bluuebunny/crossref_metadata_2025_split huggingface dataset:
A pilot‐randomized comparison of sublingual misoprostol with syntometrine on the blood loss in third stage of labor
Authors: Lam H. , Tang O. S. , Lee C. P. , Ho P. C. 
Published: December 2004

Background.  To compare sublingual misoprostol with intravenous syntometrine use during third stage of labor by measuring the blood loss.Methods.  Sixty women were randomized to receive either 600 µg misoprostol sublingually or 1 ml syntometrine intravenously during the third stage of labor after spontaneous vaginal delivery. For those with risk factors of postpartum hemorrhage such as medical induction or augmentation of labor, previous third stage complications were excluded. The blood loss in labor was measured by the alkaline–hematin method, and differences in hemoglobin before and after delivery were compared.Results.  There was no significant difference in the median measured blood loss between the misoprostol group and the syntometrine group (280 versus 226 ml, p = 0.45). The change in hemoglobin was comparable between the two groups. There were more women in the misoprostol group who required additional oxytocics, but the difference was not statistically significant. A major complication occurred in one patient in the misoprostol group with blood loss in excess of 1000 ml. The incidence of side effects such as shivering and pyrexia in women receiving misoprostol was significantly higher than that in the syntometrine group.Conclusion.  The use of sublingual misoprostol or intravenous syntometrine in spontaneous vaginal delivery resulted in a comparable amount of blood loss. Transient side effect such as fever and shivering which resolved within a day occurred more frequent to those who received sublingual misoprostol.
Incidence of venous thromboembolism in young Swedish women and possibly preventable cases among combined oral contraceptive users
Authors: Samuelsson Eva , Hägg Staffan 
Published: December 2004

Background.  We wanted to study the incidence of venous thromboembolism (VTE), acquired risk factors of VTE and preventable cases among users of combined oral contraceptives (COCs).Methods.  All women aged 15–44 years, (n = 24 373) living in the county of Jämtland, Sweden, between 1991 and 2000, constituted the study base in a retrospective case‐reference study. Women with VTE were identified through hospital registers and interviewed by telephone. The utilization of COCs according to age was obtained from a prospective prescription database, and data from national health databases were used.Results.  Of 88 women with first‐time VTE, 43 (49%) were COC users and 13 (15%) were pregnant. All women had at least one known risk factor, and 51 (58%) women had combinations of risk factors. The total incidence rate of VTE per 100 000 women‐years for all women were 36 (29–44), for nonusers 19 (12–25) for women using third generation COCs 115 (67–184), for women using other COCs 60 (37–83), and for women during pregnancy and postpartum 103 (55–177). Of the total 244 000 women‐years represented, COC users constituted 24%, pregnant women 5%, and women with other acquired risk factors 5%. The corresponding incidence rates after excluding VTE cases with other acquired risk factors were 10 (6–14), 1.2 (0.14–4.4), 64 (29–121), 27 (13–48), and 59 (24–121), per 100 000 women‐years. In 11 (26%) of the COC‐related VTE cases, there were relative contraindications for use of COCs or lack of thromboprophylaxis in relation to surgery.Conclusion.  We found a very low incidence of idiopathic VTE among young non‐OC users. The incidence of VTE during pregnancy was only slightly higher than during COC use. It was considered that a significant part of COC‐related VTE might have been avoided.
Responses of rat myocardial antioxidant defences and heat shock protein HSP72 induced by 12 and 24‐week treadmill training
Authors: Morán M. , Delgado J. , González B. , Manso R. , Megías A. 
Published: December 2004

