bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta‐analysis: budesonide treatment for collagenous colitis
Authors: Feyen B. , Wall G. C. , Finnerty E. P. , DeWitt J. E. , Reyes R. S. 
Published: September 2004

SummaryBackground : Collagenous colitis is typified by chronic watery diarrhoea and characteristic histological alterations of the colonic mucosa without endoscopic abnormalities. Budesonide, a corticosteroid with high first‐pass metabolism has been examined in collagenous colitis, but studies to date have had small numbers, and relatively low statistical power.Aim : A meta‐analysis of existing published trials was undertaken to evaluate the treatment effect of budesonide in collagenous colitis.Methods : All pertinent literature sources were searched for published reports in English of budesonide use in collagenous colitis. MEDLINE and EMBASE databases were reviewed, as well as bibliographies from published articles and available abstracts from relevant meetings. Literature that met prespecified criteria was selected for the meta‐analysis.Results : Three trials were included in the meta‐analysis. Budesonide significantly decreased stool frequency (budesonide vs. placebo OR: 20.1, 95% CI: 7.0–57.5, P < 0.0001). In general, budesonide treatment was well‐tolerated.Conclusions : Budesonide is clinically effective short‐term in collagenous colitis, and seems to be relatively well‐tolerated. Clinicians can consider this drug as a reasonable option for patients with this disorder.
Natural history of gastro‐oesophageal reflux disease diagnosed in general practice
Authors: Ruigómez A. , García Rodríguez L. A. , Wallander M.‐A. , Johansson S. , Graffner H. , Dent J. 
Published: September 2004

SummaryBackground : Cross‐sectional studies indicate that gastro‐oesophageal reflux disease symptoms have a prevalence of 10–20% in Western countries and are associated with obesity, smoking, oesophagitis, chest pain and respiratory disease.Aim : To determine the natural history of gastro‐oesophageal reflux disease presenting in primary care in the UK.Methods : Patients with a first diagnosis of gastro‐oesophageal reflux disease during 1996 were identified in the UK General Practice Research Database and compared with age‐ and sex‐matched controls. We investigated the incidence of gastro‐oesophageal reflux disease, potential risk factors and comorbidities, and relative risk for subsequent oesophageal complications and mortality.Results : The incidence of a gastro‐oesophageal reflux disease diagnosis was 4.5 per 1000 person‐years (95% confidence interval: 4.4–4.7). Prior use of non‐steroidal anti‐inflammatory drugs, smoking, excess body weight and gastrointestinal and cardiac conditions were associated with an increased risk of gastro‐oesophageal reflux disease diagnosis. Subjects with gastro‐oesophageal reflux disease had an increased risk of respiratory problems, chest pain and angina in the year after diagnosis, and had a relative risk of 11.5 (95% confidence interval: 5.9–22.3) of being diagnosed with an oesophageal complication. There was an increase in mortality in the gastro‐oesophageal reflux disease cohort only in the year following the diagnosis.Conclusions : Gastro‐oesophageal reflux disease is a disease associated with a range of potentially serious oesophageal complications and extra‐oesophageal diseases.
There is no difference in the disease severity of gastro‐oesophageal reflux disease between patients infected and not infected with Helicobacter pylori
Authors: Fallone C. A. , Barkun A. N. , Mayrand S. , Wakil G. , Friedman G. , Szilagyi A. , Wheeler C. , Ross D. 
Published: September 2004

SummaryBackground : The role of Helicobacter pylori in gastro‐oesophageal reflux disease (GERD) is controversial.Aim : To compare the severity of GERD in infected vs. non‐infected patients, as part of an ongoing randomized controlled trial that examines the impact of H. pylori eradication on GERD‐related outcomes.Methods : Consecutive GERD patients underwent urea breath testing and completed validated GERD symptom severity, and quality of life questionnaires as well as, 24‐h pH‐metry. These parameters, as well as demographics and endoscopic findings were assessed in double‐blinded fashion and compared between H. pylori‐infected and non‐infected subjects.Results : Helicobacter pylori‐infected GERD patients (n = 50) were significantly older and less educated than non‐infected patients (n = 51). They also used proton pump inhibitors less often but had no difference in symptoms (as measured with both the Spechler's Activity Index and the Gastrointestinal Symptom Rating Scale), quality of life, endoscopic findings or 24‐h pH‐metry findings.Conclusion : This prospective, double‐blind study demonstrates, using excellent GERD quantifying measures including validated symptom severity scores, endoscopy, and 24‐h pH‐metry, that there exist no clinically significant differences in clinical or laboratory‐related GERD manifestations between H. pylori‐infected and non‐infected GERD patients.
The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis
Authors: Raghunath A. S. , Hungin A. P. S. , Wooff D. , Childs S. 
Published: September 2004

