bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of a rapid urine test for the diagnosis of Helicobacter pylori infection in the Chinese population
Authors: Wong W. M. , Wong B. C. Y. , Xia H. H. X. , Tang V. S. Y. , Lai K. C. , Hu W. H. C. , Yuen M. F. , Chan C. K. , Lam S. K. 
Published: March 2003

Background:A new rapid urine test was developed to detect anti‐Helicobacter pylori antibody in urine using the principle of immunochromatography. The accuracy of this test in the Chinese population remains to be defined.Aim:To evaluate a new rapid urine test for the diagnosis of H. pylori infection in the Chinese population.Methods:Eligible patients without previous treatment of H. pylori were recruited. In‐house rapid urease test and histology were used as the gold standard. The rapid urine test (RAPIRUN H. pylori antibody) was performed and the results were compared with the gold standard.Results:One hundred and twenty‐three patients were eligible for analysis and 61 (50%) were H. pylori positive by the gold standard. The rapid urine test showed a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 96.7%, 95.2%, 95.2%, 96.7% and 95.9%, respectively. Results were obtained within 20 min and no special laboratory support was required.Conclusions:The rapid urine test by immunochromatography is highly accurate for the diagnosis of H. pylori infection in untreated Chinese patients.
Alverine citrate fails to relieve the symptoms of irritable bowel syndrome: results of a double‐blind, randomized, placebo‐controlled trial
Authors: Mitchell S. A. , Mee A. S. , Smith G. D. , Palmer K. R. , Chapman R. W. 
Published: March 2003

SummaryBackground : Alverine citrate has been used in the treatment of irritable bowel syndrome for many years.Aims : To compare the efficacy and safety of a new formulation of alverine citrate, a 120‐mg capsule, with placebo given three times daily for 12 weeks.Methods : One hundred and seven patients with irritable bowel syndrome were entered into this three‐centre, double‐blind, randomized, placebo‐controlled, parallel group trial. The primary end‐point was relief of abdominal pain indicated by improvement in the scores for severity and frequency. Secondary efficacy variables included scores for other clinical symptoms and for overall well‐being.Results : The severity and frequency of abdominal pain improved in 66% and 68% of patients treated with alverine citrate vs. 58% and 69% of the placebo group, but these differences were not significant. The mean percentage reduction in the scores for abdominal pain from baseline to the final assessment, although greater in the alverine citrate group (43.7%) compared with the placebo group (33.3%), was not statistically significant.Conclusions : Alverine citrate is no better than placebo at relieving the symptoms of irritable bowel syndrome. Future trials should be designed to take into account the high and persistent placebo response seen in this condition.
The effect of the 5‐HT3 receptor antagonist, alosetron, on brain responses to visceral stimulation in irritable bowel syndrome patients
Authors: Mayer E. A. , Berman S. , Derbyshire S. W. G. , Suyenobu B. , Chang L. , Fitzgerald L. , Mandelkern M. , Hamm L. , Vogt B. , Naliboff B. D. 
Published: March 2003

SummaryAim : To conduct a placebo‐controlled functional brain imaging study to assess the effect of the 5‐hydroxytryptamine‐3 receptor antagonist, alosetron, on irritable bowel syndrome symptoms, regional brain activation by rectosigmoid distension and associated perceptual and emotional responses.Methods : Fifty‐two non‐constipated irritable bowel syndrome patients (28 female) were enrolled in a randomized, placebo‐controlled trial with alosetron (1–4 mg b.d.). Thirty‐seven patients completed both brain scans following randomization. Rectosigmoid stimulation was performed with a computer‐controlled barostat. Changes in regional cerebral blood flow were assessed using H215O positron emission tomography. Stimulus ratings and changes in gastrointestinal symptoms were assessed using verbal descriptor scales.Results : Alosetron, but not placebo, treatment was associated with a decrease in symptom ratings, and reductions in emotional stimulus ratings. Compared to baseline, alosetron treatment was associated with reduced regional cerebral blood flow in bilateral frontotemporal and various limbic structures, including the amygdala. Compared to placebo, decreases in activity of the amygdala, ventral striatum, hypothalamus and infragenual cingulate gyrus were significantly greater after alosetron.Conclusions : In non‐constipated irritable bowel syndrome patients, 3 weeks of treatment with a 5‐hydroxytryptamine‐3 receptor antagonist decreases brain activity in response to unanticipated, anticipated and delivered aversive rectal stimuli in structures of the emotional motor system, and this is associated with a decrease in gastrointestinal symptoms.
Pathogenesis of sporadic and familial gastric cancer – implications for clinical management and cancer prevention
Authors: Ebert M. P. A. , Malfertheiner P. 
Published: March 2003

