bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ranitidine bismuth citrate and clarithromycin twice daily in the eradication of Helicobacter pylori
Authors: AXON A. T. R. , IRELAND A. , LANCASTER SMITH M. J. , ROOPRAM P. D. 
Published: October 2003

Background: Ranitidine bismuth citrate (RBC) 400 mg when given twice daily (b.d.) for 4 weeks with clarithromycin 250 mg four times daily (q.d.s.) for the first 2 weeks effectively heals duodenal ulcers and eradicates Helicobacter pylori. Aims: To compare two dosage regimens of clarithromycin, 250 mg q.d.s. and 500 mg b.d., used with ranitidine bismuth citrate (Pylorid) 400 mg b.d., for the eradication of H. pylori and for symptom relief in patients with active duodenal ulcers. Subjects: 236 patients with active duodenal ulcer and confirmed H. pylori infection. Methods: In a randomized, double‐blind, parallel group, multi‐centre study, RBC was given with clarithromycin for 2 weeks followed by 2 weeks treatment with RBC alone to allow for ulcer healing. Ulcer status was assessed by endoscopy at entry. H. pylori status was assessed by CLO Test and 13C‐urea breath test (UBT) at entry and UBT alone 4 weeks after the end of treatment. At entry, during the study and at follow‐up, ulcer symptoms were recorded on a scale of none, mild, moderate or severe. Results: 176 patients had an evaluable UBT at least 4 weeks post‐treatment. H. pylori eradication rates were 96.2% for the RBC plus clarithromycin b.d. regimen and 91.8% for the RBC plus clarithromycin q.d.s. regimen (observed data). Four weeks post‐treatment, 92% of patients receiving RBC b.d. plus clarithromycin q.d.s. and 89% receiving RBC b.d. plus clarithromycin b.d. were considered symptom successes (none or mild symptoms). Conclusions: RBC 400 mg b.d. plus clarithromycin 500 mg b.d. was as effective as RBC 400 mg b.d. plus clarithromycin 250 mg q.d.s. in eradicating H. pylori and both regimens were well tolerated. The simpler dual therapy in a b.d. regimen might well encourage greater patient compliance.
Ursodeoxycholic and tauro‐ursodeoxycholic acids for the treatment of primary biliary cirrhosis: a pilot crossover study
Authors: LARGHI A. , CROSIGNANI A. , BATTEZZATI P. M. , DE VALLE G. , ALLOCCA M. , INVERNIZZI P. , ZUIN M. , PODDA M. 
Published: October 2003

Background: Results from animal studies and preliminary data from pilot studies in patients with primary biliary cirrhosis suggest that tauro‐ursodeoxycholic acid has metabolic properties that may favour its long‐term use as an alternative to ursodeoxycholic acid for patients with chronic cholestatic liver diseases. No direct comparison of tauro‐ursodeoxycholic and ursodeoxycholic acids have yet been carried out in primary biliary cirrhosis.Methods: The effects of ursodeoxycholic and tauro‐ursodeoxycholic acids were compared in 23 patients with primary biliary cirrhosis according to a crossover design. Both drugs were administered at the daily dose of 500 mg, in a randomly assigned sequence for two 6‐month periods separated by a 3‐month wash‐out period.Results: Serum liver enzymes related to cholestasis and cytolysis consistently improved, as compared to baseline values, during the administration of both ursodeoxycholic and tauro‐ursodeoxycholic acids, but no significant difference between these two bile acids was found. Both treatments were well tolerated and no patient complained of side effects.Conclusion: In the short‐term, tauro‐ursodeoxycholic acid appears to be safe and at least as effective as ursodeoxycholic acid for the treatment of primary biliary cirrhosis.
The safety of ranitidine in over a decade of use
Authors: MILLS J. G. , KOCH K. M. , WEBSTER C. , SIRGO M. A. , FITZGERALD K. , WOOD J. R. 
Published: October 2003

