bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the ‘nutriceutical’, bovine colostrum, for the treatment of distal colitis: results from an initial study
Authors: Khan Z. , Macdonald C. , Wicks A. C. , Holt M. P. , Floyd D. , Ghosh S. , Wright N. A. , Playford R. J. 
Published: March 2003

SummaryBackground: Bovine colostrum is a rich source of nutrients, antibodies and growth factors.Aim: To examine the efficacy of colostrum enemas in the treatment of distal colitis using a randomized, double‐blind, controlled protocol.Methods: Fourteen patients (eight female), with a mean age of 45 years (range, 16–75 years) and mild to moderately severe distal colitis (Powell‐Tuck scoring system), received colostrum enema (100 mL of 10% solution) or placebo (albumin solution) b.d. for 4 weeks. Both groups also received mesalazine (1.6 g/day) or, if already taking it, had a dose increment of 1.6 g/day. Disease activity was documented at 0, 2 and 4 weeks.Results: After 4 weeks, the colostrum group showed a mean reduction in symptom score of − 2.9 (95% confidence interval (CI), − 5.4 to − 0.3), whereas the placebo group showed a mean response of + 0.5 (95% CI, − 2.4 to +3.4). The histological score improved in five of the eight patients in the colostrum group (mean response, − 0.9; 95% CI, − 1.69 to − 0.03), whereas the histological scores only improved in two of the six patients in the placebo group (mean response, 0.2; 95% CI, − 2.4 to +2.6).Conclusions: Bovine colostrum enema shows potential as a novel therapy for left‐sided colitis with additional benefits over using mesalazine alone. Further studies appear to be warranted.
Effect of the low‐affinity, noncompetitive N‐methyl‐d‐aspartate receptor antagonist dextromethorphan on visceral perception in healthy volunteers
Authors: Kuiken S. D. , Lei A. , Tytgat G. N. J. , Holman R. , Boeckxstaens G. E. E. 
Published: March 2003

SummaryBackground : The use of N‐methyl‐d‐aspartate (NMDA) receptor antagonists may hold promise for the treatment of pain of visceral origin, in particular in conditions characterized by visceral hypersensitivity.Aim : To study the effect of dextromethorphan, a low affinity, non‐competitive NMDA receptor antagonist, on visceral perception in healthy volunteers.Methods : Nine healthy volunteers (5 female, median age 22 years) underwent a gastric barostat study after oral administration of placebo, dextromethorphan 10 mg or dextromethorphan 30 mg, on three separate days in a double‐blind, randomised order. Sensations induced by step‐wise isobaric gastric distension (2 mmHg/2 min) were studied during fasting and 30 min after a meal. In addition, proximal gastric tone was measured during fasting and postprandially.Results : Compared to placebo, dextromethorphan 30 mg significantly increased the distension‐evoked sensation scores for nausea (P=0.004) and satiation (P=0.004) during fasting; and for bloating (P= 0.001), nausea (P=0.000) and satiation (P=0.01) 30 min postprandially. Dextromethorphan did not alter pain scores, proximal gastric tone or gastric compliance.Conclusions : Dextromethorphan increases the perception of non‐painful sensations during gastric distension, without altering the perception of pain. Therefore, application of dextromethorphan as a visceral analgesic is questionable. Future studies with more specific NMDA receptor antagonist are warranted.
Adult‐to‐adult right hepatic lobe living donor liver transplantation
Authors: Hayashi P. H. , Trotter J. F. 
Published: March 2003

SummarySpurred on by the critical shortage of cadaveric livers, adult‐to‐adult right hepatic lobe living donor liver transplantation has grown rapidly as a therapeutic option for selected patients. In the USA alone, the number of living donor liver transplantations has increased six‐fold in the last 4 years. The therapy can be complex, bringing together a variety of disciplines, including transplantation medicine and surgery, hepatology, psychiatry and medical ethics. Moreover, living donor liver transplantation is still defining itself in the adult‐to‐adult application. Uniform standards, guidelines and long‐term outcomes are yet to be determined. Nevertheless, initial success has been remarkable, and a basic understanding of this field is essential to any physician contemplating options for their liver failure patients. This review covers a range of topics, including recipient and donor selection and outcomes, donor risk, controversies and future issues.
Human recombinant lactoferrin is ineffective in the treatment of human Helicobacter pylori infection
Authors: Guttner Y. , Windsor H. M. , Viiala C. H. , Marshall B. J. 
Published: March 2003

