bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulation of cyclooxygenase‐2 in renal medulla
Authors: Yang T. 
Published: December 2004

AbstractAim:

Renal medulla is a major site for production and action of prostaglandins (PGs). The renal medullary functions as well as structural integrity are in part dependent on PGs under certain physiological or pathophysiological conditions. The two COX isoforms, COX‐1 (constitutive form) and COX‐2 (inducible form) are both abundantly expressed in renal inner medulla at basal state, raising a question of which COX isoform may mediate the known functions of PGs in the region. As in many other cell types, COX‐1 expression in renal medulla is unlikely subject to robust regulation. In contrast, COX‐2 expression in renal medulla is markedly stimulated by chronic salt loading, dehydration and endotoxaemia
in vivo
. At cellular levels, the signalling pathways responsible for the COX‐2 stimulation in renal medullary cells seem to involve both the mitogen‐activated protein kinases and NF‐
κ B. It is likely that in response to various insults that are detrimental to renal medulla, the induction of PG synthesis may become more dependent on COX‐2 than COX‐1, and this phenomenon may be relevant to the cytoprotective response against the insults.
Differences in the renal dopaminergic system activity between Wistar rats from two suppliers
Authors: Sampaio‐Maia B. , Serrão P. , Vieira‐Coelho M. A. , Pestana M. 
Published: December 2004

AbstractAim:  Dopamine of renal origin reduces tubular sodium reabsorption and controls blood pressure. The present study evaluated renal dopaminergic activity and its response to uninephrectomy in Wistar Han rats from two suppliers, Harlan (W‐H) and Charles River (W‐CR).Results:  After uninephrectomy, the fractional excretion of sodium (FENa+) increased in both W‐CR and W‐H rats (W‐CR: from 0.17 ± 0.01 to 0.27 ± 0.02%; W‐H: from 0.39 ± 0.04 to 0.54 ± 0.04%, P < 0.05); however, in W‐CR rats the FENa+ was lower than in W‐H rats in both Sham and uninephrectomized (Unx) animals (P < 0.05). Systolic blood pressure in Unx W‐CR rats was higher than in Unx W‐H animals (131 ± 3 vs. 122 ± 2 mmHg, P < 0.05). Uninephrectomy was accompanied in W‐H rats by increases in urinary levels (nmol g kidney−1 day−1) of dopamine (10.3 ± 0.5 vs. 8.3 ± 0.7, P < 0.05) and 3,4‐dihydroxyphenylacetic acid (DOPAC) (30.5 ± 3.7 vs. 21.3 ± 1.4, P < 0.05) and increases (P < 0.05) in maximal velocity values (Vmax in nmol mg prot−1 15 min−1, 325 ± 12 vs. 265 ± 3) for renal aromatic L‐amino acid decarboxylase (AADC), the enzyme responsible for the synthesis of renal dopamine. By contrast, in W‐CR rats uninephrectomy did not change either the urinary levels of dopamine (7.1 ± 0.5 vs. 7.6 ± 0.7) and DOPAC (25.0 ± 1.9 vs. 24.8 ± 4.1) or AADC activity (Vmax 199 ± 3 vs. 193 ± 9). The Vmax values for renal AADC in W‐CR rats were lower than those found in corresponding W‐H animals.Conclusion:  Wistar rats from different suppliers represent an important source of variability in the renal dopaminergic system activity. This may contribute to differences in sodium balance and blood pressure control in response to uninephrectomy.
Exercise‐induced HSP27, HSP70 and MAPK responses in human skeletal muscle
Authors: Thompson H. S. , Maynard E. B. , Morales E. R. , Scordilis S. P. 
Published: December 2004