Background: Ranitidine hydrochloride (Zantac) is one of the most extensively studied and widely used drugs of all time. This has provided an excellent opportunity to define its safety profile. Methods: Data from 189 controlled clinical trials in which more than 26000 patients received daily doses of ranitidine for 4 weeks or more were reviewed. More than 80% of patients were treated with up to 300 mg ranitidine daily; the remaining patients received doses of up to 1200 mg daily. Eighty‐seven trials were placebo controlled. Analyses of post‐marketing surveillance and a database of all spontaneously reported adverse events were also evaluated. Results: Overall in the clinical trial programme adverse events were reported by 20% of those receiving ranitidine compared with 27% of those receiving placebo. The pattern of events was similar in all treatment groups with no evidence of dose‐related toxicity in regimens encompassing an eightfold range of therapeutic doses. Similarly in a programme of studies designed to evaluate a dose of ranitidine of 75 mg for non‐prescription (over‐the‐counter) use in the treatment of heartburn, ranitidine was not associated with an adverse event profile distinct from that of placebo. Analysis of spontaneously reported adverse event data allowed identification of rare idiosyncratic events. Conclusions: Review of data from a large population of controlled clinical trials with analyses of postmarketing surveillance studies and spontaneously reported adverse events confirmed the excellent safety profile of ranitidine.
Daily omeprazole surpasses intermittent dosing in preventing relapse of oesophagitis: a US multi‐centre double‐blind study
Authors: SONTAG S. J. , ROBINSON M. , ROUFAIL W. , HIRSCHOWITZ B. I. , SABESIN S. M. , WU W. C. , BEHAR J. , PETERSON W. L. , KRANZ K. R. , TARNAWSKI A. , DAYAL Y. , BERMAN R. , SIMON T. J. 
Published: October 2003

Introduction: Relapse of erosive oesophagitis occurs in almost all patients if treatment is stopped after initial healing.Aim: To assess the potential of different therapeutic regimens of omeprazole to prevent relapse of erosive reflux oesophagitis after initial healing with omeprazole.Patients and methods: Patients whose active erosive reflux oesophagitis (grade 2) had healed (grade 0 or 1) after 4–8 weeks of open‐label omeprazole 40 mg daily (phase I) were eligible to join a multi‐centre, 6‐month double‐blind, placebo‐controlled maintenance study (phase II), which included endoscopy, symptom assessments, serum gastrin measurements, and gastric fundic biopsies. During phase I, endoscopy was performed at weeks 0, 4, and 8. At the end of phase I, 429 of 472 patients (91%) were healed, and there were significant reductions in heartburn, dysphagia and acid regurgitation. Of the 429 patients who healed, 406 joined phase II and were randomized to one of three groups: 20 mg omeprazole daily (n=138), 20 mg omeprazole for 3 consecutive days each week (n=137), or placebo (n=131). During phase II, endoscopy was performed at months 1, 3, and 6 or at symptomatic relapse.Results: The percentages of patients still in endoscopic remission at 6 months were 11% for placebo, 34% for omeprazole 3‐days‐a‐week, and 70% for omeprazole daily. Both omeprazole regimens were superior to placebo in preventing recurrence of symptoms (P<0.001); however, omeprazole 20 mg daily was superior to omeprazole 20 mg 3‐days‐a‐week (P<0.001). Compared to baseline, omeprazole therapy resulted in no significant differences among treatment groups in the distribution of gastric endocrine cells.Conclusions: These results show that after healing of erosive oesophagitis with 4–8 weeks of omeprazole, relapse of oesophagitis and recurrence of reflux symptoms can be prevented in 70% of patients with a maintenance regimen of 20 mg daily, but that intermittent dosing comprising 3 consecutive days each week significantly compromises efficacy.
The effect of intravenous erythromycin on solid meal gastric emptying in patients with chronic symptomatic post‐vagotomy–antrectomy gastroparesis
Authors: KENDALL B. J. , CHAKRAVARTI A. , KENDALL E. , SOYKAN I. , McCALLUM R. W. 
Published: October 2003