SummaryBackground : Lactoferrin, a multifunctional glycoprotein, is known to have anti‐microbial actions. Bovine lactoferrin and recombinant human lactoferrin have been shown to inhibit Helicobacter pylori, and more recently recombinant human lactoferrin was found to significantly increase the eradication rate of H. pylori when added to standard triple therapy.Aim : To determine the efficacy, safety and tolerability of recombinant human lactoferrin as a therapy in suppressing or eliminating H. pylori infection in subjects with minimal upper gastrointestinal symptoms who have not previously been treated.Subjects and methods : Nine healthy subjects with minimal upper gastrointestinal symptoms and a positive urea breath test were recruited. None of the volunteers had previously been treated for H. pylori. Subjects received 5 × 1.0 g human recombinant lactoferrin daily for 5 or 14 days. Breath tests were repeated during therapy and shortly after to check for eradication. The safety and tolerability of the drug were assessed by physical examination, by monitoring adverse events, and clinical laboratory evaluation.Results : No conversion of the urea breath test from positive to negative was observed and there was no consistent change in urea breath test count to indicate a possible suppression of H. pylori.Conclusion : Lactoferrin, given as a single agent, does not eradicate H. pylori infection.
Rectal tissue, plasma and urine concentrations of mesalazine after single and multiple administrations of 500 mg suppositories to healthy volunteers and ulcerative proctitis patients
Authors: Aumais G. , Lefebvre M. , Tremblay C. , Bitton A. , Martin F. , Giard A. , Madi M. , Spénard J. 
Published: March 2003

SummaryObjective : Patients with ulcerative proctitis may have rectal mucosal properties different from healthy volunteers. This project compared the pharmacokinetics of rectally administered mesalazine in these two populations.Methods : In two separate studies, nine patients with ulcerative proctitis and 16 healthy volunteers received a single 500 mg mesalazine suppository and then 500 mg every 8 h for 5 days. Blood samples were collected for 12 h in healthy volunteers and 30 h in patients, and urine for 24 h in healthy volunteers and 30 h in patients. Rectal biopsies were performed 8 h after the last dose.Results : After a single dose to patients, mean mesalazine half‐life (s.d.) was 5.0 (3.6) h. At steady‐state, means (s.d.) were 89.1 (78.9) ng/mL for Cmin, 361.1 (240.8) ng/mL for Cmax, and 7.1 (7.3) h for half‐life. Mean (range) rectal mesalazine concentrations were 167 (1.4–541.6) ng/mg tissue. After a single dose in healthy volunteers, mean (s.d.) half‐life was 4.0 (4.7) h. At steady‐state, means (s.d.) were 22.4 (61.6) ng/mL for Cmin, 359.4 (166.3) ng/mL for Cmax, and 0.9 (0.5) h for half‐life.Conclusion : Mesalazine is released in the rectum of patients, with a bioavailability of about 40%. Tissue distribution is also appreciable. Both parameters appear higher than in healthy volunteers.
Wheat‐starch‐based gluten‐free products in the treatment of newly detected coeliac disease: prospective and randomized study
Authors: Peräaho M. , Kaukinen K. , Paasikivi K. , Sievänen H. , Lohiniemi S. , Mäki M. , Collin P. 
Published: March 2003

SummaryBackground : The safety of wheat‐starch‐based gluten‐free products in the treatment of coeliac disease is debatable. Prospective studies are lacking.Aim : To compare the clinical, histological and serological response to a wheat‐starch‐based or natural gluten‐free diet in patients with newly detected coeliac disease.Methods : Fifty‐seven consecutive adults with untreated coeliac disease were randomized to a wheat‐starch‐based or natural gluten‐free diet. Clinical response, small bowel mucosal morphology, CD3+, αβ+ and γδ+ intra‐epithelial lymphocytes, mucosal human leucocyte antigen‐DR expression and serum endomysial, transglutaminase and gliadin antibodies were investigated before and 12 months after the introduction of the gluten‐free diet. Quality of life measurements were performed by standardized questionnaires and the bone mineral density was analysed.Results : In both groups, abdominal symptoms were alleviated equally by a strict diet. There were no differences between the groups in mucosal morphology, the density of intra‐epithelial lymphocytes, serum antibodies, bone mineral density or quality of life tests at the end of the study. Four patients on a natural gluten‐free diet and two on a wheat‐starch‐based gluten‐free diet had dietary lapses; as a result, inadequate mucosal, serological and clinical recovery was observed.Conclusions : The dietary response to a wheat‐starch‐based gluten‐free diet was as good as that to a natural gluten‐free diet in patients with newly detected coeliac disease.
Pharmacokinetics of budesonide controlled‐release capsules when taken with omeprazole
Authors: Edsbäcker S. , Larsson P. , Bergstrand M. 
Published: March 2003