AbstractAim:  The present work examined protein and messenger RNA (mRNA) expression of intramuscular heat shock protein 27 (HSP27), heat shock cognate (HSC70) and HSP70 in human biceps brachii (BB) and vastus lateralis (VL) subsequent to two different exercises.Methods:  Untrained subjects performed 50 high‐force eccentric contractions with their non‐dominant BB and ran downhill (−10°) for 30 min. The 48‐h PX stress response was evaluated with immunoblotting and reverse transcriptase‐polymerase chain reaction (RT‐PCR). Muscle damage was indicated indirectly at 48 h post‐exercise (PX) [loss of mobility, muscle soreness and serum creatine kinase (CK) activity].Results:  On the protein level, HSP27 and HSP70 increased significantly PX in the BB (384 and 227%, respectively; P < 0.01), but there were no significant HSP changes in the VL or in HSC70 in either muscle. The RT‐PCR data complemented these findings: BB HSP27 and HSP70C mRNA levels increased (135 and 128%, respectively; P < 0.05); in the VL only HSP70B increased (206%; P < 0.05). Phosphorylation of e‐jun NH2‐terminal kinase (JNK) and extracellular regulated kinase (ERK) increased significantly in the BB (226 and 200%, respectively; P < 0.05) but not in the VL, indicating activation of these pathways only after the resistance exercise.Conclusion:  These data indicate that the PX HSP and mitogen‐activated protein kinase responses are exercise‐specific and local, not systemic. Further, only the resistance exercise induced HSP expression (protein and mRNA) and JNK/ERK activation at 48 h PX, suggesting that these molecules may be important to long‐term skeletal muscle adaptations such as hypertrophy.
Differences in electrophysiological and contractile properties of mammalian cardiac tissues bathed in bicarbonate – and HEPES‐buffered solutions
Authors: Fülöp L. , Szigeti G. , Magyar J. , Szentandrássy N. , Ivanics T. , Miklós Z. , Ligeti L. , Kovács A. , Szénási G. , Csernoch L. , Nánási P. P. , Bányász T. 
Published: December 2004

AbstractAim:
The aim of this study was to compare the action potential configuration, contractility, intracellular Ca2+ and H+ concentrations in mammalian cardiac tissues bathed with Krebs and Tyrode solutions at 37 °C.Results:  In Langendorff‐perfused guinea‐pig hearts, loaded with the fluorescent Ca2+‐indicator Fura‐2, or H+‐sensitive dye carboxy‐SNARF, shifts from Krebs to Tyrode solution caused intra‐cellular acidification, increased diastolic pressure and [Ca2+]i, decreased systolic pressure and [Ca2+]i, leading to a reduction in the amplitude of [Ca2+]i transients and pulse pressure. Contractility was also depressed in canine ventricular trabeculae when transferred from Krebs to Tyrode solution. Shifts from Krebs to Tyrode solution increased the duration of action potentials in multicellular cardiac preparations excised from canine and rabbit hearts but not in isolated cardiomyocytes. All these changes in action potential morphology, contractility, [Ca2+]i and [H+]i were readily reversible by addition of 26 mmol L−1 bicarbonate to Tyrode solution. Effects of dofetilide and CsCl, both blockers of the delayed rectifier K current, on action potential duration were compared in Krebs and Tyrode solutions. Dofetilide lengthened rabbit ventricular action potentials in a significantly greater extent in Tyrode than in Krebs solution. Exposure of canine Purkinje fibres to CsCl evoked early after depolarizations within 40 min in all preparations incubated with Tyrode solution, but not in those bathed with Krebs solution.Conclusion:  It is concluded that the marked differences in action potential morphology, [Ca2+]i, [H+]i and contractility observed between preparations bathed with Krebs and Tyrode solutions are more likely attributable to differences in the intracellular buffering capacities of the two media.
Bile acid therapy versus placebo before and after extracorporeal shock wave lithotripsy of gallbladder stones
Authors:   THE EAST‐DANISH GALLSTONE STUDY GROUP
Published: December 2004

Aim: To study the effects of bile acid therapy on the fragmentation rate of cholesterol gallbladder stones by extracorporeal shock wave lithotripsy (ESWL) and on the clearance of fragments after ESWL. Patients and methods: One hundred and two patients with biliary pain, between one and five radiolucent gallbladder stones, and a gallbladder with a patent cystic duct were randomized to 3 weeks of double‐blind treatment with bile acids (ursodeoxycholic acid 500 mg and chenodeoxycholic acid 500 mg per day) or placebo before ESWL. After successful fragmentation by ESWL (largest fragment 5 mm) the patients were re‐randomized to 6‐month double‐blind therapy with bile acids or placebo. Results: Ninety‐nine patients completed 3 weeks of pre‐ESWL treatment. There was no statistically significant difference in fragmentation rate between the two groups. After 6 months of post‐ESWL therapy, 12 of 49 patients (24%) had cleared the fragments from their gallbladder with bile acids compared with five of 50 patients (10%) who had placebo therapy (P=0.10). There was no significant difference in the occurrence of pain between groups. The figures were no better in patients with a single stone 20 mm in diameter. Conclusion: Extracorporeal shock wave lithotripsy with or without adjuvant bile acid therapy does not seem to be an attractive therapy for patients with uncomplicated symptomatic gallstone disease.
A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C
Authors: Buti M. , Medina M. , Casado M. A. , Wong J. B. , Fosbrook L. , Esteban R. 
Published: December 2004

