bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection
Authors: Tsang S. W. C. , Chan H. L. Y. , Leung N. W. Y. , Chau T. N. , Lai S. T. , Chan F. K. L. , Sung J. J. Y. 
Published: March 2003

Background:Exacerbation of chronic hepatitis B infection can lead to fulminant hepatic failure with a mortality of up to 90%.Aim:To evaluate the efficacy of lamivudine in the treatment of this subgroup of patients.Methods:Twenty‐four patients with exacerbation of chronic hepatitis B infection and fulminant hepatic failure were treated with lamivudine, 100 mg daily. Hepatitis A, C, D and human immunodeficiency virus co‐infections and hepatocellular carcinoma were excluded.Results:The median age was 53 years (range, 24–77 years) with a male predominance of 20:4. Seventeen patients were hepatitis B e antigen positive. Mean hepatitis B virus DNA was 2079 Meq/mL. Eight patients (33%) survived (group A). Thirteen patients died and three patients received liver transplantation (67%) (group B). Baseline laboratory results were comparable between the two groups, including serum albumin, bilirubin, alanine aminotransferase, prothrombin time and creatinine. Group B patients had significantly more comorbid illnesses at baseline and more complications, including sepsis and renal failure, compared with group A patients. Six out of eight survivors (75%) had full hepatitis B e antigen seroconversion, but this was not sustained in four patients.Conclusions:Lamivudine may be useful in treating patients with fulminant hepatic failure due to exacerbation of chronic hepatitis B. Hepatitis B e antigen seroconversion was less durable in this subgroup of patients and long‐term therapy may be required.
Effects of anti‐tumour necrosis factor, interleukin‐10 and antibiotic therapy in the indometacin‐induced bowel inflammation rat model
Authors: Colpaert S. , Liu Z. , De Greef B. , Rutgeerts P. , Ceuppens J. L. , Geboes K. 
Published: March 2003

Background:The administration of indometacin to rats increases intestinal permeability and induces inflammatory pathology of the small bowel. This represents a potential model for Crohn’s disease.Aims:To analyse the pathogenic role of T cells, tumour necrosis factor and bacterial flora in indometacin‐induced changes in small bowel permeability and inflammation.Methods:Rats were given indometacin, 13 mg/kg, on day 1 and day 2. The effects of antibiotic (metronidazole, aztreonam and amoxicillin/clavulanic acid), anti‐ tumour necrosis factor and interleukin‐10 therapy were evaluated. The parameters used were weight change, serum haemoglobin, chromium‐51 ethylenediaminetetra‐acetate permeability and macro‐and microscopic score on day 5. Results in conventionally harboured rats were compared with those in T‐cell‐free rats. Additional in vitro experiments were carried out to test the effect of metronidazole on tumour necrosis factor production.Results:Indometacin administration resulted in small bowel ulcers and inflammation, independently of T cells. Metronidazole was more potent than amoxicillin/clavulanic acid and anti‐tumour necrosis factor in improving the indometacin‐induced small bowel inflammation. Only part of the efficacy was through improvement of increased intestinal permeability. Aztreonam and interleukin‐10 had no effect. Metronidazole also suppressed in vitro lipopolysaccharide‐induced tumour necrosis factor production, suggesting a therapeutic effect of this drug through the inhibition of tumour necrosis factor.Conclusions:These data implicate anaerobic bacteria and tumour necrosis factor production, but not T cells, as essential elements of the pathogenesis of indometacin‐induced small bowel inflammation. Tumour necrosis factor is also involved in the change in intestinal permeability. Metronidazole was the most efficacious drug in this model, probably because it suppressed anaerobic bacteria and directly inhibited tumour necrosis factor production.
Non‐surgical treatment of hepatocellular carcinoma
Authors: Alsowmely A. M. , Hodgson H. J. F. 
Published: March 2003