SummaryBackground : The effect of Helicobacter pylori in provoking or protecting against gastro‐oesophageal reflux disease is unclear and studies have given conflicting results. Recent guidelines recommend H. pylori eradication in patients on long‐term proton pump inhibitors.Aim : To ascertain the effect of H. pylori eradication on gastro‐oesophageal reflux disease outcomes (reflux oesophagitis and heartburn) in patients with duodenal ulcer disease, and to ascertain the effect of H. pylori infection on reflux oesophagitis concerning heartburn, pH, severity, healing and relapse rates.Methods : A systematic review of electronic databases was undertaken to September 2003. Experts in the field, pharmaceutical companies and journals were contacted about unpublished trials. Studies were reviewed according to predefined eligibility and quality criteria. Twenty‐seven studies/trials were included in the systematic review.Results : Study variation rather than therapy‐influenced results in relation to the presence or absence of oesophagitis in patients with duodenal ulcer who underwent H. pylori eradication at 6–48 months follow‐up. In patients with reflux oesophagitis no obvious differences were discovered in heartburn scores, 24‐h pH values, healing and relapse rates between H. pylori‐positive and ‐negative cases.Conclusion : There is no evidence to indicate that H. pylori eradication in duodenal ulcer disease provokes reflux oesophagitis or worsens heartburn; (ii) there are insufficient data to draw firm conclusions about the impact of H. pylori in patients with reflux oesophagitis.
Risk of malignancy in diagnosed coeliac disease: a 24‐year prospective, population‐based, cohort study
Authors: T. R. Card , J. West , G. K. T. Holmes 
Published: September 2004

SummaryBackground : There is recent evidence from studies of hospitalized and of undiagnosed patients that the risk of lymphoma for people with coeliac disease may be lower than previously thought. In addition, there have been no precise estimates of small bowel lymphoma risk due to a lack of population data.Aim : To examine these and other malignant risks in a cohort of patients more typical of those seen in routine clinical practice.Methods : A prospective cohort study of incident malignancy rates in patients with coeliac disease in southern Derbyshire compared with general population figures.Results : During 5684 person years of follow‐up 31 malignancies (excluding non‐melanoma skin cancer) occurred in comparison with 30.30 expected [standardized incidence ratio (SIR) 1.02 (0.69–1.45)]. There were four non‐Hodgkin's lymphomas (0.69 expected) SIR 5.81 (1.58–14.86), of which one originated in small bowel (0.02 expected) SIR 40.51 (1.03–225.68). GI malignancy occurred in nine (5.71 expected) SIR 1.58 (0.72–2.99), and breast cancer in three (5.08 expected) SIR 0.59 (0.12–1.73).Conclusions : There is no increase in the risk of incident malignancy in this population and the risk of non‐Hodgkin's lymphoma in general or of the small bowel is lower than previously found from UK coeliac cohorts.
Barrett's oesophagus with predominant intestinal metaplasia correlates with superficial cyclo‐oxygenase‐2 expression, increased proliferation and reduced apoptosis: changes that are partially reversed by non‐steroidal anti‐inflammatory drugs usage
Authors: Amano Y. , Ishihara S. , Kushiyama Y. , Yuki T. , Takahashi Y. , Chinuki D. , Miyake T. , Miyaoka Y. , Rumi M. A. K. , Ishimura N. , Adachi K. , Kinoshita Y. 
Published: September 2004