SummaryGastric cancer remains a great clinical challenge despite its decreasing incidence. While major progress has been achieved in the understanding of the pathogenesis and molecular biology of sporadic gastric cancer, only recently has the role of familial aggregation of gastric cancers been rediscovered. The genetic changes underlying sporadic and familial gastric cancer have been revealed, and recent studies indicate that this familial aggregation combines genetic and microbiological aspects. Thus, for the prevention of gastric cancers these findings might be helpful for the early diagnosis and for the screening of risk groups and family members.
Percutaneous ethanol injection vs. resection in patients with small single hepatocellular carcinoma: a retrospective case–control study with cost analysis
Authors: Gournay J. , Tchuenbou J. , Richou C. , Masliah C. , Lerat F. , Dupas B. , Martin T. , Nouel J. F. , Schnée M. , Montigny P. , D'Alincourt A. , Hamy A. , Paineau J. , Le Néel J. ‐C. , Le Borgne J. , Galmiche J. P. 
Published: March 2003

SummaryBackground : Percutaneous ethanol injection and hepatic resection are the most widely used curative therapeutic options for patients with compensated liver disease and small hepatocellular carcinoma.Aim : To compare percutaneous ethanol injection and hepatic resection in a selected group of consecutive French patients with a single hepatocellular carcinoma, smaller than or equal to 50 mm, in terms of survival, recurrence rate of malignancy and direct costs.Methods : The analysis of two contemporary cohorts of Child–Pugh A or B patients with a single hepatocellular carcinoma of ≤ 50 mm treated by percutaneous ethanol injection (n=55) or hepatic resection (n=50).Results : Long‐term survival was not significantly different between the two groups when the size of hepatocellular carcinoma was less than 30 mm. However, the survival of patients with hepatocellular carcinoma larger than 30 mm was higher after hepatic resection than after percutaneous ethanol injection (P=0.044). The cumulative direct costs were significantly higher in patients treated by hepatic resection than in those treated by percutaneous ethanol injection regardless of the tumour size. The calculated costs per month of survival in patients treated with percutaneous ethanol injection and hepatic resection were 999 vs. 3865 euros, respectively (P < 0.001).Conclusions : Percutaneous ethanol injection is more cost effective than hepatic resection in patients with a single hepatocellular carcinoma smaller than 30 mm. However, in patients with a larger tumour, long‐term survival is higher after hepatic resection.
Effect of different proton pump inhibitors, differences in CYP2C19 genotype and antibiotic resistance on the eradication rate of Helicobacter pylori infection by a 1‐week regimen of proton pump inhibitor, amoxicillin and clarithromycin
Authors: Kawabata H. , Habu Y. , Tomioka H. , Kutsumi H. , Kobayashi M. , Oyasu K. , Hayakumo T. , Mizuno S. , Kiyota K. , Nakajima M. , Kimoto K. , Inokuchi H. , Kawai K. 
Published: March 2003

SummaryAim : To investigate the effect of different proton pump inhibitors, S‐mephenytoin 4′‐hydroxylase (CYP2C19) genotype and antibiotic susceptibility on the eradication rate of Helicobacter pylori.Methods : One hundred and eighty‐seven H. pylori‐infected peptic ulcer patients were randomly treated with either rabeprazole (10 mg b.d.) or lansoprazole (30 mg b.d.) plus amoxicillin (750 mg b.d.) and clarithromycin (400 mg b.d.) for 1 week. The antibiotic susceptibility and CYP2C19 genotype (extensive or poor metabolizer) were investigated.Results : The eradication rates in the rabeprazole–amoxicillin–clarithromycin (RAC) and lansoprazole–amoxicillin–clarithromycin (LAC) groups were 75% and 69%, respectively, on an intention‐to‐treat basis, and 80% and 75%, respectively, on a per protocol basis. The eradication rate for clarithromycin‐resistant strains was significantly lower than that for clarithromycin‐sensitive strains (24% vs. 86%, P < 0.05). For clarithromycin‐sensitive strains in the LAC group, there was a tendency for a lower eradication rate in extensive than poor metabolizers. The eradication rate in extensive metabolizers in the RAC group tended to be higher than that in extensive metabolizers in the LAC group (89% vs. 78%, P = 0.079726).Conclusions : The success of the 1‐week proton pump inhibitor–amoxicillin–clarithromycin regimen depends on the susceptibility of H. pylori to clarithromycin. Moreover, differences in CYP2C19 genotype influence the eradication rates of lansoprazole‐based therapy, and the rabeprazole‐based regimen has an advantage especially in extensive metabolizers.
Response of fistulating Crohn's disease to infliximab treatment assessed by magnetic resonance imaging
Authors: Bell S. J. , Halligan S. , Windsor A. C. J. , Williams A. B. , Wiesel P. , Kamm M. A. 
Published: March 2003