AbstractAim:  The purpose of this study was to determine the effects of both a short (12 weeks) and a long‐term (24 weeks) endurance treadmill‐training programme on the levels of oxidative stress markers, the activity of the enzymatic antioxidants, and the content of the 72 kDa heat shock protein (HSP72) in rat myocardium.Methods:  Thirty male Wistar rats were randomly assigned to exercise trained (n = 16) and sedentary (n = 14) groups. After 12 week of training, eight rats were killed while the remaining eight continued the training programme until 24 week.Results:  Seven sedentary controls were killed together with each trained group. Levels of thiobarbituric acid‐reactive substances (TBARS), protein carbonyls, and total and oxidized glutathione (tGSH and GSSG) in myocardial homogenates were unchanged by training irrespective of the protocol duration. However, an increased content of the oxidative stress biomarkers was detected in hearts from both the 24‐week trained rats and their sedentary controls when compared with their corresponding 12‐week groups. The antioxidant enzymatic activities total and mitochondrial superoxide dismutase (tSOD and mtSOD, respectively), glutathione peroxidase (GPX) and glutathione reductase (GR), remained unchanged after the 12‐week training period whereas a significant increase in tSOD and mtSOD activities (18%, P < 0.05) was observed in heart homogenates of 24‐week trained animals as compared with their sedentary controls. HSP72 expression levels were not significantly modified after 12 week of training but a threefold increase was detected after 24 week (P < 0.05).Conclusion:  These results demonstrate that a long‐term endurance training (24 weeks) induced discrete increases in antioxidant enzyme activities in rat myocardium and elicited a marked enhancement in HSP72 expression levels. However, a shorter training programme (12 weeks), was not effective in increasing heart antioxidant defences.
Evidence that the Na+‐K+ leak/pump ratio contributes to the difference in endurance between fast‐ and slow‐twitch muscles
Authors: Clausen T. , Overgaard K. , Nielsen O. B. 
Published: December 2004

AbstractAim:  Muscles containing predominantly fast‐twitch (type II) fibres [ext. dig. longus (EDL)] show considerably lower contractile endurance than muscles containing mainly slow‐twitch (type I) fibres (soleus). To assess whether differences in Na+‐K+ fluxes and excitability might contribute to this phenomenon, we compared excitation‐induced Na+‐K+ leaks, Na+ channels, Na+‐K+ pump capacity, force and compound action potentials (M‐waves) in rat EDL and soleus muscles.Methods:  Isolated muscles were mounted for isometric contractions in Krebs–Ringer bicarbonate buffer and exposed to direct or indirect continuous or intermittent electrical stimulation. The time‐course of force decline and concomitant changes in Na+‐K+ exchange and M‐waves were recorded.Results:  During continuous stimulation at 60–120 Hz, EDL showed around fivefold faster rate of force decline than soleus. This was associated with a faster loss of excitability as estimated from the area and amplitude of the M‐waves. The net uptake of Na+ and the release of K+ per action potential were respectively 6.5‐ and 6.6‐fold larger in EDL than in soleus, which may in part be due to the larger content of Na+ channels in EDL. During intermittent stimulation with 1 s 60 Hz pulse trains, EDL showed eightfold faster rate of force decline than soleus.Conclusion:  The considerably lower contractile endurance of fast‐twitch compared with slow‐twitch muscles reflects differences in the rate of excitation‐induced loss of excitability. This is attributed to the much larger excitation‐induced Na+ influx and K+ efflux, leading to a faster rise in [K+]o in fast‐twitch muscles. This may only be partly compensated by the concomitant activation of the Na+‐K+ pumps, in particular in fibres showing large passive Na+‐K+ leaks or reduced content of Na+‐K+ pumps. Thus, endurance depends on the leak/pump ratio for Na+ and K+.
Impact of functional gastrointestinal disorders on health‐related quality of life: a population‐based case–control study
Authors: Halder S. L. S. , Locke G. R. , Talley N. J. , Fett S. L. , Zinsmeister A. R. , Melton L. J. 
Published: December 2004

SummaryBackground : The health‐related quality of life is impaired in patients with functional gastrointestinal disorders seen in referral centres.Aim : To determine whether the health‐related quality of life is impaired in subjects with functional disorders in the community and whether any differences can be explained by psychological co‐morbidity.Methods : In a population‐based, nested, case–control study, subjects reporting symptoms of either dyspepsia or irritable bowel syndrome and healthy controls were interviewed and completed a battery of psychological measures plus a validated, generic, health‐related quality of life measure (Medical Outcomes Study 36‐item short form health survey, SF‐36). The association between irritable bowel syndrome and dyspepsia and the physical and mental composite scores of SF‐36 were assessed with and without adjustment for psychological state.Results : One hundred and twelve cases (30 dyspepsia, 39 irritable bowel syndrome, 32 dyspepsia and irritable bowel syndrome and 11 gastrointestinal symptoms but not dyspepsia or irritable bowel syndrome) and 110 controls were enrolled. In the unadjusted linear regression models, irritable bowel syndrome (but not dyspepsia) was negatively associated with the physical composite score (P < 0.05); in an adjusted model, the association between the physical health‐related quality of life and irritable bowel syndrome was explained by the Symptom Checklist‐90 somatization score alone. In unadjusted models, irritable bowel syndrome and dyspepsia were each negatively associated with the mental composite score (P < 0.05). The association between the mental health‐related quality of life and dyspepsia remained after adjusting for psychological covariates, but the association between this and irritable bowel syndrome was not significant after adjustment.Conclusions : In the community, health‐related quality of life is impaired in subjects with irritable bowel syndrome and dyspepsia; however, much of this association can be explained by psychological factors.
Short‐term adverse effects of 5‐aminosalicylic acid agents in the treatment of ulcerative colitis
Authors: Loftus E. V. , Kane S. V. , Bjorkman D. 
Published: December 2004