Primary hepatocellular cancer is a disease with a poor prognosis for which there is little consensus on treatment and a paucity of comparative trials. The coexistence of cancer with cirrhosis complicates treatment, and also confers a high risk for the development of further tumours. Surgery, either by hepatic resection or orthotopic liver transplantation, is only a feasible option in a minority of patients.This article surveys the non‐surgical approaches to the treatment of hepatocellular cancers—local ablation techniques, arterial embolization with and without chemotherapy, conventional chemotherapy and hormonal modulation, and targeted and external irradiation.
Optimal serological tests for the detection of Helicobacter pylori infection in the Chinese population
Authors: Xia H. H. ‐X. , Wong B. C. Y. , Wong W. M. , Tang V. S. Y. , Cheung H. K. L. , Sham F. N. F. , Fung F. M. Y. , Lai K. C. , Hu W. H. C. , Chan C. K. , Lam S. K. 
Published: March 2003

Background:Numerous serological tests for the detection of Helicobacter pylori infection have been developed. However, many perform poorly when evaluated in the Chinese population.Aim:To search for optimal serological tests for the detection of H. pylori infection in Chinese patients.Methods:Consecutive dyspeptic patients referred for upper endoscopy were recruited. During endoscopy, gastric biopsies were taken for the CLOtest™ and histological examination. Patients were then given a 13C‐urea breath test. Sera were used to test for H. pylori infection, employing three commercial enzyme‐linked immunosorbent assay kits (pylori DTect, HP IgG and GAP IgG). Results were compared with the gold standard defined by the CLOtest™, histology and 13C‐urea breath test.Results:Among the 142 patients (47 male, 95 female; mean age, 49 years) recruited, 81 (57%) were H. pylori‐positive, 57 (40%) were H. pylori‐negative and four (3%) were defined to be indeterminate. Using a self‐defined cut‐off value after calculation, the best accuracies for the pylori DTect, HP IgG and GAP IgG tests were 97%, 91% and 80%, respectively.Conclusions:The pylori DTect test is an optimal serological test for the detection of H. pylori infection in Hong Kong Chinese patients. The HP IgG test may be used as an alternative.
Chemotherapy for colon cancer in a well‐defined French population: is it under‐ or over‐prescribed?
Authors: Faivre‐Finn C. , Bouvier A.‐M. , Mitry E. , Rassiat E. , Clinard F. , Faivre J. 
Published: March 2003

Background:It has been demonstrated that adjuvant chemotherapy in TNM stage III and palliative chemotherapy are effective treatments for colon cancer.Aim:To determine changes over a 10‐year period in the practice of adjuvant and palliative chemotherapy for colon cancer in a well‐defined French population.Methods:Some 4093 patients with colon adenocarcinoma diagnosed between 1989 and 1998 were studied. To estimate the independent effect of the studied variables, a non‐conditional logistical regression was performed.Results:The proportion of patients with stage II disease treated with adjuvant chemotherapy increased from 2.3% (1989–90) to 20.5% (1997–98). The corresponding figures for stage III patients were 7.1% and 54.9%. This increase was particularly marked in younger patients, with 47.3% of stage II and 86.1% of stage III patients under the age of 65 years being treated in the 1997–98 period, compared with 4.9% and 24.4% of those over 75 years for the same period (P < 0.0001). The use of palliative chemotherapy increased over time from 13.6% (1989–90) to 38.9% (1997–98). Again, this increase was more dramatic in the younger age group.Conclusions:The use of adjuvant chemotherapy has increased for stage II disease despite the absence of proven effectiveness. Both adjuvant and palliative chemotherapy are still under‐prescribed in patients over the age of 75 years.
The effects of the specific 5HT4 receptor agonist, prucalopride, on colonic motility in healthy volunteers
Authors: De Schryver A. M. P. , Andriesse G. I. , Samsom M. , Smout A. J. P. M. , Gooszen H. G. , Akkermans L. M. A. 
Published: March 2003

