duration of storage of the stool samples was 120 days (range, 40–225 days). The sensitivity, specificity and positive and negative predictive values were 84.3%, 97.9%, 97.2% and 88.6%, respectively. In patients with a false negative HpSA test, there was a significant delay in collecting the stool specimen after endoscopy when compared with those with a true positive HpSA test (4.2 vs. 2.3 days; P < 0.05). However, the duration of storage of the specimens was not longer, and consumption of coffee or tea and smoking habits were similar.Conclusions : HpSA testing showed good sensitivity and specificity, even with frozen stool samples stored for up to 225 days. The efficacy was not affected by coffee, tea or smoking.