SummaryAim: To determine whether there is a difference in short‐term adverse events in patients with ulcerative colitis treated with mesalazine, olsalazine or balsalazide.Methods: MEDLINE was searched for articles published until 2002. Randomized trials of oral mesalazine, olsalazine or balsalazide for the treatment of active disease or the maintenance of remission were included. Outcomes of interest were the frequencies of patients experiencing adverse events and those withdrawn due to adverse events.Results: Forty‐six trials were included. One study of mesalazine vs. sulfasalazine for active colitis showed significantly fewer patients with adverse events with mesalazine. Both balsalazide vs. sulfasalazine studies for active disease showed significantly fewer withdrawals with balsalazide. One trial of balsalazide vs. sulfasalazine for maintenance showed significantly fewer patients with adverse events with balsalazide. Otherwise, no significant differences in safety outcomes were noted.Conclusion: All three 5‐aminosalicylic acid agents are safe in the short term. In mesalazine‐treated patients, the frequencies of adverse events or withdrawals due to adverse events were comparable with those in placebo‐treated patients and lower than those in sulfasalazine‐treated patients. Overall, adverse events or withdrawals were not significantly more frequent with olsalazine than with placebo or sulfasalazine. Adverse events and study withdrawals on balsalazide were less frequent than those on sulfasalazine.
Registered nurse‐administered propofol sedation for endoscopy
Authors: Chen S. C. , Rex D. K. 
Published: December 2004

SummaryPropofol has several attractive properties that render it a potential alternative sedative agent for endoscopy. Compared with meperidine and midazolam, it has an ultra‐short onset of action, short plasma half‐life, short time to achieve sedation, faster time to recovery and discharge, and results in higher patient satisfaction. Shorter times to achieve sedation enhance efficiency in the endoscopy unit. Multiple studies have documented the safe administration of propofol by non‐anaesthesiologists. Administration by registered nurses is more cost‐effective than administration by anaesthesiologists. However, the administration of propofol by a registered nurse supervised only by the endoscopist is controversial because the drug has the potential to produce sudden and severe respiratory depression. More information is needed on how training nurses and endoscopists should proceed to give propofol, as well as the optimal level of monitoring to ensure the safety of nurse‐administered propofol.
A randomized controlled trial of calcium with vitamin D, alone or in combination with intravenous pamidronate, for the treatment of low bone mineral density associated with Crohn's disease
Authors: Bartram S. A. , Peaston R. T. , Rawlings D. J. , Francis R. M. , Thompson N. P. 
Published: December 2004

SummaryBackground : Osteoporosis is a common complication of Crohn's disease.Aim : To study the effect on the bone mineral density of a bisphosphonate (pamidronate) given intravenously, in combination with oral calcium and vitamin D supplements, compared with oral calcium and vitamin D supplements alone.Methods : Seventy‐four patients with Crohn's disease and low bone mineral density at the lumbar spine and/or hip were randomized to receive either a daily dose of 500 mg of calcium with 400 IU of vitamin D alone or in combination with four three‐monthly infusions of 30 mg of intravenous pamidronate over the course of 12 months. The main outcome measure was the change in bone mineral density at the lumbar spine and hip, measured by dual X‐ray absorptiometry, at baseline and 12 months.Results : Both groups gained bone mineral density at the lumbar spine and hip after 12 months. There were significant (P < 0.05) changes in the pamidronate group, with gains of + 2.6%[95% confidence interval (CI), 1.4–3.0] at the spine and + 1.6% (95% CI, 0.6–2.5) at the hip, compared with gains of + 1.6% (95% CI, − 0.1–3.2) and + 0.9% (95% CI, − 0.4–2.1) at the spine and hip, respectively, in the group taking vitamin D and calcium supplements alone.Conclusions : In patients with Crohn's disease and low bone mineral density, intravenous pamidronate significantly increases the bone mineral density at the lumbar spine and hip.
Patient‐led variable dosing with balsalazide as long‐term therapy for maintenance in ulcerative colitis: a 3‐year prospective observational study
Authors: Green J. R. B. , Swan C. H. J. , Gibson J. A. , Kerr G. D. , Swarbrick E. T. , Thornton P. C. 
Published: December 2004

