bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence of Peptic Ulcer not Related to Helicobacter pylori or Non‐Steroidal Anti‐Inflammatory Drug Use is Negligible in Southern Europe
Authors: Arroyo Ma Teresa , Forne Montse , De Argila Carlos Martin , Feu Faust , Arenas Juan , De La Vega Juan , Garrigues Vicente , Mora Francisco , Castro Manuel , Bujanda Luis , Cosme Angel , Castiella Agustín , Gisbert Javier P. , Hervas Antonio , Lanas Angel 
Published: May 2004

ABSTRACTBackground and Aim.  Helicobacter pylori is the major cause of peptic ulcer disease, but the proportion of H. pylori‐negative peptic ulcers seems to be increasing in developed countries. We investigated the frequency of H. pylori‐negative peptic ulcer without intake of nonsteroidal anti‐inflammatory drugs (NSAIDs) in a Mediterranean European country.Materials and Methods.  We prospectively collected consecutive patients with an endoscopically verified active peptic ulcer over 6 months from different areas of Spain. Helicobacter pylori infection was assessed by rapid urease test and histologic examination (corpus and antral biopsies). A 13C‐urea breath test was performed if H. pylori was not detected with the invasive test. Patients were considered H. pylori‐negative if all three tests were negative. NSAID use was determined by structured data collection.Results.  Of 754 consecutive peptic ulcer patients, 16 (2.1%) were H. pylori‐negative and had not used NSAIDs before the diagnosis. Of the 472 patients who had duodenal ulcers, 95.7% (n = 452) were H. pylori‐positive and only 1.69% (n = 8) were negative for both H. pylori infection and NSAID use; 193 patients had benign gastric ulcers and 87% (n = 168) of them were infected by H. pylori (p < .001 vs. duodenal ulcers). NSAID intake was more frequent in gastric ulcer patients (52.8%) than in duodenal ulcer patients (25.4%; p < .001). Consequently, the frequency of H. pylori‐negative gastric ulcer in patients not using NSAID was 4.1% (n = 8).Conclusion.  Peptic ulcer disease is still highly associated with H. pylori infection in southern Europe, and only 1.6% of all duodenal ulcers and 4.1% of all gastric ulcers were not associated with either H. pylori infection or NSAID use.
Efficacy of Two Rabeprazole/Gatifloxacin‐Based Triple Therapies for Helicobacter pylori Infection
Authors: Sharara Ala I. , Chaar Hani F. , Racoubian Eddy , Moukhachen Oussayma , Barada Kassem A. , Mourad Fadi H. , Araj George F. 
Published: May 2004

ABSTRACTObjectives.  To evaluate the efficacy of two novel treatment regimens consisting of gatifloxacin (400 mg daily), amoxicillin (1 g twice daily), and rabeprazole 20 mg once (RAG20) or twice daily (RAG40) given for 7 days in the eradication of Helicobacter pylori.Methods.  Eligible patients undergoing endoscopy and having a positive rapid urease assay for H. pylori were enrolled in this open‐label trial. Gastric biopsies from a random cohort of patients were cultured for H. pylori and in vitro susceptibility to gatifloxacin and amoxicillin was performed using the E‐test. Compliance and side‐effects were evaluated by phone calls. 14C‐urea breath tests were performed a minimum of 4 weeks after therapy and 3 weeks after any acid suppressive therapy.Results.  A total of 104 patients, 52 in each group (40 females and 64 males; mean age 45.7 years) were enrolled sequentially. Eradication occurred in 43 out of 52 patients in RAG20 group (both per‐protocol and intention‐to‐treat analysis: 83%; 95% CI: 72–93%) and in 48 of 52 patients in the RAG40 group (both per‐protocol and intention‐to‐treat analysis: 92%; 95% CI: 85–99%). Seven patients in the RAG40 group who had previously failed one or more treatment regimens for H. pylori were cured. No significant adverse effects were reported. All 50 recovered H. pylori strains were susceptible to amoxicillin and gatifloxacin in vitro.Conclusions.  A 7‐day regimen of gatifloxacin‐rabeprazole‐amoxicillin is effective eradication therapy for H. pylori. The use of rabeprazole twice daily results in superior eradication rates including cases of failed primary therapy. This new regimen is simple, well‐tolerated, and may lead to higher compliance and lower costs.
Is the Association Between Helicobacter pylori and Gastric Cancer Confined to CagA‐Positive Strains?
Authors: Held Maria , Engstrand Lars , Hansson Lars‐Erik , Bergström Reinhold , Wadström Torkel , Nyrén Olof 
Published: May 2004