Background: Chronic symptomatic gastroparesis occurs in 3–5% of patients following vagotomy and antrectomy. Erythromycin, a macrolide antibiotic, improves gastric emptying in patients with idiopathic and diabetic gastroparesis. Erythromycin's effect on gastric emptying in patients with post‐vagotomy– antrectomy gastroparesis is unknown. The aim of this study was to determine if a single dose of intravenous erythromycin (1 mg/kg or 6 mg/kg) accelerates solid meal gastric emptying in patients with chronic symptomatic post‐vagotomy–antrectomy gastroparesis.Methods: Six patients were entered into the study, three males and three females, with a mean age of 50 years. Four patients were randomized to receive erythromycin 6 mg/kg and two patients 1 mg/kg. The mean time since initial surgery was 9.2 years (range 1–16 years) with five patients having undergone a Roux‐en‐Y revision.Results: Intravenous erythromycin significantly lowered percentage gastric retention at 120 min, from a baseline of 90.5±6% (S.E.M.) to 40.1±4.8% after erythromycin (P=0.0002). Erythromycin improved gastric emptying in each patient by at least 40%. Intravenous erythromycin significantly accelerated the rate of gastric emptying in the first 30 min after meal ingestion from a baseline rate of 0.072±0.06%/min to 0.96±0.31%/min after erythromycin (P=0.028). For each of the subsequent 30 minute time periods, erythromycin had no significant effect on the rate of gastric emptying.Conclusion: Intravenous erythromycin significantly improves the initial phase of solid meal gastric emptying in patients with chronic symptomatic post‐antrectomy–vagotomy gastroparesis.
Review article: platelets in inflammatory bowel disease— pathogenetic role and therapeutic implications
Authors: COLLINS C. E. , RAMPTON D. S. 
Published: October 2003

An elevated platelet count is well recognized as a marker of inflammatory bowel disease activity. There is an increased incidence of systemic thromboembolism in this disease. Recent work indicates that platelets exhibit several proinflammatory properties including release of inflammatory mediators, and recruitment, chemotaxis and modulation of the activity of other inflammatory cells. Furthermore there is evidence that microvascular thrombosis and a procoagulant state may play a role in the pathogenesis of inflammatory bowel disease.These observations prompted recent studies of platelet activity in inflammatory bowel disease, which indicate enhanced platelet aggregation in vivo and in vitro, and increased platelet activation as measured by increased release of intracellular proteins into plasma and expression of platelet surface markers, including P‐selectin and GP53. These abnormalities could contribute to the pathogenesis of inflammatory bowel disease by enhancing inflammation and promoting microinfarction. Aminosalicylates reduce platelet activity although they also have many other additional properties to explain their efficacy in inflammatory bowel disease. There are however several specific anti‐platelet drugs now available which may provide new therapeutic possibilities in the management of this disease.
Lansoprazole versus omeprazole: influence on meal‐stimulated gastric acid secretion
Authors: DAMMANN H. G. , FUCHS W. , RICHTER G. , BURKHARDT F. , WOLF N. , WALTER Th. A. 
Published: October 2003