SummaryBackground : Cyclo‐oxygenase‐2 expression has been reported to play an important role in the metaplasia‐dysplasia‐carcinoma sequence in Barrett's oesophagus. However, the existence of cyclo‐oxygenase‐2 expressing cells in Barrett's epithelium is still uncertain.Aim : To identify the cells that express cyclo‐oxygenase‐2 protein and to investigate the relationship between cyclo‐oxygenase‐2 expression and mucin‐phenotype of Barrett's epithelium.Methods : Sections from 466 biopsy samples of Barrett's epithelium from 358 non‐medicated patients were immunohistochemically examined for the cyclo‐oxygenase‐2 expression, mucin‐phenotype, cell proliferation and apoptosis.Results : Cyclo‐oxygenase‐2 expression was detected in 71.0% of Barrett's epithelium biopsy samples. In Barrett's epithelium with the gastric predominant mucin‐phenotype, cyclo‐oxygenase‐2 expression was mainly found in stromal and deep epithelial cells, whereas in intestinal predominant mucin‐phenotype, it was mostly in superficial epithelial cell. A significant elevation of proliferating cell nuclear antigen index and suppression of apoptotic index was observed in Barrett's epithelium with superficial epithelial cyclo‐oxygenase‐2 expression. Neither such elevation of proliferating cell nuclear antigen index nor the suppression of apoptotic index could be found in chronic non‐steroidal anti‐inflammatory drugs users.Conclusions : Barrett's epithelium with intestinal mucin and superficial epithelial cyclo‐oxygenase‐2 expression possess a higher proliferation potential, but this risk may be thwarted by non‐steroidal anti‐inflammatory drugs administration.
Onset and disappearance of reflux symptoms in a Chinese population: a 1‐year follow‐up study
Authors: Wong W. M. , Lai K. C. , Lam K. F. , Hui W. M. , Huang J. Q. , Xia H. H. X. , Hu W. H. C. , Lam C. L. K. , Chan C. K. , Lam S. K. , Wong B. C. Y. 
Published: September 2004

SummaryBackground : The natural history of gastro‐oesophageal reflux disease in Asian population has not been studied before.Aim : To study the onset and disappearances of reflux symptoms over a 1‐year period in the Chinese population.Methods : A population‐based telephone survey was performed in 2002 and repeated 1 year later. The change in prevalence rate, onset and disappearance of gastro‐oesophageal reflux disease, and the change in diagnoses were assessed. Factors associated with the onset and disappearance of gastro‐oesophageal reflux disease were studied.Results : A total of 712 subjects completed the first and second survey. The annual, monthly and weekly prevalence of gastro‐oesophageal reflux disease were 34.1%, 10.1% and 2.7% respectively. The onset rate (per 1000 person‐year) and disappearance rate of any gastro‐oesophageal reflux disease and frequent gastro‐oesophageal reflux disease (≥ monthly symptoms) were 209, 40; and 395, 243 respectively. Forty‐four percentage of gastro‐oesophageal reflux disease subjects changed their diagnoses in 2003. By multiple logistic regression analysis, high anxiety score (OR: 1.2, 95% CI: 1.1–1.2) and higher educational level (OR: 2.7, 95% CI: 1.3–6.3) were associated with the onset of gastro‐oesophageal reflux disease; while the frequency of acid regurgitation (OR: 0.35, 95% CI: 0.17–0.70) and use of antisecretory therapy (OR: 0.50, 95% CI: 0.28–0.89) were associated with the disappearance of gastro‐oesophageal reflux disease.Conclusion : The prevalence of gastro‐oesophageal reflux disease is stable over 1 year. Higher anxiety score and higher educational level were associated with the onset of gastro‐oesophageal reflux disease, while lower frequency of reflux symptoms and infrequent use of antisecretory therapy were associated with the disappearance of gastro‐oesophageal reflux disease in a Chinese population.
Tumour lysis syndrome: new therapeutic strategies and classification
Authors: Cairo Mitchell S. , Bishop Michael 
Published: September 2004

SummaryTumour lysis syndrome (TLS) describes the metabolic derangements that occur with tumour breakdown following the initiation of cytotoxic therapy. TLS results from the rapid destruction of malignant cells and the abrupt release of intracellular ions, nucleic acids, proteins and their metabolites into the extracellular space. These metabolites can overwhelm the body's normal homeostatic mechanisms and cause hyperuricaemia, hyperkalaemia, hyperphosphaetemia, hypocalcaemia and uraemia. TLS can lead to acute renal failure and can be life‐threatening. Early recognition of patients at risk and initiation of therapy for TLS is essential. There is a high incidence of TLS in tumours with high proliferative rates and tumour burden such as acute lymphoblastic leukaemia and Burkitt's lymphoma. The mainstays of TLS prophylaxis and treatment include aggressive hydration and diuresis, control of hyperuricaemia with allopurinol prophylaxis and rasburicase treatment, and vigilant monitoring of electrolyte abnormalities. Urine alkalinization remains controversial. Unfortunately, there have been few comprehensive reviews on this important subject. In this review, we describe the incidence, pathophysiological mechanisms of TLS and risk factors for its development. We summarise recent advances in the management of TLS and provide a new classification system and recommendations for prophylaxis and/or treatment based on this classification scheme.
Tetramolecular immune complexes are more efficient than IVIg to prevent antibody‐dependent in vitro and in vivo phagocytosis of blood cells
Authors: Bazin Renée , Lemieux Réal , Tremblay Tony , St‐Amour Isabelle 
Published: September 2004