ABSTRACTBackground.  Infection with Helicobacter pylori is associated with an increased risk of gastric cancer. Several studies have indicated that the association differs with strain type. We aimed to find out if infection with strains lacking the virulence factor CagA is linked to gastric cancer risk.Materials and methods.  In a hospital‐based case–control study, we collected sera from 100 case patients with a newly diagnosed gastric adenocarcinoma and 96 control patients with diseases unrelated to H. pylori status. Antibodies to H. pylori were analyzed by enzyme‐linked immunosorbent assay (ELISA), and antibodies to CagA were detected by immunoblot. Logistic regression was used to obtain odds ratios (ORs) as estimates of relative risk, adjusted for potential confounding.Results.  Among the case patients, 81% were ELISA positive and 86% had antibodies to CagA. The corresponding numbers among the controls were 58% and 55%, respectively. ELISA positivity was associated with an increased risk of gastric adenocarcinoma compared to ELISA negativity (OR for gastric cancer regardless of site 3.9, 95% CI 1.9–8.2). The OR was 7.4 (95% CI 3.3–16.6) for CagA‐positive relative to CagA‐negative subjects. Among ELISA‐positive subjects the presence of CagA antibodies increased the risk 3.6 times (95% CI 1.2–11.1). ELISA‐positive CagA‐negative infections were associated with a fourfold increased risk (OR = 4.2, 95% CI 1.0–17.0) compared to no infection (ELISA‐negative and CagA‐negative).Conclusions.  Although patients with antibodies to CagA have the greatest risk of developing gastric cancer, those with CagA‐negative infections run a significantly greater risk than uninfected persons.
Inactivation of Helicobacter pylori cagA Gene Affects Motility
Authors: Figura Natale , Trabalzini Lorenza , Mini Roberta , Bernardini Giulia , Scaloni Andrea , Talamo Fabio , Lusini Paola , Ferro Elisa , Martelli Paola , Santucci Annalisa 
Published: May 2004

ABSTRACTBackground.  The cytotoxin‐associated protein CagA is a Helicobacter pylori immunodominant antigen whose gene resides in the cag pathogenicity island. Our purpose was to determine if the disruption or deletion of cagA gene could have an effect on the expression of other proteins at the proteome level. We analyzed two H. pylori strains, 328 and G27 wild‐type, bearing the cag pathogenicity island, and their respective isogenic cagA− mutants.Methods.  The proteomes of two H. pylori strains (328 and its isogenic mutant SPM328_ΔcagA) were resolved by two‐dimensional electrophoresis and the digitalized images obtained were analysed both quantitatively and qualitatively. Peculiar spots of each strain were identified by mass spectrometry or by Western blotting.Results.  The comparison between the proteome expression of an H. pylori cagA+ strain and an isogenic mutant strain where the cagA gene was disrupted showed that, as well as the lack of expression of CagA, both flagellin A and flagellin B expressions were significantly decreased. The cagA− isogenic mutant was nonmotile. G27_ΔcagA, in which CagA was inactivated by gene deletion, was nonmotile as well respecting to motile G27 wild‐type strain. Moreover, reintroduction of cagA in G27_ΔcagA restored motility.Conclusions.  Our results suggest that CagA could quantitatively influence flaA and flaB transcription or their subsequent translation and/or correct folding.
Novel Monoclonal Antibody‐Based Helicobacter pylori Stool Antigen Test
Authors: Dore Maria Pina , Negrini Riccardo , Tadeu Vincenza , Marras Lea , Maragkoudakis Emanouel , Nieddu Salvatore , Simula Luigi , Cherchi Giovanni Battista , Massarelli Giovanni , Realdi Giuseppe 
Published: May 2004