Background:Prucalopride is a selective and specific 5‐hydroxytryptamine4 receptor agonist that is known to increase stool frequency and to accelerate colonic transit.Aim:To investigate the effect of prucalopride on high‐amplitude propagated contractions and segmental pressure waves in healthy volunteers.Methods:After 1 week of dosing (prucalopride or placebo in a double‐blind, randomized, crossover fashion), colonic pressures were recorded in 10 healthy subjects using a solid‐state pressure catheter with six sensors spaced 10 cm apart. Subjects kept diary records of their bowel habits (frequency, consistency and straining). High‐amplitude propagated contractions were analysed visually, comparing their total numbers and using 10‐min time windows. Segmental pressure waves were analysed using computer algorithms, quantifying the incidence, amplitude, duration and area under the curve of all detected peaks.Results:When taking prucalopride, stool frequency increased, consistency decreased and subjects strained less. Prucalopride just failed to increase the total number of high‐amplitude propagated contractions (P=0.055). The number of 10‐min time windows containing high‐amplitude propagated contractions was increased by prucalopride (P=0.019). Prucalopride increased the area under the curve per 24 h (P=0.026).Conclusions:The 5‐hydroxytryptamine4 receptor agonist prucalopride stimulates high‐amplitude propagated contractions and increases segmental contractions, which is likely to be the underlying mechanism of its effect on bowel habits in healthy volunteers.
Effects of prucalopride on colonic transit, anorectal function and bowel habits in patients with chronic constipation
Authors: Sloots C. E. J. , Poen A. C. , Kerstens R. , Stevens M. , De Pauw M. , Van Oene J. C. , Meuwissen S. G. M. , Felt‐Bersma R. J. F. 
Published: March 2003

Background:There is a need for better tolerated drugs to normalize bowel function in chronic constipation. Prucalopride is a highly selective, specific, serotonin4 receptor agonist with enterokinetic properties.Aim:To evaluate the effects of prucalopride on bowel function, colonic transit and anorectal function in patients with chronic constipation.Methods:Twenty‐eight patients were enrolled in this double‐blind, placebo‐controlled, crossover study (prucalopride: 1 mg, n=12; 2 mg, n=16). Patients kept a bowel function diary. Colonic transit times and anorectal function (anal manometry, rectal sensitivity and rectal compliance) were assessed.Results:Prucalopride (1 mg) compared to placebo significantly increased the mean number of spontaneous complete, spontaneous and all bowel movements per week. Prucalopride (1 mg) significantly decreased the percentage of bowel movements with hard/lumpy stools and straining and increased the urge to defecate. Prucalopride (1 and 2 mg) decreased the mean total colonic transit time by 12.0 h (prucalopride 42.8 h vs. placebo 54.8 h; P=0.074). No statistically significant effects were found in any of the anorectal function parameters. Prucalopride was well tolerated. There were no clinically relevant changes in standard safety parameters.Conclusions:Prucalopride significantly improves stool frequency and consistency, and the urge to defecate, and may decrease colonic transit times in patients with chronic constipation.
Corpus gastritis in patients with endoscopic diagnosis of reflux oesophagitis and Barrett's oesophagus
Authors: Laheij R. J. F. , Van Rossum L. G. M. , De Boer W. A. , Jansen J. B. M. J. 
Published: March 2003

Background:A high level of gastric acid secretion is considered to be a risk factor for reflux oesophagitis or Barrett's oesophagus. Corpus gastritis may have a protective effect on the oesophagus, because of decreased gastric acid output.Aim:To determine if corpus gastritis is associated with reflux oesophagitis or Barrett's oesophagus.Methods:Three antral and two corpus biopsies were taken from consecutive patients in whom Helicobacter pylori testing was requested during endoscopy at a single centre between January 1995 and May 1997. Antral and corpus gastritis was studied by histology; H. pylori was studied by histology, culture and CLO test. A regression model was used to test for correlation between reflux oesophagitis, Barrett's oesophagus and risk factors.Results:During the study period, 676 patients had biopsies taken during upper gastrointestinal endoscopy. Endoscopic signs of reflux oesophagitis and Barrett's oesophagus were observed in 125 and 23 patients, respectively. Corpus gastritis was found in 59% of patients without reflux oesophagitis or Barrett's oesophagus, 45% of patients with reflux oesophagitis and 30% of patients with Barrett's oesophagus. Two hundred and fifty‐seven patients underwent follow‐up endoscopy after H. pylori therapy. During a mean follow‐up of 3 months, the incidence of reflux oesophagitis was not statistically different for patients with healing of corpus gastritis (10/98; 10%) and patients with persistent gastritis (8/97; 8%).Conclusions:Corpus gastritis was less common in patients with an endoscopic diagnosis of reflux oesophagitis or Barrett's oesophagus.
Duodenal ulcer healing with 1‐week eradication triple therapy followed, or not, by anti‐secretory treatment: a multicentre double‐blind placebo‐controlled trial
Authors: Colin R. ,   For The Hepylog Investigator Study Group
Published: March 2003