SummaryAims : To assess fistula track healing after infliximab treatment using magnetic resonance imaging.Methods : Magnetic resonance imaging and clinical evaluation were performed before and after three infliximab infusions given over a 6‐week period. Magnetic resonance images were evaluated for abscesses and fistula tracks. Paired magnetic resonance image examinations were rated ‘better’, ‘unchanged’ or ‘worse’. Magnetic resonance imaging and clinical outcomes were then compared.Results : Of the 12 referred patients, pre‐treatment magnetic resonance imaging detected abscesses in three (two not treated). Of the 10 treated patients, seven had peri‐anal fistulas, two of whom also had recto‐vaginal fistulas, and three had abdominal wall entero‐cutaneous fistulas. After infliximab, four were in remission, one had a response and five were non‐responders. One developed a peri‐anal abscess. Magnetic resonance imaging improved in six, was unchanged in two and was worse in two. In four of the six with improvement in magnetic resonance imaging, the fistula track resolved, but two of these had clinically persistent entero‐cutaneous fistulas. The clinical outcome and magnetic resonance imaging correlated in seven of the 10 patients; in three (two entero‐cutaneous and one peri‐anal), there was discordance.Conclusions : Magnetic resonance imaging identifies clinically silent sepsis. Fistulas may persist despite clinical remission. Clinical response to infliximab and clinical correlation with magnetic resonance imaging were poor in patients with abdominal entero‐cutaneous fistulas.
Effects of surgical stress and nitrous oxide anaesthesia on peri‐operative plasma levels of total homocysteineA randomised, controlled study in general surgery
Authors: Foschi D. , Rizzi A. , Zighetti M. L. , Bissi M. , Corsi F. , Trabucchi E. , Mezzetti M. , Cattaneo M. 
Published: March 2003

Previous studies of patients have shown that anaesthesia with nitrous oxide (N2O) increases the plasma levels of total homocysteine. In a randomised, controlled trial we measured the plasma total homocysteine levels in patients undergoing general surgery before and after anaesthesia with and without N2O. Plasma total homocysteine levels were measured before anaesthesia and 1, 3–5 and 24 h after incision in 24 patients randomly allocated to anaesthesia with N2O (n = 12) and without N2O (n = 12). Total homocysteine levels significantly decreased from 10.4 ± 2.7 to 8.2 ± 2.9 µmol.l−1 in the non‐N2O group 24 h after incision (p < 0.02), while they tended to increase slightly in the N2O group from 10.5 ± 4.5 to 10.9 ± 4.3 µmol.l−1 (p > 0.05). Our randomised controlled study indicates that total homocysteine decreases after general surgery in patients in whom anaesthesia is maintained without N2O, but not in patients in whom anaesthesia is maintained with N2O.
An evaluation of the Airway Management Device
Authors: Cook T. M. , Gupta K. , Gabbott D. A. , Nolan J. P. 
Published: March 2003

We have evaluated the Airway Management Device (AMD™) in 105 anaesthetised patients. We were successful in establishing a clear airway on the first attempt on 69 occasions and unable to establish a patent airway at all in 10 patients. Airway obstruction requiring removal of the device occurred during maintenance of anaesthesia in a further two cases and during emergence in three. Loss of the airway during anaesthesia occurred in eight of 95 patients and could be reversed by manipulation of the airway in six cases. Overall, a mean of 0.56 manipulations per patient were required to establish an airway and a further 0.42 per patient were required during maintenance of anaesthesia. In the 95 patients in whom an airway was established, assisted ventilation was satisfactory in 93, with a leak pressure above 20 cmH2O in 65. Intracuff pressure was measured in 12 cases and was above 100 cmH2O in eight. Minor complications occurred in 12 patients. Blood was visible on removal of the device in six cases.
A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 Near‐Infrared Spectrophotometers
Authors: Thavasothy M. , Broadhead M. , Elwell C. , Peters M. , Smith M. 
Published: March 2003