ABSTRACTBackground.  A number of noninvasive tests have been developed to establish the presence of Helicobacter pylori infection. Although polyclonal antibody‐based stool antigen testing has a good sensitivity and specificity, it is less accurate than urea breath testing. Recently, a monoclonal antibody‐based stool antigen test demonstrated an excellent performance in diagnosing H. pylori infection in adults and in pediatric populations.Aim.  To evaluate the diagnostic accuracy of a novel stool test based on monoclonal antibodies to detect H. pylori antigens in frozen human stool in the pretreatment setting.Patients and Methods.  Stool specimens were prospectively collected from 78 patients undergoing gastroscopy and stored at −20°C until tested. Helicobacter pylori infection was evaluated by histology, rapid urease testing and urea breath tests (13C‐UBT). Positivity of the three tests was considered the gold standard for H. pylori active infection. Patients with no positive test were considered negative. The gold standard was compare to the results of the monoclonal antibody stool antigen test. Frozen stool specimens were tested using a novel monoclonal‐antibody‐based enzyme immunoassay (HePy‐Stool, Biolife‐Italiana, Milan, Italy).Results.  The sensitivity and specificity of the monoclonal stool antigen test were 97%[95% confidence interval, (CI) 86–100] and 94% (95% CI: 81–99), respectively. Negative and positive predictive values were 97% (95% CI: 85–99), and 95% (95% CI: 83–99), respectively. The diagnostic accuracy was 96% (95% CI: 88–99). The likelihood ratio for a positive test was 17 and for a negative test was 0.Conclusions.  Although the 13C‐UBT is the most accurate among the available noninvasive tests, our results show that an H. pylori stool test using monoclonal antibody might be an excellent alternative.
Helicobacter pylori Infection in Children in Estonia: Decreasing Seroprevalence During the 11‐Year Period of Profound Socioeconomic Changes
Authors: Oona Marje , Utt Meeme , Nilsson Ingrid , Uibo Oivi , Vorobjova Tamara , Maaroos Heidi–Ingrid 
Published: May 2004

ABSTRACTBackground.  The prevalence of Helicobacter pylori infection is inversely associated with socioeconomic conditions in childhood. In Estonia, a high prevalence of H. pylori infection has been observed among children born in 1987 and earlier. Since 1991, after the dissolution of the USSR, profound social and economic changes have taken place in the country. The aim of the study was to evaluate changes in the seroprevalence of H. pylori infection among children in the period 1991–2002.Materials and Methods.  The hospital‐based study population consisted of two groups of children enrolled in 1991 (n = 425) and 2002 (n = 296) according to the same inclusion criteria. The immunoglobulin G antibodies to the cell surface proteins of H. pylori were determined by enzyme‐linked immunosorbent assay, and the sera with the borderline results were analyzed by immunoblot analysis. Multiple regression analysis was used to determine the associations between H. pylori seropositivity and different variables such as demographic characteristics, diagnoses and year of enrolment.Results.  The only two variables linked independently to H. pylori serostatus were age and year of enrolment: the adjusted odds of being H. pylori seropositive were 1.92 [95% confidence interval (CI) 1.33–2.76] times higher for the children enrolled in 1991 compared with the children enrolled in 2002. The age‐standardized seroprevalence rate was 42.2% (95% CI 37.4–47.0%) for the group of 1991 and 28.1% (95% CI 23.1–33.6%) for the group of 2002.Conclusion.  The prevalence of H. pylori infection among children has significantly decreased during the 11‐year period of profound socioeconomic changes in Estonia.
Increased Production of Matrix Metalloproteinases in Helicobacter pylori‐Associated Human Gastritis
Authors: Bergin Philip J , Anders Edebo , Sicheng Wen , Erik Johnsson , Jennie Andersson , Hans Lönroth , Pierre Michetti , Qiang Pan‐Hammarström , Marianne Quiding‐Järbrink 
Published: May 2004

ABSTRACTBackground and Aims.  Helicobacter pylori infection results in an active, chronic inflammation of the gastric mucosa. Previous studies have highlighted the importance of matrix metalloproteinases (MMPs) in diseases involving mucosal inflammation, prompting us to investigate MMP activity in H. pylori‐induced gastritis.Methods.  Gastric biopsies were obtained from H. pylori‐infected and uninfected volunteers, and MMP activity was assessed using substrate gel electrophoresis. MMP production was also evaluated by immunohistochemistry and real time‐polymerase chain reaction. In parallel, tissue inhibitors of MMPs (TIMP) levels and TIMP–MMP complexes were examined in corresponding tissues using enzyme‐linked immunosorbent assays and Western blotting. Finally, MMP production by gastric macrophages was determined after stimulation with H. pylori.Results.  Antral mucosa of H. pylori‐infected subjects demonstrated a 19‐fold higher MMP‐9 activity than that of uninfected individuals. MMP‐2 was present at lower levels, but was also increased in H. pylori‐infected individuals, while there was no difference in the total levels of TIMP‐1 and TIMP‐2 between the groups of volunteers. Significant numbers of MMP‐9‐containing cells were only found in the H. pylori‐infected antral mucosa. Tissue‐resident macrophages were significantly increased in H. pylori‐infected individuals, and double‐staining showed MMP‐9 colocalized to macrophages. Furthermore, gastric macrophages secreted MMP‐9 in response to H. pylori bacteria. A corresponding 10‐fold increase of gene expression of MMP‐9 was seen in patients infected with H. pylori compared to uninfected individuals.Conclusions.  Helicobacter pylori infection results in a substantial increase in MMP‐9 and MMP‐2 activity in the gastric mucosa, probably contributed to in large part by tissue‐resident macrophages, while no changes were seen in the TIMP levels. The net increase in gastric MMP activity is likely to contribute to tissue damage during H. pylori‐associated gastritis.
Contract Length as Risk Management When Labor is not Homogeneous
Authors: Maxcy Joel G. 
Published: May 2004