SummaryAim: To investigate whether omeprazole affects the pharmacokinetics and systemic effects of budesonide controlled‐release capsules when the two medications are taken together.Methods: Thirteen healthy volunteers were enrolled into a randomized, double‐blind, placebo‐controlled, cross‐over study. Participants received omeprazole, 20 mg/day, or placebo every morning for 5 days, with three 3‐mg budesonide controlled‐release capsules being given with omeprazole or placebo on day 5. After a 12‐day washout period, participants were switched from omeprazole to placebo, or vice versa, and the trial was repeated. Blood samples for pharmacokinetic evaluation and urine samples for cortisol assessments were collected before and after the budesonide doses.Results: No statistically significant differences were seen between omeprazole and placebo treatment with regard to any of the parameters analysed, including the maximum budesonide plasma concentration, time to concentration maximum, area under the concentration–time curve, mean residence time and urinary excretion of cortisol. Very few adverse events were reported during the trial, and the majority were of mild to moderate severity.Conclusion: Omeprazole treatment does not affect the pharmacokinetics or systemic effects of budesonide controlled‐release capsules when the two medications are taken simultaneously.
Helicobacter pylori strains and histologically‐related lesions affect the outcome of triple eradication therapy: a study from southern Italy
Authors: Russo F. , Berloco P. , Cuomo R. , Caruso M. L. , Di Matteo G. , Giorgio P. , De Francesco V. , Di Leo A. , Ierardi E. 
Published: March 2003

SummaryBackground : Certain evidence suggests that Helicobacter pylori strains expressing genes for cytotoxin production show a higher sensitivity than non‐cytotoxic organisms to eradication treatment. No data are available on the involvement of bacterium‐related lesions in different therapeutic outcomes.Aims : (i) To investigate whether differences in eradication rates may be related to the different expression of virulent strains (cagA, vacA, iceA) in patients undergoing proton pump inhibitor‐based triple therapy, and (ii) to evaluate whether therapeutic outcome may be affected by bacterium‐induced gastric lesions.Methods : One hundred and ten H. pylori‐positive subjects were enrolled. H. pylori was genotyped by polymerase chain reaction. Treatment consisted of lansoprazole–amoxicillin–clarithromycin, twice daily for 1 week. Eradication was checked by urea breath test.Results : The eradication rate was 70%, and the absence of cagA was associated with unsuccessful treatment. No difference between the groups with successful and unsuccessful eradication was found with regard to vacA and iceA. Lympho‐epithelial lesions and fibrosis were associated with unsuccessful treatment.Conclusions : The present data confirm the importance of cagA (but not vacA and iceA) as a predictor of successful eradication. When fibrosis and lympho‐epithelial lesions are present, therapy appears to be less effective. Therefore, these histological features may be involved in an unsuccessful therapeutic outcome.
Facial fractures and submental tracheal intubation
Authors: Amin M. , Dill‐Russell P. , Manisali M. , Lee R. , Sinton I. 
Published: March 2003

SummarySubmental tracheal intubation is a simple, quick and effective alternative to oral and nasal tracheal intubation or tracheostomy in the surgical management of selected patients with craniomaxillofacial injuries. It has a low morbidity and it does not impede the surgical field, allowing for temporary maxillo‐mandibular fixation (jaw wiring) intra‐operatively, and nasal assessment, manipulation and bone grafting, either simultaneously or as an independent procedure. We report 12 cases utilizing this technique in this retrospective study, this includes 11 patients with mid‐facial fractures and associated base of skull fractures, and one patient who underwent an elective Le Fort III advancement. The techniques and indications for submental tracheal intubation are described.
A peripheral nerve stimulator for nerve location controlled by the scrubbed anaesthetist
Authors: Ayoub C. , Lteif A. , Rizk M. , Khalili Z. , Aoude S. 
Published: March 2003

