bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori infection as a risk factor for gastrointestinal symptoms in patients using aspirin to prevent ischaemic heart disease
Authors: Laheij R. J. F. , Jansen J. B. M. J. , Verbeek A. L. M. , Verheugt F. W. A. 
Published: March 2003

Background:Aspirin use in the secondary prevention of ischaemic heart disease may provoke gastrointestinal discomfort.Objective:To register gastrointestinal symptoms and complications in patients with cardiovascular disease using aspirin and to relate these symptoms to infection with H. pylori.Methods:Blood samples were obtained from 398 consecutive patients in the Coronary‐Care Unit, University Hospital Nijmegen and analysed for serum antibody levels to H. pylori infection. Questionnaires were sent 2 weeks after discharge to assess gastrointestinal symptoms.Results:Questionnaires were returned by 314 patients (79%). A total of 183 out of 314 patients (46%) reported gastrointestinal symptoms. Of 238 patients using 80–100 mg aspirin daily, 145 (61%) recorded gastrointestinal symptoms. Besides aspirin, the use of calcium antagonists was correlated with gastrointestinal symptoms. Of the 128 patients using calcium antagonists, 84 (66%) reported gastrointestinal symptoms. The prevalence of gastrointestinal symptoms in H. pylori‐positive and ‐negative patients using aspirin was 48% and 52%, respectively.Conclusions:Two weeks after discharge almost 50% of the patients with cardiovascular disease experienced gastrointestinal symptoms, especially patients using aspirin or calcium antagonists. Patients seropositive for H. pylori and using aspirin or calcium antagonists did not have more gastrointestinal discomfort compared to non‐infected patients.
Reliability and validity of the digestive health status instrument in samples of community, primary care, and gastroenterology patients
Authors: Shaw M. J. , Beebe T. J. , Adlis S. A. , Talley N. J. 
Published: March 2003

Aim:We evaluated a previously reported digestive health status instrument in community, primary care, and gastroenterology practice populations. Multiple types of reliability, validity and responsiveness were assessed to determine the performance of the questionnaire.Methods:Study populations included community, primary care and gastroenterology subjects. Psychometric analyses included internal consistency and test–retest reliability, criterion and construct validity, and responsiveness.Results:Acceptable internal consistency was seen on all scales in all three populations. Test–retest reliability was excellent in a speciality population with reflux disease. Criterion validity was demonstrated by strong correlation of reflux scale scores and results on 24‐h pH monitoring. Scale scores varied predictably in those receiving gastrointestinal tract imaging and according to diagnosis, indicating construct validity. The reflux scale and pain index were sensitive to change with treatment for reflux disease. Multi‐trait scaling analyses from the community sample revealed a structure equivalent to that reported from a primary care sample.Conclusions:The reliability and validity of the digestive health status instrument on multiple measures in multiple settings have been demonstrated. The instrument was responsive to change with treatment for reflux disease. The demonstrated robustness attests to the suitability for future studies and clinical application.
Decreasing oesophageal acid exposure in patients with GERD: a comparison of rabeprazole and omeprazole
Authors: Galmiche J. P. , Zerbib F. , Ducrottè P. , Fournet J. , Rampal P. , Avasthy N. , Humphries T. J. 
Published: March 2003

Background:Rabeprazole has been shown to be more potent and faster than other proton pump inhibitors in in vitro studies and highly effective in decreasing oesophageal acid exposure in patients with gastro‐oesophageal reflux disease (GERD).Aim:This study was a multicentre, double‐blind, placebo‐controlled, randomized, parallel‐group comparison of three active treatment regimens utilizing two different proton pump inhibitors, or placebo, administered over 7 days in patients with GERD.Methods:Eighty‐two patients with symptomatic GERD were given placebo, rabeprazole 10 mg b.d., rabeprazole 20 mg o.m., or omeprazole 20 mg o.m. for 7 days. Twenty‐four hour oesophageal pH monitoring was performed at baseline and repeated at the conclusion of the treatment period.Results:At the end of study, the percentage time (mean ± s.d.) with pH < 4 over a 24‐h period was significantly decreased by the three active regimens but without significant difference between them (9.27 ± 4.77; 2.53 ± 4.27; 2.02 ± 1.71 and 2.91 ± 4.06 for placebo, rabeprazole 10 mg b.d., rabeprazole 20 mg o.m. and omeprazole 20 mg o.m., respectively). Acid exposure was normalized in 90% of patients treated with rabeprazole 10 mg b.d., 95% treated with rabeprazole 20 mg o.m., 78% treated with omeprazole 20 mg o.m., and only 9.5% of patients treated with placebo. Both rabeprazole and omeprazole were well‐tolerated.Conclusions:Although rabeprazole 20 mg o.m. showed greater activity numerically, this study demonstrates that rabeprazole 10 mg b.d. and 20 mg o.m. are equivalent to omeprazole 20 mg o.m. in decreasing oesophageal acid exposure.
Epidermal growth factor and its receptor in chronic active gastritis and gastroduodenal ulcer before and after Helicobacter pylori eradication
Authors: Chun Yu Wong B. , Ping Wang W. , Hau Leung So W. , Shin V. Y. , Man Wong W. , Man Yee Fung F. , Shiu Lam Liu E. , Mo Hiu W. , Kum Lam S. , Hin Cho C. 
Published: March 2003