Aims: To investigate, by means of meal‐stimulated acid secretion, the extent to which differences in plasma half‐life, bioavailability and the recommended therapeutic dose can influence the antisecretory potency of lansoprazole and omeprazole.Methods: In this double‐blind, placebo‐controlled, crossover study, 10 healthy male volunteers received 15 mg or 30 mg lansoprazole, 20 mg or 40 mg omeprazole or placebo for 5 days, in a randomized order. Meal‐stimulated acid secretion was determined by means of a homogenized test meal and intragastric titration.Results: On day 1, meal‐stimulated acid secretion was decreased by 35% and 45% after administration of 15 mg or 30 mg lansoprazole, and by 16% and 42% after 20 mg or 40 mg omeprazole. After 3 and 5 days of dosing the decreases were 53% and 48% with 15 mg lansoprazole, 82% and 82% with 30 mg lansoprazole, 43% and 39% with 20 mg omeprazole, and 76% and 83% with 40 mg omeprazole. At all measuring points during the 5‐day dosing periods, lansoprazole 15 mg and 30 mg proved superior to 20 mg omeprazole in inhibiting meal‐stimulated gastric acid secretion, but the differences were only statistically significant for the lansoprazole 30 mg dose. 30 mg lansoprazole and 40 mg omeprazole proved equipotent. On day 1 only 30 mg lansoprazole was significantly better than placebo.Conclusion: This study demonstrated the following order of antisecretory potency: 30 mg lansoprazole=40 mg omeprazole>15 mg lansoprazole≈20 mg omeprazole.
In single doses ranitidine effervescent is more effective than lansoprazole in decreasing gastric acidity
Authors: ARNESTAD J. S. , KLEVELAND P. M. , WALDUM H. L. 
Published: October 2003

Background: A rapid and reproducible decrease of gastric acidity is preferable in patients with penetrating/perforating peptic ulcers and in on‐demand treatment of some patients with dyspepsia. The present study was done to compare the effect of single doses of ranitidine effervescent with that of the proton pump inhibitor lansoprazole.Method: Twelve healthy young volunteers were studied by 11‐h intragastric continuous pH recording after the intake of ranitidine 150 or 300 mg effervescent tablets or lansoprazole 30 mg capsules. Trial medications were taken with 200 mL water, and the subjects remained fasting apart from 250 mL fluid at 4 h.Results: Ranitidine effervescent, both 150 and 300 mg, induced a rapid and persisting increase in gastric pH in most of the subjects, whereas a single dose of lansoprazole 30 mg did not affect intragastric pH in five of the twelve subjects.Conclusion: The histamine H2‐blocker ranitidine given as an effervescent formulation is superior to the proton pump inhibitor lansoprazole in inducing a rapid decrease of gastric acidity.
Somatostatin receptor scintigraphy in the initial staging of Hodgkin's disease
Authors: Van Den Anker‐Lugtenburg P. J. , Krenning E. P. , Oei H. Y. , Van Hagen M. P. , Gerrits C. J. H. , Reubi J. C. , Lamberts S. W. J. , Löwenberg B. 
Published: October 2003

Somatostatin receptor (SS‐R) scintigraphy has been successfully used in the visualization of a variety of neuroendocrine tumours. In vitro studies have shown that SS‐Rs are present in human malignant lymphomas. We conducted a prospective study in 56 consecutive untreated patients with histologically proven Hodgkin's disease (HD) and compared the results of SS‐R scintigraphy with physical and radiological examinations as initial evaluation.SS‐R scintigraphy was positive in 55/56 (98%) patients at sites of documented disease. In 20 patients SS‐R scintigraphy disclosed lymphoma localizations not revealed following procedures of conventional staging. As a result in 12 patients (21%) SS‐R scintigraphy produced a change of stage and in seven patients (13%) the additional information obtained from SS‐R scintigraphy led to a change of treatment. SS‐R scintigraphy failed to visualize sites of HD in four patients, mainly in the abdominal area. In three patients a false‐positive result was obtained.These data show that SS‐R scintigraphy provides an imaging technique that appears to visualize tumours in most patients with HD and may be clinically useful in the management of these patients.
Clinical and laboratory factors associated with platelet transfusion refractoriness: a case–control study
Authors: Alcorta Iñaki , Pereira Arturo , Ordinas Antonio 
Published: October 2003

