bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minor effects of Helicobacter pylori on gastric secretion and dose of lansoprazole during long‐term treatment in ZE and non‐ZE acid hypersecretors
Authors: Hirschowitz B. I. , Simmons J. , Mohnen J. 
Published: March 2003

Background: Helicobacter pylori infection may increase or decrease acid secretion and may augment proton pump inhibitor efficacy. Pepsin effects have not been reported. In Zollinger–Ellison syndrome (ZE) specifically, H. pylori has been reported to decrease acid.Aim:To examine H. pylori effects on secretion and dose of medication in hypersecretors (basal acid output > 15 mmol/h) undergoing long‐term treatment with individually optimized lansoprazole doses.Methods:Sixty‐five patients (47 ZE and 18 non‐ZE), treated for > 3 months to 10 years, were tested every 6 months with endoscopy, gastric analysis and serum gastrin.Results:Forty‐three per cent were H. pylori‐positive. Acid, pepsin and gastrin were not different between H. pylori‐positive and H. pylori‐negative patients before or during long‐term lansoprazole treatment. Initially, H. pylori‐positive patients required less lansoprazole than H. pylori‐negative patients (68 ± 6 vs. 96 ± 8 mg/day), but after 3 years the doses converged (83 vs. 86 mg/day). The disappearance of H. pylori in 15 patients caused no significant changes in acid, pepsin, gastrin or lansoprazole dose in the following 4 years.Conclusions: H. pylori had no significant initial or long‐term physiological or potential clinical effects on acid or pepsin secretion or gastrin in these acid hypersecretors.
Relevance of thiopurine methyltransferase activity in inflammatory bowel disease patients maintained on low‐dose azathioprine
Authors: Campbell S. , Kingstone K. , Ghosh S. 
Published: March 2003

Background:It is well‐recognized that patients with low thiopurine methyltransferase activity are more susceptible to the development of bone marrow suppression side‐effects.Aim:To study the impact of thiopurine methyltransferase activity on the clinical course of inflammatory bowel disease patients treated with low‐dose azathioprine (< 2 mg/kg).Methods:We measured the thiopurine methyltransferase activity of blood samples from 113 inflammatory bowel disease patients who were taking azathiopurine, had discontinued azathioprine because of side‐effects, or had never taken azathioprine. The thiopurine methyltransferase activity was compared with that of 17 healthy controls. Relapse rates and time to first relapse were compared in inflammatory bowel disease patients and stratified according to their thiopurine methyltransferase activity.Results:Patients who became neutropenic had a significantly lower mean thiopurine methyltransferase activity than that of patients who developed other side‐effects (analysis of variance, P < 0.05). Survival curves were constructed (time to first relapse) for patients treated with low‐dose azathioprine for thiopurine methyltransferase activities of < 20 and > 20 nmol/mL red blood cells/h. There was a significantly lower number of relapses in inflammatory bowel disease patients with lower thiopurine methyltransferase levels (P < 0.05).Conclusions:The mean thiopurine methyltransferase activity was significantly lower in patients on a low dose of azathioprine in remission compared with those who relapsed. The thiopurine methyltransferase activity was significantly lower in patients who discontinued azathioprine due to neutropenia than in those who discontinued due to other side‐effects.
Helicobacter pylori and dyspepsia: physicians' attitudes, clinical practice, and prescribing habits
Authors: O'Connor H. J. 
Published: March 2003

Background:Consensus guidelines have been published on the management of Helicobacter pylori infection and it is assumed that these guidelines are adhered to in clinical practice.Aim:To assess the changing attitudes of medical practitioners to H. pylori, and the impact of H. pylori infection on everyday clinical practice and prescribing patterns.Methods:Data for this review were gathered up to December 2000 from detailed review of medical journals, the biomedical database MEDLINE, and relevant abstracts.Results:Physician surveys show widespread acceptance of H. pylori as a causal agent in peptic ulcer disease. Gastroenterologists adopted H. pylori therapy for peptic ulcer earlier and more comprehensively than primary care physicians. Despite a low level of belief in H. pylori as a causal agent in nonulcer dyspepsia and gastro‐oesophageal reflux disease (GERD), H. pylori therapy is widely prescribed for these conditions. Proton pump inhibitor‐based triple therapy is the eradication regimen of choice by all physician groups. In routine clinical practice, there appears to be significant under‐treatment of peptic ulcer disease with H. pylori therapy, but extensive use for nonulcer indications. Prescription of H. pylori treatment regimens of doubtful efficacy appears commonplace, and are more likely in primary care. Despite the advent of H. pylori therapy, the prescription of antisecretory therapy, particularly of proton pump inhibitors, continues to rise.Conclusions:Publication of consensus guidelines per se is not enough to ensure optimal management of H. pylori infection. Innovative and ongoing educational measures are needed to encourage best practice in relation to H. pylori infection. These measures might be best directed at primary care, where the majority of dyspepsia is managed.
Different effects of short‐term omeprazole, lansoprazole or pantoprazole on the accuracy of the 13C‐urea breath test
Authors: Parente F. , Sainaghi M. , Sangaletti O. , Imbesi V. , Maconi G. , Anderloni A. , Bianchi Porro G. 
Published: March 2003