SummaryIntravenous immunoglobulins (IVIg) have immunomodulatory effects in vivo and are widely used in the treatment of autoimmune diseases, such as idiopathic thrombocytopenic purpura (ITP). The mechanisms by which IVIg can prevent platelet clearance in ITP patients are not fully understood but are known to require the participation of low affinity Fcγ receptors (FcγRs), which interact poorly with monomeric immunoglobulin G (IgG). Given the importance of low affinity FcγRs in the treatment of ITP, we hypothesized that immune complexes (IC) produced in vitro could reproduce the effects of IVIg. Small‐size tetramolecular IC were prepared using mouse monoclonal anti‐human IgG and human Fc fragments. The effects of tetramolecular IC and IVIg on the in vitro and in vivo inhibition of phagocytosis of opsonized blood cells were compared. The results obtained showed that tetramolecular IC were at least six times more efficient than IVIg to prevent phagocytosis of opsonized red blood cells in vitro, and clearance of platelets in the thrombocytopenic mouse model.
Dose and response in haemophilia – optimization of factor replacement therapy
Authors: Srivastava Alok 
Published: September 2004

SummaryThe mainstay of the management of haemophilia is the replacement of clotting factors, using clotting factor concentrates (CFC) in a way that prevents bleeding and its complications. Beginning with small doses, as whole blood and plasma over 50 years ago, highly purified CFCs are now administered frequently in large doses to effectively treat this condition so that even people with severe haemophilia can lead near normal lives. However, with such regimens, compliance and expense have both become significant issues. The question therefore is whether the current models of clotting factor replacement are optimal. This article reviews the literature on the dose–response relationship in haemophilia, with particular reference to management of musculoskeletal bleeding and surgical haemostasis. Current practices are based on uncontrolled observational data. Less intensive protocols could achieve similar outcomes. Large multi‐centre prospective studies are needed to provide comparative data on unresolved issues so that factor replacement therapy can be optimized, based on evidence.
The expression of P‐glycoprotein in AML cells with FLT3 internal tandem duplications is associated with reduced apoptosis in response to FLT3 inhibitors
Authors: Hunter Hannah M. , Pallis Monica , Seedhouse Claire H. , Grundy Martin , Gray Claire , Russell Nigel H. 
Published: September 2004

SummaryP‐glycoprotein (pgp), a membrane efflux pump, is recognized to have an anti‐apoptotic function. Internal tandem duplications (ITDs) of the Fms‐like tyrosine kinase 3 (FLT3) receptor are the most common mutations in acute myeloid leukaemia (AML). Both ITDs and pgp positivity confer an adverse clinical prognosis. FLT3 inhibitors induce variable apoptosis in cell lines transfected with FLT3 ITDs. We studied the effect of herbimycin A, AG1296 and PKC412 on primary AML blasts. All compounds showed significantly higher cell kill after 48‐h incubation in samples with an ITD compared with wild type (Herbimicin P < 0·001; AG1296 P = 0·001, PKC412, P = 0·002). Pgp‐positive samples were significantly less sensitive to herbimycin and AG1296 than pgp‐negative samples, although neither molecule inhibited the efflux function of pgp. The concurrent incubation with the pgp inhibitor PSC833 resulted in an enhanced cell kill in 4/5 ITD pgp‐positive samples versus two of nine ITD pgp‐negative samples. PKC412 inhibited pgp function and induced cell death in FLT3 ITD/pgp‐positive samples. We conclude that AML samples with a FLT3 ITD are more susceptible to these inhibitors than wild‐type samples. However, the expression of pgp in cells with FLT3 ITDs can reduce their sensitivity to FLT3 inhibitors and therefore pgp expression should be assessed in clinical trials of FLT3 inhibitors.
Loss of heterozygosity, a frequent but a non‐exclusive mechanism responsible for HLA dysregulation in non‐Hodgkin's lymphomas
Authors: Drénou Bernard , Tilanus Marcel , Semana Gilbert , Alizadeh Mehdi , Birebent Brigitte , Grosset Jean‐Marc , Dias Patricia , Van Wichen Dick , Arts Yvonne , De Santis Dianne , Fauchet Renée , Amiot Laurence 
Published: September 2004