In recent years clinical factors have largely surpassed alloimmunization as the predominant cause of platelet refractoriness. This makes it necessary to properly identify and weigh the non‐immune factors that have a major impact on refractoriness. A case–control study is suitable for such an analysis, and to our knowledge has not previously been performed to assess this issue.Fifty‐two refractory patients were compared with 52 control patients who were transfused at the same time. Only one transfusion event was analysed per patient. Clinical and laboratory data were recorded at the time of selected transfusion, and their association with refractoriness was investigated by the contingency table method and the Cox stepwise logistic regression.There were 16 (31%) patients with HLA antibodies in the index group and only one in the control group. The corrected count increment in the group of patients refractory due to HLA antibodies was significantly lower than that in non‐alloimmunized refractory patients [median (range): 48.5 (−3560, 4614) and 4058 (−4417, 6886), respectively; U = 493, P < 0.0001]. In the multivariate analysis, factors associated with refractoriness were the presence of HLA antibodies (odds ratio (OR) 50.7; 95% CI 5.5–463); fever (odds ratio 7.2; 95% CI 2.5–21) and BMT because of chronic myeloid leukaemia (odds ratio 7.3; 95% CI 1.8–30). The latter two were the only factors that remained independently associated with refractoriness after excluding alloimmunized patients and their controls.We conclude that HLA antibodies are strongly associated with platelet transfusion refractoriness, but account for less than a third of these patients. Fever and BMT because of chronic myeloid leukaemia were the only non‐immune factors independently associated with refractoriness.
Macrophages are the major target cell for HIV infection in long‐term bone marrow culture and demonstrate dual susceptibility to lymphocytotropic and monocytotropic strains of HIV‐1
Authors: Gill Vikki , Shattock Robin J. , Freedman Andrew R. , Robinson Grant , Griffin George E. , Gordon‐Smith Edward C. , Gibson Frances M. 
Published: October 2003

Haematological abnormalities are often seen in patients infected with HIV. A number of mechanisms are thought to contribute to this bone marrow suppression, including impaired stromal function and direct infection of progenitor cells. Evidence suggests that both bone marrow progenitor cells and perhaps stromal cells are open to infection by HIV, which raises the possibility that bone marrow stromal cells may serve as a reservoir for HIV. This study investigated the cellular targets and kinetics of in vitro infection of stroma in long‐term bone marrow culture (LTBMC) using both mono‐ and lymphocytotropic strains of HIV‐1. p24 ELISA and reverse transcriptase (RT) assay demonstrated that stroma could be infected with HIV and release infectious virions. The target cells for infection were shown to be macrophages by immunohistochemistry (APAAP), dual immunofluorescence staining (using CD68 and p24) and electron microscopy.The data show that it was possible to infect stroma in LTBMC with HIV and that such infection was productive. The main target for infection was bone marrow macrophages. In contrast to peripheral blood derived macrophages, these cells were susceptible to both lymphocytotropic and monocytotropic strains of HIV‐1. The data suggests that these bone marrow macrophages may act as a reservoir for HIV. Infection of bone marrow macrophages may affect haemopoiesis either by transmission of HIV infection to developing progenitor cells through direct cell‐to‐cell contact or by altering the ability of the stroma to support normal development.
Positive diepoxybutane test in only one of two brothers found to be compound heterozygotes for Fanconi's anaemia complementation group C mutations
Authors: DOKAL I. , CHASE A. , MORGAN N. V. , COULTHARD S. , HALL G. , MATHEW C. G. , ROBERTS I. 
Published: October 2003

Fanconi's anaemia (FA) is an autosomal recessive disorder characterized by diverse congenital abnormalities, the development of progressive bone marrow failure, and an increased predisposition to malignancy, particularly acute leukaemia. The FA phenotype is so variable that diagnosis on the basis of clinical manifestations alone can be difficult. The modern diagnosis of FA no longer rests entirely on the constellation of clinical and haematological abnormalities first described by Fanconi, but depends on finding elevated chromosomal breakage after incubation of peripheral blood lymphocytes with the chemical clastogens diepoxybutane (DEB) or mitomycin‐C (MMC). The cloning of the gene for FA complementation group C [FAC] provides an opportunity to test the validity of the ‘DEB test’ which in recent times has become the main arbiter as to whether a patient is classified as FA or non‐FA.We report on two brothers with similar clinical and haematological features who have both been identified as compound heterozygotes for the FAC mutations L554P and ΔG322, but only one of the brothers has a positive DEB test. On the basis of the DEB test one would be classified as FA and the other as non‐FA. The time has come to re‐evaluate the diagnostic criteria of ‘Fanconi's anaemia’.
A case of mature B‐cell ALL with coexistence of t(1;19) and t(14;18) and expression of the E2A/PBX1 fusion gene
Authors: Rowe David , Devaraj Prema E. , Irving Julie A. E. , Hogarth Linda , Hall Andrew G. , Turner Gillian E. 
Published: October 2003