SummaryAim : To estimate the cost‐effectiveness of therapy and analyse the effect of therapy compliance in naive patients with chronic hepatitis C.Methods : A decision analysis using the Markov model was performed for four different therapeutic strategies using peginterferon alfa‐2b plus ribavirin or interferon alfa‐2b plus ribavirin. Clinical data were obtained from available published reports and from the Spanish health system perspective.Results : The incremental cost‐effectiveness ratio of peginterferon alfa‐2b plus ribavirin at a fixed dose, compared with interferon alfa‐2b plus ribavirin, was 8478 euros per life year saved and 3737 euros per quality‐adjusted life year gained. Good therapeutic compliance and weight‐adjusted doses of ribavirin decreased the incremental cost‐effectiveness ratio to 1636 euros per life year saved and 721 euros per quality‐adjusted life year gained. In compliant genotype 1 patients, the incremental cost‐effectiveness ratio decreased to 916 euros per life year saved and 404 euros per quality‐adjusted life year gained, with an increase from 64 to 69 years in the threshold age at which therapy was cost‐effective. The sensitivity analysis demonstrated that changes in the values of the most relevant parameters do not modify the study outcomes.Conclusion : From the clinical and pharmaco‐economics perspective, the use of decision therapeutic analysis models suggests that the most effective therapy for chronic hepatitis C is peginterferon alfa‐2b plus ribavirin adjusted to patient body weight and with good compliance, particularly in genotyped patients.
Oesophageal cancer and cachexia: the effect of short‐term treatment with thalidomide on weight loss and lean body mass
Authors: Khan Z. H. , Simpson E. J. , Cole A. T. , Holt M. , Macdonald I. , Pye D. , Austin A. , Freeman J. G. 
Published: December 2004

SummaryBackground : Cachexia is common in patients with advanced cancer and has a direct impact on well‐being and mortality.Aim : To test the hypothesis that thalidomide can promote weight gain and lean body mass in patients with advanced oesophageal cancer.Methods : In an open‐label study, 11 patients with non‐obstructing and inoperable oesophageal cancer were established on an isocaloric diet for 2 weeks, followed by 2 weeks on thalidomide, 200 mg daily. The primary end‐points were weight change and lean body mass. Secondary end‐points were quality of life and changes in resting energy expenditure.Results : Ten patients completed the study protocol. The average caloric intake remained the same throughout the study period in all patients. Nine of 10 patients (95% confidence interval, 0.60, 0.98) lost weight on diet alone. The mean weight gain on thalidomide in the following 2 weeks was 1.29 kg (median, 1.25 kg). A similar trend was shown in the lean body mass. Eight of nine patients (95% confidence interval, 0.57, 0.98) initially lost lean body mass on diet alone (missing data in one patient). The mean gain in lean body mass on thalidomide in the following 2 weeks was 1.75 kg (median, 1.33 kg).Conclusions : Thalidomide treatment appeared to reverse the loss of weight and lean body mass over the 2‐week trial period.
Pruritus in cholestatic and other liver diseases
Authors: Mela M. , Mancuso A. , Burroughs A. K. 
Published: December 2004

SummaryPruritus is often the most troublesome symptom in patients with chronic liver disease, particularly when cholestasis is a prominent feature.The exact pathogenesis is unknown, but empirical treatment, such as cholestyramine, based on a liver‐based origin of pruritus, has been used for many years. Recently, evidence for a central mechanism for pruritus has been obtained and opioid antagonists have been tried clinically with some benefit, but their use is not widespread. In addition, the pruritus associated with intrahepatic cholestasis of pregnancy can now be alleviated in many cases by ursodeoxycholic acid. As it also improves foetal outcome, this should become first‐line therapy.We review the pathogenesis and therapy of pruritus, highlighting practical aspects to help with patients with seemingly intractable pruritus.
Esomeprazole 20 mg and lansoprazole 15 mg in maintaining healed reflux oesophagitis: Metropole study results
Authors: Lauritsen K. , Devière J. , Bigard M.‐A. , Bayerdörffer E. , Mózsik G. , Murray F. , Kristjánsdóttir S. , Savarino V. , Vetvik K. , De Freitas D. , Orive V. , Rodrigo L. , Fried M. , Morris J. , Schneider H. , Eklund S. , Larkö A. 
Published: December 2004