Background:In the management of Helicobacter pylori induced duodenal ulcer, it is still controversial whether anti‐secretory treatment needs to be continued following a 1‐week course of eradication therapy.Methods:150 patients with H. pylori active duodenal ulcer (diameter ≥ 5 mm) were included. After a 1‐week eradication treatment combining omeprazole 20 mg b.d., amoxicillin 1000 mg b.d. and clarithromycin 500 mg b.d. (OAC), patients were randomized to omeprazole 20 mg or placebo for 3 additional weeks. The primary variable was ulcer healing assessed at 4 weeks. Eradication was verified 4 weeks after cessation of study drugs by 13C‐urea breath test. Intention‐to‐treat analysis (ITT) included 131 patients with positive histopathology at inclusion.Results:Healing rates were not statistically different, at 89% and 87%, respectively, in the OAC–omeprazole and OAC–placebo groups (95% CI: –8.7; 13.7). Numerically, healing rates in patients with successful eradication was higher [94/104 (90%)] than in patients with failed eradication [21/27 (78%)]. However, the difference was not statistically significant (P < 0.1).Conclusions:One‐week OAC eradication triple therapy achieves excellent healing rates in patients with uncomplicated duodenal ulcer disease. Although the confidence interval of the difference in healing suggests little or no benefit of continued omeprazole treatment after 1 week, larger studies are needed to address this issue definitively.
Amoxicillin and ampicillin are not transferred to gastric juice irrespective of Helicobacter pylori status or acid blockade by omeprazole
Authors: Ortiz R. A. M. , Calafatti S. A. , Corazzi A. , Souza J. M. , Deguer M. , De Souza C. A. F. , Marchioretto M. A. M. , Bernasconi G. , Ferraz J. G. P. , Pedrazzoli J. 
Published: March 2003

Background:The effects of proton pump inhibitors and Helicobacter pylori infection on the distribution of drugs used for the eradication of the bacteria are poorly understood.Aim:The aim of this study was to investigate the effects of a 7‐day administration of 20 mg of omeprazole on the pharmacokinetics of amoxicillin and ampicillin in the plasma, saliva and gastric juice of individuals with and without H. pylori infection.Methods:Fifty‐four healthy volunteers without endoscopic lesions were enrolled. Twenty‐six volunteers were included in the amoxicillin study and 28 individuals in the ampicillin study. Each study had an open randomized two‐period crossover design and a 21‐day washout period between phases. Plasma, saliva and gastric juice concentrations of amoxicillin and ampicillin in subjects with and without omeprazole pre‐treatment were measured by reversed‐phase HPLC using UV detection.Results:Neither pre‐treatment with omeprazole nor H. pylori infection interfered with the plasma bioavailability of amoxicillin or ampicillin, as assessed by the AUC0–2 h. Neither ampicillin nor amoxicillin were detected in saliva or gastric juice in any study phase.Conclusion:Short‐term treatment with omeprazole does not interfere with the pharmacokinetics of amoxicillin or ampicillin. Our results also exclude the presence of a transfer mechanism for amoxicillin or ampicillin from the plasma to the gastric lumen.
The treatment of functional dyspepsia with red pepper
Authors: Bortolotti M. , Coccia G. , Grossi G. , Miglioli M. 
Published: March 2003

SummaryAim : To decrease the intensity of dyspeptic symptoms by impairing the visceral nociceptive C‐type fibres with capsaicin, contained in red pepper powder.Methods : The study was performed on 30 patients with functional dyspepsia and without gastro‐oesophageal reflux disease and irritable bowel syndrome. After a 2‐week washout period, 15 patients received, before meals randomly and in a double‐blind manner, 2.5 g/day of red pepper powder for 5 weeks, and 15 patients received placebo. A diary sheet was given to each patient to record, each day, the scores of individual and overall symptom intensity, which subsequently were averaged weekly and over the entire treatment duration.Results : The overall symptom score and the epigastric pain, fullness and nausea scores of the red pepper group were significantly lower than those of the placebo group, starting from the third week of treatment. The decrease reached about 60% at the end of treatment in the red pepper group, whilst placebo scores decreased by less than 30%.Conclusions : Red pepper was more effective than placebo in decreasing the intensity of dyspeptic symptoms, probably through a desensitization of gastric nociceptive C‐fibres induced by its content of capsaicin. It could represent a potential therapy for functional dyspepsia.
Impact of Helicobacter pylori eradication on heartburn in patients with gastric or duodenal ulcer disease — results from a randomized trial programme
Authors: Malfertheiner P. , Dent J. , Zeijlon L. , Sipponen P. , Veldhuyzen Van Zanten S. J. O. , Burman C.‐F. , Lind T , Wrangstadh M , BayerdÖrffer E , Lonovics J 
Published: March 2003