SummaryThis newly designed peripheral nerve stimulator allows the scrubbed anaesthetist performing a nerve block to adjust the electrical current output needed for localisation of the target nerve without the need for an assistant.
The effect of auricular acupuncture on anaesthesia with desflurane
Authors: Taguchi A. , Sharma N. , Ali S. Z. , Dave B. , Sessler D. I. , Kurz A. 
Published: March 2003

SummaryIn most acupuncture studies it is difficult or even impossible to conduct a truly double‐blind trial. However, this is possible when treatments are carried out on anaesthetised patients. Because acupuncture provides analgesia, we tested the hypothesis that needle stimulation of a combination of four ear acupoints would significantly reduce anaesthetic requirement. Ten healthy volunteers were anaesthetised with desflurane and randomly assigned to no treatment or acupuncture; the alternative treatment was given on a subsequent study day. Auricular acupuncture was performed with needles placed at the Shen Men, Thalamus, Tranquiliser and Master Cerebral Points on the right ear. Anaesthetic requirement, determined by the Dixon up‐and‐down method, was defined by the average desflurane concentration that prevented purposeful movement of the extremities in response to noxious electrical stimulation. Volunteers required a greater desflurane concentration to prevent movement on the control than on the acupuncture day: 4.9 (0.7; SD) vs. 4.4 (0.8) vol. %, p = 0.003. Acupuncture thus reduced anaesthetic requirement by 8.5 (7)%.
The management of pain following day‐case surgery
Authors: McHugh G. A. , Thoms G. M. M. 
Published: March 2003

SummaryThe object of this study was to assess patients' experience of pain management following day surgery. One hundred and two patients agreed to take part in a telephone survey, 2 and 4 days following day surgery. The majority of patients (73%) were broadly satisfied with the quality of pain management they received, however, there was room for improvement. Despite modern anaesthesia and surgery, 17% of patients surveyed reported having severe pain immediately following day‐case surgery. The majority (82%) of patients left the day‐case ward in pain and an even higher proportion (88%) had pain at some time between 2 and 4 days postoperatively. Severe levels of pain following discharge from hospital were a concern for 21% of patients. It was reported that day‐case staff did not always ask patients whether they were in pain. Communication with patients is vital in the delivery of optimal care. More support and more information are needed to manage patients' pain effectively, whilst in the day‐case wards and also following discharge, at home.
Geometric constraints on composition of sediment derived from erosional landscapes
Authors: Paola Chris , Swenson John B. 
Published: March 2003

Although unroofing sequences are well known in the stratigraphic record, there is no general theory for estimating relevant basic quantities such as the time history of sediment production from a particular unit or the degree of mixing between successive units. Here we investigate the production of sediment from layered source rocks that are milled off by steady‐state erosional topography. The shape of the sediment‐production function for milling off a thin horizontal layer is given by the derivative of the hypsometric function, in the form of area contained within contours as a function of contour altitude. The time‐scale for the production function, the ‘topographic mixing time’, is set by the topographic relief divided by the uplift rate. The production function for a sharp transition from one unit to another is given directly by the hypsometric function. The effects of stratal dip parallel to the mean slope of the erosional topography and finite layer thickness can be accounted for to a first approximation by simple geometric corrections to the mixing time.Finite layer thickness also has the effect of smoothing the production function although most natural hypsometric functions are smooth enough that this effect is relatively weak. The quality of an unroofing sequence can be measured in terms of the ‘sharpness’ of separation of successive peaks in sediment production produced by milling off a sequence of geometrically similar layers. This peak sharpness can be parameterized by a ratio of the interval between successive peaks in sediment production to topographic mixing time. By this measure, the quality of unroofing sequences is controlled by two parameters: the ratio of layer thickness to topographic relief, and the dip angle. The dip angle in concert with topographic mixing exerts a strong control on the degree of signal segregation; in particular, production of cleanly segregated signals for dip angles greater than about 15° requires very high ratios of layer thickness to relief. Hence identification of distinct unroofing sequences may place significant and useful constraints on the attitude and/or thickness of units in the eroding stratigraphy.
Hormonal effects of MPV‐2213ad, a new selective aromatase inhibitor, in healthy male subjects. A phase I study
Authors: Ahokoski Outi , Irjala Kerttu , Huupponen Risto , Halonen Kaija , Salminen Eeva , Scheinin Harry 
Published: March 2003