Background: Helicobacteria pylori infection of gastroduodenal mucosa is strongly associated with gastritis and peptic ulcer disease. The aims of the present study were to compare the gastroduodenal mucosal levels of epidermal growth factor (EGF) and its receptor (EGFR) among H. pylori‐negative controls and H. pylori infected patients with chronic active gastritis or gastroduodenal ulcer before and after H. pylori eradication.Methods:The protein levels of EGF in mucosal tissues and saliva were determined by a solid‐phase enzyme‐linked immunosorbent assay (ELISA). Repeat transcription‐polymerase chain reaction and the following polymerase chain reaction ELISA were employed to examine the mucosal EGFR mRNA expression.Results:Mucosal injury and H. pylori infection increased EGF protein levels and EGFR mRNA expression in the antral mucosa. The concentration of EGF in saliva was not affected by mucosal damage or H. pylori infection. Successful H. pylori eradication normalized the EGFR mRNA back to its basal level 6 weeks after treatment. However, after unsuccessful eradication their high levels in the antrum persisted. All patients experienced ulcer healing after drug treatment, regardless of H. pylori eradication.Conclusions:Mucosal damage increased the expression of EGF protein and EGFR mRNA in the gastric mucosa. H. pylori could induce the expression of EGFR but not the EGF in the antral mucosa. The expression of EGFR could be a contributing factor for ulcer healing in patients with H. pylori infection.
Maintenance of Crohn’s disease over 12 months: fixed versus flexible dosing regimen using budesonide controlled ileal release capsules
Authors: Green J. R. B. , Lobo A. J. , Giaffer M. , Travis S. , Watkins H. C. ,   THE FREEDOM INVESTIGATOR GROUP
Published: March 2003

Background:It may be possible to achieve more effective management of Crohn’s Disease by introducing a flexible dosage regimen sensitive to patients’ needs.Aim:Comparison of the efficacy and tolerability of a fixed vs. flexible budesonide controlled ileal release treatment regimen for the prevention and management of relapse in Crohn’s disease patients. Budesonide controlled ileal release is an oral formulation which delivers drug directly to disease sites in the ileum and ascending colon, by preventing more proximal release and absorption.Methods:A randomized, double‐blind comparison of a fixed dose of budesonide controlled ileal release (6 mg o.m.) and a flexible dose of budesonide controlled ileal release (3, 6 or 9 mg o.m.) for 12 months, in 143 patients in remission from ileal or ileo–caecal Crohn’s Disease.Results:Very low rates of clinical relapse in Crohn’s disease were achieved with budesonide controlled ileal release 6 mg o.m. There was no significant difference between the treatment groups with respect to the survival estimate of percentage of treatment failures (flexible group 15%, fixed group 19%; P=0.61). The average consumed dose of budesonide was comparable in both groups (5.8 mg flexible, 6.0 mg fixed). Similar proportions of patients reported adverse events (flexible 100%, fixed 97%). There were 33 serious adverse events (flexible 19, fixed 14) and 13 withdrawals due to significant adverse events (flexible 9, fixed 4).Conclusion:Maintenance treatment with budesonide controlled ileal release 6 mg o.m. is well‐tolerated and is associated with low rates of clinical relapse in stable Crohn’s disease over 12 months. Flexible dosing remains an option for individual patients, but this study has shown no advantage over a standard fixed dosing regimen.
Does the widespread use of proton pump inhibitors mask, complicate and/or delay the diagnosis of Zollinger–Ellison syndrome?
Authors: Corleto V. D. , Annibale B. , Gibril F. , Angeletti S. , Serrano J. , Venzon D. J. , Delle Fave G. , Jensen R. T. 
Published: March 2003