SummaryBackground : The patient‐centred approach is new to the management of ulcerative colitis. To date, it has only been shown to be successful in a short‐term study.Aim : To assess the feasibility, safety and efficacy of patient‐led dosing using balsalazide in the long‐term treatment of ulcerative colitis.Methods : This was a 3‐year, two‐cohort, multi‐centre study: one cohort was in stable remission (52 patients) and the other was newly in remission (76 patients) from ulcerative colitis. Two 750‐mg balsalazide capsules were given twice daily for maintenance, increased by 750‐mg increments to a maximum of 6 g for up to 7 days depending on symptom severity. Clinical assessments were made every 12–14 weeks; laboratory assessments were made every 6 months.Results : The average median daily dose of balsalazide was 3 g (range, 1.5–6 g). In the cohort with stable remission, 23 patients (44%) had relapsed by 3 years [median time to relapse, > 1095 days (36 months)]. In the cohort newly in remission, these values were 45 patients (59%) and 656 days (22 months), respectively. In the cohort with stable remission, the time since last relapse was significantly associated with relapse during the first year of treatment (P < 0.033).Conclusions : Long‐term, patient‐led, maintenance treatment with balsalazide is well tolerated with a good safety profile and is effective for patients with ulcerative colitis.
Anti‐inflammatory effects of aloe vera gel in human colorectal mucosa in vitro
Authors: Langmead L. , Makins R. J. , Rampton D. S. 
Published: December 2004

SummaryBackground : Oral aloe vera gel is widely used by patients with inflammatory bowel disease and is under therapeutic evaluation for this condition.Aim : To assess the effects of aloe vera in vitro on the production of reactive oxygen metabolites, eicosanoids and interleukin‐8, all of which may be pathogenic in inflammatory bowel disease.Methods : The anti‐oxidant activity of aloe vera was assessed in two cell‐free, radical‐generating systems and by the chemiluminescence of incubated colorectal mucosal biopsies. Eicosanoid production by biopsies and interleukin‐8 release by CaCo2 epithelial cells in the presence of aloe vera were measured by enzyme‐linked immunosorbent assay.Results : Aloe vera gel had a dose‐dependent inhibitory effect on reactive oxygen metabolite production; 50% inhibition occurred at 1 in 1000 dilution in the phycoerythrin assay and at 1 in 10–50 dilution with biopsies. Aloe vera inhibited the production of prostaglandin E2 by 30% at 1 in 50 dilution (P = 0.03), but had no effect on thromboxane B2 production. The release of interleukin‐8 by CaCo2 cells fell by 20% (P < 0.05) with aloe vera diluted at 1 in 100, but not at 1 in 10 or 1 in 1000 dilutions.Conclusion : The anti‐inflammatory actions of aloe vera gel in vitro provide support for the proposal that it may have a therapeutic effect in inflammatory bowel disease.
Green tea and gastrointestinal cancer risk
Authors: Borrelli F. , Capasso R. , Russo A. , Ernst E. 
Published: December 2004

SummaryBackground : Gastrointestinal cancer is one of the leading causes of cancer mortality in the world. Therefore, numerous efforts are being made to find chemoprotective substances able to reduce its incidence. Amongst these, green tea, one of the most popular beverages world‐wide, has been reported to provide protective effects against gastrointestinal cancer.Aim : To critically evaluate all epidemiological studies reporting an association between green tea consumption and a reduced risk of gastrointestinal cancer.Methods : Epidemiological studies of green tea consumption in relation to gastrointestinal cancer or preneoplastic lesions were identified through computerized literature searches using the following databases: Medline (Pubmed), Embase, Amed, CISCOM, Phytobase and Cochrane Library. Only epidemiological studies indicating the type of tea (green tea) and the site of either cancer or precancerous lesions (stomach or intestine) were included. No language restrictions were imposed.Results : Twenty‐one epidemiological investigations met our inclusion/exclusion criteria.Conclusion : These studies seemed to suggest a protective effect of green tea on adenomatous polyps and chronic atrophic gastritis formations. By contrast, there was no clear epidemiological evidence to support the suggestion that green tea plays a role in the prevention of stomach and intestinal cancer.
Protein‐predominant meals inhibit the development of gastric tachyarrhythmia, nausea and the symptoms of motion sickness
Authors: Levine M. E. , Muth E. R. , Williamson M. J. , Stern R. M. 
Published: December 2004