SummaryIn this study cerebral oxygenation was measured using the NIRO 300 and the INVOS 5100 spectrophotometers in 10 healthy adult volunteers, exposed to varying degrees of hyperoxia and hypoxia. The results showed similar baseline values for tissue oxygenation index and regional cerebral oxygen saturation with mean (SD) values being 64.9% (5.1) and 62.3% (6.0), respectively. The overall bias was –2.1%, with the INVOS 5100 under‐reading cerebral oxygenation compared to the NIRO 300, with limits of agreement of ±14.7%. Both monitors demonstrated similar changes in response to hyperoxia and hypocapnia (coefficient of variance for FIo2 0.45 = 10.0%, FIo2 1.0 = 10.1%, hypocapnia = 14.5%). The reasons for the bias and variability may relate to differences in the methodological approaches of the two monitors. The correlation between the monitors in response to changes in cerebral oxygenation implies that they may be useful as trend monitors in clinical practice.
The long Bain breathing system: an investigation into the implications of remote ventilation
Authors: Sweeting C. J. , Thomas P. W. , Sanders D. J. 
Published: March 2003

AbstractA long version of the Bain breathing system is commonly used when remote anaesthesia is required, such as during magnetic resonance imaging or radiotherapy. We compared the static compliance and distal pressures over a range of flows in a 1.6 and 9.6 m Bain system. We examined the effect on ventilation of increasing the length of the Bain system in lung models for 10, 20 and 70 kg patients. We found that static compliance was increased in the long Bain system. We found that with matched peak inspiratory ventilator pressures there was a reduction in peak inspiratory pressures at the patient end with the longer system (p < 0.001). A reduction in tidal volume was found with the 9.6 m Bain (p < 0.001), and positive end‐expiratory pressure was increased (p = 0.01). Although the effect on tidal volume was proportionally small in the 70 kg simulation (660 and 617 ml in 1.6 and 9.6 m systems, respectively) it increases in significance in children, with a 23% reduction in tidal volume in the 10 kg mock lung (95 and 73 ml in 1.6 and 9.6 m systems, respectively). Anaesthetists should be aware of the reduction in tidal volume and increased positive end‐expiratory pressure. During remote anaesthesia with a long Bain system, the ventilator should be adjusted to compensate.
The champagne angle
Authors: Pemberton P. L. , Calder I. , O'Sullivan C. , Crockard H A. 
Published: March 2003

SummaryA patient's observation led us to investigate whether drinking from a champagne flute required more cranio‐cervical extension than drinking from other types of wine glasses. We measured the cranio‐cervical extension required by normal volunteers to drink from four different types of glass. The mean [95% confidence intervals] extension from the neutral position required to drain each glass was: narrow flute 40°[35–44]; wide flute 22°[19‐25]; wine glass 26°[24‐29]; champagne saucer 0°[‐1‐2]. Drinking from the narrow rimmed champagne flute required significantly more extension than the other types of glass (p < 0.001), and 73% of the total available cranio‐cervical extension.
Tectono‐climatic evolution of a Neogene intramontane basin (Late Miocene Carboneras subbasin, southeast Spain): revelations from basin mapping and biofacies analysis
Authors: Brachert T. C. , Krautworst U. M. R. , Stueckrad O. M. 
Published: March 2003