Background:Proton pump inhibitors are potent acid suppressants which, at normal doses, can result in hypergastrinaemia in patients with idiopathic oesophageal reflux disease and in the control of symptoms in most patients with gastrinomas. Therefore, their use could delay or mask the diagnosis of gastrinoma.Aim:To investigate whether the widespread use of proton pump inhibitors masks or complicates the diagnosis of gastrinoma.Subjects and methods:Data from two centres with different referral criteria for suspected gastrinomas were analysed (Gastroenterology Unit, Rome, Italy and National Institutes of Health, Bethesda, MD, USA). The number of referrals and the number of new patients with gastrinoma diagnosed in the years prior to the widespread use of proton pump inhibitors (1986–1992) were compared with the numbers since proton pump inhibitors became widely available (1993–1998).Results:The decrease in referral rate (P=0.0009) and the decrease in the annual rate of gastrinoma diagnosis (P=0.0020) at both centres correlated with the increased use of proton pump inhibitors. At the Italian centre, there was a 62% decrease in annual referrals (P < 0.0001) in the post‐proton pump inhibitor period, relative to the pre‐proton pump inhibitor period, whereas there was an increase in the rate of referral of other gastrointestinal endocrine tumours. The number of new cases of gastrinoma diagnosed decreased by 40%. At the US centre, the referral rate decreased by 28% (P=0.024) in the post‐proton pump inhibitor period. There was also a 43% decrease in the number of new cases diagnosed annually in the post‐proton pump inhibitor period (P=0.0012). There was a 2.6‐fold increase in the post‐proton pump inhibitor period in the percentage of referrals with a false diagnosis of gastrinoma as the cause of hypergastrinaemia (P=0.0040).Conclusions:In both referral centres, less patients have been referred with a possible diagnosis of gastrinoma and fewer new patients with gastrinoma have been diagnosed since proton pump inhibitors became widely available. These data support the conclusion that, since proton pump inhibitors have been released, the diagnosis of gastrinoma has been masked and will probably be delayed, with the result that patients with gastrinoma will be diagnosed at more advanced stages in their disease course.
Tegaserod, a 5‐HT4 receptor partial agonist, accelerates gastric emptying and gastrointestinal transit in healthy male subjects
Authors: Degen L. , Matzinger D. , Merz M. , Appel‐Dingemanse S. , Osborne S. , Lüchinger S. , Bertold R. , Maecke H. , Beglinger C. 
Published: March 2003

Background:Serotonin and its type‐4 (5‐hydroxytryptamine4) receptor play a major role in the physiology of the gastrointestinal tract. The effect of intravenous and/or oral tegaserod, a 5‐hydroxytryptamine4 receptor partial agonist, on gastric emptying, small bowel transit and colonic transit has not been studied in detail in humans.Aim:To assess the pharmacodynamic effects of repeated oral and intravenous administration of tegaserod on gastric emptying and small intestine and colonic transit.Methods:A randomized, placebo‐controlled, double‐blind, three‐way, crossover study of 6 mg oral and 0.6 mg intravenous tegaserod in 12 healthy male subjects was performed. Each treatment arm of the study involved 3 days of twice‐daily administration and 1 day of daily administration of the study drugs.Results:In comparison with placebo, oral and intravenous tegaserod significantly increased the gastric emptying rate (P < 0.01), accelerated colonic filling (P < 0.01) and shortened colonic transit at 48 h (P < 0.05). Tegaserod shortened the small intestine transit time by 30% after oral and by 37% after intravenous administration.Conclusions:In healthy subjects, tegaserod markedly accelerated gastric emptying and small intestinal transit, and induced a small but significant acceleration of colonic transit. Tegaserod can act as a promotile agent throughout the gastrointestinal tract.
Methicillin‐resistant Staphylococcus aureus infection of percutaneous endoscopic gastrostomy sites
Authors: Hull M. , Beane A. , Bowen J. , Settle C. 
Published: March 2003