SummaryAim : To compare the efficacy of esomeprazole, 20 mg once daily, vs. lansoprazole, 15 mg once daily, for the maintenance treatment of patients with healed reflux oesophagitis.Methods : During the initial open healing phase, 1391 patients with endoscopically verified reflux oesophagitis and a history of heartburn, with or without acid regurgitation, received esomeprazole 40 mg for 4–8 weeks. Patients who were healed (identified by endoscopy at 4 or 8 weeks) and symptom free were then randomized to receive 6 months of treatment with esomeprazole, 20 mg once daily, or lansoprazole, 15 mg once daily.Results : Esomeprazole, 20 mg once daily, maintained a significantly higher proportion of patients in remission than lansoprazole, 15 mg once daily, over 6 months [83% (95% CI, 80–86%) of esomeprazole recipients compared with 74% (95% CI, 70–78%) of lansoprazole recipients; P < 0.0001; life table estimates]. When data were analysed according to baseline Los Angeles grade classification, esomeprazole, 20 mg once daily, achieved consistently higher remission rates across all grades of disease severity, whereas the efficacy of lansoprazole decreased to a greater extent with increasing severity of reflux oesophagitis.Conclusion : Esomeprazole, 20 mg once daily, is more effective than lansoprazole, 15 mg once daily, in maintaining remission in patients with healed reflux oesophagitis.
General practitioner and hospital specialist attitudes to functional gastrointestinal disorders
Authors: Gladman L. M. , Gorard D. A. 
Published: December 2004

SummaryBackground : Functional gastrointestinal symptoms generate a large workload in primary care. Research on functional gastrointestinal disorders is focused on hospital patients, but these patients may differ from those managed in primary care.Aim : To investigate any differences in attitudes of general practitioners and hospital specialists towards functional gastrointestinal illnesses.Methods : A questionnaire was sent to 200 general practitioners and 200 British Society of Gastroenterology members.Results : The response rate was 76%. Sixty‐two general practitioners believed that functional gastrointestinal symptoms represented a ‘real’ currently unexplained gastrointestinal disorder, and 67 believed such symptoms probably represented somatization of a psychological illness. In contrast, most consultants (120) believed that functional gastrointestinal symptoms represented a ‘real’ gastrointestinal disorder, with only 36 perceiving them to have a psychological basis (χ2 = 26.7, P < 0.001). More consultants than general practitioners believed that the understanding of functional gastrointestinal disorders had improved in the last 20 years (χ2 = 4.31, P < 0.05). Most consultants and most general practitioners thought that treatment for these disorders had not improved over this period. Only 21% of general practitioners had heard of the Manning criteria for the diagnosis of irritable bowel syndrome, compared to 81% of consultants (χ2 = 107, P < 0.0001); 12% of general practitioners and 83% of consultants had heard of the Rome criteria for the diagnosis of functional gastrointestinal disorders (χ2 = 154, P < 0.0001); 37% of consultants used the Manning criteria and 40% used the Rome criteria; 11% of general practitioners used the Manning criteria and 3% used the Rome criteria.Conclusions : General practitioners and consultants have differing views on functional gastrointestinal disorders. In both primary and secondary care, most doctors do not use diagnostic criteria. Further research on the factors used to diagnose functional gastrointestinal disorders in primary care is warranted.
Safety and efficacy of 7‐day rabeprazole‐ and omeprazole‐based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease
Authors: Hawkey C. J. , Atherton J. C. , Treichel H. C. , Thjodleifsson B. , Ravic M. 
Published: December 2004

SummaryAim : A double‐blind, randomized study was designed to determine whether rabeprazole‐ and omeprazole‐based triple therapy regimens are therapeutically equivalent in the eradication of Helicobacter pylori.Methods : Three hundred and forty‐five patients with current or previously active peptic ulcer and a positive H. pylori urease test were randomly assigned to receive RCA, OCA, RCM or OCM twice daily for 7 days (R, rabeprazole 20 mg; O, omeprazole 20 mg; C, clarithromycin 500 mg; A, amoxicillin 1000 mg; M, metronidazole 400 mg). H. pylori eradication was documented by negative 13C‐urea breath tests at 4 and 12 weeks, and was evaluated using a 2 × 2 factorial design with proton pump inhibitor and antibiotic as factors.Results : Overall eradication rates (per protocol/intention‐to‐treat) were 87%/77% and 85%/75% with rabeprazole and omeprazole, respectively (not significant). However, a statistical interaction between proton pump inhibitor and antibiotic was identified. RCA produced a somewhat higher eradication rate than OCA (94% vs. 84%; difference, 9.8%; 95% confidence interval, − 0.7% to + 20.4%), whereas RCM produced a lower eradication rate than OCM (79% vs. 86%; difference, 8.1%; 95% confidence interval, − 21.4% to + 5.1%). Ulcer healing rates were > 90% with H. pylori eradication. Each regimen was well tolerated.Conclusions : Rabeprazole‐ and omeprazole‐based triple therapy regimens are therapeutically equivalent in the eradication of H. pylori and well tolerated. The statistical interaction observed between the proton pump inhibitor and supplementary antibiotic may be due to chance.
Pancreatic function testing
Authors: Chowdhury R. S. , Forsmark C. E. 
Published: December 2004