SummaryBackground : Meal ingestion has been suggested to reduce susceptibility to the development of gastric tachyarrhythmia, the abnormal activity of the stomach that frequently accompanies nausea.Aim : To determine the types of meal that are most effective in preventing the development of gastric tachyarrhythmia, nausea and the symptoms of motion sickness provoked by a rotating optokinetic drum.Method : Participants received a carbohydrate beverage, a protein‐predominant beverage or nothing immediately before exposure to the rotating drum. Subjective symptoms of motion sickness and electrogastrograms were collected during a 6‐min baseline period and a subsequent 16‐min drum rotation period.Results : Subjective symptoms of motion sickness scores were significantly more severe during the no‐meal condition than during either the protein or carbohydrate condition. Central, peripheral and, to some extent, gastrointestinal symptoms were more severe during the carbohydrate condition than during the protein condition. Gastric tachyarrhythmia increased significantly less from baseline to drum rotation during both the protein and carbohydrate conditions than during the no‐meal condition.Conclusions : Liquid protein‐predominant meals were most effective in suppressing both the development of gastric tachyarrhythmia and the entire spectrum of motion sickness symptoms, including nausea.
The management of pelvic floor disorders
Authors: Cheung O. , Wald A. 
Published: December 2004

SummaryAnorectal disorders, such as faecal incontinence, defecation difficulty and conditions associated with anorectal pain, are commonly encountered in the practices of gastroenterologists, urogynaecologists and colorectal surgeons. The evaluation of these disorders has been very much improved by the development and wider availability of diagnostic tests, such as manometry, endo‐anal ultrasound, static and dynamic pelvic magnetic resonance imaging and electromyography. After briefly reviewing the normal anatomy and physiology of the anorectum, the pathophysiology and diagnostic approaches to faecal incontinence, defecation disorders and functional anorectal pain are discussed. Until recently, the management of these disorders has been largely anecdotal. However, our therapeutic armamentarium has been expanded by pharmacological agents, such as nitrates, calcium channel blockers and botulinum toxin, as well as the development of novel techniques, such as sacral nerve stimulation. These and other pharmacological, behavioural and surgical approaches are reviewed with respect to the robustness of evidence to support their efficacy in patients with these disorders.
Metformin in the treatment of patients with non‐alcoholic steatohepatitis
Authors: Uygun A. , Kadayifci A. , Isik A. T. , Ozgurtas T. , Deveci S. , Tuzun A. , Yesilova Z. , Gulsen M. , Dagalp K. 
Published: December 2004

SummaryBackground : Increased insulin resistance is the major pathogenic mechanism in the development of non‐alcoholic steatohepatitis.Aim : To investigate the therapeutic effect of metformin, a well‐known insulin‐sensitizing agent, in the treatment of non‐alcoholic steatohepatitis.Methods : Thirty‐six patients with non‐alcoholic steatohepatitis were randomized into two groups. The first group was given lipid and calorie‐restricted dietary treatment alone, and the second group was given metformin 850 mg b.d. plus dietary treatment, for 6 months. The changes in biochemical, sonographic and histological parameters were compared.Results : The mean serum alanine/aspartate aminotransferase, insulin and C‐peptide levels decreased and the index of insulin resistance improved significantly from baseline in the group given metformin. The mean changes in these parameters in the metformin group were significantly greater than those in the group given dietary treatment alone. Although more patients in the metformin group showed improvement in the necro‐inflammatory activity, compared with the group given dietary treatment alone, no significant differences in necro‐inflammatory activity or fibrosis were seen between the groups.Conclusion : The data suggest that improvement of the insulin sensitivity with metformin may improve the liver disease in patients with non‐alcoholic steatohepatitis.