Background:Proton pump inhibitors may interfere with the accuracy of the 13C‐urea breath test, but little information is available on the effect of standard doses of various proton pump inhibitors on this test.Aim:To evaluate the effect of short‐term standard doses of omeprazole, lansoprazole and pantoprazole on the accuracy of the standardized 13C‐urea breath test.Methods:A total of 124 patients with Helicobacter pylori infection, diagnosed on the basis of gastric histology, rapid urease test and 13C‐urea breath test, were studied. These patients received omeprazole, 20 mg/day, lansoprazole, 30 mg/day, or pantoprazole, 40 mg/day, for 2 weeks according to a randomized protocol. 13C‐Urea breath test was repeated on days 4, 7 and 14 while on therapy and 7 days after proton pump inhibitor withdrawal.Results:Of the patients receiving omeprazole and lansoprazole, 30% (12/40) and 20% (8/41), respectively, became 13C‐urea breath test negative during therapy, compared with none of the 42 patients treated with pantoprazole (P < 0.05). All the false negative 13C‐urea breath test results returned to positive within 1 week of drug withdrawal, with a mean recovery to 84.7 ± 15.6% of baseline δ13CO2.Conclusions:Short‐term omeprazole and lansoprazole interfere with the 13C‐urea breath test, although a return to positive test results invariably occurs within 1 week of proton pump inhibitor withdrawal. In contrast, the accuracy of the 13C‐urea breath test does not appear to be significantly impaired by short‐term pantoprazole, which therefore may not necessarily be withdrawn before this test.
A randomized trial of high‐dose interferon alpha‐2b, with or without ribavirin, in chronic hepatitis C patients who have not responded to standard dose interferon
Authors: Malik A. H. , Kumar K. S. , Malet P. F. , Ostapowicz G. , Adams G. , Wood M. , Yarbrough K. , Jones A. , Lee W. M. 
Published: March 2003

Background:Conventional interferon monotherapy fails to achieve virological clearance in most hepatitis C‐infected patients. The use of high‐dose induction regimens may improve the initial clearance of virus, while the addition of ribavirin appears to improve the rates of sustained response once clearance is achieved.Aim:To compare the efficacy and safety of re‐treatment with an induction regimen of high‐dose interferon alpha‐2b, with or without ribavirin, in chronic hepatitis C patients who have not responded to standard dose interferon monotherapy.Methods:Previous virological non‐responders to standard dose interferon (3–5 MU three times weekly for ≥ 12 weeks) were randomized to receive, unblind, either 10 MU interferon alpha‐2b daily for 10 days, then 5 MU daily for 74 days, then 5 MU three times weekly for 24 weeks (total 36 weeks) (group A), or the above regimen with the addition of ribavirin, 1000–1200 mg/day, at day 11 (group B). All patients were followed up for 24 weeks after completion of therapy.Results:End of treatment virological response was noted in one of 10 (10%) patients in group A and in eight of 15 (54%) patients in group B (P=0.04). The sole end treatment responder in group A and three in group B relapsed on follow‐up. The apparent improvement in response in group B compared to group A nearly reached statistical significance (group B 5/15 vs. group A 0/10; P=0.06).Conclusions:In this small pilot study, a 36‐week high‐dose induction interferon monotherapy protocol did not yield sustained responses in previous non‐responders to standard dose interferon. However, the same regimen with ribavirin yielded a 33% sustained response rate, nearly reaching statistical significance. The therapy was well tolerated, despite the higher doses of interferon used and the addition of ribavirin. High‐dose interferon with ribavirin appears to be a therapeutic option for non‐responders to conventional interferon monotherapy.
Effect of octreotide on fluid absorption and secretion by the normal human jejunum and ileum in vivo
Authors: Högenauer C. , Aichbichler B. , Santa Ana C. , Porter J. , Fordtran J. 
Published: March 2003