Background:Antibiotic prophylaxis for percutaneous endoscopic gastrostomy insertion remains controversial. The bacteriology of peristomal infection following percutaneous endoscopic gastrostomy insertion has been poorly studied, leading to uncertainty regarding the optimum choice of antibiotic for prophylaxis.Aim:To investigate the bacteriology of peristomal infection following percutaneous endoscopic gastrostomy insertion and to determine the contribution of methicillin‐resistant Staphylococcus aureus.Methods:Nasal and pharyngeal swabs were taken from a consecutive series of patients prior to percutaneous endoscopic gastrostomy insertion over a 6‐month period. Bacterial colonization and infection at the peristomal site were prospectively evaluated at days 2/3 and 7 post‐insertion.Results:Thirty‐one patients underwent percutaneous endoscopic gastrostomy insertion (mean age, 68 years; cerebrovascular disease, 52%). Naso‐pharyngeal colonization by methicillin‐resistant Staphylococcus aureus (35%) invariably led to peristomal colonization following percutaneous endoscopic gastrostomy insertion. Peristomal infection occurred in eight (26%) cases (seven (88%) methicillin‐resistant Staphylococcus aureus‐ positive). Peristomal infection was significantly more likely to occur in patients with naso‐pharyngeal methicillin‐resistant Staphylococcus aureus colonization (odds ratio, 10.8; 95% confidence interval, 1.6–70.9).Conclusions:Naso‐pharyngeal methicillin‐resistant Staphylococcus aureus colonization invariably predicts peristomal methicillin‐resistant Staphylococcus aureus colonization following percutaneous endoscopic gastrostomy insertion, and is associated with an increased peristomal infection rate. Currently recommended antibiotic prophylaxis regimens may be inappropriate in institutions with significant methicillin‐resistant Staphylococcus aureus colonization rates.
Does the use of immunosuppressive therapy in inflammatory bowel disease increase the risk of developing lymphoma?
Authors: Bebb J. R. , Logan R. P. H. 
Published: March 2003

Recent case reports have raised concerns regarding the risks of non‐Hodgkin’s lymphoma in patients with inflammatory bowel disease treated with immunosuppressive agents. This evidence‐based review examines this issue from data derived from the use of immunosuppression in other conditions (and inflammatory bowel disease).We conclude that, in transplant (cardiac and renal) recipients, immunosuppression increases the risk of non‐Hodgkin’s lymphoma. For non‐transplant patients (with psoriasis and rheumatoid arthritis), debate remains as to whether the observed increase in the incidence of non‐Hodgkin’s lymphoma is due to drug or disease. For inflammatory bowel diseaseper se, population studies show no significant increase in the risk of non‐Hodgkin’s lymphoma, with a relative risk of 1.3 (95% confidence interval, 0.9–1.7) compared to expected rates, and several studies of immuno‐ suppression in inflammatory bowel disease do not appear to confirm a significant rate of lymphoma incidence. Reported cases of lymphoma from single centres should be viewed with caution as evidence of increased risk.If any association exists, it is likely to be of minimal clinical significance compared to the established and more frequent risks of myelosuppression and infection, and is unlikely to outweigh the benefit of immunosuppression in inflammatory bowel disease.
Upper gastrointestinal evaluation of Chinese patients with non‐cardiac chest pain
Authors: Wong W.‐M. , Lai K. C. , Lau C. P. , Hu W. H. C. , Chen W. H. , Wong B. C. Y. , Hui W. M. , Wong Y. H. , Xia H. H. X. , Lam S. K. 
Published: March 2003

Aims:To test the usefulness of upper gastrointestinal investigations and quality of life assessment in Chinese patients with non‐cardiac chest pain.Methods:Seventy‐eight consecutive patients with non‐cardiac chest pain underwent upper endoscopy. Eight patients had upper gastrointestinal pathology (10%). The remaining 70 patients received acid perfusion test, oesophageal manometry and 24‐h ambulatory oesophageal pH (n=65)/manometry (n=61), and the results were compared with those of healthy controls (n=20). Symptoms and quality of life (SF‐36) were assessed by standard validated questionnaire.Results:Significant acid reflux symptoms were present in five (5/70, 7%) patients. Abnormal 24‐h oesophageal pH, indicating gastro‐oesophageal reflux, was found in 19 (19/65, 29%) patients. The percentage of simultaneous contractions was higher and the percentage peristalsis was lower in patients with non‐cardiac chest pain when compared with normal subjects by 24‐h ambulatory manometry. Patients with non‐cardiac chest pain had a lower SF‐36 score when compared to controls.Conclusions:Typical acid reflux symptoms are uncommon in Chinese patients with non‐cardiac chest pain, but abnormal 24‐h pH results, indicating gastro‐oesophageal reflux, were found in 29% of patients. Ineffective contractions were more frequently found in patients with non‐cardiac chest pain by 24‐h ambulatory manometry, which may have a bearing on the impaired quality of life in such patients. Upper gastrointestinal investigations are useful for the evaluation of Chinese patients with non‐cardiac chest pain.
There are no reliable symptoms for erosive oesophagitis and Barrett's oesophagus: endoscopic diagnosis is still essential
Authors: Avidan B. , Sonnenberg A. , Schnell T. G. , Sontag S. J. 
Published: March 2003