SummaryBackground : Helicobacter pylori infection has been proposed as a protective factor against the development of gastro‐oesophageal reflux disease.Aim : To study heartburn and endoscopic findings before and after H. pylori eradication therapy in patients with peptic ulcer disease.Methods : In a multicentre trial programme, patients (n = 1497) were randomized to the omeprazole triple therapy group or to the control group, and were followed for 1–6 months after treatment. Patients in whom the infection was eradicated were compared with those in whom infection persisted. The severity of heartburn was measured at baseline and at each return visit. Endoscopy was performed 6 months after therapy in two of the five studies.Results : In patients with duodenal ulcer, there was a significantly lower prevalence of heartburn after successful eradication of H. pylori relative to that after failed eradication (estimated odds ratio, 0.48). The reduction in the prevalence of heartburn in patients with gastric ulcer was independent of the post‐treatment H. pylori status. In studies in which ulcer relapse was included in the model, this factor emerged as a significant factor for heartburn. The observed incidence of oesophagitis at the last visit was not influenced by H. pylori status.Conclusions : Eradication of H. pylori in patients with peptic ulcer disease was associated with a reduced prevalence of heartburn. Prevention of ulcer relapse could be the true cause of this reduction.
Effects of rabeprazole, 20 mg, or esomeprazole, 20 mg, on 24‐h intragastric pH and serum gastrin in healthy subjects
Authors: Warrington S. , Baisley K. , Boyce M. , Tejura B. , Morocutti A. , Miller N. 
Published: March 2003

SummaryAim : To compare the antisecretory effects of rabeprazole and esomeprazole in an open, randomized, two‐way crossover, clinical pharmacology study.Methods : Twenty‐four healthy subjects (14 men, 10 women; mean age 26.8 years) received rabeprazole 20 mg or esomeprazole 20 mg daily on days 1–5, witha 14‐day ‘wash‐out’. Intragastric pHwasrecordedcontinuously, and serum gastrin measured, on days 0, 1 and 5.Results : On day 0, mean intragastric pH AUC was significantly higher before the esomeprazole than before the rabeprazole treatment in four of the five time intervals analysed. On days 1 and 5, mean intragastric pH AUC was higher after rabeprazole than esomeprazole during 5–11, 14–24 and 0–24 h after dosing. Mean pH AUC in the first 5 h after dosing on day 5 was higher after esomeprazole than rabeprazole (P=0.012). On day 1, mean per cent times pH > 3 and > 4 were significantly greater after rabeprazole than esomeprazole during 0–14, 14–24 and 0–24 h. On day 5, mean serum gastrin AUC0‐4 was higher (P = 0.017) after rabeprazole than esomeprazole (335 vs. 316 pg/mL.h).Conclusion : In this clinical pharmacology study, rabeprazole 20 mg daily was more effective than esomeprazole 20 mg daily in increasing intragastric pH and maintaining pH > 3 and > 4. On day 5, mean pH AUC was higher after esomeprazole than rabeprazole.
Gastroenterology and the pharmaceutical industry
Authors: Rakatansky H. 
Published: March 2003

SummaryPhysicians’ relationships with industry derive from the moral imperative to advocate and work for the best interests of patients. Private industry generally operates to satisfy the best interests of the stockholders or owners. Conflicts arise between these interests and are magnified by the inequality of the financial positions of physicians and industry. Because the ultimate consumer of the products (drugs, medical devices, etc.) of the biomedical industry must enlist a physician as an intermediary, the physician has become the target of industry in a sophisticated marketing effort that includes the offering of financial and other incentives. These conflicts and incentives are pervasive throughout clinical and research endeavors. Standards for resolution, if not elimination, of these conflicts have been proposed by various respected organizations. Individual physicians and medical organizations should evaluate these standards and, if pertinent and appropriate, endorse and follow them.