Background:We hypothesized that part of the non‐specific antidiarrhoeal effect of octreotide is mediated by a proabsorptive or antisecretory effect on small intestinal active electrolyte transport.Methods:To measure the effect of octreotide on net absorption, the jejunum and ileum of normal human subjects were perfused with a balanced electrolyte solution; to measure the effect of octreotide on normal active chloride secretion, the jejunum was perfused with a bicarbonate‐free solution.Results:During perfusion of a balanced electrolyte solution, octreotide increased basal net fluid absorption in the jejunum and ileum by about 40 mL/h per 30 cm. In the jejunum, octreotide markedly inhibited basal and sham feeding‐stimulated active chloride secretion and inhibited water secretion by 28 and 51 mL/h per 30 cm, respectively.Conclusions:Octreotide causes an increase in the net epithelial cell absorption rate of a balanced electrolyte solution in the normal jejunum and ileum. In the jejunum, this proabsorptive effect is mediated mainly by the reduction of normal active electrolyte secretion, rather than by stimulation of normal active electrolyte absorption. These results support the hypothesis that part of the antidiarrhoeal action of octreotide is due to its effects on active electrolyte transport mechanisms by normal epithelial cells of the small intestine.
Comparison of lansoprazole and famotidine for gastric acid inhibition during the daytime and night‐time in different CYP2C19 genotype groups
Authors: Shirai N. , Furuta T. , Xiao F. , Kajimura M. , Hanai H. , Ohashi K. , Ishizaki T. 
Published: March 2003

Background:The acid inhibitory effect of lansoprazole depends on the S‐mephenytoin 4′‐hydroxylase (CYP2C19) genotype status. The effect of famotidine is independent of this genotype.Aim:To investigate the acid inhibitory effects of lansoprazole vs. famotidine during the daytime and night‐time with reference to different CYP2C19 genotypes.Methods:Fifteen healthy volunteers were given 20 mg famotidine twice a day or 30 mg lansoprazole once a day for 8 days. On post‐dose day 8, 24‐h intragastric pH monitoring was performed.Results:During the daytime, the intragastric pH with lansoprazole was significantly higher than that with famotidine in the heterozygous extensive metabolizer group, whereas no significant difference was observed in the homozygous extensive metabolizer group. During the night‐time, the intragastric pH with famotidine was quite similar to that with lansoprazole in the heterozygous extensive metabolizer and poor metabolizer groups. However, during the night‐time, the intragastric pH with famotidine was significantly higher than that with lansoprazole in the homozygous extensive metabolizer group.Conclusions:An insufficient acid inhibition by lansoprazole during the night‐time in the homozygous extensive metabolizer group could be compensated for by famotidine. CYP2C19 genotype testing appears to be useful for predicting the optimal acid inhibitory drug treatment collated with circadian intragastric pH change.
Dose finding study of mosapride in functional dyspepsia: a placebo‐controlled, randomized study
Authors: Hallerbäck B. I. , Bommelaer G. , Bredberg E. , Campbell M. , Hellblom M. , Lauritsen K. , Wienbeck M. , Holmgren L. ‐L. 
Published: March 2003

Background:Prokinetic agents have shown variable efficacy in the treatment of functional dyspepsia. Mosapride is a new prokinetic 5‐hydroxytryptamine‐4 agonistic agent.Aim:To evaluate the efficacy of three dosage regimens of mosapride compared with placebo in the treatment of functional dyspepsia.Methods:Patients were randomly allocated to treatment with placebo or mosapride (5 mg b.d., 10 mg b.d. or 7.5 mg t.d.s.) in a double‐blind, prospective, multicentre, multinational study. The change in symptom severity score from an untreated baseline week to the sixth week of treatment was used to compare treatment efficacy.Results:There were 141, 140, 143 and 142 patients valid for evaluation in the intention‐to‐treat population in the placebo, mosapride 5 mg b.d., mosapride 10 mg b.d. and mosapride 7.5 mg t.d.s. groups, respectively. The mean changes in the overall dyspeptic symptom score were – 0.90, – 0.94, – 0.88 and – 0.89, respectively, and the proportions of patients feeling better at the end of the treatment period were 60%, 59%, 59% and 61%, respectively. No statistically significant difference was seen.Conclusions:Treatment of functional dyspepsia with mosapride was not superior to placebo. The result raises the question of whether treatment with prokinetic agents is appropriate for functional dyspepsia.
Baclofen‐mediated gastro‐oesophageal acid reflux control in patients with established reflux disease
Authors: Cange L. , Johnsson E. , Rydholm H. , Lehmann A. , Finizia C. , Lundell L. , Ruth M. 
Published: March 2003