ABSTRACTExceptional 3‐D exposures of fault blocks forming a 5 km × 10 km clastic sediment‐starved, marine basin (Carboneras subbasin, southeast Spain) allow a test of the response of carbonate sequence stratigraphic architectures to climatic and tectonic forcing. Temperate and tropical climatic periods recorded in biofacies serve as a chronostratigraphic framework to reconstruct the status of the basin within three time‐slices (late Tortonian–early Messinian, late Messinian, Pliocene). Structural maps and isopach maps trace out the distribution of fault blocks, faults, and over time, their relative motions, propagational patterns and life times, which demonstrate a changing layout of the basin because of a rotation of the regional transtensional stress field. Progradation of early Messinian reefal systems was perpendicular to the master faults of the blocks, which were draped by condensed fore‐slope sediments. The hangingwall basins coincided with the toe‐of‐slope of the reef systems. The main phase of block faulting during the late Tortonian and earliest Messinian influenced the palaeogeography until the late Pliocene (cumulative throw < 150–240 m), whereas displacements along block bounding faults, which moved into the hangingwall, died out over time. An associated shift of the depocentres of calciturbidites, slump masses and fault scarp degradation breccias reflects 500–700 m of fault propagation into the hangingwall. The shallow‐water systems of the footwall areas were repeatedly subject to emergence and deep peripheral erosion, which imply slow net relative uplift of the footwall. In the dip‐slope settings, erosional truncations of tilted proximal deposits prevail, which indicate rotational relative uplift. Block movements were on the order of magnitude of third order sea‐level fluctuations during the late Tortonian and earliest Messinian. We suggest that this might be the reason for the common presence of offlapping geometries in early Messinian reef systems of the Betic Cordilleras. During the late Pliocene, uplift rates fell below third order rates of sea‐level variations. However, at this stage, the basin was uplifted too far to be inundated by the sea again. The evolution of the basin may serve as a model for many other extensional basins around the world.
Perindopril postmarketing surveillance: a 12 month study in 47 351 hypertensive patients
Authors: Speirs C. , Wagniart F. , Poggi L. 
Published: March 2003

Aims
To gain information on serious adverse events in a large number of patients exposed to perindopril.
Methods
Four thousand sevenhundred and eighty‐eight general practitioners throughout France collaborated in the recruitment of 47 351 patients for a 12 month postmarketing study. Data collection was undertaken by company representatives under the supervision of nine regional medical officers. Computerised data entry was performed by six pharmaceutical officers. Serious adverse events were later individually reviewed medically.
Results
Withdrawals due to adverse events occurred in 6.1% of female and 3.2% of males patients. The ascertainment of adverse events in this study approved satisfactory, as shown by the reported incidence of cough, which was 11.3% in women and 7.8% in men, this being compatible with the best estimates of the true incidence of cough during ACE‐inhibitor therapy. Serious adverse reactions—anaphylaxis and blood dyscrasias—were rare.
Conclusions
This study successfully followed a large cohort of patients treated with perindopril and failed to demonstrate any unexpected hazards.
Different effects of itraconazole on the pharmacokinetics of fluvastatin and lovastatin
Authors: Kivistö K. T. , Kantola T. , Neuvonen P. J. 
Published: March 2003

Aims
The effects of itraconazole on the pharmacokinetics of fluvastatin and lovastatin, two inhibitors of HMG‐CoA reductase with different pharmacokinetic properties, were studied.
Methods
Two separate randomized, placebo‐controlled, cross‐over studies, each involving 10 healthy volunteers, were carried out. The general design was identical in both studies. The subjects took either 100 mg itraconazole or matched placebo orally once daily for 4 days. On day 4, 40 mg fluvastatin or 40 mg lovastatin was administered orally. Plasma concentrations of fluvastatin, lovastatin, lovastatin acid, itraconazole and hydroxyitraconazole were determined up to 24 h.
Results
Itraconazole had no significant effect on the Cmax (190±124 ng ml−1vs 197±189 ng ml−1 (mean±s.d.)) or total AUC (368±153 ng ml−1 h vs 324±155 ng ml−1 h) of fluvastatin compared with placebo. However, the t1/2,z of fluvastatin was slightly prolonged by itraconazole (2.8±0.49 h vs 2.4±0.51 h; P<0.05). The Cmax of lovastatin was increased about 15‐fold (P<0.01) and the total AUC more than 15‐fold (P<0.01) by itraconazole. Similarly, the Cmax and total AUC of lovastatin acid were increased about 12‐fold (95% CI, 5.3 to 17.7‐fold; P<0.01) and 15‐fold (95% CI, 4.6 to 26.2‐fold; P<0.01) by itraconazole, respectively. The t1/2,z of lovastatin averaged 3.7±3.8 h and that of lovastatin acid 4.7±4.0 h during the itraconazole phase; these variables could not be determined in all subjects during the placebo phase.
Conclusions
Itraconazole, even at a small dosage of 100 mg daily, greatly elevated plasma concentrations of lovastatin and its active metabolite, lovastatin acid. Lovastatin should therefore not be used concomitantly with itraconazole and other potent CYP3A4 inhibitors, or the dosage of lovastatin should be greatly reduced while using a CYP3A4 inhibitor. In contrast, fluvastatin concentrations were not significantly increased by itraconazole, indicating that fluvastatin has much less potential than lovastatin for clinically significant interactions with itraconazole and other CYP3A4 inhibitors.