Aims
A novel non‐steroidal competitive inhibitor of the aromatase enzyme, MPV‐2213ad, was entered into an open dose‐escalation study. The objective of this study was to investigate the tolerability and efficiency of this new compound with assessment of the hormonal effects after study drug administration.
Methods
MPV‐2213ad was given to 39 healthy male volunteers. Single increasing oral doses of 0.003, 0.03, 0.3, 3, 9, 30 and 100 mg were given to three subjects at each dose level, after which ten subjects received the 300 mg dose and eight subjects the highest 600 mg dose of MPV‐2213ad.
Results
Serum oestradiol levels were suppressed by 58–65% when MPV‐2213ad was given at doses between 0.3 and 30 mg. A reduction in serum oestradiol levels by 83% from baseline was achieved with the 300 mg dose. No additional decrease was seen with the highest dose. The suppression lasted longer with higher doses of MPV‐2213ad. After the 300 and 600 mg doses serum oestradiol returned to baseline within 4 days. Marked increases in serum concentrations of testosterone, androstenedione, 17‐OH‐progesterone, LH and FSH were also observed at doses between 100 and 600 mg of MPV‐2213ad. The drug was well‐tolerated and the adverse events were mild or moderate including hot flushes, mild vertigo, nausea, acne and gastrointestinal discomfort.
Conclusions
MPV‐2213ad has a potent, dose‐dependent inhibitory effect on serum oestradiol. It was selective for the aromatase enzyme with no signs of adreno‐cortical suppression or haematological or biochemical toxicity.
How reproducible is bilateral forearm plethysmography?
Authors: Petrie John R. , Ueda Shinichiro , Morris Andrew D. , Murray Lilian S. , Elliott Henry L. , Connell John M. C. 
Published: March 2003

Aims
In studies using strain‐gauge forearm plethysmography to measure changes in forearm blood flow (FBF) during intra‐arterial infusions of vasoactive substances, measurements are often made in both arms simultaneously and the change in ratio of the infused and control arms used to express responses. However, the reproducibility of bilateral plethysmography in this setting has not been addressed in published studies. The unilateral technique remains in use, and forearm vascular resistance (FVR), an alternative method of expressing responses, is used by some investigators. We have assessed: (a) the intra‐subject variability of bilateral FBF measurements (FBF ratios) at rest, after unilateral forearm exercise, and during intra‐arterial infusions of vasoconstrictor substances; (b) whether bilateral plethysmography is more reproducible than unilateral plethysmography; and (c) the reproducibility of FVR (unilateral and bilateral).
Methods
Study 1 Nine healthy subjects attended 3 study days, 1 week apart. FBF was measured at rest and after 2 min of standardized unilateral forearm exercise; between‐day intra‐subject variability was expressed as coefficients of variation (CV) calculated using two‐way analysis of variance (ANOVA). Study 2 Five healthy subjects attended 2 study days when FBF was measured during incremental infusions of noradrenaline (15, 30, 150, 300 pmol min−1 ) and angiotensin II (1, 5, 10, 50 pmol min−1 ); for each individual subject at each dose intra‐subject variability was assessed using the difference between responses (percentage change from baseline) on days 1 and 2.
Results
Study 1 At rest, intra‐subject variability (CV) of baseline FBF ratios was 19% compared with 31% (left) and 39% (right) for unilateral FBF measurements. After ipsilateral exercise, unilateral FBF measurements were more reproducible (32 vs 17%) than FBF ratios; by 20 min after exercise, the previous pattern had been re‐established (19 vs 27%). Intra‐subject variability (CV) of baseline FVR ratio and post‐exercise FVR was 14%. Study 2 Inter‐quartile ranges of the differences between responses on days 1 and 2 (FBF ratios vs FBF) were: angiotensin II 14 vs 18%; noradrenaline 16 vs 27%.
Conclusions
FBF ratios are more reproducible than unilateral FBF measurements at rest (CV 19%vs 39%) and for measuring responses to intra‐arterial infusions of vasoconstrictor substances. FVR may have a small reproducibility advantage. Non‐experimental stimuli can cause significant and misleading changes in measured responses if unilateral measurements are used; it is therefore recommended that responses to intra‐arterial infusions should be measured using bilateral forearm plethysmography with the results expressed as FBF ratios.