Aim:To explore the effect of baclofen on oesophageal acid exposure in patients with gastro‐oesophageal reflux disease.Methods and materials:Twenty patients with established reflux disease were included in this double‐blind, randomized, crossover study. Baclofen, 40 mg, or placebo was given as a single dose with a washout period of 4 weeks. Symptoms were assessed by a visual analogue scale. Oesophageal pH was registered for 12 h and analysed for the whole period and for the 0–4‐h, 4–8‐h, 8–12‐h and 2‐h post‐prandial periods.Results:Baclofen significantly reduced the number of reflux episodes during the 0–4‐h (7.9 vs. 16.5, P < 0.0001; post‐prandially: 6.0 vs. 11.2, P < 0.0001) and 0–12‐h (46.5 vs. 73, P=0.0001; post‐prandially: 18.8 vs. 29.3, P < 0.0001) periods. The fraction of time with pH < 4 was significantly lowered during the 0–4‐h period (9.3 vs. 15.6, P=0.0019; post‐prandially: 16.1 vs. 23.5, P=0.0083). Similar results were also obtained in patients with a hiatus hernia (n=13). Belching was significantly reduced (32 vs. 69 episodes, P < 0.01).Conclusions:A single oral dose of 40 mg baclofen significantly reduced both the number of reflux episodes and the fraction of time with pH < 4, an effect primarily found during the first 4 h after dosing.
Induction and maintenance of clinical remission by interferon‐β in patients with steroid‐refractory active ulcerative colitis—an open long‐term pilot trial
Authors: Musch E. , Andus T. , Malek M. 
Published: March 2003

Background:The imbalance of pro‐ and anti‐inflammatory cytokines plays an important role in the pathogenesis of inflammatory bowel disease. Shifting this disturbed ratio by means of TNF‐antibodies or interferon has been shown to be helpful in treating Crohn's disease and multiple sclerosis, respectively.Aim:This pilot study investigated whether interferon‐β can induce clinical remission in corticoid‐refractory ulcerative colitis.Methods:Twenty‐five patients with steroid‐refractory active ulcerative colitis (Clinical activity index according to Rachmilewitz: 13.5 ± 5.2) were treated in an open pilot trial with 0.5 MIU human natural interferon‐β (hn‐IFN‐β) i.v. (n=18) or 1 MIU recombinant interferon‐β‐1a (r‐IFN‐β‐1‐a) s.c. (n=7) daily with the goal of induction of remission. Subsequent maintenance treatment was carried out for 52.0 ± 78.8 weeks (range 4–336 weeks) with the same dose, three times per week.Results:Twenty‐two of 25 patients (88%) went into remission during induction treatment (hn‐IFN‐β 16/18, r‐IFN‐β‐1a 6/7). Mean time to response was 3.0 ± 1.3 weeks. Mean length of remission was 13.0 ± 19.7 months. Only eight of 22 patients in remission relapsed during maintenance treatment. Five of these went into remission again after increasing the dose. Adverse events consisted of slight to moderate flu‐like symptoms and slight to moderate hair loss in five of 15 female patients.Conclusion:Although this open pilot study included only a small number of patients, the high response rate suggests that interferon‐β may be a safe and effective treatment for steroid‐refractory active ulcerative colitis.
Meta‐analysis: the efficacy of intravenous H2‐receptor antagonists in bleeding peptic ulcer
Authors: Levine J. E. , Leontiadis G. I. , Sharma V. K. , Howden C. W. 
Published: March 2003