Aims:To evaluate the sensitivity and specificity of different symptoms in erosive reflux oesophagitis and Barrett's oesophagus.Methods:The presence of reflux symptoms was compared between a case population of 306 patients with endoscopically determined erosive reflux oesophagitis, 235 patients with biopsy‐proven Barrett's oesophagus and a control population of 198 subjects without reflux disease.Results:Heartburn at any time and heartburn at night represented the only two symptoms to be simultaneously sensitive and specific. Symptoms that were induced by various foods, such as fat, tomato, chocolate, citrus or spices, tended to cluster in the same sub‐group of patients. Similarly, heartburn induced by exercise, lying down or bending over tended to occur in the same sub‐groups. The frequency of symptoms was influenced more by the presence of mucosal erosions than by the presence of Barrett's oesophagus. Reflux symptoms occurred more frequently in the presence rather than the absence of Barrett's oesophagus, and in long segment rather than short segment of Barrett's mucosa.Conclusions:Endoscopic inspection of the oesophageal mucosa remains the only certain method by which to reliably diagnose erosive reflux oesophagitis and Barrett's oesophagus.
A double‐blind, randomized, placebo‐controlled trial of essential fatty acid supplementation in the maintenance of remission of ulcerative colitis
Authors: Middleton S. J. , Naylor S. , Woolner J. , Hunter J. O. 
Published: March 2003

SummaryBackground : Essential fatty acid supplementation has been found to ameliorate certain chronic inflammatory diseases. This effect is thought to be mediated through the modulation of eicosanoid synthesis. Pro‐inflammatory eicosanoids have been implicated in ulcerative colitis.Aim : To investigate the possible therapeutic benefit of essential fatty acids in quiescent ulcerative colitis to reduce the frequency of disease relapse.Methods : A randomized, double‐blind, placebo‐controlled study was performed with a treatment duration of 12 months. Patients with quiescent disease received either trial medication (gamma‐linolenic acid, 1.6 g, eicosapentaenoic acid, 270 mg, and docosahexaenoic acid, 45 mg, per day) or placebo (sunflower oil, 500 mg/day). The primary end‐point was disease activity, assessed by a previously validated clinical index, sigmoidoscopic appearance and histology.Results : Sixty‐three patients were randomized, 31 to receive essential fatty acid treatment and 32 to receive placebo. Disease relapse rates were similar at 12 months (placebo, 38%; essential fatty acids, 55%), as were changes in sigmoidoscopic grade from baseline.Conclusions : The supplementation of the diet with this combination of essential fatty acids does not prolong the period of disease remission of ulcerative colitis.
The burden of illness of non‐cardiac chest pain
Authors: Eslick G. D. , Coulshed D. S. , Talley N. J. 
Published: March 2003

SUMMARYBackground : Non‐cardiac chest pain is a common condition affecting approximately one‐quarter of the population during their lifetime, but the long‐term economic costs of non‐cardiac chest pain are poorly defined.Methods : A MEDLINE and Current Contents search was performed from 1991 to 2002 using specific keywords. All major articles on the subject of non‐cardiac chest pain in this period were reviewed and their reference lists searched.Results : Limited studies suggest that the majority of those with non‐cardiac chest pain do not consult a doctor regarding their symptoms; the drivers of health care seeking are not known. The impact on the quality of life in consulters can be severe, with as many as 36% reporting much lower quality of life levels. The diagnosis of non‐cardiac chest pain can be difficult due to the heterogeneous nature of the condition, with significant overlap of gastro‐oesophageal reflux disease, chest wall syndromes and psychiatric disease, which may drive up the costs of management. The prognosis appears to be good, but there are conflicting results in long‐term studies.Conclusions : The costs of non‐cardiac chest pain to the health care system are likely to be large and represent a significant proportion of each Western country's health care budget. Further studies are required to determine methods of reducing health care costs.