AbstractThis paper examines the choice of contract length for workers who possess unique skills. Uncertainty, facing both the worker and the firm, creates an incentive to reallocate risk. The uncertainty arises from two sources: variation in the market value of the worker's human capital and fluctuation in the worker's physical production. Long‐term contracts are typically modeled as compensating wage differentials, or as a solution to the problem of asymmetric information. This paper develops a model proposing more complex behavior in the reallocation of risk between the contracting parties. The model shows that long‐term labor contracts are most likely to be observed when price uncertainty in the labor market exceeds the worker's productive uncertainty.
Union–Firm Bargaining, Productivity Improvement and Endogenous Growth
Authors: Palokangas Tapio 
Published: May 2004

AbstractThis paper presents a growth model with two sectors. In the high‐tech sector, R&D increases productivity and union–firm bargaining determines wages, but in the traditional sector there are neither R&D nor labour unions. The government is able to regulate union bargaining power. The main results are as follows. Because firms try to escape wage increases through the improvement of productivity by R&D, the increase in union bargaining power boosts R&D and growth. It is welfare enhancing to strengthen (weaken) unions when the growth rate is below (above) some critical level. A specific rule is presented for when de‐unionization is socially desirable.
Do the Falling Earnings of Immigrants Apply to Self‐employed Immigrants?
Authors: Frenette Marc 
Published: May 2004

AbstractIt is well known that the earnings of recent cohorts of immigrant men have fallen further behind native‐born men. Using several years of Canadian Census data, this study finds that immigrants have turned to self‐employment at a much faster rate than the native born. In addition, the earnings gap between self‐employed immigrant and native‐born men has not grown with successive cohorts, but rather has followed a cyclical movement: narrowing at the peak, and widening in times of weaker economic activity. However, immigrants choosing self‐employment still face challenges, as their earnings are far below native‐born earnings, and convergence is a lengthy process.
Early Career Mobility and Earnings Profiles of German Apprentices: Theory and Empirical Evidence
Authors: Bougheas Spiros , Georgellis Yannis 
Published: May 2004

AbstractWe investigate how apprenticeship training affects the early career mobility and earnings profiles of young apprentices in Germany. The heterogeneous quality and nature (whether general or firm specific) of training across firms is expected to be reflected in the post‐apprenticeship mobility and earning patterns of young workers. In this paper, we argue that a simple model of training and labour turnover can explain such patterns. Specifically, assuming that job changes are associated with a loss of accumulated firm‐specific skills, the model predicts that although movers initially experience a productivity loss, their earnings grow at a faster rate than those of stayers. As job changes become more costly the longer a worker stays with the training firm, later movers experience a larger reduction in their earnings compared with direct movers. Estimated selectivity‐corrected earnings equations for movers and stayers, based on data from the German Socioeconomic Panel (GSOEP), support the predictions of the model and highlight important differences in earnings profiles and mobility patterns by apprenticeship firm size.
Propylthiouracil and carbimazole associated‐antineutrophil cytoplasmic antibodies (ANCA) in patients with Graves’ disease
Authors: Harper L. , Chin L. , Daykin J. , Allahabadia A. , Heward J. , Gough S. C. , Savage C. O. , Franklyn J. A. 
Published: May 2004