SummaryBackground : Although a previous meta‐analysis found that intravenous H2‐receptor antagonists were only weakly beneficial in bleeding gastric ulcer and of no benefit in bleeding duodenal ulcer, patients with ulcer bleeding continue to receive such treatment.Aim : To re‐evaluate the efficacy of intravenous H2‐receptor antagonists in ulcer re‐bleeding, surgery and mortality by updating the previous meta‐analysis.Methods : After two independent literature searches, randomized, placebo‐controlled trials of intravenous H2‐receptor antagonists in bleeding ulcer published between 1984 and 2000 were added to those from the initial meta‐analysis. Pooled rates of re‐bleeding, surgery and death were re‐calculated, together with the relative risk reduction, absolute risk reduction, number needed to treat and Mantel–Haenszel odds ratio.Results : Intravenous H2‐receptor antagonists did not significantly reduce re‐bleeding, surgery or death in bleeding duodenal ulcer. There were small but significant reductions in re‐bleeding, surgery and death in bleeding gastric ulcer; the absolute risk reductions were 7.2%, 6.7% and 3.2%, respectively.Conclusions : Intravenous H2‐receptor antagonists are of no value in bleeding duodenal ulcer, although they may be mildly beneficial in bleeding gastric ulcer. Because proton pump inhibitors have a greater inhibitory effect on gastric acid secretion than H2‐receptor antagonists, they may be more effective in ulcer bleeding and should be further evaluated for that indication.
The importance of endoscopic ultrasonography in the management of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma
Authors: Caletti G. , Zinzani P. L. , Fusaroli P. , Buscarini E. , Parente F. , Federici T. , Peyre S. , De Angelis C. , Bonanno G. , Togliani T. , Pileri S. , Tura S. ,   THE ITALIAN GASTRIC LYMPHOMA STUDY GROUP
Published: March 2003

SummaryBackground : Anti‐Helicobacter pylori therapy has been reported to cause regression of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma in a high percentage of patients. However, in some patients, these lesions persist despite antibiotic treatment.Aim : To determine the various endosonographic findings that may predict the regression of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma post‐antibiotics.Methods : Seventy‐six patients with Helicobacter pylori‐positive gastric mucosa‐associated lymphoid tissue lymphoma were studied. Follow‐up data were available on 51 patients. All patients were treated with antibiotics. Participants underwent pre‐ and post‐anti‐Helicobacter pylori therapy endoscopy with gastric biopsies, followed by endoscopic ultrasonography examination of the stomach.Results : Helicobacter pylori was eradicated in 45 of 51 (88%) patients. At the 2‐year follow‐up, complete regression of mucosa‐associated lymphoid tissue lymphoma was seen in 28 of 51 (55%) patients: 12 of 16 (75%) patients in stage T1m N0, 11 of 19 (58%) patients in stage T1sm N0, four of eight (50%) patients in stages T1m N1 and T1sm N1, and one of four (25%) patients in stage T2 N0. None of the stage T2 N1 patients achieved clinical regression.Conclusions : Endoscopic ultrasonography evaluation of gastric mucosa‐associated lymphoid tissue lymphoma plays a pivotal role in the initial staging and post‐treatment follow‐up evaluation of these lesions. Accurate staging is essential in the determination of the optimal treatment modality.
Impact of supplement with Lactobacillus‐ and Bifidobacterium‐containing yogurt on triple therapy for Helicobacter pylori eradication
Authors: Sheu B.‐S. , Wu J. ‐J. , Lo C. ‐Y. , Wu H. ‐W. , Chen J. ‐H. , Lin Y. ‐S. , Lin M. ‐D. 
Published: March 2003

SUMMARYAim : To test whether supplements of Lactobacillus‐ and Bifidobacterium‐containing yogurt (AB‐Yogurt) affect the success of Helicobacter pylori eradication.Methods : One hundred and sixty H. pylori‐infected patients were randomized into a triple‐plus‐yogurt group or a triple‐only group, receiving 1 week of triple therapy with and without supplements of AB‐Yogurt, respectively. In the triple‐plus‐yogurt group, AB‐Yogurt was continued for 4 weeks after triple therapy. Eight weeks later, patients were assessed for the success of H. pylori eradication. The stool samples of 22 randomly selected patients, 11 from each group, were provided on enrolment, at the first week and at the fifth week for evaluation of the percentage of Bifidobacterium in anaerobes.Results : By intention‐to‐treat analysis, the triple‐plus‐yogurt group had a higher H. pylori eradication rate than the triple‐only group (91% vs. 78%, P < 0.05). The per protocol H. pylori eradication rates were similar for both groups (93.5% vs. 89%, P = N.S.). Only patients supplemented with AB‐Yogurt showed restoration of the percentage of Bifidobacterium in the anaerobes of stools at the fifth week to the level in the stools on enrolment.Conclusions : Supplement with AB‐Yogurt can improve the intention‐to‐treat eradication rates of H. pylori, and can restore the depletion of Bifidobacterium in stools after triple therapy.