SummaryThe frequent alteration of human leucocyte antigen (HLA) class I molecule expression observed in non‐Hodgkin's lymphomas (NHL), similarly to solid tumours, has been reported to favour tumoral escape from the immune system. In order to identify the underlying mechanisms, we analysed 15 HLA defective NHL including partial (n = 10) and total class I (n = 5) loss, as well as HLA class II defects (n = 5). The HLA defect concerned HLA‐A and ‐B antigens in 14 of 15 cases. In the cases with partial defect, the use of specific allelic monoclonal antibodies detected a defect of both alleles of A or B loci in six of seven tested cases. Allelic reverse transcription polymerase chain reaction (RT‐PCR) demonstrated defects in six of nine cases, including four alterations of both A and B mRNA alleles. Real‐time quantitative RT‐PCR (RQ‐PCR) did not detect the HLA‐DR transcript in the two negative HLA‐DR lymphomas, contrasting with the presence of CMH II transactivator (CIITA) transcript. Loss of heterozygosity (LOH) was detected in nine of 14 cases through variable pattern of nine microsatellites markers of the HLA locus. Taken together, these findings demonstrate the complexity and the variability of the mechanisms underlying HLA protein deficiencies with a high frequency of LOH. The diversity of these mechanisms indicates the importance of positive selection of HLA altered clones in the development of these NHL cases.
Flow cytometric analysis of BCL‐2 can distinguish small numbers of acute lymphoblastic leukaemia cells from B‐cell precursors
Authors: Hartung Leah , Bahler David W. 
Published: September 2004

SummaryFlow cytometric identification of small numbers of precursor B‐cell acute lymphoblastic leukaemia (B‐ALL) cells in post‐treatment marrow specimens could benefit from the identification of additional, easily detectable markers that could be used in most cases. In this study, we evaluate whether bcl‐2 expression quantified by four‐colour flow cytometry can be effectively used to discriminate precursor B‐ALL blasts from normal B‐cell precursors (haematogones) and function as a leukaemia‐specific marker. Levels of bcl‐2 in the 22 precursor B‐ALL cases studied were found to be significantly higher (over sixfold higher on average) than those present in haematogone populations from 22 control marrow specimens. Higher relative levels of bcl‐2 expression in the B‐ALL cases were maintained with respect to both immature CD34+ and more mature CD34− haematogone subsets, and appeared stable. Dilutional studies indicated that multiparameter flow cytometry analysis using bcl‐2 could identify precursor B‐ALL blasts representing as few as 1% of CD19+ cells or 0·01% of total leucocytes in bone marrow specimens containing substantial numbers of haematogones. This study suggests that bcl‐2 may be an important marker for flow cytometric detection and quantification of small numbers of residual precursor B‐ALL cells in bone marrow specimens.
The risk of overanticoagulation in patients with heart failure on coumarin anticoagulants
Authors: Visser Loes E. , Bleumink Gysèle S. , Trienekens Paul H. , Vulto Arnold G. , Hofman Albert , Stricker Bruno H. Ch. 
Published: September 2004

SummaryHeart failure has been identified as a risk factor for increased coumarin anticoagulant responsiveness in several small‐scale experiments. Epidemiological studies quantifying the risk of overanticoagulation by heart failure in a non‐selected population on coumarins are scarce. Therefore, we investigated whether patients with heart failure have an increased risk of overanticoagulation and determined the effect of incidental heart failure on coumarin dose requirements. A cohort study of all patients was performed from an outpatient anticoagulation clinic treated with acenocoumarol or phenprocoumon between 1 January 1990 and 1 January 2000. All cohort members were followed until the first occurrence of an international normalized ratio (INR) ≥6·0, the last INR assessment, death, loss to follow‐up, or end of the study period. Of the 1077 patients in the cohort, 396 developed an INR ≥6·0. The risk of overanticoagulation was 1·66 [95% confidence interval (CI): 1·33–2·07] for cases of prevalent heart failure and 1·91 (95%CI: 1·31–2·79) for incidental cases. The decrease in dose requirements in patients with incidental heart failure showed a significant trend from the fifth INR measurement preceding the date of incidental heart failure to the third measurement after this date. Heart failure is an independent risk factor for overanticoagulation. Therefore, patients with heart failure should be closely monitored to prevent potential bleeding complications.