SummaryPancreatic function tests are most commonly used to diagnose chronic pancreatitis. These tests include tests which document exocrine or endocrine gland insufficiency and tests which instead measure gradations of decreased secretory capacity. The tests in the former category generally become abnormal when advanced, longstanding chronic pancreatitis is present. Tests in the latter category, however, have the potential to detect chronic pancreatitis at an earlier stage than other available diagnostic tests, including commonly used imaging tests such as computed tomography and endoscopic retrograde cholangiopancreatography. This potential advantage of diagnostic sensitivity is, however, counterweighed by the fact that these tests which measure stimulated secretory capacity are only available at a very few referral centres. This article will review the variety of pancreatic function tests and describe their rationale, accuracy, cost, and clinical usefulness.
Health‐related anxiety and the effect of open‐access endoscopy in US patients with dyspepsia
Authors: Quadri A. , Vakil N. 
Published: December 2004

SummaryBackground : The role of endoscopy in dyspepsia is the subject of debate. The detection of lesions is infrequent, but patients may benefit from the knowledge that the examination is normal. We sought to determine the prevalence of health‐related anxiety in dyspeptic patients referred for open‐access endoscopy and to investigate the effect of endoscopy on health‐related anxiety.Methods : Consecutive patients referred for open‐access endoscopy from primary care were studied using a validated questionnaire for health‐related anxiety before and after endoscopy, at 1 month and 6 months. Symptoms were assessed using a validated questionnaire at 1 and 6 months.Results : One hundred and nine patients were studied (69 women and 40 men; mean age, 49 ± 15 years). Thirty‐six of the 109 patients (33%) had high anxiety scores at baseline (mean score, 41 ± 1), which decreased after endoscopy to 35 ± 1 (P < 0.05). The changes persisted at 1 month (33 ± 1) and 6 months (33 ± 1). Endoscopic findings were as follows: normal examination, 120; erosive oesophagitis, 11 (Grade A); erosive duodenitis (all Helicobacter pylori‐negative), 6. Scales for preoccupation with health and fear of illness and death showed significant improvement after endoscopy, and the effects were preserved for 6 months. Anxiety scores in our population were substantially higher than in a corresponding UK population.Conclusions : Health‐related anxiety is common in dyspeptic patients referred for endoscopy. Endoscopy decreases the preoccupation with health and fear of illness and death in patients with severe anxiety, and the effects persist for 6 months.
Abdominal and pelvic surgery in patients with irritable bowel syndrome
Authors: Hasler W. L. , Schoenfeld P. 
Published: December 2004

SummaryAim : To systematically review research on the prevalence of abdominal and pelvic surgery in patients with irritable bowel syndrome.Methods : Computer searches of MEDLINE, EMBASE and Current Contents were performed independently by both investigators to identify appropriate studies. Primary study selection criteria included: (i) population‐based samples of adult irritable bowel syndrome patients; (ii) the use of appropriate symptom‐based criteria to identify irritable bowel syndrome patients; and (iii) comparison of the prevalence of abdominal and pelvic surgery in irritable bowel syndrome patients vs. control populations. Secondary analysis was performed on published studies of referral populations and case series.Results : Two population‐based studies met the primary study selection criteria and revealed an increased prevalence of surgery in irritable bowel syndrome patients vs. controls for cholecystectomy (4.6% vs. 2.4%, respectively; odds ratio, 1.9; 95% confidence interval, 1.2–3.2) and hysterectomy (18% vs. 12%, respectively; odds ratio, 1.6; 95% confidence interval, 1.1–2.2). Secondary analysis revealed an increased prevalence of appendectomy and other abdominal and pelvic surgery in irritable bowel syndrome patients.Conclusions : Irritable bowel syndrome is associated with a disproportionately high prevalence of abdominal and pelvic surgery, but most studies exhibit sub‐optimal study design and do not define the factors causing the increased prevalence of surgery in these patients.