The translocation t(1;19)(q23;p13) is found in 3–5% of all acute lymphoblastic leukaemias (ALL) and results in the expression of an E2A/PBX1 hybrid gene transcript. This translocation is very closely associated with a pre‐B phenotype. t(14;18) is associated with follicular B‐cell lymphoma and is characterized by over‐expression of the bcl‐2 oncogene. We describe a case of ALL in an adult with a mature B‐cell immunophenotype and a single abnormal cell line with a complex karyotype showing both t(1;19) and t(14;18).Two reports of this phenomenon have been published previously and molecular analysis, where performed, showed the E2A gene was not rearranged, suggesting the t(1;19) was a molecular variant of the established translocation. In contrast, molecular analysis of our case demonstrated expression of the E2A/PBX1 fusion transcript typically associated with t(1;19) in pre‐B ALL but showed it to be present at an extremely low level, despite the abnormal karyotype being found in the majority of metaphase cells. Analysis of bcl‐2 expression showed a significant up‐regulation.A down‐regulation of the E2A/PBX1 hybrid gene as a consequence of the enhanced expression of bcl‐2 may be a possible mechanism for this finding.
Unrelated donor bone marrow transplantation for children with relapsed acute lymphoblastic leukaemia in second complete remission
Authors: OAKHILL A. , PAMPHILON D. H. , POTTER M. N. , STEWARD C. G. , GOODMAN S. , GREEN A. , GOULDEN P. , GOULDEN N. J. , HALE G. , WALDMANN H. , CORNISH J. M. M. 
Published: October 2003

Allogeneic sibling bone marrow transplantation (BMT) is the recommended treatment for relapsed childhood acute lymphoblastic leukaemia (ALL), but appropriate donors are only available in 30% of cases. Unfortunately, BMT from unrelated donors (UD) has been associated with high rates of severe graft‐versus‐host disease (GvHD) and transplant‐related mortality (TRM). In an attempt to improve outcome in UD‐BMT we have assessed the impact of T‐cell depletion using CAMPATH‐1 (anti‐CD52) monoclonal antibodies in 50 consecutively referred patients with relapsed ALL in second remission. All were previously treated according to MRC protocols UKALL X and XI, and then given chemotherapy on MRC R1 from relapse until UD‐BMT. 19 patients had relapsed on and 31 off therapy.Patients and donors were fully matched at HLA‐A, ‐B, ‐DR and ‐DQ loci in 29 cases and mismatched in 21 (four mismatched for more than one antigen). Pre‐transplant conditioning comprised CAMPATH‐1G, cyclophosphamide and total body irradiation. Bone marrow was T‐cell depleted in vitro using CAMPATH‐1 antibodies. Additional GvHD prophylaxis consisted of cyclosporin A (42 cases), cyclosporin plus methotrexate (four) or none (four). 47 patients engrafted. The incidence of acute GvHD was very low: two patients with grade II disease in the matched group, four with grade II–IV in the mismatched group. Only four patients have chronic GvHD. The actuarial event‐free survival (EFS) at 2 years is 53%, with no significant difference between the matched and mismatched group. Further leukaemic relapse was the most important cause of failure.These results are similar to the most favourable published reports for HLA‐matched sibling BMT in relapsed ALL.