Summaryobjective  Propylthiouracil treatment of Graves’ disease has been postulated to provoke antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitis. We aimed to investigate whether carbimazole therapy was also associated with increased risk of ANCA.design  The occurrence of ANCA and the relationship to thionamide treatment was investigated in a cross‐sectional study in a consecutive series of 407 patients’ with Graves’ disease, 200 with Hashimoto's thyroiditis and 649 normal euthyroid subjects.measurements  ANCA was measured by indirect immunofluorescence (IIF) and enzyme‐linked immunosorbent assay (ELISA) for proteinase 3 and myeloperoxidase‐ANCA.results  The prevalence of ANCA, as measured by IIF, was increased in the Graves’ disease cohort (19·9%) compared with euthyroid controls (4·6%; P < 0·001). The prevalence of MPO‐ANCA (measured by ELISA) was also increased in Graves’ disease (P = 0·019). ANCA prevalence was more strongly associated with propylthiouracil treatment than carbimazole (P = 0·0265), although risk of ANCA was also higher in Graves’ patients treated with carbimazole than controls (RR 2·2, P < 0·0001). ANCA positivity was not increased in patients with Hashimoto's thyroiditis.conclusion  This study revealed a high prevalence of ANCA in treated patients with Graves’ disease but not in those with Hashimoto's thyroiditis. Furthermore, within the Graves’ disease population, ANCA development was associated with propylthiouracil usage to a greater extent than carbimazole. These findings suggest that the altered immune environment associated with autoimmune thyroid disease is not sufficient to develop ANCA but treatment with thionamides is important in promoting ANCA development.
Comparison of single daily dose of methimazole and propylthiouracil in the treatment of Graves’ hyperthyroidism
Authors: He Chih‐Tsueng , Hsieh An‐Tsz , Pei Dee , Hung Yi‐Jen , Wu Ling‐Yi , Yang Tsao‐Chin , Lian Wei‐Cheng , Huang Wen‐Sheng , Kuo Shi‐Wen 
Published: May 2004

Summaryobjective  The present study was to compare the efficacy of a single daily dose of methimazole (MMI) and propylthiouracil (PTU) in the treatment of Graves’ hyperthyroidism.background  Antithyroid drugs, MMI and PTU, are widely used in the treatment of hyperthyroidism. Previous studies in the treatment of hyperthyroidism with a single daily dose of antithyroid drugs have demonstrated a more favourable result with MMI. However, the efficacy of a single daily dose of PTU was inconsistent. In this study, we examined the therapeutic efficacy of single daily doses of MMI and PTU on the change of thyroid hormones and thyrotropin receptor antibodies (TRAb) levels.methods  Thirty patients with newly diagnosed Graves’ hyperthyroidism were randomly divided into two groups, each receiving a single dose of either 15 mg MMI or 150 mg PTU daily for 12 weeks. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), total thyroxine (TT4), thyrotropin (TSH), free thyroxine (FT4), and TRAb levels at baseline and at the end of 4, 8 and 12 weeks during the study period.results  There was no significant difference in baseline thyroid function parameters. Serum TT3, TT4 and FT4 levels in the MMI‐treated group were significantly lower than those of the PTU‐treated group after 4 weeks and through the end of the study. MMI also has superior effect on reducing serum TRAb levels than PTU after 8 weeks and at the end of the study.conclusion  During the 12‐week treatment of Graves’ hyperthyroidism, a single daily dose of 15 mg MMI was much more effective in the induction of euthyroidism than a single daily dose of 150 mg PTU. In the doses used in this study, MMI is preferable to PTU when a once‐daily regimen of antithyroid drug is considered for the treatment of Graves’ hyperthyroidism.
Vitamin A and iron supplementation is as efficient as hormonal therapy in constitutionally delayed children
Authors: Zadik Z. , Sinai T. , Zung A. , Reifen R. 
Published: May 2004

Summaryobjective  To assess the effect of nutritional supplementation on growth and puberty in constitutionally delayed children.patients  One hundred and two boys, 13·6–15·5 years of age, who were referred because of short stature and delayed puberty.methods  The boys were randomly allocated to one of the following treatment groups: oxandrolone therapy, 5 mg/day for 6 months (n = 15), testosterone depot, 100 mg monthly for 3 months (n = 15) or for 6 months (n = 20), nutritional programme (n = 17), oxandrolone and nutritional programme (n = 15) or passive observation (n = 20). Boys in the nutritional programmes received 12 mg/day iron and 6000 IU/week of vitamin A. Outcome measurements were of height, weight, pubertal signs, dietary intake, serum vitamin A, iron, GH and IGF‐1.results  Six months of vitamin A supplementation induced growth acceleration similar to that seen in the oxandrolone‐ and testosterone‐treated children, and significantly greater than in the observation group (9·3 ± 2·9 vs. 4·0 ± 0·9 crn/yr, P < 0·001). Whereas in the vitamin A‐supplemented group, puberty (increase in testicular volume ≥ 12 ml) was induced within 12 months. In all testosterone‐treated patients, pubic hair was noted within 3 months and a testicular volume of ≥ 12 ml was observed 9–12 months after the initiation of therapy. No pubertal signs were noted in the observation group during this time.conclusions  Subnormal vitamin A intake is one of the aetiological factors in delayed pubertal maturation. Supplementation of both vitamin A and iron to normal constitutionally delayed children with subnormal vitamin A intake is as efficacious as hormonal therapy in the induction of growth and puberty.